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Sub-Field: 361.11

Package: Integrated Billing

EXPLANATION OF BENEFITS(#361.1)-->361.11

Sub-Field: 361.11

Information

Parent File	Name	Number	Package
EXPLANATION OF BENEFITS(#361.1)	835 CLAIM LEVEL ADJUSTMENTS	361.11	Integrated Billing

Details

Field # Name Loc Type Details

ADJUSTMENT CATEGORY (GRP CODE)

0;1

SET

************************REQUIRED FIELD************************

'CO' FOR Contractual Obligations;
'CR' FOR Corrections and Reversals;
'OA' FOR Other Adjustments;
'PI' FOR Payor Initiated Reductions;
'PR' FOR Patient Responsibility;
'MM' FOR Medicare Message;

LAST EDITED: JAN 19, 1999
HELP-PROMPT: Enter the group code associated with the adjustment
DESCRIPTION:
This is the group code as reported on the EOB for the adjustment
TECHNICAL DESCR:
This data is found in the electronic eob (835) in the data element CAS-01
CROSS-REFERENCE: 361.11^B
1)= S ^IBM(361.1,DA(1),10,"B",$E(X,1,30),DA)=""
2)= K ^IBM(361.1,DA(1),10,"B",$E(X,1,30),DA)

REASONS

1;0

Multiple #361.111

DESCRIPTION:
This is the list of reasons returned for claim-level adjustments to the claim.