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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
.01 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)
1 REASONS 1;0 Multiple #361.111 361.111

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