108 (131) ADJUSTMENT REASON (161.91)

Name	Value
CODE	108
STATUS EFFECTIVE DATE	2003-06-01 00:00:00 STATUS: ACTIVE FEE USE: APPLICABLE
DESCRIPTION EFFECTIVE DATE	DESCRIPTION: Rent/purchase guidelines were not met. DESCRIPTION: Rent/purchase guidelines were not met. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. DESCRIPTION: Rent/purchase guidelines were not met. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
SUSPENSION DESCRIPTION	Rent/purchase guidelines were not met. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
REMITTANCE REMARK
CORE SCENARIO	Billed Service Not Covered
ADJUSTMENT GROUP