0 Cannot provide further status electronically.
1 For more detailed information, see remittance advice.
2 More detailed information in letter.
3 Claim has been adjudicated and is awaiting payment cycle.
4 This is a subsequent request for information from the original request.
5 This is a final request for information.
6 Balance due from the subscriber.
7 Claim may be reconsidered at a future date.
8 No payment due to contract/plan provisions.
Note: Inactive as of ASC X12 Version 4020. Refer to 107 for new verbiage.
9 No payment will be made for this claim.
10 All originally submitted procedure codes have been combined.
Note: Inactive as of ASC X12 Version 4020. Refer to 12 for new verbiage.
11 Some originally submitted procedure codes have been combined.
Note: Inactive as of ASC X12 Version 4020. Refer to 12 for new verbiage.
12 One or more originally submitted procedure codes have been combined.
Note: Changed as of 6/01
13 All originally submitted procedure codes have been modified.
Note: Inactive as of ASC X12 Version 4020. Refer to 15 for new verbiage.
14 Some all originally submitted procedure codes have been modified.
Note: Inactive as of ASC X12 Version 4020. Refer to 15 for new verbiage.
15 One or more originally submitted procedure code have been modified.
Note: Changed as of 6/01
16 Claim/encounter has been forwarded to entity.
17 Claim/encounter has been forwarded by third party entity to entity.
18 Entity received claim/encounter, but returned invalid status.
19 Entity acknowledges receipt of claim/encounter.
Note: Changed as of 6/01
20 Accepted for processing.
Note: Changed as of 6/01
21 Missing or invalid information.
Note: Changed as of 6/01
22 ... before entering the adjudication system.
Note: Changed as of 6/01
23 Returned to Entity.
Note: Changed as of 6/01
24 Entity not approved as an electronic submitter.
Note: Changed as of 6/01
25 Entity not approved.
Note: Changed as of 6/01
26 Entity not found.
Note: Changed as of 6/01
27 Policy canceled.
Note: Changed as of 6/01
28 Claim submitted to wrong payer.
Note: Inactive as of ASC X12 Version 4020. Refer to 116 for new verbiage.
29 Subscriber and policy number/contract number mismatched.
30 Subscriber and subscriber id mismatched.
31 Subscriber and policyholder name mismatched.
32 Subscriber and policy number/contract number not found.
33 Subscriber and subscriber id not found.
34 Subscriber and policyholder name not found.
35 Claim/encounter not found.
37 Predetermination is on file, awaiting completion of services.
38 Awaiting next periodic adjudication cycle.
39 Charges for pregnancy deferred until delivery.
40 Waiting for final approval.
41 Special handling required at payer site.
42 Awaiting related charges.
44 Charges pending provider audit.
45 Awaiting benefit determination.
46 Internal review/audit.
47 Internal review/audit - partial payment made.
48 Referral/authorization.
Note: Changed as of 2/01
49 Pending provider accreditation review.
50 Claim waiting for internal provider verification.
51 Investigating occupational illness/accident.
52 Investigating existence of other insurance coverage.
53 Claim being researched for Insured ID/Group Policy Number error.
54 Duplicate of a previously processed claim/line.
55 Claim assigned to an approver/analyst.
56 Awaiting eligibility determination.
57 Pending COBRA information requested.
59 Non-electronic request for information.
60 Electronic request for information.
61 Eligibility for extended benefits.
64 Re-pricing information.
65 Claim/line has been paid.
66 Payment reflects usual and customary charges.
67 Payment made in full.
68 Partial payment made for this claim.
69 Payment reflects plan provisions.
Note: Inactive as of ASC X12 Version 4020. Refer to 107 for new verbiage.
70 Payment reflects contract provisions.
Note: Inactive as of ASC X12 Version 4020. Refer to 107 for new verbiage.
71 Periodic installment released.
72 Claim contains split payment.
73 Payment made to entity, assignment of benefits not on file.
78 Duplicate of an existing claim/line, awaiting processing.
81 Contract/plan does not cover pre-existing conditions.
83 No coverage for newborns.
84 Service not authorized.
85 Entity not primary.
86 Diagnosis and patient gender mismatch.
Note: Changed as of 2/00
87 Denied: Entity not found.
88 Entity not eligible for benefits for submitted dates of service.
89 Entity not eligible for dental benefits for submitted dates of service.
90 Entity not eligible for medical benefits for submitted dates of service.
91 Entity not eligible/not approved for dates of service.
92 Entity does not meet dependent or student qualification.
93 Entity is not selected primary care provider.
94 Entity not referred by selected primary care provider.
95 Requested additional information not received.
96 No agreement with entity.
97 Patient eligibility not found with entity.
98 Charges applied to deductible.
99 Pre-treatment review.
100 Pre-certification penalty taken.
101 Claim was processed as adjustment to previous claim.
102 Newborn's charges processed on mother's claim.
103 Claim combined with other claim(s).
104 Processed according to plan provisions.
105 Claim/line is capitated.
106 This amount is not entity's responsibility.
107 Processed according to contract/plan provisions.
Note: Changed as of 6/01
108 Coverage has been canceled for this entity.
109 Entity not eligible.
110 Claim requires pricing information.
111 At the policyholder's request these claims cannot be submitted electronically.
112 Policyholder processes their own claims.
113 Cannot process individual insurance policy claims.
114 Should be handled by entity.
115 Cannot process HMO claims
116 Claim submitted to incorrect payer.
117 Claim requires signature-on-file indicator.
118 TPO rejected claim/line because payer name is missing.
119 TPO rejected claim/line because certification information is missing
120 TPO rejected claim/line because claim does not contain enough information
121 Service line number greater than maximum allowable for payer.
122 Missing/invalid data prevents payer from processing claim.
123 Additional information requested from entity.
124 Entity's name, address, phone and id number.
125 Entity's name.
126 Entity's address.
127 Entity's phone number.
128 Entity's tax id.
129 Entity's Blue Cross provider id
130 Entity's Blue Shield provider id
131 Entity's Medicare provider id.
132 Entity's Medicaid provider id.
133 Entity's UPIN
134 Entity's CHAMPUS provider id.
135 Entity's commercial provider id.
136 Entity's health industry id number.
137 Entity's plan network id.
138 Entity's site id .
139 Entity's health maintenance provider id (HMO).
140 Entity's preferred provider organization id (PPO).
Note: Changed as of 6/01
141 Entity's administrative services organization id (ASO).
142 Entity's license/certification number.
143 Entity's state license number.
144 Entity's specialty license number.
145 Entity's specialty code.
146 Entity's anesthesia license number.
147 Entity's qualification degree/designation (e.g. RN,PhD,MD)
Note: New as of 2/97
148 Entity's social security number.
149 Entity's employer id.
150 Entity's drug enforcement agency (DEA) number.
152 Pharmacy processor number.
153 Entity's id number.
154 Relationship of surgeon & assistant surgeon.
155 Entity's relationship to patient
156 Patient relationship to subscriber
157 Entity's Gender
158 Entity's date of birth
159 Entity's date of death
160 Entity's marital status
161 Entity's employment status
162 Entity's health insurance claim number (HICN).
163 Entity's policy number.
164 Entity's contract/member number.
165 Entity's employer name, address and phone.
166 Entity's employer name.
167 Entity's employer address.
168 Entity's employer phone number.
169 Entity's employer id.
Note: Inactive for version 004060. Duplicates code 149.
170 Entity's employee id.
171 Other insurance coverage information (health, liability, auto, etc.).
172 Other employer name, address and telephone number.
173 Entity's name, address, phone, gender, DOB, marital status, employment status and relation to subscriber.
Note: Changed as of 2/00
174 Entity's student status.
175 Entity's school name.
176 Entity's school address.
177 Transplant recipient's name, date of birth, gender, relationship to insured.
Note: Changed as of 2/00
178 Submitted charges.
179 Outside lab charges.
180 Hospital s semi-private room rate.
181 Hospital s room rate.
182 Allowable/paid from primary coverage.
183 Amount entity has paid.
184 Purchase price for the rented durable medical equipment.
185 Rental price for durable medical equipment.
186 Purchase and rental price of durable medical equipment.
187 Date(s) of service.
188 Statement from-through dates.
189 Facility admission date
Note: Changed as of 10/06
190 Facility discharge date
Note: Changed as of 10/06
191 Date of Last Menstrual Period (LMP)
Note: New as of 2/97
192 Date of first service for current series/symptom/illness.
193 First consultation/evaluation date.
Note: New as of 2/97
194 Confinement dates.
195 Unable to work dates.
196 Return to work dates.
197 Effective coverage date(s).
198 Medicare effective date.
199 Date of conception and expected date of delivery.
200 Date of equipment return.
201 Date of dental appliance prior placement.
202 Date of dental prior replacement/reason for replacement.
203 Date of dental appliance placed.
204 Date dental canal(s) opened and date service completed.
205 Date(s) dental root canal therapy previously performed.
206 Most recent date of curettage, root planing, or periodontal surgery.
207 Dental impression and seating date.
208 Most recent date pacemaker was implanted.
209 Most recent pacemaker battery change date.
210 Date of the last x-ray.
211 Date(s) of dialysis training provided to patient.
212 Date of last routine dialysis.
213 Date of first routine dialysis.
214 Original date of prescription/orders/referral.
Note: New as of 2/97
215 Date of tooth extraction/evolution.
216 Drug information.
217 Drug name, strength and dosage form.
218 NDC number.
219 Prescription number.
220 Drug product id number.
221 Drug days supply and dosage.
222 Drug dispensing units and average wholesale price (AWP).
223 Route of drug/myelogram administration.
224 Anatomical location for joint injection.
225 Anatomical location.
226 Joint injection site.
227 Hospital information.
228 Type of bill for UB claim
Note: Changed as of 6/01 and 10/06
229 Hospital admission source.
230 Hospital admission hour.
231 Hospital admission type.
232 Admitting diagnosis.
233 Hospital discharge hour.
234 Patient discharge status.
235 Units of blood furnished.
236 Units of blood replaced.
237 Units of deductible blood.
238 Separate claim for mother/baby charges.
239 Dental information.
240 Tooth surface(s) involved.
241 List of all missing teeth (upper and lower).
242 Tooth numbers, surfaces, and/or quadrants involved.
243 Months of dental treatment remaining.
244 Tooth number or letter.
245 Dental quadrant/arch.
246 Total orthodontic service fee, initial appliance fee, monthly fee, length of service.
247 Line information.
248 Accident date, state, description and cause.
249 Place of service.
250 Type of service.
251 Total anesthesia minutes.
252 Authorization/certification number.
253 Procedure/revenue code for service(s) rendered. Please use codes 454 or 455.
Note: Deleted as of 2/97
254 Primary diagnosis code.
255 Diagnosis code.
256 DRG code(s).
257 ADSM-III-R code for services rendered.
258 Days/units for procedure/revenue code.
259 Frequency of service.
260 Length of medical necessity, including begin date.
Note: New as of 2/97
261 Obesity measurements.
262 Type of surgery/service for which anesthesia was administered.
263 Length of time for services rendered.
264 Number of liters/minute & total hours/day for respiratory support.
265 Number of lesions excised.
266 Facility point of origin and destination - ambulance.
267 Number of miles patient was transported.
268 Location of durable medical equipment use.
269 Length/size of laceration/tumor.
270 Subluxation location.
271 Number of spine segments.
272 Oxygen contents for oxygen system rental.
273 Weight.
274 Height.
275 Claim.
276 UB04/HCFA-1450/1500 claim form
Note: Changed as of 6/01 and 10/06
277 Paper claim.
278 Signed claim form.
279 Itemized claim.
280 Itemized claim by provider.
281 Related confinement claim.
282 Copy of prescription.
283 Medicare worksheet.
284 Copy of Medicare ID card.
285 Vouchers/explanation of benefits (EOB).
286 Other payer's Explanation of Benefits/payment information.
287 Medical necessity for service.
288 Reason for late hospital charges.
289 Reason for late discharge.
290 Pre-existing information.
291 Reason for termination of pregnancy.
292 Purpose of family conference/therapy.
293 Reason for physical therapy.
294 Supporting documentation.
295 Attending physician report.
296 Nurse's notes.
297 Medical notes/report.
Note: New as of 2/97
298 Operative report.
299 Emergency room notes/report.
300 Lab/test report/notes/results.
Note: New as of 2/97
301 MRI report.
302 Refer to codes 300 for lab notes and 311 for pathology notes
Note: Removed prior to 2/97
303 Physical therapy notes. Please use code 297:6O (6 'OH' - not zero)
Note: Deleted as of 2/97
304 Reports for service.
305 X-ray reports/interpretation.
306 Detailed description of service.
307 Narrative with pocket depth chart.
308 Discharge summary.
309 Code was duplicate of code 299
Note: Removed prior to 2/97
310 Progress notes for the six months prior to statement date.
311 Pathology notes/report.
312 Dental charting.
313 Bridgework information.
314 Dental records for this service.
315 Past perio treatment history.
316 Complete medical history.
317 Patient's medical records.
318 X-rays.
319 Pre/post-operative x-rays/photographs.
Note: New as of 2/97
320 Study models.
321 Radiographs or models.
322 Recent fm x-rays.
323 Study models, x-rays, and/or narrative.
324 Recent x-ray of treatment area and/or narrative.
325 Recent fm x-rays and/or narrative.
326 Copy of transplant acquisition invoice.
327 Periodontal case type diagnosis and recent pocket depth chart with narrative.
328 Speech therapy notes. Please use code 297:6R
Note: Deleted as of 2/97
329 Exercise notes.
330 Occupational notes.
331 History and physical.
332 Authorization/certification (include period covered).
Note: New as of 2/97
333 Patient release of information authorization.
334 Oxygen certification.
335 Durable medical equipment certification.
336 Chiropractic certification.
337 Ambulance certification/documentation.
338 Home health certification. Please use code 332:4Y
Note: Deleted as of 2/97
339 Enteral/parenteral certification.
340 Pacemaker certification.
341 Private duty nursing certification.
342 Podiatric certification.
343 Documentation that facility is state licensed and Medicare approved as a surgical facility.
344 Documentation that provider of physical therapy is Medicare Part B approved.
345 Treatment plan for service/diagnosis
346 Proposed treatment plan for next 6 months.
347 Refer to code 345 for treatment plan and code 282 for prescription
Note: Removed prior to 2/97
348 Chiropractic treatment plan.
349 Psychiatric treatment plan. Please use codes 345:5I, 5J, 5K, 5L, 5M, 5N, 5O (5 'OH' - not zero), 5P
Note: Deleted as of 2/97
350 Speech pathology treatment plan. Please use code 345:6R
Note: Deleted as of 2/97
351 Physical/occupational therapy treatment plan. Please use codes 345:6O (6 'OH' - not zero), 6N
Note: Deleted as of 2/97
352 Duration of treatment plan.
353 Orthodontics treatment plan.
354 Treatment plan for replacement of remaining missing teeth.
355 Has claim been paid?
356 Was blood furnished?
357 Has or will blood be replaced?
358 Does provider accept assignment of benefits?
359 Is there a release of information signature on file?
360 Is there an assignment of benefits signature on file?
361 Is there other insurance?
362 Is the dental patient covered by medical insurance?
363 Will worker's compensation cover submitted charges?
364 Is accident/illness/condition employment related?
365 Is service the result of an accident?
366 Is injury due to auto accident?
367 Is service performed for a recurring condition or new condition?
368 Is medical doctor (MD) or doctor of osteopath (DO) on staff of this facility?
369 Does patient condition preclude use of ordinary bed?
370 Can patient operate controls of bed?
371 Is patient confined to room?
372 Is patient confined to bed?
373 Is patient an insulin diabetic?
374 Is prescribed lenses a result of cataract surgery?
375 Was refraction performed?
376 Was charge for ambulance for a round-trip?
377 Was durable medical equipment purchased new or used?
378 Is pacemaker temporary or permanent?
379 Were services performed supervised by a physician?
380 Were services performed by a CRNA under appropriate medical direction?
Note: Changed as of 10/99
381 Is drug generic?
382 Did provider authorize generic or brand name dispensing?
383 Was nerve block used for surgical procedure or pain management?
384 Is prosthesis/crown/inlay placement an initial placement or a replacement?
385 Is appliance upper or lower arch & is appliance fixed or removable?
386 Is service for orthodontic purposes?
387 Date patient last examined by entity
Note: New as of 2/97
388 Date post-operative care assumed
Note: New as of 2/97
389 Date post-operative care relinquished
Note: New as of 2/97
390 Date of most recent medical event necessitating service(s)
Note: New as of 2/97
391 Date(s) dialysis conducted
Note: New as of 2/97
392 Date(s) of blood transfusion(s)
Note: New as of 2/97
393 Date of previous pacemaker check
Note: New as of 2/97
394 Date(s) of most recent hospitalization related to service
Note: New as of 2/97
395 Date entity signed certification/recertification
Note: New as of 2/97
396 Date home dialysis began
Note: New as of 2/97
397 Date of onset/exacerbation of illness/condition
Note: New as of 2/97
398 Visual field test results
Note: New as of 2/97
399 Report of prior testing related to this service, including dates
Note: New as of 2/97
400 Claim is out of balance
Note: New as of 2/97
401 Source of payment is not valid
Note: New as of 2/97
402 Amount must be greater than zero
Note: New as of 2/97
403 Entity referral notes/orders/prescription
Note: New as of 2/97
404 Specific findings, complaints, or symptoms necessitating service
Note: New as of 2/97
405 Summary of services
Note: New as of 2/97
406 Brief medical history as related to service(s)
Note: New as of 2/97
407 Complications/mitigating circumstances
Note: New as of 2/97
408 Initial certification
Note: New as of 2/97
409 Medication logs/records (including medication therapy)
Note: New as of 2/97
410 Explain differences between treatment plan and patient's condition
Note: New as of 2/97
411 Medical necessity for non-routine service(s)
Note: New as of 2/97
412 Medical records to substantiate decision of non-coverage
Note: New as of 2/97
413 Explain/justify differences between treatment plan and services rendered.
Note: New as of 2/97
414 Need for more than one physician to treat patient
Note: New as of 2/97
415 Justify services outside composite rate
Note: New as of 2/97
416 Verification of patient's ability to retain and use information
Note: New as of 2/97
417 Prior testing, including result(s) and date(s) as related to service(s)
Note: New as of 2/97
418 Indicating why medications cannot be taken orally
Note: New as of 2/97
419 Individual test(s) comprising the panel and the charges for each test
Note: New as of 2/97
420 Name, dosage and medical justification of contrast material used for radiology procedure
Note: New as of 2/97
421 Medical review attachment/information for service(s)
Note: New as of 2/97
422 Homebound status
Note: New as of 2/97
423 Prognosis
Note: Inactive for 004030, since 10/99. LOINC codes have the ability to ask for prognosis.
424 Statement of non-coverage including itemized bill
Note: New as of 2/97
425 Itemize non-covered services
Note: New as of 2/97
426 All current diagnoses
Note: New as of 2/97
427 Emergency care provided during transport
Note: New as of 2/97
428 Reason for transport by ambulance
Note: New as of 2/97
429 Loaded miles and charges for transport to nearest facility with appropriate services
Note: New as of 2/97
430 Nearest appropriate facility
Note: New as of 2/97
431 Provide condition/functional status at time of service
Note: New as of 2/97
432 Date benefits exhausted
Note: New as of 2/97
433 Copy of patient revocation of hospice benefits
Note: New as of 2/97
434 Reasons for more than one transfer per entitlement period
Note: New as of 2/97
435 Notice of Admission
Note: New as of 2/97
436 Short term goals
Note: New as of 2/97
437 Long term goals
Note: New as of 2/97
438 Number of patients attending session
Note: New as of 2/97
439 Size, depth, amount, and type of drainage wounds
Note: New as of 2/97
440 why non-skilled caregiver has not been taught procedure
Note: New as of 2/97
441 Entity professional qualification for service(s)
Note: New as of 2/97
442 Modalities of service
Note: New as of 2/97
443 Initial evaluation report
Note: New as of 2/97
444 Method used to obtain test sample
Note: New as of 2/97
445 Explain why hearing loss not correctable by hearing aid
Note: New as of 2/97
446 Documentation from prior claim(s) related to service(s)
Note: New as of 2/97
447 Plan of teaching
Note: New as of 2/97
448 Invalid billing combination. See STC12 for details. This code should only be used to indicate an inconsistency between two or more data elements on the claim. A detailed explanation is required in STC12 when this code is used.
Note: New as of 2/97
449 Projected date to discontinue service(s)
Note: New as of 2/97
450 Awaiting spend down determination
Note: New as of 2/97
451 Preoperative and post-operative diagnosis
Note: New as of 2/97
452 Total visits in total number of hours/day and total number of hours/week
Note: New as of 2/97
453 Procedure Code Modifier(s) for Service(s) Rendered
Note: New as of 2/97
454 Procedure code for services rendered.
Note: New as of 2/97
455 Revenue code for services rendered.
Note: New as of 2/97
456 Covered Day(s)
Note: New as of 2/97
457 Non-Covered Day(s)
Note: New as of 2/97
458 Coinsurance Day(s)
Note: New as of 2/97
459 Lifetime Reserve Day(s)
Note: New as of 2/97
460 NUBC Condition Code(s)
Note: New as of 2/97
461 NUBC Occurrence Code(s) and Date(s)
Note: New as of 2/97
462 NUBC Occurrence Span Code(s) and Date(s)
Note: New as of 2/97
463 NUBC Value Code(s) and/or Amount(s)
Note: New as of 2/97
464 Payer Assigned Claim Control Number
Note: New as of 2/97, Changed as of 10/04
465 Principal Procedure Code for Service(s) Rendered
Note: New as of 2/97
466 Entities Original Signature
Note: New as of 2/97
467 Entity Signature Date
Note: New as of 2/97
468 Patient Signature Source
Note: New as of 2/97
469 Purchase Service Charge
Note: New as of 2/97
470 Was service purchased from another entity?
Note: New as of 2/97
471 Were services related to an emergency?
Note: New as of 2/97
472 Ambulance Run Sheet
Note: New as of 2/97
473 Missing or invalid lab indicator
Note: New as of 6/98
474 Procedure code and patient gender mismatch
Note: Changed as of 2/00
475 Procedure code not valid for patient age
Note: Changed as of 2/00
476 Missing or invalid units of service
Note: New as of 6/98
477 Diagnosis code pointer is missing or invalid
Note: New as of 6/98
478 Claim submitter's identifier (patient account number) is missing
Note: New as of 6/98
479 Other Carrier payer ID is missing or invalid
Note: New as of 6/98
480 Other Carrier Claim filing indicator is missing or invalid
Note: New as of 6/98
481 Claim/submission format is invalid.
Note: New as of 10/98
482 Date Error, Century Missing
Note: New as of 2/99
483 Maximum coverage amount met or exceeded for benefit period.
Note: New as of 6/99
484 Business Application Currently Not Available
Note: New as of 2/00
485 More information available than can be returned in real time mode. Narrow your current search criteria.
Note: New as of 2/01
486 Principle Procedure Date
Note: New as of 10/01
487 Claim not found, claim should have been submitted to/through 'entity'
Note: New as of 2/02
488 Diagnosis code(s) for the services rendered.
Note: New as of 6/02
489 Attachment Control Number
Note: New as of 10/02
490 Other Procedure Code for Service(s) Rendered
Note: New as of 2/03
491 Entity not eligible for encounter submission
Note: New as of 2/03
492 Other Procedure Date
Note: New as of 2/03
493 Version/Release/Industry ID code not currently supported by information holder
Note: New as of 2/03
494 Real-Time requests not supported by the information holder, resubmit as batch request
Note: New as of 2/03
495 Requests for re-adjudication must reference the newly assigned payer claim control number for this previously adjusted claim. Correct the payer claim control number and re-submit.
Note: New as of 9/03
496 Submitter not approved for electronic claim submissions on behalf of this entity
Note: New as of 2/04
497 Sales tax not paid
Note: New as of 6/04
498 Maximum leave days exhausted
Note: New as of 6/04
499 No rate on file with the payer for this service for this entity
Note: New as of 6/04
500 Entity's Postal/Zip Code
Note: New as of 6/04
501 Entity's State/Province
Note: New as of 6/04
502 Entity's City
Note: New as of 6/04
503 Entity's Street Address
Note: New as of 6/04
504 Entity's Last Name
Note: New as of 6/04
505 Entity's First Name
Note: New as of 6/04
506 Entity is changing processor/clearinghouse. This claim must be submitted to the new processor/clearinghouse
Note: New as of 6/04
507 HCPCS
Note: New as of 10/04
508 ICD9
Note: New as of 10/04
509 E-Code
Note: New as of 10/04
510 Future date
Note: New as of 10/04
511 Invalid character
Note: New as of 10/04
512 Length invalid for receiver's application system
Note: New as of 10/04
513 HIPPS Rate Code for services Rendered
Note: New as of 10/04
514 Entities Middle Name
Note: New as of 10/04
515 Managed Care review
Note: New as of 10/04
516 Adjudication or Payment Date
Note: New as of 10/04
517 Adjusted Repriced Claim Reference Number
Note: New as of 10/04
518 Adjusted Repriced Line item Reference Number
Note: New as of 10/04
519 Adjustment Amount
Note: New as of 10/04
520 Adjustment Quantity
Note: New as of 10/04
521 Adjustment Reason Code
Note: New as of 10/04
522 Anesthesia Modifying Units
Note: New as of 10/04
523 Anesthesia Unit Count
Note: New as of 10/04
524 Arterial Blood Gas Quantity
Note: New as of 10/04
525 Begin Therapy Date
Note: New as of 10/04
526 Bundled or Unbundled Line Number
Note: New as of 10/04
527 Certification Condition Indicator
Note: New as of 10/04
528 Certification Period Projected Visit Count
Note: New as of 10/04
529 Certification Revision Date
Note: New as of 10/04
530 Claim Adjustment Indicator
Note: New as of 10/04
531 Claim Disproportinate Share Amount
Note: New as of 10/04
532 Claim DRG Amount
Note: New as of 10/04
533 Claim DRG Outlier Amount
Note: New as of 10/04
534 Claim ESRD Payment Amount
Note: New as of 10/04
535 Claim Frequency Code
Note: New as of 10/04
536 Claim Indirect Teaching Amount
Note: New as of 10/04
537 Claim MSP Pass-through Amount
Note: New as of 10/04
538 Claim or Encounter Identifier
Note: New as of 10/04
539 Claim PPS Capital Amount
Note: New as of 10/04
540 Claim PPS Capital Outlier Amount
Note: New as of 10/04
541 Claim Submission Reason Code
Note: New as of 10/04
542 Claim Total Denied Charge Amount
Note: New as of 10/04
543 Clearinghouse or Value Added Network Trace
Note: New as of 10/04
544 Clinical Laboratory Improvement Amendment
Note: New as of 10/04
545 Contract Amount
Note: New as of 10/04
546 Contract Code
Note: New as of 10/04
547 Contract Percentage
Note: New as of 10/04
548 Contract Type Code
Note: New as of 10/04
549 Contract Version Identifier
Note: New as of 10/04
550 Coordination of Benefits Code
Note: New as of 10/04
551 Coordination of Benefits Total Submitted Charge
Note: New as of 10/04
552 Cost Report Day Count
Note: New as of 10/04
553 Covered Amount
Note: New as of 10/04
554 Date Claim Paid
Note: New as of 10/04
555 Delay Reason Code
Note: New as of 10/04
556 Demonstration Project Identifier
Note: New as of 10/04
557 Diagnosis Date
Note: New as of 10/04
558 Discount Amount
Note: New as of 10/04
559 Document Control Identifier
Note: New as of 10/04
560 Entity's Additional/Secondary Identifier
Note: New as of 10/04
561 Entity's Contact Name
Note: New as of 10/04
562 Entity's National Provider Identifier (NPI)
Note: New as of 10/04
563 Entity's Tax Amount
Note: New as of 10/04
564 EPSDT Indicator
Note: New as of 10/04
565 Estimated Claim Due Amount
Note: New as of 10/04
566 Exception Code
Note: New as of 10/04
567 Facility Code Qualifier
Note: New as of 10/04
568 Family Planning Indicator
Note: New as of 10/04
569 Fixed Format Information
Note: New as of 10/04
570 Free Form Message Text
Note: New as of 10/04
571 Frequency Count
Note: New as of 10/04
572 Frequency Period
Note: New as of 10/04
573 Functional Limitation Code
Note: New as of 10/04
574 HCPCS Payable Amount Home Health
Note: New as of 10/04
575 Homebound Indicator
Note: New as of 10/04
576 Immunization Batch Number
Note: New as of 10/04
577 Industry Code
Note: New as of 10/04
578 Insurance Type Code
Note: New as of 10/04
579 Investigational Device Exemption Identifier
Note: New as of 10/04
580 Last Certification Date
Note: New as of 10/04
581 Last Worked Date
Note: New as of 10/04
582 Lifetime Psychiatric Days Count
Note: New as of 10/04
583 Line Item Charge Amount
Note: New as of 10/04
584 Line Item Control Number
Note: New as of 10/04
585 Line Item Denied Charge or Non-covered Charge
Note: New as of 10/04
586 Line Note Text
Note: New as of 10/04
587 Measurement Reference Identification Code
Note: New as of 10/04
588 Medical Record Number
Note: New as of 10/04
589 Medicare Assignment Code
Note: New as of 10/04
590 Medicare Coverage Indicator
Note: New as of 10/04
591 Medicare Paid at 100% Amount
Note: New as of 10/04
592 Medicare Paid at 80% Amount
Note: New as of 10/04
593 Medicare Section 4081 Indicator
Note: New as of 10/04
594 Mental Status Code
Note: New as of 10/04
595 Monthly Treatment Count
Note: New as of 10/04
596 Non-covered Charge Amount
Note: New as of 10/04
597 Non-payable Professional Component Amount
Note: New as of 10/04
598 Non-payable Professional Component Billed Amount
Note: New as of 10/04
599 Note Reference Code
Note: New as of 10/04
600 Oxygen Saturation Qty
Note: New as of 10/04
601