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Sub-Field: 361.1151

Package: Integrated Billing

EXPLANATION OF BENEFITS(#361.1)-->361.115-->361.1151

Sub-Field: 361.1151


Information

Parent File Name Number Package
361.115 ADJUSTMENTS 361.1151 Integrated Billing

Details

Field # Name Loc Type Details
.01 GROUP CODE 0;1 SET
  • 'CO' FOR Contractual Obligations;
  • 'CR' FOR Corrections and Reversals;
  • 'OA' FOR Other Adjustments;
  • 'PI' FOR Payor Initiated Reductions;
  • 'PR' FOR Patient Responsibility;
  • 'LQ' FOR Line Item Remark Code WebMD Kludge;

  • LAST EDITED:  OCT 30, 2003
  • CROSS-REFERENCE:  361.1151^B
    1)= S ^IBM(361.1,DA(2),15,DA(1),1,"B",$E(X,1,30),DA)=""
    2)= K ^IBM(361.1,DA(2),15,DA(1),1,"B",$E(X,1,30),DA)
1 REASONS 1;0 Multiple #361.11511 361.11511

  • DESCRIPTION:  
    This is the list of reasons returned for line-level adjustments to the claim.
2 PAYER POLICY REFERENCE 2;0 Multiple #361.11512 361.11512

  • DESCRIPTION:  
    These are the payer policy references listed on the payer web site. Up to 5 payer policy references are allowed on the 835 record.
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