Claim Adjustment Group Code

SAS Name
CLM_ADJUST_GRP_CD

Claim adjustment group code used to categorize a payment adjustment for a claim or claim line. This field is currently only populated for Direct Contracting (DC), Comprehensive Kidney Care Contracting (CKCC) and Kidney Care First (KCF) model claims.

Comments

This code set is an external code set maintained by X12 (www.x12.org/codes). This field is not populated prior to 2021

Source: NCH

Code Code value
CO Contractual obligation
OA Other adjustment
PR Patient responsibility