Updated research request forms and data security approval requirement effective 4/24/23
This variable is contained in the following files:
SAS Name
REV_CNTR_ADJUST_RSN_CD
Claim adjustment reason code used to describe why a claim or claim line was paid differently than billed. This field is currently only populated for Direct Contracting (DC), Comprehensive Kidney Care Contracting (CKCC) and Kidney Care First (KCF) model claims.
This is not a comprehensive list of values; refer to website below for current values and descriptions:
| Code | Code value |
|---|---|
| 94 | Processed in Excess of charges |
| 119 | Benefit maximum for this time period or occurrence has been reached |
| 132 | Prearranged demonstration project adjustment |
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