Files > ADJUSTMENT REASON

name
ADJUSTMENT REASON
number
161.91
location
^FB(161.91,
description
This file contains a list of claim adjustment reason codes. These codes are used to indicate why the amount paid is different from the amount billed on a health care claim. The source of the codes is the National Health Care Claim Payment/Committee Bulletins. It is available from Washington Publishing Company. The associated suspend code, suspension description, and applicability for use by VA on fee claims is provided by the Fee Replacement Project Management Office in Denver which represents the VA Chief Business Office. This file is exported with data and the contents should not be locally modified.
Fields
#NameLocationTypeDetailsIndexDescription
.01code(+)0;1FREE TEXTBCode value.
1status effective date1;0MULTIPLE161.911
2description effective date2;0MULTIPLE161.912
3associated suspend code0;2POINTER161.27This field should be populated for every adjustment code that is currently applicable for use on fee claims. The software will automatically copy this value to the SUSPEND CODE field in an invoice file after the adjustment reason code is specified for the invoice. If more than one adjustment reason is specified, the one with the largest dollar impact will be used to determine the suspend code.
4suspension description4;0WORD-PROCESSING

Not Referenced