What Is The Claim Adjustment Group Code?

Reasons codes generally appear on the explanation of the benefits that help to know why a claim has been adjusted and if there is no adjustment to the line then it means that there is no adjustment reason code. The reason codes have lots of benefits in saving your time and money in the medical billing.

What is the Claim Adjustment Reason Code?

The claim adjustment reason code will communicate with the adjustment and it helps to know why a service line or claim was paid differently than it was billed. There will not claim adjustment reason code if there is no adjustment for the line, go to this web-site.

What are the Claim Adjustment Group Codes?

What are the Claim Adjustment Group Codes
  • Contractual Obligation (CO)

The CO group code is generally used when a joint contractual agreement between the payee and payer resulted in an adjustment. These adjustments are usually considered as a write off for the provider and not billed to the patient.

  • Other Adjustments (OA)

The other adjustment group code is used when there are no other group codes apply to the adjustment.

  • Payer Initiated Reductions (PI)

This kind of group code is used when the adjustment is not the responsibility of the patient, in the option of the payer, and there is not supporting contract between the payer and provider.

  • Patient Responsibility (PR)
Patient Responsibility

This kind of group codes is generally used when the adjustments present a specific amount of money that is required to be billed to the insured and patient. Usually, this group code is used for the copy adjustments and deductible adjustments.

The various kinds of codes include does not describe a description of code value but they also indicate the usage, notes and guidelines and much more for the additional information. the user can get know about the meaning and instruction and other aspects of the code list with the help of Code Maintenance Group that help you to enhance your knowledge regarding all kinds of codes.

Each and every code will start on a specific date and the date when the code was first available on the list of code used in the original business message. Once the code is populated then the date will be identified as the last date of the vote and no longer be used in the original business messages. So, with the help of this information, you may get complete knowledge about What is Claim Adjustment Reason Code and how they are beneficial for you in getting your denied claim.

claim adjustment reason codes

The claim adjustment reason codes provide you best possible help to save your money and time on different medical billing and help to enhance your knowledge regarding various kinds of codes that you can implement to get a claim on your billing. But it is important for you to get complete information about your codes such as their starting date, end date and claim amount and many more that help you to get high relief and stress free billing process in a best effective and efficient manner.