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    Claim Status Codes
    • 22 Nov 2024
    • 28 Minutes to read
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    Contents

    Claim Status Codes

    • Updated on 22 Nov 2024
    • 28 Minutes to read
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    Article summary

    Medical claim status codes are standardized codes used to provide information about the current status of a medical claim. These codes are typically defined by organizations such as the Health Insurance Portability and Accountability Act (HIPAA) and the American National Standards Institute (ANSI), particularly in the X12 277 transaction for claim status responses.

    Click here for the X12 Source

    0Cannot provide further status electronically.
    Start: 01/01/1995
    1For more detailed information, see remittance advice.
    Start: 01/01/1995
    2More detailed information in letter.
    Start: 01/01/1995
    3Claim has been adjudicated and is awaiting payment cycle.
    Start: 01/01/1995
    6Balance due from the subscriber.
    Start: 01/01/1995
    12One or more originally submitted procedure codes have been combined.
    Start: 01/01/1995 | Last Modified: 06/30/2001
    15One or more originally submitted procedure code have been modified.
    Start: 01/01/1995 | Last Modified: 06/30/2001
    16Claim/encounter has been forwarded to entity. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    17Claim/encounter has been forwarded by third party entity to entity. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    18Entity received claim/encounter, but returned invalid status. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    19Entity acknowledges receipt of claim/encounter. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    20Accepted for processing.
    Start: 01/01/1995 | Last Modified: 06/30/2001
    21Missing or invalid information. Usage: At least one other status code is required to identify the missing or invalid information.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    23Returned to Entity. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    24Entity not approved as an electronic submitter. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    25Entity not approved. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    26Entity not found. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    27Policy canceled.
    Start: 01/01/1995 | Last Modified: 06/30/2001
    29Subscriber and policy number/contract number mismatched.
    Start: 01/01/1995
    30Subscriber and subscriber id mismatched.
    Start: 01/01/1995
    31Subscriber and policyholder name mismatched.
    Start: 01/01/1995
    32Subscriber and policy number/contract number not found.
    Start: 01/01/1995
    33Subscriber and subscriber id not found.
    Start: 01/01/1995
    34Subscriber and policyholder name not found.
    Start: 01/01/1995
    35Claim/encounter not found.
    Start: 01/01/1995
    37Predetermination is on file, awaiting completion of services.
    Start: 01/01/1995
    38Awaiting next periodic adjudication cycle.
    Start: 01/01/1995
    39Charges for pregnancy deferred until delivery.
    Start: 01/01/1995
    40Waiting for final approval.
    Start: 01/01/1995
    41Special handling required at payer site.
    Start: 01/01/1995
    42Awaiting related charges.
    Start: 01/01/1995
    44Charges pending provider audit.
    Start: 01/01/1995
    45Awaiting benefit determination.
    Start: 01/01/1995
    46Internal review/audit.
    Start: 01/01/1995
    47Internal review/audit - partial payment made.
    Start: 01/01/1995
    49Pending provider accreditation review.
    Start: 01/01/1995
    50Claim waiting for internal provider verification.
    Start: 01/01/1995
    51Investigating occupational illness/accident.
    Start: 01/01/1995
    52Investigating existence of other insurance coverage.
    Start: 01/01/1995
    53Claim being researched for Insured ID/Group Policy Number error.
    Start: 01/01/1995
    54Duplicate of a previously processed claim/line.
    Start: 01/01/1995
    55Claim assigned to an approver/analyst.
    Start: 01/01/1995
    56Awaiting eligibility determination.
    Start: 01/01/1995
    57Pending COBRA information requested.
    Start: 01/01/1995
    59Information was requested by a non-electronic method. Usage: At least one other status code is required to identify the requested information.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    60Information was requested by an electronic method. Usage: At least one other status code is required to identify the requested information.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    61Eligibility for extended benefits.
    Start: 01/01/1995
    64Re-pricing information.
    Start: 01/01/1995
    65Claim/line has been paid.
    Start: 01/01/1995
    66Payment reflects usual and customary charges.
    Start: 01/01/1995
    72Claim contains split payment.
    Start: 01/01/1995
    73Payment made to entity, assignment of benefits not on file. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    78Duplicate of an existing claim/line, awaiting processing.
    Start: 01/01/1995
    81Contract/plan does not cover pre-existing conditions.
    Start: 01/01/1995
    83No coverage for newborns.
    Start: 01/01/1995
    84Service not authorized.
    Start: 01/01/1995
    85Entity not primary. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    86Diagnosis and patient gender mismatch.
    Start: 01/01/1995 | Last Modified: 02/28/2000
    88Entity not eligible for benefits for submitted dates of service. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    89Entity not eligible for dental benefits for submitted dates of service. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    90Entity not eligible for medical benefits for submitted dates of service. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    91Entity not eligible/not approved for dates of service. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    92Entity does not meet dependent or student qualification. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    93Entity is not selected primary care provider. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    94Entity not referred by selected primary care provider. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    95Requested additional information not received. Usage: At least one other status code is required to identify the requested information.
    Start: 01/01/1995 | Last Modified: 11/01/2024
    96No agreement with entity. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    97Patient eligibility not found with entity. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    98Charges applied to deductible.
    Start: 01/01/1995
    99Pre-treatment review.
    Start: 01/01/1995
    100Pre-certification penalty taken.
    Start: 01/01/1995
    101Claim was processed as adjustment to previous claim.
    Start: 01/01/1995
    102Newborn's charges processed on mother's claim.
    Start: 01/01/1995
    103Claim combined with other claim(s).
    Start: 01/01/1995
    104Processed according to plan provisions (Plan refers to provisions that exist between the Health Plan and the Consumer or Patient)
    Start: 01/01/1995 | Last Modified: 06/01/2008
    105Claim/line is capitated.
    Start: 01/01/1995
    106This amount is not entity's responsibility. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    107Processed according to contract provisions (Contract refers to provisions that exist between the Health Plan and a Provider of Health Care Services)
    Start: 01/01/1995 | Last Modified: 06/01/2008
    109Entity not eligible. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    110Claim requires pricing information.
    Start: 01/01/1995
    111At the policyholder's request these claims cannot be submitted electronically.
    Start: 01/01/1995
    114Claim/service should be processed by entity. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    116Claim submitted to incorrect payer.
    Start: 01/01/1995
    117Claim requires signature-on-file indicator.
    Start: 01/01/1995
    121Service line number greater than maximum allowable for payer.
    Start: 01/01/1995
    123Additional information requested from entity. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    124Entity's name, address, phone and id number. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    125Entity's name. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    126Entity's address. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    127Entity's Communication Number. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    128Entity's tax id. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    129Entity's Blue Cross provider id. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    130Entity's Blue Shield provider id. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    131Entity's Medicare provider id. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    132Entity's Medicaid provider id. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    133Entity's UPIN. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    134Entity's TRICARE provider id. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 03/01/2022
    135Entity's commercial provider id. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    136Entity's health industry id number. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    137Entity's plan network id. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    138Entity's site id . Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    139Entity's health maintenance provider id (HMO). Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    140Entity's preferred provider organization id (PPO). Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    141Entity's administrative services organization id (ASO). Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    142Entity's license/certification number. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    143Entity's state license number. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    144Entity's specialty license number. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    145Entity's specialty/taxonomy code. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    146Entity's anesthesia license number. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    147Entity's qualification degree/designation (e.g. RN,PhD,MD). Usage: This code requires use of an Entity Code.
    Start: 02/28/1997 | Last Modified: 07/01/2017
    148Entity's social security number. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    149Entity's employer id. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    150Entity's drug enforcement agency (DEA) number. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    152Processor Control Number
    Start: 01/01/1995 | Last Modified: 11/01/2024
    153Entity's id number. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    154Relationship of surgeon & assistant surgeon.
    Start: 01/01/1995
    155Entity's relationship to patient. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    156Patient relationship to subscriber
    Start: 01/01/1995
    157Entity's Gender. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    158Entity's date of birth. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    159Entity's date of death. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    160Entity's marital status. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    161Entity's employment status. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    162Entity's health insurance claim number (HICN). Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    163Entity's policy/group number. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    164Entity's contract/member number. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    165Entity's employer name, address and phone. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    166Entity's employer name. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    167Entity's employer address. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    168Entity's employer phone number. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    170Entity's employee id. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    171Other insurance coverage information (health, liability, auto, etc.).
    Start: 01/01/1995
    172Other employer name, address and telephone number.
    Start: 01/01/1995
    173Entity's name, address, phone, gender, DOB, marital status, employment status and relation to subscriber. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    174Entity's student status. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    175Entity's school name. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    176Entity's school address. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    177Transplant recipient's name, date of birth, gender, relationship to insured.
    Start: 01/01/1995 | Last Modified: 02/28/2000
    178Total Claim Charge Amount
    Start: 01/01/1995 | Last Modified: 11/01/2024
    179Outside lab charges.
    Start: 01/01/1995
    180Hospital's semi-private room rate.
    Start: 01/01/1995 | Last Modified: 11/01/2024
    181Hospital's room rate.
    Start: 01/01/1995 | Last Modified: 11/01/2024
    182Allowable/paid from other entities coverage Usage: This code requires the use of an entity code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    183Amount entity has paid. Usage: This code requires use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    184Purchase price for the rented durable medical equipment.
    Start: 01/01/1995
    185Rental price for durable medical equipment.
    Start: 01/01/1995
    186Purchase and rental price of durable medical equipment.
    Start: 01/01/1995
    187Date(s) of service.
    Start: 01/01/1995
    188Statement from-through dates.
    Start: 01/01/1995
    189Facility admission date
    Start: 01/01/1995 | Last Modified: 10/31/2006
    190Facility discharge date
    Start: 01/01/1995 | Last Modified: 10/31/2006
    191Date of Last Menstrual Period (LMP)
    Start: 02/28/1997
    192Date of first service for current series/symptom/illness.
    Start: 01/01/1995
    193First consultation/evaluation date.
    Start: 02/28/1997
    194Confinement dates.
    Start: 01/01/1995
    195Unable to work dates/Disability Dates.
    Start: 01/01/1995 | Last Modified: 09/20/2009
    196Return to work dates.
    Start: 01/01/1995
    197Effective coverage date(s).
    Start: 01/01/1995
    198Medicare effective date.
    Start: 01/01/1995
    199Date of conception and expected date of delivery.
    Start: 01/01/1995
    200Date of equipment return.
    Start: 01/01/1995
    201Date of dental appliance prior placement.
    Start: 01/01/1995
    202Date of dental prior replacement/reason for replacement.
    Start: 01/01/1995
    203Date of dental appliance placed.
    Start: 01/01/1995
    204Date dental canal(s) opened and date service completed.
    Start: 01/01/1995
    205Date(s) dental root canal therapy previously performed.
    Start: 01/01/1995
    206Most recent date of curettage, root planing, or periodontal surgery.
    Start: 01/01/1995
    207Dental impression and seating date.
    Start: 01/01/1995
    208Most recent date pacemaker was implanted.
    Start: 01/01/1995
    209Most recent pacemaker battery change date.
    Start: 01/01/1995
    210Date of the last x-ray.
    Start: 01/01/1995
    211Date(s) of dialysis training provided to patient.
    Start: 01/01/1995
    212Date of last routine dialysis.
    Start: 01/01/1995
    213Date of first routine dialysis.
    Start: 01/01/1995
    214Original date of prescription/orders/referral.
    Start: 02/28/1997
    215Date of tooth extraction/evolution.
    Start: 01/01/1995
    216Drug information.
    Start: 01/01/1995
    217Drug name, strength and dosage form.
    Start: 01/01/1995
    218NDC number.
    Start: 01/01/1995
    219Prescription number.
    Start: 01/01/1995
    222Drug dispensing units and average wholesale price (AWP).
    Start: 01/01/1995
    223Route of drug/myelogram administration.
    Start: 01/01/1995
    224Anatomical location for joint injection.
    Start: 01/01/1995
    225Anatomical location.
    Start: 01/01/1995
    226Joint injection site.
    Start: 01/01/1995
    227Hospital information.
    Start: 01/01/1995
    228Type of bill for UB claim
    Start: 01/01/1995 | Last Modified: 10/31/2006
    229Hospital admission source.
    Start: 01/01/1995
    230Hospital admission hour.
    Start: 01/01/1995
    231Hospital admission type.
    Start: 01/01/1995
    232Admitting diagnosis.
    Start: 01/01/1995
    233Hospital discharge hour.
    Start: 01/01/1995
    234Patient discharge status.
    Start: 01/01/1995
    235Units of blood furnished.
    Start: 01/01/1995
    236Units of blood replaced.
    Start: 01/01/1995
    237Units of deductible blood.
    Start: 01/01/1995
    238Separate claim for mother/baby charges.
    Start: 01/01/1995
    239Dental information.
    Start: 01/01/1995
    240Tooth surface(s) involved.
    Start: 01/01/1995
    241List of all missing teeth (upper and lower).
    Start: 01/01/1995
    242Tooth numbers, surfaces, and/or quadrants involved.
    Start: 01/01/1995
    243Months of dental treatment remaining.
    Start: 01/01/1995
    244Tooth number or letter.
    Start: 01/01/1995
    245Dental quadrant/arch.
    Start: 01/01/1995
    246Total orthodontic service fee, initial appliance fee, monthly fee, length of service.
    Start: 01/01/1995
    247Line information.
    Start: 01/01/1995
    249Place of service.
    Start: 01/01/1995
    250Type of service.
    Start: 01/01/1995
    251Total anesthesia minutes.
    Start: 01/01/1995
    252Entity's prior authorization/certification number. Usage: This code requires the use of an Entity Code.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    254Principal diagnosis code.
    Start: 01/01/1995 | Last Modified: 01/30/2011
    255Diagnosis code.
    Start: 01/01/1995
    256DRG code(s).
    Start: 01/01/1995
    257ADSM-III-R code for services rendered.
    Start: 01/01/1995
    258Days/units for procedure/revenue code.
    Start: 01/01/1995
    259Frequency of service.
    Start: 01/01/1995
    260Length of medical necessity, including begin date.
    Start: 02/28/1997
    261Obesity measurements.
    Start: 01/01/1995
    262Type of surgery/service for which anesthesia was administered.
    Start: 01/01/1995
    263Length of time for services rendered.
    Start: 01/01/1995
    264Number of liters/minute & total hours/day for respiratory support.
    Start: 01/01/1995
    265Number of lesions excised.
    Start: 01/01/1995
    266Facility point of origin and destination - ambulance.
    Start: 01/01/1995
    267Number of miles patient was transported.
    Start: 01/01/1995
    268Location of durable medical equipment use.
    Start: 01/01/1995
    269Length/size of laceration/tumor.
    Start: 01/01/1995
    270Subluxation location.
    Start: 01/01/1995
    271Number of spine segments.
    Start: 01/01/1995
    272Oxygen contents for oxygen system rental.
    Start: 01/01/1995
    273Weight.
    Start: 01/01/1995
    274Height.
    Start: 01/01/1995
    275Claim.
    Start: 01/01/1995
    276UB04/HCFA-1450/1500 claim form
    Start: 01/01/1995 | Last Modified: 10/31/2006
    277Paper claim.
    Start: 01/01/1995
    279Claim/service must be itemized
    Start: 01/01/1995 | Last Modified: 10/17/2010
    281Related confinement claim.
    Start: 01/01/1995
    282Copy of prescription.
    Start: 01/01/1995
    283Medicare entitlement information is required to determine primary coverage
    Start: 01/01/1995 | Last Modified: 01/27/2008
    284Copy of Medicare ID card.
    Start: 01/01/1995
    286Other payer's Explanation of Benefits/payment information.
    Start: 01/01/1995
    287Medical necessity for service.
    Start: 01/01/1995
    288Hospital late charges
    Start: 01/01/1995 | Last Modified: 10/17/2010
    290Pre-existing information.
    Start: 01/01/1995
    291Reason for termination of pregnancy.
    Start: 01/01/1995
    292Purpose of family conference/therapy.
    Start: 01/01/1995
    293Reason for physical therapy.
    Start: 01/01/1995
    294Supporting documentation. Usage: At least one other status code is required to identify the supporting documentation.
    Start: 01/01/1995 | Last Modified: 07/01/2017
    295Attending physician report.
    Start: 01/01/1995
    296Nurse's notes.
    Start: 01/01/1995
    297Medical notes/report.
    Start: 02/28/1997
    298Operative report.
    Start: 01/01/1995
    299Emergency room notes/report.
    Start: 01/01/1995
    300Lab/test report/notes/results.
    Start: 02/28/1997
    301MRI report.
    Start: 01/01/1995
    305Radiology/x-ray reports and/or interpretation
    Start: 01/01/1995 | Last Modified: 01/30/2011
    306Detailed description of service.
    Start: 01/01/1995
    307Narrative with pocket depth chart.
    Start: 01/01/1995
    308Discharge summary.
    Start: 01/01/1995
    310Progress notes for the six months prior to statement date.
    Start: 01/01/1995
    311Pathology notes/report.
    Start: 01/01/1995
    312Dental charting.
    Start: 01/01/1995
    313Bridgework information.
    Start: 01/01/1995
    314Dental records for this service.
    Start: 01/01/1995
    315Past perio treatment history.
    Start: 01/01/1995
    316Complete medical history.
    Start: 01/01/1995
    318X-rays/radiology films
    Start: 01/01/1995 | Last Modified: 10/17/2010
    319Pre/post-operative x-rays/photographs.
    Start: 02/28/1997
    320Study models.
    Start: 01/01/1995
    322Recent Full Mouth X-rays
    Start: 01/01/1995 | Last Modified: 10/17/2010
    323Study models, x-rays, and/or narrative.
    Start: 01/01/1995
    324Recent x-ray of treatment area and/or narrative.
    Start: 01/01/1995
    325Recent fm x-rays and/or narrative.
    Start: 01/01/1995
    326Copy of transplant acquisition invoice.
    Start: 01/01/1995
    327Periodontal case type diagnosis and recent pocket depth chart with narrative.
    Start: 01/01/1995
    329Exercise notes.
    Start: 01/01/1995
    330Occupational notes.
    Start: 01/01/1995
    331History and physical.
    Start: 01/01/1995 | Last Modified: 08/01/2007
    333Patient release of information authorization.
    Start: 01/01/1995
    334Oxygen certification.
    Start: 01/01/1995
    335Durable medical equipment certification.
    Start: 01/01/1995
    336Chiropractic certification.
    Start: 01/01/1995
    337Ambulance certification/documentation.
    Start: 01/01/1995
    339Enteral/parenteral certification.
    Start: 01/01/1995
    340Pacemaker certification.
    Start: 01/01/1995
    341Private duty nursing certification.
    Start: 01/01/1995
    342Podiatric certification.
    Start: 01/01/1995
    343Documentation that facility is state licensed and Medicare approved as a surgical facility.
    Start: 01/01/1995
    344Documentation that provider of physical therapy is Medicare Part B approved.
    Start: 01/01/1995
    345Treatment plan for service/diagnosis
    Start: 01/01/1995
    346Proposed treatment plan for next 6 months.
    Start: 01/01/1995
    352Duration of treatment plan.
    Start: 01/01/1995
    353Orthodontics treatment plan.
    Start: 01/01/1995
    354Treatment plan for replacement of remaining missing teeth.
    Start: 01/01/1995
    360Benefits Assignment Certification Indicator
    Start: 01/01/1995 | Last Modified: 10/17/2010
    363Possible Workers' Compensation
    Start: 01/01/1995 | Last Modified: 10/17/2010
    364Is accident/illness/condition employment related?
    Start: 01/01/1995
    365Is service the result of an accident?
    Start: 01/01/1995
    366Is injury due to auto accident?
    Start: 01/01/1995
    374Is prescribed lenses a result of cataract surgery?
    Start: 01/01/1995
    375Was refraction performed?
    Start: 01/01/1995
    380CRNA supervision/medical direction.
    Start: 01/01/1995 | Last Modified: 10/17/2010
    382Did provider authorize generic or brand name dispensing?
    Start: 01/01/1995
    383Nerve block use (surgery vs. pain management)
    Start: 01/01/1995 | Last Modified: 10/17/2010
    384Is prosthesis/crown/inlay placement an initial placement or a replacement?
    Start: 01/01/1995
    385Is appliance upper or lower arch & is appliance fixed or removable?
    Start: 01/01/1995
    386Orthodontic Treatment/Purpose Indicator
    Start: 01/01/1995 | Last Modified: 10/17/2010
    387Date patient last examined by entity. Usage: This code requires use of an Entity Code.
    Start: 02/28/1997 | Last Modified: 07/01/2017
    388Date post-operative care assumed
    Start: 02/28/1997
    389Date post-operative care relinquished
    Start: 02/28/1997
    390Date of most recent medical event necessitating service(s)
    Start: 02/28/1997
    391Date(s) dialysis conducted
    Start: 02/28/1997
    394Date(s) of most recent hospitalization related to service
    Start: 02/28/1997
    395Date entity signed certification/recertification Usage: This code requires use of an Entity Code.
    Start: 02/28/1997 | Last Modified: 07/01/2017
    396Date home dialysis began
    Start: 02/28/1997
    397Date of onset/exacerbation of illness/condition
    Start: 02/28/1997
    398Visual field test results
    Start: 02/28/1997
    400Claim is out of balance
    Start: 02/28/1997
    401Source of payment is not valid
    Start: 02/28/1997
    402Amount must be greater than zero. Usage: At least one other status code is required to identify which amount element is in error.
    Start: 02/28/1997 | Last Modified: 07/01/2017
    403Entity referral notes/orders/prescription. Usage: this code requires use of an entity code.
    Start: 02/28/1997 | Last Modified: 11/01/2024
    406Brief medical history as related to service(s)
    Start: 02/28/1997
    407Complications/mitigating circumstances
    Start: 02/28/1997
    408Initial certification
    Start: 02/28/1997
    409Medication logs/records (including medication therapy)
    Start: 02/28/1997
    414Necessity for concurrent care (more than one physician treating the patient)
    Start: 02/28/1997 | Last Modified: 10/17/2010
    417Prior testing, including result(s) and date(s) as related to service(s)
    Start: 02/28/1997
    419Individual test(s) comprising the panel and the charges for each test
    Start: 02/28/1997
    420Name, dosage and medical justification of contrast material used for radiology procedure
    Start: 02/28/1997
    428Reason for transport by ambulance
    Start: 02/28/1997
    430Nearest appropriate facility
    Start: 02/28/1997
    431Patient's condition/functional status at time of service.
    Start: 02/28/1997 | Last Modified: 10/17/2010
    432Date benefits exhausted
    Start: 02/28/1997
    433Copy of patient revocation of hospice benefits
    Start: 02/28/1997
    434Reasons for more than one transfer per entitlement period
    Start: 02/28/1997
    435Notice of Admission
    Start: 02/28/1997
    441Entity professional qualification for service(s). Usage: This code requires the use of an Entity Code.”
    Start: 02/28/1997 | Last Modified: 11/01/2024
    442Modalities of service
    Start: 02/28/1997
    443Initial evaluation report
    Start: 02/28/1997
    449Projected date to discontinue service(s)
    Start: 02/28/1997
    450Awaiting spend down determination
    Start: 02/28/1997
    451Preoperative and post-operative diagnosis
    Start: 02/28/1997
    452Total visits in total number of hours/day and total number of hours/week
    Start: 02/28/1997
    453Procedure Code Modifier(s) for Service(s) Rendered
    Start: 02/28/1997
    454Procedure code for services rendered.
    Start: 02/28/1997
    455Revenue code for services rendered.
    Start: 02/28/1997
    456Covered Day(s)
    Start: 02/28/1997
    457Non-Covered Day(s)
    Start: 02/28/1997
    458Coinsurance Day(s)
    Start: 02/28/1997
    459Lifetime Reserve Day(s)
    Start: 02/28/1997
    460NUBC Condition Code(s)
    Start: 02/28/1997
    464Payer Assigned Claim Control Number
    Start: 02/28/1997 | Last Modified: 10/31/2004
    465Principal Procedure Code for Service(s) Rendered
    Start: 02/28/1997
    466Entity's Original Signature. Usage: This code requires use of an Entity Code.
    Start: 02/28/1997 | Last Modified: 07/01/2017
    467Entity Signature Date. Usage: This code requires use of an Entity Code.
    Start: 02/28/1997 | Last Modified: 07/01/2017
    468Patient Signature Source
    Start: 02/28/1997
    469Purchase Service Charge
    Start: 02/28/1997
    470Was service purchased from another entity? Usage: This code requires use of an Entity Code.
    Start: 02/28/1997 | Last Modified: 07/01/2017
    471Were services related to an emergency?
    Start: 02/28/1997
    472Ambulance Run Sheet
    Start: 02/28/1997
    473Missing or invalid lab indicator
    Start: 06/30/1998
    474Procedure code and patient gender mismatch
    Start: 06/30/1998 | Last Modified: 02/29/2000
    475Procedure code not valid for patient age
    Start: 06/30/1998 | Last Modified: 02/29/2000
    476Missing or invalid units of service
    Start: 06/30/1998
    477Diagnosis code pointer is missing or invalid
    Start: 06/30/1998
    478Claim submitter's identifier
    Start: 06/30/1998 | Last Modified: 01/24/2010
    479Other Carrier payer ID is missing or invalid
    Start: 06/30/1998
    480Entity's claim filing indicator. Usage: This code requires use of an Entity Code.
    Start: 06/30/1998 | Last Modified: 07/01/2017
    481Claim/submission format is invalid.
    Start: 10/31/1998
    483Maximum coverage amount met or exceeded for benefit period.
    Start: 06/30/1999
    484Business Application Currently Not Available
    Start: 02/29/2000
    485More information available than can be returned in real-time mode. Narrow your current search criteria.
    Start: 02/28/2001 | Last Modified: 11/01/2024
    486Principal Procedure Date
    Start: 10/31/2001 | Last Modified: 07/01/2009
    487Claim not found, claim should have been submitted to/through 'entity'. Usage: This code requires use of an Entity Code.
    Start: 02/28/2002 | Last Modified: 07/01/2017
    488Diagnosis code(s) for the services rendered.
    Start: 06/30/2002
    489Attachment Control Number
    Start: 10/31/2002
    490Other Procedure Code for Service(s) Rendered
    Start: 02/28/2003
    491Entity not eligible for encounter submission. Usage: This code requires use of an Entity Code.
    Start: 02/28/2003 | Last Modified: 07/01/2017
    492Other Procedure Date
    Start: 02/28/2003
    493Version/Release/Industry ID code not currently supported by information holder
    Start: 02/28/2003
    494Real-time requests not supported by the information holder, resubmit as batch request.
    Start: 02/28/2003 | Last Modified: 11/01/2024
    495Requests for re-adjudication must reference the newly assigned payer claim control number for this previously adjusted claim. Correct the payer claim control number and re-submit.
    Start: 10/31/2003
    496Submitter not approved for electronic claim submissions on behalf of this entity. Usage: This code requires use of an Entity Code.
    Start: 02/29/2004 | Last Modified: 07/01/2017
    497Sales tax not paid
    Start: 06/30/2004
    498Maximum leave days exhausted
    Start: 06/30/2004
    499No rate on file with the payer for this service for this entity Usage: This code requires use of an Entity Code.
    Start: 06/30/2004 | Last Modified: 07/01/2017
    500Entity's Postal/Zip Code. Usage: This code requires use of an Entity Code.
    Start: 06/30/2004 | Last Modified: 07/01/2017
    501Entity's State/Province. Usage: This code requires use of an Entity Code.
    Start: 06/30/2004 | Last Modified: 07/01/2017
    502Entity's City. Usage: This code requires use of an Entity Code.
    Start: 06/30/2004 | Last Modified: 07/01/2017
    503Entity's Street Address. Usage: This code requires use of an Entity Code.
    Start: 06/30/2004 | Last Modified: 07/01/2017
    504Entity's Last Name. Usage: This code requires use of an Entity Code.
    Start: 06/30/2004 | Last Modified: 07/01/2017
    505Entity's First Name. Usage: This code requires use of an Entity Code.
    Start: 06/30/2004 | Last Modified: 07/01/2017
    506Entity is changing processor/clearinghouse. This claim must be submitted to the new processor/clearinghouse. Usage: This code requires use of an Entity Code.
    Start: 06/30/2004 | Last Modified: 07/01/2017
    507HCPCS
    Start: 10/31/2004
    508ICD9 Usage: At least one other status code is required to identify the related procedure code or diagnosis code.
    Start: 10/31/2004 | Last Modified: 07/01/2017
    509External Cause of Injury Code.
    Start: 10/31/2004 | Last Modified: 03/01/2016
    510Future date. Usage: At least one other status code is required to identify the data element in error.
    Start: 10/31/2004 | Last Modified: 07/01/2017
    511Invalid character. Usage: At least one other status code is required to identify the data element in error.
    Start: 10/31/2004 | Last Modified: 07/01/2017
    512Length invalid for receiver's application system. Usage: At least one other status code is required to identify the data element in error.
    Start: 10/31/2004 | Last Modified: 07/01/2017
    513HIPPS Rate Code for services rendered
    Start: 10/31/2004 | Last Modified: 11/01/2024
    514Entity's Middle Name Usage: This code requires use of an Entity Code.
    Start: 10/31/2004 | Last Modified: 07/01/2017
    515Managed Care review
    Start: 10/31/2004
    516Other Entity's Adjudication or Payment/Remittance Date. Usage: An Entity code is required to identify the Other Payer Entity, i.e. primary, secondary.
    Start: 10/31/2004 | Last Modified: 07/01/2017
    517Adjusted Repriced Claim Reference Number
    Start: 10/31/2004
    518Adjusted Repriced Line item Reference Number
    Start: 10/31/2004
    519Adjustment Amount
    Start: 10/31/2004
    520Adjustment Quantity
    Start: 10/31/2004
    521Adjustment Reason Code
    Start: 10/31/2004
    522Anesthesia Modifying Units
    Start: 10/31/2004
    523Anesthesia Unit Count
    Start: 10/31/2004
    524Arterial Blood Gas Quantity
    Start: 10/31/2004
    525Begin Therapy Date
    Start: 10/31/2004
    526Bundled or Unbundled Line Number
    Start: 10/31/2004
    527Certification Condition Indicator
    Start: 10/31/2004
    528Certification Period Projected Visit Count
    Start: 10/31/2004
    529Certification Revision Date
    Start: 10/31/2004
    530Claim Adjustment Indicator
    Start: 10/31/2004
    531Claim Disproportinate Share Amount
    Start: 10/31/2004
    532Claim DRG Amount
    Start: 10/31/2004
    533Claim DRG Outlier Amount
    Start: 10/31/2004
    534Claim ESRD Payment Amount
    Start: 10/31/2004
    535Claim Frequency Code
    Start: 10/31/2004
    536Claim Indirect Teaching Amount
    Start: 10/31/2004
    537Claim MSP Pass-through Amount
    Start: 10/31/2004
    538Claim or Encounter Identifier
    Start: 10/31/2004
    539Claim PPS Capital Amount
    Start: 10/31/2004
    540Claim PPS Capital Outlier Amount
    Start: 10/31/2004
    541Claim Submission Reason Code
    Start: 10/31/2004
    542Claim Total Denied Charge Amount
    Start: 10/31/2004
    543Clearinghouse or Value Added Network Trace
    Start: 10/31/2004
    544Clinical Laboratory Improvement Amendment (CLIA) Number
    Start: 10/31/2004 | Last Modified: 03/01/2018
    545Contract Amount
    Start: 10/31/2004
    546Contract Code
    Start: 10/31/2004
    547Contract Percentage
    Start: 10/31/2004
    548Contract Type Code
    Start: 10/31/2004
    549Contract Version Identifier
    Start: 10/31/2004
    550Coordination of Benefits Code
    Start: 10/31/2004
    551Coordination of Benefits Total Submitted Charge
    Start: 10/31/2004
    552Cost Report Day Count
    Start: 10/31/2004
    553Covered Amount
    Start: 10/31/2004
    554Date Claim Paid
    Start: 10/31/2004
    555Delay Reason Code
    Start: 10/31/2004
    556Demonstration Project Identifier
    Start: 10/31/2004
    557Diagnosis Date
    Start: 10/31/2004
    558Discount Amount
    Start: 10/31/2004
    559Document Control Identifier
    Start: 10/31/2004
    560Entity's Additional/Secondary Identifier. Usage: This code requires use of an Entity Code.
    Start: 10/31/2004 | Last Modified: 07/01/2017
    561Entity's Contact Name. Usage: This code requires use of an Entity Code.
    Start: 10/31/2004 | Last Modified: 07/01/2017
    562Entity's National Provider Identifier (NPI). Usage: This code requires use of an Entity Code.
    Start: 10/31/2004 | Last Modified: 07/01/2017
    563Entity's Tax Amount. Usage: This code requires use of an Entity Code.
    Start: 10/31/2004 | Last Modified: 07/01/2017
    564EPSDT Indicator
    Start: 10/31/2004
    565Estimated Claim Due Amount
    Start: 10/31/2004
    566Exception Code
    Start: 10/31/2004
    567Facility Code Qualifier
    Start: 10/31/2004
    568Family Planning Indicator
    Start: 10/31/2004
    569Fixed Format Information
    Start: 10/31/2004
    571Frequency Count
    Start: 10/31/2004
    572Frequency Period
    Start: 10/31/2004
    573Functional Limitation Code
    Start: 10/31/2004
    574HCPCS Payable Amount Home Health
    Start: 10/31/2004
    575Homebound Indicator
    Start: 10/31/2004
    576Immunization Batch Number
    Start: 10/31/2004
    577Industry Code
    Start: 10/31/2004
    578Insurance Type Code
    Start: 10/31/2004
    579Investigational Device Exemption Identifier
    Start: 10/31/2004
    580Last Certification Date
    Start: 10/31/2004
    581Last Worked Date
    Start: 10/31/2004
    582Lifetime Psychiatric Days Count
    Start: 10/31/2004
    583Line Item Charge Amount
    Start: 10/31/2004
    584Line Item Control Number
    Start: 10/31/2004
    585Denied Charge or Non-covered Charge
    Start: 10/31/2004 | Last Modified: 07/09/2007
    586Line Note Text
    Start: 10/31/2004
    587Measurement Reference Identification Code
    Start: 10/31/2004
    588Medical Record Number
    Start: 10/31/2004
    589Provider Accept Assignment Code
    Start: 10/31/2004 | Last Modified: 10/17/2010
    590Medicare Coverage Indicator
    Start: 10/31/2004
    591Medicare Paid at 100% Amount
    Start: 10/31/2004
    592Medicare Paid at 80% Amount
    Start: 10/31/2004
    593Medicare Section 4081 Indicator
    Start: 10/31/2004
    594Mental Status Code
    Start: 10/31/2004
    595Monthly Treatment Count
    Start: 10/31/2004
    596Non-covered Charge Amount
    Start: 10/31/2004
    597Non-payable Professional Component Amount
    Start: 10/31/2004
    598Non-payable Professional Component Billed Amount
    Start: 10/31/2004
    599Note Reference Code
    Start: 10/31/2004
    600Oxygen Saturation Qty
    Start: 10/31/2004
    601Oxygen Test Condition Code
    Start: 10/31/2004
    602Oxygen Test Date
    Start: 10/31/2004
    603Old Capital Amount
    Start: 10/31/2004
    604Originator Application Transaction Identifier
    Start: 10/31/2004
    605Orthodontic Treatment Months Count
    Start: 10/31/2004
    606Paid From Part A Medicare Trust Fund Amount
    Start: 10/31/2004
    607Paid From Part B Medicare Trust Fund Amount
    Start: 10/31/2004
    608Paid Service Unit Count
    Start: 10/31/2004
    609Participation Agreement
    Start: 10/31/2004
    610Patient Discharge Facility Type Code
    Start: 10/31/2004
    611Peer Review Authorization Number
    Start: 10/31/2004
    612Per Day Limit Amount
    Start: 10/31/2004
    613Physician Contact Date
    Start: 10/31/2004
    614Physician Order Date
    Start: 10/31/2004
    615Policy Compliance Code
    Start: 10/31/2004
    616Policy Name
    Start: 10/31/2004
    617Postage Claimed Amount
    Start: 10/31/2004
    618PPS-Capital DSH DRG Amount
    Start: 10/31/2004
    619PPS-Capital Exception Amount
    Start: 10/31/2004
    620PPS-Capital FSP DRG Amount
    Start: 10/31/2004
    621PPS-Capital HSP DRG Amount
    Start: 10/31/2004
    622PPS-Capital IME Amount
    Start: 10/31/2004
    623PPS-Operating Federal Specific DRG Amount
    Start: 10/31/2004
    624PPS-Operating Hospital Specific DRG Amount
    Start: 10/31/2004
    625Predetermination of Benefits Identifier
    Start: 10/31/2004
    626Pregnancy Indicator
    Start: 10/31/2004
    627Pre-Tax Claim Amount
    Start: 10/31/2004
    628Pricing Methodology
    Start: 10/31/2004
    629Property Casualty Claim Number
    Start: 10/31/2004
    630Referring CLIA Number
    Start: 10/31/2004
    631Reimbursement Rate
    Start: 10/31/2004
    632Reject Reason Code
    Start: 10/31/2004
    633Related Causes Code (Accident, auto accident, employment)
    Start: 10/31/2004 | Last Modified: 10/17/2010
    634Remark Code
    Start: 10/31/2004
    635Repriced Ambulatory Patient Group Code
    Start: 10/31/2004
    636Repriced Line Item Reference Number
    Start: 10/31/2004
    637Repriced Saving Amount
    Start: 10/31/2004
    638Repricing Per Diem or Flat Rate Amount
    Start: 10/31/2004
    639Responsibility Amount
    Start: 10/31/2004
    640Sales Tax Amount
    Start: 10/31/2004
    642Service Authorization Exception Code
    Start: 10/31/2004
    643Service Line Paid Amount
    Start: 10/31/2004
    644Service Line Rate
    Start: 10/31/2004
    645Service Tax Amount
    Start: 10/31/2004
    646Ship, Delivery or Calendar Pattern Code
    Start: 10/31/2004
    647Shipped Date
    Start: 10/31/2004
    648Similar Illness or Symptom Date
    Start: 10/31/2004
    649Skilled Nursing Facility Indicator
    Start: 10/31/2004
    650Special Program Indicator
    Start: 10/31/2004
    651State Industrial Accident Provider Number
    Start: 10/31/2004
    652Terms Discount Percentage
    Start: 10/31/2004
    653Test Performed Date
    Start: 10/31/2004
    654Total Denied Charge Amount
    Start: 10/31/2004
    655Total Medicare Paid Amount
    Start: 10/31/2004
    656Total Visits Projected This Certification Count
    Start: 10/31/2004
    657Total Visits Rendered Count
    Start: 10/31/2004
    658Treatment Code
    Start: 10/31/2004
    659Unit or Basis for Measurement Code
    Start: 10/31/2004
    660Universal Product Number
    Start: 10/31/2004
    661Visits Prior to Recertification Date Count CR702
    Start: 10/31/2004
    662X-ray Availability Indicator
    Start: 10/31/2004
    663Entity's Group Name. Usage: This code requires use of an Entity Code.
    Start: 10/31/2004 | Last Modified: 07/01/2017
    664Orthodontic Banding Date
    Start: 10/31/2004
    665Surgery Date
    Start: 10/31/2004
    666Surgical Procedure Code
    Start: 10/31/2004
    667Real-time requests not supported by the information holder, do not resubmit.
    Start: 02/28/2005 | Last Modified: 11/01/2024
    668Missing Endodontics treatment history and prognosis
    Start: 06/30/2005
    669Dental service narrative needed.
    Start: 10/31/2005
    670Funds applied from a consumer spending account such as consumer directed/driven health plan (CDHP), Health savings account (H S A) and or other similar accounts
    Start: 06/30/2006 | Last Modified: 02/28/2007
    671Funds may be available from a consumer spending account such as consumer directed/driven health plan (CDHP), Health savings account (H S A) and or other similar accounts
    Start: 06/30/2006 | Last Modified: 02/28/2007
    672Other Payer's payment information is out of balance
    Start: 10/31/2006
    673Patient Reason for Visit
    Start: 10/31/2006
    674Authorization exceeded
    Start: 10/31/2006
    675Facility admission through discharge dates
    Start: 10/31/2006
    676Entity possibly compensated by facility. Usage: This code requires use of an Entity Code.
    Start: 10/31/2004 | Last Modified: 07/01/2017
    677Entity not affiliated. Usage: This code requires use of an Entity Code.
    Start: 10/31/2004 | Last Modified: 07/01/2017
    678Revenue code and patient gender mismatch
    Start: 10/31/2006
    679Submit newborn services on mother's claim
    Start: 10/31/2006
    680Entity's Country. Usage: This code requires use of an Entity Code.
    Start: 10/31/2004 | Last Modified: 07/01/2017
    681Claim currency not supported
    Start: 10/31/2006
    682Cosmetic procedure
    Start: 02/28/2007
    683Awaiting Associated Hospital Claims
    Start: 02/28/2007
    684Rejected. Syntax error noted for this claim/service/inquiry. See Functional or Implementation Acknowledgement for details. Usage: Only for use to reject claims or status requests in transactions that were 'accepted with errors' on a 997 or 999 Acknowledgement.
    Start: 11/05/2007 | Last Modified: 11/01/2024
    685Claim could not complete adjudication in real-time. Claim will continue processing in a batch mode. Do not resubmit.
    Start: 01/27/2008 | Last Modified: 11/01/2024
    686The claim/ encounter has completed the adjudication cycle and the entire claim has been voided
    Start: 01/27/2008
    687Claim predetermination/estimation could not be completed in real-time. Do not resubmit.
    Start: 01/27/2008 | Last Modified: 11/01/2024
    688Present on Admission Indicator for reported diagnosis code(s).
    Start: 01/27/2008
    689Entity was unable to respond within the expected time frame. Usage: This code requires use of an Entity Code.
    Start: 06/01/2008 | Last Modified: 07/01/2017
    690Multiple claims or estimate requests cannot be processed in real-time.
    Start: 06/01/2008 | Last Modified: 11/01/2024
    691Multiple claim status requests cannot be processed in real-time.
    Start: 06/01/2008 | Last Modified: 11/01/2024
    692Contracted funding agreement, subscriber is employed by the provider of services.
    Start: 09/21/2008 | Last Modified: 11/01/2024
    693Amount must be greater than or equal to zero. Usage: At least one other status code is required to identify which amount element is in error.
    Start: 01/25/2009 | Last Modified: 07/01/2017
    694Amount must not be equal to zero. Usage: At least one other status code is required to identify which amount element is in error.
    Start: 01/25/2009 | Last Modified: 07/01/2017
    695Entity's Country Subdivision Code. Usage: This code requires use of an Entity Code.
    Start: 01/25/2009 | Last Modified: 07/01/2017
    696Claim Adjustment Group Code.
    Start: 01/25/2009
    697Invalid Decimal Precision. Usage: At least one other status code is required to identify the data element in error.
    Start: 07/01/2009 | Last Modified: 07/01/2017
    698Form Type Identification
    Start: 07/01/2009
    699Question/Response from Supporting Documentation Form
    Start: 07/01/2009
    700ICD10. Usage: At least one other status code is required to identify the related procedure code or diagnosis code.
    Start: 07/01/2009 | Last Modified: 07/01/2017
    701Initial Treatment Date
    Start: 07/01/2009
    702Repriced Claim Reference Number
    Start: 11/01/2009
    703Advanced Billing Concepts (ABC) code
    Start: 01/24/2010
    704Claim Note Text
    Start: 01/24/2010
    705Repriced Allowed Amount
    Start: 01/24/2010
    706Repriced Approved Amount
    Start: 01/24/2010
    707Repriced Approved Ambulatory Patient Group Amount
    Start: 01/24/2010
    708Repriced Approved Revenue Code
    Start: 01/24/2010
    709Repriced Approved Service Unit Count
    Start: 01/24/2010
    710Line Adjudication Information. Usage: At least one other status code is required to identify the data element in error.
    Start: 01/24/2010 | Last Modified: 07/01/2017
    711Stretcher purpose
    Start: 01/24/2010
    712Obstetric Additional Units
    Start: 01/24/2010
    713Patient Condition Description
    Start: 01/24/2010
    714Care Plan Oversight Number
    Start: 01/24/2010
    715Acute Manifestation Date
    Start: 01/24/2010
    716Repriced Approved DRG Code
    Start: 01/24/2010
    717This claim has been split for processing.
    Start: 01/24/2010
    718Claim/service not submitted within the required timeframe (timely filing).
    Start: 01/24/2010
    719NUBC Occurrence Code(s)
    Start: 01/24/2010
    720NUBC Occurrence Code Date(s)
    Start: 01/24/2010
    721NUBC Occurrence Span Code(s)
    Start: 01/24/2010
    722NUBC Occurrence Span Code Date(s)
    Start: 01/24/2010
    723Drug days supply
    Start: 01/24/2010
    724Drug Quantity
    Start: 01/24/2010 | Last Modified: 11/01/2024
    725NUBC Value Code(s)
    Start: 01/24/2010
    726NUBC Value Code Amount(s)
    Start: 01/24/2010
    727Accident date
    Start: 01/24/2010
    728Accident state
    Start: 01/24/2010
    729Accident description
    Start: 01/24/2010
    730Accident cause
    Start: 01/24/2010
    731Measurement value/test result
    Start: 01/24/2010
    732Information submitted inconsistent with billing guidelines. Usage: At least one other status code is required to identify the inconsistent information.
    Start: 01/24/2010 | Last Modified: 07/01/2017
    733Prefix for entity's contract/member number. Usage: This code requires the use of an Entity Code.
    Start: 01/24/2010 | Last Modified: 11/01/2024
    734Verifying premium payment
    Start: 06/06/2010
    735This service/claim is included in the allowance for another service or claim.
    Start: 06/06/2010
    736A related or qualifying service/claim has not been received/adjudicated.
    Start: 06/06/2010
    737Current Dental Terminology (CDT) Code
    Start: 06/06/2010
    738Home Infusion EDI Coalition (HEIC) Product/Service Code
    Start: 06/06/2010
    739Jurisdiction Specific Procedure or Supply Code
    Start: 06/06/2010
    740Drop-Off Location
    Start: 06/06/2010
    741Entity must be a person. Usage: This code requires use of an Entity Code.
    Start: 06/06/2010 | Last Modified: 07/01/2017
    742Payer Responsibility Sequence Number Code
    Start: 06/06/2010
    743Entity's credential/enrollment information. Usage: This code requires use of an Entity Code.
    Start: 10/17/2010 | Last Modified: 07/01/2017
    744Services/charges related to the treatment of a hospital-acquired condition or preventable medical error.
    Start: 10/17/2010
    745Identifier Qualifier Usage: At least one other status code is required to identify the specific identifier qualifier in error.
    Start: 10/17/2010 | Last Modified: 07/01/2017
    746Duplicate Submission Usage: use only at the information receiver level in the Health Care Claim Acknowledgement transaction.
    Start: 10/17/2010 | Last Modified: 07/01/2017
    747Hospice Employee Indicator
    Start: 10/17/2010
    748Corrected Data Usage: Requires a second status code to identify the corrected data.
    Start: 10/17/2010 | Last Modified: 07/01/2017
    749Date of Injury/Illness
    Start: 10/17/2010
    750Auto Accident State or Province Code
    Start: 10/17/2010 | Last Modified: 01/30/2011
    751Ambulance Pick-up State or Province Code
    Start: 10/17/2010 | Last Modified: 01/30/2011
    752Ambulance Drop-off State or Province Code
    Start: 10/17/2010 | Last Modified: 01/30/2011
    753Co-pay status code.
    Start: 01/30/2011
    754Entity Name Suffix. Usage: This code requires the use of an Entity Code.
    Start: 01/30/2011 | Last Modified: 07/01/2017
    755Entity's primary identifier. Usage: This code requires the use of an Entity Code.
    Start: 01/30/2011 | Last Modified: 07/01/2017
    756Entity's Received Date. Usage: This code requires the use of an Entity Code.
    Start: 01/30/2011 | Last Modified: 07/01/2017
    757Last seen date.
    Start: 01/30/2011
    758Repriced approved HCPCS code.
    Start: 01/30/2011
    759Round trip purpose description.
    Start: 01/30/2011
    760Tooth status code.
    Start: 01/30/2011
    761Entity's referral number. Usage: This code requires the use of an Entity Code.
    Start: 01/30/2011 | Last Modified: 07/01/2017
    762Locum Tenens Provider Identifier. Code must be used with Entity Code 82 - Rendering Provider
    Start: 01/20/2013
    763Ambulance Pickup ZipCode
    Start: 01/20/2013
    764Professional charges are non covered.
    Start: 06/02/2013
    765Institutional charges are non covered.
    Start: 06/02/2013
    766Services were performed during a Health Insurance Exchange (HIX) premium payment grace period.
    Start: 11/01/2013
    767Qualifications for emergent/urgent care
    Start: 01/26/2014
    768Service date outside the accidental injury coverage period.
    Start: 01/26/2014
    769DME Repair or Maintenance
    Start: 06/01/2014
    770Duplicate of a claim processed or in process as a crossover/coordination of benefits claim.
    Start: 09/28/2014
    771Claim submitted prematurely. Please resubmit after crossover/payer to payer COB allotted waiting period.
    Start: 09/28/2014
    772The greatest level of diagnosis code specificity is required.
    Start: 03/01/2016
    773One calendar year per claim.
    Start: 11/01/2016
    774Experimental/Investigational
    Start: 11/01/2016
    775Entity Type Qualifier (Person/Non-Person Entity). Usage: this code requires use of an entity code.
    Start: 07/01/2017
    776Pre/Post-operative care
    Start: 07/01/2017
    777Processed based on multiple or concurrent procedure rules.
    Start: 07/01/2017
    778Non-Compensable incident/event. Usage: To be used for Property and Casualty only.
    Start: 07/01/2017
    779Service submitted for the same/similar service within a set timeframe.
    Start: 11/01/2017
    780Lifetime benefit maximum
    Start: 11/01/2017
    781Claim has been identified as a readmission
    Start: 11/01/2017
    782Second surgical opinion
    Start: 03/01/2018
    783Federal sequestration adjustment
    Start: 11/01/2018
    784Electronic Visit Verification criteria do not match.
    Start: 03/01/2019
    785Missing/Invalid Sterilization/Abortion/Hospital Consent Form.
    Start: 07/01/2019
    786Submit claim to the third party property and casualty automobile insurer.
    Start: 07/01/2019
    787Resubmit a new claim, not a replacement claim.
    Start: 07/01/2019
    788Submit these services to the Pharmacy plan/processor for further consideration/adjudication.
    Start: 07/01/2019 | Last Modified: 11/01/2024
    789Submit these services to the patient's Medical Plan for further consideration.
    Start: 07/01/2019
    790Submit these services to the patient's Dental Plan for further consideration.
    Start: 07/01/2019
    791Submit these services to the patient's Vision Plan for further consideration.
    Start: 07/01/2019
    792Submit these services to the patient's Behavioral Health Plan for further consideration.
    Start: 07/01/2019
    793Submit these services to the patient's Property and Casualty Plan for further consideration.
    Start: 07/01/2019
    794Claim could not complete adjudication in real time. Resubmit as a batch request.
    Start: 11/01/2020
    795Claim submitted prematurely. Please provide the prior payer's final adjudication.
    Start: 11/01/2020
    796Procedure code not valid for date of service.
    Start: 11/01/2021
    798Claim predetermination/estimation could not be completed in real time. Claim requires manual review upon submission. Do not resubmit.
    Start: 08/01/2022
    799Resubmit a replacement claim, not a new claim.
    Start: 08/01/2022
    800Entity's required reporting has been forwarded to the jurisdiction. Usage: This code requires use of an Entity Code. To be used for Property and Casualty only.
    Start: 03/01/2023
    801Entity's required reporting was accepted by the jurisdiction. Usage: This code requires use of an Entity Code. To be used for Property and Casualty only.
    Start: 03/01/2023
    802Entity's required reporting was rejected by the jurisdiction. Usage: This code requires use of an Entity Code. To be used for Property and Casualty only.
    Start: 03/01/2023
    803Provider reporting has been rejected due to non-compliance with the jurisdiction's mandated registration. To be used for Property and Casualty only.
    Start: 03/01/2023
    804Exceeds inquiry limit for batch.
    Start: 07/01/2024
    805Mammography Certification Number
    Start: 07/01/2024
    806Residential county does not match the county of the service location.
    Start: 07/01/2024
    807Health Risk Assessment
    Start: 07/01/2024
    808Manifestation diagnosis code cannot be billed as a Principal Diagnosis.
    Start: 11/01/2024



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