Adjustment Reason Codes

These codes are used to identify the type and source for why the adjustment is needed.

Adjudication processing error

EDI/Entry error

Contract information loaded Incorrect

Contract- Update information received after effective date of contract

Contract- Incorrect payment percentage applied to claim

Eligibility-Incorrect eligibility information received

Eligibility-Incorrect eligibility information loaded in system

Corrected billing received

Duplicate adjustment request