Claim Adjustment Group Code

Reminder: DUA and VRDC access needs to be extended or renewed annually. Read more.

This variable is contained in the following files:

Home Health Agency (Fee-for-Service) Hospice (Fee-for-Service) Inpatient (Fee-for-Service) Outpatient (Fee-for-Service) Skilled Nursing Facility (Fee-for-Service)

SAS Name

CLM_ADJUST_GRP_CD

Claim adjustment group code used to categorize a payment adjustment for a claim or claim line. This field is currently only populated for Direct Contracting (DC), Comprehensive Kidney Care Contracting (CKCC) and Kidney Care First (KCF) model claims.

Comments

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

Code	Code value
CO	Contractual obligation
OA	Other adjustment
PR	Patient responsibility