C058 Adjustment Reason
C058 Adjustment Reason
To provide a reason and related explanation for a Health Care Claim or Service change in payment versus the original submitted charges
Position
Element
Name
Type
Requirement
Min
Max
Repeat
C058-01
Claim Adjustment Reason Code
Identifier (ID)
Mandatory
1
5
-
Code identifying the detailed reason the adjustment was made
C058-02
Code List Qualifier Code
Identifier (ID)
Conditional
1
3
-
Code identifying a specific industry code list
C05802 qualifies C05803, C05804, C05805, C05806 and C05807.
C058-03
Industry Code
String (AN)
Conditional
1
30
-
Code indicating a code from a specific industry code list
C058-04
Industry Code
String (AN)
Conditional
1
30
-
Code indicating a code from a specific industry code list
C058-05
Industry Code
String (AN)
Conditional
1
30
-
Code indicating a code from a specific industry code list
C058-06
Industry Code
String (AN)
Conditional
1
30
-
Code indicating a code from a specific industry code list
C058-07
Industry Code
String (AN)
Optional
1
30
-
Code indicating a code from a specific industry code list