Code identifying the status of an entire claim as assigned by the payor, claim review organization or repricing organization
Type
ID
Length
Max 2 / Min 1
Codes
<> 1
Processed as Primary
<> 2
Processed as Secondary
<> 3
Processed as Tertiary
<> 4
Denied
<> 5
Pended
<> 6
Approved as amended
<> 7
Approved as submitted
<> 8
Cancelled due to inactivity
<> 9
Pending - under investigation
<> 10
Received, but not in process
<> 11
Rejected, duplicate claim
<> 12
Rejected, please resubmit with corrections
<> 13
Suspended
<> 14
Suspended - incomplete claim
<> 15
Suspended - investigation with field
<> 16
Suspended - return with material
<> 17
Suspended - review pending
<> 18
Suspended Product Registration
<> 19
Processed as Primary, Forwarded to Additional Payer(s)
<> 20
Processed as Secondary, Forwarded to Additional Payer(s)
<> 21
Processed as Tertiary, Forwarded to Additional Payer(s)
<> 22
Reversal of Previous Payment
<> 23
Not Our Claim, Forwarded to Additional Payer(s)
<> 24
Transferred to Proper Carrier
<> 25
Predetermination Pricing Only - No Payment
<> 26
Documentation Claim - No Payment Associated
<> 27
Reviewed
<> 28
Repriced
<> 29
Audited
<> 30
Processed as Conditional
<> 31
Not Our Claim, Unable to Forward
<> 32
Reversal of Previous Payment for Primary Claim
<> 33
Reversal of Previous Payment for Secondary Claim
<> 34
Reversal of Previous Payment of Tertiary Claim
<> 35
Patient/Subscriber Not Recognized
<> AD
Additional
<> AP
Appealed
<> CC
Weekly Certification
<> CL
Closed
<> CP
Open
<> I
Initial
<> RA
Reaudited
<> RB
Reissue
<> RC
Reopened and Closed
<> RD
Redetermination
<> RO
Reopened
