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Back  RFI # 1445: 835 AdjRsn 78

Formal vs. Informal Help Informal Formal


Michelle Hackett


In testing with Edifecs, we are getting an error when the adjustment quantity is given for reason codes other than 78 (non-covered days/room charge adjustment). TR3 states CAS04/07/10/13/16/19 are required if CAS02/05/08/11/14/17/ is non-covered day. Is quantity in the CAS not allowed for any other reason than non-covered day?


This issue is explicitly addressed in guide 005010X221. The situational rule on the 2100 CAS04 element reads "Required when the CAS02 adjustment reason code is related to non-covered days. If not required by this implementation guide, do not send." A similar note applies to all other Quantity elements within the 2100 loop CAS segment.

Therefore, the CAS quantity within the 2100 loop (position 0200) is restricted to only be used when related to non-covered days. The quantity is not allowed at that location for any other reasons.
Submission 11/3/2011
Status Date 12/19/2011
Status F - Final
Primary References
Document 005010X221
Set ID835
Segment Position0200
Segment IDCAS
Element Position04
Industry NameQuantity