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Back  RFI # 196: Multiple CAS segments

Formal vs. Informal Help Informal Formal

Submitter

Nick Miller

Description

Instead of combining multiple adjustments onto one CAS segment, we have been creating individual CAS segments for each claim adjustment reason code. Our payees have accepted the transactions for over a year.

What we want to know is, by doing the segments as we are, are we violating any standards? Mostly, we are interested in the HIPAA standards.

Submitter Assigned Keywords

CAS HIPAA

Response

This issue is explicitly addressed in guide 004010X091 on pages 95 and 148. Notes on those pages read:
A single CAS segment contains six repetitions of the “adjustment trio” composed of adjustment reason code, adjustment amount, and adjustment quantity. These six adjustment trios are used to report up
to six adjustments related to a particular Claim Adjustment Group Code (CAS01). The first adjustment is reported in the first adjustment trio (CAS02-CAS04). If there is a second non-zero adjustment, it is
reported in the second adjustment trio (CAS05-CAS07), and so on through the sixth adjustment trio (CAS17-CAS19).
Submission 2/7/2005
Status Date 4/12/2005
Status F - Final
Primary References
Document 004010X091A1
Section3.1
Page95
Set ID835
Segment IDCAS