(ASC X12) 1129 Adjustment Reason Code Characteristic
TYPE=ID MIN=1 MAX=2
Specifies an additional characteristic of the adjustment reason
Codes
1 | Primary Disability – Frozen |
2 | Primary Disability – Non-frozen |
3 | Dependent Disability – Frozen |
4 | Dependent Disability – Non-frozen |
5 | Retirement – Frozen |
6 | Retirement – Non-frozen |
7 | Permanent |
8 | Temporary |
9 | Canadian |
10 | Joint |
11 | Deferred |
12 | Eligible |
13 | Applied |
14 | Receiving |
15 | Defense Medical Evaluation |
16 | Delayed Reporting Penalty (Insured) |
17 | Engineering Services |
18 | Expert Test (Trial) |
19 | Expert Fees and Expenses (excluding tests and testimony) |
22 | Fee Schedule Savings |
23 | Fatal |
24 | Permanent Total |
25 | Permanent Total Supplemental |
26 | Permanent Partial Scheduled |
27 | Permanent Partial Unscheduled |
28 | Temporary Total |
29 | Temporary Partial |
30 | Employer Liability |
31 | Permanent Partial Disfigurement |
32 | Employer Paid |
34 | Funeral Expenses |
35 | Penalties |
36 | Interest |
37 | Employer’s Legal Expenses |
38 | Claimant’s Legal Expenses |
39 | Payments to Physicians |
40 | Hospital Costs |
41 | Other Medical |
42 | Vocational Rehabilitation Evaluation |
43 | Vocational Rehabilitation Education |
44 | Other Vocational Rehabilitation |
45 | Total Temporary Catastrophic |
46 | Unknown Payment Type |
57 | Vocational Rehabilitation Maintenance |
58 | Claim Value Recovery |
60 | Deductible Recovery |
61 | Additional Living Expense |
62 | Alternative Dispute Resolution Services |
63 | Anesthesiologist |
64 | Annuity |
65 | Attorney Expenses |
66 | Attorney Fees |
67 | Auto Liability Subrogation |
69 | Not Eligible |
71 | Catastrophic Benefits |
72 | Central Index Bureau Filing Fees |
73 | Chiropractor |
74 | Indemnity Reserves |
75 | Medical Reserves |
76 | Expense Reserves |
77 | Vocational Rehabilitation Reserves |
78 | Indemnity Payments |
79 | Medical Payments |
80 | Expense Payments |
81 | Vocational Rehabilitation Payments |
82 | Claim Payment |
83 | Claim Reserve |
84 | Bodily Injury Payment |
85 | Bodily Injury Reserve |
86 | Property Damage Payment |
87 | Property Damage Reserve |
88 | Comprehensive Payment |
89 | Comprehensive Reserve |
90 | Collision Payment |
91 | Collision Reserve |
92 | Salvage |
93 | Expert Witness Fees |
94 | Claimant Legal Expense |
95 | Claimant Medical Evaluation |
96 | Commercial Photographers |
97 | Mandated Medical Exam |
98 | Death Benefits |
99 | Defense Attorney Fees and Expenses |
A1 | Funeral Benefits |
A2 | Hearing Attendance or Representation Fees |
A3 | Hospital – Inpatient Charges |
A4 | Hospital – Outpatient Charges |
A5 | Hospital Bill Audit |
A6 | Impairment Income Benefits |
A7 | Independent Adjustor Expense |
A8 | Independent Medical Exam |
A9 | Legal Expenses – Miscellaneous |
B1 | Liability Settlement |
B2 | Life Pension |
B3 | Lump Sum Remarriage Payment |
B4 | Lump Sum Settlement Amount |
B5 | Major Case of Individual Case Reporting |
B6 | Medical Equipment |
B7 | Peer Review Board Expenses |
B8 | Medical Management Services |
B9 | Medical Records or Reports |
C1 | Medical Rehabilitation |
C2 | Medical Test (Trial) |
C3 | No-fault benefit or expense (Non-Workers Compensation) |
C4 | Nursing Care |
C5 | Extended Care Facility |
C6 | State Fund – Other |
C7 | Penalties Paid on Medical Benefits |
C8 | Penalties Paid on Indemnity Benefits |
C9 | Pension Indemnity Benefit |
D1 | Permanent Partial Disfigurement |
D2 | Personal Property or Contents |
D3 | Pharmacy |
D4 | Photographs other than Commercial |
D5 | Physiotherapy |
D6 | PPO (Preferred Provider Organization) Fees or Expenses |
D7 | Product Liability Subrogation |
D8 | Property Adjustment |
D9 | Provider Bill Audit Expense |
E1 | Radiology |
E2 | Time and Expense Fees |
E3 | Scheduled Award |
E4 | Social Security |
E5 | State Second Injury Fund |
E6 | State Supplemental Fund |
E7 | Supplemental Permanent Total Benefits |
F1 | Testing Lab |
F2 | Third Party Contribution |
F3 | Transportation – Other |
F4 | Transportation – Medical Treatment |
F5 | Treating or Panel Physician |
F6 | Utilization Review – Hospital |
F7 | Utilization Review – Physician |
F8 | Unallocated Indemnity |
F9 | Unallocated Medical |
G2 | Witness Fees and Expenses – Other than Expert Witness |
G3 | Vocational Rehabilitation Training |
G4 | Appraisal Fees |
G5 | Autopsy Fees |
G6 | Surveillance Special Investigation Fees and Expenses |
G7 | Temporary Income Benefits |
G8 | State Fund – Other |
G9 | Federal Second Injury Fund |
H2 | Federal Supplemental Fund |
H3 | Flat Rate |
Appears in
AD1 | Adjustment Amount |
Categories: