08/24/2021
(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 |
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