08/24/2021
(ASC X12) 1203 Maintenance Reason Code
TYPE=ID MIN=2 MAX=3
Code identifying the reason for the maintenance change
Codes
| 1 | Divorce |
| 2 | Birth |
| 3 | Death |
| 4 | Retirement |
| 5 | Adoption |
| 6 | Strike |
| 7 | Termination of Benefits |
| 8 | Termination of Employment |
| 9 | Consolidation Omnibus Budget Reconciliation Act (COBRA) |
| 10 | Consolidation Omnibus Budget Reconciliation Act (COBRA) Premium Paid |
| 11 | Surviving Spouse |
| 12 | Lay Off |
| 13 | Leave of Absence |
| 14 | Voluntary Withdrawal |
| 15 | Primary Care Provider (PCP) Change |
| 16 | Quit |
| 17 | Fired |
| 18 | Suspended |
| 19 | Sabbatical |
| 20 | Active |
| 21 | Disability |
| 22 | Plan Change |
| 23 | Furloughed |
| 24 | Resigned |
| 25 | Change in Identifying Data Elements |
| 26 | Declined Coverage |
| 27 | Pre-Enrollment |
| 28 | Initial Enrollment |
| 29 | Benefit Selection |
| 30 | Discrimination Test |
| 31 | Legal Separation |
| 32 | Marriage |
| 33 | Personnel Data |
| 34 | Investment Elections and Contribution Rates |
| 35 | Loan Repayment |
| 36 | Contribution or Plan Allocation |
| 37 | Leave of Absence with Benefits |
| 38 | Leave of Absence without Benefits |
| 39 | Lay Off with Benefits |
| 40 | Lay Off without Benefits |
| 41 | Re-enrollment |
| 42 | New Entity |
| 43 | Change of Location |
| 44 | Change of Telephone Number |
| 45 | Went Out of Business |
| 46 | Current Customer Information File in Error |
| 47 | Account Balance Reporting |
| 48 | Fees Processing |
| 49 | Interfund Transfer |
| 4A | Business Name Change |
| 4B | Business Name Correction |
| 4C | Physical or Mailing Address Correction |
| 50 | Loan Request |
| 51 | Enrollment in Subsequent Benefit Plan |
| 52 | Health Care Facility Change |
| 53 | Name Synonym Add |
| 54 | Sub Location Add |
| 55 | Sub Location Change |
| 56 | Sub Location Expire |
| 57 | Buyout |
| 58 | Merger |
| 59 | Non Payment |
| 60 | Coverage Placed Elsewhere |
| 61 | Duplicate Coverage |
| 62 | Change in Ownership |
| 63 | Business Sold |
| 64 | Underwriting Reason |
| 65 | No Employees, Exposure or Operations |
| 66 | Revocation of Voluntary Market Acceptance |
| 67 | Include Primary Business Management |
| 68 | Exclude Primary Business Management |
| 69 | Failure to Pay Deductible |
| 70 | Misrepresented Information |
| 71 | Rewritten |
| 72 | Adding a Jurisdiction |
| 73 | Deleting a Jurisdiction |
| 75 | Occupational Illness |
| 76 | Change Insured Federal Employer Identification Number (FEIN) |
| 77 | Change Employer Federal Employer Identification Number (FEIN) |
| 78 | Change Employer Unemployment Insurance (UI) Code |
| 79 | Change Policy Number |
| 80 | Modification without a Specific Operating Unit Location in Jurisdiction |
| 81 | Change Policy Effective Date |
| 82 | Change Policy Expiration Date |
| 83 | Change Insurer Federal Employer Identification Number (FEIN) |
| 84 | No Eligible Employees |
| 85 | Reinstatement – Canceled in Error |
| 86 | Change in Insured Information |
| 87 | Change in Employer Information |
| 88 | Parent Identification Change |
| 89 | Change to Expiration Date |
| 90 | Phone Verify Only |
| AA | Dissatisfaction with Office Staff |
| AB | Dissatisfaction with Medical Care/Services Rendered |
| AC | Inconvenient Office Location |
| AD | Dissatisfaction with Office Hours |
| AE | Unable to Schedule Appointments in a Timely Manner |
| AF | Dissatisfaction with Physician’s Referral Policy |
| AG | Less Respect and Attention Time Given than to Other Patients |
| AH | Patient Moved to a New Location |
| AI | No Reason Given |
| AJ | Appointment Times not Met in a Timely Manner |
| XB | Became Medical Only |
| XI | Indemnity |
| XL | Became Lost Time |
| XM | Medical Only |
| XN | Notification Only |
| XT | Transfer |
| ZZ | Mutually Defined |
Appears in
| CRI | Claim Report Information |
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