Section title: External Code Lists
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Claim Adjustment Group Codes

974

These codes categorize a payment adjustment.

Maintenance Request Status

The list below shows the status of change requests which are in process.

Each request will be in one of the following statuses:

  1. Received
    The request has been submitted but is not yet under review.
  2. Pending
    Staff has looked at the request to ensure it's a legitimate request (not spam), that it is assigned to the correct CMG, and that all required information is present.
  3. In Process
    The CMG has initiated their decision process.
  4. On Hold
    The CMG has initiated their decision process but cannot complete it at this time.
  5. CMG Approved
    The CMG has considered and approved the request, this does not mean it was approved exactly as submitted, it means maintenance related to the request was approved. Requests in this status will be applied to the next version.
  6. CMG Disapproved
    The CMG has considered and disapproved the request, no maintenance action will occur. Requests in this status are complete/final.
Status Last Reviewed: 11/1/2024
Num. Date Requested Description Type Code Status
317 12/6/2021 Legislative / Regulatory Issues New   In Process
318 8/28/2024 NS=No Surprises Act
GM=Government mandate / legal mandate
SF= statutory fee schedule imposed by law/regulations.		 New   Pending

Maintenance Request Form

Fields marked with an asterisk (*) are required

*The description you are suggesting for a new code or to replace the description for a current code.
*Explain the business scenario or use case when the requested new code would be used, the reason an existing code is no longer appropriate for the code list’s business purpose, or reason the current description needs to be revised.
5/20/2018
COContractual Obligation
Start: 05/20/2018
OAOther Adjustment
Start: 05/20/2018
PIPayor Initiated Reduction
Start: 05/20/2018
PRPatient Responsibility
Start: 05/20/2018