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Variable: CLM_DISP_CD

Claim Disposition Code

Description:

Code indicating the disposition or outcome of the processing of the claim record.

Values

This variable is coded, and will contain one of the following values.

Value Description
1 DEBIT ACCEPTED
2 DEBIT ACCEPTED (AUTOMATIC ADJUSTMENT) APPLICABLE THROUGH 4/4/93
3 CANCEL ACCEPTED
4 OUTPATIENT HISTORY ONLY ACCEPTED
50 BENEFICIARY NOT IN FILE
51 TRUE NOT IN FILE
52 MASTER RECORD AT ANOTHER CWF SITE
53 RECORD IN CMS ALPHA MATCH
54 CROSS-REFERENCE HIC
55 NAME/SEX MIS-MATCH
57 BENEFICIARY RECORD ARCHIVED, ONLY SKELETON EXISTS
58 BENEFICIARY RECORD BLOCKED FOR CROSS-REFERENCE
59 BENEFICIARY RECORD FROZEN FOR CLERICAL CORRECTION
60 ABEND ERROR
61 CROSS-REFERENCE/DATA BASE PROBLEM
AA AUTOMATIC ADJUSTMENT
AB TRANSACTION CAUSED CICS ABNORMAL END OF JOB
BT HISTORY CLAIM NOT PRESENT TO SUPPORT SPELL OF ILLNESS
CI CICS PROCESSING ERROR
CR CROSSOVER REJECT
ER CONSISTENCY EDIT REJECT
RD TRANSACTION ERROR
RT RETRIEVE PENDING
SV SECURITY VIOLATION
UR UTILIZATION REJECT
~ MISSING
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