# Claim edit: Missing adjustment reason code

> Stedi now rejects 837P professional, 837D dental, and 837I institutional claims that include an adjustment amount or quantity without a corresponding adjustment reason code.

Published Apr 22, 2026

Product: Claim edits

Stedi now rejects [837P professional](https://www.stedi.com/docs/healthcare/submit-professional-claims), [837D dental](https://www.stedi.com/docs/healthcare/submit-dental-claims), and [837I institutional](https://www.stedi.com/docs/healthcare/submit-institutional-claims) claims that include an adjustment amount or quantity without a corresponding adjustment reason code.

## How the edit works

In a healthcare claim, an [adjustment](https://www.stedi.com/blog/why-era-payments-dont-match-claim-charges) is a dollar amount that reduces what the payer owes the provider. Adjustments can cover things like a contractual write-off or the patient's responsibility, such as a co-pay or deductible.

Payers apply adjustments during adjudication and return them, along with other payment information, to the provider in an [Electronic Remittance Advice (ERA)](https://www.stedi.com/docs/healthcare/claim-responses-overview). Adjustments are provided at both the claim and service-line level.

In the ERA, each adjustment's dollar amount is paired with a [Claim Adjustment Reason Code (CARC)](https://x12.org/codes/claim-adjustment-reason-codes). The reason code explains why the adjustment was made.

When billing a secondary or tertiary payer – a process called coordination of benefits (COB) – the provider or their billing system copies the prior payer's adjustments onto the claim.

Each adjustment has a reason code, a dollar amount, and an optional quantity. Not all three are required, but if an amount or quantity is present, the reason code must be too.

**Claim-level adjustment reason code**

| **Claim type**                                                                          | **JSON API field**                                                                                                                                                                                                                                                                                                                 | **X12 element**                                                                                              |
| --------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------ |
| [837P professional](https://www.stedi.com/docs/healthcare/submit-professional-claims)   | [`claimInformation.otherSubscriberInformation[].claimLevelAdjustments[].adjustmentDetails[].adjustmentReasonCode`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-claims#body.claimInformation.otherSubscriberInformation.claimLevelAdjustments.adjustmentDetails.adjustmentReasonCode)                       | `CAS-02`, `CAS-05`, `CAS-08`, `CAS-11`, `CAS-14`, and `CAS-17` of Loop `2320` (Other Subscriber Information) |
| [837D dental](https://www.stedi.com/docs/healthcare/submit-dental-claims)               | [`claimInformation.otherSubscriberInformation[].claimLevelAdjustments[].adjustmentDetails[].adjustmentReasonCode`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-dental-claims#body.claimInformation.otherSubscriberInformation.claimLevelAdjustments.adjustmentDetails.adjustmentReasonCode)                | `CAS-02`, `CAS-05`, `CAS-08`, `CAS-11`, `CAS-14`, and `CAS-17` of Loop `2320` (Other Subscriber Information) |
| [837I institutional](https://www.stedi.com/docs/healthcare/submit-institutional-claims) | [`claimInformation.otherSubscriberInformation.claimLevelAdjustments[].claimAdjustmentDetails[].adjustmentReasonCode`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-institutional-claims#body.claimInformation.otherSubscriberInformation.claimLevelAdjustments.claimAdjustmentDetails.adjustmentReasonCode) | `CAS-02`, `CAS-05`, `CAS-08`, `CAS-11`, `CAS-14`, and `CAS-17` of Loop `2320` (Other Subscriber Information) |

**Service line-level adjustment reason code**

| **Claim type**                                                                          | **JSON API field**                                                                                                                                                                                                                                                                                                                                          | **X12 element**                                                                                               |
| --------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------- |
| [837P professional](https://www.stedi.com/docs/healthcare/submit-professional-claims)   | [`claimInformation.serviceLines[].lineAdjudicationInformation[].claimAdjustmentInformation[].adjustmentDetails[].adjustmentReasonCode`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-claims#body.claimInformation.serviceLines.lineAdjudicationInformation.claimAdjustmentInformation.adjustmentDetails.adjustmentReasonCode)        | `CAS-02`, `CAS-05`, `CAS-08`, `CAS-11`, `CAS-14`, and `CAS-17` of Loop `2430` (Line Adjudication Information) |
| [837D dental](https://www.stedi.com/docs/healthcare/submit-dental-claims)               | [`claimInformation.serviceLines[].lineAdjudicationInformation[].claimAdjustmentInformation[].adjustmentDetails[].adjustmentReasonCode`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-dental-claims#body.claimInformation.serviceLines.lineAdjudicationInformation.claimAdjustmentInformation.adjustmentDetails.adjustmentReasonCode) | `CAS-02`, `CAS-05`, `CAS-08`, `CAS-11`, `CAS-14`, and `CAS-17` of Loop `2430` (Line Adjudication Information) |
| [837I institutional](https://www.stedi.com/docs/healthcare/submit-institutional-claims) | [`claimInformation.serviceLines[].lineAdjudicationInformation[].lineAdjustment[].claimAdjustmentDetails[].adjustmentReasonCode`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-institutional-claims#body.claimInformation.serviceLines.lineAdjudicationInformation.lineAdjustment.claimAdjustmentDetails.adjustmentReasonCode)        | `CAS-02`, `CAS-05`, `CAS-08`, `CAS-11`, `CAS-14`, and `CAS-17` of Loop `2430` (Line Adjudication Information) |

If the amount or quantity is copied without the corresponding reason code, the payer can't process the adjustment and will reject the claim.

This [edit](https://www.stedi.com/docs/healthcare/claim-edits-and-repairs#edits) catches the issue before the claim reaches the payer. It prevents payer rejections, which are slower and delay payment for the provider.

## Rejection errors

If you submit a claim using Stedi's [Claim Submission API endpoints](https://www.stedi.com/docs/healthcare/intro-to-claim-submission#api-claim-submission) and the claim fails the edit, you'll get back an error response in real time. The response includes details in the `errors` array.

```jsonc
{
  "errors": [
    {
      "code": "33",
      "description": "Missing Adjustment Reason Code. When an adjustment amount or quantity is present on the claim then a corresponding adjustment reason code is required. Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}
```

If you submit a claim using [SFTP](https://www.stedi.com/docs/healthcare/submit-claims-sftp-connection) and the claim fails the edit, Stedi will reject the claim with a [277CA claim acknowledgment](https://www.stedi.com/docs/healthcare/claim-responses-overview#277ca-claim-acknowledgment). The acknowledgment will include a related [claim status category code](https://x12.org/codes/claim-status-category-codes), [claim status code](https://x12.org/codes/claim-status-codes), and error message.

```jsx
STC*A6>521*[DATE]*U*[AMOUNT]********Missing Adjustment Reason Code. When an adjustment amount or quantity is present on the claim then a corresponding adjustment reason code is required. Correct and resubmit.~
```