RAS Reason Adjustment

To supply Claim Adjustment Reason Codes and amounts as needed for an entire claim or for a particular service within the claim being paid

Position
Element
Name
Type
Requirement
Min
Max
Repeat
RAS01
Monetary Amount
Decimal number (R)
Mandatory
1
18
1
Monetary amount
RAS01 is the amount of adjustment.
RAS02
Claim Adjustment Group Code
Identifier (ID)
Mandatory
1
2
1
Code identifying the general category of payment adjustment
RAS03
Adjustment Reason
Composite (composite)
Mandatory
15
01
Claim Adjustment Reason Code
Identifier (ID)
Mandatory
1
5
-
Code identifying the detailed reason the adjustment was made
02
Code List Qualifier Code
Identifier (ID)
Conditional
1
3
-
Code identifying a specific industry code list
P0203: If either C058-02 or C058-03 is present, then the other is required
C05802 qualifies C05803, C05804, C05805, C05806 and C05807.
03
Industry Code
String (AN)
Conditional
1
30
-
Code indicating a code from a specific industry code list
04
Industry Code
String (AN)
Conditional
1
30
-
Code indicating a code from a specific industry code list
C0403: If C058-04 is present, then C058-03 is required
05
Industry Code
String (AN)
Conditional
1
30
-
Code indicating a code from a specific industry code list
C0504: If C058-05 is present, then C058-04 is required
06
Industry Code
String (AN)
Conditional
1
30
-
Code indicating a code from a specific industry code list
C0605: If C058-06 is present, then C058-05 is required
07
Industry Code
String (AN)
Optional
1
30
-
Code indicating a code from a specific industry code list
C0706: If C058-07 is present, then C058-06 is required
RAS04
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
RAS04 is the units of service being adjusted.

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