CRI Claim Report Information

To specify information about the claim being reported

Position: CRI-01 · Element: 875 · Name: Maintenance Type Code · Type: Identifier (ID) · Requirement: Conditional · Min: 3 · Max: 3 · Repeat: -

Code identifying the specific type of item maintenance.

P010708: If either CRI-01, CRI-07 or CRI-08 are present, then the others are required

Position: CRI-02 · Element: 1029 · Name: Claim Status Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 2 · Repeat: -

Code identifying the status of an entire claim as assigned by the payor, claim review organization or repricing organization

Position: CRI-03 · Element: 1203 · Name: Maintenance Reason Code · Type: Identifier (ID) · Requirement: Optional · Min: 2 · Max: 3 · Repeat: -

Code identifying the reason for the maintenance change.

Position: CRI-04 · Element: 1073 · Name: Yes/No Condition or Response Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 1 · Repeat: -

Code indicating a Yes or No condition or response.

CRI04 specifies whether there is an agreement to compensate. A ``Y'' indicates an agreement to compensate with liability. An ``N'' indicates there is no agreement to compensate.

Position: CRI-05 · Element: 594 · Name: Frequency Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 1 · Repeat: -

Code indicating frequency or type of payment.

CRI05 specifies the frequency of the scheduled report.

Position: CRI-06 · Element: 1032 · Name: Claim Filing Indicator Code · Type: Identifier (ID) · Requirement: Mandatory · Min: 1 · Max: 2 · Repeat: -

Code identifying type of claim

Position: CRI-07 · Element: 1250 · Name: Date Time Period Format Qualifier · Type: Identifier (ID) · Requirement: Conditional · Min: 2 · Max: 3 · Repeat: -

Code indicating the date format, time format, or date and time format.

Position: CRI-08 · Element: 1251 · Name: Date Time Period · Type: String (AN) · Requirement: Conditional · Min: 1 · Max: 35 · Repeat: -

Expression of a date, a time, or range of dates, times or dates and times.

CRI08 specifies the effective date of Maintenance Type Code CRI01.