CAS Claims Adjustment
To supply 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
Code identifying the general category of payment adjustment.
Code identifying the detailed reason the adjustment was made
Monetary amount
CAS03 is the amount of adjustment.
Numeric value of quantity
CAS04 is the units of service being adjusted.
Code identifying the detailed reason the adjustment was made
L050607: If CAS-05 is present, then at least one of CAS-06 or CAS-07 is required
Monetary amount
C0605: If CAS-06 is present, then CAS-05 is required
CAS06 is the amount of the adjustment.
Numeric value of quantity
C0705: If CAS-07 is present, then CAS-05 is required
CAS07 is the units of service being adjusted.
Code identifying the detailed reason the adjustment was made
L080910: If CAS-08 is present, then at least one of CAS-09 or CAS-10 is required
Monetary amount
C0908: If CAS-09 is present, then CAS-08 is required
CAS09 is the amount of the adjustment.
Numeric value of quantity
C1008: If CAS-10 is present, then CAS-08 is required
CAS10 is the units of service being adjusted.
Code identifying the detailed reason the adjustment was made
L111213: If CAS-11 is present, then at least one of CAS-12 or CAS-13 is required
Monetary amount
C1211: If CAS-12 is present, then CAS-11 is required
CAS12 is the amount of the adjustment.
Numeric value of quantity
C1311: If CAS-13 is present, then CAS-11 is required
CAS13 is the units of service being adjusted.
Code identifying the detailed reason the adjustment was made
L141516: If CAS-14 is present, then at least one of CAS-15 or CAS-16 is required
Monetary amount
C1514: If CAS-15 is present, then CAS-14 is required
CAS15 is the amount of the adjustment.
Numeric value of quantity
C1614: If CAS-16 is present, then CAS-14 is required
CAS16 is the units of service being adjusted.
Code identifying the detailed reason the adjustment was made
L171819: If CAS-17 is present, then at least one of CAS-18 or CAS-19 is required
Monetary amount
C1817: If CAS-18 is present, then CAS-17 is required
CAS18 is the amount of the adjustment.
Numeric value of quantity
C1917: If CAS-19 is present, then CAS-17 is required
CAS19 is the units of service being adjusted.