Stream: CARIN IG for Blue Button®
Topic: ExplanationOfBenefit.item.adjudication.reason
John Achoukian (Sep 30 2020 at 22:59):
ExplanationOfBenefit.item.adjudication.reason
For any given service line, which we consider an item, there can be multiple payment explanation codes applied.
The spec allows for one reason.
We see that we can provide multiple adjudication denial reason codes, but there is nowhere to put multiple non-denial adjudication reason codes.
Please advise.
John Achoukian (Oct 02 2020 at 15:21):
@Saul Kravitz Hi Saul - Any feedback on the ExplanationOfBenefit.item.adjudication.reason item? Thanks, John
Saul Kravitz (Oct 05 2020 at 13:36):
@Pat Taylor @Amol Vyas
Pat Taylor (Oct 07 2020 at 20:01):
@John Achoukian Hi John, Are there industry standard code systems for the non-denial reasons? @Saul Kravitz @Amol Vyas
Jason Teeple (Oct 20 2020 at 18:18):
Aren't we using the CARC/RARC Codes? @Pat Taylor
edited my original comment
Pat Taylor (Oct 21 2020 at 17:56):
@Jason Teeple @John Achoukian CARIN uses CARC / RARC codes. The CARCs explain why a payment amount is different from the submitted charges. @Amol Vyas
Last updated: Apr 12 2022 at 19:14 UTC
