01611

Payment Adjustment Code

2020-01-06
Definition: This field contains any payment adjustment due to drugs or medical devices. Refer to User-defined Table 0468 - Payment Adjustment Code in Chapter 2C, Code Tables, for suggested values. This field is defined by CMS or other regulatory agencies
LengthNot specified
5 values
1No payment adjustment
2Designated current drug or biological payment adjustment applies to APC (status indicator G)
3Designated new device payment adjustment applies to APC (status indicator H)
4Designated new drug or new biological payment adjustment applies to APC (status indicator J)
5Deductible not applicable (specific list of HCPCS codes)
22 components
1O-Identifier
2O-Text
3CName of Coding System
4O-Alternate Identifier
5O-Alternate Text
6CName of Alternate Coding System
7C-Coding System Version ID
8O-Alternate Coding System Version ID
9O-Original Text
10O-Second Alternate Identifier
11O-Second Alternate Text
12CName of Second Alternate Coding System
13O-Second Alternate Coding System Version ID
14C-Coding System OID
15O-Value Set OID
16C-Value Set Version ID
17C-Alternate Coding System OID
18O-Alternate Value Set OID
19C-Alternate Value Set Version ID
20C-Second Alternate Coding System OID
21O-Second Alternate Value Set OID
22C-Second Alternate Value Set Version ID