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
1 | No payment adjustment |
2 | Designated current drug or biological payment adjustment applies to APC (status indicator G) |
3 | Designated new device payment adjustment applies to APC (status indicator H) |
4 | Designated new drug or new biological payment adjustment applies to APC (status indicator J) |
5 | Deductible not applicable (specific list of HCPCS codes) |
22 components
| 1 | O | - | Identifier | |
| 2 | O | - | Text | |
| 3 | C | Name of Coding System | ||
| 4 | O | - | Alternate Identifier | |
| 5 | O | - | Alternate Text | |
| 6 | C | Name of Alternate Coding System | ||
| 7 | C | - | Coding System Version ID | |
| 8 | O | - | Alternate Coding System Version ID | |
| 9 | O | - | Original Text | |
| 10 | O | - | Second Alternate Identifier | |
| 11 | O | - | Second Alternate Text | |
| 12 | C | Name of Second Alternate Coding System | ||
| 13 | O | - | Second Alternate Coding System Version ID | |
| 14 | C | - | Coding System OID | |
| 15 | O | - | Value Set OID | |
| 16 | C | - | Value Set Version ID | |
| 17 | C | - | Alternate Coding System OID | |
| 18 | O | - | Alternate Value Set OID | |
| 19 | C | - | Alternate Value Set Version ID | |
| 20 | C | - | Second Alternate Coding System OID | |
| 21 | O | - | Second Alternate Value Set OID | |
| 22 | C | - | Second Alternate Value Set Version ID |