ASC X12 004010

1383 Claim Submission Reason Code
TYPE=ID MIN=2 MAX=2

Code identifying reason for claim submission


00       Original
01       Cancellation
02       Corrected and Verified Original Claim
03       Corrected and Verified Final Claim
05       Replace
07       Duplicate
08       Pre-Determination
09       Encounter
15       Resubmission
16       Proposed
17       Cancel to be Reissued
18       Reissue
20       Final Transmission
22       Information Copy
27       Verify
28       Late Charges
29       Adjustment
PB       Predetermination of Dental Benefits