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