Provider Adjustment Reason Codes

Maintence Request Status 7/1/2017 LAST UPDATED

The Provider Adjustment Reason codes are used to report payment adjustments that are not related to a specific claim, bill, or service.

The list below shows the status of change requests which are in process. The list is updated on the first of each month.

Each request will be in one of the following statuses:

  1. Received
    The request has been submitted but is not yet under review.
  2. Triaged
    Staff has looked at the request to ensure it's a legitimate request (not spam), that it is assigned to the correct CMG, and that all required information is present.
  3. In Process
    The CMG has initiated their decision process.
  4. On Hold
    The CMG has initiated their decision process but cannot complete it at this time.
  5. CMG Approved
    The CMG has considered and approved the request, this does not mean it was approved exactly as submitted, it means maintenance related to the request was approved. Requests in this status will be applied to the next version.
  6. CMG Disapproved
    The CMG has considered and disapproved the request, no maintenance action will occur. Requests in this status are complete/final.
Num. Date Requested Description Type Code Status