X12 Workbook: Data Segments

NOT FOR IMPLEMENTATION

CRI Claim Report Information

To specify information about the claim being reported

TRANSACTION SETS USED IN:

REF	ELE ID	NAME	RPT	ATTRIBUTES
01	875	Maintenance Type Code		X	ID	3/3
02	1029	Claim Status Code		O	ID	1/2
03	1203	Maintenance Reason Code		O	ID	2/3
04	1073	Yes/No Condition or Response Code		O/Z	ID	1/1
05	594	Frequency Code		O/Z	ID	1/1
06	1032	Claim Filing Indicator Code		M	ID	1/2
07	1250	Date Time Period Format Qualifier		X	ID	2/3
08	1251	Date Time Period		X/Z	AN	1/35
09	1129	Adjustment Reason Code Characteristic		O/Z	ID	1/2
10	9	Late Reason Code		O/Z	ID	2/2
11	1321	Condition Indicator		O/Z	ID	2/3

Adds data element to position 11.

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Syntax Notes
01	P010708 - If either CRI01, CRI07 or CRI08 are present, then the others are required.
09	C0901 - If CRI09 is present, then CRI01 is required.
10	C1001 - If CRI10 is present, then CRI01 is required.
Semantic Notes
04	CRI04 specifies whether there is an agreement to compensate. A "Y" indicates an agreement to compensate with liability; an "N" indicates there is no agreement to compensate.
05	CRI05 specifies the frequency of the scheduled report.
08	CRI08 specifies the effective date of Maintenance Type Code CRI01.
09	CRI09 is the payment adjustment associated with the Maintenance Type Code.
10	CRI10 is the reason the transaction is late.
11	CRI11 indicates Loss Type.

Adds semantic note to position 11.

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DM Index -- Transaction Set Index -- Segment Index -- Composite Index -- Data Element Index -- Code Source Index

NOT FOR IMPLEMENTATION