added gacl config files to upgrade instructions

[openemr.git] / interface / billing / claim_status_codes.php

<?php

$claim_status_codes = array(
 '1'  => xl('Processed as Primary'),
 '2'  => xl('Processed as Secondary'),
 '3'  => xl('Processed as Tertiary'),
 '4'  => xl('Denied'),
 '5'  => xl('Pended'),
 '11' => xl('Received, but not in process'),
 '13' => xl('Suspended'),
 '15' => xl('Suspended - investigation with field'),
 '16' => xl('Suspended - return with material'),
 '17' => xl('Suspended - review pending'),
 '19' => xl('Processed as Primary, Forwarded to Additional Payer(s)'),
 '20' => xl('Processed as Secondary, Forwarded to Additional Payer(s)'),
 '21' => xl('Processed as Tertiary, Forwarded to Additional Payer(s)'),
 '22' => xl('Reversal of Previous Payment'),
 '23' => xl('Not Our Claim, Forwarded to Additional Payer(s)'),
 '25' => xl('Predetermination Pricing Only - No Payment'),
 '27' => xl('Reviewed')

 /****
 // See http://www.wpc-edi.com/codes
 //
 '0' => xl('Cannot provide further status electronically.'),
 '1' => xl('For more detailed information, see remittance advice.'),
 '2' => xl('More detailed information in letter.'),
 '3' => xl('Claim has been adjudicated and is awaiting payment cycle.'),
 '4' => xl('This is a subsequent request for information from the original request.'),
 '5' => xl('This is a final request for information.'),
 '6' => xl('Balance due from the subscriber.'),
 '7' => xl('Claim may be reconsidered at a future date.'),
 '8' => xl('No payment due to contract/plan provisions.'),
 '9' => xl('No payment will be made for this claim.'),
 '10' => xl('All originally submitted procedure codes have been combined.'),
 '11' => xl('Some originally submitted procedure codes have been combined.'),
 '12' => xl('One or more originally submitted procedure codes have been combined.'),
 '13' => xl('All originally submitted procedure codes have been modified.'),
 '14' => xl('Some all originally submitted procedure codes have been modified.'),
 '15' => xl('One or more originally submitted procedure code have been modified.'),
 '16' => xl('Claim/encounter has been forwarded to entity.'),
 '17' => xl('Claim/encounter has been forwarded by third party entity to entity.'),
 '18' => xl('Entity received claim/encounter, but returned invalid status.'),
 '19' => xl('Entity acknowledges receipt of claim/encounter.'),
 '20' => xl('Accepted for processing.'),
 '21' => xl('Missing or invalid information.'),
 '22' => xl('... before entering the adjudication system.'),
 '23' => xl('Returned to Entity.'),
 '24' => xl('Entity not approved as an electronic submitter.'),
 '25' => xl('Entity not approved.'),
 '26' => xl('Entity not found.'),
 '27' => xl('Policy canceled.'),
 '28' => xl('Claim submitted to wrong payer.'),
 '29' => xl('Subscriber and policy number/contract number mismatched.'),
 '30' => xl('Subscriber and subscriber id mismatched.'),
 '31' => xl('Subscriber and policyholder name mismatched.'),
 '32' => xl('Subscriber and policy number/contract number not found.'),
 '33' => xl('Subscriber and subscriber id not found.'),
 '34' => xl('Subscriber and policyholder name not found.'),
 '35' => xl('Claim/encounter not found.'),
 '37' => xl('Predetermination is on file, awaiting completion of services.'),
 '38' => xl('Awaiting next periodic adjudication cycle.'),
 '39' => xl('Charges for pregnancy deferred until delivery.'),
 '40' => xl('Waiting for final approval.'),
 '41' => xl('Special handling required at payer site.'),
 '42' => xl('Awaiting related charges.'),
 '44' => xl('Charges pending provider audit.'),
 '45' => xl('Awaiting benefit determination.'),
 '46' => xl('Internal review/audit.'),
 '47' => xl('Internal review/audit - partial payment made.'),
 '48' => xl('Referral/authorization.'),
 '49' => xl('Pending provider accreditation review.'),
 '50' => xl('Claim waiting for internal provider verification.'),
 '51' => xl('Investigating occupational illness/accident.'),
 '52' => xl('Investigating existence of other insurance coverage.'),
 '53' => xl('Claim being researched for Insured ID/Group Policy Number error.'),
 '54' => xl('Duplicate of a previously processed claim/line.'),
 '55' => xl('Claim assigned to an approver/analyst.'),
 '56' => xl('Awaiting eligibility determination.'),
 '57' => xl('Pending COBRA information requested.'),
 '59' => xl('Non-electronic request for information.'),
 '60' => xl('Electronic request for information.'),
 '61' => xl('Eligibility for extended benefits.'),
 '64' => xl('Re-pricing information.'),
 '65' => xl('Claim/line has been paid.'),
 '66' => xl('Payment reflects usual and customary charges.'),
 '67' => xl('Payment made in full.'),
 '68' => xl('Partial payment made for this claim.'),
 '69' => xl('Payment reflects plan provisions.'),
 '70' => xl('Payment reflects contract provisions.'),
 '71' => xl('Periodic installment released.'),
 '72' => xl('Claim contains split payment.'),
 '73' => xl('Payment made to entity, assignment of benefits not on file.'),
 '78' => xl('Duplicate of an existing claim/line, awaiting processing.'),
 '81' => xl('Contract/plan does not cover pre-existing conditions.'),
 '83' => xl('No coverage for newborns.'),
 '84' => xl('Service not authorized.'),
 '85' => xl('Entity not primary.'),
 '86' => xl('Diagnosis and patient gender mismatch.'),
 '87' => xl('Denied: Entity not found.'),
 '88' => xl('Entity not eligible for benefits for submitted dates of service.'),
 '89' => xl('Entity not eligible for dental benefits for submitted dates of service.'),
 '90' => xl('Entity not eligible for medical benefits for submitted dates of service.'),
 '91' => xl('Entity not eligible/not approved for dates of service.'),
 '92' => xl('Entity does not meet dependent or student qualification.'),
 '93' => xl('Entity is not selected primary care provider.'),
 '94' => xl('Entity not referred by selected primary care provider.'),
 '95' => xl('Requested additional information not received.'),
 '96' => xl('No agreement with entity.'),
 '97' => xl('Patient eligibility not found with entity.'),
 '98' => xl('Charges applied to deductible.'),
 '99' => xl('Pre-treatment review.'),
 '100' => xl('Pre-certification penalty taken.'),
 '101' => xl('Claim was processed as adjustment to previous claim.'),
 '102' => xl('Newborn\'s charges processed on mother\'s claim.'),
 '103' => xl('Claim combined with other claim(s).'),
 '104' => xl('Processed according to plan provisions.'),
 '105' => xl('Claim/line is capitated.'),
 '106' => xl('This amount is not entity\'s responsibility.'),
 '107' => xl('Processed according to contract/plan provisions.'),
 '108' => xl('Coverage has been canceled for this entity.'),
 '109' => xl('Entity not eligible.'),
 '110' => xl('Claim requires pricing information.'),
 '111' => xl('At the policyholder\'s request these claims cannot be submitted electronically.'),
 '112' => xl('Policyholder processes their own claims.'),
 '113' => xl('Cannot process individual insurance policy claims.'),
 '114' => xl('Should be handled by entity.'),
 '115' => xl('Cannot process HMO claims'),
 '116' => xl('Claim submitted to incorrect payer.'),
 '117' => xl('Claim requires signature-on-file indicator.'),
 '118' => xl('TPO rejected claim/line because payer name is missing.'),
 '119' => xl('TPO rejected claim/line because certification information is missing'),
 '120' => xl('TPO rejected claim/line because claim does not contain enough information'),
 '121' => xl('Service line number greater than maximum allowable for payer.'),
 '122' => xl('Missing/invalid data prevents payer from processing claim.'),
 '123' => xl('Additional information requested from entity.'),
 '124' => xl('Entity\'s name, address, phone and id number.'),
 '125' => xl('Entity\'s name.'),
 '126' => xl('Entity\'s address.'),
 '127' => xl('Entity\'s phone number.'),
 '128' => xl('Entity\'s tax id.'),
 '129' => xl('Entity\'s Blue Cross provider id'),
 '130' => xl('Entity\'s Blue Shield provider id'),
 '131' => xl('Entity\'s Medicare provider id.'),
 '132' => xl('Entity\'s Medicaid provider id.'),
 '133' => xl('Entity\'s UPIN'),
 '134' => xl('Entity\'s CHAMPUS provider id.'),
 '135' => xl('Entity\'s commercial provider id.'),
 '136' => xl('Entity\'s health industry id number.'),
 '137' => xl('Entity\'s plan network id.'),
 '138' => xl('Entity\'s site id .'),
 '139' => xl('Entity\'s health maintenance provider id (HMO).'),
 '140' => xl('Entity\'s preferred provider organization id (PPO).'),
 '141' => xl('Entity\'s administrative services organization id (ASO).'),
 '142' => xl('Entity\'s license/certification number.'),
 '143' => xl('Entity\'s state license number.'),
 '144' => xl('Entity\'s specialty license number.'),
 '145' => xl('Entity\'s specialty code.'),
 '146' => xl('Entity\'s anesthesia license number.'),
 '147' => xl('Entity\'s qualification degree/designation (e.g. RN,PhD,MD)'),
 '148' => xl('Entity\'s social security number.'),
 '149' => xl('Entity\'s employer id.'),
 '150' => xl('Entity\'s drug enforcement agency (DEA) number.'),
 '152' => xl('Pharmacy processor number.'),
 '153' => xl('Entity\'s id number.'),
 '154' => xl('Relationship of surgeon & assistant surgeon.'),
 '155' => xl('Entity\'s relationship to patient'),
 '156' => xl('Patient relationship to subscriber'),
 '157' => xl('Entity\'s Gender'),
 '158' => xl('Entity\'s date of birth'),
 '159' => xl('Entity\'s date of death'),
 '160' => xl('Entity\'s marital status'),
 '161' => xl('Entity\'s employment status'),
 '162' => xl('Entity\'s health insurance claim number (HICN).'),
 '163' => xl('Entity\'s policy number.'),
 '164' => xl('Entity\'s contract/member number.'),
 '165' => xl('Entity\'s employer name, address and phone.'),
 '166' => xl('Entity\'s employer name.'),
 '167' => xl('Entity\'s employer address.'),
 '168' => xl('Entity\'s employer phone number.'),
 '169' => xl('Entity\'s employer id.'),
 '170' => xl('Entity\'s employee id.'),
 '171' => xl('Other insurance coverage information (health, liability, auto, etc.).'),
 '172' => xl('Other employer name, address and telephone number.'),
 '173' => xl('Entity\'s name, address, phone, gender, DOB, marital status, employment status and relation to subscriber.'),
 '174' => xl('Entity\'s student status.'),
 '175' => xl('Entity\'s school name.'),
 '176' => xl('Entity\'s school address.'),
 '177' => xl('Transplant recipient\'s name, date of birth, gender, relationship to insured.'),
 '178' => xl('Submitted charges.'),
 '179' => xl('Outside lab charges.'),
 '180' => xl('Hospital s semi-private room rate.'),
 '181' => xl('Hospital s room rate.'),
 '182' => xl('Allowable/paid from primary coverage.'),
 '183' => xl('Amount entity has paid.'),
 '184' => xl('Purchase price for the rented durable medical equipment.'),
 '185' => xl('Rental price for durable medical equipment.'),
 '186' => xl('Purchase and rental price of durable medical equipment.'),
 '187' => xl('Date(s) of service.'),
 '188' => xl('Statement from-through dates.'),
 '189' => xl('Hospital admission date.'),
 '190' => xl('Hospital discharge date.'),
 '191' => xl('Date of Last Menstrual Period (LMP)'),
 '192' => xl('Date of first service for current series/symptom/illness.'),
 '193' => xl('First consultation/evaluation date.'),
 '194' => xl('Confinement dates.'),
 '195' => xl('Unable to work dates.'),
 '196' => xl('Return to work dates.'),
 '197' => xl('Effective coverage date(s).'),
 '198' => xl('Medicare effective date.'),
 '199' => xl('Date of conception and expected date of delivery.'),
 '200' => xl('Date of equipment return.'),
 '201' => xl('Date of dental appliance prior placement.'),
 '202' => xl('Date of dental prior replacement/reason for replacement.'),
 '203' => xl('Date of dental appliance placed.'),
 '204' => xl('Date dental canal(s) opened and date service completed.'),
 '205' => xl('Date(s) dental root canal therapy previously performed.'),
 '206' => xl('Most recent date of curettage, root planing, or periodontal surgery.'),
 '207' => xl('Dental impression and seating date.'),
 '208' => xl('Most recent date pacemaker was implanted.'),
 '209' => xl('Most recent pacemaker battery change date.'),
 '210' => xl('Date of the last x-ray.'),
 '211' => xl('Date(s) of dialysis training provided to patient.'),
 '212' => xl('Date of last routine dialysis.'),
 '213' => xl('Date of first routine dialysis.'),
 '214' => xl('Original date of prescription/orders/referral.'),
 '215' => xl('Date of tooth extraction/evolution.'),
 '216' => xl('Drug information.'),
 '217' => xl('Drug name, strength and dosage form.'),
 '218' => xl('NDC number.'),
 '219' => xl('Prescription number.'),
 '220' => xl('Drug product id number.'),
 '221' => xl('Drug days supply and dosage.'),
 '222' => xl('Drug dispensing units and average wholesale price (AWP).'),
 '223' => xl('Route of drug/myelogram administration.'),
 '224' => xl('Anatomical location for joint injection.'),
 '225' => xl('Anatomical location.'),
 '226' => xl('Joint injection site.'),
 '227' => xl('Hospital information.'),
 '228' => xl('Type of bill for UB-92 claim.'),
 '229' => xl('Hospital admission source.'),
 '230' => xl('Hospital admission hour.'),
 '231' => xl('Hospital admission type.'),
 '232' => xl('Admitting diagnosis.'),
 '233' => xl('Hospital discharge hour.'),
 '234' => xl('Patient discharge status.'),
 '235' => xl('Units of blood furnished.'),
 '236' => xl('Units of blood replaced.'),
 '237' => xl('Units of deductible blood.'),
 '238' => xl('Separate claim for mother/baby charges.'),
 '239' => xl('Dental information.'),
 '240' => xl('Tooth surface(s) involved.'),
 '241' => xl('List of all missing teeth (upper and lower).'),
 '242' => xl('Tooth numbers, surfaces, and/or quadrants involved.'),
 '243' => xl('Months of dental treatment remaining.'),
 '244' => xl('Tooth number or letter.'),
 '245' => xl('Dental quadrant/arch.'),
 '246' => xl('Total orthodontic service fee, initial appliance fee, monthly fee, length of service.'),
 '247' => xl('Line information.'),
 '248' => xl('Accident date, state, description and cause.'),
 '249' => xl('Place of service.'),
 '250' => xl('Type of service.'),
 '251' => xl('Total anesthesia minutes.'),
 '252' => xl('Authorization/certification number.'),
 '253' => xl('Procedure/revenue code for service(s) rendered. Please use codes 454 or 455.'),
 '254' => xl('Primary diagnosis code.'),
 '255' => xl('Diagnosis code.'),
 '256' => xl('DRG code(s).'),
 '257' => xl('ADSM-III-R code for services rendered.'),
 '258' => xl('Days/units for procedure/revenue code.'),
 '259' => xl('Frequency of service.'),
 '260' => xl('Length of medical necessity, including begin date.'),
 '261' => xl('Obesity measurements.'),
 '262' => xl('Type of surgery/service for which anesthesia was administered.'),
 '263' => xl('Length of time for services rendered.'),
 '264' => xl('Number of liters/minute & total hours/day for respiratory support.'),
 '265' => xl('Number of lesions excised.'),
 '266' => xl('Facility point of origin and destination - ambulance.'),
 '267' => xl('Number of miles patient was transported.'),
 '268' => xl('Location of durable medical equipment use.'),
 '269' => xl('Length/size of laceration/tumor.'),
 '270' => xl('Subluxation location.'),
 '271' => xl('Number of spine segments.'),
 '272' => xl('Oxygen contents for oxygen system rental.'),
 '273' => xl('Weight.'),
 '274' => xl('Height.'),
 '275' => xl('Claim.'),
 '276' => xl('UB-92/HCFA-1450/HCFA-1500 claim form.'),
 '277' => xl('Paper claim.'),
 '278' => xl('Signed claim form.'),
 '279' => xl('Itemized claim.'),
 '280' => xl('Itemized claim by provider.'),
 '281' => xl('Related confinement claim.'),
 '282' => xl('Copy of prescription.'),
 '283' => xl('Medicare worksheet.'),
 '284' => xl('Copy of Medicare ID card.'),
 '285' => xl('Vouchers/explanation of benefits (EOB).'),
 '286' => xl('Other payer\'s Explanation of Benefits/payment information.'),
 '287' => xl('Medical necessity for service.'),
 '288' => xl('Reason for late hospital charges.'),
 '289' => xl('Reason for late discharge.'),
 '290' => xl('Pre-existing information.'),
 '291' => xl('Reason for termination of pregnancy.'),
 '292' => xl('Purpose of family conference/therapy.'),
 '293' => xl('Reason for physical therapy.'),
 '294' => xl('Supporting documentation.'),
 '295' => xl('Attending physician report.'),
 '296' => xl('Nurse\'s notes.'),
 '297' => xl('Medical notes/report.'),
 '298' => xl('Operative report.'),
 '299' => xl('Emergency room notes/report.'),
 '300' => xl('Lab/test report/notes/results.'),
 '301' => xl('MRI report.'),
 '302' => xl('Refer to codes 300 for lab notes and 311 for pathology notes'),
 '303' => xl('Physical therapy notes. Please use code 297:6O (6 \'OH\' - not zero)'),
 '304' => xl('Reports for service.'),
 '305' => xl('X-ray reports/interpretation.'),
 '306' => xl('Detailed description of service.'),
 '307' => xl('Narrative with pocket depth chart.'),
 '308' => xl('Discharge summary.'),
 '309' => xl('Code was duplicate of code 299'),
 '310' => xl('Progress notes for the six months prior to statement date.'),
 '311' => xl('Pathology notes/report.'),
 '312' => xl('Dental charting.'),
 '313' => xl('Bridgework information.'),
 '314' => xl('Dental records for this service.'),
 '315' => xl('Past perio treatment history.'),
 '316' => xl('Complete medical history.'),
 '317' => xl('Patient\'s medical records.'),
 '318' => xl('X-rays.'),
 '319' => xl('Pre/post-operative x-rays/photographs.'),
 '320' => xl('Study models.'),
 '321' => xl('Radiographs or models.'),
 '322' => xl('Recent fm x-rays.'),
 '323' => xl('Study models, x-rays, and/or narrative.'),
 '324' => xl('Recent x-ray of treatment area and/or narrative.'),
 '325' => xl('Recent fm x-rays and/or narrative.'),
 '326' => xl('Copy of transplant acquisition invoice.'),
 '327' => xl('Periodontal case type diagnosis and recent pocket depth chart with narrative.'),
 '328' => xl('Speech therapy notes. Please use code 297:6R'),
 '329' => xl('Exercise notes.'),
 '330' => xl('Occupational notes.'),
 '331' => xl('History and physical.'),
 '332' => xl('Authorization/certification (include period covered).'),
 '333' => xl('Patient release of information authorization.'),
 '334' => xl('Oxygen certification.'),
 '335' => xl('Durable medical equipment certification.'),
 '336' => xl('Chiropractic certification.'),
 '337' => xl('Ambulance certification/documentation.'),
 '338' => xl('Home health certification. Please use code 332:4Y'),
 '339' => xl('Enteral/parenteral certification.'),
 '340' => xl('Pacemaker certification.'),
 '341' => xl('Private duty nursing certification.'),
 '342' => xl('Podiatric certification.'),
 '343' => xl('Documentation that facility is state licensed and Medicare approved as a surgical facility.'),
 '344' => xl('Documentation that provider of physical therapy is Medicare Part B approved.'),
 '345' => xl('Treatment plan for service/diagnosis'),
 '346' => xl('Proposed treatment plan for next 6 months.'),
 '347' => xl('Refer to code 345 for treatment plan and code 282 for prescription'),
 '348' => xl('Chiropractic treatment plan.'),
 '349' => xl('Psychiatric treatment plan. Please use codes 345:5I, 5J, 5K, 5L, 5M, 5N, 5O (5 \'OH\' - not zero), 5P'),
 '350' => xl('Speech pathology treatment plan. Please use code 345:6R'),
 '351' => xl('Physical/occupational therapy treatment plan. Please use codes 345:6O (6 \'OH\' - not zero), 6N'),
 '352' => xl('Duration of treatment plan.'),
 '353' => xl('Orthodontics treatment plan.'),
 '354' => xl('Treatment plan for replacement of remaining missing teeth.'),
 '355' => xl('Has claim been paid?'),
 '356' => xl('Was blood furnished?'),
 '357' => xl('Has or will blood be replaced?'),
 '358' => xl('Does provider accept assignment of benefits?'),
 '359' => xl('Is there a release of information signature on file?'),
 '360' => xl('Is there an assignment of benefits signature on file?'),
 '361' => xl('Is there other insurance?'),
 '362' => xl('Is the dental patient covered by medical insurance?'),
 '363' => xl('Will worker\'s compensation cover submitted charges?'),
 '364' => xl('Is accident/illness/condition employment related?'),
 '365' => xl('Is service the result of an accident?'),
 '366' => xl('Is injury due to auto accident?'),
 '367' => xl('Is service performed for a recurring condition or new condition?'),
 '368' => xl('Is medical doctor (MD) or doctor of osteopath (DO) on staff of this facility?'),
 '369' => xl('Does patient condition preclude use of ordinary bed?'),
 '370' => xl('Can patient operate controls of bed?'),
 '371' => xl('Is patient confined to room?'),
 '372' => xl('Is patient confined to bed?'),
 '373' => xl('Is patient an insulin diabetic?'),
 '374' => xl('Is prescribed lenses a result of cataract surgery?'),
 '375' => xl('Was refraction performed?'),
 '376' => xl('Was charge for ambulance for a round-trip?'),
 '377' => xl('Was durable medical equipment purchased new or used?'),
 '378' => xl('Is pacemaker temporary or permanent?'),
 '379' => xl('Were services performed supervised by a physician?'),
 '380' => xl('Were services performed by a CRNA under appropriate medical direction?'),
 '381' => xl('Is drug generic?'),
 '382' => xl('Did provider authorize generic or brand name dispensing?'),
 '383' => xl('Was nerve block used for surgical procedure or pain management?'),
 '384' => xl('Is prosthesis/crown/inlay placement an initial placement or a replacement?'),
 '385' => xl('Is appliance upper or lower arch & is appliance fixed or removable?'),
 '386' => xl('Is service for orthodontic purposes?'),
 '387' => xl('Date patient last examined by entity'),
 '388' => xl('Date post-operative care assumed'),
 '389' => xl('Date post-operative care relinquished'),
 '390' => xl('Date of most recent medical event necessitating service(s)'),
 '391' => xl('Date(s) dialysis conducted'),
 '392' => xl('Date(s) of blood transfusion(s)'),
 '393' => xl('Date of previous pacemaker check'),
 '394' => xl('Date(s) of most recent hospitalization related to service'),
 '395' => xl('Date entity signed certification/recertification'),
 '396' => xl('Date home dialysis began'),
 '397' => xl('Date of onset/exacerbation of illness/condition'),
 '398' => xl('Visual field test results'),
 '399' => xl('Report of prior testing related to this service, including dates'),
 '400' => xl('Claim is out of balance'),
 '401' => xl('Source of payment is not valid'),
 '402' => xl('Amount must be greater than zero'),
 '403' => xl('Entity referral notes/orders/prescription'),
 '404' => xl('Specific findings, complaints, or symptoms necessitating service'),
 '405' => xl('Summary of services'),
 '406' => xl('Brief medical history as related to service(s)'),
 '407' => xl('Complications/mitigating circumstances'),
 '408' => xl('Initial certification'),
 '409' => xl('Medication logs/records (including medication therapy)'),
 '410' => xl('Explain differences between treatment plan and patient\'s condition'),
 '411' => xl('Medical necessity for non-routine service(s)'),
 '412' => xl('Medical records to substantiate decision of non-coverage'),
 '413' => xl('Explain/justify differences between treatment plan and services rendered.'),
 '414' => xl('Need for more than one physician to treat patient'),
 '415' => xl('Justify services outside composite rate'),
 '416' => xl('Verification of patient\'s ability to retain and use information'),
 '417' => xl('Prior testing, including result(s) and date(s) as related to service(s)'),
 '418' => xl('Indicating why medications cannot be taken orally'),
 '419' => xl('Individual test(s) comprising the panel and the charges for each test'),
 '420' => xl('Name, dosage and medical justification of contrast material used for radiology procedure'),
 '421' => xl('Medical review attachment/information for service(s)'),
 '422' => xl('Homebound status'),
 '423' => xl('Prognosis'),
 '424' => xl('Statement of non-coverage including itemized bill'),
 '425' => xl('Itemize non-covered services'),
 '426' => xl('All current diagnoses'),
 '427' => xl('Emergency care provided during transport'),
 '428' => xl('Reason for transport by ambulance'),
 '429' => xl('Loaded miles and charges for transport to nearest facility with appropriate services'),
 '430' => xl('Nearest appropriate facility'),
 '431' => xl('Provide condition/functional status at time of service'),
 '432' => xl('Date benefits exhausted'),
 '433' => xl('Copy of patient revocation of hospice benefits'),
 '434' => xl('Reasons for more than one transfer per entitlement period'),
 '435' => xl('Notice of Admission'),
 '436' => xl('Short term goals'),
 '437' => xl('Long term goals'),
 '438' => xl('Number of patients attending session'),
 '439' => xl('Size, depth, amount, and type of drainage wounds'),
 '440' => xl('why non-skilled caregiver has not been taught procedure'),
 '441' => xl('Entity professional qualification for service(s)'),
 '442' => xl('Modalities of service'),
 '443' => xl('Initial evaluation report'),
 '444' => xl('Method used to obtain test sample'),
 '445' => xl('Explain why hearing loss not correctable by hearing aid'),
 '446' => xl('Documentation from prior claim(s) related to service(s)'),
 '447' => xl('Plan of teaching'),
 '448' => xl('Invalid billing combination. See STC12 for details. This code should only be used to indicate an inconsistency between two or more data elements on the claim. A detailed explanation is required in STC12 when this code is used.'),
 '449' => xl('Projected date to discontinue service(s)'),
 '450' => xl('Awaiting spend down determination'),
 '451' => xl('Preoperative and post-operative diagnosis'),
 '452' => xl('Total visits in total number of hours/day and total number of hours/week'),
 '453' => xl('Procedure Code Modifier(s) for Service(s) Rendered'),
 '454' => xl('Procedure code for services rendered.'),
 '455' => xl('Revenue code for services rendered.'),
 '456' => xl('Covered Day(s)'),
 '457' => xl('Non-Covered Day(s)'),
 '458' => xl('Coinsurance Day(s)'),
 '459' => xl('Lifetime Reserve Day(s)'),
 '460' => xl('NUBC Condition Code(s)'),
 '461' => xl('NUBC Occurrence Code(s) and Date(s)'),
 '462' => xl('NUBC Occurrence Span Code(s) and Date(s)'),
 '463' => xl('NUBC Value Code(s) and/or Amount(s)'),
 '464' => xl('Payer Assigned Claim Control Number'),
 '465' => xl('Principal Procedure Code for Service(s) Rendered'),
 '466' => xl('Entities Original Signature'),
 '467' => xl('Entity Signature Date'),
 '468' => xl('Patient Signature Source'),
 '469' => xl('Purchase Service Charge'),
 '470' => xl('Was service purchased from another entity?'),
 '471' => xl('Were services related to an emergency?'),
 '472' => xl('Ambulance Run Sheet'),
 '473' => xl('Missing or invalid lab indicator'),
 '474' => xl('Procedure code and patient gender mismatch'),
 '475' => xl('Procedure code not valid for patient age'),
 '476' => xl('Missing or invalid units of service'),
 '477' => xl('Diagnosis code pointer is missing or invalid'),
 '478' => xl('Claim submitter\'s identifier (patient account number) is missing'),
 '479' => xl('Other Carrier payer ID is missing or invalid'),
 '480' => xl('Other Carrier Claim filing indicator is missing or invalid'),
 '481' => xl('Claim/submission format is invalid.'),
 '482' => xl('Date Error, Century Missing'),
 '483' => xl('Maximum coverage amount met or exceeded for benefit period.'),
 '484' => xl('Business Application Currently Not Available'),
 '485' => xl('More information available than can be returned in real time mode. Narrow your current search criteria.'),
 '486' => xl('Principle Procedure Date'),
 '487' => xl('Claim not found, claim should have been submitted to/through \'entity\''),
 '488' => xl('Diagnosis code(s) for the services rendered.'),
 '489' => xl('Attachment Control Number'),
 '490' => xl('Other Procedure Code for Service(s) Rendered'),
 '491' => xl('Entity not eligible for encounter submission'),
 '492' => xl('Other Procedure Date'),
 '493' => xl('Version/Release/Industry ID code not currently supported by information holder'),
 '494' => xl('Real-Time requests not supported by the information holder, resubmit as batch request'),
 '495' => xl('Requests for re-adjudication must reference the newly assigned payer claim control number for this previously adjusted claim. Correct the payer claim control number and re-submit.'),
 '496' => xl('Submitter not approved for electronic claim submissions on behalf of this entity'),
 '497' => xl('Sales tax not paid'),
 '498' => xl('Maximum leave days exhausted'),
 '499' => xl('No rate on file with the payer for this service for this entity'),
 '500' => xl('Entity\'s Postal/Zip Code'),
 '501' => xl('Entity\'s State/Province'),
 '502' => xl('Entity\'s City'),
 '503' => xl('Entity\'s Street Address'),
 '504' => xl('Entity\'s Last Name'),
 '505' => xl('Entity\'s First Name'),
 '506' => xl('Entity is changing processor/clearinghouse. This claim must be submitted to the new processor/clearinghouse'),
 '507' => xl('HCPCS'),
 '508' => xl('ICD9'),
 '509' => xl('E-Code'),
 '510' => xl('Future date'),
 '511' => xl('Invalid character'),
 '512' => xl('Length invalid for receiver\'s application system'),
 '513' => xl('HIPPS Rate Code for services Rendered'),
 '514' => xl('Entities Middle Name'),
 '515' => xl('Managed Care review'),
 '516' => xl('Adjudication or Payment Date'),
 '517' => xl('Adjusted Repriced Claim Reference Number'),
 '518' => xl('Adjusted Repriced Line item Reference Number'),
 '519' => xl('Adjustment Amount'),
 '520' => xl('Adjustment Quantity'),
 '521' => xl('Adjustment Reason Code'),
 '522' => xl('Anesthesia Modifying Units'),
 '523' => xl('Anesthesia Unit Count'),
 '524' => xl('Arterial Blood Gas Quantity'),
 '525' => xl('Begin Therapy Date'),
 '526' => xl('Bundled or Unbundled Line Number'),
 '527' => xl('Certification Condition Indicator'),
 '528' => xl('Certification Period Projected Visit Count'),
 '529' => xl('Certification Revision Date'),
 '530' => xl('Claim Adjustment Indicator'),
 '531' => xl('Claim Disproportinate Share Amount'),
 '532' => xl('Claim DRG Amount'),
 '533' => xl('Claim DRG Outlier Amount'),
 '534' => xl('Claim ESRD Payment Amount'),
 '535' => xl('Claim Frequency Code'),
 '536' => xl('Claim Indirect Teaching Amount'),
 '537' => xl('Claim MSP Pass-through Amount'),
 '538' => xl('Claim or Encounter Identifier'),
 '539' => xl('Claim PPS Capital Amount'),
 '540' => xl('Claim PPS Capital Outlier Amount'),
 '541' => xl('Claim Submission Reason Code'),
 '542' => xl('Claim Total Denied Charge Amount'),
 '543' => xl('Clearinghouse or Value Added Network Trace'),
 '544' => xl('Clinical Laboratory Improvement Amendment'),
 '545' => xl('Contract Amount'),
 '546' => xl('Contract Code'),
 '547' => xl('Contract Percentage'),
 '548' => xl('Contract Type Code'),
 '549' => xl('Contract Version Identifier'),
 '550' => xl('Coordination of Benefits Code'),
 '551' => xl('Coordination of Benefits Total Submitted Charge'),
 '552' => xl('Cost Report Day Count'),
 '553' => xl('Covered Amount'),
 '554' => xl('Date Claim Paid'),
 '555' => xl('Delay Reason Code'),
 '556' => xl('Demonstration Project Identifier'),
 '557' => xl('Diagnosis Date'),
 '558' => xl('Discount Amount'),
 '559' => xl('Document Control Identifier'),
 '560' => xl('Entity\'s Additional/Secondary Identifier'),
 '561' => xl('Entity\'s Contact Name'),
 '562' => xl('Entity\'s National Provider Identifier (NPI)'),
 '563' => xl('Entity\'s Tax Amount'),
 '564' => xl('EPSDT Indicator'),
 '565' => xl('Estimated Claim Due Amount'),
 '566' => xl('Exception Code'),
 '567' => xl('Facility Code Qualifier'),
 '568' => xl('Family Planning Indicator'),
 '569' => xl('Fixed Format Information'),
 '570' => xl('Free Form Message Text'),
 '571' => xl('Frequency Count'),
 '572' => xl('Frequency Period'),
 '573' => xl('Functional Limitation Code'),
 '574' => xl('HCPCS Payable Amount Home Health'),
 '575' => xl('Homebound Indicator'),
 '576' => xl('Immunization Batch Number'),
 '577' => xl('Industry Code'),
 '578' => xl('Insurance Type Code'),
 '579' => xl('Investigational Device Exemption Identifier'),
 '580' => xl('Last Certification Date'),
 '581' => xl('Last Worked Date'),
 '582' => xl('Lifetime Psychiatric Days Count'),
 '583' => xl('Line Item Charge Amount'),
 '584' => xl('Line Item Control Number'),
 '585' => xl('Line Item Denied Charge or Non-covered Charge'),
 '586' => xl('Line Note Text'),
 '587' => xl('Measurement Reference Identification Code'),
 '588' => xl('Medical Record Number'),
 '589' => xl('Medicare Assignment Code'),
 '590' => xl('Medicare Coverage Indicator'),
 '591' => xl('Medicare Paid at 100% Amount'),
 '592' => xl('Medicare Paid at 80% Amount'),
 '593' => xl('Medicare Section 4081 Indicator'),
 '594' => xl('Mental Status Code'),
 '595' => xl('Monthly Treatment Count'),
 '596' => xl('Non-covered Charge Amount'),
 '597' => xl('Non-payable Professional Component Amount'),
 '598' => xl('Non-payable Professional Component Billed Amount'),
 '599' => xl('Note Reference Code'),
 '600' => xl('Oxygen Saturation Qty'),
 '601' => xl('Oxygen Test Condition Code'),
 '602' => xl('Oxygen Test Date'),
 '603' => xl('Old Capital Amount'),
 '604' => xl('Originator Application Transaction Identifier'),
 '605' => xl('Orthodontic Treatment Months Count'),
 '606' => xl('Paid From Part A Medicare Trust Fund Amount'),
 '607' => xl('Paid From Part B Medicare Trust Fund Amount'),
 '608' => xl('Paid Service Unit Count'),
 '609' => xl('Participation Agreement'),
 '610' => xl('Patient Discharge Facility Type Code'),
 '611' => xl('Peer Review Authorization Number'),
 '612' => xl('Per Day Limit Amount'),
 '613' => xl('Physician Contact Date'),
 '614' => xl('Physician Order Date'),
 '615' => xl('Policy Compliance Code'),
 '616' => xl('Policy Name'),
 '617' => xl('Postage Claimed Amount'),
 '618' => xl('PPS-Capital DSH DRG Amount'),
 '619' => xl('PPS-Capital Exception Amount'),
 '620' => xl('PPS-Capital FSP DRG Amount'),
 '621' => xl('PPS-Capital HSP DRG Amount'),
 '622' => xl('PPS-Capital IME Amount'),
 '623' => xl('PPS-Operating Federal Specific DRG Amount'),
 '624' => xl('PPS-Operating Hospital Specific DRG Amount'),
 '625' => xl('Predetermination of Benefits Identifier'),
 '626' => xl('Pregnancy Indicator'),
 '627' => xl('Pre-Tax Claim Amount'),
 '628' => xl('Pricing Methodology'),
 '629' => xl('Property Casualty Claim Number'),
 '630' => xl('Referring CLIA Number'),
 '631' => xl('Reimbursement Rate'),
 '632' => xl('Reject Reason Code'),
 '633' => xl('Related Causes Code'),
 '634' => xl('Remark Code'),
 '635' => xl('Repriced Approved Ambulatory Patient Group'),
 '636' => xl('Repriced Line Item Reference Number'),
 '637' => xl('Repriced Saving Amount'),
 '638' => xl('Repricing Per Diem or Flat Rate Amount'),
 '639' => xl('Responsibility Amount'),
 '640' => xl('Sales Tax Amount'),
 '641' => xl('Service Adjudication or Payment Date'),
 '642' => xl('Service Authorization Exception Code'),
 '643' => xl('Service Line Paid Amount'),
 '644' => xl('Service Line Rate'),
 '645' => xl('Service Tax Amount'),
 '646' => xl('Ship, Delivery or Calendar Pattern Code'),
 '647' => xl('Shipped Date'),
 '648' => xl('Similar Illness or Symptom Date'),
 '649' => xl('Skilled Nursing Facility Indicator'),
 '650' => xl('Special Program Indicator'),
 '651' => xl('State Industrial Accident Provider Number'),
 '652' => xl('Terms Discount Percentage'),
 '653' => xl('Test Performed Date'),
 '654' => xl('Total Denied Charge Amount'),
 '655' => xl('Total Medicare Paid Amount'),
 '656' => xl('Total Visits Projected This Certification Count'),
 '657' => xl('Total Visits Rendered Count'),
 '658' => xl('Treatment Code'),
 '659' => xl('Unit or Basis for Measurement Code'),
 '660' => xl('Universal Product Number'),
 '661' => xl('Visits Prior to Recertification Date Count CR702'),
 '662' => xl('X-ray Availability Indicator'),
 '663' => xl('Entity\'s Group Name'),
 '664' => xl('Orthodontic Banding Date'),
 '665' => xl('Surgery Date'),
 '666' => xl('Surgical Procedure Code'),
 '667' => xl('Real-Time requests not supported by the information holder, do not resubmit'),
 '668' => xl('Missing Endodontics treatment history and prognosis'),
 '669' => xl('Dental service narrative needed.')
 ****/
);
?>