PC110

Data Element

Claim Status

Description

Status of the claim header or claim line:

O = Original
A = Adjusted – data on claim has been changed*
B = Back Out/Reversal – total claim dollar amounts will be reduced by the amounts on claim; an adjustment, amendment, or replacement claim is expected to replace claim
D = Delete/Drop – claim line will be dropped from data
M = Amendment – data on claim has been changed*
R = Replacement – data on claim has been changed*
V = Void – total claim dollar amounts will be reduced by the amounts on claim
F = Final Status for Paid Claims (use when the versioning process does not require claim status to identify final claim); use as default

*These values have the same meaning. The values differ to align with submitting entity claims systems in an effort to reduce submitting entity data transformation.

TypeText
Formatchar
Length1
Threshold100%
RequiredRequired
Tip / Notes
Rank071