There use to be explicit and extended definitions of the Health care claim adjustment 
reason codes on the WPC web site, however, when I checked the site, they were not 
there. Does anyone have these definitions? What I am looking for are the GROUP codes. 
(i.e. Patient Responsibility- PR,  Contractual Obligations -CO, Corrections and 
Reversals- CR, Patient Initiated Reductions- PI and OA- Other Adjustments.

Also, I have the VTBCBS mapping and the Utah mapping via Jan Root. I wanted to know if 
there were any repricers or any non-risk entities that have completed the mapping 
crosswalk?

Thank you for your time.

Best regards,

Jim Driscoll
Business Analyst-Software Development
Sloans Lake Managed Care
1355 South Colorado Blvd.
Denver, CO 80222
303.504.5367 direct
303.504.5367 fax
1.800.457.2345



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