Disposition Codes

80.1 - Disposition Codes (Rev. 4009, Issued: 03-23-18, Effective: 04-23-18, Implementation: 04-23-18) Each reply record will contain a disposition code that indicates the action taken on the bill by the Host and what action the MAC’s should take next. Below are the list of common disposition codes applicable to CWF processing 01 -Approved 03 -Cancel Accepted 04 -Accrete History (Action Code ‘07’ or Entry Code ‘09’) Accepted 50 -Not in file 51 -Not in file on CMS batch system 52 -Master Record housed at another CWF site 53 -Record in CMS alpha match 54 -Matched to Cross-referenced HICN 55 -Does not match master record 56 -MBI/HICN mismatch 60 -I/O Error on database 61 -Cross reference/database problem AA -Auto Adjust error AB -Transaction caused CICS ABEND BO -Beneficiary Other Information (HUBO) edits CI -CICS processing problem CM -Certified Medical Necessity (HUCM) Edits CR –A/B Crossover Reject ER -Consistency Edit Reject EP -Libby Montana (HUEP) project edits IV -Intravenous Immune Globulin transaction (HUIV) edits PA -Prior Authorization transaction (HUPA) edits RD -End Stage Renal (HURD) transaction edits SP -Medicare Secondary Payer transaction (HUSP) edits UR -Utilization Reject