Glossary term
Claim status category code
Short answer
A claim status category code is the top-level status in a 277 response. Codes beginning with A indicate acknowledgment, P means pending, F means finalized, R means the payer is requesting more information, and E signals an error. Each category code is paired with a more specific claim status code that explains the exact reason.
What is the difference between a category code and a status code?
The category code gives the general state of the claim. The claim status code, from a separate list, gives the specific reason, such as waiting on medical records or paid in full.
Where are claim status codes used?
Both code lists are maintained as X12 external code sources and are used in 277 claim status responses and 277CA acknowledgments.
Which terms relate to Claim status category code?
Which guides cover this term?
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