Is California using only the latest approved ANSI adjustment reason codes only?
No, the California DWC/WCIS has adopted the ANSI adjustment reason codes in the IAIABC Implementation Guide for Medical Bill Payment Records, July 4, 2002. The DWC\WCIS has also determined that the use of newer code values is “optional” for the sender and will accept newer codes values for the medical code sets. The “optional” requirement makes it essential that the sender and receiver have the same code sets to minimize the 058 error in the 824 detailed acknowledgements. Therefore if a trading partner plans to utilize newer code values than the code values required by the IAIABC and the California DWC\WCIS, the trading partner should institute a procedure with the DWC\WCIS to communicate what newer code values will be utilize within each and every medical code set.
