What additional claim data is required for adjustments?
• The correct type of bill for an adjustment should end with “7”. Examples: 117, 217, 717, etc. If using FISS to adjust the claim, the system automatically updates the adjustment with the appropriate type of bill. • A Claim Change Reason Code (CCRC) is entered in the first available Condition Codes field (FL 18-28). A listing of CCRCs used for claims adjustment is available in the Claims Correction section of the FISS Reference Guide. • Enter the Document Control Number (DCN) of the claim you are adjusting in FL 64. This information can be found in the “DCN” field on MAP171D or on the Remittance Advice (RA) you received when the original claim processed. If using FISS to adjust the claim, the system automatically populates the DCN field of the adjustment with the original claim’s DCN. For more information about accessing MAP171D, see the instructions for using the “Claims (Option 12)” option in the Inquiry Menu section of the FISS Reference Guide. • Explain why you are submitting the a
