Sample CSV File
"Code","Description","Effective Date","Deactivation Date","Last Modified Date","Notes"
"1","Deductible Amount","01/01/1995","","",""
"2","Coinsurance Amount","01/01/1995","","",""
"3","Co-payment Amount","01/01/1995","","",""
"4","The procedure code is inconsistent with the modifier used or a required modifier is missing.","01/01/1995","","",""
"5","The procedure code/bill type is inconsistent with the place of service.","01/01/1995","","",""
"6","The procedure/revenue code is inconsistent with the patient's age.","01/01/1995","","06/30/2002",""
"7","The procedure/revenue code is inconsistent with the patient's gender.","01/01/1995","","06/30/2002",""
"8","The procedure code is inconsistent with the provider type/specialty (taxonomy).","01/01/1995","","06/30/2002",""
"9","The diagnosis is inconsistent with the patient's age.","01/01/1995","","",""
"10","The diagnosis is inconsistent with the patient's gender.","01/01/1995","","02/29/2000",""
"11","The diagnosis is inconsistent with the procedure.","01/01/1995","","",""
"12","The diagnosis is inconsistent with the provider type.","01/01/1995","","",""
"13","The date of death precedes the date of service.","01/01/1995","","",""
"14","The date of birth follows the date of service.","01/01/1995","","",""
"15","Payment adjusted because the submitted authorization number is missing, invalid, or does not apply to the billed services or provider. This change to be effective 4/1/2008: The authorization number is missing, invalid, or does not apply to the billed services or provider.","01/01/1995","","09/30/2007",""
"16","Claim/service lacks information which is needed for adjudication. At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code.)","01/01/1995","","06/30/2006",""