Scrubber Rule for missing Adjustment Reason Codes

Secondary electronic claims must include adjustment reason codes to report the primary payment and adjustments. The scrubber in Claims Manager will remove any claim that contains an insurance adjustment without the reason codes and place it On Hold until corrected.

  • If the primary payment and/or adjustment was posted prior to version 7.0.6065 which included the addition of the Adjustment Code grid, secondary electronic is not an option.
  • For versions after 7.0.6065, if reason codes are missing and the claim has to go electronically, the insurance payment must be deleted from the ledger, corrected in Insurance Payment Posting and then posted again. The claim will also have to be Rebuilt to save changes before submitting electronically.