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Adjustment Code Definition

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Manage posting or adjustment codes. These codes define payments and adjustments made to myAvatar MSO from a funding source.

Avatar MSO > System Maintenance > Adjustment Code Definition

Process overview:

  • A report is sent to a funding source from myAvatar MSO which contains all myAvatar MSO approved services for a date range, where payments were made to providers.

  • The funding source sends a report to myAvatar MSO which contains services with adjustments codes that display which services were approved and which were denied (if any).

  • Denied services can be modified and resubmitted for approval.

  1. In the Add or Edit Posting Code field:

  • Select Add to create a posting code.

  • Select Edit to change a posting code's information.

  1. In the Posting Code field, enter the code.

  2. In the Name Of Code field, select the code. Once this form is filed the code number cannot be edited.

  3. In the Code Definition field, enter the code description.

  4. In the Allow General Distribution field:

  • Select Yes to allow the adjustment code to be applied to a group of services.

  • Select No to allow the adjustment code to be applied to an individual service.

  1. In the Adjustment, Payment, Or Transfer field:

  • Select Payment for payment codes.

  • Select Adjustment for codes that adjust a service that has not been paid.

  • Select Transfer for codes that transfer liability from one funding source to another.

  1. In the Allow Funding Source Override field:

  • Select Yes to limit funding sources that can use this code (Exclude Funding Source field).

  • Select No to allow all funding sources to use the code.

  1. In the Exclude Funding Sources field, select the funding sources to prevent from using the code.

  2. In the Error Message For Funding Source Override field, enter the message that displays when an excluded funding source (Exclude Funding Source field) is selected to use the code.

  3. In the Credit Or Debit field:

  • Select Credit if the code applies payment.

  • Select Debit if the code reverses payment.

  1. Is This A Reversal Code field:

  • Select Yes to create a reversal code. Every credit code should have an associated reversal code.

  • Select No to create a posting code.

  1. In the What Code Is It A Reversal For field, select the posting code.

  2. Click File Adjustment Code.

SQL Table

  • SYSTEM.table_adjustment_codes