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Version: v0.0.2

Variable: CLAIM_ADJUSTMENT_GROUP_CODES

const CLAIM_ADJUSTMENT_GROUP_CODES: object

The 4 spec-fixed Claim Adjustment Group Codes. Frozen literal union via as const so consumers compare code === CLAIM_ADJUSTMENT_GROUP_CODES.PR and TypeScript narrows exhaustively.

  • CO - Contractual Obligation. The provider's contracted write-off (e.g. payer fee schedule below billed charges). The PROVIDER eats this. Posting CO to patient responsibility is the wrong-party bug.
  • PR - Patient Responsibility. Patient deductible / coinsurance / copay / non-covered. The PATIENT owes this. This is the patient-statement total.
  • OA - Other Adjustment. Used when neither CO nor PR fits - typically prior-payer payments, COB adjustments, withholding for refund. Use is fact-pattern-specific.
  • PI - Payer Initiated Reductions. Payer-side reduction the provider may not dispute under the contract - e.g. bundling edits, prepayment review reductions.

Type Declaration

CO

readonly CO: "CO" = "CO"

OA

readonly OA: "OA" = "OA"

PI

readonly PI: "PI" = "PI"

PR

readonly PR: "PR" = "PR"

Example

import { CLAIM_ADJUSTMENT_GROUP_CODES } from "@cosyte/x12";
function bucketFor(group: string): "provider" | "patient" | "other" | "payer-edit" | "unknown" {
switch (group) {
case CLAIM_ADJUSTMENT_GROUP_CODES.CO: return "provider";
case CLAIM_ADJUSTMENT_GROUP_CODES.PR: return "patient";
case CLAIM_ADJUSTMENT_GROUP_CODES.OA: return "other";
case CLAIM_ADJUSTMENT_GROUP_CODES.PI: return "payer-edit";
default: return "unknown";
}
}