US · guidance
CMS Pub. 100-04, ch. 27, § 80.1
Disposition Codes
Each reply record will contain a disposition code that indicates the action taken on the
bill by the Host and what action the MAC’s should take next.
Below are the list of common disposition codes applicable to CWF processing
01 -Approved
03 -Cancel Accepted
04 -Accrete History (Action Code ‘07’ or Entry Code ‘09’) Accepted
50 -Not in file
51 -Not in file on CMS batch system
52 -Master Record housed at another CWF site
53 -Record in CMS alpha match
54 -Matched to Cross-referenced HICN
55 -Does not match master record
56 -MBI/HICN mismatch
60 -I/O Error on database
61 -Cross reference/database problem
AA -Auto Adjust error
AB -Transaction caused CICS ABEND
BO -Beneficiary Other Information (HUBO) edits
CI -CICS processing problem
CM -Certified Medical Necessity (HUCM) Edits
CR –A/B Crossover Reject
ER -Consistency Edit Reject
EP -Libby Montana (HUEP) project edits
IV -Intravenous Immune Globulin transaction (HUIV) edits
PA -Prior Authorization transaction (HUPA) edits
RD -End Stage Renal (HURD) transaction edits
SP -Medicare Secondary Payer transaction (HUSP) edits
UR -Utilization Reject
History
(Rev. 4009, Issued: 03-23-18, Effective: 04-23-18, Implementation: 04-23-18)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
b275f9bd34de19f965eb1fe4b7ee40c6580785066013d2db3f1d26253fd80b80
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