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The appropriate code indicating the disposition of the third party billing. If no TPL code is reported, this field must equal spaces. Valid TPL status codes are:
01 - TPL Adjudicated - Total Payment Shown: TPL Status Code 01 is to be reported when payment has been received from individual third party resource. The amount of payment received must be reported in the TPL amount field.
02 - TPL Adjudicated - Individual Not Covered: TPL Status Code 02 is to be reported when advised by the third party resource that the individual was not insured at the time goods or services were provided.
03 - TPL Adjudicated - Service Not Covered: TPL Status Code 03 is to be reported when advised by the third party resource that goods or services provided are not covered.
04 - TPL Adjudicated - Spend-Down Met: TPL Status Code 04 is to be reported when the individual's Form 2432, Split Billing Transmittal shows $0 liability.
05 - Client not covered: TPL Status Code 05 is to be reported when a client informs the clinic that the third party resource identified on the Medical Eligibility Card is not in force.
06 - Services not covered: TPL Status Code 06 is to be reported when the clinic determines that the identified resource is not applicable to the service provided.
07 - Third Party Adjudication Pending: TPL Status Code 07 may be reported when an invoice has been submitted to the third party and reasonable follow-up efforts to obtain payment have failed.
10 - Deductible Not Met: TPL Status Code 10 is to be reported when the clinic has been informed by the third party resource that nonpayment of the service was because the deductible was not met.
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