What does 98 mean in AAA03?

98 (Experimental Service or Procedure): The requested service is considered experimental or investigational under the plan's medical policy — a validation-level signal that the service falls in a category the plan does not certify through the standard path.

AAA03 — Reject Reason Code (X12 element 901)

98 — Experimental Service or Procedure

Draft — pending verification

This reference entry has not yet been verified against its authoritative source (X12 005010X217 TR3 / element 901 code list — verify against licensed copy). Do not rely on it for production configuration until this notice is removed.

How 98 is used

Returned in AAA03. These typically re-route to medical-policy review rather than ending the conversation; capture and route rather than treating as a terminal error.

Example

A request for a procedure the plan's medical policy classifies as investigational returns AAA03 = 98.

Where it lives in the transaction

98 is a value of AAA03 — Reject Reason Code (X12 element 901), carried in the AAA (Request Validation), 278 response — returned at the loop level where the problem was found of the 278 Health Care Services Review — Response (005010X217). For the payer-side view of how PA Bridge normalizes these codes across X12 and FHIR intake, see the articles section.