This code system http://hl7.org/fhir/v2/0468 defines the following codes:

CodeDisplay
1No payment adjustment
2Designated current drug or biological payment adjustment applies to APC (status indicator G)
3Designated new device payment adjustment applies to APC (status indicator H)
4Designated new drug or new biological payment adjustment applies to APC (status indicator J)
5Deductible not applicable (specific list of HCPCS codes)