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This variable is contained in the following files:
SAS Name
CLM_FINL_ACTN_IND
This field is stored in the CMS Integrated Data Repository (IDR) as the final action indicator; however, CMS has verified that for 2015 encounter records, this field should not be used to identify the final version of the record. Note that the term “final action” is used differently in encounter data, compared to fee-for-service (FFS) claims.
| Code | Code value |
|---|---|
| Y | Final action and the claim is not voided |
| N | Subsequent adjustments to the claim exist or the final action was to void the claim |
Duplicate services across multiple final action records may exist, and users should make appropriate adjustments when identifying distinct services. Additional information regarding identification of distinct services – or identification of populations appears in the Medicare Encounter Data User Guide.
Final action records are only indicative of the latest accepted record within a claim family that has been linked by the Medicare Advantage Organization (MAO) and may not be indicative of risk adjustment eligibility.
Source: CMS Integrated Data Repository (IDR)