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This variable is contained in the following files:
SAS Name
CLM_NGACO_IND_5_CD
This field represents the benefit enhancement indicator that identifies these are Next Generation (NG) Accountable Care Organization (ACO) claims that qualify for specific claims processing edits.
| Code | Code value |
|---|---|
| 0 | Base record (no enhancements) |
| 1 | Population Based Payments (PBP) |
| 2 | Telehealth |
| 3 | Post Discharge Home Health Visits |
| 4 | 3-Day SNF Waiver |
| 5 | Capitation |
This field comes from the CLM-NG-ACO-IND-5-CD that is present on the first claim record included in the stay. If there is no CLM-NG-ACO-IND-5-CD on the first claim then take the first found code on any of the other claims that make up the stay.
This field is new in 2015.
Source: NCH