Claim Procedure Code 13 (Encounter)

SAS Name

The code that indicates the procedure(s) performed during the period covered by the institutional claim. There are up to 13 procedures on the claim. The principal procedure is recorded in ICD_PRCDR_CD1, and secondary, tertiary, etc. procedures are in ICD_PRCDR_CD2–13.


The ICD-9-CM codes were named as the HIPPA standard code set for inpatient hospital procedures. For inpatient and skilled nursing claims, health care providers use the International Classification of Diseases version 9 (ICD-9) procedure codes to describe the service provided. Starting in October 2015, the ICD-10 Procedure Coding System (ICD-10-PCS), is used.

HCPCS/CPT codes were named as the standard code set for physician services and other health care services.

Source: Medicare Advantage Organizations (MAOs)