Alzheimer's Disease and Related Disorders or Senile Dementia Mid-Year Indicator

SAS Name
ALZH_DEMEN_MID

This code specifies whether the beneficiary met the chronic condition algorithm criteria on July 1 of the specified reference period.

Comments

The CCW’s chronic condition flags require beneficiaries to satisfy both claims criteria (a minimum number/type of claims that have the proper diagnosis codes and occurred within a specified time period) and coverage criteria (FFS Part A and Part B coverage during the entire specified time period).

For Alzheimer's disease and related disorders or senile dementia, beneficiaries must have at least one inpatient, SNF, home health, Part B institutional, or Part B noninstitutional (carrier) claim with a related code in any position during the 3-year reference period.

The CCW’s criteria were developed after reviewing validated algorithms from the research literature and criteria used by other federal data sources. You can find more detailed information on the criteria on the CCW website: https://www.ccwdata.org/web/guest/condition-categories

Source: CCW (derived)

ResDAC Comments
From CY 2017 to CY 2021, the MBSF: Chronic Conditions segment also has a newer (CC30) version. Mid-year indicators are not available in the CC30 version.
Code Code value
0 Beneficiary did not meet claims criteria or have sufficient fee-for-service (FFS)
coverage
1 Beneficiary met claims criteria but did not have sufficient FFS coverage
2 Beneficiary did not meet claims criteria but had sufficient FFS coverage
3 Beneficiary met claims criteria and had sufficient FFS coverage