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This variable is contained in the following files:
SAS Name
CLM_RSDL_PYMT_IND_CD
This is a claim level field to the indicator used by CWF claims processing for the purpose of bypassing its normal MSP editing that would otherwise apply to ongoing responsibility for medicals (ORM) or worker's compensation Medicare Set-Aside Arrangements (WCMSA).
| Code | Code value |
|---|---|
| X | Residual Payment |
Normally, CWF does not allow a secondary payment on MSP involving ORM or WCMSA, so the RPI will be used to allow CWF to make an exception to its normal routine.
This field comes from the Claim Residual Payment Indicator Code (CLM-RSDL-PMT-IND-CD) that is present on the first claim record included in the stay. If there is no CLM-RSDL-PMT-IND-CD on the 1st claim, then take the first-round code on any of the other claims that make up the stay.
This field is new in 2015.
Source: NCH