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This variable is contained in the following files:
SAS Name
NCH_CLM_TYPE_CD
The type of claim that was submitted. There are different claim types for each major category of health care provider.
Source: NCH
| Code | Code value |
|---|---|
| 10 | Home Health Agency (HHA) claim |
| 20 | Non swing bed skilled nursing facility (SNF) claim |
| 30 | Swing bed SNF claim |
| 40 | Hospital outpatient claim |
| 50 | Hospice claim |
| 60 | Inpatient claim |
| 71 | Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim |
| 72 | Local carrier DMEPOS claim |
| 81 | Durable medical equipment regional carrier (DMERC); non-DMEPOS claim |
| 82 | DMERC; DMEPOS claim |
This variable may not always indicate the type of service performed; for example, when the claim type code = 60 (inpatient), the services may actually be for post-acute care. Additional information regarding the type of service on the claim can be found in a CCW Technical Guidance document entitled: "Getting Started with Medicare data".
Note that there is a data issue with the incorrect assignment of National Claims History (NCH) claim type codes for 37,962 Part B carrier and DMERC (claim type codes 71,72,81,82) claims processed on
01/27/23 (i.e., the NCH_WKLY_PROC_DT). For nearly all of the affected claims, the NCH_CLM_TYPE_CD was incorrectly assigned an 81 instead of 82; there are also 7 of the total impacted claims where the NCH_CLM_TPYE_CD was incorrectly assigned 71 instead of 72.