NCH Claim Type Code

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

Comments

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.

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