Prior Authorization Indicator Code

SAS Name
PA_IND_CD

This field identifies the indicator assigned by CMS for each prior authorization program to define the applicable line of business i.e., Part A, Part B, DME, Home Health and Hospice.

Comments

This field comes from the Prior Authorization Indicator Code (CLM-PRIOR-AUTHRZ-IND-SW) that is present on the first claim record included in the stay. If there is no prior authorization indicator switch on the 1st claim record then take the first found code on any of the other claims that make up the stay.

This field is new in October 2014 (not populated through 2018).

Source: NCH

Code Code value
A Part A
B Part B
D DME
H Home Health and Hospice
Followed by a three digit number (e.g., A123)
Null/missing