Search Data Variables

Monthly Medicare deductible payments payments

Annual Medicare payments (For Part D, it's the sum of monthly cvrd_d_plan_pd_amt )

Monthly Medicare payments (For Part D, it's the cvrd_d_plan_pd_amt ; also includes Medicare Advantage premiums), (based on claim through date)

Medication Dosage Form Code

The physical form of a dose of medication, such as a capsule or injection.

Medispan code

MEDI-SPAN THERAPEUTIC CLASSIFICATION SYSTEM CODE. USER NOTE: THIS IS MEDI-SPAN MASTER DRUG DATA BASE (MDDB) DATA ELEMENT "GENERIC PRODUCT INDICATOR" FROM POSITIONS 17-30 IN THE GENERIC PRODUCT (G1) RECORD, PREVIOUSLY REFERRED TO AS THE "G017" RECORD. THE MDDB PRODUCT VERSION 8, APRIL 2003 WAS USED.

MEDPAR Active Cross Reference Indicator

This field is derived from the third position of the provider number that is present on the first claim record included in the stay.

MedPAR Admitting Diagnosis Version Code (ICD-9 or ICD-10)

Effective with Version 'J', the code used to indicate if the admitting diagnosis code (variable called AD_DGNS) is ICD-9 or ICD-10.

MEDPAR Beneficiary Claim Account Number

MEDPAR Beneficiary Identification Code

The BIC reported on the first claim record included in the stay, representing the values existing on the CWF beneficiary master record on the date the CWF host site processed the claim.

MEDPAR Beneficiary Primary Payer Code

The code indicating the type of payer who has primary responsibility for the payment of the Medicare beneficiary's claims related to the stay.

MEDPAR Beneficiary Total Coinsurance Day Count

The count of the total number of coinsurance days involved with the beneficiary's stay in a facility.

MEDPAR Blood Administration Charge Amount

The charge amount (rounded to whole dollars) for blood storage and processing related to the beneficiary's stay.

MEDPAR Bundled Adjustment Amount

This field represents the amount (rounded to whole dollars) the claim was reduced by. This field only applies to providers participating in the CMMI model 1 bundled payment program and the adjustment is calculated off the base operating DRG amount field. See CMMI webpage for details on the Model 1 bundled payment program. http://innovation.cms.gov/initiatives/bundled-payments/

MEDPAR Care Improvement Model Code

The code used to identify that the care improvement model is being used for bundling payments. The valid value for care improvement model 1 is '61'. The valid value for care improvement model 2 is '62'. The valid value for care improvement model 3 is '63'. The valid value for care improvement model 4 is '64'. The value is also reflected in the demonstration trailer.

MedPAR Claim Inpatient Initial MS-DRG Code

This field comes from the Claim Inpatient Initial MS DRG Code field (CLM-IP-INITL-MS-DRG-CD) that is present on the first NCH claim record included in the stay. If there is no CLM-IP-INITL-MS-DRG-CD on the 1st claim, then take the first found code on any of the other claims that make up the stay.

MedPAR Claim Model Reimbursement Amount

This field contains the "Net Reimbursement Amount" of what Medicare would have paid for Global Budget Services from a hospital participating in the particular model. If the claim only includes global services, the reimbursement amount (CLM_PMT_AMT) will reflect $0 (zero). If the claim includes global services and non-global services, the reimbursement amount will reflect the amount Medicare actually paid for the non-global services.

MEDPAR Claim Present on Admission Diagnosis Code Count

Effective with Version 'J', the count of the number of Present on Admission (POA) codes reported on the Inpatient/SNF claim. The purpose of this count is to indicate how many claim POA diagnosis trailers are present.

MedPAR Claim Representative Payee (RP) Indicator Code

This is a claim level field to designate bypassing of the prior authorization processing for claims with a representative payee when an 'R' is present in the field.

MedPAR Claim Residual Payment Indicator Code

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).

MEDPAR Diagnosis Code

The diagnosis code identifying the beneficiary's principal or other diagnosis (including E code).

NOTE: Prior to Version H, the principal diagnosis code was not stored with the 'OTHER' diagnosis codes. During the Version H conversion the CLM_PRNCPAL_DGNS_CD was added as the first occurrence.

NOTE1: Effective with Version 'J', this field has been expanded from 5 bytes to 7 bytes to accommodate the future implementation of ICD-10.

NOTE2: Effective with Version 'J', the diagnosis E codes are stored in a separate trailer (CLM_DGNS_E_GRP).

OCCURS MIN: 0 OCCURS MAX: 25

MedPAR Diagnosis Code 2

The diagnosis code in the 2nd position identifying the conditions(s) for which the beneficiary was receiving care.

MedPAR Diagnosis Code 3

The diagnosis code in the 3rd position identifying the conditions(s) for which the beneficiary was receiving care

MedPAR Diagnosis Code 4

The diagnosis code in the 4th position identifying the conditions(s) for which the beneficiary was receiving care

MedPAR Diagnosis Code 5

The diagnosis code in the 5th position identifying the conditions(s) for which the beneficiary was receiving care.

MedPAR Diagnosis Code 6

The diagnosis code in the 6th position identifying the conditions(s) for which the beneficiary was receiving care.

MedPAR Diagnosis Code 7

The diagnosis code in the 7th position identifying the conditions(s) for which the beneficiary was receiving care.

MedPAR Diagnosis Code 8

The diagnosis code in the 8th position identifying the conditions(s) for which the beneficiary was receiving care

MedPAR Diagnosis Code 9

The diagnosis code in the 9th position identifying the conditions(s) for which the beneficiary was receiving care.

MEDPAR Diagnosis E Code Count

Effective with Version 'J', the count of the number of diagnosis E codes reported on the Inpatient/SNF claim. The purpose of this count is to indicate how many diagnosis E trailers are present.

MEDPAR Diagnosis E Code Present on Admission Indicator

Effective with Version 'J', the code used to identify the Present on Admission (POA) indicator code associated with the diagnosis E codes.

MedPAR Diagnosis Present on Admission Indicator 10