Occurrence Code T-MSIS Analytic Files (TAF) Claims Research Identifiable Files (RIFs), CCW Codebook, V1, November 2019 01 THRU 09 = Accident 10 THRU 19 = Medical condition 20 THRU 39 = Insurance related 40 THRU 69 = Service related A1 - G3 = Miscellaneous 01 = Accident /Medical Coverage- accident-related injury for which there is medical payment coverage. Provide the date of accident/injury 02 = No-fault insurance involved, including auto accident/other - The date of an accident where the state has applicable no-fault liability laws, (i.e., legal basis for settlement without admission or proof of guilt) 03 = Accident/tort liability - The date of an accident resulting from a third party's action that may involve a civil court process in an attempt to require payment by the third party, other than no-fault liability. 04 = Accident/Employment related - The date of an accident relating to the patient's employment 05 = Accident/No Medical or Liability coverage - Code indicating accident related injury for which there is no medical payment or third-party liability coverage 06 = Crime victim - Code indicating the date on which a medical condition resulted from alleged criminal action committed by one or more parties 07 = Reserved for national assignment. 08 = Reserved for national assignment. 09 = Start of Infertility Treatment Cycle - Code indicating the start of infertility treatment cycle 10 = Last Menstrual Period - Code indicating the date of the last menstrual period. ONLY applies when patient is being treated for maternity related condition. 11 = Onset of symptoms/illness - The date the patient first became aware of symptoms/illness. 12 = Date of onset for a chronically dependent individual (CDI) – (Home Health claims only.) Code indicates the date the patient/bene became a chronically dependent individual. This is the first month of the 3-month period immediately prior to eligibility under Respite Care Benefit. 13 = Reserved for national assignment. 14 = Reserved for national assignment. 15 = Reserved for national assignment. 16 = Date of Last Therapy - Code indicates the last day of therapy services (e.g., physical, occupational or speech therapy). 17 = Date outpatient occupational therapy plan established or last reviewed - Code indicating the date an occupational therapy plan was established or last reviewed. 18 = Date of retirement (patient/bene) - Code indicates the date of retirement for the patient/bene. 19 = Date of retirement spouse - Code indicates the date of retirement for the patient's spouse. 20 = Guarantee of payment began - (Part A hospital claims only.) Date on which the hospital begins claiming payment under the guarantee of payment provision. 21 = UR notice received – (Part A SNF claims only.) Code indicating the date of receipt by the SNF of the UR committee's finding that the admission or future stay was not medically necessary. 22 = Active care ended - The date on which a covered level of care ended in a SNF or general hospital, or date active care ended in a psychiatric or tuberculosis hospital or date on which patient was released on a trial basis from a residential facility. Code is not required if code "21" is used. 23 = Cancellation of Hospice benefits - The date of cancellation of hospice election period. For FI Use Only. Providers Do Not Report. 24 = Date insurance denied - The date of receipt of the insurer's denial of coverage (by a higher priority payer). 25 = Date benefits terminated by primary payer - The date on which coverage (including worker's compensation benefits or no-fault coverage) is no longer available to the patient. 26 = Date skilled nursing facility (SNF) bed available - The date on which a SNF bed became available to a hospital inpatient who required only SNF level of care. 27 = Date of Hospice Certification or Re-Certification -- code indicates the date of certification or recertification of the hospice benefit period, beginning with the first two initial benefit periods of 90 days each and the subsequent 60-day benefit periods. 28 = Date comprehensive outpatient rehabilitation facility (CORF) plan established or last reviewed - Code indicating the date a comprehensive outpatient rehabilitation plan was established or last reviewed. 29 = Date OPT plan established or last reviewed - the date a plan of treatment was established for outpatient physical therapy. 30 = Date speech pathology plan treatment established or last reviewed - The date a speech pathology plan of treatment was established or last reviewed. 31 = Date bene notified of intent to bill (accommodations) - The date of the notice provided to the patient by the hospital stating that he no longer required a covered level of inpatient care. 32 = Date bene notified of intent to bill (procedures or treatment) - The date of the notice provided to the patient by the hospital stating requested care (diagnostic procedures or treatments) is not considered reasonable or necessary. 33 = First day of the Medicare coordination period for ESRD bene - The first day of the Medicare coordination period during which Medicare benefits are secondary to benefits payable under an EGHP. Required only for ESRD beneficiaries. 34 = Date of election of extended care facilities - The date the guest elected to receive extended care services (used by Religious Nonmedical Health Care Institutions only). 35 = Date treatment started for physical therapy - The date services were initiated by the billing provider for physical therapy. 36 = Date of Inpatient hospital discharge for a covered transplant procedure(s) - The date of discharge for a hospital stay in which the patient received a covered transplant procedure. Entered on bills for which the hospital is billing for immunosuppressive drugs. NOTE: When the patient received a covered and a non-covered transplant, the covered transplant predominates. 37 = The date of inpatient hospital discharge when patient received a non-covered transplant procedure - The date of discharge for an inpatient hospital stay during which the patient received a noncovered transplant procedure. Entered on bills for which the hospital is billing for immunosuppressive drugs. Hospital is billing for immunosuppressive drugs. 38 = Date treatment started for home IV therapy - Date the patient was first treated in his home for IV therapy. 39 = Date discharged on a continuous course of IV therapy - Date the patient was discharged from the hospital on a continuous course of IV therapy. 40 = Scheduled date of admission - The date on which a patient will be admitted as an inpatient to the hospital. (This code may only be used on an outpatient claim.) 41 = Date of First Test for Pre-admission Testing - The date on which the first outpatient diagnostic test was performed as part of a pre-admission testing (PAT) program. This code may only be used if a date of admission was scheduled prior to the administration of the test(s). 42 = Date of discharge - (Hospice claims only.) The date on which a beneficiary terminated their election to receive hospice benefits from the facility rendering the bill. 43 = Scheduled Date of Canceled Surgery - date which ambulatory surgery was scheduled. 44 = Date treatment started for occupational therapy - The date the provider initiated services for occupational therapy. 45 = Date treatment started for speech therapy - The date the provider initiated services for speech therapy. 46 = Date treatment started for cardiac rehabilitation - The date the provider initiated services for cardiac rehabilitation. 47 = Date Cost Outlier Status Begins - code indicates that this is the first day the cost outlier threshold is reached. For Medicare purposes, a bene must have regular coinsurance and/or lifetime reserve days available beginning on this date to allow coverage of additional daily charges for the purpose of making cost outlier payments. 48 - 49= Payer codes - Code reserved for internal use only by third party payers. CMS assigns as needed for your use. Providers will not report it. 50-69 = Reserved for state assignment A1 = Birthdate, Insured A - The birthdate of the individual in whose name the insurance is carried. A2 = Effective date, Insured A policy - A code indicating the first date insurance is in force. A3 = Benefits exhausted - Code indicating the last date for which benefits are available and after which no payment can be made to payer A. A4 = Split Bill Date - Date patient became Medicaid eligible due to medically needy spend down (sometimes referred to as “Split Bill Date”). B1 = Birthdate, Insured B - The birthdate of the individual in whose name the insurance is carried. B2 = Effective date, Insured B policy - A code indicating the first date insurance is in force. B3 = Benefits exhausted - code indicating the last date for which benefits are available and after which no payment can be made to payer B. C1 = Birthdate, Insured C - The birthdate of the individual in whose name the insurance is carried. C2 = Effective date, Insured C policy - A code indicating the first date insurance is in force. C3 = Benefits exhausted - Code indicating the last date for which benefits are available and after which no payment can be made to payer C. E1 = Birthdate, Insured D - The birthdate of the individual in whose name the insurance is carried. E2 = Effective date, Insured D policy - A code indicating the first date insurance is in force. E3 = Benefits exhausted - Code indicating the last date for which benefits are available and after which no payment can be made to payer D. F1 = Birthdate, Insured E - The birthdate of the individual in whose name the insurance is carried. F2 = Effective date, Insured E policy - A code indicating the first date insurance is in force. F3 = Benefits exhausted - Code indicating the last date for which benefits are available and after which no payment can be made to payer E. G1 = Birthdate, Insured F - The birthdate of the individual in whose name the insurance is carried. G2 = Effective date, Insured F policy - A code indicating the first date insurance is in force. G3 = Benefits exhausted - Code indicating the last date for which benefits are available and after which no payment can be made to payer F. Null/missing= source value is missing or unknown