Blue Button 2.0

Carrier Claim Payment Denial Code

{
  "resourceType" : "CodeSystem",
  "id" : "carr-clm-pmt-dnl-cd",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns="http://www.w3.org/1999/xhtml"><h2>Carrier Claim Payment Denial Code</h2><div><p>The code on a non-institutional claim indicating to whom payment was made or if the claim was denied. Source: https://bluebutton.cms.gov/resources/variables/carr<em>clm</em>pmt<em>dnl</em>cd</p>
</div><p>This code system https://bluebutton.cms.gov/assets/ig/CodeSystem-carr-clm-pmt-dnl-cd defines the following codes:</p><table class="codes"><tr><td><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td>!<a name="carr-clm-pmt-dnl-cd-.33"> </a></td><td>MSP cost avoided - COB Contractor (converted to '00' 2-byte code)</td><td>MSP cost avoided - COB Contractor (converted to '00' 2-byte code)</td></tr><tr><td>@<a name="carr-clm-pmt-dnl-cd-.64"> </a></td><td>MSP cost avoided - BC/BS Voluntary Agreements (converted to '12' 2-byte code)</td><td>MSP cost avoided - BC/BS Voluntary Agreements (converted to '12' 2-byte code)</td></tr><tr><td>#<a name="carr-clm-pmt-dnl-cd-.35"> </a></td><td>MSP cost avoided - Office of Personnel Management (converted to '13' 2-byte code)</td><td>MSP cost avoided - Office of Personnel Management (converted to '13' 2-byte code)</td></tr><tr><td>$<a name="carr-clm-pmt-dnl-cd-.36"> </a></td><td>MSP cost avoided - Workman's Compensation (WC) Datamatch (converted to '14' 2-byte code)</td><td>MSP cost avoided - Workman's Compensation (WC) Datamatch (converted to '14' 2-byte code)</td></tr><tr><td>*<a name="carr-clm-pmt-dnl-cd-.42"> </a></td><td>MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) (eff. 4/2006) (converted to '15' 2-byte code)</td><td>MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) (eff. 4/2006) (converted to '15' 2-byte code)</td></tr><tr><td>(<a name="carr-clm-pmt-dnl-cd-.40"> </a></td><td>MSP cost avoided - Liability Insurer VDSA (eff. 4/2006) (converted to '16' 2-byte code)</td><td>MSP cost avoided - Liability Insurer VDSA (eff. 4/2006) (converted to '16' 2-byte code)</td></tr><tr><td>)<a name="carr-clm-pmt-dnl-cd-.41"> </a></td><td>MSP cost avoided - No-Fault Insurer VDSA (eff. 4/2006) (converted to '17' 2-byte code)</td><td>MSP cost avoided - No-Fault Insurer VDSA (eff. 4/2006) (converted to '17' 2-byte code)</td></tr><tr><td>+<a name="carr-clm-pmt-dnl-cd-.43"> </a></td><td>MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement (eff. 4/2006) (converted to '18' 2 -byte code)</td><td>MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement (eff. 4/2006) (converted to '18' 2 -byte code)</td></tr><tr><td>&lt;<a name="carr-clm-pmt-dnl-cd-.60"> </a></td><td>MSP cost avoided - MIR Group Health Plan (eff. 1/2009) (converted to '21' 2-byte code)</td><td>MSP cost avoided - MIR Group Health Plan (eff. 1/2009) (converted to '21' 2-byte code)</td></tr><tr><td>&gt;<a name="carr-clm-pmt-dnl-cd-.62"> </a></td><td>MSP cost avoided - MIR non-Group Health Plan (eff. 1/2009) (converted to '22' 2-byte code)</td><td>MSP cost avoided - MIR non-Group Health Plan (eff. 1/2009) (converted to '22' 2-byte code)</td></tr><tr><td>%<a name="carr-clm-pmt-dnl-cd-.37"> </a></td><td>MSP cost avoided - Recovery Audit Contractor - California (eff. 10/2005) (converted to '25' 2-byte code)</td><td>MSP cost avoided - Recovery Audit Contractor - California (eff. 10/2005) (converted to '25' 2-byte code)</td></tr><tr><td>&amp;<a name="carr-clm-pmt-dnl-cd-.38"> </a></td><td>MSP cost avoided - Recovery Audit Contractor - Florida (eff. 10/2005) (converted to '26' 2-byte code)</td><td>MSP cost avoided - Recovery Audit Contractor - Florida (eff. 10/2005) (converted to '26' 2-byte code)</td></tr></table></div>"
  },
  "url" : "https://bluebutton.cms.gov/assets/ig/CodeSystem-carr-clm-pmt-dnl-cd",
  "identifier" : {
    "value" : "https://bluebutton.cms.gov/assets/ig/CodeSystem-carr-clm-pmt-dnl-cd.html"
  },
  "version" : "1.1.1",
  "name" : "Carrier Claim Payment Denial Code",
  "title" : "Carrier Claim Payment Denial Code",
  "status" : "active",
  "date" : "2018-11-27T15:56:35+00:00",
  "publisher" : "CMS Blue Button 2.0 Team",
  "description" : "The code on a non-institutional claim indicating to whom payment was made or if the claim was denied. Source: https://bluebutton.cms.gov/resources/variables/carr_clm_pmt_dnl_cd",
  "caseSensitive" : true,
  "valueSet" : "https://bluebutton.cms.gov/assets/ig/ValueSet-carr-clm-pmt-dnl-cd",
  "hierarchyMeaning" : "is-a",
  "content" : "complete",
  "concept" : [
    {
      "code" : "!",
      "display" : "MSP cost avoided - COB Contractor (converted to '00' 2-byte code)",
      "definition" : "MSP cost avoided - COB Contractor (converted to '00' 2-byte code)"
    },
    {
      "code" : "@",
      "display" : "MSP cost avoided - BC/BS Voluntary Agreements (converted to '12' 2-byte code)",
      "definition" : "MSP cost avoided - BC/BS Voluntary Agreements (converted to '12' 2-byte code)"
    },
    {
      "code" : "#",
      "display" : "MSP cost avoided - Office of Personnel Management (converted to '13' 2-byte code)",
      "definition" : "MSP cost avoided - Office of Personnel Management (converted to '13' 2-byte code)"
    },
    {
      "code" : "$",
      "display" : "MSP cost avoided - Workman's Compensation (WC) Datamatch (converted to '14' 2-byte code)",
      "definition" : "MSP cost avoided - Workman's Compensation (WC) Datamatch (converted to '14' 2-byte code)"
    },
    {
      "code" : "*",
      "display" : "MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) (eff. 4/2006) (converted to '15' 2-byte code)",
      "definition" : "MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) (eff. 4/2006) (converted to '15' 2-byte code)"
    },
    {
      "code" : "(",
      "display" : "MSP cost avoided - Liability Insurer VDSA (eff. 4/2006) (converted to '16' 2-byte code)",
      "definition" : "MSP cost avoided - Liability Insurer VDSA (eff. 4/2006) (converted to '16' 2-byte code)"
    },
    {
      "code" : ")",
      "display" : "MSP cost avoided - No-Fault Insurer VDSA (eff. 4/2006) (converted to '17' 2-byte code)",
      "definition" : "MSP cost avoided - No-Fault Insurer VDSA (eff. 4/2006) (converted to '17' 2-byte code)"
    },
    {
      "code" : "+",
      "display" : "MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement (eff. 4/2006) (converted to '18' 2 -byte code)",
      "definition" : "MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement (eff. 4/2006) (converted to '18' 2 -byte code)"
    },
    {
      "code" : "<",
      "display" : "MSP cost avoided - MIR Group Health Plan (eff. 1/2009) (converted to '21' 2-byte code)",
      "definition" : "MSP cost avoided - MIR Group Health Plan (eff. 1/2009) (converted to '21' 2-byte code)"
    },
    {
      "code" : ">",
      "display" : "MSP cost avoided - MIR non-Group Health Plan (eff. 1/2009) (converted to '22' 2-byte code)",
      "definition" : "MSP cost avoided - MIR non-Group Health Plan (eff. 1/2009) (converted to '22' 2-byte code)"
    },
    {
      "code" : "%",
      "display" : "MSP cost avoided - Recovery Audit Contractor - California (eff. 10/2005) (converted to '25' 2-byte code)",
      "definition" : "MSP cost avoided - Recovery Audit Contractor - California (eff. 10/2005) (converted to '25' 2-byte code)"
    },
    {
      "code" : "&",
      "display" : "MSP cost avoided - Recovery Audit Contractor - Florida (eff. 10/2005) (converted to '26' 2-byte code)",
      "definition" : "MSP cost avoided - Recovery Audit Contractor - Florida (eff. 10/2005) (converted to '26' 2-byte code)"
    }
  ]
}