Line Primary Payer Code (if not Medicare)

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{
  "resourceType" : "CodeSystem",
  "id" : "line-bene-prmry-pyr-cd",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns="http://www.w3.org/1999/xhtml"><h2>Line Primary Payer Code (if not Medicare)</h2><div><p>The code specifying a federal non-Medicare program or other source that has primary responsibility for the payment of the Medicare beneficiary's medical bills relating to the line item service on the non-institutional claim. The presence of a primary payer code indicates that some other payer besides Medicare covered at least some portion of the charges. Source: https://bluebutton.cms.gov/resources/variables/line<em>bene</em>prmry<em>pyr</em>cd</p>
</div><p>This code system https://bluebutton.cms.gov/assets/ig/CodeSystem-line-bene-prmry-pyr-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<a name="line-bene-prmry-pyr-cd-A"> </a></td><td>Working aged bene/spouse with employer group health plan (EGHP)</td><td>Working aged bene/spouse with employer group health plan (EGHP)</td></tr><tr><td>B<a name="line-bene-prmry-pyr-cd-B"> </a></td><td>End stage renal disease (ESRD) beneficiary in the 18 month coordination period with an employer group health plan</td><td>End stage renal disease (ESRD) beneficiary in the 18 month coordination period with an employer group health plan</td></tr><tr><td>C<a name="line-bene-prmry-pyr-cd-C"> </a></td><td>Conditional payment by Medicare; future reimbursement expected</td><td>Conditional payment by Medicare; future reimbursement expected</td></tr><tr><td>D<a name="line-bene-prmry-pyr-cd-D"> </a></td><td>Automobile no-fault</td><td>Automobile no-fault</td></tr><tr><td>E<a name="line-bene-prmry-pyr-cd-E"> </a></td><td>Workers' compensation</td><td>Workers' compensation</td></tr><tr><td>F<a name="line-bene-prmry-pyr-cd-F"> </a></td><td>Public Health Service or other federal agency (other than Dept. of Veterans Affairs)</td><td>Public Health Service or other federal agency (other than Dept. of Veterans Affairs)</td></tr><tr><td>G<a name="line-bene-prmry-pyr-cd-G"> </a></td><td>Working disabled bene (under age 65 with LGHP)</td><td>Working disabled bene (under age 65 with LGHP)</td></tr><tr><td>H<a name="line-bene-prmry-pyr-cd-H"> </a></td><td>Black Lung</td><td>Black Lung</td></tr><tr><td>I<a name="line-bene-prmry-pyr-cd-I"> </a></td><td>Dept. of Veterans Affairs</td><td>Dept. of Veterans Affairs</td></tr><tr><td>L<a name="line-bene-prmry-pyr-cd-L"> </a></td><td>Any liability insurance</td><td>Any liability insurance</td></tr><tr><td>M<a name="line-bene-prmry-pyr-cd-M"> </a></td><td>Override code: EGHP services involved</td><td>Override code: EGHP services involved</td></tr><tr><td>N<a name="line-bene-prmry-pyr-cd-N"> </a></td><td>Override code: non-EGHP services involved</td><td>Override code: non-EGHP services involved</td></tr><tr><td>W<a name="line-bene-prmry-pyr-cd-W"> </a></td><td>Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Null/missing= Medicare is primary payer</td><td>Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Null/missing= Medicare is primary payer</td></tr></table></div>"
  },
  "url" : "https://bluebutton.cms.gov/assets/ig/CodeSystem-line-bene-prmry-pyr-cd",
  "identifier" : {
    "value" : "https://bluebutton.cms.gov/assets/ig/CodeSystem-line-bene-prmry-pyr-cd.html"
  },
  "version" : "1.1.1",
  "name" : "Line Primary Payer Code (if not Medicare)",
  "title" : "Line Primary Payer Code (if not Medicare)",
  "status" : "active",
  "date" : "2018-11-27T15:56:35+00:00",
  "publisher" : "CMS Blue Button 2.0 Team",
  "description" : "The code specifying a federal non-Medicare program or other source that has primary responsibility for the payment of the Medicare beneficiary's medical bills relating to the line item service on the non-institutional claim. The presence of a primary payer code indicates that some other payer besides Medicare covered at least some portion of the charges. Source: https://bluebutton.cms.gov/resources/variables/line_bene_prmry_pyr_cd",
  "caseSensitive" : true,
  "valueSet" : "https://bluebutton.cms.gov/assets/ig/ValueSet-line-bene-prmry-pyr-cd",
  "hierarchyMeaning" : "is-a",
  "content" : "complete",
  "concept" : [
    {
      "code" : "A",
      "display" : "Working aged bene/spouse with employer group health plan (EGHP)",
      "definition" : "Working aged bene/spouse with employer group health plan (EGHP)"
    },
    {
      "code" : "B",
      "display" : "End stage renal disease (ESRD) beneficiary in the 18 month coordination period with an employer group health plan",
      "definition" : "End stage renal disease (ESRD) beneficiary in the 18 month coordination period with an employer group health plan"
    },
    {
      "code" : "C",
      "display" : "Conditional payment by Medicare; future reimbursement expected",
      "definition" : "Conditional payment by Medicare; future reimbursement expected"
    },
    {
      "code" : "D",
      "display" : "Automobile no-fault",
      "definition" : "Automobile no-fault"
    },
    {
      "code" : "E",
      "display" : "Workers' compensation",
      "definition" : "Workers' compensation"
    },
    {
      "code" : "F",
      "display" : "Public Health Service or other federal agency (other than Dept. of Veterans Affairs)",
      "definition" : "Public Health Service or other federal agency (other than Dept. of Veterans Affairs)"
    },
    {
      "code" : "G",
      "display" : "Working disabled bene (under age 65 with LGHP)",
      "definition" : "Working disabled bene (under age 65 with LGHP)"
    },
    {
      "code" : "H",
      "display" : "Black Lung",
      "definition" : "Black Lung"
    },
    {
      "code" : "I",
      "display" : "Dept. of Veterans Affairs",
      "definition" : "Dept. of Veterans Affairs"
    },
    {
      "code" : "L",
      "display" : "Any liability insurance",
      "definition" : "Any liability insurance"
    },
    {
      "code" : "M",
      "display" : "Override code: EGHP services involved",
      "definition" : "Override code: EGHP services involved"
    },
    {
      "code" : "N",
      "display" : "Override code: non-EGHP services involved",
      "definition" : "Override code: non-EGHP services involved"
    },
    {
      "code" : "W",
      "display" : "Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Null/missing= Medicare is primary payer",
      "definition" : "Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Null/missing= Medicare is primary payer"
    }
  ]
}