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Total Coinsurance Days Count

CLM_INSTNL_MDCR_COINS_DAY_CNT

THE COUNT OF THE TOTAL NUMBER OF COINSURANCE DAYS INVOLVED WITH THE BENEFICIARYS STAY IN A FACILITY. [NCH, HRMZ] FOR MEDICAID, THE NUMBER OF COVERED INPATIENT HOSPITAL DAYS OCCURRING AFTER THE 60TH DAY AND BEFORE THE 91ST DAY, OR THE NUMBER OF COVERED INPATIENT SKILLED NURSING FACILITY DAYS OCCURRING AFTER THE 20TH DAY AND BEFORE THE 101ST DAY OF THE BENEFIT PERIOD. [HRMZ]

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath 
ExplanationOfBenefit.adjudication.where(
  category.coding.where(
    system = 'https://bluebutton.cms.gov/fhir/CodeSystem/Adjudication' and
      code = 'CLM_INSTNL_MDCR_COINS_DAY_CNT'
  ).exists()
).value
Coverage / Claim Type
  • Inpatient
  • SNF
Source View
V2_MDCR_CLM_INSTNL
Source Column
CLM_INSTNL_MDCR_COINS_DAY_CNT
Sources
  • FISS
  • NCH
Profiles
  • CMS

Example 

3

Mappings

CCW
  • BENE_TOT_COINSRNC_DAYS_CNT

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