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Claim Line Benefit Enhancement 4 Code

CLM_LINE_BNFT_ENHNCMT_4_CD

A CODE IDENTIFYING THE FOURTH APPLICABLE ACCOUNTABLE CARE ORGANIZATION (ACO) BENEFIT ENHANCEMENT INDICATOR (BEI) THAT APPLIED TO THE CLAIM LINE. REFERENCE TABLE: CLM_BNFT_ENHNCMT_CD

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath 
ExplanationOfBenefit.supportingInfo.where(
  category.coding.where(
    system = 'https://bluebutton.cms.gov/fhir/CodeSystem/Supporting-Information'
  ).exists() and
    category.coding.where(code = 'CLM_BNFT_ENHNCMT_CD').exists()
).value
Coverage / Claim Type
  • Carrier
Source View
V2_MDCR_CLM_LINE_DCMTN
Source Column
CLM_LINE_BNFT_ENHNCMT_4_CD
Sources
  • MCS
  • NCH
Profiles
  • CMS

Notes

There may be multiple. These are unordered, but there are a maximum of 5 per institutional claim header, and 5 per professional claim line.The infoSequence element on the ExplanationOfBenefit.item can be used to determine which are relevant to a given claim line.

Mappings

CCLF
  • CCLFB.CLM_DEMO_4TH_NUM

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