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MCO Paid Switch

CLM_MDCR_INSTNL_MCO_PD_SW

A SWITCH INDICATING WHETHER OR NOT A MANAGED CARE ORGANIZATION (MCO) HAS PAID THE PROVIDER FOR AN INSTITUTIONAL CLAIM. [NCH]

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_MDCR_INSTNL_MCO_PD_SW'
    ).exists()
).code.coding.code
Coverage / Claim Type
  • HHA
  • Hospice
  • Inpatient
  • Outpatient
  • SNF
Source View
V2_MDCR_CLM_INSTNL
Source Column
CLM_MDCR_INSTNL_MCO_PD_SW
Reference Table
https://bluebutton.cms.gov/fhir/CodeSystem/CLM-MDCR-INSTNL-MCO-PD-SW
Sources
  • FISS
  • NCH
Profiles
  • CMS

Example 

1

Mappings

CCW
  • CLM_MCO_PD_SW

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