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Deductible Amount

CLM_MDCR_IP_BENE_DDCTBL_AMT

The amount of the deductible the beneficiary paid for inpatient services, as originally submitted on the institutional claim. [NCH] NCH derivation: Derived from CLM_VAL_CD and CLM_VAL_AMT. Derivation rule: Based on the presence of value code equal to A1, B1, or C1, move the corresponding value amount to the NCH_BENE_IP_DDCTBL_AMT. [NCH]

Field Metadata

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

Example

19.11

Mappings

CCLF
  • CCLFA.CLM_MDCR_IP_BENE_DDCTBL_AMT
CCW
  • NCH_BENE_IP_DDCTBL_AMT

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