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The code outlining the primary payer.

CLM_NCH_PRMRY_PYR_CD

A code identifying the coverage type of the primary payer when Medicare is the secondary payer as defined by the Common Working File (CWF). Reference table: CLM_NCH_PRMRY_PYR_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_NCH_PRMRY_PYR_CD').exists()
).code.coding.where(
  system = 'https://bluebutton.cms.gov/fhir/CodeSystem/CLM-PRMRY-PYR-CD'
).code
Coverage / Claim Type
  • HHA
  • Hospice
  • Inpatient
  • Outpatient
  • SNF
Source View
V2_MDCR_CLM
Source Column
CLM_NCH_PRMRY_PYR_CD
Reference Table
https://bluebutton.cms.gov/fhir/CodeSystem/CLM-NCH-PRMRY-PYR-CD
Sources
  • FISS
  • MCS
  • NCH
Profiles
  • CMS

Example

I

Mappings

CCLF
  • CCLF1.CLM_NCH_PRMRY_PYR_CD
CCW
  • NCH_PRMRY_PYR_CD

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official website of theU.S. Department of Health and Human Services and theCenters for Medicare & Medicaid Services.

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