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Claim Type Code

CLM_TYPE_CD

A CODE IDENTIFYING THE SOURCE AND TYPE OF CLAIM SUBMITTED THROUGH THE MEDICARE OR MEDICAID PROGRAM. FOR EXAMPLE: 60 = MEDICARE NATIONAL CLAIMS HISTORY (NCH) INPATIENT CLAIM 8900 = MEDICAID FEE FOR SERVICE DENTAL REFERENCE TABLE: CLM_TYPE_CD

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath
ExplanationOfBenefit.type.coding.where(
system = 'https://bluebutton.cms.gov/fhir/CodeSystem/CLM-TYPE-CD'
).code
Coverage / Claim Type
  • Carrier
  • DME
  • HHA
  • Hospice
  • Inpatient
  • Outpatient
  • SNF
Source View
V2_MDCR_CLM
Source Column
CLM_TYPE_CD
Sources
  • FISS
  • MCS
  • NCH
  • VMS
Profiles
  • Basis
  • Regular
  • CMS

Example

72

Mappings

CCLF
  • CCLF1.CLM_TYPE_CD
  • CCLF2.CLM_TYPE_CD
  • CCLF3.CLM_TYPE_CD
  • CCLF4.CLM_TYPE_CD
  • CCLF5.CLM_TYPE_CD
  • CCLF6.CLM_TYPE_CD
  • CCLFA.CLM_TYPE_CD
  • CCLFB.CLM_TYPE_CD
CCW
  • NCH_CLM_TYPE_CD
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