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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
  • Pharmacy
Source View
V2_MDCR_CLM
Source Column
CLM_TYPE_CD
Reference Table
https://bluebutton.cms.gov/fhir/CodeSystem/CLM-TYPE-CD
Sources
  • DDPS
Profiles
  • Basis
  • Regular
  • CMS

Example 

1

Mappings

CCLF
  • CCLF7.CLM_TYPE_CD

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