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Variable: CLM_DDCTBL_COINSRNC_CD

Claim Deductible Coinsurance Code

Description:

CODE INDICATING WHETHER THE REVENUE CENTER CHARGES ARE SUBJECT TO DEDUCTIBLE AND/OR COINSURANCE.

Values

This variable is coded, and will contain one of the following values.

Value Description
0 Charges are subject to deductible and coinsurance
1 Charges are not subject to deductible
2 Charges are not subject to coinsurance
3 Charges are not subject to deductible or coinsurance
4 No charge or units associated with this revenue center code. (For multiple HCPCS per single revenue center code) For revenue center code 0001, the following MSP override values may be present:
M Override code; EGHP (employer group health plan) services involved
N Override code; non-EGHP services involved
X Override code: MSP (Medicare is secondary payer) cost avoided
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