Variable: CLM_PRMRY_PYR_CD

Line Primary Payer Code (if not Medicare)

Description:

The code specifying a federal non-Medicare program or other source that has primary responsibility for the payment of the Medicare beneficiary's medical bills relating to the line item service on the non-institutional claim.

Values

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

Value	Description
A	WORKING AGED BENEFICIARY/SPOUSE WITH EMPLOYER GROUP HEALTH PLAN
B	ESRD BENEFICIARY IN 12 MONTH PERIOD WITH EMPLOYER GROUP HEALTH PLAN
C	ANY CONDITIONAL MEDICARE PAYMENT SITUATION
D	AUTOMOBILE NO FAULT OR ANY LIABILITY INSURANCE
E	WORKER'S COMPENSATION INCLUDING BLACK LUNG
F	VETERAN'S AFFAIRS, PUBLIC HEALTH SERVICE, OR OTHER FEDERAL AGENCY
G	WORKING DISABLED
H	BLACK LUNG
I	VETERAN'S AFFAIRS
L	LIABILITY
M	OVERRIDE CODE EMPLOYEE GROUP HEALTH PLAN SERVICE INVOLVED
N	OVERRIDE CODE NON-EMPLOYEE GROUP HEALTH PLAN SERVICE INVOLVED
W	WORKER'S COMPENSATION SET-ASIDE
X	OVERRIDE CODE MSP COST AVOIDED
Y	OTHER SECONDARY PAYER INVESTIGATION SHOWS MEDICARE PRIMARY
Z	MEDICARE IS PRIMARY PAYER
~	NO DESCRIPTION AVAILABLE