Variable: LINE_OTHR_APLD_IND_CD7
Line Other Applied Indicator 7 Code
Description
The code used to identify the reason the claim payment amount was adjusted during claims processing.
Comment
See the associated amounts in the LINE_OTHR_APLD_AMT{#} field. There are up to 7 of these line applied indicator fields (LINE_OTHR_APLD_IND_CD1 -LINE_OTHR_APLD_IND_CD7).
Values
This variable is coded, and will contain one of the following values.
| Value | Description |
|---|---|
| A | Gramm-Rudman reduction required for services (03/03/1986-09/30/1986) |
| B | Interest addition |
| C | Positive rounding adjustment (due to line item distribution from total claim reimbursement amount) |
| D | Negative rounding adjustment (due to line item distribution from total claim reimbursement amount) |
| E | Primary Payer allowed charge |
| F | Good cause |
| G | PMD Demonstration Reduction |
| H | Sequestration Reduction Amount |
| I | eRX Negative Adjustment Reduction Amount |
| J | ACO Payment Adjustment Amount (Pioneer ACO Reduction) - eff. 1/2014 |
| K | ASC Quality Reporting Payment Reduction (eff. 1/2014) |
| L | (unknown value) |
| M | Physician Quality Reporting System (PQRS) Negative Payment Adjustment – eff. 1/2015 |
| N | None |
| O | Value Modifier Payment Adjustment – eff. 1/2015 |
| P | (unknown value) |
| Q | Electronic Health Record (EHR) Negative Payment Adjustment – eff. 1/2015 |
| S | Prior Authorization Reduction (eff. 10/2016) |
| T | Comprehensive Primary Care Plus (CPC+) Payment Adjustment (eff. 4/2017) |
Other Info
Some additional information on this variable:
- Short Name: LINE_OTHR_APLD_IND_CD7
- Long Name: LINE_OTHR_APLD_IND_CD7
- Type: CHAR
- Length: 1
- Source: NCH
- Value Format: