Variable: LINE_PRCSG_IND_CD
Line Processing Indicator Code
Description
The code on a non-institutional claim indicating to whom payment was made or if the claim was denied.
Comment
n/a
Values
This variable is coded, and will contain one of the following values.
| Value | Description |
|---|---|
| A | Allowed |
| B | Benefits exhausted |
| C | Non-covered care |
| D | Denied (from BMAD) |
| I | Invalid data |
| L | CLIA |
| M | Multiple submittal--duplicate line item |
| N | Medically unnecessary |
| O | Other |
| P | Physician ownership denial |
| Q | MSP cost avoided (contractor #88888) - voluntary agreement |
| R | Reprocessed--adjustments based on subsequent reprocessing of claim |
| S | Secondary payer |
| T | MSP cost avoided - IEQ contractor |
| U | MSP cost avoided - HMO rate cell adjustment |
| V | MSP cost avoided - litigation settlement |
| X | MSP cost avoided - generic |
| Y | MSP cost avoided - IRS/SSA data match project |
| Z | Bundled test, no payment |
| 00 | MSP cost avoided - COB Contractor |
| 12 | MSP cost avoided - BC/BS Voluntary Agreements |
| 13 | MSP cost avoided - Office of Personnel Management |
| 14 | MSP cost avoided - Workman's Compensation (WC) Datamatch |
| 15 | MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) (eff. 4/2006) |
| 16 | MSP cost avoided - Liability Insurer VDSA (eff.4/2006) |
| 17 | MSP cost avoided - No-Fault Insurer VDSA (eff.4/2006) |
| 18 | MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement (eff.4/2006) |
| 21 | MSP cost avoided - MIR Group Health Plan (eff.1/2009) |
| 22 | MSP cost avoided - MIR non-Group Health Plan (eff.1/2009) |
| 25 | MSP cost avoided - Recovery Audit Contractor - California (eff.10/2005) |
| 26 | MSP cost avoided - Recovery Audit Contractor - Florida (eff.10/2005) Effective 4/1/02, the Line Processing Indicator code was expanded to a 2-byte field. The NCH instituted a crosswalk from the 2-byte code to a 1-byte character code. Below are the character codes (found in NCH & NMUD). At some point, NMUD will carry the 2-byte code but NCH will continue to have the 1-byte character code. ! MSP cost avoided - COB Contractor ('00' 2-byte code) @ MSP cost avoided - BC/BS Voluntary Agreements ('12' 2-byte code) # MSP cost avoided - Office of Personnel Management ('13' 2-byte code) $ MSP cost avoided - Workman's Compensation (WC) Datamatch ('14' 2-byte code) * MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) ('15' 2-byte code) (eff. 4/2006) ( MSP cost avoided - Liability Insurer VDSA ('16' 2-byte code) (eff. 4/2006) ) MSP cost avoided - No-Fault Insurer VDSA ('17' 2-byte code) (eff. 4/2006) + MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement ('18' 2-byte code) (eff. 4/2006) < MSP cost avoided - MIR Group Health Plan ('21' 2-byte code) (eff. 1/2009) > MSP cost avoided - MIR non-Group Health Plan ('22' 2-byte code) (eff. 1/2009) % MSP cost avoided - Recovery Audit Contractor - California ('25' 2-byte code) (eff. 10/2005) & MSP cost avoided - Recovery Audit Contractor - Florida ('26' 2-byte code) (eff. 10/2005) |
Other Info
Some additional information on this variable:
- Short Name: PRCNGIND
- Long Name: LINE_PRCSG_IND_CD
- Type: CHAR
- Length: 2
- Source: NCH
- Value Format: