NAME TYPE LENGTH ------------------------------------- ------ Line Beneficiary Primary CHAR 1 Payer Code 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 noninstitutional claim. SHORT NAME: LPRPAYCD LONG NAME: LINE_BENE_PRMRY_PYR_CD CODES: Beneficiary Primary Payer Table ------------------------------- A = Working aged bene/spouse with employer group health plan (EGHP) B = End stage renal disease (ESRD) beneficiary in the 18 month coordination period with an employer group health plan C = Conditional payment by Medicare; future reimbursement expected D = Automobile no-fault (eff. 4/97; Prior to 3/94, also included any liability insurance) E = Workers' compensation F = Public Health Service or other federal agency (other than Dept. of Veterans Affairs) G = Working disabled bene (under age 65 with LGHP) H = Black Lung I = Dept. of Veterans Affairs J = Any liability insurance (eff. 3/94 - 3/97) L = Any liability insurance (eff. 4/97) (eff. 12/90 for carrier claims and 10/93 for FI claims; obsoleted for all claim types 7/1/96) M = Override code: EGHP services involved (eff. 12/90 for carrier claims and 10/93 for FI claims; obsoleted for all claim types 7/1/96) N = Override code: non-EGHP services involved (eff. 12/90 for carrier claims and 10/93 for FI claims; obsoleted for all claim types 7/1/96) BLANK = Medicare is primary payer (not sure of effective date: in use 1/91, if not earlier) T = MSP cost avoided - IEQ contractor (eff. 7/96 carrier claims only) U = MSP cost avoided - HMO rate cell adjust- ment contractor (eff. 7/96 carrier claims only) V = MSP cost avoided - litigation settlement contractor (eff. 7/96 carrier claims only) X = MSP cost avoided override code (eff. 12/90 for carrier claims and 10/93 for FI claims; obsoleted for all claim types 7/1/96) ***Prior to 12/90*** Y = Other secondary payer investigation shows Medicare as primary payer Z = Medicare is primary payer NOTE: Values C, M, N, Y, Z and BLANK indicate Medicare is primary payer. (values Z and Y were used prior to 12/90. BLANK was suppose to be effective after 12/90, but may have been used prior to that date.) SOURCE: CWF,VA,DOL,SSA