NAME TYPE LENGTH ------------------------------------- ------ Carrier Claim Payment CHAR 1 Denial Code The code on a noninstitutional claim indicating to whom payment was made or if the claim was denied. SHORT NAME: PMTDNLCD LONG NAME: CARR_CLM_PMT_DNL_CD CODES: Carrier Claim Payment Denial Table ---------------------------------- 0 = Denied 1 = Physician/supplier 2 = Beneficiary 3 = Both physician/supplier and beneficiary 4 = Hospital (hospital based physicians) 5 = Both hospital and beneficiary 6 = Group practice prepayment plan 7 = Other entries (e.g. Employer, union) 8 = Federally funded 9 = PA service A = Beneficiary under limitation of liability B = Physician/supplier under limitation of liability D = Denied due to demonstration involvement (eff. 5/97) E = MSP cost avoided IRS/SSA/HCFA Data Match (eff. 7/3/00) F = MSP cost avoided HMO Rate Cell (eff. 7/3/00) G = MSP cost avoided Litigation Settlement (eff. 7/3/00) H = MSP cost avoided Employer Voluntary Reporting (eff. 7/3/00) J = MSP cost avoided Insurer Voluntary Reporting (eff. 7/3/00) K = MSP cost avoided Initial Enrollment Questionnaire (eff. 7/3/00) P = Physician ownership denial (eff 3/92) Q = MSP cost avoided - (Contractor #88888) voluntary agreement (eff. 1/98) T = MSP cost avoided - IEQ contractor (eff. 7/96) (obsolete 6/30/00) U = MSP cost avoided - HMO rate cell adjustment (eff. 7/96) (obsolete 6/30/00) V = MSP cost avoided - litigation settlement (eff. 7/96) (obsolete 6/30/00) X = MSP cost avoided - generic Y = MSP cost avoided - IRS/SSA data match project (obsolete 6/30/00) SOURCE: CWF