CCW Denominator File - CCW Version 11/2006 If associated CCW data is read into a SAS version 6.x environment, the "SHORT NAMES" will be displayed in the output file. If associated CCW data is read into a SAS version 8.x environment, the "LONG NAMES" will be displayed in the output file. NAME TYPE LENGTH ------------------------------------- ------ 1. Encrypted 723 Beneficiary CHAR 15 ID A unique CCW beneficiary identifier field that is specific to the Chronic Condition Warehouse. This field is encrypted prior to delivery to researchers. The BENE_ID field is used to cross- reference data for each beneficiary across all claim and assessment data files. SHORT NAME: BENE_ID LONG NAME: BENE_ID SOURCE: CCW 2. STATE CODE CHAR 2 THIS FIELD SPECIFIES THE STATE OF RESIDENCE OF THE BENEFICIARY AND IS BASED ON THE MAILING ADDRESS USED FOR CASH BENEFITS OR THE MAILING ADDRESS USED FOR OTHER PURPOSES (FOR EXAMPLE, PREMIUM BILLING). THIS INFORMATION IS MAINTAINED FROM CHANGE OF ADDRESS NOTICES SENT IN BY THE BENEFICIARIES, AND IS APPENDED TO THE RECORD AT TIME OF PROCESSING IN CENTRAL OFFICE. THE CODING SYSTEM IS THE SSA SYSTEM, NOT THE FEDERAL INFORMATION PROCESSING STANDARD (FIPS). sHORT NAME: STATE_CD LONG NAME: STATE_CODE SOURCE: SSA AND RRB BENEFICIARY RECORD SYSTEMS. FOR RRB BENEFICIARIES, THE STATE IS CODED IN SSA BASED ON MAILING ADDRESS. LIMITATIONS: IN SOME CASES, THE CODE MAY NOT BE THE ACTUAL STATE OF RESIDENCE. (FOR EXAMPLE, IF THE BENEFICIARY HAS A REPRESENTATIVE PAYEE). 3. COUNTY CODE CHAR 3 THIS CODE SPECIFIES THE SSA CODE FOR THE COUNTY OF RESIDENCE OF THE BENEFICIARY. EACH STATE HAS A SERIES OF CODES BEGINNING WITH '000' FOR EACH COUNTY WITHIN THAT STATE. CERTAIN CITIES WITHIN THAT STATE HAVE THEIR OWN CODE. COUNTY CODES MUST BE COMBINED WITH STATE CODES IN ORDER TO LOCATE THE SPECIFIC COUNTY. THE CODING SYSTEM IS THE SSA SYSTEM, NOT THE FEDERAL INFORMATION PROCESSING SYSTEM (FIPS). SHORT NAME: CNTY_CD LONG NAME: BENE_COUNTY_CD EDIT-RULES: NUMERIC SOURCE: 'GEOGRAPHIC CODE MANUAL FOR STATE AND COUNTY OF RESIDENCE' PRODUCED BY THE SSA. LIMITATIONS: SOME CODES MAY BE INVALID, UNKNOWN, OR '999'. (DIFFERENT FROM FIPS) 4. ZIP CODE OF RESIDENCE CHAR 9 THIS FIELD SPECIFIES THE ZIP CODE AND IS BASED UPON THE MAILING ADDRESS USED FOR CASH BENEFITS TO THE BENEFICIARY OR FOR OTHER PURPOSES (E.G., PREMIUM BILLING). 9 DIGITS SHORT NAME: BENE_ZIP LONG NAME: BENE_ZIP_CD EDIT-RULES: 9-DIGIT ZIP 5-DIGIT ZIP - ZERO BACK FILLED 3-DIGIT ZIP - ALL NINES NO ZIP - ALL ZEROS COMMENT: CODES IDENTIFY POSTAL SERVICE AREAS WITHIN THE U.S.A. BUT DO NOT NECESSARILY ADHERE TO BOUNDARIES OF CITIES, COUNTIES, STATES, OR OTHER JURISDICTIONS. THE CODE IS APPENDED TO THE RECORD AT TIME OF PROCESSING IN CENTRAL OFFICE. THE FIRST THREE POSITIONS OF THE ZIP CODE REPRESENT A PARTICULAR SECTIONAL POSTAL CENTER OR A METROPOLITAN CITY. THE FOLLOWING TWO DIGITS REPRESENT THE ASSOCIATED POST POST OFFICE SERVED BY THE POSTAL CENTER OR THE DELIVERY AREA SERVED BY THE POSTAL STATION. SOURCE: EDB LIMITATIONS: ZIP CODE MAY NOT CORRESPOND WITH STATE OF RESIDENCE. 5. DATE OF BIRTH DATE 8 THIS DATE SPECIFIES THE BENEFICIARY'S DATE OF BIRTH. 8 DIGITS SHORT NAME: BENE_DOB LONG NAME: BENE_BIRTH_DT EDIT-RULES: YYYYMMDD SOURCE: SSA AND RRB BENEFICIARY RECORD SYSTEMS 6. SEX CHAR 1 THIS FIELD INDICATES THE SEX OF THE BENEFICIARY. SHORT NAME: SEX LONG NAME: BENE_SEX_IDENT_CD CODES: 0 = UNKNOWN 1 = MALE 2 = FEMALE 7. BENEFICIARY RACE CODE CHAR 1 THE RACE OF A BENEFICIARY. SHORT NAME: RACE LONG NAME: BENE_RACE_CD CODES: 0 = UNKNOWN 1 = WHITE 2 = BLACK 3 = OTHER 4 = ASIAN 5 = HISPANIC 6 = NORTH AMERICAN NATIVE SQL-INFO: CHAR(1) NOT NULL SOURCE: SSA 8. AGE NUM 3 BENEFICIARY'S AGE AT BEGINNING OF REFERENCE YEAR. SHORT NAME: AGE LONG NAME: BENE_AGE_AT_BEG_REF_YR 3 DIGITS CODES: MAXIMUM AGE IS 115 9. ORIGINAL REASON FOR CHAR 1 ENTITLEMENT CODE THIS FIELD INDICATES THE REASON FOR THE BENEFICIARY'S ORIGINAL ENTITLEMENT TO MEDICARE BENEFITS. SHORT NAME: OREC LONG NAME: BENE_ENTLMT_RSN_ORIG CODES: 0 = OLD AGE AND SURVIVORS INSURANCE (OASI) 1 = DISABILITY INSURANCE BENEFITS (DIB) 2 = ESRD 3 = BOTH DIB AND ESRD SOURCE: SSA AND RRB BENEFICIARY RECORD SYSTEMS 10. CURRENT REASON FOR CHAR 1 ENTITLEMENT CODE THIS FIELD INDICATES THE REASON FOR THE BENEFICIARY'S CURRENT ENTITLEMENT TO MEDICARE BENEFITS. SHORT NAME: CREC LONG NAME: BENE_ENTLMT_RSN_CURR CODES: 0 = OLD AGE AND SURVIVOR'S INSURANCE (OASI) 1 = DISABILITY INSURANCE BENEFITS (DIB) 2 = ESRD 3 = DIB AND ESRD SOURCE: ENROLLMENT DATA BASE 11. END STAGE RENAL DISEASE CHAR 1 INDICATOR (ESRD) THIS FIELD SPECIFIES THAT A BENEFICIARY IS AFFLICTED WITH END STAGE RENAL DISEASE (ESRD). SHORT NAME: ESRD_IND LONG NAME: BENE_ESRD_IND CODES: EFFECTIVE 1992 Y = THE BENEFICIARY HAS ESRD 0 = THE BENEFICIARY DOES NOT HAVE ESRD 12. MEDICARE STATUS CODE CHAR 2 THIS FIELD SPECIFIES THE REASON FOR THE BENEFICIARY'S ENTITLEMENT. SHORT NAME: MS_CD LONG NAME: BENE_MDCR_STUS_CD CODES: 10 = AGED WITHOUT ESRD 11 = AGED WITH ESRD 20 = DISABLED WITHOUT ESRD 21 = DISABLED WITH ESRD 31 = ESRD ONLY SOURCE: THIS FIELD IS CODED FROM AGE, ORIGINAL REASON FOR ENTITLEMENT, CURRENT REASON FOR ENTITLEMENT AND ESRD INDICATOR CONTAINED IN THE ENROLLMENT DATA BASE AT THE CENTRAL OFFICE AT THE DATE OF PROCESSING. 13. PART A TERMINATION CODE CHAR 1 THIS CODE SPECIFIES THE REASON PART A ENTITLEMENT WAS TERMINATED. SHORT NAME: A_TRM_CD LONG NAME: BENE_PTA_TRMNTN_CD CODES: EFFECTIVE 1992 0 = NOT TERMINATED 1 = DEAD 2 = NON-PAYMENT OF PREMIUM 3 = VOLUNTARY WITHDRAWAL 9 = OTHER TERMINATION SOURCE: ENROLLMENT DATA BASE 14. PART B TERMINATION CHAR 1 THIS CODE SPECIFIES THE REASON PART B ENTITLEMENT WAS TERMINATED. SHORT NAME: B_TRM_CD LONG NAME: BENE_PTB_TRMNTN_CD CODES: EFFECTIVE 1992 0 = NOT TERMINATED 1 = DEAD 2 = NON-PAYMENT OF PREMIUM 3 = VOLUNTARY WITHDRAWAL 9 = OTHER TERMINATION SOURCE: ENROLLMENT DATA BASE 15. MEDICARE ENTITLEMENT/BUY-IN CHAR 1 INDICATOR OCCURS: 12 TIMES SHORT NAME: BUYIN01 (THROUGH BUYIN12) LONG NAME: BENE_MDCR_ENTLMT_BUYIN_IND_01 (THROUGH BENE_MDCR_ENTLMT_BUYIN_IND_12) CODES: 0 = NOT ENTITLED 1 = PART A ONLY 2 = PART B ONLY 3 = PART A AND PART B A = PART A, STATE BUY-IN B = PART B, STATE BUY-IN C = PARTS A AND B, STATE BUY-IN 16. HMO INDICATOR CHAR 1 CODE INDICATING BENEFICIARY HAS MEMBERSHIP IN HEALTH MAINTENANCE ORGANIZATION. OCCURS: 12 TIMES SHORT NAME: HMOIND01 (THROUGH HMOIND12) LONG NAME: BENE_HMO_IND_01 (THROUGH BENE_HMO_IND_12) CODES: EFFECTIVE 1992 0 = NOT A MEMBER OF HMO 1 = NON LOCK-IN, HCFA TO PROCESS PROVIDER CLAIMS 2 = NON LOCK-IN, GHO TO PROCESS IN-PLAN PART A AND IN-AREA PART B CLAIMS A = LOCK-IN, HCFA TO PROCESS PROVIDER CLAIMS B = LOCK-IN, GHO TO PROCESS IN-PLAN PART A AND IN-AREA PART B CLAIMS C = LOCK-IN, GHO TO PROCESS ALL PROVIDER CLAIMS 17. HI COVERAGE CHAR 2 TOTAL NUMBER OF MONTHS OF PART A COVERAGE SHORT NAME: A_MO_CNT LONG NAME: BENE_HI_CVRAGE_TOT_MONS 2 DIGITS 18. SMI COVERAGE CHAR 2 TOTAL NUMBER OF MONTHS OF PART B COVERAGE SHORT NAME: B_M0_CNT LONG NAME: BENE_SMI_CVRAGE_TOT_MONS 2 DIGITS 19. HMO COVERAGE CHAR 2 TOTAL NUMBER OF MONTHS OF HMO COVERAGE. SHORT NAME: HMO_MO LONG NAME: BENE_HMO_CVRAGE_TOT_MONS 2 DIGITS 20. STATE BUY-IN COVERAGE CHAR 2 TOTAL NUMBER OF MONTHS OF STATE BUY-IN. SHORT NAME: BUYIN_MO LONG NAME: BENE_STATE_BUYIN_TOT_MONS 2 DIGITS 21. VALID DATE OF DEATH SWITCH CHAR 2 SHORT NAME: V_DOD_SW LONG NAME: BENE_VALID_DEATH_DT_SW CODES: V = VALID DEATH DATE BLANK = DEFAULT 22. DATE OF DEATH DATE 8 THIS FIELD INDICATES THE DATE OF DEATH OF THE BENEFICIARY. 8 DIGITS SHORT NAME: DEATH_DT LONG NAME: BENE_DEATH_DT EDIT-RULES: YYYYMMDD ZEROS = NOT APPLICABLE IF DAY OF DEATH IS UNKNOWN, CODED AS LAST DAY OF MONTH 23. BENEFICIARY ENROLLMENT NUM 4 REFERENCE YEAR ENROLLMENT YEAR THIS FIELD INDICATES THE REFERENCE YEAR OF ENROLLMENT OF THE BENEFICIARY. 4 DIGITS SHORT NAME: RFRNC_YR LONG NAME: BENE_ENROLLMT_REF_YR EDIT-RULES: YY 24. BENE_ID with more than one NUM 8 record It has been noted that on rare occasions a single BENE_ID can be listed more than once in the CMS 100% Denominator File. The BENEDPSQ number can be used in combination with the BENE_ID to generate a unique key for all records in the CMS 100% Denominator File. The BENEDPSQ is 0 where there is only one record for a BENE_ID. Where more than one record per BENE_ID exists the value will be greater than 0. This will serve as a flag for the instances where there are multiple records for a single BENE_ID. For example, when a BENE_ID has multiple records this value will be 1 for the first record with the same BENE_ID, 2 for the second record, etc. 25. UNEQUATED BENEFICIARY CHAR 2 IDENTIFICATION CODE (BIC) This code specifies the type of beneficiary for cash payment programs and identifies the type of relationship between the individual and primary beneficiary when the individual is qualified under another’s account. SHORT NAME: CRNT_BIC LONG NAME: CRNT_BIC_CD 26. CMS 5% SAMPLE FLAG CHAR 1 A flag indicating whether the beneficiary was included in the CMS 5% Denominator File for the reference year. SHORT NAME: FIVEPCT LONG NAME: FIVE_PERCENT_FLAG CODES: Y = Included in CMS 5% Denominator File Null = Not included in CMS 5% Denominator File 27. ENHANCED 5% SAMPLE FLAG CHAR 1 A flag indicating whether the beneficiary was included in the enhanced CCW 5% sample (i.e., once in, always in). This flag distinguishes between the beneficiaries that are part of the CMS annual 5% and those that are included as part of the ever-enrolled Chronic Condition Warehouse. SHORT NAME: EFIVEPCT LONG NAME: ENHANCED_ FIVE_PERCENT_FLAG CODES: Y = Included in enhanced 5% sample Null = Not included in enhanced 5% sample