United States Health Information Knowledgebase


Health Insurance Type Value Set

URI:Not Available at Publication
Purpose:Identify the types of insurance plans or programs covering a patient's care.
Definition:This value set uses the ACS X12 vocabulary for Insurance Type Code (ASC X12 Data Element 1336) and has been limited by HITSP to the value set reproduced below in Table 2-52 Health Insurance Type Value Set Definition. The type of health plan covering the individual, e.g., an HMO, PPO, POS, etc.
Effective Date:2008-12-18
Creation Date:2008-12-18
Code System Name:Accredited Standards Committee (ASC)
Code System Source:Accredited Standards Committee (ASC) X12 Standards Release 004010
Concept Code Concept Name Definition
12 Medicare Secondary Working Aged Beneficiary or Spouse with Employer Group Health Plan Not Provided
13 Medicare Secondary End-Stage Renal Disease Beneficiary in the 12 month coordination period with an employer's group health plan Not Provided
14 Medicare Secondary, No-fault Insurance including Auto is Primary Not Provided
15 Medicare Secondary Worker's Compensation Not Provided
16 Medicare Secondary Public Health Service (PHS)or Other Federal Agency Not Provided
41 Medicare Secondary Black Lung Not Provided
42 Medicare Secondary Veteran's Administration Not Provided
43 Medicare Secondary Disabled Beneficiary Under Age 65 with Large Group Health Plan (LGHP) Not Provided
47 Medicare Secondary, Other Liability Insurance is Primary Not Provided
AP Auto Insurance Policy Not Provided
C1 Commercial Not Provided
CO Consolidated Omnibus Budget Reconciliation Act (COBRA) Not Provided
CP Medicare Conditionally Primary Not Provided
D Disability Not Provided
DB Disability Benefits Not Provided
EP Exclusive Provider Organization Not Provided
FF Family or Friends Not Provided
GP Group Policy Not Provided
HM Health Maintenance Organization (HMO) Not Provided
HN Health Maintenance Organization (HMO) - Medicare Risk Not Provided
HS Special Low Income Medicare Beneficiary Not Provided
IN Indemnity Not Provided
IP Individual Policy Not Provided
LC Long Term Care Not Provided
LD Long Term Policy Not Provided
LI Life Insurance Not Provided
LT Litigation Not Provided
MA Medicare Part A Not Provided
MB Medicare Part B Not Provided
MC Medicaid Not Provided
MH Medigap Part A Not Provided
MI Medigap Part B Not Provided
MP Medicare Primary Not Provided
OT Other Not Provided
PE Property Insurance - Personal Not Provided
PL Personal Not Provided
PP Personal Payment (Cash - No Insurance) Not Provided
PR Preferred Provider Organization (PPO) Not Provided
PS Point of Service (POS) Not Provided
QM Qualified Medicare Beneficiary Not Provided
RP Property Insurance - Real Not Provided
SP Supplemental Policy Not Provided
TF Tax Equity Fiscal Responsibility Act (TEFRA) Not Provided
WC Workers Compensation Not Provided
WU Wrap Up Policy Not Provided
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There are no Conceptual Domains linked to Health Insurance Type Value Set.

Relationship Organization Item
is utilized by HITSP Health Insurance Type   

There are no Value Domains linked to Health Insurance Type Value Set.

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