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Admission date

MC018, Oregon

Versions: September 27, 2011 - v2011.1.1• June 25, 2012 - v2013.0.0• June 27, 2013 - v2014.0.0• 2015.0.1Compare Versions


Name:Admission date
Data Element ID:MC018
Description:example: 20090603
State:Oregon
Data Type:Date
Format:CCYYMMDD
Length:8
Threshold:1%
Required:Yes
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File Specification for Multiple versionsMedical Claims File Submission - 2015.0.1

Data Element ID Data Element Description Type Format Length
Multiple versionsMC001 Payer type Not Provided Text 1
Multiple versionsMC003 Product code Not Provided Text 3
Multiple versionsMC004 Claim ID Payer's unique claim identifier Text 80
Multiple versionsMC005 Service line counter Increments of 1 for each claim line Numeric 4
Multiple versionsMC010 Member ID Plan-specific unique member identifier Text 30
Multiple versionsMC017 Payment date example: 20090624) Date CCYYMMDD 8
Multiple versionsMC018 Admission date example: 20090603 Date CCYYMMDD 8
Multiple versionsMC023 Discharge status Not Provided Text 2
Multiple versionsMC024 Rendering provider ID Identifier for the rendering provider as assigned by the reporting entity Text 30
Multiple versionsMC036 Type of bill Required only for institutional claims. Numeric 3
Multiple versionsMC037 Place of service Required only for professional claims. Text 2
Multiple versionsMC038 Claim status Was claim paid, denied, CCO encounter, or MCO encounter only? Text 1
Multiple versionsMC038A COB status Was claim a COB claim? Text 1
Multiple versionsMC041 Principal diagnosis ICD-10 diagnosis code for dates of service beginning 10/01/2014. Include all characters (example: E10.359). ICD-9 diagnosis code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 01220) Text 7
Multiple versionsMC041P POA flag 1 Present on admission flag for principal diagnosis. Text 1
Multiple versionsMC042 Diagnosis 2 ICD-10 diagnosis code for dates of service beginning 10/01/2014. Include all characters (example: E10.359). ICD-9 diagnosis code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 01220) Text 7
Multiple versionsMC042P POA flag 2 Present on admission flag for diagnosis 2. Required if MC042 is populated. Text 1
Multiple versionsMC043 Diagnosis 3 ICD-10 diagnosis code for dates of service beginning 10/01/2014. Include all characters (example: E10.359). ICD-9 diagnosis code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 01220) Text 7
Multiple versionsMC043P POA flag 3 Present on admission flag for diagnosis 3. Required if MC043 is populated. Text 1
Multiple versionsMC044 Diagnosis 4 ICD-10 diagnosis code for dates of service beginning 10/01/2014. Include all characters (example: E10.359). ICD-9 diagnosis code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 01220) Text 7
Multiple versionsMC044P POA flag 4 Present on admission flag for diagnosis 4. Required if MC044 is populated. Text 1
Multiple versionsMC045 Diagnosis 5 ICD-10 diagnosis code for dates of service beginning 10/01/2014. Include all characters (example: E10.359). ICD-9 diagnosis code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 01220) Text 7
Multiple versionsMC045P POA flag 5 Present on admission flag for diagnosis 5. Required if MC045 is populated. Text 1
Multiple versionsMC046 Diagnosis 6 ICD-10 diagnosis code for dates of service beginning 10/01/2014. Include all characters (example: E10.359). ICD-9 diagnosis code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 01220) Text 7
Multiple versionsMC046P POA flag 6 Present on admission flag for diagnosis 6. Required if MC046 is populated. Text 1
Multiple versionsMC047 Diagnosis 7 ICD-10 diagnosis code for dates of service beginning 10/01/2014. Include all characters (example: E10.359). ICD-9 diagnosis code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 01220) Text 7
Multiple versionsMC047P POA flag 7 Present on admission flag for diagnosis 7. Required if MC047 is populated. Text 1
Multiple versionsMC048 Diagnosis 8 ICD-10 diagnosis code for dates of service beginning 10/01/2014. Include all characters (example: E10.359). ICD-9 diagnosis code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 01220) Text 7
Multiple versionsMC048P POA flag 8 Present on admission flag for diagnosis 8. Required if MC048 is populated. Text 1
Multiple versionsMC049 Diagnosis 9 ICD-10 diagnosis code for dates of service beginning 10/01/2014. Include all characters (example: E10.359). ICD-9 diagnosis code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 01220) Text 7
Multiple versionsMC049P POA flag 9 Present on admission flag for diagnosis 9. Required if MC049 is populated. Text 1
Multiple versionsMC050 Diagnosis 10 ICD-10 diagnosis code for dates of service beginning 10/01/2014. Include all characters (example: E10.359). ICD-9 diagnosis code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 01220) Text 7
Multiple versionsMC050P POA flag 10 Present on admission flag for diagnosis 10. Required if MC050 is populated. Text 1
Multiple versionsMC051 Diagnosis 11 ICD-10 diagnosis code for dates of service beginning 10/01/2014. Include all characters (example: E10.359). ICD-9 diagnosis code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 01220) Text 7
Multiple versionsMC051P POA flag 11 Present on admission flag for diagnosis 11 Required if MC051 is populated. Text 1
Multiple versionsMC052 Diagnosis 12 ICD-10 diagnosis code for dates of service beginning 10/01/2014. Include all characters (example: E10.359). ICD-9 diagnosis code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 01220) Text 7
Multiple versionsMC052P POA flag 12 Present on admission flag for diagnosis 12 Required if MC052 is populated. Text 1
Multiple versionsMC053 Diagnosis 13 ICD-10 diagnosis code for dates of service beginning 10/01/2014. Include all characters (example: E10.359). ICD-9 diagnosis code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 01220) Text 7
Multiple versionsMC053P POA flag 13 Present on admission flag for diagnosis 13 Required if MC053 is populated. Text 1
Multiple versionsMC054 Revenue code Include all digits (example: 0320) Text 4
Multiple versionsMC055 CPT/CPT II/HCPCS procedure code CPT, CPT II or HCPCS code. Include all digits (examples: 29870 or G0289) Text 5
Multiple versionsMC056 Procedure modifier 1 CPT or HCPCS modifier. Include all digits (examples: 50 or AA) Text 2
Multiple versionsMC057 Procedure modifier 2 CPT or HCPCS modifier. Include all digits (examples: 50 or AA) Text 2
Multiple versionsMC057A Procedure modifier 3 CPT or HCPCS modifier. Include all digits (examples: 50 or AA) Text 2
Multiple versionsMC057B Procedure modifier 4 CPT or HCPCS modifier. Include all digits (examples: 50 or AA) Text 2
Multiple versionsMC058 Principal inpatient procedure code ICD-10 procedure code for dates of service after 10/01/2014. Include all characters, (example: B245ZZ3). ICD-9 procedure code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 0085) Text 7
Multiple versionsMC058A Inpatient procedure code 2 ICD-10 procedure code for dates of service after 10/01/2014. Include all characters, (example: B245ZZ3). ICD-9 procedure code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 0085) Text 7
Multiple versionsMC058B Inpatient procedure code 3 ICD-10 procedure code for dates of service after 10/01/2014. Include all characters, (example: B245ZZ3). ICD-9 procedure code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 0085) Text 7
Multiple versionsMC058C Inpatient procedure code 4 ICD-10 procedure code for dates of service after 10/01/2014. Include all characters, (example: B245ZZ3). ICD-9 procedure code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 0085) Text 7
Multiple versionsMC058D Inpatient procedure code 5 ICD-10 procedure code for dates of service after 10/01/2014. Include all characters, (example: B245ZZ3). ICD-9 procedure code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 0085) Text 7
Multiple versionsMC058E Inpatient procedure code 6 ICD-10 procedure code for dates of service after 10/01/2014. Include all characters, (example: B245ZZ3). ICD-9 procedure code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 0085) Text 7
Multiple versionsMC058F Inpatient procedure code 7 ICD-10 procedure code for dates of service after 10/01/2014. Include all characters, (example: B245ZZ3). ICD-9 procedure code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 0085) Text 7
Multiple versionsMC058G Inpatient procedure code 8 ICD-10 procedure code for dates of service after 10/01/2014. Include all characters, (example: B245ZZ3). ICD-9 procedure code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 0085) Text 7
Multiple versionsMC058H Inpatient procedure code 9 ICD-10 procedure code for dates of service after 10/01/2014. Include all characters, (example: B245ZZ3). ICD-9 procedure code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 0085) Text 7
Multiple versionsMC058J Inpatient procedure code 10 ICD-10 procedure code for dates of service after 10/01/2014. Include all characters, (example: B245ZZ3). ICD-9 procedure code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 0085) Text 7
Multiple versionsMC058K Inpatient procedure code 11 ICD-10 procedure code for dates of service after 10/01/2014. Include all characters, (example: B245ZZ3). ICD-9 procedure code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 0085) Text 7
Multiple versionsMC058L Inpatient procedure code 12 ICD-10 procedure code for dates of service after 10/01/2014. Include all characters, (example: B245ZZ3). ICD-9 procedure code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 0085) Text 7
Multiple versionsMC058M Inpatient procedure code 13 ICD-10 procedure code for dates of service after 10/01/2014. Include all characters, (example: B245ZZ3). ICD-9 procedure code for dates of service before 10/01/2014. If ICD-9 include all digits and exclude decimal point (example: 0085) Text 7
Multiple versionsMC059 Date of service - From example: 20090603 Date CCYYMMDD 8
Multiple versionsMC060 Date of service - Thru example: 20090603 Date CCYYMMDD 8
Multiple versionsMC061 Quantity Count of units sent on claim line. Numeric 5
Multiple versionsMC062 Charges Two explicit decimal places. Enter 0 if amount equals zero. Leave blank if missing. Example: 15102.00 Numeric 12
Multiple versionsMC062A Allowed amount Two explicit decimal places. Enter 0 if amount equals zero. Leave blank if missing. Example: 15102.00 Numeric 12
Multiple versionsMC063 Payment Two explicit decimal places. Enter 0 if amount equals zero. Leave blank if missing. Example: 15102.00 Numeric 12
Multiple versionsMC064 Prepaid amount Two explicit decimal places. Enter 0 if amount equals zero. Leave blank if missing. Example: 15102.00 Numeric 12
Multiple versionsMC065 Co-payment Two explicit decimal places. Enter 0 if amount equals zero. Leave blank if missing. Example: 15102.00 Numeric 12
Multiple versionsMC066 Co-insurance Two explicit decimal places. Enter 0 if amount equals zero. Leave blank if missing. Example: 15102.00 Numeric 12
Multiple versionsMC067 Deductible Two explicit decimal places. Enter 0 if amount equals zero. Leave blank if missing. Example: 15102.00 Numeric 12
Multiple versionsMC067A Patient pay amount Required if any of MC065, MC066, or MC067 are missing. Two explicit decimal places. Enter 0 if amount equals zero. Leave blank if missing. Example: 15102.00 Numeric 12
Multiple versionsMC070 Discharge date Required only for institutional claims. Use 99991231 if patient has not discharged. (example: 20090605). Date CCYYMMDD 8
Multiple versionsMC076 Billing provider ID Identifier for the billing provider as assigned by the reporting entity Text 30
Multiple versionsQC05 Prior version claim number Required for participants in Q-Corp initiative. Text 80
Multiple versionsQC06 Claim received date Required for participants in Q-Corp initiative. Date CCYYMMDD 8
Multiple versionsQC22 DRG DRG paid by payer. If not available send billed DRG. Required for participants in Q-Corp initiative. Example: 061 Text 3
Multiple versionsQC23 DRG type Required for participants in Q-Corp initiative. Valid values: C (CMS v.24) or M (MS-DRG) Text 1
Multiple versionsQC37 LOINC code Placeholder for the Q-Corp initiative. Text 8
Multiple versionsQC38 Lab result Placeholder for the Q-Corp initiative. Text 8
Multiple versionsQC39 Micro/macro albumin result Placeholder for the Q-Corp initiative. Text 1
Multiple versionsOHLC1 COB allowed amount Required for participants in OHLC high value medical home initiative. Two explicit decimal places. Enter 0 if amount equals zero. Leave blank if missing. Example: 15102.00 Numeric 12
Multiple versionsOHLC2 Risk withhold amount Required for participants in OHLC high value medical home initiative. Two explicit decimal places. Enter 0 if amount equals zero. Leave blank if missing. Example: 15102.00 Numeric 12
Multiple versionsMC008 Plan specific contract number Plan specific contract number (aka group number) Text 30
Multiple versionsMC201 ICD version code Specifies the claim's ICD version. Text 2
Multiple versionsMC202 Empty field For future implementation Not Supplied Not Supplied Not Supplied
Multiple versionsMC203 Empty field For future implementation Not Supplied Not Supplied Not Supplied
Multiple versionsMC204 Empty field For future implementation Not Supplied Not Supplied Not Supplied
Multiple versionsMC205 Empty field For future implementation Not Supplied Not Supplied Not Supplied
Multiple versionsMC206 Empty field For future implementation Not Supplied Not Supplied Not Supplied
Multiple versionsMC207 Empty field For future implementation Not Supplied Not Supplied Not Supplied
Multiple versionsMC208 Empty field For future implementation Not Supplied Not Supplied Not Supplied
Multiple versionsMC209 Empty field For future implementation Not Supplied Not Supplied Not Supplied
Multiple versionsMC210 Empty field For future implementation Not Supplied Not Supplied Not Supplied

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