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All Payer Claims: Data Element Comparison

Selected Items
Action Name Data Element ID Version State/Organization
Claim Status PC025 2010-03-16 Maine
Claim Status PC025 v1.2 Maine
Data Element: Claim Status PC025 - 2010-03-16
(Maine)
Claim Status PC025 - v1.2
(Maine)
[Shared]Data Element ID PC025 PC025
[Unshared]Definition Not Provided This field contains the status of the claim as reported by the payer.
[Shared] State / Source Maine
Maine
[Unshared]Data Type integer NUMBER
[Shared]Length 2 2
[Shared]Field Name STATUS STATUS
[Unshared]DATE AVAIL '1/1/2003 Not Supplied
[Unshared]Date Required Not Supplied '2003-01-31
[Unshared]Warnings Not Supplied A minimum of 97% of all records submitted must have a valid claim status code. Not all payers are able to qualify the processing the claim with the specificity of the available valid codes. The vast majority of all claims are coded as 01 - processed as primary. Claims processed as secondary may have dramatically lower payments for services rendered because another payer had primary responsibility. A small number of payers are unable to distinguish claims processed as primary from those processed as secondary.
Data Element: Claim Status PC025 - 2010-03-16
(Maine)
Claim Status PC025 - v1.2
(Maine)
[Unshared]01 Not Utilized Processed as primary
[Unshared]02 Not Utilized Processed as secondary
[Unshared]03 Not Utilized Processed as tertiary
[Unshared]04 Not Utilized Denied
[Unshared]19 Not Utilized Processed as primary, forwarded to additional payer(s)
[Unshared]20 Not Utilized Processed as secondary, forwarded to additional payer(s)
[Unshared]21 Not Utilized Processed as tertiary, forwarded to additional payer(s)
[Unshared]22 Not Utilized Reversal of previous payment
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