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All Payer Claims: Data Element Comparison

Selected Items
Action Name Data Element ID Version State/Organization
Insurance Type Code/Product ME003 December 1, 2010 - v2.1 Massachusetts
Insurance Type Code/Product ME003 June 7, 2013 - v3.1 Massachusetts
Insurance Type Code/Product ME003 October 1, 2014 - v4.0 Massachusetts
Data Element: Insurance Type Code/Product ME003 - December 1, 2010 - v2.1
(Massachusetts)
Insurance Type Code/Product ME003 - June 7, 2013 - v3.1
(Massachusetts)
Insurance Type Code/Product ME003 - October 1, 2014 - v4.0
(Massachusetts)
[Shared]Data Element ID ME003 ME003 ME003
[Shared]Definition Type / Product Identification Code Type / Product Identification Code Type / Product Identification Code
[Shared] State / Source Massachusetts
Massachusetts
Massachusetts
[Unshared]Data Type Text Text Lookup Table - Text
[Unshared]Data Type Description Lookup Table tlkpInsuranceTypeCode tlkpInsuranceTypeCode
[Unshared]Format tlkpInsuranceTypeCode char[2] char[2]
[Shared]Length 2 2 2
[Shared]Column 3 3 3
[Shared]Threshold 1 1 1
[Unshared]Encrypted No
[Unshared]Required All
[Unshared]APCD - GIC Carrier Threshold 1 Not Supplied Not Supplied
[Unshared]Cat Not Supplied A1 A1
[Unshared]Condition Not Supplied All All
[Unshared]Date Active (version) '10/20/2010 Not Supplied Not Supplied
[Unshared]Element Submission Guideline This field indicates the type of product the member has, such as HMO, PPO, POS, Auto Medical, Indemnity, Workers Compensation. Report the code that defines the type of insurance under which this member's eligibility is maintained. EXAMPLE: HM = HMO Report the code that defines the type of insurance under which this member's eligibility is maintained. EXAMPLE: HM = HMO
[Shared]File ME ME ME
[Unshared]Old Length 2 Not Supplied Not Supplied
Data Element: Insurance Type Code/Product ME003 - December 1, 2010 - v2.1
(Massachusetts)
Insurance Type Code/Product ME003 - June 7, 2013 - v3.1
(Massachusetts)
Insurance Type Code/Product ME003 - October 1, 2014 - v4.0
(Massachusetts)
[Unshared]09 Not Utilized Self-pay Self-pay
[Unshared]10 Not Utilized Central Certification Central Certification
[Unshared]11 Not Utilized Other Non-Federal Programs Other Non-Federal Programs
[Shared]12 Preferred Provider Organization (PPO) Preferred Provider Organization (PPO) Preferred Provider Organization (PPO)
[Shared]13 Point of Service (POS) Point of Service (POS) Point of Service (POS)
[Shared]14 Exclusive Provider Organization (EPO) Exclusive Provider Organization (EPO) Exclusive Provider Organization (EPO)
[Shared]15 Indemnity Insurance Indemnity Insurance Indemnity Insurance
[Shared]16 Health Maintenance Organization (HMO) Medicare Advantage Health Maintenance Organization (HMO) Medicare Advantage Health Maintenance Organization (HMO) Medicare Advantage
[Shared]17 Dental Maintenance Organization (DMO) Dental Maintenance Organization (DMO) Dental Maintenance Organization (DMO)
[Unshared]20 Not Utilized Medicare Advantage PPO Medicare Advantage PPO
[Unshared]21 Not Utilized Medicare Advantage Private Fee for Service Medicare Advantage Private Fee for Service
[Shared]AM Automobile Medical Automobile Medical Automobile Medical
[Unshared]BL Not Utilized Blue Cross / Blue Shield Blue Cross / Blue Shield
[Unshared]CC Not Utilized Commonwealth Care Commonwealth Care
[Unshared]CE Not Utilized Commonwealth Choice Commonwealth Choice
[Unshared]CH Not Utilized CHAMPUS CHAMPUS
[Unshared]CI Not Utilized Commercial Insurance Commercial Insurance
[Shared]DS Disability Disability Disability
[Shared]HM Health Maintenance Organization Health Maintenance Organization Health Maintenance Organization
[Shared]HN HMO Medicare Risk/Medicare Part C HMO Medicare Risk/Medicare Part C HMO Medicare Risk/Medicare Part C
[Unshared]IC Not Utilized Not Utilized Integrated Care Organization
[Shared]LI Liability Liability Liability
[Shared]LM Liability Medical Liability Medical Liability Medical
[Shared]MA Medicare Part A Medicare Part A Medicare Part A
[Shared]MB Medicare Part B Medicare Part B Medicare Part B
[Shared]MC Medicaid Medicaid Medicaid
[Shared]MD Medicare Part D Medicare Part D Medicare Part D
[Shared]MO Medicaid Managed Care Organization Medicaid Managed Care Organization Medicaid Managed Care Organization
[Shared]MP Medicare Primary Medicare Primary Medicare Primary
[Unshared]MS Not Utilized Medicare Secondary Plan Medicare Secondary Plan
[Shared]OF Other Federal Program (e.g. Black Lung) Other Federal Program (e.g. Black Lung) Other Federal Program (e.g. Black Lung)
[Shared]QM Qualified Medicare Beneficiary Qualified Medicare Beneficiary Qualified Medicare Beneficiary
[Shared]SC Senior Care Option Senior Care Option Senior Care Option
[Shared]SP Supplemental Policy Supplemental Policy Supplemental Policy
[Unshared]TF Not Utilized HSN Trust Fund HSN Trust Fund
[Shared]TV Title V Title V Title V
[Shared]VA Veterans Administration Plan Veterans Administration Plan Veterans Administration Plan
[Shared]WC Workers' Compensation Workers' Compensation Workers' Compensation
[Unshared]ZZ Not Utilized Other Other
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