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All Payer Claims: Data Element Comparison

Selected Items
Action Name Data Element ID Version State/Organization
Claim Status DC031 December 1, 2010 - v2.1 Massachusetts
Claim Status DC031 June 7, 2013 - v3.1 Massachusetts
Claim Status DC031 October 1, 2014 - v4.0 Massachusetts
Data Element: Claim Status DC031 - December 1, 2010 - v2.1
(Massachusetts)
Claim Status DC031 - June 7, 2013 - v3.1
(Massachusetts)
Claim Status DC031 - October 1, 2014 - v4.0
(Massachusetts)
[Shared]Data Element ID DC031 DC031 DC031
[Shared]Definition Claim Line Status Claim Line Status Claim Line Status
[Shared] State / Source Massachusetts
Massachusetts
Massachusetts
[Unshared]Data Type Integer Lookup Table - Numeric Lookup Table - Numeric
[Unshared]Data Type Description Lookup Table tlkpClaimStatus tlkpClaimStatus
[Unshared]Format tlkpClaimStatus varchar[2] varchar[2]
[Shared]Length 2 2 2
[Shared]Column 32 32 32
[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 A0 A0
[Unshared]Condition Not Supplied All All
[Unshared]Date Active (version) '6/24/2010 Not Supplied Not Supplied
[Unshared]Element Submission Guideline A code indicating the submitting carriers sequence on a multiple-carrier claim Report the value that defines the payment status of this claim line Report the value that defines the payment status of this claim line
[Shared]File DC DC DC
[Unshared]Old Length 2 Not Supplied Not Supplied
Data Element: Claim Status DC031 - December 1, 2010 - v2.1
(Massachusetts)
Claim Status DC031 - June 7, 2013 - v3.1
(Massachusetts)
Claim Status DC031 - October 1, 2014 - v4.0
(Massachusetts)
[Unshared]01 Processed as primary Not Utilized Not Utilized
[Unshared]1 Not Utilized Processed as primary Processed as primary
[Unshared]02 Processed as secondary Not Utilized Not Utilized
[Unshared]2 Not Utilized Processed as secondary Processed as secondary
[Unshared]03 Processed as tertiary Not Utilized Not Utilized
[Unshared]3 Not Utilized Processed as tertiary Processed as tertiary
[Unshared]04 Denied Not Utilized Not Utilized
[Unshared]4 Not Utilized Denied Denied
[Shared]19 Processed as primary, forwarded to additional payer(s) Processed as primary, forwarded to additional payer(s) Processed as primary, forwarded to additional payer(s)
[Shared]20 Processed as secondary, forwarded to additional payer(s) Processed as secondary, forwarded to additional payer(s) Processed as secondary, forwarded to additional payer(s)
[Shared]21 Processed as tertiary, forwarded to additional payer(s) Processed as tertiary, forwarded to additional payer(s) Processed as tertiary, forwarded to additional payer(s)
[Shared]22 Reversal of previous payment Reversal of previous payment Reversal of previous payment
[Unshared]23 Not Utilized Not our claim, forwarded to additional payer(s) Not our claim, forwarded to additional payer(s)
[Unshared]25 Not Utilized Predetermination Pricing Only - no payment Predetermination Pricing Only - no payment
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