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All Payer Claims: Data Element Comparison

Selected Items
Action Name Data Element ID Version State/Organization
Claim Status MC038 December 1, 2010 - v2.1 Massachusetts
Claim Status MC038 June 7, 2013 - v3.1 Massachusetts
Claim Status MC038 October 1, 2014 - v4.0 Massachusetts
Data Element: Claim Status MC038 - December 1, 2010 - v2.1
(Massachusetts)
Claim Status MC038 - June 7, 2013 - v3.1
(Massachusetts)
Claim Status MC038 - October 1, 2014 - v4.0
(Massachusetts)
[Shared]Data Element ID MC038 MC038 MC038
[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 39 39 39
[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 Actually describes the payment status of the specific service line record. See lookup for valid values. 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 MC MC MC
[Unshared]Old Length 2 Not Supplied Not Supplied
Data Element: Claim Status MC038 - December 1, 2010 - v2.1
(Massachusetts)
Claim Status MC038 - June 7, 2013 - v3.1
(Massachusetts)
Claim Status MC038 - 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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