United States Health Information Knowledgebase

 

All Payer Claims: Data Element Comparison

Selected Items
Action Name Data Element ID Version State/Organization
Coordination of Benefits/TPL Liability Amount PC065 December 1, 2010 - v2.1 Massachusetts
Coordination of Benefits/TPL Liability Amount PC065 June 7, 2013 - v3.1 Massachusetts
Coordination of Benefits/TPL Liability Amount PC065 October 1, 2014 - v4.0 Massachusetts
Data Element: Coordination of Benefits/TPL Liability Amount PC065 - December 1, 2010 - v2.1
(Massachusetts)
Coordination of Benefits/TPL Liability Amount PC065 - June 7, 2013 - v3.1
(Massachusetts)
Coordination of Benefits/TPL Liability Amount PC065 - October 1, 2014 - v4.0
(Massachusetts)
[Shared]Data Element ID PC065 PC065 PC065
[Shared]Definition Amount due from a Secondary Carrier when known Amount due from a Secondary Carrier when known Amount due from a Secondary Carrier when known
[Shared] State / Source Massachusetts
Massachusetts
Massachusetts
[Shared]Data Type Integer Integer Integer
[Shared]Data Type Description Currency Currency Currency
[Unshared]Format DDDDCC ┬▒varchar[10] ┬▒varchar[10]
[Shared]Length 10 10 10
[Shared]Column 67 67 67
[Unshared]Threshold 0 1 1
[Unshared]Encrypted No
[Unshared]Required All
[Unshared]APCD - GIC Carrier Threshold 1 Not Supplied Not Supplied
[Unshared]Cat Not Supplied A2 A2
[Unshared]Condition Not Supplied Required when PC025 = 19, 20 or 21 Required when PC025 = 19, 20 or 21
[Unshared]Date Active (version) '6/24/2010 Not Supplied Not Supplied
[Unshared]Element Submission Guideline The amount that another carrier/insurer is liable for. Example is known 'gap coverage' where Payer-to-Payer transactions took place. Code zero cents (00) where applicable. Example: 150.00 will be reported as 15000. Report the amount that another carrier / insurer is liable for after submitting payer has processed this claim line. Report 0 if there is no COB / TPL amount. Do not code decimal or round up / down to whole dollars, code zero cents (00) when applicable. EXAMPLE: 150.00 is reported as 15000; 150.70 is reported as 15070 Report the amount that another carrier / insurer is liable for after submitting payer has processed this claim line. Report 0 if there is no COB / TPL amount. Do not code decimal or round up / down to whole dollars, code zero cents (00) when applicable. EXAMPLE: 150.00 is reported as 15000; 150.70 is reported as 15070
[Shared]File PC PC PC
[Unshared]Old Length 10 Not Supplied Not Supplied
Data Element: Coordination of Benefits/TPL Liability Amount PC065 - December 1, 2010 - v2.1
(Massachusetts)
Coordination of Benefits/TPL Liability Amount PC065 - June 7, 2013 - v3.1
(Massachusetts)
Coordination of Benefits/TPL Liability Amount PC065 - October 1, 2014 - v4.0
(Massachusetts)
There are no enumerated permissible values for these data elements.
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