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All Payer Claims: Data Element Comparison

Selected Items
Action Name Data Element ID Version State/Organization
Product Line of Business Model PR004 October 22, 2010 - v2.0 Massachusetts
Product Line of Business Model PR004 June 7, 2013 - v3.1 Massachusetts
Product Line of Business Model PR004 October 1, 2014 - v4.0 Massachusetts
Data Element: Product Line of Business Model PR004 - October 22, 2010 - v2.0
(Massachusetts)
Product Line of Business Model PR004 - June 7, 2013 - v3.1
(Massachusetts)
Product Line of Business Model PR004 - October 1, 2014 - v4.0
(Massachusetts)
[Shared]Data Element ID PR004 PR004 PR004
[Unshared]Definition The Line of Business / Insurance Model the Product relates to. Line of Business / Insurance Model the Product relates to. Line of Business / Insurance Model the Product relates to.
[Shared] State / Source Massachusetts
Massachusetts
Massachusetts
[Unshared]Data Type Text Lookup Table - Text Lookup Table - Text
[Unshared]Data Type Description Lookup Table tlkpProductLineOfBusiness tlkpProductLineOfBusiness
[Unshared]Format tlkpProductLineOfBusiness char[2] char[2]
[Shared]Length 2 2 2
[Shared]Column 4 4 4
[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) '10/3/2010 Not Supplied Not Supplied
[Unshared]Element Submission Guideline See lookup for valid values, such as HMO Open, HMO Closed, POS, EPO, Medicaid FFS, Disability, etc. Report the code that defines the Line of Business model that this product follows. EXAMPLE: 12 = PPO Report the code that defines the Line of Business model that this product follows. EXAMPLE: 12 = PPO
[Shared]File PR PR PR
[Unshared]Old Length 2 Not Supplied Not Supplied
Data Element: Product Line of Business Model PR004 - October 22, 2010 - v2.0
(Massachusetts)
Product Line of Business Model PR004 - June 7, 2013 - v3.1
(Massachusetts)
Product Line of Business Model PR004 - October 1, 2014 - v4.0
(Massachusetts)
[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
[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]AC Accident Only Accident Only Accident Only
[Shared]BH Basic Hospital Basic Hospital Basic Hospital
[Shared]CH CHAMPUS CHAMPUS CHAMPUS
[Shared]DM Dental Maintenance Organization Dental Maintenance Organization Dental Maintenance Organization
[Shared]DS Disability Disability Disability
[Shared]HC HMO - Closed HMO - Closed HMO - Closed
[Shared]HO HMO - Open HMO - Open HMO - Open
[Shared]IN Individual Individual Individual
[Shared]LM Liability Medical Liability Medical Liability Medical
[Shared]MC Medicaid FFS Medicaid FFS Medicaid FFS
[Shared]MO Medicaid Managed Care Organization Medicaid Managed Care Organization Medicaid Managed Care Organization
[Shared]MP Medicare Primary Medicare Primary Medicare Primary
[Shared]MR Medicare Medicare Medicare
[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]PC Medicaid Primary Care Clinician Plan Medicaid Primary Care Clinician Plan Medicaid Primary Care Clinician Plan
[Shared]PR Preferred Provider Organization (PPO) Preferred Provider Organization (PPO) Preferred Provider Organization (PPO)
[Unshared]QH Not Utilized Not Utilized Qualified Health Plan
[Shared]QM Qualified Medicare Beneficiary/SLMB Qualified Medicare Beneficiary/SLMB Qualified Medicare Beneficiary/SLMB
[Unshared]SA Self Administered Group Self-Administered Group Self-Administered Group
[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
[Unshared]UN Not Utilized Unemployment Unemployment
[Shared]VA Veterans Administration Plan Veterans Administration Plan Veterans Administration Plan
[Unshared]VS Not Utilized Vision Vision
[Shared]WC Workers' Compensation Workers' Compensation Workers' Compensation
[Unshared]ZZ Mutually Defined Other Other Other
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