Master Data Element Dictionary, version 20240608: NCMMIS 5501 - 6000
PA Type Codes Accepting Attachments
NCMMIS Number: 5501
Description: This is a subset of all the PA Type codes (DE#4601). It includes only those PA types that may have attachments.
Data Type: CHARACTER
Size: X(3)
Functional Area Owner: Prior Authorization
Valid Values:
From Value | Thru Value | Short Description | Long Description |
|---|---|---|---|
A04 | A04 | DME | DURABLE MEDICAL EQUIPMENT |
A05 | A05 | DENTAL | DENTAL |
A06 | A06 | ORTHODONTI | ORTHODONTIC |
A08 | A08 | HEARING AI | HEARING AID |
A10 | A10 | HOSPICE | HOSPICE |
A11 | A11 | LTC - NF | LONG TERM CARE - NURSING FACILITY |
A12 | A12 | LTC - SH | LONG TERM CARE - SPECIALTY HOSP |
A16 | A16 | MEDICAL | MEDICAL |
A17 | A17 | OUT OF STA | OUT OF STATE |
A18 | A18 | OOS SURGER | OUT OF STATE SURGERY |
A19 | A19 | SURGERY | SURGERY |
A21 | A21 | PDN | PRIVATE DUTY NURSING |
A22 | A22 | TRANSPLANT | TRANSPLANTS |
A23 | A23 | EXC. TO LE | EXCEPTION TO LEGISLATIVE LIMITS |
A24 | A24 | MPW | MEDICAID FOR PREGNANT WOMEN |
A31 | A31 | LTC-CAP | LONG TERM CARE - CAP |
A35 | A35 | OPTICAL | OPTICAL |
A36 | A36 | VISUAL AID | VISUAL AID |
A37 | A37 | REFRACTION | REFRACTION PRIOR APPROVAL |
A39 | A39 | OOS - AMBU | OUT OF STATE AMBULANCE |
A47 | A47 | THER. LEAV | THERAPEUTIC LEAVE |
A60 | A60 | AMBULANCE | AMBULANCE |
A61 | A61 | HOME HLTH | HOME HEALTH |
A80 | A80 | AUD IMPL | AUDITORY IMPLANTS |
A99 | A99 | PHARMACY | PHARMACY |
P21 | P21 | APPLI DME | APPLIANCES/DME |
P22 | P22 | AUDIOLOGY | AUDIOLOGY |
P23 | P23 | CCE | CASE CONSULTATION AND EDUCATION |
P24 | P24 | CBRS | COMMUNITY BASED REHABILITATIVE SERVICES |
P25 | P25 | DEV. EVAL. | DEVELOPMENTAL EVALUATIONS |
P26 | P26 | ADAP FORM | ADAP FORMULARYDRUGS |
P27 | P27 | FAM COUNSE | FAMILY COUNSELING AND THERAPY |
P28 | P28 | FORMULA | FORMULA |
P29 | P29 | INPAT. HOS | INPATIENT HOSPITAL ADMISSION |
P30 | P30 | HOME NURSI | HOME NURSING CARE |
P31 | P31 | NUTRITION | NUTRITION SERVICES |
P32 | P32 | OP HOSP V | OUTPATIENT HOSPITAL VISITS |
P33 | P33 | PHYS. OFFI | PHYSICIANS OFFICE VISIT |
P34 | P34 | PSYCHOLOGI | PSYCHOLOGICAL SERVICES |
P35 | P35 | SW SERVICE | SOCIAL WORK SERVICES |
P36 | P36 | OT SERVICE | OCCUPATIONAL THERAPY SERVICES |
P37 | P37 | SPEECH/LAN | SPEECH/LANGUAGE SERVICES |
P38 | P38 | SUPPLIES | SUPPLIES |
P39 | P39 | TARGETED C | TARGETED CASE MANAGEMENT |
P40 | P40 | CHEMOTHERA | CHEMOTHERAPY |
P41 | P41 | ORTHODONTI | ORTHODONTIA |
P42 | P42 | OUTP. DIAL | OUTPATIENT DIALYSIS |
P43 | P43 | RADIATION | RADIATION TREATMENT |
P44 | P44 | RESIDENTIA | RESIDENTIAL CARE |
P45 | P45 | OP HOSP S | OUTPATIENT HOSPITAL SURGERY |
P46 | P46 | ER VISITS | EMERGENCY ROOM VISITS |
P47 | P47 | PHYS. THER | PHYSICAL THERAPY |
P48 | P48 | DENT VISIT | DENTAL OFFICE VISITS |
P49 | P49 | HIT | HOME INFUSION THERAPY |
P50 | P50 | SC FORMUL | SICKLE CELL FORMULARY |
P51 | P51 | ERYTHROPO | ERYTHROPOIETIN |
P52 | P52 | DPH DRUG | DPH DRUGS - OTHER |
Last Update: 11/20/2023 8:48:57 AM
Antifungal Treatment Contraindication Indicator
NCMMIS Number: 5502
Description: Antifungal Treatment Contraindication Indicator indicates if the recipient is unable to receive treatment with topical antifungal therapy and Diflucan.
Data Type: CHARACTER
Size: X(1)
Functional Area Owner: Prior Authorization
Valid Values:
Last Update: 5/18/2010 4:13:58 PM
Antifungal Other Condition
NCMMIS Number: 5503
Description: Antifungal Other Condition describes the other condition.
Data Type: CHARACTER
Size: X(30)
Functional Area Owner: Prior Authorization
Valid Values:
Last Update: 5/18/2010 4:13:59 PM
Orencia More Than One Biologic RA Agent Indicator
NCMMIS Number: 5504
Description: Orencia More Than One Biologic RA Agent Indicator indicates if the recipient will be receiving more than one biologic rheumatoid arthritis agent at the same time.
Data Type: CHARACTER
Size: X(1)
Functional Area Owner: Prior Authorization
Valid Values:
Last Update: 5/17/2010 4:06:42 PM
Oencia Moderate to Severe Rheumatoid Arthritis Indicator
NCMMIS Number: 5505
Description: Orencia Moderate to Severe Rheumatoid Arthritis Indicator indicates if the recipient has this condition.
Data Type: CHARACTER
Size: X(1)
Functional Area Owner: Prior Authorization
Valid Values:
Last Update: 5/17/2010 4:06:44 PM
Orencia Moderate to Severe JIA/JRA Indicator
NCMMIS Number: 5506
Description: Orencia Moderate to Severe JIA/JRA Indicator indicates if the recipient has Juevenile Idiopathic Arthritis (JIA) or Juvenile Rheumatoid Arthritis (JRA).
Data Type: CHARACTER
Size: X(1)
Functional Area Owner: Prior Authorization
Valid Values:
Last Update: 5/17/2010 4:06:47 PM
Simponi More Than One Biologic RA Agent Indicator
NCMMIS Number: 5507
Description: Simponi More Than One Biologic RA Agent Indicator indicates if the recipient will be receiving more than one biologic rheumatoid arthritis agent at the same time.
Data Type: CHARACTER
Size: X(1)
Functional Area Owner: Prior Authorization
Valid Values:
Last Update: 5/17/2010 4:06:56 PM
Simponi TB Evaluation Code
NCMMIS Number: 5508
Description: Simponi TB Evaluation Code indicates if the recipient will be evaluated and screened for the presence of latent TB infection.
Data Type: CHARACTER
Size: X(1)
Functional Area Owner: Prior Authorization
Valid Values:
From Value | Thru Value | Short Description | Long Description |
|---|---|---|---|
N | N | NO | NO |
W | W | NOTWARR | NOT WARRANTED |
Y | Y | YES | YES |
Last Update: 11/20/2023 8:42:38 AM