Master Data Element Dictionary, version 20240608: NCMMIS 6501 - 7000

Master Data Element Dictionary, version 20240608: NCMMIS 6501 - 7000

Software Version Number (SVN)

NCMMIS Number: 6501

Description: Software Version Number (SVN) specifies a version of software.

Data Type: CHARACTER

Size: X(4)

Functional Area Owner: E-Commerce

Valid Values:

From Value

Thru Value

Short Description

Long Description

From Value

Thru Value

Short Description

Long Description

3A

3A

3A FIXED

NCPDP VERSION 3.2 FIXED CLAIM 3A

0012

0012

PC/PACES12

PC/PACES II VERSION 12

0013

0013

PC/PACES13

PC/PACES II VERSION 13

32

32

32 VAR

NCPDP VERSION 3.2 VARIABLE CLAIM

0120

0120

POSV12

POS VERSION 12

0130

0130

POSV13

POS VERSION 13

0140

0140

POSV14

POS VERSION 14

2012

2012

MCEFSVN

MANAGED CARE ENROLLMENT FIELD SOFTWARE VERSION NO.

 

Last Update: 3/4/2021 1:49:37 PM

 

RSS URL Map

NCMMIS Number: 6502

Description:

Data Type:

Size:

Functional Area Owner: Provider

Valid Values:

Last Update: 7/14/2010 2:15:31 PM

 

Services Code

NCMMIS Number: 6503

Description:

Data Type:

Size:

Functional Area Owner: Provider

Valid Values:

Last Update: 7/14/2010 2:15:45 PM

 

Endorsement Required Indicator

NCMMIS Number: 6504

Description:

Data Type:

Size:

Functional Area Owner: Provider

Valid Values:

Last Update: 7/14/2010 2:15:45 PM

 

Preference Sequence Identifier

NCMMIS Number: 6505

Description:

Data Type:

Size:

Functional Area Owner: Provider

Valid Values:

Last Update: 7/14/2010 2:15:45 PM

 

Preference Type Code

NCMMIS Number: 6506

Description:

Data Type:

Size:

Functional Area Owner: Provider

Valid Values:

Last Update: 7/14/2010 2:15:45 PM

 

Preference Name

NCMMIS Number: 6507

Description: Preference Name

Data Type: CHARACTER

Size: X(30)

Functional Area Owner: Provider

Valid Values:

Last Update: 3/19/2012 9:18:17 AM

 

Preference Value

NCMMIS Number: 6508

Description: Preference Value

Data Type: CHARACTER

Size: X(8000)

Functional Area Owner: Provider

Valid Values:

Last Update: 3/19/2012 9:21:01 AM

 

Active Indicator

NCMMIS Number: 6509

Description: Active Indicator

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Provider

Valid Values:

Last Update: 4/19/2013 1:52:08 PM

 

Zip Code Location Code

NCMMIS Number: 6510

Description: Code indicating if the zip code is I(n-state) or B(order).

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Provider

Valid Values:

Last Update: 4/18/2013 10:07:39 AM

 

TPL - Justification Reason Code

NCMMIS Number: 6511

Description: The justification for a beneficiary's Part A or Prat B Medicare Entitlement Dates based on His/Her Disablity insurance Benefits

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Third Party Liability

Valid Values:

From Value

Thru Value

Short Description

Long Description

From Value

Thru Value

Short Description

Long Description

space

space

N/A

BLANK: NOT ENTITLED

1

1

ENTITLED

BENEFICIARY IS ENTITLED TO MEDICARE COVERAGE DUE TO PRIOR DISABILTY ENTITLEMENT

 

Last Update: 3/12/2021 1:31:50 PM

 

Dental Documentation of Medical Necessity

NCMMIS Number: 6512

Description: Dental Documentation of Medical Necessity describes the reason for the PA request.

Data Type:

Size:

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 7/14/2010 4:28:14 PM

 

Adult Non-Covered Service Indicator

NCMMIS Number: 6513

Description: Adult Non-Covered Service Indicator indicates if the requested service for an adult recipient is a non-covered service.

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 8/13/2010 9:32:04 AM

 

Provider Locator Code

NCMMIS Number: 6514

Description: Provider Locator Code specifies the type of address associated with a provider identifying a pay-to, correspondence and one or more service locations.

Data Type: CHARACTER

Size: X(3)

Functional Area Owner: Provider

Valid Values:

From Value

Thru Value

Short Description

Long Description

From Value

Thru Value

Short Description

Long Description

001

001

Pay-to

Pay-to

002

002

CORSPNDNCE

Correspondence

003

999

Service

Service

 

Last Update: 3/8/2021 4:19:42 PM

 

Billing Provider Same as Requesting Provider Indicator

NCMMIS Number: 6515

Description: Billing Provider Same as Requesting Provider Indicator allows a provider to indicate that the billing provider is also the requesting provider.

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 4/22/2013 10:56:56 AM

 

TPL - Non-Entitlement Status

NCMMIS Number: 6516

Description: The reason for the beneficiary's current non-entitlement to Part-A/Part B Medicare Benefits. Occurs when there is no Part A/Part B entitlement start and Termination date. See also 7901 and 7902

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Third Party Liability

Valid Values:

From Value

Thru Value

Short Description

Long Description

From Value

Thru Value

Short Description

Long Description

D

D

DENIED

COVERAGE WAS DENIED

F

F

VOIDED

TERMINATED DUE TO INVALID ENROLLMENT OR ENROLLMENT VOIDED

H

H

NOT-ELIGIB

NOT-ELIGIBLE FOR FREE PART A OR DID NOT ENROLL FOR PREMIUM PART A

N

N

NOT A VALI

NOT A VALID SSA HOC, BUT USED BY HCFA'S THIRD PARTY

SYSTEM TO INDICATE A 'POTENTIAL'PTA ENTITLEMENT DATE

R

R

REFUSED

REFUSED BENEFITS

 

Last Update: 3/12/2021 1:31:50 PM

 

TPL - Accrete Adjustment Code

NCMMIS Number: 6517

Description: Code that indicate the type of third party Part A/Part B accretion adjustment action taken and the reason for the adjustment

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Third Party Liability

Valid Values:

From Value

Thru Value

Short Description

Long Description

From Value

Thru Value

Short Description

Long Description

space

space

N/A

BLANK: NOT APPLICABLE

C

C

RECONCILLA

OPM ACCRETED THE BENEFICIARY DURING THE 8/82 AND 9/82 OPM/SPACE RECONCILIATION BILLING

E

E

START DATE

THE PREVIOUS START DATE WAS ADJUSTED TO AN EARLIER DATE

J

J

5

THE ACCRETION WAS CREATED IN THE 3/77 OR 5/77 MBR/SPACE RECONCILLATION BILLING

L

L

2

THE PREVIOUS START DATE WAS ADJUSTED TO A LATER DATE

R

R

ACCRETE CR

THE ACCRETION WAS CREATED IN THE 4/87 MBR/SPACE RECONCILIATION BILLING

S

S

HISTORY OV

THE NEW ACCRETION DATE WAS ADJUSTED TO A LATER DATE DUE TO A PRIOR HISTORY OVERLAP INVOLVING THE SAME AGENCIES

V

V

1

THE PREVIOUS START DATE WAS ADJUSTED DUE TO AN OPM RIC V TRANSACTION

7

7

4

A NEW OPM INITIATED ACCRETION CONTAINS AN ADJUSTED DATE THAT IS LATER THAN REQUESTED DUE TO POLICY

8

8

3

THE NEW ACCRETION DATE WAS ADJUSTED TO A LATER DATE DUE TO A PRIOR HISTORY OVERLAP INVOLVING DIFFERENT AGENCIES

 

Last Update: 3/12/2021 1:31:50 PM

 

Correspondence Address Line Number

NCMMIS Number: 6518

Description: Correspondence Address Line Number indicates the number of lines of correspondence providers associated with a PA record.

Data Type: NUMERIC

Size: X(2)

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 7/16/2010 11:51:01 AM

 

Comments Line Number

NCMMIS Number: 6519

Description: Comments Line Number indicates the number of lines of comments associated with a PA record.

Data Type: NUMERIC

Size: X(2)

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 7/16/2010 11:51:19 AM

 

Viral Load Date

NCMMIS Number: 6520

Description: Viral Load Date is the date of the viral load test.

Data Type: DATE

Size: X(10)

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 4/19/2013 1:52:46 PM

 

Ad Hoc report request identifying number

NCMMIS Number: 6521

Description: Internal number used to create a unique row

Data Type:

Size:

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 7/21/2010 11:20:49 AM

 

Report Request User Id

NCMMIS Number: 6522

Description: Report Request User Id is the system ID of the user requesting the report.

Data Type: CHARACTER

Size: X(7)

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 4/18/2013 10:08:41 AM

 

Report Request TimeStamp

NCMMIS Number: 6523

Description: Audit Timestamp specifies the date and time an add, update, or delete was performed on a datastore.

Data Type:

Size:

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 7/21/2010 11:20:49 AM

 

Report Type Code

NCMMIS Number: 6524

Description: Report Type Code is the specific report being requested.