Code of Massachusetts Regulations › 129 CMR - HEALTH CARE QUALITY AND COST COUNCIL › Title 129 CMR 2.00 - Uniform Reporting System For Health Care Claims Data Sets › Section 2.12 - Source Codes

Current through Register 1525, July 5, 2024
(1)
Admission Source Code (Data Element: MC021)
SOURCE: National Uniform Billing Data Element Specifications
AVAILABLE FROM:
National Uniform Billing Committee
American Hospital Association
840 Lake Shore Drive
Chicago, IL 60697
ABSTRACT: A variety of codes explaining who recommended admission to a medical facility.
(2)
Admission Type Code (Data Element: MC020)
SOURCE: National Uniform Billing Data Element Specifications
AVAILABLE FROM:
National Uniform Billing Committee
American Hospital Association
840 Lake Shore Drive
Chicago, IL 60697
ABSTRACT: A variety of codes explaining the priority of the admission to a medical facility.
(3)
Current Procedural Terminology (CPT) Codes (Data Element: MC055)
SOURCE: Physicians' Current Procedural Terminology (CPT) Manual
AVAILABLE FROM:
Order Department
American Medical Association
515 North State Street
Chicago, IL 60610
ABSTRACT: A listing of descriptive terms and identifying codes for reporting medical services and procedures performed by physicians.
(4)
Health Care Common Procedural Coding System (Data Element: MC055)
SOURCE: Health Care Common Procedural Coding System
AVAILABLE FROM:
www.cms.gov/medicare/hcpcs.htm
Centers for Medicare and Medicaid Services
Center for Health Plans and Providers
CCPP/DCPC
C5-08-27
7500 Security Boulevard
Baltimore, MD 21244-1850
ABSTRACT: HCPCS is the Centersfor Medicare and Medicaid Services (CMS) coding scheme to group procedures performed for payment to providers.
(5)
Centers for Medicare and Medicaid Services National Plan ID
(Data Elements: DC002, HD003, MC002, ME002, PC002, TR003)
SOURCE: Plan ID Database
AVAILABLE FROM:
Centers for Medicare and Medicaid Services
Centers for Beneficiary Services
Administration Group
Division of Membership Operations
SI-05-06
7500 Security Boulevard
Baltimore, MD 21244-1850
ABSTRACT: The Centers for Medicare and Medicaid Services is developing the Plan ID, which will be proposed as the standard unique identifier for each health plan under the Health Insurance Portability and Accountability Act of 1996.
(6)
Centers for Medicare and Medicaid Services National Provider Identifier
(Data Elements: DC020, MC026)
SOURCE: National Provider System
AVAILABLE FROM:
Centers for Medicare and Medicaid Services
Office of Information Services
Security and Standards Group
Director, Division of Health Care Information Systems
7500 Security Boulevard
Baltimore, MD 21244-1850
ABSTRACT: The Centers for Medicare and Medicaid Services is developing the National Provider Identifiers, which is proposed as the standard unique identifier for each health care provider under the Health Insurance Portability and Accountability Act of 1996.
(7)
International Classification of Diseases Clinical Mod (ICD-9-CM) Procedure (Data Elements: MC040, MC041, MC043, MC044, MC045, MC046, MC047, MC048, MC049, MC050, MC051, MC052, MC053, MC058)
SOURCE: International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM)
AVAILABLE FROM:
U.S. National Center for Health Statistics
Commission of Professional and Hospital Activities
1968 Green Road
Ann Arbor, MI 48105
ABSTRACT: The International Classification of Diseases, 9th Revision, Clinical Modification, describes the classification of morbidity and mortality information for statistical purposes and for the indexing of hospital records by disease and operations.
(8)
National Association of Boards of Pharmacy Number (Data Element: PC021)
SOURCE: National Association of Boards of Pharmacy Database and Listings
AVAILABLE FROM:
National Council for Prescription Drug Program
4201 North 24th Street
Suite 365
Phoenix, AZ 85016
ABSTRACT: A unique number assigned in the U.S. and its territories to individual clinic, hospital, chain, and independent pharmacy locations that conduct businessat retailbybilling third-party drug benefit payers. The National Council for Prescription Drug Programs (NCPDP) maintains this database under contract from the National Association of Boards of Pharmacy. The National Association of Boards of Pharmacy is a seven-digit numeric number with the following format SSNNNNC, where SS=NCPDP assigned state code number, NNNN=NCPDP assigned pharmacy location number, and C=check digit calculated by algorithm from previous six digits.
(9)
National Association of Insurance Commissioners (NAIC) Code
(Data Elements: DC001, HD002, MC001, ME001, PC001, TR002)
SOURCE: National Association of Insurance Commissioners Company Code List Manual
AVAILABLE FROM:
National Association of Insurance Commissioners
Publications Department
12th Street, Suite 1100
Kansas City, MO 64105-1925
ABSTRACT: Codes that uniquely identify each insurance company.
(10)
National Drug Code (Data Element: PC026)
SOURCE: Blue Book, Price Alert, National Drug Data File
AVAILABLE FROM:
First Databank, The Hearst Corporation
1111 Bayhill Drive
San Bruno, CA 94066
ABSTRACT: The National Drug Code is a coding convention established by the Food and Drug Administration to identify the labeler, product number, and package sizes of FDA-approved prescription drugs. There are over 170,000 National Drug Codes on file.
(11)
National Uniform Billing Committee (NUBC) Codes
(Data Element: MC054)
SOURCE: National Uniform Billing Data Element Specifications
AVAILABLE FROM:
National Uniform Billing Committee
American Hospital Association
840 Lake Shore Drive
Chicago, IL 60697
ABSTRACT: Revenue codes are a classification of hospital charges in a standard grouping that is controlled by the National Uniform Billing Committee. Place of service codes specify the type of location where a service is provided.
(12)
Discharge Status Code (Data Element: MC023)
SOURCE: National Uniform Billing Data Element Specifications
AVAILABLE FROM:
National Uniform Billing Committee
American Hospital Association
840 Lake Shore Drive
Chicago, IL 60697
ABSTRACT: A variety of codes indicating member status as of the date of service-thru field.
(13)
States and Outlying Areas of the U.S.
(Data Elements: DC015, DC028, MC015, MC034, ME016, PC015, PC023)
SOURCE: National Zip Code and Post Office Directory
AVAILABLE FROM:
U.S. Postal Service
National Information Data Center
P.O. Box 2977
Washington, DC 20013
ABSTRACT: Provides names, abbreviations, and codes for the 50 states, the District of Columbia, and the outlying areas of the U.S. The entities listed are considered to be the first order divisions of the U.S. Microfiche.
(14)
Uniform Billing Claim Form Bill Type (Data Element: MC036)
SOURCE: National Uniform Billing Data Element Specifications Type of Bill Positions 1 and 2
AVAILABLE FROM:
National Uniform Billing Committee
American Hospital Association
840 Lake Shore Drive
Chicago, IL 60697
ABSTRACT: A variety of codes describing the type of medical facility.
(15)
X12 Directories
SOURCE: X12.3 Data Element Directory; X12.22 Segment Directory
AVAILABLE FROM:
Data Interchange Standards Association, Inc. (DISA)
Suite 200
1800 Diagonal Road
Alexandria, VA 22314-2852
ABSTRACT: The data element directory contains the format and descriptions of data elements used to construct X12 segments. It also contains code lists associated with these data elements. The segment director contains the format and definitions of the data segments used to construct the X12 transaction sets.
(16)
ZIP Code (Data Elements: DC016, DC029, MC016, MC035, ME017, PC016, PC024)
SOURCE: National Zip Code and Post Office Directory, Publication 65, The USPS Domestic Mail Manual
AVAILABLE FROM:
U.S. Postal Service
Washington, DC 20260
New Orders
Superintendent of Documents
P.O. Box 371954
Pittsburgh, PA 15250-7954
ABSTRACT: The ZIP Code is a geographic identifier of areas within the United States and its territories for purposes of expediting mail distributionbythe U.S. PostalService. It is five or nine numeric digits. The ZIP Code structure divides the U.S. into ten large groups of states. The leftmost digit identifies one of these groups. The next two digits identifya smaller geographic area within the large group. The two right-most digits identify a local delivery area. In the nine digit ZIP Code, the four digits that follow the hyphen further subdivide the delivery service area. The two leftmost digits identify a sector that may consist of several large buildings, blocks or groups of streets. The rightmost digits divide the sector into segments suchas a street, a block, a floor of a building, or a cluster of mailboxes. The USPS Domestics Mail Manual includes information on the use of the new 11-digit ZIP code.
(17)
Race and Ethnicity Codes (Data Elements: ME020, ME021, ME022, ME023, ME024, ME025 and ME026)
Source: Massachusetts Division of Health Care Finance and Policy Hospital Inpatient Discharge Data Electronic Records Submission Specification, September 2006
And Hierarchy for Reporting Ethnicity, September 14, 2006
Available from:
Massachusetts Division of Health Care Finance and Policy
2 Boylston Street
Boston, MA 02116
ABSTRACT: This document provides the technical and data specifications, including edit specifications, required for the Massachusetts Hospital Inpatient Discharge Data.
(18)
Language Codes (Data Element: ME027)
SOURCE: Guidelines for the Implementation, Interpretation and Enforcement ofthe Boston Public Health Commission's Standardized Data Collection Regulation
AVAILABLE FROM:
Boston Public Health Commission
1010 Massachusetts Avenue
Boston, MA 02118
ABSTRACT: This document provides technicaland data specifications for acute hospitals to report race, ethnicityand language data for all inpatient, outpatientobservation, and outpatient emergency department visits.