layout.fixed.naaccr.doc.naaccr15.primaryPayerAtDx.html Maven / Gradle / Ivy

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        Alternate Name
        Item #
        Length
        Source of Standard
        Column #
    
    
        Primary Payer at Diagnosis (CoC)

        630
        2
        CoC
        778 - 779
    


Description
Primary payer/insurance carrier at the time of initial diagnosis and/or treatment.
Rationale
This item is used in financial analysis and as an indicator for quality and outcome analyses. The Joint Commission on Accreditation of Healthcare Organizations requires the patient admission page document the type of insurance or payment structure that will cover the patient while being cared for at the hospital.
Codes

    
        
            01
            Not insured
        
        
            02
            Not insured, self-pay
        
        
            10
            Insurance, NOS
        
        
            20
            Private Insurance: Managed care, HMO, or PPO
        
        
            21
            Private Insurance: Fee-for-Service
        
        
            31
            Medicaid
        
        
            35
            Medicaid - Administered through a Managed Care plan
        
        
            60
            Medicare/Medicare, NOS
        
        
            61
            Medicare with supplement, NOS
        
        
            62
            Medicare - Administered through a Managed Care plan
        
        
            63
            Medicare with private supplement
        
        
            64
            Medicare with Medicaid eligibility
        
        
            65
            TRICARE
        
        
            66
            Military
        
        
            67
            Veterans Affairs
        
        
            68
            Indian/Public Health Service
        
        
            99
            Insurance status unknown

01	Not insured
02	Not insured, self-pay
10	Insurance, NOS
20	Private Insurance: Managed care, HMO, or PPO
21	Private Insurance: Fee-for-Service
31	Medicaid
35	Medicaid - Administered through a Managed Care plan
60	Medicare/Medicare, NOS
61	Medicare with supplement, NOS
62	Medicare - Administered through a Managed Care plan
63	Medicare with private supplement
64	Medicare with Medicaid eligibility
65	TRICARE
66	Military
67	Veterans Affairs
68	Indian/Public Health Service
99	Insurance status unknown