NCH MQA Query Patch Code

Variable Name :MQAQUERY

Label :NCH MQA Query Patch Code 

Effective with Version H, a code used (for internal editing purposes) to indicate that the CWFMQA process changed the query code submitted on the claim record. 

NOTE: Beginning with NCH weekly process date 10/3/97 field was populated with data. Claims processed prior to 10/3/97 will contain spaces in this field. 

DB2 ALIAS: MQA_QUERY_PATCH_CD 

SAS ALIAS: MQAQUERY 

STANDARD ALIAS: NCH_MQA_QUERY_PATCH_CD 

TITLE ALIAS: MQA_QUERY_PATCH_IND 

CODES: 

Y = MQA changed bill query code on a action code 6 (force action code 2) bill to a zero. (Eff. 10/12/93) 

Z = MQA changed bill query code on a action code 4 (cancel only adjustment) bill to zero. (Eff. 5/16/94) 

SOURCE: NCH QA Process 

Variable Name :DISP_CD

Label :Claim Disposition Code

Code indicating the disposition or outcome of the processingof the claim record. 

DB2 ALIAS: CLM_DISP_CD 

SAS ALIAS: DISP_CD 

STANDARD ALIAS: CLM_DISP_CD 

TITLE ALIAS: DISPOSITION_CD 

CODES: REFER TO: CLM_DISP_TB IN THE CODES APPENDIX 

SOURCE: CWF

Variable Name :EDITDISP

Label :NCH Edit Disposition Code

Effective with Version H, a code used (for internal editing purposes) to indicate the disposition of the claim after editing in the CWFMQA process. 

NOTE: Beginning with NCH weekly process date 10/3/97 field was populated with data. Claims processed prior to 10/3/97 will contain spaces in this field. 

DB2 ALIAS: NCH_EDIT_DISP_CD 

SAS ALIAS: EDITDISP 

STANDARD ALIAS: NCH_EDIT_DISP_CD 

TITLE ALIAS: NCH_EDIT_DISP

CODES:

 00 = No MQA errors 

10 = Possible duplicate 

20 = Utilization error 

30 = Consistency error 

40 = Entitlement error 

50 = Identification error 

60 = Logical duplicate 

70 = Systems duplicate 

SOURCE: NCH QA Process 

Variable Name :BIC_MDFY

Label :NCH Claim BIC Modify H Code

Effective with Version H, the code used (for internal editing purposes) to identify a claim record that was submitted with an incorrect HA, HB, or HC BIC. 

NOTE: Beginning with NCH weekly process date 10/3/97 field was populated with data. Claims processed prior to 10/3/97 will contain spaces in this field. 

DB2 ALIAS: NCH_BIC_MDFY_CD 

SAS ALIAS: BIC_MDFY 

STANDARD ALIAS: NCH_CLM_BIC_MDFY_CD 

TITLE ALIAS: BIC_MODIFY_CD

CODES: 

H = BIC submitted by CWF = HA, 

HB or HC blank = No HA, HB or HC BIC present 

SOURCE: NCH QA Process 

Variable Name :CNTY_CD

Label :Beneficiary Residence SSA Standard County Code

The SSA standard county code of a beneficiary's residence. 

 DA3 ALIAS: SSA_STANDARD_COUNTY_CODE 

DB2 ALIAS: BENE_SSA_CNTY_CD 

SAS ALIAS: CNTY_CD 

STANDARD ALIAS: BENE_RSDNC_SSA_STD_CNTY_CD 

TITLE ALIAS: BENE_COUNTY_CD EDIT-RULES: OPTIONAL: MAY BE BLANK 

SOURCE: SSA/EDB