NAME:        	Line Processing Indicator Code
 
 
 DESCRIPTION: 	The code on a non-institutional claim indicating to 
		whom payment was made or if the claim was denied.
 
  
 SHORT NAME: 	PRCNGIND

 LONG NAME: 	LINE_PRCSG_IND_CD

 TYPE:		CHAR
 
 LENGTH: 	2
 
 SOURCE: 	CWF

 
 CODE VALUES: 	A  = 	Allowed

  		B  = 	Benefits exhausted

  		C  = 	Non-covered care

  		D  = 	Denied (from BMAD)

  		I  = 	Invalid data

 		L  = 	CLIA 

  		M  = 	Multiple submittal--duplicate line item

  		N  = 	Medically unnecessary

  		O  = 	Other

  		P  = 	Physician ownership denial
 
  		Q  = 	MSP cost avoided (contractor #88888) -  voluntary agreement
 
  		R  = 	Reprocessed--adjustments based on subsequent reprocessing 
			   of claim

  		S  = 	Secondary payer

  		T  = 	MSP cost avoided - IEQ contractor
 
  		U  = 	MSP cost avoided - HMO rate cell adjustment
 
  		V  = 	MSP cost avoided - litigation settlement 

  		X  = 	MSP cost avoided - generic

  		Y  = 	MSP cost avoided - IRS/SSA data match project

  		Z  = 	Bundled test, no payment  


   		00 = 	MSP cost avoided - COB Contractor

   		12 = 	MSP cost avoided - BC/BS Voluntary Agreements

   		13 = 	MSP cost avoided - Office of Personnel Management

  		14 = 	MSP cost avoided - Workman's Compensation (WC) Datamatch

   		15 = 	MSP cost avoided - Workman's Compensation Insurer Voluntary 
			   Data Sharing Agreements (WC VDSA) (eff. 4/2006)

   		16 = 	MSP cost avoided - Liability Insurer VDSA (eff.4/2006)

   		17 = 	MSP cost avoided - No-Fault Insurer VDSA  (eff.4/2006)

  		18 = 	MSP cost avoided - Pharmacy Benefit Manager Data Sharing 
			   Agreement (eff.4/2006)

   		21 = 	MSP cost avoided - MIR Group Health Plan (eff.1/2009)

   		22 = 	MSP cost avoided - MIR non-Group Health Plan (eff.1/2009)

   		25 = 	MSP cost avoided - Recovery Audit Contractor - California 
			   (eff.10/2005)

   		26 = 	MSP cost avoided - Recovery Audit Contractor - Florida 
			   (eff.10/2005)


   		Effective 4/1/02, the Line Processing Indicator code was 
		expanded to a 2-byte field.  The NCH instituted a crosswalk 
		from the 2-byte code to a 1-byte character code. 

		Below are the character codes (found in NCH &  NMUD). At 
		some point, NMUD will carry the 2-byte code but NCH will 
		continue to have the 1-byte character code.


   		! 	MSP cost avoided - COB Contractor ('00' 2-byte code)
 
		@ 	MSP cost avoided - BC/BS Voluntary Agreements ('12' 2-byte code)
 
		# 	MSP cost avoided - Office of Personnel Management ('13' 2-byte 
			  code)
 
		$ 	MSP cost avoided - Workman's Compensation (WC) Datamatch ('14' 
			  2-byte code) 

		* 	MSP cost avoided - Workman's Compensation Insurer Voluntary 
			  Data Sharing Agreements (WC VDSA) ('15' 2-byte code) 
			  (eff. 4/2006)
 
		( 	MSP cost avoided - Liability Insurer VDSA ('16' 2-byte code) 
			  (eff. 4/2006)
 
		) 	MSP cost avoided - No-Fault Insurer VDSA ('17' 2-byte code) 
			  (eff. 4/2006)
 
		+ 	MSP cost avoided - Pharmacy Benefit Manager Data Sharing 
			  Agreement ('18' 2-byte code) (eff. 4/2006)
 
		< 	MSP cost avoided - MIR Group Health Plan ('21' 2-byte code) 
			  (eff. 1/2009)
 
		> 	MSP cost avoided - MIR non-Group Health Plan ('22' 2-byte code) 
			  (eff. 1/2009)
 
		% 	MSP cost avoided - Recovery Audit Contractor - California 
			  ('25' 2-byte code) (eff. 10/2005) 

		& 	MSP cost avoided - Recovery Audit Contractor - Florida ('26' 
			  2-byte code) (eff. 10/2005) 


 COMMENT:	-