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Monthly Claims Care Coordination Data (CCCD) Partner Meeting January 2014

HFS Presenters:

Meeting Objective

High Level Review of Medicare Data

Please submit any Medicare questions you have to Paul Stieber.

Let's now move to outstanding questions. . .

#1 Why does dx code have a length of 8?

Question: Why does the field diagnosis-cd have a length of 8? Can you please provide few examples for such diag codes.

Answer: The length is because there are older claims in the HFS data warehouse (pre-HIPAA) that are 8 digits. In order to maintain the integrity of the older data, the field length is always kept at 8. Since the oldest claims in CCCD are from 2007 (7 years old), there are no claims that are 8 digit codes. 

#2 Can Amount Fields be negative?

Question: Do you think amount fields could be negative, if yes what would be the position of sign?

Answer: The only amount fields that can be negative are Long Term Care (LTC) claims. They can be negative at the line level. However, if you add up all line of an LTC claim for one DCN, the total should not be negative.


Question: We see same POS_CD is mapped to multiple standard POS_Cd. Can you please tell us how to use this xref and pick one out of many? Eg: Current 'K' is mapped to Unconverted (12,13,14)

Answer: Place of Service is converted from 2 bytes to 1 byte in order to fit into our old system. Therefore, the HFS PlaceOfServiceCd will not map 1:1 to HIPAA standard codes. We've translated HFS PlaceOfServiceCds to the HIPAA standard codes as best as we can in the crosswalk posted on the HFS CCCD website.

#4 Control File Layout

Question: We need the begin and end position for each field in control file for MMAI and ICP.

Answer: All data is shared through the single CCCD dataset. There is not a different one for MMAI and ICP. The file begin and end positions for this one control file are as follows:

FileType  CHAR (25) Positions 1-25
LoadDt Date Format 'YYYY-MM-DD' Positions 26-35
RecordCount Integer Positions 36-45

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