U Unknown Member Century Year Report the date the member / patient Full Date Member/Patient's MC 14 Date of 6/24/10 Day - int[8] was born in CCYYMMDD Format. All 98% B - Integer date of birth Birth CCYYMMDD Used to validate Unique Member ID. Report the city name of the member / Member Address City City name of the MC 15 6/24/10 Text patient. Used to validate Unique All 98% B City Name Member Member/Patient Member ID. External Address State Report the state of the patient as Member Code External Code State / Province of defined by the US Postal Service. MC 16 11/8/12 char[2] All 98% B State Source 2 Source 2 - the Patient Report Province when Country Code - Text States does not = USA. External Address Zip Report the 5 or 9 Zip Code as Member Code External Code Zip Code of the defined by the United States Postal MC 17 11/8/12 varchar[9] All 98% B ZIP Code Source 2 Source 2 - Zip Member / Patient Service. When submitting the 9-digit - Text Codes Zip Code do not include hyphen. Report the date that the payer approved this claim line for payment Date in CCYYMMDD Format. This Century Year Date Service Service Full Date element was designed to capture MC 18 6/24/10 Month Day - int[8] Approved by All 93% C Approved - Integer date other than the Paid date. If CCYYMMDD Payer (AP Date) Approved Date and Paid Date are the same, then the date here should match Paid Date. Required when = 002 and MC036 = Report the date of admit to a facility 11, 18, 21, Century Year Admission Full Date Inpatient Admit in CCYYMMDD Format. Only 28, 41, 65, MC 19 11/8/12 Day - int[8] 98% A1 Date - Integer Date applies to facility claims where Type 66, 84, 86 CCYYMMDD of Bill = an inpatient setting. or 89 (type of bill indicates an inpatient visit)
U Unknown MC 14 Member Date of Birth 6/24/10 Full Date - Integer Century Year Day - CCYYMMDD int[8] Member/Patient's date of birth Report the date the member / patient was born in CCYYMMDD Format. Used to validate Unique Member ID. All 98% B MC 15 Member City Name 6/24/10 Text Address City Member City name of the Member/Patient Report the city name of the member / patient. Used to validate Unique Member ID. All 98% B MC 16 Member State 11/8/12 External Code Source 2 - Text Address State External Code Source 2 - States char[2] State / Province of the Patient Report the state of the patient as defined by the US Postal Service. Report Province when Country Code does not = USA. All 98% B MC 17 Member ZIP Code 11/8/12 External Code Source 2 - Text Address Zip External Code Source 2 - Zip Codes varchar[9] Zip Code of the Member / Patient Report the 5 or 9 Zip Code as defined by the United States Postal Service. When submitting the 9-digit Zip Code do not include hyphen. All 98% B MC 18 Date Service Approved (AP Date) 6/24/10 Full Date - Integer Century Year Month Day - CCYYMMDD int[8] Date Service Approved by Payer Report the date that the payer approved this claim line for payment in CCYYMMDD Format. This element was designed to capture date other than the Paid date. If Approved Date and Paid Date are the same, then the date here should match Paid Date. All 93% C MC 19 Admission Date 11/8/12 Full Date - Integer Century Year Day - CCYYMMDD int[8] Inpatient Admit Date Report the date of admit to a facility in CCYYMMDD Format. Only applies to facility claims where Type of Bill = an inpatient setting. Required when = 002 and MC036 = 11, 18, 21, 28, 41, 65, 66, 84, 86 or 89 (type of bill indicates an inpatient visit) 98% A1