Required when MC094 = 002 and MC036 = External Code Report the ICD procedure code Other External 11, 18, 21, Source 8 - when applicable. The Integer point is ICD-CM Codes ICD Other 28, 41, 65, MC 88 10/30/14 ICDCM varchar[7] not coded. The ICD procedure must 1% C Procedure Source 8 Procedure Code 66, 84, 86 Procedure be repeated for all lines of the claim if Code - 5 - Text or 89 (type Codes necessary. of bill indicates an inpatient visit) Required when MC094 = 002 and MC036 = External Code Report the seventh ICD procedure External 11, 18, 21, Source 8 - code when applicable. The Integer Codes ICD Other 28, 41, 65, MC 89 10/30/14 ICDCM varchar[7] point is not coded. The ICD 1% C Procedure Source 8 Procedure Code 66, 84, 86 Procedure procedure must be repeated for all Code - 6 - Text or 89 (type Codes lines of the claim if necessary. of bill indicates an inpatient visit) Report the date that appears on the check and/or remit and/or explanation of benefits and Required Century Year corresponds to any and all types of when Full Date Paid date of the MC 90 Paid Date 11/8/12 Month Day - int[8] payment in CCYYMMDD Format. MC038 = 98% A0 - Integer claim line CCYYMMDD This can be the same date as 1, 2, 3, 19, Processed Date. EXAMPLE: Claims 20, or 21 paid in full, partial or zero paid must have a date reported here.
MC 88 Other ICD-CM Procedure Code - 5 10/30/14 External Codes Source 8 - Text External Code Source 8 - ICDCM Procedure Codes varchar[7] ICD Other Procedure Code Report the ICD procedure code when applicable. The Integer point is not coded. The ICD procedure must be repeated for all lines of the claim if necessary. Required when MC094 = 002 and MC036 = 11, 18, 21, 28, 41, 65, 66, 84, 86 or 89 (type of bill indicates an inpatient visit) 1% C MC 89 Procedure Code - 6 10/30/14 External Codes Source 8 - Text External Code Source 8 - ICDCM Procedure Codes varchar[7] ICD Other Procedure Code Report the seventh ICD procedure code when applicable. The Integer point is not coded. The ICD procedure must be repeated for all lines of the claim if necessary. Required when MC094 = 002 and MC036 = 11, 18, 21, 28, 41, 65, 66, 84, 86 or 89 (type of bill indicates an inpatient visit) 1% C MC 90 Paid Date 11/8/12 Full Date - Integer Century Year Month Day - CCYYMMDD int[8] Paid date of the claim line Report the date that appears on the check and/or remit and/or explanation of benefits and corresponds to any and all types of payment in CCYYMMDD Format. This can be the same date as Processed Date. EXAMPLE: Claims paid in full, partial or zero paid must have a date reported here. Required when MC038 = 1, 2, 3, 19, 20, or 21 98% A0