Required when = 002 and MC036 = External Code Report the sixth ICD procedure code 11, 18, 21, Other External Source 8 - when applicable. The Integer point is 28, 41, 65, ICD-CM Codes ICD MC 88 10/30/14 ICDCM varchar[7] not coded. The ICD procedure must 66, 84, 86 1% C Procedure Source 8 Procedure Code Procedure be repeated for all lines of the claim if or 89 (type Code - 5 - Text Codes necessary. of bill indicates an inpatient visit) Required when MC094 = 002 and MC036 = Report the seventh ICD procedure Other External External Code 11, 18, 21, code when applicable. The Integer ICD-CM Codes Source 8 - ICD Other 28, 41, 65, MC 89 10/30/14 varchar[7] point is not coded. The ICD 1% C Procedure Source 8 Procedure Procedure Code 66, 84, 86 procedure must be repeated for all Code - 6 - Text Codes or 89 (type 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 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 Procedure Code Report the sixth 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 = 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 Other ICD-CM Procedure Code - 6 10/30/14 External Codes Source 8 - Text External Code Source 8 - 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 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
v6-apcd-medical-claim-file-submission-guide-FINAL.docx