Report the version number of this service line. The version number Version Service Line begins with 0 and is incremented by MC 6 6/24/10 Integer Counter varchar[4] All 100% A0 Number Version Number 1 for each subsequent version of that service line. No alpha or special characters. Insured Report the number that defines the Group or Group / Policy insured group or policy. Do not MC 7 6/24/10 Text ID Group All 9% 06 Policy Number report the number that uniquely Number identifies the subscriber or member. MC 8 All % 07 Report the Plan assigned contract number. Do not include values in Plan this field that will distinguish one Specific MC 9 6/24/10 Text ID Contract Contract Number member of the family from another. All 98% 08 Contract This should be the contract or Number certificate number for the subscriber and all of the dependents. Member Member/Patient's Report the unique number / identifier Suffix or Contract MC 10 6/24/10 Text ID Sequence of the member / patient within the All 98% Sequence Sequence contract. Number Number MC 11 Report the value that defines the Individual Lookup Patient to Patient's relationship to the MC 12 6/24/10 Table char[2] Subscriber All 98% B Subscriber. EXAMPLE: 20 = Self / Code Text Relationship Code Employee Description Spouse Grandfather or Grandmother Grandson or Granddaughter Nephew or Niece
MC 6 Version Number 6/24/10 Integer Counter varchar[4] Service Line Version Number Report the version number of this service line. The version number begins with 0 and is incremented by 1 for each subsequent version of that service line. No alpha or special characters. All 100% A0 MC 7 Insured Group or Policy Number 6/24/10 Text ID Group Group / Policy Number Report the number that defines the insured group or policy. Do not report the number that uniquely identifies the subscriber or member. All 9% MC 8 All % MC 9 Plan Specific Contract Number 6/24/10 Text ID Contract Contract Number Report the Plan assigned contract number. Do not include values in this field that will distinguish one member of the family from another. This should be the contract or certificate number for the subscriber and all of the dependents. All 98% MC 10 Member Suffix or Sequence Number 6/24/10 Text ID Sequence Member/Patient's Contract Sequence Number Report the unique number / identifier of the member / patient within the contract. All 98% MC 11 MC 12 Individual Code 6/24/10 Lookup Table Text char[2] Patient to Subscriber Relationship Code Report the value that defines the Patient's relationship to the Subscriber. EXAMPLE: 20 = Self / Employee All 98% B Description Spouse Grandfather or Grandmother Grandson or Granddaughter 07 Nephew or Niece 06 08
v6-apcd-medical-claim-file-submission-guide-Redline-.docx