Report the appropriate code that External External Code defines an occurrence span category Code Occurrence Span MC Span 11/8/12 Source 14 - char[2] of the claim or patient. If not All 1% B Source Code Code - 5 Value Codes applicable do not report any value 14 - Text here. Start Date that Required Century Year Report the appropriate start date that Span Full Date corresponds to when MC 11/8/12 Month Day - int[8] corresponds to the occurrence code 100% B Start Date - Integer Occurrence Span MC237 is CCYYMMDD in CCYYMMDD Format. - 5 Code - 5 populated End Date that Required Century Year Report the appropriate start date that Span Full Date corresponds to when MC 11/8/12 Month Day - int[8] corresponds to the occurrence code 100% B End Date - - Integer Occurrence Span MC238 is CCYYMMDD in CCYYMMDD Format. 5 Code - 5 populated Report the GIC Member Identification Required number as provided to GIC Plan MC GIC ID 11/8/12 Text ID GIC varchar[9] GIC Member ID when 100% A0 Submitters. If not applicable do not MC241 = 3 report any value here. Report the value that describes the member's / subscriber's enrollment Lookup into one of the predefined categories; APCD ID Member MC 10/30/14 - int[1] aligns enrollment to appropriate All 100% A2 Code Enrollment Type Integer editing and thresholds. EXAMPLE: 1 = FIG - Fully Insured Commercial Group Enrollee. Value Description FIG - Fully-Insured Commercial 1 Group Enrollee 2 SIG - Self-Insured Group Enrollee GIC - Insurance Commission 3 Enrollee MCO - MassHealth Managed 4 Care Organization Enrollee 5 Supplemental Policy Enrollee ICO - Integrated Care 6 Organization or SCO Senior – Care Option
MC Span Code - 5 11/8/12 External Code Source 14 - Text External Code Source 14 - Value Codes char[2] Occurrence Span Code Report the appropriate code that defines an occurrence span category of the claim or patient. If not applicable do not report any value here. All 1% B MC Span Start Date - 5 11/8/12 Full Date - Integer Century Year Month Day - CCYYMMDD int[8] Start Date that corresponds to Occurrence Span Code - 5 Report the appropriate start date that corresponds to the occurrence code in CCYYMMDD Format. Required when MC237 is populated 100% B MC Span End Date - 5 11/8/12 Full Date - Integer Century Year Month Day - CCYYMMDD int[8] End Date that corresponds to Occurrence Span Code - 5 Report the appropriate start date that corresponds to the occurrence code in CCYYMMDD Format. Required when MC238 is populated 100% B MC GIC ID 11/8/12 Text ID GIC varchar[9] GIC Member ID Report the GIC Member Identification number as provided to GIC Plan Submitters. If not applicable do not report any value here. Required when MC241 = 3 100% A0 MC APCD ID Code 10/30/14 Lookup - Integer int[1] Member Enrollment Type Report the value that describes the member's / subscriber's enrollment into one of the predefined categories; aligns enrollment to appropriate editing and thresholds. EXAMPLE: 1 = FIG - Fully Insured Commercial Group Enrollee. All 100% A2 Value Description 1 FIG - Fully-Insured Commercial Group Enrollee 2 SIG - Self-Insured Group Enrollee 3 GIC - Insurance Commission Enrollee 4 MCO - MassHealth Managed Care Organization Enrollee 5 Supplemental Policy Enrollee 6 ICO - Integrated Care Organization or SCO – Senior Care Option
v5-apcd-medical-claim-file-submission-guide-REDLINE.docx