package gov.cms.mpsm.rda.v1.fiss

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FISS Adjustment Medicare Beneficiary Identifier (MBI) Indicator

Used in: FissClaim

• ADJUSTMENT_MBI_INDICATOR_HIC_SUBMITTED_ON_ADJUSTMENT_OR_CANCEL_CLAIM = 0

• ADJUSTMENT_MBI_INDICATOR_MBI_SUBMITTED_ON_ADJUSTMENT_OR_CANCEL_CLAIM = 1

FISS Adjustment Requestor Identification

Used in: FissClaim

• ADJUSTMENT_REQUESTOR_CODE_FISCAL_INTERMEDIARY = 0

• ADJUSTMENT_REQUESTOR_CODE_HOSPITAL_PROVIDER = 1

• ADJUSTMENT_REQUESTOR_CODE_PEER_REVIEW_ORGANIZATION = 2

• ADJUSTMENT_REQUESTOR_CODE_SYSTEM = 3

FISS Adm Type Code

Used in: FissClaim

• ADM_TYPE_0 = 0

• ADM_TYPE_EMERGENCY = 1

• ADM_TYPE_URGENT = 2

• ADM_TYPE_ELECTIVE = 3

• ADM_TYPE_NEWBORN = 4

• ADM_TYPE_TRAUMA_CENTER = 5

• ADM_TYPE_9 = 6

Assignment of Benefits Indicator

Used in: FissBeneZPayer, FissInsuredPayer

• ASSIGNMENT_OF_BENEFITS_INDICATOR_BENEFITS_ASSIGNED = 0

• ASSIGNMENT_OF_BENEFITS_INDICATOR_NO_BENEFITS_ASSIGNED = 1

Used in: FissClaim

• oneof badt_status

  • FissClaimStatus badt_status_enum = 1

  • string badt_status_unrecognized = 2

• optional string badt_loc = 3

• optional string badt_oper_id = 4

• optional string badt_reas = 5

• optional string badt_curr_date_cymd = 6

• uint32 rda_position = 7

  RDA Position: Indicates which position this audit trail is located in on the claim. This value is assigned by RDA.

Used in: FissPayer

• uint32 rda_position = 1

  RDA Position: Indicates which position this mcs audit is located in on the claim. This value is assigned by RDA.

• oneof payers_id

  • FissPayersCode payers_id_enum = 2

  • string payers_id_unrecognized = 3

• optional string payers_name = 4

• oneof rel_ind

  • FissReleaseOfInformation rel_ind_enum = 5

  • string rel_ind_unrecognized = 6

• oneof assign_ind

  • FissAssignmentOfBenefitsIndicator assign_ind_enum = 7

  • string assign_ind_unrecognized = 8

• optional string provider_number = 9

• optional string adj_dcn_icn = 10

• optional string prior_pmt = 11

• optional string est_amt_due = 12

• oneof bene_rel

  • FissPatientRelationshipCode bene_rel_enum = 13

  • string bene_rel_unrecognized = 14

• optional string bene_last_name = 15

• optional string bene_first_name = 16

• optional string bene_mid_init = 17

• optional string bene_ssn_hic = 18

• optional string insured_group_name = 19

• optional string bene_dob = 20

• oneof bene_sex

  • FissBeneficiarySex bene_sex_enum = 21

  • string bene_sex_unrecognized = 22

• optional string treat_auth_cd = 23

• oneof insured_sex

  • FissBeneficiarySex insured_sex_enum = 24

  • string insured_sex_unrecognized = 25

• oneof insured_rel_x12

  • FissPatientRelationshipCode insured_rel_x12_enum = 26

  • string insured_rel_x12_unrecognized = 27

FISS Beneficiary Sex

Used in: FissBeneZPayer, FissInsuredPayer

• BENEFICIARY_SEX_FEMALE = 0

• BENEFICIARY_SEX_MALE = 1

• BENEFICIARY_SEX_UNKNOWN = 2

Used in: FissClaim

• BILL_CLASSIFICATION_INPATIENT_PART_A = 0

• BILL_CLASSIFICATION_HOSPITAL_BASED_OR_INPATIENT_PART_B = 1

• BILL_CLASSIFICATION_OUTPATIENT = 2

• BILL_CLASSIFICATION_OTHER_PART_B = 3

• BILL_CLASSIFICATION_INTERMEDIATE_CARE_LEVEL_I = 4

• BILL_CLASSIFICATION_INTERMEDIATE_CARE_LEVEL_II = 5

• BILL_CLASSIFICATION_SUBACUTE_INPATIENT = 6

• BILL_CLASSIFICATION_SWING_BED = 7

• BILL_CLASSIFICATION_RESERVED_FOR_NATIONAL_ASSIGNMENT = 8

Used in: FissClaim

• BILL_CLASSIFICATION_FOR_CLINICS_RURAL_HEALTH_FACILITY = 0

• BILL_CLASSIFICATION_FOR_CLINICS_HOSPITAL_BASED_OR_INDEPENDENT_RENAL_DIALYSIS_FACILITY = 1

• BILL_CLASSIFICATION_FOR_CLINICS_FREE_STANDING_PROVIDER_BASED_FQHC = 2

• BILL_CLASSIFICATION_FOR_CLINICS_OTHER_REHABILITATION_FACILITY = 3

• BILL_CLASSIFICATION_FOR_CLINICS_COMPREHENSIVE_OUTPATIENT_REHABILITATION_FACILITY = 4

• BILL_CLASSIFICATION_FOR_CLINICS_COMMUNITY_MENTAL_HEALTH_CENTER = 5

• BILL_CLASSIFICATION_FOR_CLINICS_OPIOID_TREATMENT_PROGRAM = 6

• BILL_CLASSIFICATION_FOR_CLINICS_RESERVED_FOR_NATIONAL_ASSIGNMENT = 7

• BILL_CLASSIFICATION_FOR_CLINICS_OTHER = 8

Used in: FissClaim

• BILL_CLASSIFICATION_FOR_SPECIAL_FACILITIES_HOSPICE_NON_HOSPITAL_BASED = 0

• BILL_CLASSIFICATION_FOR_SPECIAL_FACILITIES_HOSPICE_HOSPITAL_BASED = 1

• BILL_CLASSIFICATION_FOR_SPECIAL_FACILITIES_AMBULATORY_SURGICAL_CENTER_SERVICES_TO_HOSPITAL_OUTPATIENTS = 2

• BILL_CLASSIFICATION_FOR_SPECIAL_FACILITIES_FREE_STANDING_BIRTHING_CENTER = 3

• BILL_CLASSIFICATION_FOR_SPECIAL_FACILITIES_CRITICAL_ACCESS_HOSPITALS = 4

• BILL_CLASSIFICATION_FOR_SPECIAL_FACILITIES_RESIDENTIAL_FACILITY = 5

• BILL_CLASSIFICATION_FOR_SPECIAL_FACILITIES_OPIOID_TREATMENT_PROGRAM = 6

• BILL_CLASSIFICATION_FOR_SPECIAL_FACILITIES_RESERVED_FOR_NATIONAL_ASSIGNMENT = 7

• BILL_CLASSIFICATION_FOR_SPECIAL_FACILITIES_OTHER = 8

Used in: FissClaim

• BILL_FACILITY_TYPE_HOSPITAL = 0

• BILL_FACILITY_TYPE_SKILLED_NURSING_FACILITY = 1

• BILL_FACILITY_TYPE_HOME_HEALTH = 2

• BILL_FACILITY_TYPE_RELIGIOUS_NON_MEDICAL_HOSPITAL = 3

• BILL_FACILITY_TYPE_RELIGIOUS_NON_MEDICAL_EXTENDED_CARE = 4

• BILL_FACILITY_TYPE_INTERMEDIATE_CASE = 5

• BILL_FACILITY_TYPE_CLINIC_OR_HOSPITAL_BASED_RENAL_DIALYSIS_FACILITY = 6

• BILL_FACILITY_TYPE_SPECIAL_FACILITY_OR_HOSPITAL_ASC_SURGERY = 7

• BILL_FACILITY_TYPE_RESERVED_FOR_NATIONAL_ASSIGNMENT = 8

Used in: FissClaim

• BILL_FREQUENCY_NON_PAYMENT_OR_ZERO_CLAIM = 0

• BILL_FREQUENCY_ADMIT_THROUGH_DISCHARGE_CLAIM = 1

• BILL_FREQUENCY_INTERIM_FIRST_CLAIM = 2

• BILL_FREQUENCY_INTERIM_SECOND_CLAIM = 3

• BILL_FREQUENCY_INTERIM_LAST_CLAIM = 4

• BILL_FREQUENCY_REPLACEMENT_OF_PRIOR_CLAIM = 5

• BILL_FREQUENCY_VOID_OR_CANCEL_OF_PRIOR_CLAIM = 6

• BILL_FREQUENCY_HOME_HEALTH_PPS_FINAL_CLAIM = 7

• BILL_FREQUENCY_ADMISSION_NOTICE_HOSPICE = 8

• BILL_FREQUENCY_HOSPICE_TERMINATION_OR_REVOCATION_NOTICE = 9

• BILL_FREQUENCY_HOSPICE_CHANGE_OF_PROVIDER_NOTICE = 10

• BILL_FREQUENCY_HOSPICE_ELECTION_VOID_OR_CANCEL = 11

• BILL_FREQUENCY_HOSPICE_CHANGE_OF_OWNERSHIP = 12

• BILL_FREQUENCY_ADJUSTMENT_CLAIM_F = 13

• BILL_FREQUENCY_ADJUSTMENT_CLAIM_G = 14

• BILL_FREQUENCY_ADJUSTMENT_CLAIM_H = 15

• BILL_FREQUENCY_ADJUSTMENT_CLAIM_I = 16

• BILL_FREQUENCY_ADJUSTMENT_CLAIM_J = 17

• BILL_FREQUENCY_ADJUSTMENT_CLAIM_K = 18

• BILL_FREQUENCY_ADJUSTMENT_CLAIM_L = 19

• BILL_FREQUENCY_ADJUSTMENT_CLAIM_M = 20

• BILL_FREQUENCY_ADJUSTMENT_CLAIM_N = 21

• BILL_FREQUENCY_ADJUSTMENT_CLAIM_O = 22

• BILL_FREQUENCY_ADJUSTMENT_CLAIM_P = 23

• BILL_FREQUENCY_REOPENING = 24

• BILL_FREQUENCY_TEMPORARY_FOR_ENCOUNTER_CLAIMS = 25

FISS Cancel Adjustment Code

Used in: FissClaim

• CANCEL_ADJUSTMENT_CODE_HOME_HEALTH_PROSPECTIVE_PAYMENT_SYSTEM_FINAL_NOT_RECEIVED = 0

• CANCEL_ADJUSTMENT_CODE_COVERAGE = 1

• CANCEL_ADJUSTMENT_CODE_DUPLICATE = 2

• CANCEL_ADJUSTMENT_CODE_PROVIDER_CANCELLED_EPISODE = 3

• CANCEL_ADJUSTMENT_CODE_FISCAL_INTERMEDIARY_CANCELLED_EPISODE = 4

• CANCEL_ADJUSTMENT_CODE_OTHER = 5

• CANCEL_ADJUSTMENT_CODE_PLAN_TRANSFER = 6

• CANCEL_ADJUSTMENT_CODE_SCRAMBLE_HIC = 7

FISS (Fiscal Intermediary Shared Systems) Claim

Used in: FissClaimChange

• string dcn = 1

  Document Control Number: Identification number for a claim. It provides a reference number for the control and monitoring of specific claims, and differentiates between claims for the same beneficiary.

• string rda_claim_key = 112

  Claim Key: The claim key is simply a concatenation of the DCN and the INTERMEDIARY-NB fields. By itself, The DCN is not guaranteed to be a globally unique number, so it is combined with the INTERMEDIARY-NB to ensure uniqueness across different contractor workloads.

• string hic_no = 2

  Health Insurance Claim Number: Identifies the beneficiary number associated with a claim record, as assigned by CMS.

• oneof curr_status

  Current Status: This field identifies the current condition of the claim (paid, reject, deny, etc.) for the record.

  • FissClaimStatus curr_status_enum = 3

  • string curr_status_unrecognized = 36

• oneof curr_loc_1

  Current Location 1: This field identifies the type of processing occurring on the claim.

  • FissProcessingType curr_loc_1_enum = 4

  • string curr_loc_1_unrecognized = 37

• oneof curr_loc_2

  Current Location 2: The first and second digits represent the driver name. The third and fourth digits allow for more definition with the driver for the location.

  • FissCurrentLocation2 curr_loc_2_enum = 5

  • string curr_loc_2_unrecognized = 38

• optional string prov_state_cd = 16

  Provider State Code

• optional string prov_typ_facil_cd = 17

  Provider Type Facility Code

• optional string prov_emer_ind = 18

  Provider Emergency Indicator

• optional string prov_dept_id = 19

  Provider Department Identification

• optional string meda_prov_id = 29

  Medicare Provider ID: The Medicare Provider ID consists of the following: * Provider State Code * Provider Type Facility Code * Provider Emergency Indicator * Provider Department Identification

• optional string meda_prov_6 = 41

• optional string total_charge_amount = 20

  Total Charge Amount: This amount may not be equal to the sum of all the revenue lines.

• optional string recd_dt_cymd = 21

  Received Date: The date the claim was received by the Intermediary.

• optional string recd_dt_cymd_text = 110

• optional string curr_tran_dt_cymd = 22

  Current Transaction Date: The last date that the status/location changed or the claim was updated.

• optional string curr_tran_dt_cymd_text = 111

• optional string adm_diag_code = 23

  Admitting Diagnosis Code: Diagnosis code describing the inpatient condition at the time of the admission.

• optional string principle_diag = 24

  Principle Diagnosis Code: ICD-9-CM code relating to the condition established after study to be chiefly responsible for the treatment identified in the claim.

• optional string npi_number = 25

  National Provider Identifier (NPI) Number: Number as assigned by CMS to identify health plans, providers, and clearinghouses. The NPI, which contains no embedded information about the health care provider it identifies, never changes. It may be deactivated and then reactivated, but it does not expire. Individual providers will be assigned one NPI number and organizations will be assigned one NPI number; however, organizations may define themselves as having subparts and receive multiple NPIs. This field may be used to Cross walk to the Online Survey Certification and Reporting System (OSCAR) number.

• optional string mbi = 26

  Medicare Beneficiary Identifier: Medicare Beneficiary Number assigned by CMS.

• optional string fed_tax_nb = 27

  Federal Tax Number: Number assigned to the provider by the Federal Government for tax reporting purposes, also known as a tax identification number (TIN) or an employer identification number (EIN).

• optional string prac_loc_addr1 = 30

  Practice Location Address 1: This field identifies the first address of the Provider practice hospital location extracted from the Provider Enrollment Chain and Ownership System (PECOS) file.

• optional string prac_loc_addr2 = 31

  Practice Location Address 2: This field identifies the second address of the Provider practice hospital location extracted from the Provider Enrollment Chain and Ownership System (PECOS) file.

• optional string prac_loc_city = 32

  Practice Location City: This field identifies the city address of the Provider practice hospital location extracted from the Provider Enrollment Chain and Ownership System (PECOS) file.

• optional string prac_loc_state = 33

  Practice Location State: This field identifies the state address of the Provider practice hospital location extracted from the Provider Enrollment Chain and Ownership System (PECOS) file.

• optional string prac_loc_zip = 34

  Practice Location Zip: This field identifies the zip code address of the Provider practice hospital location extracted from the Provider Enrollment Chain and Ownership System (PECOS) file.

• optional string stmt_cov_from_cymd = 39

• optional string stmt_cov_from_cymd_text = 102

• optional string stmt_cov_to_cymd = 40

• optional string stmt_cov_to_cymd_text = 103

• oneof lob_cd

  Location of Bill

  • FissBillFacilityType lob_cd_enum = 42

  • string lob_cd_unrecognized = 43

• oneof serv_typ_cd

  Bill Classification

  • FissBillClassification serv_type_cd_enum = 44

  • FissBillClassificationForClinics serv_type_cd_for_clinics_enum = 45

  • FissBillClassificationForSpecialFacilities serv_type_cd_for_special_facilities_enum = 46

  • string serv_typ_cd_unrecognized = 47

• oneof freq_cd

  Bill Frequency

  • FissBillFrequency freq_cd_enum = 48

  • string freq_cd_unrecognized = 49

• optional string bill_typ_cd = 50

  3-digit Bill Type Code (concatenation of location of bill, bill classification, and bill frequency).

• optional string reject_cd = 53

  Reject Code

• optional string full_part_den_ind = 54

  Fully or Partially Denied Indicator

• optional string non_pay_ind = 55

  Non-Pay Code Indicator

• optional string xref_dcn_nbr = 56

  Cross-reference Document Control Number

• oneof adj_req_cd

  Adjustment Requestor Identification

  • FissAdjustmentRequestorCode adj_req_cd_enum = 57

  • string adj_req_cd_unrecognized = 58

• optional string adj_reas_cd = 59

  Adjustment Reason Code

• optional string cancel_xref_dcn = 60

  Cancel Cross-reference Document Control Number

• optional string cancel_date_cymd = 61

  Cancel Date

• oneof canc_adj_cd

  Cancel Adjustment Code

  • FissCancelAdjustmentCode canc_adj_cd_enum = 62

  • string canc_adj_cd_unrecognized = 63

• optional string original_xref_dcn = 64

  Original Cross-Reference Document Control Number

• optional string paid_dt_cymd = 65

  Paid Date

• optional string adm_date_cymd = 66

  Admission Date

• optional string adm_date_cymd_text = 104

• oneof adm_source

  Source of Admission

  • FissSourceOfAdmission adm_source_enum = 67

  • string adm_source_unrecognized = 68

• oneof primary_payer_code

  Primary Payer Code

  • FissPayersCode primary_payer_code_enum = 69

  • string primary_payer_code_unrecognized = 70

• optional string attend_phys_id = 71

  Attending Physician NPI

• optional string attend_phys_lname = 72

  Attending Physician Last Name

• optional string attend_phys_fname = 73

  Attending Physician First Name

• optional string attend_phys_mint = 74

  Attending Physician Middle Initial

• oneof attend_phys_flag

  Attending Physician Flag

  • FissPhysicianFlag attend_phys_flag_enum = 75

  • string attend_phys_flag_unrecognized = 76

• optional string operating_phys_id = 77

  Operating Physician NPI

• optional string oper_phys_lname = 78

  Operating Physician Last Name

• optional string oper_phys_fname = 79

  Operating Physician First Name

• optional string oper_phys_mint = 80

  Operating Physician Middle Initial

• oneof oper_phys_flag

  Operating Physician Flag

  • FissPhysicianFlag oper_phys_flag_enum = 81

  • string oper_phys_flag_unrecognized = 82

• optional string oth_phys_id = 83

  Other Physician NPI

• optional string oth_phys_lname = 84

  Other Physician Last Name

• optional string oth_phys_fname = 85

  Other Physician First Name

• optional string oth_phys_mint = 86

  Other Physician Middle Initial

• oneof oth_phys_flag

  Other Physician Flag

  • FissPhysicianFlag oth_phys_flag_enum = 87

  • string oth_phys_flag_unrecognized = 88

• optional string xref_hic_nbr = 89

  Cross-Reference Health Insurance Claim Number

• oneof proc_new_hic_ind

  Process new Health Insurance Claim Number

  • FissProcessNewHealthInsuranceClaimNumberIndicator proc_new_hic_ind_enum = 90

  • string proc_new_hic_ind_unrecognized = 91

• optional string new_hic = 92

  New Health Insurance Claim Number

• oneof repos_ind

  Repository Indicator

  • FissRepositoryIndicator repos_ind_enum = 93

  • string repos_ind_unrecognized = 94

• optional string repos_hic = 95

  Repository HIC

• oneof mbi_subm_bene_ind

  Health Insurance Claim (HIC) Number or Medicare Beneficiary Identify (MBI)

  • FissHealthInsuranceClaimNumberOrMedicareBeneficiaryIdentifier mbi_subm_bene_ind_enum = 96

  • string mbi_subm_bene_ind_unrecognized = 97

• oneof adj_mbi_ind

  Adjustment Medicare Beneficiary Identifier (MBI) Indicator

  • FissAdjustmentMedicareBeneficiaryIdentifierIndicator adj_mbi_ind_enum = 98

  • string adj_mbi_ind_unrecognized = 99

• optional string drg_cd = 106

  DRG

• optional string group_code = 107

  Group Code

• oneof clm_typ_ind

  Claim Type Indicator

  • FissClaimTypeIndicator clm_typ_ind_enum = 108

  • string clm_typ_ind_unrecognized = 109

• oneof adm_typ_cd

  Adm Type Code

  • FissAdmTypeCode adm_typ_cd_enum = 114

  • string adm_typ_cd_unrecognized = 115

• optional string adj_mbi = 100

  Adjustment Medicare Beneficiary Identifier

• optional string medical_record_no = 101

  Medical Record Number

• string intermediary_nb = 113

  Intermediary Number This field identifies the identification number of the fiscal intermediary as designated by the Centers for Medicare and Medicaid Services (CMS).

• repeated FissProcedureCode fiss_proc_codes = 28

  FISS Procedure Codes

• repeated FissDiagnosisCode fiss_diag_codes = 35

  FISS Diagnosis Codes

• repeated FissPayer fiss_payers = 51

  FISS Payers

• repeated FissAuditTrail fiss_audit_trail = 52

  FISS Audit Trail

• repeated FissRevenueLine fiss_revenue_lines = 105

  FISS Revenue Line

Used in: FissAuditTrail, FissClaim

• CLAIM_STATUS_BLANK = 0

• CLAIM_STATUS_ROUTING = 1

• CLAIM_STATUS_FORCE = 10

• CLAIM_STATUS_SUSPEND = 2

• CLAIM_STATUS_PAID = 3

• CLAIM_STATUS_DENIED = 4

• CLAIM_STATUS_INACTIVE = 5

• CLAIM_STATUS_REJECT = 6

• CLAIM_STATUS_RTP = 7

• CLAIM_STATUS_MOVE = 8

• CLAIM_STATUS_RETURN_TO_PRO = 9

FISS Claim Type Indicator

Used in: FissClaim

• CLAIM_TYPE_INPATIENT = 0

• CLAIM_TYPE_SNF = 1

• CLAIM_TYPE_OUTPATIENT = 2

• CLAIM_TYPE_HOME_HEALTH = 3

• CLAIM_TYPE_HOSPICE = 4

• CLAIM_TYPE_PART_B = 5

• CLAIM_TYPE_TOB_X20_X28 = 6

• CLAIM_TYPE_TOB_130_138 = 7

Used in: FissClaim

• CURRENT_LOCATION_2_PREPROCESSING = 0

• CURRENT_LOCATION_2_UNMATCHED = 1

• CURRENT_LOCATION_2_CABLE = 2

• CURRENT_LOCATION_2_CABLED = 3

• CURRENT_LOCATION_2_FLOOR = 4

• CURRENT_LOCATION_2_FINAL = 5

• CURRENT_LOCATION_2_OFFLINE = 6

• CURRENT_LOCATION_2_CROSS_WALK_DOWN = 7

• CURRENT_LOCATION_2_POST_PAY_7500 = 8

• CURRENT_LOCATION_2_POST_PAY_7501 = 9

• CURRENT_LOCATION_2_POST_PAY_7502 = 10

• CURRENT_LOCATION_2_POST_PAY_7503 = 11

• CURRENT_LOCATION_2_POST_PAY_7504 = 12

• CURRENT_LOCATION_2_POST_PAY_7505 = 13

• CURRENT_LOCATION_2_POST_PAY_7506 = 14

• CURRENT_LOCATION_2_POST_PAY_7507 = 15

• CURRENT_LOCATION_2_POST_PAY_7508 = 16

• CURRENT_LOCATION_2_POST_PAY_7509 = 17

• CURRENT_LOCATION_2_POST_PAY_7510 = 18

• CURRENT_LOCATION_2_POST_PAY_7511 = 19

• CURRENT_LOCATION_2_POST_PAY_7512 = 20

• CURRENT_LOCATION_2_POST_PAY_7513 = 21

• CURRENT_LOCATION_2_POST_PAY_7514 = 22

• CURRENT_LOCATION_2_POST_PAY_7515 = 23

• CURRENT_LOCATION_2_POST_PAY_7516 = 24

• CURRENT_LOCATION_2_POST_PAY_7517 = 25

• CURRENT_LOCATION_2_POST_PAY_7518 = 26

• CURRENT_LOCATION_2_POST_PAY_7519 = 27

• CURRENT_LOCATION_2_POST_PAY_7520 = 28

• CURRENT_LOCATION_2_POST_PAY_7521 = 29

• CURRENT_LOCATION_2_POST_PAY_7522 = 30

• CURRENT_LOCATION_2_POST_PAY_7523 = 31

• CURRENT_LOCATION_2_POST_PAY_7524 = 32

• CURRENT_LOCATION_2_POST_PAY_7525 = 33

• CURRENT_LOCATION_2_POST_PAY_7526 = 34

• CURRENT_LOCATION_2_POST_PAY_7527 = 35

• CURRENT_LOCATION_2_POST_PAY_7528 = 36

• CURRENT_LOCATION_2_POST_PAY_7529 = 37

• CURRENT_LOCATION_2_POST_PAY_7530 = 38

• CURRENT_LOCATION_2_POST_PAY_7531 = 39

• CURRENT_LOCATION_2_POST_PAY_7532 = 40

• CURRENT_LOCATION_2_POST_PAY_7533 = 41

• CURRENT_LOCATION_2_POST_PAY_7534 = 42

• CURRENT_LOCATION_2_POST_PAY_7535 = 43

• CURRENT_LOCATION_2_POST_PAY_7536 = 44

• CURRENT_LOCATION_2_POST_PAY_7537 = 45

• CURRENT_LOCATION_2_POST_PAY_7538 = 46

• CURRENT_LOCATION_2_POST_PAY_7539 = 47

• CURRENT_LOCATION_2_POST_PAY_7540 = 48

• CURRENT_LOCATION_2_POST_PAY_7541 = 49

• CURRENT_LOCATION_2_POST_PAY_7542 = 50

• CURRENT_LOCATION_2_POST_PAY_7543 = 51

• CURRENT_LOCATION_2_POST_PAY_7544 = 52

• CURRENT_LOCATION_2_POST_PAY_7545 = 53

• CURRENT_LOCATION_2_POST_PAY_7546 = 54

• CURRENT_LOCATION_2_POST_PAY_7547 = 55

• CURRENT_LOCATION_2_POST_PAY_7548 = 56

• CURRENT_LOCATION_2_POST_PAY_7549 = 57

• CURRENT_LOCATION_2_POST_PAY_7550 = 58

• CURRENT_LOCATION_2_POST_PAY_7551 = 59

• CURRENT_LOCATION_2_POST_PAY_7552 = 60

• CURRENT_LOCATION_2_POST_PAY_7553 = 61

• CURRENT_LOCATION_2_POST_PAY_7554 = 62

• CURRENT_LOCATION_2_POST_PAY_7555 = 63

• CURRENT_LOCATION_2_POST_PAY_7556 = 64

• CURRENT_LOCATION_2_POST_PAY_7557 = 65

• CURRENT_LOCATION_2_POST_PAY_7558 = 66

• CURRENT_LOCATION_2_POST_PAY_7559 = 67

• CURRENT_LOCATION_2_POST_PAY_7560 = 68

• CURRENT_LOCATION_2_POST_PAY_7561 = 69

• CURRENT_LOCATION_2_POST_PAY_7562 = 70

• CURRENT_LOCATION_2_POST_PAY_7563 = 71

• CURRENT_LOCATION_2_POST_PAY_7564 = 72

• CURRENT_LOCATION_2_POST_PAY_7565 = 73

• CURRENT_LOCATION_2_POST_PAY_7566 = 74

• CURRENT_LOCATION_2_POST_PAY_7567 = 75

• CURRENT_LOCATION_2_POST_PAY_7568 = 76

• CURRENT_LOCATION_2_POST_PAY_7569 = 77

• CURRENT_LOCATION_2_POST_PAY_7570 = 78

• CURRENT_LOCATION_2_POST_PAY_7571 = 79

• CURRENT_LOCATION_2_POST_PAY_7572 = 80

• CURRENT_LOCATION_2_POST_PAY_7573 = 81

• CURRENT_LOCATION_2_POST_PAY_7574 = 82

• CURRENT_LOCATION_2_POST_PAY_7575 = 83

• CURRENT_LOCATION_2_POST_PAY_7576 = 84

• CURRENT_LOCATION_2_POST_PAY_7577 = 85

• CURRENT_LOCATION_2_POST_PAY_7578 = 86

• CURRENT_LOCATION_2_POST_PAY_7579 = 87

• CURRENT_LOCATION_2_POST_PAY_7580 = 88

• CURRENT_LOCATION_2_POST_PAY_7581 = 89

• CURRENT_LOCATION_2_POST_PAY_7582 = 90

• CURRENT_LOCATION_2_POST_PAY_7583 = 91

• CURRENT_LOCATION_2_POST_PAY_7584 = 92

• CURRENT_LOCATION_2_POST_PAY_7585 = 93

• CURRENT_LOCATION_2_POST_PAY_7586 = 94

• CURRENT_LOCATION_2_POST_PAY_7587 = 95

• CURRENT_LOCATION_2_POST_PAY_7588 = 96

• CURRENT_LOCATION_2_POST_PAY_7589 = 97

• CURRENT_LOCATION_2_POST_PAY_7590 = 98

• CURRENT_LOCATION_2_POST_PAY_7591 = 99

• CURRENT_LOCATION_2_POST_PAY_7592 = 100

• CURRENT_LOCATION_2_POST_PAY_7593 = 101

• CURRENT_LOCATION_2_POST_PAY_7594 = 102

• CURRENT_LOCATION_2_POST_PAY_7595 = 103

• CURRENT_LOCATION_2_POST_PAY_7596 = 104

• CURRENT_LOCATION_2_POST_PAY_7597 = 105

• CURRENT_LOCATION_2_POST_PAY_7598 = 106

• CURRENT_LOCATION_2_POST_PAY_7599 = 107

Used in: FissClaim

• optional string diag_cd_2 = 1

  Diagnosis Code Two: This field identifies the International Classification of Diseases (ICD) -9 or ICD-10 code describing the condition of the patient for a particular claim record, which co-exist at the time of admission, or develop subsequently. For copybooks where this field contains up to twenty five diagnosis’ occurrences, the first occurrence describes the principle diagnosis, the second through twenty fifth occurrences describe the additional/secondary diagnosis. Other copybooks identify this field as the patient’s second diagnosis code.

• oneof diag_poa_ind

  Diagnosis Present On Admission (POA) Indicator: This field identifies the patient’s condition that is present at the time the order for inpatient admission to a general acute care hospital occurs. This indicator is assigned to every principal and secondary diagnosis on an inpatient acute care hospital claim, and the external cause of injury codes. Conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered as present on admission. The Centers for Medicare and Medicaid Services (CMS) does not require a POA indicator for the external cause of injury code unless it is being reported as another diagnosis. Effective with discharges on or after 10/01/07.

  • FissDiagnosisPresentOnAdmissionIndicator diag_poa_ind_enum = 2

  • string diag_poa_ind_unrecognized = 4

• optional string bit_flags = 3

  Bit Flags: This field identifies a set of flags returned by DRG Grouper or Medicare Code Editor (MCE) to indicate claim diagnosis errors effective with discharges on or after 10/01/07.

• uint32 rda_position = 5

  RDA Position: Indicates which position this diagnosis code is located in on the claim. This value is assigned by RDA.

Used in: FissDiagnosisCode

• DIAGNOSIS_PRESENT_ON_ADMISSION_INDICATOR_NO = 0

  No, not present at the time of inpatient admission.

• DIAGNOSIS_PRESENT_ON_ADMISSION_INDICATOR_UNKNOWN = 1

  Unknown, the documentation is insufficient to determine if the condition was present at the time of inpatient admission.

• DIAGNOSIS_PRESENT_ON_ADMISSION_INDICATOR_CLINICALLY_UNDETERMINED = 2

  Clinically undetermined, the provider is unable to clinically determine whether the condition was present at the time of inpatient admission or not.

• DIAGNOSIS_PRESENT_ON_ADMISSION_INDICATOR_YES = 3

  Yes, Present at the time of inpatient admission.

• DIAGNOSIS_PRESENT_ON_ADMISSION_INDICATOR_UNREPORTED = 4

  Unreported/not used, exempt from POA reporting - This code is the equivalent code of a blank on the UB04, however, it is determined that blanks are undesirable when submitting the data via the 4010A1.

FISS Health Insurance Claim (HIC) Number or Medicare Beneficiary Identifier (MBI)

Used in: FissClaim

• FISS_HIC_OR_MBI_IS_HIC = 0

• FISS_HIC_OR_MBI_IS_MBI = 1

Used in: FissPayer

• uint32 rda_position = 1

  RDA Position: Indicates which position this mcs audit is located in on the claim. This value is assigned by RDA.

• oneof payers_id

  • FissPayersCode payers_id_enum = 2

  • string payers_id_unrecognized = 3

• optional string payers_name = 4

• oneof rel_ind

  • FissReleaseOfInformation rel_ind_enum = 6

  • string rel_ind_unrecognized = 7

• oneof assign_ind

  • FissAssignmentOfBenefitsIndicator assign_ind_enum = 8

  • string assign_ind_unrecognized = 9

• optional string provider_number = 10

• optional string adj_dcn_icn = 11

• optional string prior_pmt = 12

• optional string est_amt_due = 13

• oneof insured_rel

  • FissPatientRelationshipCode insured_rel_enum = 14

  • string insured_rel_unrecognized = 15

• optional string insured_name = 16

• optional string insured_ssn_hic = 17

• optional string insured_group_name = 18

• optional string insured_group_nbr = 19

• optional string treat_auth_cd = 20

• oneof insured_sex

  • FissBeneficiarySex insured_sex_enum = 21

  • string insured_sex_unrecognized = 22

• oneof insured_rel_x12

  • FissPatientRelationshipCode insured_rel_x12_enum = 23

  • string insured_rel_x12_unrecognized = 24

• optional string insured_dob = 25

• optional string insured_dob_text = 26

FISS NDC quantity qualifier: This field identifies the NDC quantity qualifier

Used in: FissRevenueLine

• NDC_QTY_QUAL_F2 = 0

• NDC_QTY_QUAL_GR = 1

• NDC_QTY_QUAL_ME = 2

• NDC_QTY_QUAL_ML = 3

• NDC_QTY_QUAL_UN = 4

FISS Non Billable Code: This field identifies whether the revenue code and/or the HCPCS code are valid.

Used in: FissRevenueLine

• NON_BILL_ESRD = 0

• NON_BILL_INVALID_HCPCS_EMC = 1

• NON_BILL_INVALID_HCPCS_HC = 2

• NON_BILL_INVALID_REV_CODE = 3

• NON_BILL_R = 4

• NON_BILL_S = 5

• NON_BILL_T = 6

FISS Patient Relationship Code

Used in: FissBeneZPayer, FissInsuredPayer

• PATIENT_RELATIONSHIP_CODE_DEFAULT = 0

• PATIENT_RELATIONSHIP_CODE_PATIENT_IS_INSURED = 1

• PATIENT_RELATIONSHIP_CODE_SPOUSE = 2

• PATIENT_RELATIONSHIP_CODE_NATURAL_CHILD_INSURED_HAS_FINANCIAL_RESPONSIBILITY = 3

• PATIENT_RELATIONSHIP_CODE_NATURAL_CHILD_INSURED_DOES_NOT_HAVE_FINANCIAL_RESPONSIBILITY = 4

• PATIENT_RELATIONSHIP_CODE_STEP_CHILD = 5

• PATIENT_RELATIONSHIP_CODE_FOSTER_CHILD = 6

• PATIENT_RELATIONSHIP_CODE_WARD_OF_THE_COURT = 7

• PATIENT_RELATIONSHIP_CODE_EMPLOYEE = 8

• PATIENT_RELATIONSHIP_CODE_UNKNOWN = 9

• PATIENT_RELATIONSHIP_CODE_HANDICAPPED_DEPENDENT = 10

• PATIENT_RELATIONSHIP_CODE_ORGAN_DONOR = 11

• PATIENT_RELATIONSHIP_CODE_CADAVER_DONOR = 12

• PATIENT_RELATIONSHIP_CODE_GRANDCHILD = 13

• PATIENT_RELATIONSHIP_CODE_NIECE_OR_NEPHEW = 14

• PATIENT_RELATIONSHIP_CODE_INJURED_PLAINTIFF = 15

• PATIENT_RELATIONSHIP_CODE_SPONSORED_DEPENDENT = 16

• PATIENT_RELATIONSHIP_CODE_MINOR_DEPENDENT_OF_A_MINOR_DEPENDENT = 17

• PATIENT_RELATIONSHIP_CODE_PARENT = 18

• PATIENT_RELATIONSHIP_CODE_GRANDPARENT = 19

• PATIENT_RELATIONSHIP_CODE_LIFE_PARTNER = 20

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_21 = 21

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_22 = 22

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_23 = 23

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_24 = 24

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_25 = 25

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_26 = 26

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_27 = 27

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_28 = 28

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_29 = 29

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_30 = 30

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_31 = 31

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_32 = 32

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_33 = 33

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_34 = 34

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_35 = 35

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_36 = 36

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_37 = 37

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_38 = 38

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_39 = 39

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_40 = 40

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_41 = 41

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_42 = 42

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_43 = 43

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_44 = 44

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_45 = 45

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_46 = 46

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_47 = 47

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_48 = 48

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_49 = 49

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_50 = 50

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_51 = 51

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_52 = 52

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_53 = 53

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_54 = 54

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_55 = 55

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_56 = 56

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_57 = 57

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_58 = 58

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_59 = 59

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_60 = 60

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_61 = 61

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_62 = 62

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_63 = 63

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_64 = 64

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_65 = 65

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_66 = 66

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_67 = 67

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_68 = 68

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_69 = 69

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_70 = 70

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_71 = 71

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_72 = 72

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_73 = 73

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_74 = 74

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_75 = 75

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_76 = 76

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_77 = 77

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_78 = 78

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_79 = 79

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_80 = 80

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_81 = 81

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_82 = 82

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_83 = 83

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_84 = 84

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_85 = 85

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_86 = 86

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_87 = 87

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_88 = 88

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_89 = 89

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_90 = 90

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_91 = 91

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_92 = 92

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_93 = 93

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_94 = 94

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_95 = 95

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_96 = 96

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_97 = 97

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_98 = 98

• PATIENT_RELATIONSHIP_CODE_RESERVED_FOR_NATIONAL_ASSIGNMENT_99 = 99

FISS Payer

Used in: FissClaim

• oneof payer

  • FissBeneZPayer beneZPayer = 1

  • FissInsuredPayer insuredPayer = 2

FISS Payers Code

Used in: FissBeneZPayer, FissClaim, FissInsuredPayer

• PAYERS_CODE_MEDICAID = 0

• PAYERS_CODE_BLUE_CROSS = 1

• PAYERS_CODE_OTHER = 2

• PAYERS_CODE_NONE = 3

• PAYERS_CODE_WORKING_AGE = 4

• PAYERS_CODE_END_STAGE_RENAL_DISEASE_BENEFICIARY = 5

  End Stage Renal Disease (ESRD) Beneficiary in 30 Month Coordination Period with an EGHP (Employer Group Health Plan).

• PAYERS_CODE_CONDITIONAL_PAYMENT = 6

• PAYERS_CODE_AUTO_NO_FAULT = 7

• PAYERS_CODE_WORKERS_COMPENSATION = 8

• PAYERS_CODE_PUBLIC_HEALTH_SERVICE_OR_OTHER_FEDERAL_AGENCY = 9

• PAYERS_CODE_DISABLED = 10

• PAYERS_CODE_BLACK_LUNG = 11

• PAYERS_CODE_VETERANS_ADMINISTRATION = 12

• PAYERS_CODE_LIABILITY = 13

• PAYERS_CODE_MEDICARE = 14

FISS Physician Flag

Used in: FissClaim

• PHYSICIAN_FLAG_NO = 0

FISS Procedure Code

Used in: FissClaim

• string proc_cd = 1

  Procedure Code: Identifies the principal procedure (first code) and other procedures (codes two through twenty five) performed during the billing period covered by the claim. This field is required for inpatient claims.

• uint32 rda_position = 2

  RDA Position: Indicates which position this procedure code is located in on the claim. This value is assigned by RDA.

• optional string proc_flag = 16

  Procedure Flag: Identifies a set of flags returned from the Medicare Code Editor (MCE) module to indicate claim procedure code errors.

• optional string proc_dt = 17

  Procedure Date: Date the procedure was conducted.

FISS Process New Health Insurance Claim Number Indicator

Used in: FissClaim

• PROCESS_NEW_HIC_INDICATOR_E = 0

  The new HIC entered is cross-referenced on the Beneficiary file and this cross-reverenced HIC is also cross-referenced. The chain continues for 25 HICs, or the NEW HIC number is in a cross-reference loop.

• PROCESS_NEW_HIC_INDICATOR_Y = 1

  Incorrect HIC number, process new HIC number.

• PROCESS_NEW_HIC_INDICATOR_S = 2

  The cross-referenced HIC number on the beneficiary file is the same as the original HIC number on the claim.

Processing Type Enum that maps Processing Types to ASCII values

Used in: FissClaim

• PROCESSING_TYPE_BATCH = 0

• PROCESSING_TYPE_MANUAL = 1

• PROCESSING_TYPE_OFFLINE = 2

Release of Information

Used in: FissBeneZPayer, FissInsuredPayer

• RELEASE_OF_INFORMATION_NO_RELEASE_ON_FILE = 0

• RELEASE_OF_INFORMATION_SIGNED_STATEMENT_IS_RESTRICTED_OR_LIMITED = 1

• RELEASE_OF_INFORMATION_SIGNED_STATEMENT_WAS_OBTAINED = 2

FISS Repository Indicator

Used in: FissClaim

• REPOSITORY_INDICATOR_HIC_HAS_BEEN_MOVED = 0

• REPOSITORY_INDICATOR_NOT_APPLICABLE = 1

FISS Revenue Line

Used in: FissClaim

• uint32 rda_position = 1

  RDA Position: Indicates which position this procedure code is located in on the claim. This value is assigned by RDA.

• oneof non_bill_rev_code

  Non Billable Code

  • FissNonBillRevCode non_bill_rev_code_enum = 16

  • string non_bill_rev_code_unrecognized = 17

• oneof ndc_qty_qual

  NDC Quantity Qual

  • FissNdcQtyQual ndc_qty_qual_enum = 34

  • string ndc_qty_qual_unrecognized = 35

• optional string rev_cd = 18

  Revenue Code

• optional uint32 rev_units_billed = 19

  Total Units or Number of Services Billed

• optional uint32 rev_serv_unit_cnt = 20

  Total Units or Number of Services Billed

• optional string serv_dt_cymd = 21

  Service Date

• optional string serv_dt_cymd_text = 22

• optional string hcpc_cd = 23

  Healthcare Common Procedure Coding (HCPC) Code

• optional string hcpc_ind = 24

  Healthcare Common Procedure Coding (HCPC) Indicator

• optional string hcpc_modifier = 25

  Healthcare Common Procedure Coding (HCPC)

• optional string hcpc_modifier2 = 26

  Healthcare Common Procedure Coding (HCPC) Second Occurrence

• optional string hcpc_modifier3 = 27

  Healthcare Common Procedure Coding (HCPC) Third Occurrence

• optional string hcpc_modifier4 = 28

  Healthcare Common Procedure Coding (HCPC) Fourth Occurrence

• optional string hcpc_modifier5 = 29

  Healthcare Common Procedure Coding (HCPC) Fifth Occurrence

• optional string apc_hcpcs_apc = 30

  Ambulatory Payment Classification (APC) Healthcare Common Procedure Coding System (HCPCS) APC

• optional string aco_red_rarc = 31

  Accountable Care Organization (ACO) Reduction Remittance Advice Remark Code

• optional string aco_red_carc = 32

  Pioneer Accountable Care Organization (ACO) Reduction CARC

• optional string aco_red_cagc = 33

  Pioneer Accountable Care Organization (ACO) Reduction Group Code

• optional string ndc = 36

  NDC assigned to each medication

• optional string ndc_qty = 37

  Quantity of NDC medication assigned

FISS Source of Admission

Used in: FissClaim

• SOURCE_OF_ADMISSION_PHYSICIAN_REFERRAL = 0

• SOURCE_OF_ADMISSION_CLINIC_REFERRAL = 1

• SOURCE_OF_ADMISSION_HEALTH_MAINTENANCE_ORGANIZATION_REFERRAL = 2

• SOURCE_OF_ADMISSION_TRANSFER_FROM_HOSPITAL = 3

• SOURCE_OF_ADMISSION_TRANSFER_FROM_SKILLED_NURSING_FACILITY = 4

• SOURCE_OF_ADMISSION_TRANSFER_FROM_ANOTHER_HEALTH_CARE_FACILITY = 5

• SOURCE_OF_ADMISSION_EMERGENCY_ROOM = 6

• SOURCE_OF_ADMISSION_COURT_OR_LAW_ENFORCEMENT = 7

• SOURCE_OF_ADMISSION_INFORMATION_NOT_AVAILABLE = 8

• SOURCE_OF_ADMISSION_TRANSFER_FROM_CRITICAL_ACCESS_HOSPITAL = 9

• SOURCE_OF_ADMISSION_TRANSFER_FROM_ANOTHER_HOME_HEALTH_AGENCY = 10

• SOURCE_OF_ADMISSION_READMISSION_TO_SAME_HOME_HEALTH_AGENCY = 11

• SOURCE_OF_ADMISSION_TRANSFER_FROM_HOSPITAL_INPATIENT_IN_SAME_FACILITY = 12

• SOURCE_OF_ADMISSION_TRANSFER_FROM_AMBULATORY_SURGICAL_CENTER = 13

• SOURCE_OF_ADMISSION_TRANSFER_FROM_HOSPICE_UNDER_HOSPICE_PLAN_OF_CARE_OR_ENROLLED_IN_HOSPICE_PROGRAM = 14

• SOURCE_OF_ADMISSION_TRANSFER_FROM_DESIGNATED_DISASTER_ALTERNATE_CARE_SITE = 15