Blue Button 2.0 Implementation Guide

CodeSystem: carr-clm-pmt-dnl-cd

Formats: XML, JSON, Turtle

Carrier Claim Payment Denial Code

The code on a non-institutional claim indicating to whom payment was made or if the claim was denied. Source: https://bluebutton.cms.gov/resources/variables/carrclmpmtdnlcd

This code system https://bluebutton.cms.gov/assets/ig/CodeSystem-carr-clm-pmt-dnl-cd defines the following codes:

CodeDisplayDefinition
! MSP cost avoided - COB Contractor (converted to '00' 2-byte code)MSP cost avoided - COB Contractor (converted to '00' 2-byte code)
@ MSP cost avoided - BC/BS Voluntary Agreements (converted to '12' 2-byte code)MSP cost avoided - BC/BS Voluntary Agreements (converted to '12' 2-byte code)
# MSP cost avoided - Office of Personnel Management (converted to '13' 2-byte code)MSP cost avoided - Office of Personnel Management (converted to '13' 2-byte code)
$ MSP cost avoided - Workman's Compensation (WC) Datamatch (converted to '14' 2-byte code)MSP cost avoided - Workman's Compensation (WC) Datamatch (converted to '14' 2-byte code)
* MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) (eff. 4/2006) (converted to '15' 2-byte code)MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) (eff. 4/2006) (converted to '15' 2-byte code)
( MSP cost avoided - Liability Insurer VDSA (eff. 4/2006) (converted to '16' 2-byte code)MSP cost avoided - Liability Insurer VDSA (eff. 4/2006) (converted to '16' 2-byte code)
) MSP cost avoided - No-Fault Insurer VDSA (eff. 4/2006) (converted to '17' 2-byte code)MSP cost avoided - No-Fault Insurer VDSA (eff. 4/2006) (converted to '17' 2-byte code)
+ MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement (eff. 4/2006) (converted to '18' 2 -byte code)MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement (eff. 4/2006) (converted to '18' 2 -byte code)
< MSP cost avoided - MIR Group Health Plan (eff. 1/2009) (converted to '21' 2-byte code)MSP cost avoided - MIR Group Health Plan (eff. 1/2009) (converted to '21' 2-byte code)
> MSP cost avoided - MIR non-Group Health Plan (eff. 1/2009) (converted to '22' 2-byte code)MSP cost avoided - MIR non-Group Health Plan (eff. 1/2009) (converted to '22' 2-byte code)
% MSP cost avoided - Recovery Audit Contractor - California (eff. 10/2005) (converted to '25' 2-byte code)MSP cost avoided - Recovery Audit Contractor - California (eff. 10/2005) (converted to '25' 2-byte code)
& MSP cost avoided - Recovery Audit Contractor - Florida (eff. 10/2005) (converted to '26' 2-byte code)MSP cost avoided - Recovery Audit Contractor - Florida (eff. 10/2005) (converted to '26' 2-byte code)