NAME              TYPE   LENGTH
 -------------------------------------   ------
 7.   NCH Claim Type              CHAR   2
      Code
  
 The code used to identify the type of claim record being
 processed in NCH.
  
 NOTE1:  During the Version H conversion this field was
 populated with data throughout history (back to
 service year 1991).
  
 NOTE2:  During the Version I conversion this field was
 expanded to include inpatient 'full' encounter
 claims (for service dates after 6/30/97).
  
 DB2      ALIAS : NCH_CLM_TYPE_CD
 SAS      ALIAS : CLM_TYPE
 STANDARD ALIAS : NCH_CLM_TYPE_CD
 TITLE    ALIAS : CLAIM_TYPE
  
 LENGTH         : 2
  
 DERIVATIONS :
 FFS CLAIM TYPE CODES DERIVED FROM:
 NCH CLM_NEAR_LINE_RIC_CD
 NCH PMT_EDIT_RIC_CD
 NCH CLM_TRANS_CD
 NCH PRVDR_NUM
  
 INPATIENT 'FULL' ENCOUNTER TYPE CODE DERIVED FROM:
 (Pre-HDC processing -- AVAILABLE IN NCH)
 CLM_MCO_PD_SW
 CLM_RLT_COND_CD
 MCO_CNTRCT_NUM
 MCO_OPTN_CD
 MCO_PRD_EFCTV_DT
 MCO_PRD_TRMNTN_DT
  
 DERIVATION RULES:
  
 SET CLM_TYPE_CD TO 10 (HHA CLAIM) WHERE THE
 FOLLOWING CONDITIONS ARE MET:
 1.   CLM_NEAR_LINE_RIC_CD EQUAL 'V','W' OR 'U'
 2.   PMT_EDIT_RIC_CD EQUAL 'F'
 3.   CLM_TRANS_CD EQUAL '5'
  
 SET CLM_TYPE_CD TO 20 (SNF NON-SWING BED CLAIM)
 WHERE THE FOLLOWING CONDITIONS ARE MET:
 1.   CLM_NEAR_LINE_RIC_CD EQUAL 'V'
 2.   PMT_EDIT_RIC_CD EQUAL 'C' OR 'E'
 3.   CLM_TRANS_CD EQUAL '0' OR '4'
 4.   POSITION 3 OF PRVDR_NUM IS NOT 'U', 'W', 'Y'
 OR 'Z'
  
 SET CLM_TYPE_CD TO 30 (SNF SWING BED CLAIM)
 WHERE THE FOLLOWING CONDITIONS ARE MET:
 1.   CLM_NEAR_LINE_RIC_CD EQUAL 'V'
 2.   PMT_EDIT_RIC_CD EQUAL 'C' OR 'E'
 3.   CLM_TRANS_CD EQUAL '0' OR '4'
 4.   POSITION 3 OF PRVDR_NUM EQUAL 'U', 'W', 'Y'
 OR 'Z'
  
 SET CLM_TYPE_CD TO 40 (OUTPATIENT CLAIM)
 WHERE THE FOLLOWING CONDITIONS ARE MET:
 1.   CLM_NEAR_LINE_RIC_CD EQUAL 'W'
 2.   PMT_EDIT_RIC_CD EQUAL 'D'
 3.   CLM_TRANS_CD EQUAL '6'
  
 SET CLM_TYPE_CD TO 50 (HOSPICE CLAIM)
 WHERE THE FOLLOWING CONDITIONS ARE MET:
 1.   CLM_NEAR_LINE_RIC_CD EQUAL 'V'
 2.   PMT_EDIT_RIC_CD EQUAL 'I'
 3.   CLM_TRANS_CD EQUAL 'H'
  
 SET CLM_TYPE_CD TO 60 (INPATIENT CLAIM)
 WHERE THE FOLLOWING CONDITIONS ARE MET:
 1.   CLM_NEAR_LINE_RIC_CD EQUAL 'V'
 2.   PMT_EDIT_RIC_CD EQUAL 'C' OR 'E'
 3.   CLM_TRANS_CD EQUAL '1' '2' OR '3'
  
 SET CLM_TYPE_CD TO 61 (INPATIENT 'FULL' ENCOUNTER
 CLAIM - PRIOR TO HDC PROCESSING - AFTER 6/30/97 -
 12/4/00) WHERE THE FOLLOWING CONDITIONS ARE MET:
 1.   CLM_MCO_PD_SW = '1'
 2.   CLM_RLT_COND_CD = '04'
 3.   MCO_CNTRCT_NUM
 MCO_OPTN_CD = 'C'
 CLM_FROM_DT & CLM_THRU_DT ARE WITHIN THE
 MCO_PRD_EFCTV_DT & MCO_PRD_TRMNTN_DT
 ENROLLMENT PERIODS
  
 SET_CLM_TYPE_CD TO 61 (INPATIENT 'FULL' ENCOUNTER
 CLAIM -- EFFECTIVE WITH HDC PROCESSING) WHERE THE
 FOLLOWING CONDITIONS ARE MET:
 1.   CLM_NEAR_LINE_RIC_CD EQUAL 'V'
 2.   PMT_EDIT_RIC_CD EQUAL 'C' OR 'E'
 3.   CLM_TRANS_CD EQUAL '1' '2' OR '3'
 4.   FI_NUM = 80881
  
 SET CLM_TYPE_CD TO 71 (RIC O non-DMEPOS CLAIM)
 WHERE THE FOLLOWING CONDITIONS ARE MET:
 1.   CLM_NEAR_LINE_RIC_CD EQUAL 'O'
 2.   HCPCS_CD not on DMEPOS table
  
 SET CLM_TYPE_CD TO 72 (RIC O DMEPOS CLAIM)
 WHERE THE FOLLOWING CONDITIONS ARE MET:
 1.   CLM_NEAR_LINE_RIC_CD EQUAL 'O'
 2.   HCPCS_CD on DMEPOS table (NOTE: if one or
 more line item(s) match the HCPCS on the
 DMEPOS table).
  
 SET CLM_TYPE_CD TO 81 (RIC M non-DMEPOS DMERC
 CLAIM)
 WHERE THE FOLLOWING CONDITIONS ARE MET:
 1.   CLM_NEAR_LINE_RIC_CD EQUAL 'M'
 2.   HCPCS_CD not on DMEPOS table
  
 SET CLM_TYPE_CD TO 82 (RIC M DMEPOS DMERC CLAIM)
 WHERE THE FOLLOWING CONDITIONS ARE MET:
 1.   CLM_NEAR_LINE_RIC_CD EQUAL 'M'
 2.   HCPCS_CD on DMEPOS table (NOTE: if one or
 more line item(s) match the HCPCS on the
 DMEPOS table).
  
 SOURCE         : NCH
  
 CODE TABLE     : NCH_CLM_TYPE_TB