Alternate Name Item # Length Source of Standard Column #
Primary Payer at Diagnosis (CoC)
630 2 CoC 778 - 779
Description
Primary payer/insurance carrier at the time of initial diagnosis and/or treatment.
Rationale
This item is used in financial analysis and as an indicator for quality and outcome analyses. The Joint Commission on Accreditation of Healthcare Organizations requires the patient admission page document the type of insurance or payment structure that will cover the patient while being cared for at the hospital.
Codes
67 Veterans Affairs
68 Indian/Public Health Service
99 Insurance status unknown
01 Not insured
02 Not insured, self-pay
10 Insurance, NOS
20 Private Insurance: Managed care, HMO, or PPO
21 Private Insurance: Fee-for-Service
31 Medicaid
35 Medicaid - Administered through a Managed Care plan
60 Medicare/Medicare, NOS
61 Medicare with supplement, NOS
62 Medicare - Administered through a Managed Care plan
63 Medicare with private supplement
64 Medicare with Medicaid eligibility
65 TRICARE
66 Military