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Elizabeth M. Whitehorn, Director

Monthly Claims Care Coordination Data (CCCD) Partner Meeting April 2014

HFS Presenters:

  • Katey Staley

  • Patricia Murphy

  • Sumanth Pasham 

  • Paul Stieber

Meeting Objective

  • General updates on Medicare claims

  • Review questions from health plans

Meeting Organization

Please attempt to submit questions online during the webinar.

These slides will be modified to include any updates as the result of today's discussion and will be posted on the CCCD Data Webpage within the next two days.

Medicare Update

Two significant issues found related to Medicare in the April CCCD run:

  • Sequence Line Values

  • Null Values

Medicare Update: SeqLineNbr

A new field titled SeqLineNbr was added to the end of the NIPS, Procedure, and Revenue Codes files. During testing of the Medicare data, this field was identified as necessary to properly sort the data. 

What are the differences between ServiceLineNbr and SeqLineNbr?

ServiceLineNbr is the first level of sort on a claim. It sorts on the service level. SeqLineNbr provides a deeper sort of the claims at the revenue, procedure and NIPs level. Claims would always first be sorted by ServiceLineNbr before SeqLineNbr.

Remember that any significant update like this is summarized on the Updates tab of the Data Dictionary. 

Medicare Update: NULL Value

The addition of Medicare data brought NULL values where they previously did not exist.

This was not caught and dealt with effectively by HFS during testing.

HFS will address this for May CCCD and would like health plans to implement strategies to deal with this for April.

For primary fields for the April CCCD, please set NULL values equal to zero (numeric) or blank (text).

For any primary keys for May CCCD, HFS will replace any NULL value with a blank (text) or zero value (numeric) starting with the May CCCD run. 

These are the primary keys that HFS thinks need to be addressed:

  • RevenueHCPCSCD should be a space when Null

  • RevenueHCPCSMod1Cd should be two spaces when Null

  • RevenueHCPCSMod2Cd should be two spaces when Null

  • NDCNumber1 should be a space when Null

  • NDCQuantity1 should be 0.0 when Null

HFS is currently assessing the extent to which differences exist in how NULL values are handled in Medicare versus Medicaid data. The outcome of this assessment and the plan to address by HFS will be sent out by the end of next week (i.e., 4/25/2014).

#1 Should SeqLineNbr be a primary key?

Question:  HFS does not have SeqLineNbr marked as a primary key and it seems like it needs to in order for data to sort effectively.  Should SeqLineNbr be marked as a primary key.

Answer:  Yes, SeqLineNbr should be a primary key. HFS has updated the CCCD Data Dictionary dated 4/10/2014 to reflect this change.

Please use secure email when communicating claims data!

If you are communicating any part of an actual claim in emailing HFS about an issue, please assume that PHI is included in what you want to send and always use secure email when referencing a specific claim.

If you don't have secure email yet, please call Paul Stieber with the information at 312-814-6817.

Future CCCD Partner Meetings

  • Wednesday, 5/14/2014; 10:00-11:00 AM Central

  • Wednesday, 6/18/2014; 10:00-11:00 AM Central

  • June meeting is tentative and will be confirmed in May

Please send feedback. . .

Complete survey at the end of this webinar and/or E-mail Paul Stieber.