stack/dev/seeds/bcda_v3_cclf_absent.csv at main

Files

kert 7e53d9360a chore(bcda): vendor CMSgov/bcda-app + bcda.cms.gov v3 artefacts sparsely, flatten the v3 data dictionary into crosswalk seeds, weekly drift workflow

dev/vendor/MANIFEST.toml pins bcda-app@7decdcc (v3 handler + tests, request
validation middleware, OperationOutcome writer, v3 Postman collection, gzip
fixtures, sandbox config, LICENSE) and the bcda.cms.gov v3 data dictionary,
v2 dictionary and official v3 sample ndjson. vendor_bcda_app.py --verify |
--check | --sync (stdlib only); the bcda-vendor workflow runs --check weekly
and files an issue on drift — nothing auto-commits, a payload change upstream
is something a human reads before the flattener is re-pointed.

gen_bcda_v3_crosswalk.py writes dev/seeds/bcda_v3_data_dictionary.csv
(fhirPath, IDR sourceColumn, ccwMapping, cclfMapping per v3 field),
bcda_v3_cclf_crosswalk.csv (293 CCLF elements -> v3 field) and
bcda_v3_cclf_absent.csv (52 CCLF fields v3 does not carry); the CCLF sheet
has label/name swapped on data rows and is normalised. Tests assert the
committed seeds match the vendored workbook.

refs #1139

2026-10-25 13:08:05 -04:00

11 KiB

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1	cclf_file	element	field_name	field_description
2	CCLF0	1	File Number Label	“File Number” This field will be left-justified and right-padded with spaces.
3	CCLF0	2	Delimiter	“\|”
4	CCLF0	3	File Description Label	“File Description” This field will be left-justified and right-padded with spaces.
5	CCLF0	4	Delimiter	“\|”
6	CCLF0	5	Total Records Count Label	“Total Records Count” This field will be left-justified and right-padded with spaces.
7	CCLF0	6	Delimiter	“\|”
8	CCLF0	7	Record Length Label	“Record Length” This field will be left-justified and right-padded with spaces.
9	CCLF1	4	BENE_HIC_NUM	Legacy Beneficiary HICN field I Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims, and the HICN value will no longer be displayed. The Beneficiary HIC Number will be blank in CCLFs generated effective January 1, 2020, onwards.
10	CCLF1	26	BENE_EQTBL_BIC_HICN_NUM	Legacy Beneficiary Equitable BIC HICN Number. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, MBI will be accepted on claims, and the HICN value/ Beneficiary Equitable BIC HICN Number will no longer be displayed. The Beneficiary Equitable BIC HICN Number will be blank in CCLFs generated effective January 1, 2020, onwards.
11	CCLF2	4	BENE_HIC_NUM	Legacy Beneficiary HICN field. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims and the HICN value will no longer be displayed. The Beneficiary HIC Number will be blank in CCLFs generated effective January 1, 2020, onwards.
12	CCLF2	11	BENE_EQTBL_BIC_HICN_NUM	Legacy Beneficiary Equitable BIC HICN Number. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims, and the HICN value/ Beneficiary Equitable BIC HICN Number will no longer be displayed. The Beneficiary Equitable BIC HICN Number will be blank in CCLFs generated effective January 1, 2020, onwards.
13	CCLF3	3	BENE_HIC_NUM	Legacy Beneficiary HICN field. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims, and the HICN value will no longer be displayed. The Beneficiary HIC Number will be blank in CCLFs generated effective January 1, 2020, onwards.
14	CCLF3	5	CLM_VAL_SQNC_NUM	An arbitrary sequential number that uniquely identifies a procedure code record within the claim.
15	CCLF3	8	BENE_EQTBL_BIC_HICN_NUM	Legacy Beneficiary Equitable BIC HICN Number. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims, and the HICN value/ Beneficiary Equitable BIC HICN Number will no longer be displayed. The Beneficiary Equitable BIC HICN Number will be blank in CCLFs generated effective January 1, 2020, onwards.
16	CCLF4	3	BENE_HIC_NUM	Legacy Beneficiary HICN field. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims, and the HICN value will no longer be displayed. The Beneficiary HIC Number will be blank in CCLFs generated effective January 1, 2020, onwards.
17	CCLF4	6	CLM_VAL_SQNC_NUM	An arbitrary sequential number that uniquely identifies a procedure code record within the claim.
18	CCLF4	8	BENE_EQTBL_BIC_HICN_NUM	Legacy Beneficiary Equitable BIC HICN Number. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims and the HICN value/ Beneficiary Equitable BIC HICN Number will no longer be displayed. The Beneficiary Equitable BIC HICN Number will be blank effective January 1, 2020.
19	CCLF5	4	BENE_HIC_NUM	Legacy Beneficiary HICN field. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims, and the HICN value will no longer be displayed. The HICN field will be blank effective January 1, 2020.
20	CCLF5	8	RNDRG_PRVDR_TYPE_CD	Indicates the type of provider who provided the service associated with this line item on the claim. Provider Type Code include: 0 = Clinics, groups, associations, partnerships, or other entities 1 = Physicians or suppliers reporting as solo practitioners 2 = Suppliers (other than sole proprietorship) 3 = Institutional provider 4 = Independent laboratories 5 = Clinics (multiple specialties) 6 = Groups (single specialty) 7 = Other entities 8 = Family Practice UI = UPIN Identification N2 = National Council for Prescription Drug Programs D = National Supplier Clearinghouse BP = PIN Individual BG = PIN Group A = Online Survey, Certification and Reporting
21	CCLF5	27	BENE_EQTBL_BIC_HICN_NUM	Legacy Beneficiary Equitable BIC HICN Number. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims, and the HICN value/ Beneficiary Equitable BIC HICN Number will no longer be displayed. The Beneficiary Equitable BIC HICN Number will be blank effective January 1, 2020.
22	CCLF5	49	HCPCS_BETOS_CD	A code representing a clinical category. The Berenson-Eggers Type of Service (BETOS) code.
23	CCLF6	4	BENE_HIC_NUM	Legacy Beneficiary HICN field. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims, and the HICN value will no longer be displayed. The Beneficiary HIC Number will be blank in CCLFs generated effective January 1, 2020, onwards.
24	CCLF6	23	BENE_EQTBL_BIC_HICN_NUM	Legacy Beneficiary Equitable BIC HICN Number. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims, and the HICN value/ Beneficiary Equitable BIC HICN Number will no longer be displayed. The Beneficiary Equitable BIC HICN Number will be blank in CCLFs generated effective January 1, 2020, onwards.
25	CCLF7	3	BENE_HIC_NUM	Legacy Beneficiary HICN field. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims, and the HICN value will no longer be displayed. The Beneficiary HIC Number will be blank in CCLFs generated effective January 1, 2020, onwards.
26	CCLF8	2	BENE_HIC_NUM	Legacy Beneficiary HICN field. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims, and the HICN value will no longer be displayed. The Beneficiary HIC Number will be blank in CCLFs generated effective January 1, 2020, onwards.
27	CCLF8	3	BENE_FIPS_STATE_CD	Identifies the state where the beneficiary receiving services resides. I H
28	CCLF8	4	BENE_FIPS_CNTY_CD	Identifies the county where the beneficiary receiving services resides. I H
29	CCLF8	5	BENE_ZIP_CD	The beneficiary’s ZIP code as indicated in their Medicare enrollment record. I H
30	CCLF8	9	BENE_AGE	The beneficiary’s current age, as calculated by subtracting the beneficiary’s date of birth from the current date. I H
31	CCLF8	13	BENE_RNG_BGN_DT	The date the beneficiary enrolled in Hospice. I H
32	CCLF8	14	BENE_RNG_END_DT	The date the beneficiary is- enrolled in hospice. I H
33	CCLF8	22	BENE_LINE_1_ADR	The first line of the street address. I
34	CCLF8	23	BENE_LINE_2_ADR	The second line of the street address. I
35	CCLF8	24	BENE_LINE_3_ADR	The third line of the street address. I
36	CCLF8	25	BENE_LINE_4_ADR	The fourth line of the street address. I
37	CCLF8	26	BENE_LINE_5_ADR	The fifth line of the street address. I
38	CCLF8	27	BENE_LINE_6_ADR	The sixth line of the street address. I
39	CCLF8	31	GEO_ZIP4_CD	A four-digit extension to a ZIP Code that represents a subdivision for mailing purposes of the ZIP Code. I
40	CCLF9	1	HICN_MBI_XREF_IND…	M = MBI Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims, and the HICN value will no longer be displayed. The Beneficiary HIC Number will be blank in CCLFs generated effective January 1, 2020, onwards.
41	CCLF9	6	BENE_RRB_NUM	Legacy RRB number. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the Medicare Beneficiary Identifier (MBI) will be accepted on claims, and the HICN and RRB will no longer be displayed. These fields will be blank effective January 1, 2020, in CCLF files.
42	CCLFA	3	BENE_HIC_NUM	Legacy Beneficiary HICN field. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims, and the HICN value will no longer be displayed. The Beneficiary HIC Number will be blank in CCLFs generated effective January 1, 2020, onwards.
43	CCLFA	16	CLM_PBP_INCLSN_AMT	The amount that would have been paid in the absence of PBP/ AIPBP Reduction. The value for the PBP/AIPBP Inclusion Amount is derived from the table and column called “CMS_VIEW_CLM_PRD.CLM_VAL_AMT” when the value code within the field called “CLM_VAL_CD” equals “Q0.”
44	CCLFA	17	CLM_PBP_RDCTN_AMT	The PBP/AIPBP Reduction Amount withheld from payment to the Provider. The value for the PBP/AIPBP Reduction Amount is derived from the table and column called “CMS_VIEW_CLM_PRD.CLM_VAL_AMT” when the value code within the field called “CLM_VAL_CD” equals “Q1.”
45	CCLFA	27	CLM_OPRTNL_OUTLR_AMT	Operating Outlier Amount (DSH)
46	CCLFA	28	CLM_MDCR_NEW_TECH_AMT	Medicare new technology add-on payment
47	CCLFA	29	CLM_ISLET_ISOLN_AMT	Islet Isolation Add-on payment amount
48	CCLFA	30	CLM_SQSTRTN_RDCTN_AMT	The payment to the provider will be reduced by the amount specified by CMS.
49	CCLFA	33	CLM_MIPS_PMT_AMT	Capital MIPS payment costs
50	CCLFB	4	BENE_HIC_NUM	Legacy Beneficiary HICN field. Note: To comply with MACRA of 2015, after the end of the New Medicare Card Transition Period in December 2019, only the MBI will be accepted on claims, and the HICN value will no longer be displayed. The Beneficiary HIC Number will be blank in CCLFs generated effective January 1, 2020, onwards.
51	CCLFB	16	CLM_PBP_INCLSN_AMT	The amount that would have been paid in the absence of PBP/AIPBP Reduction. The value for the PBP/AIPBP Inclusion Amount is derived from the table and column called “CMS_VIEW_CLM_PRD.CLM_LINE_OTHR_APLD_AMT” when the value code within the field called “CLM_LINE_OTHR_APLD_CD” equals “J.”
52	CCLFB	17	CLM_PBP_RDCTN_AMT	The PBP/AIPBP Reduction Amount withheld from payment to the Provider. The value for the PBP/AIPBP Reduction Amount is derived from the table and column called “CMS_VIEW_CLM_PRD.CLM_LINE_OTHR_APLD_AMT” when the value code within the field called “CLM_LINE_OTHR_APLD_CD” equals “L.”
53	CCLFB	20	CLM_SQSTRTN_RDCTN_AMT	The payment to the provider will be reduced by the amount specified by CMS. Only one period has been defined by CMS for a 2% reduction that began on 04/01/2013 as part of government sequestration.

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