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[ GROUPING n/a ICD-9-CM 07/2009
birth date HL7 Encounter CPT 99201 99202 99203 99204 99205 99212 99213 99214 99215 99241 99242 99243 99244 99245 99341 99342 99343 99344 99345 LOINC 21112-8
Birth date National Quality Forum 2.16.840.1.113883.3.560.100.4 Code
Descriptor 2.16.840.1.113883.1.11.1 Gender Individual Characteristic1 HL7 Administrative Gender (2.16.840.1.113883.5.1) F Female M Male HL7 UN Undifferentiated CDC NCHS 2.16.840.1.114222.4.11.836 Race CDC Race and Ethnicity Code 3/30/2007 1002-5 American Indian or Alaska Native 2028-9 Asian 2054-5 Black or African American 2076-8) Native Hawaiian or Other Pacific Islander 2106-3 White 2131-1
Other Race 2.16.840.1.114222.4.11.837
Ethnicity 2135-2 Hispanic or Latino 2186-5 Not Hispanic or Latino PHDSC Payer Source of Payment Typology October 2010 MEDICARE Medicare (Managed Care)
Medicare HMO Medicare PPO Medicare POS Medicare Managed Care Other Medicare (Non-managed Care) Medicare FFS Drug Benefit& Medicare Medical Savings Account (MSA) Medicare Non-managed Care Other Medicare Other MEDICAID Medicaid (Managed Care) Medicaid HMO Medicaid PPO, Medicaid PCCM (Primary Care Case Management) Medicaid Managed Care Other Medicaid (Non-managed Care Plan) Medicaid/SCHIP Medicaid Applicant Medicaid - Out of State Medicaid OtherL OTHER GOVERNMENT (Federal/State/Local) (excluding Department of Corrections) Department of Defense TRICARE (CHAMPUS) TRICARE Prime--HMO TRICARE Extra--PPO" TRICARE Standard - Fee For Service% TRICARE For Life--Medicare Supplement TRICARE Reserve Select4 Uniformed Services Family Health Plan (USFHP) -- HMO Department of Defense - (other) Military Treatment Facility Enrolled Prime--HMO Non-enrolled Space Available TRICARE For Life (TFL) Dental --Stand Alone Department of Veterans Affairs' Veteran care--Care provided to Veterans+ Direct Care--Care provided in VA facilities2 Indirect Care--Care provided outside VA facilities Fee Basis( Foreign Fee/Foreign Medical Program(FMP), Contract Nursing Home/Community Nursing Home State Veterans Home Sharing Agreements Other Federal Agency Non-veteran care8 Civilian Health and Medical Program for the VA (CHAMPVA)% Spina Bifida Health Care Program (SB)) Children of Women Vietnam Veterans (CWVV) Other non-veteran care Indian Health Service or Tribe Indian Health Service - Regular Indian Health Service - Contract$ Indian Health Service - Managed Care! Indian Tribe - Sponsored Coverage HRSA Program Title V (MCH Block Grant) Migrant Health Program Ryan White Act Other
Black Lung State Government1 State SCHIP program (codes for individual states)* Specific state programs (list/ local code), State, not otherwise specified (other state) Local Government Local - Managed care HMO PPO POS
FFS/Indemnity4 Local, not otherwise specified (other local, county)6 Other Government (Federal, State, Local not specified)0 Federal, State, Local not specified managed care) Federal, State, Local not specified - HMO) Federal, State, Local not specified - PPO) Federal, State, Local not specified - POS@ Federal, State, Local not specified - not specified managed care) Federal, State, Local not specified - FFS+ Federal, State, Local not specified - Other
Other Federal DEPARTMENTS OF CORRECTIONS Corrections Federal Corrections State Corrections Local Corrections Unknown Level PRIVATE HEALTH INSURANCE Managed Care (Private) Commercial Managed Care - HMO Commercial Managed Care - PPO Commercial Managed Care - POS Exclusive Provider Organization Gatekeeper PPO (GPPO) Managed Care, Other (non HMO)$ Private Health Insurance - Indemnity Commercial Indemnity< Self-insured (ERISA) Administrative Services Only (ASO) plan. Medicare supplemental policy (as second payer)3 P r i v a t e h e a l t h i n s u r a n c e o t h e r c o m m e r c i a l I n d e m n i t y W Managed Care (private) or private health insurance (indemnity), not otherwise specified Organized Delivery System Small Employer Purchasing Group Other Private Insurance BLUE CROSS/BLUE SHIELD BC Managed Care BC Managed Care - HMO BC Managed Care - PPO BC Managed Care - POS BC Managed Care - Other BC Indemnity- BC (Indemnity or Managed Care) - Out of State, BC (Indemnity or Managed Care) - Unspecified& BC (Indemnity or Managed Care) - Other[ MANAGED CARE, UNSPECIFIED (to be used only if one can't distinguish public from private)0 Other Managed Care, Unknown if public or privateC NO PAYMENT from an Organization/Agency/Program/Private Payer Listed Self-pay No Charge Charity Professional Courtesy Research/Clinical Trial Refusal to Pay/Bad Debt Hill Burton Free Care Research/Donor No Payment, Other MISCELLANEOUS/OTHER Foreign National Other (Non-government) Disability Insurance Long-term Care Insurance Worker's Compensation Worker's Comp HMO Worker's Comp Fee-for-Service W o r k e r s C o m p O t h e r M a n a g e d C a r e ! Worker's Comp, Other unspecified Auto Insurance (no fault)5 Other specified (includes Hospice - Unspecified plan)- No Typology Code available for payment source Unavailable / Unknown 2.16.840.1.113883.3.221.5( National Committee for Quality Assurance Procedure 2.16.840.1.113883.3.464.0001.97 2.16.840.1.113883.3.464.0001.139 2.16.840.1.113883.3.464.0001.140 2.16.840.1.113883.3.464.0001.141 2.16.840.1.113883.3.464.0001.142 2.16.840.1.113883.3.464.0001.143 2.16.840.1.113883.3.464.0001.50 V70.0= Routine general medical examination at a health care facility V70.35 Other medical examination for administrative purposes V70.5, Health examination of defined subpopulations V70.6( Health examination in population surveys V70.8, Other specified general medical examinations V70.9' Unspecified general medical examination 2.16.840.1.113883.3.464.0001.48 99211 99384 99385 99386 99387 99394 99395 99396 99397 99217 99218 99219 99220 99401 99402 99403 99404 99411 99412 99420 99429 99455 99456 encounter outpatient 06/2009 99347-99350 2.16.840.1.113883.3.464.0001.49$ "encounter outpatient" CPT code list) "encounter outpatient" ICD-9-CM code list
Medication RxNorm Pneumococcal Vaccination 90669 90670 pneumococcal vaccination CVX 100* pneumococcal conjugate vaccine, polyvalent 133) pneumococcal conjugate vaccine, 13 valent) Pneumococcal Vaccination ages 2 and older 90732/ Pneumococcal Vaccination ages 2 years and older 33# pneumococcal polysaccharide vaccine! Pneumococcal Vaccination all ages1 "Pneumococcal Vaccination all ages" CPT code list1 "Pneumococcal Vaccination all ages" CVX code list pneumococcal vaccine 854931> pneumococcal capsular polysaccharide type 1 vaccine 0.05 MG/ML 854933@ pneumococcal capsular polysaccharide type 10A vaccine 0.05 MG/ML 854935@ pneumococcal capsular polysaccharide type 11A vaccine 0.05 MG/ML 854937@ pneumococcal capsular polysaccharide type 12F vaccine 0.05 MG/ML 854939? pneumococcal capsular polysaccharide type 14 vaccine 0.05 MG/ML 854941@ pneumococcal capsular polysaccharide type 15B vaccine 0.05 MG/ML 854943@ pneumococcal capsular polysaccharide type 17F vaccine 0.05 MG/ML 854945@ pneumococcal capsular polysaccharide type 18C vaccine 0.05 MG/ML 854947@ pneumococcal capsular polysaccharide type 19A vaccine 0.05 MG/ML 854949@ pneumococcal capsular polysaccharide type 19F vaccine 0.05 MG/ML 854951> pneumococcal capsular polysaccharide type 2 vaccine 0.05 MG/ML 854953? pneumococcal capsular polysaccharide type 20 vaccine 0.05 MG/ML 854955@ pneumococcal capsular polysaccharide type 22F vaccine 0.05 MG/ML 854957@ pneumococcal capsular polysaccharide type 23F vaccine 0.05 MG/ML 854959> pneumococcal capsular polysaccharide type 3 vaccine 0.05 MG/ML 854961@ pneumococcal capsular polysaccharide type 33F vaccine 0.05 MG/ML< 854963> pneumococcal capsular polysaccharide type 4 vaccine 0.05 MG/ML 854965> pneumococcal capsular polysaccharide type 5 vaccine 0.05 MG/ML 854967? pneumococcal capsular polysaccharide type 6B vaccine 0.05 MG/ML 854969? pneumococcal capsular polysaccharide type 7F vaccine 0.05 MG/ML 854971> pneumococcal capsular polysaccharide type 8 vaccine 0.05 MG/ML 854973? pneumococcal capsular polysaccharide type 9N vaccine 0.05 MG/ML 854975? pneumococcal capsular polysaccharide type 9V vaccine 0.05 MG/ML 854977E pneumococcal capsular polysaccharides (23) 0.5 ML Injectable Solution 2.16.840.1.113883.3.464.0001.429% pneumococcal vaccine ages 2 and older 854981k Pneumovax 23 (Pneumococcal vaccine polyvalent) Injectable Solution, appropriate for populations 2 and above 2.16.840.1.113883.3.464.0001.430 Pneumococcal Vaccine all ages0 "Pneumococcal Vaccine all ages" RxNorm code list Value Set Developer
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