Health Care Codes Lists

**Overview**
This data package contains information about the Centers for Medicare and Medicaid Services (CMS) Place of Service Codes. It consists of Healthcare Claim for Adjustment, Status Category and Status Codes as well as Healthcare Insurance over Business Process Application Error, Payment Type and Report Type Codes. It also comprises of data about Healthcare Provider Characteristics, Remittance Advice Remark, Services Decision Reason, Inpatient Revenue Crosswalk Codes.

**Description**
This data package contains the Centers for Medicare & Medicaid Services (CMS) maintain Place of Service Codes Set used throughout the healthcare industry. These standard codes require all health plans and providers to use standard code sets to populate data elements in each transaction. This standard names the place of service code set currently maintained by CMS as the code set to be used for describing sites of service in such claims.

Place of Service information is often needed to determine the acceptability of direct billing of Medicare, Medicaid and private insurance services provided by a given provider. Claim Adjustment Reason Codes communicate an adjustment, meaning that they must communicate why a claim or service line was paid differently than it was billed. If there is no adjustment to a claim, then there is no adjustment reason code. Claim Status Category Codes indicate the general category of the status accepted, rejected, additional information requested. Health Care Claim Status Codes convey the status of an entire claim or a specific service line. Claim status codes communicate information about the status of a claim whether it's been received, pended, or paid. The Claim Status transaction is not used as a financial transaction. This Insurance Business Process Application Error Codes list is for use by all users across the insurance and healthcare industry. It gives a summary of business process errors and their corresponding codes. This code list may also be used for responses to inquiries regarding provider participation or registration in a program or plan.

Health Care Insurance Payment Type Codes are used to identify the type and purpose of the health insurance for the payment amount transmitted. Healthcare Provider Characteristics Codes is intended to provide codified responses to questions presented to a health care provider applying to or registering with an entity and to report the outcome of such application or registration. It may also be used for responses to inquiries regarding provider participation or registration in a program or plan. Healthcare Remittance Advice Remark Codes (RARCs) are used to provide additional explanation for an adjustment already described by a Claim Adjustment Reason Code (CARC) or to convey information about remittance processing for all medical claims. Health Care Services Decision Reason Codes are used to indicate the primary reason for the certification action code assigned as part of a health care services review for all medical claims.

The objective of the Health Care Services Decision Reason Codes is to create better access to health insurance, limit fraud and abuse and reduce administrative costs in terms of health care services review. The Inpatient Revenue Code Crosswalk is used for an insurance company whether the procedure was performed in the emergency room, operating room or another department. If a revenue code is attached to a supply code, it identifies the equipment and whether the equipment was used in the hospital or taken home by a patient. If a revenue code is attached to a supply code, it identifies the equipment and whether the equipment was used in the hospital or taken home by a patient. This is important because many of the procedures done in the hospital may be done in different areas.

**Benefits**
- Useful for medical care providers, patients, policymakers and medical research groups and health planners. health care codes lists database is available on centers for medicare & medicaid services website in raw form, whereas a john snow labs (jsl) customer gets it in a clean and normalized form ready to use and create his own custom reports. easy to comprehend for the customers who are unfamiliar with the medical terminologies as all abbreviated terms are replaced with full form, unlike health care codes lists datasets which are full of abbreviations.

**License Information**
The use of John Snow Labs datasets is free for personal and research purposes. For commercial use please subscribe to the [Data Library](https://www.johnsnowlabs.com/marketplace/) on John Snow Labs website. The subscription will allow you to use all John Snow Labs datasets and data packages for commercial purposes.

**Included Datasets**
- [Centers for Medicare and Medicaid Services Place of Service Codes Set](https://www.johnsnowlabs.com/marketplace/centers-for-medicare-and-medicaid-services-place-of-service-codes-set)
- In this dataset the place of service codes and their descriptions have been cited. These codes should be used on professional claims to specify the entity where service(s) were rendered. These Place of Service Codes database have been updated from November 17, 2016.
- [Health Care Claim Adjustment Reason Codes](https://www.johnsnowlabs.com/marketplace/health-care-claim-adjustment-reason-codes)
- This dataset explains information on Claim adjustment reason codes to communicate an adjustment, meaning that this information communicates why a claim or service line was paid differently than it was billed. If there is no adjustment to a claim/line, then there is no adjustment reason code.
- [Health Care Claim Status Category Codes](https://www.johnsnowlabs.com/marketplace/health-care-claim-status-category-codes)
- This dataset explains the Claim Status Category Codes that indicate the general category of the status (accepted, rejected, additional information requested, etc.) which is further detailed in the Claim Status Codes.
- [Health Care Claim Status Codes](https://www.johnsnowlabs.com/marketplace/health-care-claim-status-codes)
- Health Care Claim Status Codes convey the status of an entire claim or a specific service line. Claim status codes communicate information about the status of a claim, i.e., whether it's been received, pended, or paid. The Claim Status transaction is not used as a financial transaction.
- [Health Care Insurance Business Process Application Error Codes](https://www.johnsnowlabs.com/marketplace/health-care-insurance-business-process-application-error-codes)
- This Insurance Business Process Application Error Codes list is for use by all users across the insurance and healthcare industry. It has information on business process application error codes and their descriptions, status of the codes whether active, to be deactivated or deactivated.
- [Health Care Insurance Payment Type Codes](https://www.johnsnowlabs.com/marketplace/health-care-insurance-payment-type-codes)
- Healthcare Insurance Payment Type Codes are transmitted in 005010X306, loop 2300, RMR02. They identify the type and purpose of the health insurance for the payment amount transmitted. This dataset also contains information on the different payment type codes and their descriptions, use of the codes, and the start and modified dates for each code.
- [Health Care Insurance Report Type Codes](https://www.johnsnowlabs.com/marketplace/health-care-insurance-report-type-codes)
- Healthcare Insurance Report Type Codes is a dataset that defines the type of report being described in an insurance claim and are transmitted in 005010X306, loop 2300, REF03. This dataset also contains information on the different report type codes and their descriptions, start and modified dates, and the status of each code whether active, to be deactivated or deactivated.
- [Health Care Provider Characteristics Codes](https://www.johnsnowlabs.com/marketplace/health-care-provider-characteristics-codes)
- This Healthcare Provider Characteristics Codes list is for use with health care provider information for enrollment and credentialing transactions and their corresponding responses. This dataset also contains information on the different provider characteristics codes and their descriptions, the start and modified dates and the status of each code.
- [Health Care Remittance Advice Remark Codes](https://www.johnsnowlabs.com/marketplace/health-care-remittance-advice-remark-codes)
- Healthcare Remittance Advice Remark Codes (RARCs) are used to provide additional explanation for an adjustment already described by a Claim Adjustment Reason Code (CARC) or to convey information about remittance processing for all medical claims.
- [Health Care Services Decision Reason Codes](https://www.johnsnowlabs.com/marketplace/health-care-services-decision-reason-codes)
- Health Care Services Decision Reason Codes are used to indicate the primary reason for the certification action code assigned as part of a health care services review for all medical claims. This dataset also contains information on the different decision reason codes and their descriptions, the start and modified dates, and the status for each code.
- [Health Care Services Type Codes](https://www.johnsnowlabs.com/marketplace/health-care-services-type-codes)
- Health Care Service Type Codes are used to identify the classification of service or benefits. This external code list is for use in ASC X12 Transaction Sets 270, 271 and 278, versions 006010 and higher. Version 005010 codes are available within the ASC X12 TR3 Implementation Guide. This dataset also contains information on the different service type codes and their descriptions, the start and modified dates, and the status for each code.
- [Multiple Procedure Payment Reduction](https://www.johnsnowlabs.com/marketplace/multiple-procedure-payment-reduction)
- This dataset shows the therapy payment amount reduced by MPPR (Multiple Procedure Payment Reduction) is applied toward the therapy caps. MPPR amount may increase the amount of medically necessary therapy services the beneficiary receives before exceeding the therapy caps. Medicare is applying MPPR to the non-facility Practice Expense (PE) payment of select therapy services paid under the Medicare Physician Fee Schedule (MPFS).

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