Carrier/AB MAC Indicators for the Common Working File (CWF) (Rev. 1586, 10-06-08)

by  Jared Staheli
June 25th, 2015

The carrier/AB MAC record submitted to CWF must contain the following indicators:

Description Payment Indicator Payment Deductible Indicator Deductible Type of Service
Pneumococcal “1” 100 percent “1” Zero deductible “V”
Influenza “1” 100 percent “1” Zero deductible “V”
Hepatitis B “0” 80 percent “0” Deductible applies "1"

A payment indicator of “1” represents 100 percent payment. A deductible indicator of “1” represents a zero deductible. A payment indicator of “0” represents 80 percent payment. A deductible indicator of “0” indicates that a deductible applies to the claim.

The record must also contain a “V” in the type of service field, which indicates that this is a pneumococcal or influenza virus vaccine. Carriers/AB MACs use a “1” in the type of service field which indicates medical care for a hepatitis B vaccine.

References:

Carrier/AB MAC Indicators for the Common Working File (CWF) (Rev. 1586, 10-06-08). (2015, June 25). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/carrier-ab-mac-indicators-for-the-common-working-file-cwf-rev-1586-10-06-08-26905.html

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