Informational Encounter Indicator

SAS Name
INFRMTL_ENCTR_IND_SW

The indicator switch used to identify if a beneficiary is enrolled in a Managed Care Organization (MCO).

Comments

If any claim that comprises the Stay has a condition code (CLM_RLT_COND_CD) equal to '04' populate the MEDPAR Informational Encounter Switch with a 'Y'. If no '04' condition code, populate field with an 'N'. This field is new in 2011.

Source: NCH

Code Code value
Y Yes, beneficiary is a Managed care enrollee (hospital expects to receive payment from an MCO)
N No, beneficiary is not a MCO enrollee