CN1

Contract Information

Pos: 160

Max: 1

Detail - Optional

Loop: 2300

Elements: 6

User Option (Usage): Situational

To specify basic data about the contract or contract line item

Element Summary:

	Ref	Id	Element Name	Req	Type	Min/Max	Usage
	CN101	1166	Contract Type Code Description: Code identifying a contract type	M	ID	2/2	Required

Code

Name

Diagnosis Related Group (DRG)

Description: A patient classification scheme, which provides means of relating the type of patients a hospital treats to the costs incurred by the hospital, to determine quality of care and utilization of services in a hospital setting

Per Diem

Description: A contract which allows certain charges to be on a rate per day basis

Variable Per Diem

Description: A contract which allows certain charges to be on a rate per day basis, where the rate may not remain constant

Flat

Description: A contract between the provider of service and the destination payor whereby the flat rate charges may differ from the total itemized charges

Capitated

Description: A contract between the provider of service and the destination payor which allows payment to the provider of service on a per member per month basis

Percent

Other

CN102	782	Monetary Amount Description: Monetary amount Industry: Contract Amount Required if provider is contractually obligated to provide this information on the claim.	O	R	1/18	Situational
CN103	332	Percent Description: Percent expressed as a percent Industry: Contract Percentage Alias: Allowance or Charge Percent Required if provider is contractually obligated to provide this information on the claim.	O	R	1/6	Situational
CN104	127	Reference Identification Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier Industry: Contract Code Required if provider is contractually obligated to provide this information on the claim.	O	AN	1/30	Situational
CN105	338	Terms Discount Percent Description: Terms discount percentage, expressed as a percent, available to the purchaser if an invoice is paid on or before the Terms Discount Due Date Industry: Terms Discount Percentage Required if provider is contractually obligated to provide this information on the claim.	O	R	1/6	Situational
CN106	799	Version Identifier Description: Revision level of a particular format, program, technique or algorithm Industry: Contract Version Identifier Required if provider is contractually obligated to provide this information on the claim.	O	AN	1/30	Situational

1.	CN102 is the contract amount.
2.	CN103 is the allowance or charge percent.
3.	CN104 is the contract code.
4.	CN106 is an additional identifying number for the contract.

Notes:

1. The developers of this implementation guide recommend that for non-capitated situations, contract information be maintained in the receiver�s files and not be transmitted with each claim whenever possible. It is recommended that submitters always include CN1 for encounters that include only capitated services.
2. Required if the provider is contractually obligated to provide contract information on this claim.

Example:

CN1*02*550~