CIP.002.196

MEDICARE-HIC-NUM

Data Element

DE Number

CIP196

System DE Number

CIP.002.196

File Name

CIP - CLAIM INPATIENT

File Segment Number

CIP00002

File Segment Name

CLAIM-HEADER-RECORD-IP

Last updated

09/12/2024

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The Medicare HIC Number (HICN) is an identifier formerly used by SSA and CMS to identify all Medicare beneficiaries. For many beneficiaries, their SSN was a major component of their HICN. To prevent identify theft, among other reasons, HICN gradually were retired and replaced by the Medicare Beneficiary Identifier (MBI) over the course of 2018 and 2019. HICN continue to be used by Medicare for limited administrative purposes after 2019 but starting in 2020 the MBI became the primary identifier for Medicare beneficiaries. HICN consists of two components: SSN & alpha-suffix or (for Railroad IDs) prefix and ID (not always SSN based)
Size	X(12)
FLF Start Position	1145
FLF Stop Position	1156
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Conditional 2. Value must be 12 characters or less 3. Value must not contain a pipe or asterisk symbols 4. (Not Dual Eligible) if Dual Eligible Code (ELG.DE.085) value equals "00", then value must not be populated 5. Value must be populated when Crossover Indicator (CIP.002.023) equals "1" and Medicare Beneficiary Identifier (CIP.002.222) is not populated

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date
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RULE ID	RULE Definition
RULE-6559	If a claim line is a non-denied claim line from an IP file, then the Medicare HIC number value reported must be compatible with specified T-MSIS picture format: X(12).
RULE-712	If the medicare hic number is populated on a non-denied claim from an IP file, then the medicare hic number reported must not contain any pipe or asterisk characters.
RULE-713	If a non-denied, crossover IP claim has a value populated for medicare beneficiary ID, the IP claim must have a value populated for medicare hic number.

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Measure ID	Measure Name
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DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CLT140	CLT.002.140	MEDICARE-HIC-NUM	CLT00002	CLAIM-HEADER-RECORD-LT
COT122	COT.002.122	MEDICARE-HIC-NUM	COT00002	CLAIM-HEADER-RECORD-OT
CRX079	CRX.002.079	MEDICARE-HIC-NUM	CRX00002	CLAIM-HEADER-RECORD-RX
ELG050	ELG.003.050	MEDICARE-HIC-NUM	ELG00003	VARIABLE-DEMOGRAPHICS-ELIGIBILITY