MIA Medicare Inpatient Adjudication

To provide claim-level data related to the adjudication of Medicare inpatient claims

Position
Element
Name
Type
Requirement
Min
Max
Repeat
MIA01
Quantity
Decimal number (R)
Mandatory
1
15
1
Numeric value of quantity
MIA01 is the covered days.
MIA02
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA02 is the Prospective Payment System (PPS) Operating Outlier amount.
MIA03
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
MIA03 is the lifetime psychiatric days.
MIA04
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA04 is the Diagnosis Related Group (DRG) amount.
MIA05
Reference Identification
String (AN)
Optional
1
50
1
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
MIA05 is the Claim Payment Remark Code. See Code Source 411.
MIA06
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA06 is the disproportionate share amount.
MIA07
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA07 is the Medicare Secondary Payer (MSP) pass-through amount.
MIA08
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA08 is the total Prospective Payment System (PPS) capital amount.
MIA09
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA09 is the Prospective Payment System (PPS) capital, federal specific portion, Diagnosis Related Group (DRG) amount.
MIA10
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA10 is the Prospective Payment System (PPS) capital, hospital specific portion, Diagnosis Related Group (DRG), amount.
MIA11
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA11 is the Prospective Payment System (PPS) capital, disproportionate share, hospital Diagnosis Related Group (DRG) amount.
MIA12
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA12 is the old capital amount.
MIA13
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA13 is the Prospective Payment System (PPS) capital indirect medical education claim amount.
MIA14
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA14 is hospital specific Diagnosis Related Group (DRG) Amount.
MIA15
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
MIA15 is the cost report days.
MIA16
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA16 is the federal specific Diagnosis Related Group (DRG) amount.
MIA17
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA17 is the Prospective Payment System (PPS) Capital Outlier amount.
MIA18
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA18 is the indirect teaching amount.
MIA19
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA19 is the professional component amount billed but not payable.
MIA20
Reference Identification
String (AN)
Optional
1
50
1
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
MIA20 is the Claim Payment Remark Code. See Code Source 411.
MIA21
Reference Identification
String (AN)
Optional
1
50
1
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
MIA21 is the Claim Payment Remark Code. See Code Source 411.
MIA22
Reference Identification
String (AN)
Optional
1
50
1
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
MIA22 is the Claim Payment Remark Code. See Code Source 411.
MIA23
Reference Identification
String (AN)
Optional
1
50
1
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
MIA23 is the Claim Payment Remark Code. See Code Source 411.
MIA24
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA24 is the capital exception amount.

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