MOA Medicare Outpatient Adjudication

To convey claim-level data related to the adjudication of Medicare claims not related to an inpatient setting

Position
Element
Name
Type
Requirement
Min
Max
Repeat
MOA01
Percent
Decimal number (R)
Optional
1
10
1
Percentage expressed as a decimal
MOA01 is the reimbursement rate.
MOA02
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MOA02 is the claim Health Care Financing Administration Common Procedural Coding System (HCPCS) payable amount.
MOA03
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
MOA03 is the Claim Payment Remark Code. See Code Source 411.
MOA04
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
MOA04 is the Claim Payment Remark Code. See Code Source 411.
MOA05
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
MOA05 is the Claim Payment Remark Code. See Code Source 411.
MOA06
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
MOA06 is the Claim Payment Remark Code. See Code Source 411.
MOA07
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
MOA07 is the Claim Payment Remark Code. See Code Source 411.
MOA08
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MOA08 is the End Stage Renal Disease (ESRD) payment amount.
MOA09
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MOA09 is the professional component amount billed but not payable.

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