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MIA Inpatient Adjudication

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

Sequence
Element
Name
Type
Requirement
Min
Max
Repeat
01
380
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
MIA01 is the covered days.
02
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA02 is the Prospective Payment System (PPS) Operating Outlier amount.
03
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
MIA03 is the lifetime psychiatric days.
04
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA04 is the Diagnosis Related Group (DRG) amount.
05
Reference Identification
String (AN)
Optional
1
80
1
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
MIA05 is the Remittance Advice Remark Code. See Code Source 411.
06
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA06 is the disproportionate share amount.
07
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA07 is the Medicare Secondary Payer (MSP) pass-through amount.
08
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA08 is the total Prospective Payment System (PPS) capital amount.
09
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.
10
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.
11
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.
12
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA12 is the old capital amount.
13
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA13 is the Prospective Payment System (PPS) capital indirect medical education claim amount.
14
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA14 is hospital specific Diagnosis Related Group (DRG) Amount.
15
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
MIA15 is the cost report days.
16
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA16 is the federal specific Diagnosis Related Group (DRG) amount.
17
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA17 is the Prospective Payment System (PPS) Capital Outlier amount.
18
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA18 is the indirect teaching amount.
19
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA19 is the professional component amount billed but not payable.
20
Reference Identification
String (AN)
Optional
1
80
1
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
MIA20 is the Remittance Advice Remark Code. See Code Source 411.
21
Reference Identification
String (AN)
Optional
1
80
1
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
MIA21 is the Remittance Advice Remark Code. See Code Source 411.
22
Reference Identification
String (AN)
Optional
1
80
1
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
MIA22 is the Remittance Advice Remark Code. See Code Source 411.
23
Reference Identification
String (AN)
Optional
1
80
1
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
MIA23 is the Remittance Advice Remark Code. See Code Source 411.
24
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
MIA24 is the capital exception amount.

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Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference and Mapping Guides are provided for marketing purposes and are free of charge. All names, logos, and brands of third parties listed on our site are trademarks of their respective owners (including “X12”, which is a trademark of X12 Incorporated). Stedi, Inc. and its products and services are not endorsed by, sponsored by, or affiliated with these third parties. Our use of these names, logos, and brands is for identification purposes only, and does not imply any such endorsement, sponsorship, or affiliation.