FISS DDE Provider Online Guide

Chapter I: Online System Terminology

Document Control Number

Purpose

The FISS DDE Provider Online System refers to the claim control number as a DCN. The DCN provides a reference number for the control and monitoring of each claim. To differentiate between claims for the beneficiary, the system creates a unique control number. The DCN may also be referred to as the ICN.

The DCN is a 23-position number assigned by the system. It is the identifying code for each claim and serves the following functions:

  • Completes the ‘key’ to automate the finding of claims on the claim file (with beneficiary identification number)
  • Contains a Year (position 2‑3) and Julian date (position 4‑6) which provides the system with the claim's entry date
  • Contains an Origin code (position 14) which identifies the claim's mode of submission

Points to Remember

  • You are not able to search for claims in the online system using the DCN
  • When an adjustment or cancel is submitted online, the system automatically plugs in the appropriate DCN of the original claim
  • The DCN is referenced on the following documents:
    • Remittance advice (shows as ICN due to standardization of the remittance advice)
    • ADR
  • The DCN is not referenced on the 201 Pend Report (claim status)

Every DCN tells a story; the following is an example DCN and an explanation of each position.

DCN = 21800700814502ILA

Position 1 2–3 4–6 7–10 11–12 13 14 15–17 18-23
DCN 2 18 007 0081 45 0 2 ILA N/A

The following chart defines the various DCN field positions.

DCN Field Position(s) Definition Significance
1 Century code This code is used to indicate the century in which the DCN is established:
1 is used to indicate years 1900–1999
2 is used to indicate years 2000 and after
Valid values are 0 through 9
2–3 Year The last two digits of the year during which the claim is received
4–6 Julian date Reports the Julian date which corresponds to the calendar date that the claim is received
In the example above, the Julian date 007 equals January 7
7–10 Batch sequence Primary sequencing field, beginning with 0000 and ending with 9999
FISS can accept up to 10,000 batches of claims per day
11–12 Claim sequence Secondary sequencing field, beginning with 00 and ending with 99
A batch may contain as few claims as one or as many as 100
13 Choices/Split Indicator Site-specific field used on split bills.

Valid values are:
C – Choices
V – Veteran’s Administration
0 (zero) – default when not used at a site
14 Origin Designates method of claim entry into the system.

Valid values for the origin are:
0 – Unknown
1 – EMC batch format (electronic)
2 – EMC/UB04/Other
3 – EMC/Other
4 – FISS online data entered claim
5 – FISS non-DDE claim
6 – Other EMC/UB04
7 – Other EMCnon-UB04
8 – UB-04 hard copy
9 – Other hard copy
15–17 Business Segment Identifier (BSI) Three-position alphanumeric field.
First two characters (15-16) are jurisdiction (state) code
Next character (17) identifies the type of Medicare contract.

Valid values include:
A – Part A MAC/Fiscal Intermediary
B – Part B MAC/Carrier
D – Durable Medical Equipment Regional Carrier
R – Regional Home Health Intermediary
18–21 Home Health Split/Mass Adjustment Indicator/Future Area (Field used as needed)

Home Health Split

Valid values include:
B – Adjustment claim for services after the date of death
C – Incarcerated beneficiary CWF error code U538H
D – DCN altered due to file fix to make DCN unique
E – XXG adjustment claim generated upon receipt of IUR with error code U538Q, beneficiary unlawfully present
H – System generated adjustment for prior processed claim (inpt only) or blood data
M – Duplicate mass adjustment
N – Incorrect patient status on IPPS with payments rejected
O – Benefits exhausted
P – System generated Post Pay activity
R – System generated adjustment for interrupted stay
S – For HIS/Tribal Hospitals with payments rejected
T – Unsolicited adjustments
U – Unsolicited
V – Unsolicted adjustment for assiciated service (prior auth.)
Z – Adjustment for incorrect patient status on IPPS claim

Mass Adjusment Indicator: User defined

Future Area: positions reserved for future use
22–23 Site Location (Field used as needed)

Code used to identify site location controlling the workload where more than one location processes claims for a MAC

Revised 4/15/2018