Data related to an individual’s insurance coverage for health care.

Data Element

Coverage Status
Description (*Please confirm or update this field for the new USCDI version*)

Presence or absence of health care insurance.

Comment

Coverage Status for service item

This concept is better defined at the service item level or at a patient level rather than encounter or claim level for the following reasons: 

  • There could be a mix of coverages for any particular encounter or claim.
  • A claim may contain several items, some of which are covered and others not.
  • Claims can be covered by a variety of insurers.

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