line_item_coordination_of_benefits

Describes the adjudication performed for a line item on behalf of the payer. According to the EDI specification, this is only used for Coordination of Benefits, but some reprices also use it for claims repricing

Primary Key:

• line_item_coordination_of_benefits_id

Foreign Keys:

• coordination_of_benefits_index_chosen_by => login.login_id
• line_item_id => line_item.line_item_id

Indexes:

• line_item_coordination_of_benefits_cob_index_chosen_by_idx - coordination_of_benefits_index_chosen_by
• line_item_coordination_of_benefits_cob_index_chosen_idx - coordination_of_benefits_index_chosen
• line_item_coordination_of_benefits_line_item_id_idx - line_item_id

Column	Data Type	Nullable	Indexed	Description
line_item_coordination_of_benefits_id	bigint	No	Yes	Snowflake ID for line item coordination of benefits. Generated through expression:
line_item_id	bigint	No	Yes	Link to line item record. Generated through expression:
other_payer_primary_id	text	No	No	Points to the payer responsible for the reimbursement in the claim loop (From Loop 2430 SVD01). The identifier must be the same as the Loop ID-2330B NM109. Generated through expression:
paid_amount	numeric	Yes	No	The amount paid for a line item on a claim. (Loop 2430 SVD02). Generated through expression:
procedure_qualifier	product_service_id_type	Yes	No	The type of procedure code for a line item on a claim. For example: 'HC' for 'HCPCS' (Loop 2430 SVD03_01).. Generated through expression:
procedure_code	text	No	No	The procedure code being adjusted. (Loop 2430 SVD03_02) Generated through expression:
procedure_modifiers	text[]	No	No	- Generated through expression:
procedure_description	text	No	No	- Generated through expression:
paid_quantity	numeric	Yes	No	- Generated through expression:
bundled_or_unbundled_line_number	text	No	No	- Generated through expression:
payment_date	date	Yes	No	- Generated through expression:
remaining_patient_liability	numeric	Yes	No	- Generated through expression:
prior_authorization_number	text	No	No	Prior authorization number for this COB record. (From 2400 loop REF G1: when REF04_02 equals the other_payer_primary_id for this row) Generated through expression:
predetermination_of_benefits_identifier	text	No	No	Predetermination of benefits identification number (from 2400 loop REF G3: when REF04_02 equals the other_payer_primary_id for this row) Generated through expression:
referral_number	text	No	No	Referral number (from 2400 loop REF 9F: when REF04_02 equals the other_payer_primary_id for this row) Generated through expression:
coordination_of_benefits_index_chosen	bigint	Yes	Yes	- Generated through expression:
coordination_of_benefits_index_chosen_at	timestamp with time zone	Yes	No	- Generated through expression:
coordination_of_benefits_index_chosen_by	bigint	Yes	Yes	- Generated through expression: