Medicare Secondary Payer Manual (Pub. 100-05), Ch. 6 § 40.2
CWF Claim Matching Criteria Against MSP Records
40.2 - CWF Claim Matching Criteria Against MSP Records
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
The matching criteria between the claim and the MSP auxiliary occurrence in CWF is as
follows:
HICN/MBI, MSP type, MSP effective date and termination date, insurance type, patient
relationship code and validity indicator for the same insurer. Note, NGHP records
includes matching on the family of diagnosis codes.