STATUS

Buy-In Status Code. This data element contains a numeric entry which defines the current Buy-In status for Medicare Part A and Part B. The codes provide a concise, definitive means of communication between CMS (Centers for Medicare and Medicaid Services) and the States. This field appears on the INQB screen as two separate fields, one for Part A and one for Part B.

The following Buy-In Status Codes apply to both Part A and Part B unless specified otherwise:

Note: If the following values appear in the CUR-BUY-IN-STATUS field, the associated actions should be taken:

16xx: Verify if the client is not deceased

1728: Verify residency

2xxx: Request IEVS report to verify Medicare entitlement

42xx: Contact the Medicare Buy-In Unit (Buy-In is not ongoing.)

1125	The effective date of an accretion submitted by the State was adjusted to the first month after the closed period deletion date on record. The code will be changed to 41 (ongoing) next month unless deleted.
1161 1163	Accretion submitted by the State has been added to the Buy-In Program. The code will be changed to 41 (ongoing) next month unless deleted.
1165	A written request for accretion was processed and added to the Buy-In Program. The code will be changed to 41 (ongoing) next month unless deleted.
1167	(Part B Only) -- An accretion submitted by a county public worker has been added to the Buy-In Program.
1180	(Part B Only) -- Informs the State that CMS has established a Buy-In record for an SSI recipient. The code will be changed to 41 (ongoing) next month unless deleted.
1184	(Part B Only) -- Informs the State that an accretion submitted as a response to code 86 has been established. The code will be changed to 41 (ongoing) next month unless deleted.
14	Buy-In deleted as the recipient is entitled to free Part A or as a result of CMS internal systems adjustment.
15	Buy-In deleted because individual does not meet Medicare requirements (age, citizenship, residency, etc.).
16	Buy-In deleted because the beneficiary is deceased.
1728	Buy-In deleted because individual moved out-of-state.
1750	CMS annulled or established a closed period of Buy-In coverage.
1751	Buy-In deleted based on deletion record submitted by the State.
1753	Buy-In deleted based on a death deletion record submitted by the State.
1759	Buy-In deleted per State’s written request.
2050 2051 2053	State’s request to delete Buy-In was rejected because there is no record of ongoing Buy-In for the claim number submitted.
21XX 2161 2163 2175 2184	Accretion submitted by the State cannot be matched to a CMS record (e.g., no record of the claim number; the claim number matches the claim number on CMS record but name/birthdate/sex do not match; beneficiary has no Medicare entitlement, etc.). Code 2184 applies to Part B only.
23	CMS informs the State that the claim number and/or the Beneficiary Identification Code has been changed.
2350 2351 2353	Informs the State that a claim number change was processed to a deletion record. Code 2353 applies to Part B only.
2361 2363 2375 2384	Informs the State that a claim number change was processed to an accretion record. Code 2384 applies to Part B only.
2399	Informs the State that a claim number change was processed to a State submitted changed record.
2450 2451 2453	Deletion action submitted by the State was rejected because the effective date was blank, incomplete or otherwise in error.
2461 2463 2475 2484	Accretion record submitted by the State was rejected because the effective date was blank, incomplete or in error. Code 2484 applies to Part B only.
2561 2563 2575 2584	Accretion action submitted by the State duplicates an existing accretion record. Code 2584 applies to Part B only.
27	Intended action submitted by the State was rejected because the transaction contained an impossible transaction code. This code is followed by the erroneous input code (e.g., 2750).
2961 2963 2975 2984	An accretion action was rejected because there is a death deletion on record that is at least one month earlier than the effective accretion date. Code 2984 applies to Part B only.
3061 3063 3075 3084	The effective date of the State’s accretion record was adjusted to a later effective date to conform with the Medicare entitlement date. Code 3084 applies to Part B only.
41	Beneficiary continues to be eligible on the State’s Buy-In Program and there has not been a change in status since the last update.
42	CMS informs the State of a credit adjustment to the State’s premium liability. Credit actions can be due to the adjustment of accretion/deletion dates or as a result of duplicate billings.
4211	The accretion date on an ongoing record was adjusted to a later date due to the change in Medicare entitlement date.
4214 4215	The deletion date in an established record was adjusted to an earlier date because the individual did not meet requirements for Medicare.
4216	The date of death in an established record was incorrect and has been adjusted to an earlier date.
4268	The accretion date was adjusted to a later date by a CMS clerical action resulting in a credit to the State.
4269	The deletion date was adjusted to an earlier date by a CMS clerical action resulting in a credit to the State.
4361 4363 4384	An earlier period of Buy-In coverage, resulting from a retroactive State accretion, has been established. Code 4384 applies to Part B only.
4368	The accretion date was adjusted to an earlier date by a CMS clerical action resulting in a debit to the State.
4369	The deletion date was adjusted to a later date by a CMS clerical action resulting in a debit to the State.
4375	A closed period (simultaneous accretion/deletion) Buy-In record has been established.
4380	(Part B Only) -- Informs the State that an earlier period of Buy-In has been established due to a retroactive SSI accretion.
44	Informs the State that the monthly Part A or Part B premium rate was decreased resulting in a credit to the State.
45	Informs the State that the monthly Part A or Part B premium rate was increased resulting in a debit to the State.
4999	The State’s request to correct the Buy-In eligibility code or State Welfare Identification Number (SWIN) was rejected because the claim number or State agency code in code 99 transaction did not match a CMS master record.
50	Used by the State to annul Buy-In coverage or to terminate a closed period record for code 1165 or 1167 accretion.
51	Used by the State to delete an individual from the Buy-In Program because the individual is longer eligible for Buy-In.
53	Used by the State to delete an individual from the Buy-In Program because the individual is deceased.
61 63	Used by the State to accrete an individual on the State’s Buy-In Program.
75	Used by the State to request Buy-In for a closed period (simultaneous accretion/deletion) for the beneficiary.
84	(Part B Only) -- Used by the State to accrete a beneficiary to the Buy-In Program in response to code 86.
86	(Part B Only) -- Informs the State that a beneficiary is entitled to SSI benefits and may be eligible for Buy-In.
87	(Part B Only) -- Informs the State that SSI entitlement has terminated for the beneficiary and action is needed to determine the individual’s continuing eligibility for Buy-In.
99	Used by the State to correct the Buy-In eligibility code or the State Welfare Identification Number (SWIN).