Common Data Layout

Version 2.1 was published on July 1, 2021 and is available for download. 

Request APCD-CDL

The purpose of the Common Data Layout (CDL) for All-Payer Claims Databases (APCD-CDL™) is to harmonize the claims collection effort across states and reduce the burden of data submission. The overall goals of this effort are to improve efficiency, reduce administrative costs and improve accuracy in claims data collection. 

The APCD-CDL™ consists of technical specifications and multiple file layouts composed of data elements, data types, maximum field lengths, descriptions, valid values, and references to industry standards. APCD-CDL™ files collect adjudicated medical, pharmacy, and dental claims data for all eligible members, with data about members and providers.

  • Member Eligibility: demographic data for members eligible for medical, pharmacy, and dental benefits, including references to ASC X12 270/271 implementation guides.

  • Medical Claims: service-level remittance with clinical diagnosis codes, medical procedure codes, and charges and payments data, including references to the ASC X12 Post Adjudicated Claims Data Reporting Guides (Institutional and Professional).

  • Pharmacy Claims: service-level remittance with drug-dispensing, pharmacy and prescribing physician, and charges and payments data, including references to the NCPDP Uniform Healthcare Payer Data Standard Implementation Guide.

  • Dental Claims: service-level remittance with clinical diagnosis codes, dental procedure codes, teeth treated, and charges and payments data, including references to the ASC X12 Post Adjudicated Claims Data Reporting Guide (Dental).

  • Providers: provider identifiers, such as the National Provider Identifiers (NPI), with provider name, practice location(s), and specialty data for all providers on all other files.

  • Header and Trailer Records: support successful data exchange.

APCD-CDL™ Maintenance Process

In January 2019, the APCD Council called for volunteers to participate on an advisory committee to establish a process to maintain the APCD-CDL™. Made up of states, payers and vendors, the advisory committee collectively decided that the APCD-CDL™:

  • Will be updated every other year to support a predictable timeframe

  • Anyone who has requested a copy of the APCD-CDL™ will be able to submit a request for a modification to the APCD-CDL™ within the timeframe described in the process below using a standard request form

  • Corrections to the APCD-CDL™ will be made on an as needed basis

Using the Data Maintenance Request (DMR) form, any organization that has requested a copy of the APCD-CDL™ can suggest a modification during the 18 months after the release of the most current version of the APCD-CDL™. The APCD Council recommends that individuals within an organization work together and submit a single DMR form on behalf of the entire organization rather than submitting multiple DMRs. 

At the end of the 18 months, all DMRs will be consolidated and posted to the APCD Council website for a 45-day comment period.  At the close of the comment period, the advisory committee, made of up of APCD Council staff and NAHDO members, will review all comments and make recommendations.  A summary of the final recommendations will be posted to the APCD Council website. APCD Council staff will make the recommended changes to the APCD-CDL™ and new version will be released at the start of the new two year period (e.g. January 1, 2023).

 

A webinar will be held to present the changes in the new version.

For more information about the maintenance process, please email apcd.council@unh.edu