Effective Dates: 03/13/2019 - Present Previous | Next

TN 4 (03-19)

GN 01702.525 Totalization Coding

A. Introduction

Totalization coding is used to generate notice language in claims for U.S. benefits (Totalization or nonTotalization) and to produce an earnings record to be sent to the foreign country with a claim for foreign benefits. In addition, since entitlement to a Totalization benefit cannot establish entitlement to premium-free hospital insurance (HI) under Medicare (see GN 01701.140), the presence of some codes prevents automatic HI enrollment. The Social Security Administration has developed a series of Totalization codes to indicate on the Master Beneficiary Record (MBR) the status of a claim for U.S. Totalization benefits and the name of the agreement country involved.

B. Process

Totalization codes are posted to the MBR only when there is a claim for U.S. Totalization benefits. The coding is systems generated based on entries on the modernized claims system (MCS) screens. Claims for benefits from a foreign country do not generate any codes or indicators. However, the Division of International Operations (DIO) will annotate the Modernized Development Worksheet (MDW) screen when a claim for benefits is forwarded to the foreign country.

C. Definitions

1. Totalization Status Codes (TSC)

TSCs are two digit codes that describe the status of a claim for U.S. Totalization benefits. The different codes are defined below.

a. Award Codes

Codes Definition
A1 Number holder (NH) is insured only by combining U.S. and foreign coverage.
A3 NH is insured only by combining U.S. and foreign coverage and the beneficiary is entitled to premium-free HI as a Medicare Qualified Government Employee or an End Stage Renal Disease beneficiary.
E2

NH was initially insured only by combining U.S. and foreign coverage, subsequently acquired enough additional U.S. credits to be insured based on U.S. coverage alone but continues entitlement to Totalization benefits because they are greater (see GN 01701.305B.1.).

b. Denial codes

Codes Definition
D1

NH has fewer than 6 quarters of coverage (QCs) (see GN 01701.110)

D2

NH has at least 6 QCs but is not insured even after counting foreign coverage.
D3

NH is insured based on U.S. coverage alone.
D4

NH is insured based on U.S. coverage alone or by combining U.S. and foreign coverage but does not meet another entitlement factor (e.g., age).

c. Claim pending codes

Codes Definition
P1

NH has at least 6 QCs but is not insured and the claim cannot be adjudicated until the foreign coverage record is received.

P2

A nonTotalization claim has been awarded but Totalization may yield an earlier month of entitlement or disability insured status.

d. Termination codes

Code Definition
T1

Totalization benefits have terminated because the beneficiary became entitled to higher nonTotalization benefits.

2. Totalization Country Codes (TCC)

TCCs are 5 character alpha codes that identify, by country, the agreement under which a claim for U.S. Totalization benefits has been filed. Where an applicant has filed under more than one agreement, only one code will be shown. These codes are defined below.

Name of Country TCC Code

Australia

AUSSI

Austria

 AUSTR

Belgium

 BELGI
Brazil BRAZI

Canada

 CANAD

Chile

 CHILE

Czech Republic

CZECH

Denmark

DENMK

Finland

 FINLA

France

 FRANC

Germany

 GERMA

Greece

 GREEK
Hungary HUNGA
Iceland ICELA

Ireland

 IRELA

Italy

 ITALY

Japan

JAPAN

Korea (South)

 KOREA

Luxembourg

 LUXEM

Netherlands

 NETHE
Norway NORWA

Poland

POLND

Portugal

 PORTU

Slovak Republic

 SLOVA
Slovenia SLOVE

Spain

 SPAIN
Sweden SWEDE
Switzerland SWISS
United Kingdom UKING
Uruguay URUGU
To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201702525
GN 01702.525 - Totalization Coding - 03/13/2019
Batch run: 03/13/2019
Rev:03/13/2019