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 - 11/06/2018
Batch run: 04/18/2025
Rev:11/06/2018

Program Operations Manual System (POMS)