1 CMS RIF REPORT AS OF: 12/13/2007 SOURCE: CA REPOSITORY NAME LENGTH BEG END CONTENTS ----------------------------------------------------------------------------------------------------------------------- *** Medicare Provider Analysis and Review 560 1 560 REC THE REPRESENTATION OF A BENEFICIARY STAY IN AN INPATIENT HOSPITAL OR IN A SKILLED NURSING FACILITY (SNF) WHICH MAY INCLUDE ONE OR MORE FINAL ACTION CLAIMS. THE MEDICARE PROVIDER ANALYSIS AND REVIEW (MEDPAR) FILE CONTAINS DATA FROM CLAIMS FOR SERVICES PROVIDED TO MEDICARE BENEFICIARIES ADMITTED TO MEDICARE- CERTIFIED HOSPITALS AND SKILLED NURSING FACILITIES (SNF). THE FILE IS CREATED QUARTERLY IN MARCH, JUNE, SEPTEMBER, AND DECEMBER, AND IS GENERALLY AVAILABLE TWO WEEKS AFTER THE END OF THE QUARTER. EACH MEDPAR RECORD REPRESENTS A BENEFICIARY STAY IN AN INPATIENT HOSPITAL (WHERE DISCHARGED) OR IN A SNF (MAY BE 'STILL A PATIENT'; COMPLETE DISCHARGE DATA NOT ALWAYS RECEIVED), AND MAY INCLUDE ONE CLAIM OR MULTIPLE CLAIMS. (APPROXIMATELY 95% OF INPATIENT MEDPAR RECORDS AND 50% OF SNF MEDPAR RECORDS INVOLVE A SINGLE CLAIM.) BEGINNING IN JUNE 2007, THE MEDPAR FILE WAS REVISED TO IMPLEMENT A POLICY CHANGE THAT CHANGED HOW THE SSI DAY COUNT IS CALCULATED. THE LENGTH OF STAY IS NOW USED TO CALCULATE THE SSI DAY COUNT INSTEAD OF USING COVERED DAYS. OTHER CHANGES TO THE FILE INCLUDED: (1) ADDING THE NPI FIELD TO THE FILE; AND (2) FILLER WAS ADDED TO THE DIAGNOSIS AND PROCEDURE CODE GROUPS AND AT THE END OF THE RECORD. BEGINNING IN JUNE 1995, THE INPATIENT AND SNF CLAIMS FROM THE NATIONAL CLAIMS HISTORY (NCH) 100% NEARLINE FILE BECAME THE SOURCE OF MEDPAR. ALSO EFFECTIVE JUNE, 1995, A MEDPAR RECORD REPRESENTS FINAL ACTION CLAIMS DATA IN WHICH ALL ADJUSTMENTS HAVE BEEN RESOLVED (THEREBY ELIMINATING CREDIT-ONLY SITUATIONS). (PRIOR TO JUNE 1995, MEDPAR WAS CREATED FROM CLAIMS FROM THE MEDICARE QUALITY ASSURANCE (MQA) SYSTEM; A MEDPAR RECORD REPRESENTED AN ACCUMULATION OF ADJUSTMENT CLAIMS, SOMETIMES INCLUDING CREDIT-ONLY STAYS.) EFFECTIVE WITH THE 9/96 UPDATE THE 1995 MEDPAR WAS CREATED AS FOLLOWS: 1. EACH MONTH INPATIENT AND SNF CLAIMS ARE ACCUMULATED FROM THE NCH NEARLINE REPOSITORY. 2. AT THE END OF EACH QUARTER, THE MONTHLY FILES ARE MERGED INTO A DATABASE CONTAINING ALL CLAIMS FOR THE CURRENT YEAR AND PRIOR TWO YEARS. THE DATABASE IS PROCESSED THROUGH THE FINAL ACTION ALGORITHMS. 3. THE FINAL-ACTIONED DATABASE IS SPLIT INTO TWO SEGMENTS FOR EACH YEAR. INPATIENT CLAIMS WITH DISCHARGE DATES AND SNF CLAIMS WITH ADMISSION DATES IN JANUARY THROUGH SEPTEMBER ARE IN THE FIRST SEGMENT; CLAIMS WITH DATES IN OCTOBER THROUGH DECEMBER ARE IN THE SECOND SEGMENT. THIS ALLOWS FOR THE CREATION OF FISCAL YEAR OR CALENDAR YEAR FILES AS NEEDED. 4. THE CLAIMS REMAINING FROM THE FINAL ACTION PROCESSING ARE COLLAPSED BY CLAIM NUMBER, ADMISSION DATE, AND PROVIDER NUMBER (ALL IN ASCENDING ORDER) TO CREATE A STAY RECORD. THE RECORDS ARE FURTHER SORTED BY CLAIM FROM DATE, CLAIM THRU DATE, (BOTH IN ASCENDING ORDER), HCFA PROCESS DATE (DESCENDING), AND QUERY CODE (DESCENDING); AND THE RESULTS ARE USED TO CREATE MEDPAR. FOR THE 6/95 THROUGH THE 6/96 UPDATES THE 1995 MEDPAR WAS CREATED AS FOLLOWS: * EACH MONTH INPATIENT AND SNF CLAIMS ARE ACCUMULATED FROM THE NCH NEARLINE REPOSITORY. * AT THE END OF EACH QUARTER, THE MONTHLY FILES ARE MERGED INTO A DATABASE CONTAINING ALL CLAIMS FOR THE CURRENT YEAR AND PRIOR TWO YEARS. THE DATABASE IS SPLIT INTO TWO SEGMENTS FOR EACH YEAR. INPATIENT CLAIMS WITH DISCHARGE DATES AND SNF CLAIMS WITH ADMISSION DATES IN JANUARY THROUGH SEPTEMBER ARE IN THE FIRST SEGMENT; CLAIMS WITH DATES IN OCTOBER THROUGH DECEMBER ARE IN THE SECOND SEGMENT. THIS ALLOWS FOR THE CREATION OF FISCAL YEAR OR CALENDAR YEAR FILES AS NEEDED. * THE SEGMENTS ARE PROCESSED THROUGH THE FINAL ACTION ALGORITHMS. THE CLAIMS REMAINING FROM THE FINAL ACTION PROCESSING ARE COLLAPSED BY CLAIM NUMBER, ADMISSION DATE, AND PROVIDER NUMBER (ALL IN ASCENDING ORDER) TO CREATE A STAY RECORD. THE RECORDS ARE FURTHER SORTED BY CLAIM FROM DATE, CLAIM THRU DATE, (BOTH IN ASCENDING ORDER), HCFA PROCESS DATE (DESCENDING), AND QUERY CODE (DESCENDING); AND THE RESULTS ARE USED TO CREATE MEDPAR. NOTE: THERE ARE 60%, 20% AND "OTHER" 20% FILES CREATED QUARTERLY FOR EACH FISCAL YEAR (FY) AND CALENDAR YEAR (CY) MEDPAR FILES. THESE FILES ARE DERIVED BASED ON THE FOLLOWING CRITERIA: 60% -- 9TH POS. OF HIC; SELECTION VALUES 1,2,3,6,7,9 20% -- 9TH POS. OF HIC; SELECTION VALUES 0, 5 OTHER 20% -- 9TH POS. OF HIC; SELECTION VALUES 4,8 SYSTEM ALIAS : MEDPR560 LIMITATIONS : REFER TO : MEDPAR_MAR_QTRLY_UPDT_LIM 1. MEDPAR Claim Locator Number Group 11 1 11 GRP This number uniquely identifies the beneficiary. 2. MEDPAR Beneficiary Claim Account Number 9 1 9 CHAR The number identifying the primary beneficiary under the SSA or RRB programs submitted. NOTE: This field comes from the CAN that is present on the first claim record included in the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : CAN STANDARD ALIAS : MEDPAR_BENE_CLM_ACNT_NUM LENGTH : 9 SOURCE : NCH 3. MEDPAR Category Equatable Beneficiary Identification Code 2 10 11 CHAR The code which categorizes groups of BICs representing similar relationships between the beneficiary and the primary wage earner. The equatable BIC module electronically matches two records that contain different BICs where it is apparent that both are records for the same beneficiary. It validates the BIC and returns a base BIC under which to house the record in the national claims history (NCH) databases. (All records for a beneficiary are stored under a single BIC.) NOTE: This field comes from the NCH category base BIC that is present on the first claim record included in the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : EQ_BIC STANDARD ALIAS : MEDPAR_CTGRY_EQTBL_BIC_CD LENGTH : 2 SOURCE : NCH CODE TABLE : CTGRY_EQTBL_BENE_IDENT_TB 4. MEDPAR BENEFICIARY AGE COUNT 3 12 14 NUM The beneficiary's age as of date of admission. DB2 ALIAS : UNDEFINED STANDARD ALIAS : MEDPAR_BENE_AGE_CNT LENGTH : 3 SIGNED : N DERIVATIONS : This field is derived by subtracting the bene date of birth from the admission date, present on the first claim record included in the stay. Exception: If the resulting age is 64, and the MSC = 10 or 11, the age is changed to 65. SOURCE : NCH 5. MEDPAR Beneficiary Sex Code 1 15 15 CHAR The sex of a beneficiary. NOTE: This field comes from the sex code that is present on the first claim record included in the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : SEX STANDARD ALIAS : MEDPAR_BENE_SEX_CD LENGTH : 1 SOURCE : NCH CODE TABLE : BENE_SEX_IDENT_TB 6. MEDPAR Beneficiary Race Code 1 16 16 CHAR The race of a beneficiary. NOTE: This field comes from the race code that is present on the first claim record included in the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : RACE STANDARD ALIAS : MEDPAR_BENE_RACE_CD LENGTH : 1 SOURCE : NCH CODE TABLE : BENE_RACE_TB 7. MEDPAR Beneficiary Medicare Status Code 2 17 18 CHAR The CWF-derived reason for a beneficiary's entitlement to Medicare benefits, as of the reference date (CLM_THRU_DT). DB2 ALIAS : UNDEFINED SAS ALIAS : MS_CD STANDARD ALIAS : MEDPAR_BENE_MDCR_STUS_CD LENGTH : 2 DERIVATIONS : CWF derives MSC from the following: 1. Date of birth 2. Claim through date 3. Original/Current reasons for entitlement 4. ESRD indicator 5. Beneficiary claim number Items 1,3,4,5 come from the CWF beneficiary master record; Item 2 comes from the FI/Carrier claim record. MSC is assigned as follows: MSC OASI DIB ESRD AGE BIC _____ ______ _____ ______ _____ _____ 10 YES N/A NO 65 AND OVER N/A 11 YES N/A YES 65 AND OVER N/A 20 NO YES NO UNDER 65 N/A 21 NO YES YES UNDER 65 N/A 31 NO NO YES ANY AGE T. SOURCE : NCH CODE TABLE : BENE_MDCR_STUS_TB 8. MEDPAR Beneficiary Residence SSA Standard State Code 2 19 20 CHAR The SSA standard state code of a beneficiary's residence. NOTE: This field comes from the state code that is present on the first claim record included in the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : STATE_CD STANDARD ALIAS : MEDPAR_BENE_RSDNC_SSA_STATE_CD LENGTH : 2 SOURCE : NCH CODE TABLE : GEO_SSA_STATE_TB 9. MEDPAR Beneficiary Residence SSA Standard County Code 3 21 23 CHAR The SSA standard county code of a beneficiary's residence. NOTE: This field comes from the county code that is present on the first claim record included in the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : CNTY_CD STANDARD ALIAS : MEDPAR_BENE_RSDNC_SSA_CNTY_CD LENGTH : 3 SOURCE : NCH 10. MEDPAR Beneficiary Mailing Contact Zip Code 5 24 28 CHAR The zip code of the mailing address where the beneficiary may be contacted. NOTE: This field comes from the zip code that is present on the first claim record included in the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : BENE_ZIP STANDARD ALIAS : MEDPAR_BENE_MLG_CNTCT_ZIP_CD LENGTH : 5 SOURCE : NCH 11. FILLER CHAR 4 29 32 DB2 ALIAS : FILLER LENGTH : 4 12. MEDPAR Admission Day Code 1 33 33 NUM The code indicating the day of the week on which the beneficiary was admitted to a facility. DB2 ALIAS : UNDEFINED SAS ALIAS : ADMSNDAY STANDARD ALIAS : MEDPAR_ADMSN_DAY_CD LENGTH : 1 SIGNED : N DERIVATIONS : This field is derived from the admission date that is present on the first claim record included in the stay. SOURCE : NCH CODES : 1 = Sunday 2 = Monday 3 = Tuesday 4 = Wednesday 5 = Thursday 6 = Friday 7 = Saturday 13. MEDPAR Beneficiary Discharge Status Code 1 34 34 CHAR The code used to identify the status of the patient as of the CLM_THRU_DT. DB2 ALIAS : UNDEFINED SAS ALIAS : DSCHRGCD STANDARD ALIAS : MEDPAR_BENE_DSCHRG_STUS_CD LENGTH : 1 DERIVATIONS : This field is derived from the claim status code that is present on the last claim record included in the stay. SOURCE : NCH CODES : A = Discharged alive (claim status code other than 20 or 30) B = Discharged dead (claim status code = 20) C = Still a patient (claim status code = 30) 14. MEDPAR GHO Paid Code 1 35 35 CHAR The code indicating whether or not a GHO has paid the provider for the claim(s). NOTE: This field comes from the GHO-paid indicator that is present on the first claim record included in the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : GHOPDCD STANDARD ALIAS : MEDPAR_GHO_PD_CD LENGTH : 1 SOURCE : NCH CODES : 1 = GHO has paid the provider Blank Or 0 = GHO has not paid the provider 15. MEDPAR PPS Indicator Code 1 36 36 CHAR The code indicating whether or not the facility is being paid under the prospective payment system (PPS). DB2 ALIAS : UNDEFINED SAS ALIAS : PPS_IND STANDARD ALIAS : MEDPAR_PPS_IND_CD LENGTH : 1 DERIVATIONS : If the condition code not equal 65 on all of the claims included in the stay and the third position of the provider number is numeric set MEDPAR_PPS_IND_CD to 2 (PPS). Otherwise set it to 0 (Non PPS.) SOURCE : NCH CODES : 0 = Non PPS 2 = PPS 16. MEDPAR Organization NPI Number 10 37 46 CHAR ON AN INSTITUTIONAL CLAIM, THE NATIONAL PROVIDER IDENTIFIER (NPI) NUMBER ASSIGNED TO UNIQUELY IDENTIFY THE INSTITUTIONAL PROVIDER CERTIFIED BY MEDICARE TO PROVIDE SERVICES TO THE BENEFICIARY. NOTE: EFFECTIVE MAY 23, 2007, THE NPI BECAME THE NATIONAL STANDARD IDENTIFIER FOR COVERED HEALTH CARE PROVIDERS. THE NPI WILL REPLACE CURRENT OSCAR PROVIDER NUMBERS, UPINS, NSC NUMBERS, AND LOCAL CONTRACTOR PROVIDER IDENTIFICATION NUMBERS (PINS) ON STANDARD HIPPA CLAIM TRANSACTIONS. NOTE1: CMS HAS DETERMINED THAT DUAL PROVIDER IDENTIFIERS (LEGACY NUMBERS AND NEW NPI) MUST BE AVAILABLE IN THE NCH. AFTER THE 5/07 NPI IMPLE- MENTATION, THE STANDARD SYSTEM MAINTAINERS WILL ADD THE LEGACY NUMBER TO THE CLAIM WHEN IT IS ADJUDICATED. NOTE: THIS FIELD COMES FROM THE ORGANIZATION NPI THAT IS PRESENT ON THE FIRST CLAIM RECORD INCLUDED IN THE STAY. DB2 ALIAS : MEDPAR_ORG_NPI_NUM LENGTH : 10 17. MEDPAR ProviderNumber Group 6 47 52 GRP 18. MEDPAR Provider State Code 2 47 48 NUM The first two positions of the provider number, identifying the state of the institutional provider that furnished services to the beneficiary during the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : PRVSTATE STANDARD ALIAS : MEDPAR_PRVDR_STATE_CD LENGTH : 2 SIGNED : N DERIVATIONS : This field comes from positions 1 & 2 of the provider number that is present on the first claim record included in the stay. SOURCE : NCH CODE TABLE : GEO_SSA_STATE_TB 19. MEDPAR Provider Number Third Position Code 1 49 49 CHAR The third position of the provider number, identifying the category of institutional provider that furnished services to the beneficiary during the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : PRVNUM3 STANDARD ALIAS : MEDPAR_PRVDR_NUM_3RD_CD LENGTH : 1 DERIVATIONS : This field is position 3 of the provider number from the first claim record included in the stay modified as follows: Where position 3 is an alpha character (S, T, U, W or Y) move to the MEDPAR provider special unit code and replace with a '0'. Where position 3 is an alpha character (M or R) move to the MEDPAR provider special unit code and replace with a '1'. SOURCE : NCH 20. MEDPAR Provider Number Serial Code 3 50 52 CHAR The last three positions of the provider number, identifying the specific serial numbers of the institutional provider that furnished services to the beneficiary during the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : PRVDRSRL STANDARD ALIAS : MEDPAR_PRVDR_NUM_SRL_CD LENGTH : 3 DERIVATIONS : This field comes from positions 4 - 6 of the provider number on the first claim record included in the stay. SOURCE : NCH 21. MEDPAR Provider Number Special Unit Code 1 53 53 CHAR The code identifying the special numbering system for units of hospitals that are excluded from PPS or hospitals with SNF swing-bed designation. DB2 ALIAS : UNDEFINED SAS ALIAS : SPCLUNIT STANDARD ALIAS : MEDPAR_PRVDR_NUM_SPCL_UNIT_CD LENGTH : 1 DERIVATIONS : If the third position of the provider number from the first claim record included in the stay equals 'M', 'R', 'S', 'T', 'U', 'W', 'Y' OR 'Z', it is moved to this field, otherwise it is blank. SOURCE : NCH CODES : M = PPS-exempt psychiatric unit in CAH R = PPS-exempt rehabilitation unit in CAH S = PPS-exempt psychiatric unit T = PPS-exempt rehabilitation unit U = Swing-bed short-term/acute care hospital W = Swing-bed long-term hospital Y = Swing-bed rehabilitation hospital Z = Swing-bed rural primary care hospital; eff. 10/97 changed to critical access hospitals Blanks = Not PPS-exempt or swing-bed designation 22. MEDPAR Short Stay/Long Stay/SNF Indicator Co de 1 54 54 CHAR The code indicating whether the stay is a short stay, long stay, or SNF. DB2 ALIAS : UNDEFINED SAS ALIAS : SSLSSNF STANDARD ALIAS : MEDPAR_SS_LS_SNF_IND_CD LENGTH : 1 DERIVATIONS : This field is derived from the third position of the provider number that is present on the first claim record included in the stay. SOURCE : NCH CODES : N = SNF Stay (Prvdr3 = 5, 6, U, W, Y, or Z) S = Short-Stay (Prvdr3 = 0, M, R, S, T) L = Long-Stay (All Others) 23. MEDPAR Stay Final Action Claims Count 2 55 56 PACK The count of the number of claim records (final action) included in the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : FACLMCNT STANDARD ALIAS : MEDPAR_STAY_FINL_ACTN_CLM_CNT LENGTH : 3 SIGNED : Y DERIVATIONS : This field is derived by counting the number of final action claims used to create the stay. SOURCE : NCH 24. MEDPAR Latest Claim Accretion Date 4 57 60 PACK The date the latest claim record included in the stay was accreted (posted/processed) to the beneficiary master record at the CWF host). DB2 ALIAS : UNDEFINED SAS ALIAS : ACRTNDT STANDARD ALIAS : MEDPAR_LTST_CLM_ACRTN_DT LENGTH : 7 SIGNED : Y DERIVATIONS : This field comes from the highest accretion date that is present on the claim records included in the stay. SOURCE : NCH EDIT RULES : YYYYDDD 25. MEDPAR Beneficiary Medicare Benefit Exhausted Date 4 61 64 PACK The last date for which the beneficiary had Medicare coverage. This field is completed only where benefits were exhausted before the discharge date and during the period covered by stay. DB2 ALIAS : UNDEFINED SAS ALIAS : EXHST_DT STANDARD ALIAS : MEDPAR_BENE_MDCR_BNFT_EXHST_DT LENGTH : 7 SIGNED : Y DERIVATIONS : This field comes from the highest benefits exhausted date that is present on the claim records included in the stay. SOURCE : NCH EDIT RULES : YYYYDDD 26. MEDPAR SNF Qualification From Date 4 65 68 PACK The beginning date of the beneficiary's qualifying stay. For Inpatient claims, the date relates to the PPS portion of the inlier for which there is no utilization to benefits. For SNF claims, the date relates to the qualifying stay from a hospital that is at least two days in a row if the source of admission is an 'a', or at least three days in a row if the source of admission is other than an 'a'. DB2 ALIAS : UNDEFINED SAS ALIAS : QLFYFROM STANDARD ALIAS : MEDPAR_SNF_QUALN_FROM_DT LENGTH : 7 SIGNED : Y DERIVATIONS : This field comes from occurrence span code = 70 and related occurrence span from date, if present on any of the claim records included in the stay. If more than one record has an occurrence span code = 70, with different span dates, teh date from the last claim record included in the stay is used. SOURCE : NCH EDIT RULES : YYYYDDD 27. MEDPAR SNF Qualification Through Date 4 69 72 PACK The ending date of the beneficiary's qualifying stay. For Inpatient claims, the date relates to the PPS portion of the inlier for which there is no utilization to benefits. For SNF claims, the date relates to the qualifying stay from a hospital that is at least two days in a row if the source of admission is an 'A', or at least three days in a row if the source of admission is other than an 'A'. DB2 ALIAS : UNDEFINED SAS ALIAS : QLFYTHRU STANDARD ALIAS : MEDPAR_SNF_QUALN_THRU_DT LENGTH : 7 SIGNED : Y DERIVATIONS : This field comes from the occurrence span code = 70 and related occurrence span thru date, if present on any of the claims included in the stay. If more than one record has an occurrence span code = 70, with different span dates, the date from the last claim record included in the stay is used. SOURCE : NCH EDIT RULES : YYYYDDD 28. MEDPAR Admission Date 4 73 76 PACK The date the beneficiary was admitted for Inpatient care or the date that care started. NOTE: This field comes from the admission date that is present on the first claim record included in the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : ADMSNDT STANDARD ALIAS : MEDPAR_ADMSN_DT LENGTH : 7 SIGNED : Y SOURCE : NCH EDIT RULES : YYYYDDD 29. MEDPAR Discharge Date 4 77 80 PACK The date on which the beneficiary was discharged or died. NOTE: This field comes from the highest claim thru date that is present on the claim records included in the stay, where the claim status code is other than '30' (still patient) on the last claim record included in the stay. Inpatient claims will always have a discharge date; SNF claims could have a zero date. DB2 ALIAS : UNDEFINED SAS ALIAS : DSCHRGDT STANDARD ALIAS : MEDPAR_DSCHRG_DT LENGTH : 7 SIGNED : Y SOURCE : NCH EDIT RULES : YYYYDDD 30. MEDPAR Covered Level Care Thru Date 4 81 84 PACK The date on which a covered level of care ended in a SNF. DB2 ALIAS : UNDEFINED SAS ALIAS : CVRLVLDT STANDARD ALIAS : MEDPAR_CVR_LVL_CARE_THRU_DT LENGTH : 7 SIGNED : Y DERIVATIONS : This field comes from the date associated with occurrence code = 22 if present on any of the claims included in the stay. If multiple dates, the highest date is used. This field is only applicable to SNF claims. SOURCE : NCH EDIT RULES : YYYYDDD 31. MEDPAR Beneficiary Death Date 4 85 88 PACK The date the beneficiary died. DB2 ALIAS : UNDEFINED SAS ALIAS : DEATHDT STANDARD ALIAS : MEDPAR_BENE_DEATH_DT LENGTH : 7 SIGNED : Y DERIVATIONS : This field comes from the beneficiary death date, if present on the enrollment database, which is accessed prior to creation of the quarterly MEDPAR file. SOURCE : EDB LIMITATIONS : REFER TO : MEDPAR_DOD_LIM EDIT RULES : YYYYDDD 32. MEDPAR Beneficiary Death Date Verified Code 1 89 89 CHAR The code indicating whether the beneficiary's date of death has been verified (SOURCE: SSA's MBR) or originated from a claim record. DB2 ALIAS : UNDEFINED SAS ALIAS : DEATHCD STANDARD ALIAS : MEDPAR_BENE_DEATH_DT_VRFY_CD LENGTH : 1 DERIVATIONS : This field is derived from the enrollment database's beneficiary source death date code, or from the presence of a claim status code = '20' (expired) on the last claim record included in the stay. SOURCE : EDB,NCH CODES : V = Date of death verified (EDB received DOD from SSA's MBR) B = Date of death taken from claim (EDB received DOD from claim) N = Date of death not verified (neither V or B applicable, but claim status code indicated death) Space = No date of death indicated 33. MEDPAR INTERNAL USE SSI GROUP 5 90 94 GRP 34. MEDPAR Internal Use SSI Indicator Code 1 90 90 CHAR Limited availability; for internal use only; applicable to Inpatient claims only. Where not available, this field is blank. DB2 ALIAS : UNDEFINED SAS ALIAS : SSICD STANDARD ALIAS : MEDPAR_INTRNL_USE_SSI_IND_CD LENGTH : 1 COMMENTS : Limited availability; for internal use only; applicable to Inpatient claims only. Where not available, this field is blank. 35. MEDPAR Internal Use SSI Day Count 3 91 93 PACK DB2 ALIAS : UNDEFINED LENGTH : 5 SIGNED : Y COMMENTS : LIMITED AVAILABILITY; FOR INTERNAL USE; APPLICABLE TO INPATIENT CLAIMS ONLY. WHERE NOT APPLICABLE, THIS FIELD WILL CONTAIN ZEROES. NOTE: IN JUNE 2007, A CHANGE WAS MADE TO USE THE LENGTH OF STAY COUNT IN THE CALCULATION OF THE SSI DAY COUNT. PRIOR TO JUNE 2007, THE UTILIZATION (COVERED) DAY COUNT WAS USED. 36. FILLER CHAR 1 94 94 DB2 ALIAS : FILLER LENGTH : 1 37. MEDPAR Length of Stay Day Count 3 95 97 PACK The count in days of the total length of a beneficiary's stay in a hospital or SNF. DB2 ALIAS : UNDEFINED SAS ALIAS : LOSCNT STANDARD ALIAS : MEDPAR_LOS_DAY_CNT LENGTH : 5 SIGNED : Y DERIVATIONS : This field is derived by subtracting the date of discharge (or thru date in SNF cases where beneficiary is still a patient) from the date of admission. If difference is '0,' the value becomes a '1.' SOURCE : NCH 38. MEDPAR Outlier Day Count 2 98 99 PACK The count of the number of days paid as outliers (either a day or cost outlier) under PPS beyond the DRG threshold. DB2 ALIAS : UNDEFINED SAS ALIAS : OUTLRDAY STANDARD ALIAS : MEDPAR_OUTLIER_DAY_CNT LENGTH : 3 SIGNED : Y DERIVATIONS : This field is derived by checking the MEDPAR utilization day count against the DRG threshold table (DRG weights file). SOURCE : MEDPAR 39. MEDPAR Utilization Day Count 3 100 102 PACK The count of the number of covered days of care that are chargeable to Medicare utilization for the stay. DB2 ALIAS : UNDEFINED LENGTH : 5 SIGNED : Y DERIVATIONS : This field is derived by accumulating the utilization day count that is present on any of the claim records included in the stay (i.e., the sum of utilization days reported on the claims that comprise the stay). SOURCE : NCH 40. MEDPAR Beneficiary Total Coinsurance Day Count 2 103 104 PACK The count of the total number of coinsurance days involved with the beneficiary's stay in a facility. For Inpatient services, the beneficiary is liable for a daily coinsurance amount after the 60th day and before the 91st day in a single spell of illness; for SNF services, the beneficiary is liable for a daily coinsurance amount after the 20th day and before the 101st day in a single spell of illness. DB2 ALIAS : UNDEFINED SAS ALIAS : COIN_DAY STANDARD ALIAS : MEDPAR_TOT_COINSRNC_DAY_CNT LENGTH : 3 SIGNED : Y DERIVATIONS : This field is derived by accumulating the coinsurance day count that is present on any of the claim records included in the stay (i.e., the sum of coinsurance days reported on the claims that comprise the stay). SOURCE : NCH 41. MEDPAR Beneficiary LRD Used Count 2 105 106 PACK The count of the number of lifetime reserve days (LRD) used by the beneficiary for this stay. DB2 ALIAS : UNDEFINED SAS ALIAS : LRD_USE STANDARD ALIAS : MEDPAR_BENE_LRD_USE_CNT LENGTH : 3 SIGNED : Y DERIVATIONS : This field is derived by accumulating the lifetime reserve days used count that is present on any of the claim records included in the stay (i.e., the sum of LRD reported on the claims that comprise the stay). SOURCE : NCH 42. FILLER CHAR 12 107 118 DB2 ALIAS : FILLER LENGTH : 12 43. MEDPAR Beneficiary Part A Coinsurance Liability Amount 4 119 122 PACK The amount of money (rounded to whole dollars) identified as the beneficiary's liability for part A coinsurance for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : COIN_AMT STANDARD ALIAS : MEDPAR_BENE_PTA_COINSRNC_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the beneficiary's part a coinsurance liability amount that is present on any of the claim records included in the stay (i.e., the sum of coinsurance amounts reported on the claims that comprise the stay). SOURCE : NCH EDIT RULES : +$$$$$$$ 44. MEDPAR Beneficiary Inpatient Deductible Liability Amount 4 123 126 PACK The amount of money (rounded to whole dollars) identified as the beneficiary's liability for the Inpatient deductible for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : DED_AMT STANDARD ALIAS : MEDPAR_BENE_IP_DDCTBL_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the beneficiary Inpatient deductible amount that is present on any of the claim records included in the stay (i.e., the sum of the Inpatient deductibles reported on the claims that comprise the stay). SOURCE : NCH EDIT RULES : +$$$$$$$ Rounded; On-size (overflow) Situation = All nines 45. MEDPAR Beneficiary Blood Deductible Liability Amount 4 127 130 PACK The amount of money (rounded to whole dollars) identified as the beneficiary's liability for the blood deductible for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : BLDDEDAM STANDARD ALIAS : MEDPAR_BENE_BLOOD_DDCTBL_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the beneficiary blood deductible liability amount that is present on any of the claim records included in the stay (i.e., the sum of the blood deductibles reported on the claims that comprise the stay). SOURCE : NCH LIMITATIONS : REFER TO : MEDPAR_BLOOD_DDCTBL_AMT_LIM EDIT RULES : +$$$$$$$ Rounded; On-size (overflow) Situation = All nines 46. MEDPAR Beneficiary Primary Payer Amount 4 131 134 PACK The amount of payment (rounded to whole dollars) made on behalf of the beneficiary by a primary payer other than Medicare, which has been applied to the covered Medicare charges for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : PRPAYAMT STANDARD ALIAS : MEDPAR_BENE_PRMRY_PYR_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the beneficiary primary payer payment amount that is present on any of the claim records included in the stay (i.e., the sum of the primary payer amounts reported on the claims that comprise the stay). SOURCE : NCH EDIT RULES : +$$$$$$$ Rounded; On-size (overflow) situation = All nines 47. MEDPAR DRG Outlier Approved Payment Amount 4 135 138 PACK The amount of additional payment (rounded to whole dollars) approved due to an outlier situation over the DRG allowance for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : OUTLRAMT STANDARD ALIAS : MEDPAR_DRG_OUTLIER_PMT_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the DRG outlier approved payment amount (value code = 17 amount) that is present on any of the claim records included in the stay (i.e., the sum of outlier amounts reported on the claims that comprise the stay). COMMENTS : THIS AMOUNT IS ALREADY INCLUDED IN THE MEDPAR MEDICARE PAYMENT AMOUNT. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 48. MEDPAR Inpatient Disproportionate Share Amount 4 139 142 PACK The amount paid over the DRG amount (rounded to whole dollars) for the disproportionate share hospital for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : DISP_SHR STANDARD ALIAS : MEDPAR_IP_DSPRPRTNT_SHR_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the value amount associated with value code = 18 that is present on any of the claim records included in the stay (i.e., the sum of value code 18 amounts reported on the claims that comprise the stay). COMMENTS : THIS AMOUNT IS ALREADY INCLUDED IN THE MEDPAR MEDICARE PAYMENT AMOUNT. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 49. MEDPAR Indirect Medical Education (IME) Amount 4 143 146 PACK The amount of additional payment (rounded to whole dollars) made to teaching hospitals for IME for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : IME_AMT STANDARD ALIAS : MEDPAR_IME_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the value amount associated with value code = 19 that is present on any of the claim records included in the stay (i.e., the sum of IME amounts - value code 19 amounts - reported on the claims that comprise the stay). COMMENTS : This amount is already included in the MEDPAR Medicare payment amount. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 50. MEDPAR DRG Price Amount 4 147 150 PACK The amount (called the 'DRG price' for purposes of MEDPAR analysis) that would have been paid if no deductibles, coinsurance, primary payers, or outliers were involved (rounded to whole dollars). DB2 ALIAS : UNDEFINED SAS ALIAS : DRGPRICE STANDARD ALIAS : MEDPAR_DRG_PRICE_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the following amounts: MEDPAR Medicare payment amount, MEDPAR beneficiary primary payer payment amount, MEDPAR beneficiary coinsurance liability amount, MEDPAR beneficiary Inpatient deductible liability amount, MEDPAR beneficiary blood deductible amount; and then subtracting from the sum the MEDPAR DRG outlier approved payment amount. SOURCE : NCH LIMITATIONS : REFER TO : MEDPAR_DRG_PRICE_AMT_LIM EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 51. MEDPAR Total Pass Through Amount 4 151 154 PACK The total of all claim pass through amounts (rounded to whole dollars) for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : PASSTHRU STANDARD ALIAS : MEDPAR_PASS_THRU_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by multiplying the pass thru per diem amount that is present on the last claim record included in the stay times the MEDPAR utilization day count (the sum of the utilization (covered) days reported on the claims that comprise the stay). COMMENTS : Items reimbursed as pass through include capital-related costs, direct medical education costs, kidney acquisition costs for hospitals approved as rtc's, and bad debts (per provider reimbursement manual, part 1, section 2405.2). The MEDPAR pass thru amount is not included in the MEDPAR Medicare payment amount. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 52. MEDPAR Total PPS Capital Amount 4 155 158 PACK The total amount (rounded to whole dollars) that is payable for capital PPS (e.g., reimbursement for depreciation, rent, certain interest, real estate taxes for hospital buildings/equipment subject to PPS). DB2 ALIAS : UNDEFINED SAS ALIAS : PPS_CPTL STANDARD ALIAS : MEDPAR_TOT_PPS_CPTL_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the total PPS capital amount that is present on any of the claim records included in the stay (i.e., the sum of total PPS capital amounts reported on the claims that comprise the stay). COMMENTS : This field is already included in the MEDPAR Medicare payment amount. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 53. FILLER CHAR 12 159 170 DB2 ALIAS : FILLER LENGTH : 12 54. MEDPAR Total Charge Amount 4 171 174 PACK The total amount (rounded to whole dollars) of all charges (covered and noncovered) for all services provided to the beneficiary for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : TOTCHRG STANDARD ALIAS : MEDPAR_TOT_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the total charge amount from all claim records included in the stay (i.e., the sum of total charges reported on the claims that comprise the stay). SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 55. MEDPAR Total Covered Charge Amount 4 175 178 PACK The portion of the total charges amount (rounded to whole dollars) that is covered by Medicare for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : CVRCHRG STANDARD ALIAS : MEDPAR_TOT_CVR_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by calculating the covered charges from all claim records included in the stay (i.e., subtract the revenue center noncovered charge amount from the revenue center total charge amount for revenue center code = 0001 that is reported on the claims that comprise the stay; sum the results). Exception: if there exists an erroneous condition relative to revenue center code 0001, the calculation will be made for each revenue center code included on the claims that comprise the stay with the results summed to create the total. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 56. MEDPAR Medicare Payment Amount 4 179 182 PACK Amount of payment made from the Medicare trust fund for the services covered by the claim record. Generally, the amount is calculated by the fi; and represents what was paid to the institutional provider, with the exceptions noted below. **Note: in some situations, a negative claim payment amount May be present; e.g., (1) when a beneficiary is charged the full deductible during a short stay and the deductible exceeded the amount Medicare pays; or (2) when a beneficiary is charged a coinsurance amount during a long stay and the coinsurance amount exceeds the amount Medicare pays (most prevalent situation involves psych hospitals who are paid a daily per diem rate no matter what the charges are.) Under ip PPS, Inpatient hospital services are paid based on a predetermined rate per discharge, using the DRG patient classification system and the pricer program. On the ip PPS claim, the payment amount includes the DRG outlier approved payment amount, disproportionate share (since 5/1/86), in- direct medical education (since 10/1/88), total PPS capital (since 10/1/91). It does not include the pass thru amounts (i.e., capital-related costs, direct medical education costs, kidney acquisition costs, bad debts); or any beneficiary-paid amounts (i.e., deductibles and coinsurance); or any other payer remibursement. Under SNF PPS, SNFs will classify beneficiaries using the patient classification system known as rugs III. For the SNF PPS claim, the SNF pricer will calculate/return the rate for each revenue center line item with revenue center code = '0022'; multiply the rate times the units count; and then sum the amount payable for all lines with revenue center code '0022' to determine the total claim payment amount. Exceptions: For claims involving demos and bba encounter data, the amount reported in this field May not just represent the actual provider payment. For demo ids '01','02','03','04' -- claims contain amount paid to the provider, except that special 'differentials' paid outside the normal payment system are not included. For demo ids '05','15' -- encounter data 'claims' contain amount Medicare would have paid under ffs, instead of the actual pay- ment to the MCO. For demo ids '06','07','08' -- claims contain actual provider payment but represent a special negotiated bundled payment for both part a and part B services. To identify what the conventional provider part a payment would have been, check value code = 'y4'. For bba encounter data (non-demo) -- 'claims' contain amount Medicare would have paid under ffs, instead of the actual payment to the bba plan. DB2 ALIAS : UNDEFINED SAS ALIAS : PMT_AMT STANDARD ALIAS : MEDPAR_MDCR_PMT_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the payment amount that is present on all of the claim records included in the stay (i.e, the sum of payment (reimbursement) reported on the claims that comprise the stay). SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 57. MEDPAR All Accommodations Total Charge Amount 4 183 186 PACK The total charge amount (rounded to whole dollars) for all accommodations (routine hospital room and board charges for general care, coronary care and/or intensive care units) related to a beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : ACMDTNS STANDARD ALIAS : MEDPAR_ACMDTNS_TOT_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is the sum of MEDPAR private room charge amount, MEDPAR semiprivate room charge amount, MEDPAR ward charge amount, MEDPAR intensive care charge amount, and MEDPAR coronary care charge amount (i.e., the accumulation of the revenue center total charge amount associated with revenue center codes 0100 - 0219 from all claim records included in the stay). SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 58. MEDPAR Departmental Total Charge Amount 4 187 190 PACK The total charge amount (rounded to whole dollars) for all ancillary departments (other than routine room and board, CCU, and ICU) related to a beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : DPRTMNTL STANDARD ALIAS : MEDPAR_DPRTMNTL_TOT_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center codes 0220 - 0999 from all claim records included in the stay (i.e, the sum of charges for all revenue centers other than accommodations 0100 - 0219). SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 59. MEDPAR Accomodations Days Group 10 191 200 GRP 60. MEDPAR Private Room Day Count 2 191 192 PACK The count of the number of private room days used by the beneficiary for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : PRVTDAY STANDARD ALIAS : MEDPAR_PRVT_ROOM_DAY_CNT LENGTH : 3 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center unit count associated with accommodation revenue center codes 011x and 014x from all claim records included in the stay. Exception for SNF rugs demo eff 3/96 SNF update: field is derived from revenue center codes in the 9033-9044 series. SOURCE : NCH 61. MEDPAR Semiprivate Room Day Count 2 193 194 PACK The count of the number of semi-private room days used by the beneficiary for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : SPRVTDAY STANDARD ALIAS : MEDPAR_SEMIPRVT_ROOM_DAY_CNT LENGTH : 3 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center unit count associated with accommodation revenue center codes 010X, 012X, 013X, 016X - 019X from all claim records included in the stay. Exception for SNF rugs demo eff 3/96 SNF update: field is derived from revenue center codes in the 9019-9032 series. SOURCE : NCH 62. MEDPAR Ward Day Count 2 195 196 PACK The count of the number of ward days used by the beneficiary for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : WARDDAY STANDARD ALIAS : MEDPAR_WARD_DAY_CNT LENGTH : 3 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center unit count associated with accommodation revenue center code 015x from all claim records included in the stay. Exception for SNF rugs demo eff 3/96 SNF update: field is derived from revenue center codes in the 9000-9018 series. SOURCE : NCH 63. MEDPAR Intensive Care Day Count 2 197 198 PACK The count of the number of intensive care days used by the beneficiary for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : ICARECNT STANDARD ALIAS : MEDPAR_INTNSV_CARE_DAY_CNT LENGTH : 3 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center unit count associated with accommodation revenue center codes 020X (all 9 subcategories) from all claims included in the stay. SOURCE : NCH LIMITATIONS : There is approximately a 20% error rate in the revenue center code category 0206 due to coders misunderstanding the term 'post ICU' as including any day after an ICU stay rather than just days in a step-down/lower case version of an ICU. 'Post' was removed from the revenue center code 0206 description, effective 10/1/96 (12/96 MEDPAR update). 0206 Is now defined as 'intermediate ICU'. 64. MEDPAR Coronary Care Day Count 2 199 200 PACK The count of the number of coronary care days used by the beneficiary for the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : CRNRYDAY STANDARD ALIAS : MEDPAR_CRNRY_CARE_DAY_CNT LENGTH : 3 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center unit count associated with accommodation revenue center code 021x (all six subcategories) from all claim records included in the stay. SOURCE : NCH LIMITATIONS : There is approximately a 20% error rate in the revenue center code category 0214 due to coders misunderstanding the term 'post ccu' as including any day after a ccu stay rather than just days in a step-down/lower case version of a ccu. 'Post' was removed from the revenue center code 0214 description, effective 10/1/96 (12/96 MEDPAR update). 0214 Is now defined as 'intermediate ccu'. 65. MEDPAR Accomodations Charges Group 20 201 220 GRP 66. MEDPAR Private Room Charge Amount 4 201 204 PACK The charge amount (rounded to whole dollars) for private room accommodations related to a beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : PRVTAMT STANDARD ALIAS : MEDPAR_PRVT_ROOM_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center codes 011x and 014x from all claim records included in the stay. Exception for SNF rugs demo eff 3/96 SNF update: field is derived from revenue center codes in the 9033-9044 series. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 67. MEDPAR Semi-Private Room Charge Amount 4 205 208 PACK The charge amount (rounded to whole dollars) for semi- private room accommodations related to a beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : SPRVTAMT STANDARD ALIAS : MEDPAR_SEMIPRVT_ROOM_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center codes 010x, 012x, 013x, and 016x - 019x from all claim records included in the stay. Exception for SNF rugs demo eff 3/96 SNF update: field is derived from revenue center codes in the 9019-9032 series. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 68. MEDPAR Ward Charge Amount 4 209 212 PACK The charge amount (rounded to whole dollars) for ward accommodations related to a beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : WARDAMT STANDARD ALIAS : MEDPAR_WARD_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center code 015x from all claim records included in the stay. Exception for SNF rugs demo eff 3/96 SNF update: field is derived from revenue center codes in the 9000-9018 series. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 69. MEDPAR Intensive Care Charge Amount 4 213 216 PACK The charge amount (rounded to whole dollars) for intensive care accommodations related to a beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : ICAREAMT STANDARD ALIAS : MEDPAR_INTNSV_CARE_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with accommodation revenue center code 020x from all claim records included in the stay. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 70. MEDPAR Coronary Care Charge Amount 4 217 220 PACK The charge amount (rounded to whole dollars) for coronary care accommodations related to a beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : CRNRYAMT STANDARD ALIAS : MEDPAR_CRNRY_CARE_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with accommodation revenue center code 021X from all claim records included in the stay. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 71. MEDPAR Service Charges Group 100 221 320 GRP 72. MEDPAR Other Service Charge Amount 4 221 224 PACK The charge amount (rounded to whole dollars) for other services (revenue centers that do not fit into other categories) related to a beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : OTHRAMT STANDARD ALIAS : MEDPAR_OTHR_SRVC_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with the 'other' revenue center codes from all claim records included in the stay. the 'other' codes include 0002-0099, 022x, 023x, 024x, 052x, 053x, 055x - 060x, 064x - 070x, 076x - 078x, 090x - 095x, and 099x. (Some of these codes are not yet assigned.) SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 73. MEDPAR Pharmacy Charge Amount 4 225 228 PACK The charge amount (rounded to whole dollars) for pharmaceutical costs related to the beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : PHRMCAMT STANDARD ALIAS : MEDPAR_PHRMCY_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center codes 025x, 026x, and 063x from all claims records included in the stay. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 74. MEDPAR Medical/Surgical Supple Charge Amount 4 229 232 PACK The charge amount (rounded to whole dollars) for medical/surgical supplies related to the beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : SUPLYAMT STANDARD ALIAS : MEDPAR_MDCL_SUPLY_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center codes 027x and 062x from all claim records included in the stay. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 75. MEDPAR DME Charge Amount 4 233 236 PACK The charge amount (rounded to whole dollars) for DME (purchase of new DME and rentals) related to the beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : DME_AMT STANDARD ALIAS : MEDPAR_DME_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center codes 0290, 0291, 0292, and 0294 - 0299 from all claim records included in the stay. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 76. MEDPAR Used DME Charge Amount 4 237 240 PACK The charge amount (rounded to whole dollars) for used DME (purchase of used DME) related to the beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : UDME_AMT STANDARD ALIAS : MEDPAR_USED_DME_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center code 0293 from all claim records included in the stay. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 77. MEDPAR Physical Therapy Charge Amount 4 241 244 PACK The charge amount (rounded to whole dollars) for physical therapy services provided during the beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : PHYTHAMT STANDARD ALIAS : MEDPAR_PHYS_THRPY_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center code 042x from all claims records included in the stay. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 78. MEDPAR Occupational Therapy Charge Amount 4 245 248 PACK The charge amount (rounded to whole dollars) for occupational therapy services provided during the beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : OCPTLAMT STANDARD ALIAS : MEDPAR_OCPTNL_THRPY_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center code 043x from all claims records included in the stay. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 79. MEDPAR Speech Pathology Charge Amount 4 249 252 PACK The charge amount (rounded to whole dollars) for speech pathology services (speech, language, audiology) provided during the beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : SPCH_AMT STANDARD ALIAS : MEDPAR_SPCH_PTHLGY_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center code 044x and 047x from all claim records included in the stay. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 80. MEDPAR Inhalation Therapy Charge Amount 4 253 256 PACK The charge amount (rounded to whole dollars) for inhalation therapy services (respiratory and pulmonary function) provided during the beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : INHLTAMT STANDARD ALIAS : MEDPAR_INHLTN_THRPY_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center codes 041x and 046x from all claim records included in the stay. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 81. MEDPAR Blood Charge Amount 4 257 260 PACK The charge amount (rounded to whole dollars) for blood provided during the beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : BLOODAMT STANDARD ALIAS : MEDPAR_BLOOD_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center code 038x from all claim records included in the stay. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 82. MEDPAR Blood Administration Charge Amount 4 261 264 PACK The charge amount (rounded to whole dollars) for blood storage and processing related to the beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : BLDADMIN STANDARD ALIAS : MEDPAR_BLOOD_ADMIN_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center code 039x from all claim records included in the stay. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 83. MEDPAR Operating Room Charge Amount 4 265 268 PACK The charge amount (rounded to whole dollars) for the operating room, recovery room, and labor room delivery used by the beneficiary during the stay. DB2 ALIAS : UNDEFINED SAS ALIAS : OROOMAMT STANDARD ALIAS : MEDPAR_OPRTG_ROOM_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center codes 036X, 071X, and 072X from all claim records included in the stay. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 84. MEDPAR Lithotripsy Charge Amount 4 269 272 PACK The charge amount (rounded to whole dollars) for lithotripsy services provided during the beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : LTHTRPSY STANDARD ALIAS : MEDPAR_LTHTRPSY_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS : This field is derived by accumulating the revenue center total charge amount associated with revenue center code 079X from all claim records included in the stay. SOURCE : NCH EDIT RULES : +$$$$$$$ ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES 85. MEDPAR Cardiology Charge Amount 4 273 276 PACK The charge amount (rounded to whole dollars) for cardiology services and electrocardiogram(s) provided during the beneficiary's stay. DB2 ALIAS : UNDEFINED SAS ALIAS : CRDLGY STANDARD ALIAS : MEDPAR_CRDLGY_CHRG_AMT LENGTH : 7 SIGNED : Y DERIVATIONS :