Data Dictionary. Reference Table 18. Reference Table 13 List of updates made to Reference Tables 26

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1 Data Dictionary Definitions and Data Availability Pages 2-9 This section provides as list of all data elements with their definitions, and the availability for release of each element. Lookup Tables Pages This section provides reference tables related to certain data elements. Accepted values and definitions are listed in each section. Reference Table 1 Admit Source 10 Reference Table 2 Admit Type 12 Reference Table 3 Discharge Status 13 Reference Table 4 Encounter Type 16 Reference Table 5 Ethnicity 17 Reference Table 6 Language 18 Reference Table 7 Payer Grouping 19 Reference Table 8 Place of Service - Inpatient 20 Reference Table 9 Place of Service - Outpatient 21 Reference Table 10 Present on Admission Indicator 23 Reference Table 11 Race 24 Reference Table 12 Sex 25 Reference Table 13 List of updates made to Reference Tables 26 Patient Class Mapping This section provides more information on how patient class is populated. Reference Table 14 Patient Class Mapping Pages Hospital ID's Pages This section provides a list of Facilities and their associated Hospital ID. Reference Table 15 List of Hospital ID's - By Facility Name 28 Reference Table 16 List of Hospital ID's - By Hospital ID 35 Crosswalk of Field Names Pages This section provides a crosswalk for different field names used for each data element related to OHA Insight, OHA DataTrack, and the Patient Origin Study (POS) Files. Reference Table 17 Crosswalk of Field Names 42 Data Validations Pages This section provides all data validations that are used in OHA DataTrack. Each batch of data submitted is run against these validations. Reference Table 18 Data Validations 44 OHA Data Dictionary, Updated 9/16/14

2 Data Definitions and Availability Notes: Data Element The name of the data field used in OHA Data Systems. Definition The definition for the data element. Calculated/ Submitted C = This data element is calculated from data elements that are submitted. Data? S = This data element is a field that is submitted by Hospitals. Data Available For Y = Available for release (when requested) Release? Y* = Yes with exceptions (See note in corresponding definition field for requirement) N = Not Available for Release Data Element Definition 95% Confidence Level Is the observed vs. expected statistically significant at the 95% confidence level Address House number and street name of patient Calculated/ Submitted Data? Data Available For Release? Insight Standard POS File *as requested Custom POS File *as requested C Y N N S N N N Admit Date Admit Source Admit Time Admit Type Date of admission or start of care Point of Origin for Admission or Visit, a code indicating the point of patient origin for this admission or visit - See Reference Table 1 for accepted values. The time the patient was admitted or start of care *Note: Data not available on all encounters. Admission Type, a code indicating the priority of this admission/visit - See Reference Table 2 for accepted values. S N Y Y S Y Y Y S N N Y* S Y Y Y Age Patient age at date of admission C Y Y Y Arrival Date Arrival date - Data Field used by CMS and TJC for Care Measures, and their definitions apply S N N N Arrival Time Arrival time - Data Field used by CMS and TJC for Care Measures, and their definitions apply S N N N Birth Date The patient s month, day, and complete year of birth S N Y Y* Birth Weight The weight of a baby at birth measured in grams S N N N OHA Data Dictionary Definitions and Data Availability, Updated 5/27/14 Page 2 of 48

3 Data Element County Code Definition A numeric code identifying the county of patient residence, calculated from the patient's zip code Calculated/ Submitted Data? Data Available For Release? Insight Standard POS File *as requested Custom POS File *as requested C Y Y Y CPT Code CPT Date Decision to Admit Date Decision to Admit Time Diagnosis - Admit Diagnosis - Primary Diagnosis - Secondary A five digit code describing non-inpatient procedures and services performed by physicians and hospitals - CPT and HCPCS Codes are combined in this element The date corresponding to the CPT Code when the procedure or service was performed or occurred Decision to admit date - Data Field used by CMS and TJC for Care Measures, and their definitions apply Decision to admit time - Data Field used by CMS and TJC for Care Measures, and their definitions apply S N N Y S N N Y S N N N S N N N The ICD-9 Code describing the initial diagnosis upon arrival S N N Y The ICD-9 Code describing the primary condition of the patient during the encounter. S Y Y Y The ICD-9 Code describing a secondary condition of the patient during the encounter. S Y Y Y Discharge Date The date the patient was discharged S N Y Y Discharge Month Month of the Discharge Date C N N Y Discharge Quarter Quarter of the Discharge Date C Y N Y Discharge Status Discharge Status or the final place or setting to which the patient was discharged on the day of discharge - See Reference Table 3 for accepted values. S Y Y Y Discharge Time The time the patient was discharged from care *Note: Field not required for submission. S N N Y* Discharge Year Year of the Discharge Date C Y Y Y DRG A Diagnosis Related Group that organizes ICD-9 codes into a complex, comprehensive system based upon multiple factors. C Y Y Y OHA Data Dictionary Definitions and Data Availability, Updated 5/27/14 Page 3 of 48

4 Data Element DRG Weight ED Departure Date ED Departure Time EM Code Encounter Type Ethnicity Expected - Length of Stay Expected Average Charges Definition Each DRG has a payment weight assigned to it, based on the average resources used to treat Medicare patients in that DRG. ED Departure Date - Data Field used by CMS and TJC for Care Measures, and their definitions apply ED Departure Time - Data Field used by CMS and TJC for Care Measures, and their definitions apply E/M Code - Data Field used by CMS and TJC for Care Measures, and their definitions apply The type of visit for this record, specifies Inpatient or Outpatient - See Reference Table 4 for accepted values. Ethnicity code assigned to patient record - See Reference Table 5 for accepted values. *Note: Field not required for submission. Required for GCHC Hospitals. Is the benchmark value created from the average length of stay for all patients by each RDRG, DRG, Year and Patient Class. This Expected LOS excludes outliers, which are three standard deviations away from the mean. The mean also excludes any LOS less than 1 day and greater than 365 days. Is the benchmark value created from the average of charge for all patients by each RDRG, DRG, Year and Patient Class. This Expected Charge excludes outliers, which are three standard deviations away from the mean. The mean also excludes any charge less than $700 and greater than $2,000,000. Calculated/ Submitted Data? Data Available For Release? Insight Standard POS File *as requested Custom POS File *as requested C N N Y S N N N S N N N S N N N S N N Y S N N Y* C Y N N C Y N N Expected Mortality Is the benchmark value created from the average mortality for all patients by each C Y N N RDRG, DRG, Year and Patient Class. First Name First name of patient S N N N OHA Data Dictionary Definitions and Data Availability, Updated 5/27/14 Page 4 of 48

5 Data Element Fiscal Year Hospital ICU Admission Date ICU Discharge Date Language Definition State Fiscal Calendar Year Dates of 7/1/YYYY to 6/30/YYYY The hospital that submitted this patient record. This is a unique identifier assigned to each hospital by OHA. - See Reference Table 15 for values ICU admission date - Data Field used by CMS and TJC for Care Measures, and their definitions apply ICU discharge date - Data Field used by CMS and TJC for Care Measures, and their definitions apply Language code assigned to patient record - See Reference Table 6 for accepted values. Note: Field not required for submission. Required for GCHC Hospitals. Calculated/ Submitted Data? Data Available For Release? Insight Standard POS File *as requested Custom POS File *as requested C Y N N S Y Y Y S N N N S N N N S N N Y* Last Name Last name of patient S N N N Length of Stay The length of the patient encounter in days. C Y Y Y MDC MDC - MSDRG Medical Record Number Medical/Surgical The Medical Diagnostic Coding that groups DRGs into similar categories C Y Y Y The Medical Diagnostic Coding that groups DRGs into similar categories C Y Y Y The number assigned to the patient s medical/health record by the hospital that distinguishes that patient and their medical record from all other patients. S N N N Medicare categorization of DRG s as medical or surgical. C Y N Y Middle Name Middle name of patient S N N N MSDRG A Diagnosis Related Group that organizes ICD-9 codes into a complex, comprehensive system based upon multiple factors C Y Y Y Outlier The patients determined to be three standard deviations away from the means for each RDRG, DRG, Year and Patient Class for either LOS or Charges. C N N N OHA Data Dictionary Definitions and Data Availability, Updated 5/27/14 Page 5 of 48

6 Data Element Definition Patient Account Number The patient s unique alphanumeric number assigned by the hospital to facilitate retrieval of individual s account of services containing financial billing records and posting of the payment Patient Class Code submitted by the hospital defining the patients class. This code is determined from the Encounter type ID and the Place of Service code given by the hospital. - See Reference Table 14 for more information Calculated/ Submitted Data? Data Available For Release? Insight Standard POS File *as requested Custom POS File *as requested S N N N C* Y Y Y Payer Group (Primary Payer) Payer ID Payer Name Payer group code, a code indicating the responsible party for primary payment - See Reference Table 7 for accepted values. Patient's health insurance policy number associated with the primary payer on the record Full name of the primary payer on the record S Y Y Y S N N N S N N N Place of Service The place of service that the patient was last seen in before discharge. - See Reference Tables 8 and 9 for accepted values. Practitioner - Attending A code identifying the attending practitioner or attending refers to the patient's primary doctor. *Note: Physician identifying information is not shared amongst hospitals therefore hospitals can request to see their own physician data but cannot see that physicians data from another hospital. Practitioner - Attributing A code identifying the primary surgeon of record. *Note: Physician identifying information is not shared amongst hospitals therefore hospitals can request to see their own physician data but cannot see that physicians data from another hospital. S N N Y S Y* N Y* S Y* N Y* OHA Data Dictionary Definitions and Data Availability, Updated 5/27/14 Page 6 of 48

7 Data Element Practitioner - Referring Practitioner - Admitting Present on Admission (POA) Procedure - Primary Procedure - Secondary Procedure Date - Primary Procedure Date - Secondary Product Group - Diagnosis Product Group - Procedure Product Line - Diagnosis Product Line - DRG Product Line - MSDRG Definition A code identifying the referring physician during encounter of care. *Note: Physician identifying information is not shared amongst hospitals therefore hospitals can request to see their own physician data but cannot see that physicians data from another hospital. A code identifying the physician who admits the patient. *Note: Physician identifying information is not shared amongst hospitals therefore hospitals can request to see their own physician data but cannot see that physicians data from another hospital. Present on admission indicator related to each ICD-9 diagnosis The ICD-9 code describing the primary procedure performed during the episode of care The ICD-9 code describing the secondary procedures performed during the episode of care. - See ICD-9 Procedure tab for lookup codes and definitions. The date the principal procedure was performed. The date secondary procedure 2-9 was performed. A code made of the 1st 3 characters of the primary diagnosis. - See ICD-9 Diagnosis tab for lookup codes and definitions. A rollup of encounters based on primary procedure. The product group is the first 2 characters of primary procedure. Rollup of primary diagnosis based on general categorization. - See ICD-9 Diagnosis tab for lookup codes and definitions. Rollup of DRGs based on general categorization. Rollup of MSDRGs based on general categorization. Product Line - Procedure Rollup of primary procedures based on general categorization. Calculated/ Submitted Data? Data Available For Release? Insight Standard POS File *as requested Custom POS File *as requested S Y* N Y* S Y* N Y* S N N Y S Y Y Y S Y Y Y S N N Y S N N Y C Y N Y C N N Y C Y N Y C Y Y Y C Y Y Y C Y N Y OHA Data Dictionary Definitions and Data Availability, Updated 5/27/14 Page 7 of 48

8 Data Element Provider Contact Date Provider Contact Time PTHIC Number Race RDRG Definition Provider contact date - Data Field used by CMS and TJC for Care Measures, and their definitions apply Provider contact time - Data Field used by CMS and TJC for Care Measures, and their definitions apply The patient's Medicare health insurance claim number - Data Field used by CMS and TJC for Care Measures, and their definitions apply A self identified classification indicating the race with which the patient most closely identifies. - See Reference Table 11 for accepted values. The Refined Diagnosis-Related Group are classes of secondary diagnosis that are disease and procedure specific. Each class represents a different level of utilization for a given principal diagnosis or surgical procedure. Calculated/ Submitted Data? Data Available For Release? Insight Standard POS File *as requested Custom POS File *as requested S N N N S N N N S N N N S N N Y* S Y Y Y Recurring Code that specifies that this episode of the outpatient care is recurring. S N N Y* *Note: Field not required for submissio n. Revenue Charge The sum of charges corresponding to the Revenue Code S N N N Revenue Code UB-04 Revenue code S N N N Severity The severity is the classification assigned using the Refined DRG where each patient is assigned a rating between 1 and 4 in which 1 is the least complicated and 4 is the most complicated. C Y N N Severity Adjusted Case Mix Sex This estimates the average resources used to treat each patient by taking the DRG Weight of that patient and multiplying by the Severity Rating. The sex of the patient's recorded at admission or start of care. - See Reference Table 12 for accepted values. C Y N N S Y Y Y State Total Charges The state of residence of the patient, based on the zip code. The total hospital charges for the episode of care, including both covered and non-covered charges. C Y N Y S Y Y Y OHA Data Dictionary Definitions and Data Availability, Updated 5/27/14 Page 8 of 48

9 Data Element Units of Service Zip Code Definition Total units of service for the CPT or HCPCS code provided. The postal code of the patient's primary residence. Calculated/ Submitted Data? Data Available For Release? Insight Standard POS File *as requested Custom POS File *as requested S N N N S Y Y Y OHA Data Dictionary Definitions and Data Availability, Updated 5/27/14 Page 9 of 48

10 Admit Source Definition: The source of the referral for this admission or visit. Code Description Definition 1 2 Inpatient: The patient was admitted to this facility. Outpatient: The patient presented for outpatient services. Examples: Includes patients coming from home or workplace and patients receiving care at home (such as home health services.) Inpatient: The patient was admitted to this facility. Outpatient: The patient presented to this facility for outpatient services. Office 3 Reserved for national assignment. Discontinued effective 10/1/2007. Inpatient: The patient was admitted to this facility as a hospital transfer from an acute Discontinued. Effective 7/1/ care facility where he or she was an inpatient or outpatient. Outpatient: The patient was transferred to this facility as an outpatient from an acute care facility. Usage Note: Excludes transfers from hospital inpatient in the same facility (see Code D) Inpatient: The patient was admitted to this facility as a transfer from a SNF, ICF or ALF where he or she was a resident. Outpatient: The patient presented to this facility for outpatient or referenced diagnostic services from a SNF, ICF or ALF where he or she was a resident. Inpatient: The patient was admitted to this facility as a transfer from another type of health care facility not defined elsewhere in this code list. Outpatient: The patient presented to this facility for services from another health care facility not defined elsewhere in this code list. Inpatient: The patient was admitted to this facility upon the direction of a court of law or upon the request of a law enforcement agency representative. Outpatient: The patient presented to this facility upon the direction of a court of law or upon the request of a law enforcement agency representative for outpatient or referenced diagnostic services. Usage Note: Includes transfers from incarceration facilities. Inpatient: The patient s Point of Origin is not known. Outpatient: The patient s Point of Origin is not known. Available A Reserved for national assignment. Discontinued effective 10/1/2007. B Discontinued. Effective 7/1/2010. C Discontinued. Effective 7/1/2010. D Non-health Care Facility Point of Origin Clinic or Physician s Transfer From a Hospital (Different Facility) Transfer From a Skilled Nursing Facility (SNF) or Intermediate Care Facility (ICF) or Assisted Living Facility Transfer From Another Health Care Facility Court/Law Enforcement Information not Transfer From One Distinct Unit of the Hospital to another Distinct Unit of the Same Hospital Resulting in a Separate Claim to the Payer Reference Table 1 Inpatient: The patient was admitted to this facility as a transfer from hospital inpatient within this hospital resulting in a separate claim to the payer. Outpatient: The patient received outpatient services in this facility as a transfer from within this hospital resulting in a separate claim to the payer. Usage Note: For purposes of this code, Distinct Unit is defined as a unique level of care at the hospital requiring the issuance of a separate claim to the payer. Examples could include observation services, rehab units, a unit in a critical access hospital, or a swing bed located in an acute hospital. OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 10 of 48

11 E F G-Z Transfer From Ambulatory Surgery Center Transfer From Hospice Inpatient: The patient was admitted to this facility as a transfer from an ambulatory surgery center. Outpatient: The patient presented to this facility for outpatient or referenced diagnostic services from an ambulatory surgery center. Inpatient: The patient was admitted to this facility as a transfer from hospice facility. Outpatient: The patient presented to this facility or outpatient or referenced diagnostic services from a hospice facility. Reserved for national assignment. Admit Source (Code Structure for Newborns) Note: Newborn coding structure must be used when the Type of Admission Code 4 is used. Code Description Definition 1 Reserved for national assignment. Discontinued effective 10/1/ Reserved for national assignment. Discontinued effective 10/1/ Reserved for national assignment. Discontinued effective 10/1/ Reserved for national assignment. Discontinued effective 10/1/ Born Inside this Hospital A baby is born inside this hospital. 6 Born Outside this Hospital A baby is born outside of this hospital. 9 Reserved for assignment by the NUBC. OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 11 of 48

12 Admit Type Reference Table 2 Definition: The priority of the admission or visit. Code Description Definition 1 Emergency The patient requires immediate medical intervention as a result of severe, lifethreatening or potentially disabling conditions. Generally, the patient is admitted through the emergency room. 2 Urgent The patient requires immediate attention for the care and treatment of a physical or mental disorder. Generally, the patient is admitted to the first available and suitable accommodation. 3 Elective The patient s condition permits adequate time to schedule the availability of a suitable accommodation. 4 Newborn A baby born within this facility. Use of this code necessitates the use of special Point of Origin/Source of Admission table. 5 Trauma Center Visit to a trauma center hospital as licensed or designated by the state or local government authority authorized to do so, or as verified by the American College of Surgeons and involving trauma activation. (Use Revenue Code 068x to capture trauma activation charges involving pre-hospital notification.) 6-8 Reserved for national assignment. 9 Information Not Available The hospital does not have this information in its records. OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 12 of 48

13 Discharge Status Definition: The patient s status as of the ending service date of the period covered on the record. Code Description/Definition Discharged to Home or Self Care (routine discharge) Usage Note: Includes discharge to home, home on oxygen if DME only, any other DME only, group home, 01 foster care, independent living and other residential care arrangements, outpatient programs, such as partial hospitalization or outpatient chemical dependency programs. Effective 10/1/ Reference Table 3 Discharged/transferred to a Short Term General Hospital for Inpatient Care Discharged/transferred to Skilled Nursing Facility (SNF) with Medicare Certification in anticipation of Skilled Care Usage Note: Medicare Indicates that the patient is discharged/ transferred to a Medicare certified nursing facility. For hospitals with an approved swing bed arrangement, use Code 61 - Swing Bed. For reporting other discharge/transfers to nursing facilities see 04 and 64. Discharged/transferred to a facility that provides Custodial or Supportive Care Usage Note: Includes intermediate care facilities (ICFs) if specifically designated at the state level. Also used to designate patients that are discharged/ transferred to a nursing facility with neither Medicare nor Medicaid certification and for discharges/transfers to Assisted Living Facilities. Effective 10/1/2009 Discharged/transferred to a Designated Cancer Center or Children s Hospital Usage Note: Transfers to non-designated cancer hospitals should use Code 02. A list of (National Cancer Institute) designated cancer centers can be found at Discharged/transferred to Home Under Care of Organized Home Health Service Organization in Anticipation of Covered Skilled Care Usage Note: Report this code when the patient is discharged/transferred to home with a written plan of care (tailored to the patient's medical needs) for home care services. Not used for home health services provided by a DME supplier or from a Home IV provider for home IV services. Left Against Medical Advice or Discontinued Care Reserved for National Assignment Admitted as an Inpatient to this Hospital. Usage Note: For use only on Medicare outpatient claims. Applies only to those Medicare outpatient services Reserved for National Assignment Expired Discharged/transferred to Court/Law Enforcement Usage Note: Includes transfers to incarceration facilities such as jail, prison or other detention facilities. Effective 10/1/2009 Reserved for National Assignment Still Patient Usage Note: Used when the patient is still within the same facility, typically used when billing for leave of absence days or interim bills. Reserved for National Assignment Expired at Home Usage Note: For use only on Medicare and TRICARE claims for hospice care. Expired in a Medical Facility (e.g. hospital, SNF, ICF, or free standing hospice) Usage Note: For use only on Medicare and TRICARE claims for hospice care. Expired Place unknown Usage Note: For use only on Medicare and TRICARE claims for hospice claims. OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 13 of 48

14 Discharged/transferred to a Federal Health Care Facility. Usage Note: Discharges and transfers to a government operated health facility such as a Department of Defense Hospital, a Veteran's Administration hospital or a Veteran's Administration nursing facility. To be used whenever the destination at discharge is a federal health care facility, whether the patient lives there or not. Reserved for National Assignment Hospice Home Hospice Medical Facility (Certified) Providing Hospice-Level Care Reserved for National Assignment Discharged/transferred to a Hospital-Based Medicare Approved Swing Bed Usage Note: Medicare Used for reporting patients discharged/transferred to a SNF level of care within the hospital's approved swing bed arrangement. Discharged/ transferred to an Inpatient Rehabilitation Facility (IRF) including Rehabilitation Distinct Part Units of a Hospital Discharged/transferred to a Medicare-certified Long Term Care Hospital (LTCH) Usage Note: For hospitals that meet Medicare criteria for LTCH certification. Discharged/transferred to a Nursing Facility Certified under Medicaid but not Certified under Medicare Discharged/transferred to a Psychiatric Hospital or Psychiatric Distinct Part Unit of a Hospital Discharged/transferred to a Critical Access Hospital (CAH) Reserved for National Assignment Discharged/transferred to a Designated Disaster Alternative Care Site (Effective 10/1/13) Discharged/transferred to Another Type of Health Care Institution not Defined Elsewhere in this Code List (See Code 95 for a discharge with a Planned Acute Care Hospital Inpatient Readmission) Discontinued 4/1/03 Reserved for Assignment by the NUBC Discharged to Home or Self Care with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) Discharged/Transferred to a Short Term General Hospital for Inpatient Care with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) Discharged/Transferred to a Skilled Nursing Facility (SNF) with Medicare Certification with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) Discharged/Transferred to a Facility that Provides Custodial or Supportive Care with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) Discharged/Transferred to a Designated Cancer Center or Children s Hospital with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) Discharged/Transferred to Home Under Care of Organized Home Health Service Organization with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) Discharged/Transferred to Court/Law Enforcement with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) Discharged/Transferred to a Federal Health Care Facility with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) Discharged/Transferred to a Hospital-based Medicare Approved Swing Bed with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) Discharged/Transferred to an Inpatient Rehabilitation Facility (IRF) including Rehabilitation Distinct Part Units of a Hospital with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) Discharged/Transferred to a Medicare Certified Long Term Care Hospital (LTCH) with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 14 of 48

15 Discharged/Transferred to a Nursing Facility Certified Under Medicaid but not Certified Under Medicare with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) Discharged/Transferred to a Psychiatric Hospital or Psychiatric Distinct Part Unit of a Hospital with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) Discharged/Transferred to a Critical Access Hospital (CAH) with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) Discharged/Transferred to Another Type of Health Care Institution not Defined Elsewhere in this Code List with a Planned Acute Care Hospital Inpatient Readmission (Effective 10/1/13) Reserved for Assignment by the NUBC OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 15 of 48

16 Encounter Type Reference Table 4 Definition: The type of patient. Code Description Definition I Inpatient All discharges from Acute Care, Newborns, Medical Rehabilitation, Skilled Nursing Care (including swing beds, long term acute care, inpatient hospice and designated units), and Behavioral Health (including Psychiatric Care and Chemical Dependency Care). Submit all inpatient visits on discharge. O Outpatient All patient visits treated on an outpatient basis. A person who is not admitted to the hospital as inpatient, but is registered on the hospital records as an outpatient and receives services (rather than supplies alone) from the hospital. Where a tissue sample, blood sample, or specimen is taken by personnel that are neither employed nor arranged for by the hospital and is sent to the hospital for performance of tests, the tests are not outpatient hospital services since the patient does not directly receive services from the hospital. OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 16 of 48

17 Ethnicity Definition: The ethnicity code assigned to the patient s record. Reference Table 5 Note: If Hispanic or Latino is being reported under Ethnicity (preferred), do not report Hispanic or Latino under Race (Code 6 ). Code Description Definition 1 Hispanic or Latino A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. 2 Non Hispanic or Latino Patient is not of Hispanic or Latino ethnicity. 3 Unavailable or Unknown Select this category if the patient is unable to physically respond, there is no available family member or caregiver to respond for the patient, or if for any reason, the demographic portion of the medical record cannot be completed. 4 Declined A person who is unwilling to provide an answer to the question of Hispanic or Latino ethnicity. OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 17 of 48

18 Language Reference Table 6 Definition: The language code assigned to the patient s record. Code Description Definition 1 English A person who's primary language is English. 2 Spanish A person who's primary language is Spanish. 3 Other Some other language not classified on this list. 4 Declined A person not wanting to respond to the question regarding language. 5 Unavailable or Unknown Attempts to capture race were unattainable due to other circumstances. OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 18 of 48

19 Reference Table 7 Payer Grouping Definition: The financial class (high-level) of the primary payer on the claim. Code Description Definition A B C Self Pay Bureau of Workers Compensation (BWC) Medicare (traditional/ fee-for-service) The patient has no insurance and is ineligible for governmental assistance. Patient paid for service out of pocket. HCAP should be classified under this category. Primary payer is the Bureau of Workers Compensation. Primary payer is traditional fee for service Medicare provider. D Medicaid (traditional) Primary payer is traditional Ohio Medicaid provider. E Other Government Primary payer is a government provider and is NOT Ohio Medicaid or Medicare. (Examples: Champus, Veterans, DOD/Tricare, Indiana Medicaid, etc.) F Commercial Insurance Private or group plans including auto insurances. All commercial insurance payers including commercial managed care payers should be classified here. (Examples: Blue Cross Primary, HMO, PPO, Med Mutual, UHC, Blue Cross, Aetna.) I Other Some other payer not classified in this list. M Medicaid Managed Care Non fee for service, Medicaid Managed Care Plan. O Medicare Managed Non fee for service, Medicare Managed Care Plan. Blue Cross Crossover should be Care classified here. Q Charity Uncompensated No charge was submitted and the episode was classified as Charity Care. OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 19 of 48

20 Reference Table 8 Place of Service - Inpatient Definition: The place of service that the patient was last seen in before discharge. Code Description Definition 1 Acute Medical/Surgical Unit Assigned to inpatients, including newborns receiving care in the medical/surgical areas of a short-term hospital and not included in any other described level of care. 2 3 Medical Rehabilitation Unit Alternate Level of Care (SNF/Swing Bed Skilled) Relatively intense program including cardiology rehab, physical therapy and/or occupational therapy that requires a multidisciplinary coordinated team approach to upgrade the patient s ability to function. Care is provided in an inpatient setting. Maintains an organized professional staff and permanent facilities including inpatient beds that provide continuous nursing and other health-related psychosocial and personal services to patients who are not in an acute phase of illness but who primarily require continued care on an inpatient basis. Long Term Acute Care Hospital (LTACH) patients would also be included in this category. 5 Hospice Inpatient care or services means short-term, general inpatient care provided either through a contract arrangement with an appropriately licensed and Medicare-certified hospital or long term care facility or directly by a hospice program in its hospice inpatient facility to provide pain control and symptom management that cannot be accomplished in another setting. 6 Psychiatric/ Behavioral Health Chemical Dependency Care: Provides diagnostic and therapeutic services to patients with alcoholism or other drug dependencies. Includes care for inpatient/resident treatment for patients whose course of treatment involves more intensive care than provided in an outpatient setting or where patient requires supervised withdrawal. Psychiatric Care: Provides acute or long-term inpatient care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems, on the basis of physician s orders and approved nursing care plans. Long term care may include intensive supervision to the chronically mentally ill, mentally disordered, or other mentally incompetent persons. OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 20 of 48

21 this hierarchy. Code Description Definition Reference Table 9 Place of Service - Outpatient Definition: The outpatient place of service identifies where the patient received treatment. Use one of the following codes in 3 Observation Patients put into an observation bed and not admitted as an inpatient, regardless of point of referral. Observation Services are those services furnished by a hospital on its premises, including the use of a bed, periodic monitoring by nursing and other staff, and any other services that are reasonable and necessary to evaluate a patient s condition or to determine the need for a possible (inpatient) admission to the hospital. Any record with a revenue code in category 0760, 0762, and 0769 including those with a surgical or emergency service revenue code. 2 Outpatient Surgery 1 Emergency Room 4 Therapy Patients seen on an outpatient basis for some billable procedure regardless of whether it was performed in a surgery suite. Any record not classified as Observation AND with a revenue code in categories 036X, 0481, 049X or 0750, or any record from a free standing ambulatory surgery center. Patients seen at a hospital based emergency room and treated then released. Any record not classified as Observation or Outpatient Surgery AND with revenue codes 0450, 0451, 0452, Patients seen on an outpatient basis for rehabilitation. Any record not classified as Emergency Room, Outpatient Surgery or Observation AND with revenue codes in categories 041X-044X, or 093X-095X. This includes Respiratory, Physical, Occupational and Speech Therapies, Medical Rehabilitation, Therapeutic Rehabilitation or Athletic Training respectively. 5 Lab/ Radiology Any record not classified as Emergency Room, Outpatient Surgery or Observation AND with revenue codes in categories 030X, 031X, 032X-035X, 040X, 048X except 481, 061X, 073X-074X or 092X. This includes Diagnostic and Routine Laboratory Testing, Diagnostic and Therapeutic Radiology, Nuclear Medicine, CAT Scans, Imaging, MRIs, EKGs and ECGs, EEGs. 7 Hospice Medicare Certified Hospice care provided by the hospital in the patient s home residence whether it's a private residence, nursing home, off-site hospital or an assisted living facility. Includes records with but not limited to records with revenue codes in category 065X. 8 Psychiatric/Behavioral Health Patients seen on an outpatient basis for psychiatric or behavioral health treatment. Records may include but not limited to records with revenue codes 090X-091X. 9 Urgent Care Off Site Patients seen in an offsite urgent care facility on an outpatient basis. Records may include but not limited to records with revenue codes OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 21 of 48

22 10 Urgent Care On Site (Fast Track) Patients seen at a hospital based emergency room then referred to an urgent care site in the hospital. Includes records not previously designated and may include but not limited to records with revenue codes Clinic Off Site Patients seen on an outpatient or physician visit at an off-site hospital based outpatient clinic. Some of the requirements for a hospital based clinic: Off-site clinic must be off the hospital s main campus but within 35 miles of the main campus. Operates under the main provider s license unless state law mandates separate licensure. Has ready access to the hospital and other provider-based clinics medical records. Physicians and staff operating within the clinic are under the same reporting structure as all other hospital departments. Incorporated into the hospital s organizational chart. Includes records with but not limited to records with revenue codes 051X-052X. 12 Clinic On Site Patients seen on an outpatient or physician visit at an on-site hospital based outpatient clinic. Some of the requirements for a hospital based clinic: On-site clinic must be on the hospital s main campus. Operates under the main provider s license unless state law mandates separate licensure. Has ready access to the hospital and other provider-based clinics medical records. Physicians and staff operating within the clinic are under the same reporting structure as all other hospital departments. Incorporated into the hospital s organizational chart. Includes records with but not limited to records with revenue codes 051X-052X. 6 Other Outpatient Includes records not previously designated and may include but not limited to records with revenue codes in categories 038X-039X, 046X-047X, 058X-060X, 064X, 066X, 082X- 085X, or 088X. This includes Blood Products and Storage, Audiology and Pulmonary, Home Health visits & units, Home Health Oxygen & IV, Preventative Care, 0761 treatment room and 0769 other specialty servicers, Hemodialysis, peritoneum and miscellaneous dialysis. OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 22 of 48

23 Present on Admission Indicator Reference Table 10 Definition: Indicator related to each ICD-9 diagnosis Code Description/ Definition Y Diagnosis was present at the time of inpatient admission N Diagnosis was not present at the time of inpatient admission U W 1 Documentation is insufficient to determine if the condition was present at the time of inpatient admission Clinically undetermined, provider unable to clinically determine whether the condition was present at the time of inpatient admission Unreported/ Not Used, exempt from POA reporting. OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 23 of 48

24 Race Definition: The Race code assigned to the patient s record. Reference Table 11 *Notes: - The preferred standard is to report Hispanic or Latino under Ethnicity. If you are unable to report Ethnicity, then please include Hispanic or Latino under Race (Code 6 ). - If documentation indicates the patient has more than one race, and you are only able to submit one race, select the first listed race (ex. Black-White, Indian-White). Code Description Definition 1 White or Caucasian A person having origins in any of the peoples of Europe, North Africa or the Middle East. 2 African American /Black A person having origins in any of the black racial groups of Africa. 3 American Indian /Alaska Native A person having origins in any of the people of North and South America (including Central America) and who maintains tribal affiliation or community attachment. 4 Asian A person having origins in any of the original peoples of the Far East, Southeast Asia or the Indian subcontinent including Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam. 5 Native Hawaiian A person having origins in any of the original peoples of Hawaii, Guam, Samoa or other /Other Pacific Islander Pacific Islands. 6 7 Hispanic/Latino of Any Race *Please see note Unavailable or Unknown A person of Cuban, Mexican, Puerto Rico, South or Central American or other Spanish culture or origin. Attempts to capture race were unattainable due to other circumstances. 9 Declined A person NOT wanting to respond to the question regarding race. OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 24 of 48

25 Sex Reference Table 12 Definition: The sex of the patient as recorded at admission, outpatient service, or start of care. Code Description/ Definition F Female M Male U Unknown OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 25 of 48

26 List of Updates Reference Table 13 Date Category Reason for Update 10/1/2013 Discharge Status Added codes 81-95; Updated to reflect NUBC standards effective 10/1/2013 1/3/2013 Outpatient Place of Service Updated code usage; Added hierarchy to definition to prioritize observation patients 5/27/2014 Language Corrected definitions for values 4 and 5 (Descriptions were correct; Definitions were switched.) OHA Data Dictionary Lookup Tables, Updated 5/27/14 Page 26 of 48

27 Patient Class Mapping Reference Table 14 The data submission process changed starting with 2012 Discharge Data. The new format included a change in the way that the "Patient Class" was collected for each patient encounter. Prior to 2012 data, hospitals grouped each encounter into one patient class. For 2012 and later data, hospitals grouped each patient encounter into an "Encounter Type" (Inpatient or Outpatient), and a "Place of Service" to further define the type of patient. OHA has created a mapping for the process of submitting patient class back to the older patient class categories. This was done to not interfere with the existing data systems, including Insight and the POS Files that many hospitals receive. The tables below show the mapping from the Encounter Type and Place of Service codes used in the new file format to the Patient Classes shown in Insight and the POS Files. Please Note: - The definitions for the Encounter Type and Place of Service can be found in Reference Tables 4, 8 and 9. - Prior to 2012 data, the Patient Class included a category for "Recurring". This no longer exists as a category under Place of Service. Inpatient Encounter Type Place of Service Patient Class I - Inpatient 1 - Acute Medical/Surgical Unit I Inpatient I - Inpatient 2 - Medical Rehabilitation Unit I Inpatient I - Inpatient 3 - Alternate Level of Care (SNF/Swing Bed Skilled) S Inpatient SNF I - Inpatient 5 - Inpatient Hospice I Inpatient I - Inpatient 6 - Inpatient Psychiatric/ Behavior Health I Inpatient Outpatient Encounter Type Place of Service Patient Class O - Outpatient 1 - Emergency room E Emergency O - Outpatient 2 - Outpatient surgery U Ambulatory Surgery O - Outpatient 3 - Observation B Observation O - Outpatient 4 - Therapy H Outpatient Rehabilitation O - Outpatient 5 - Lab/ Radiology L Lab O - Outpatient 6 - Other Outpatient O Outpatient O - Outpatient 7 - Hospice O Outpatient O - Outpatient 8 - Psychiatric/ Behavior Health P Outpatient Pysch O - Outpatient 9 - Urgent Care - Off Site G Urgent Care O - Outpatient 10 - Urgent Care - On Site F Fast Track ER O - Outpatient 11 - Clinic - Off Site C Clinic O - Outpatient 12 - Clinic - On Site C Clinic OHA Data Dictionary Patient Class Mapping, Updated 5/27/14 Page 27 of 48

28 List of Hospital ID's - By Facility Name Reference Table 15 Facility Name Hospital ID Acuity Specialty Hospital-Ohio Valley 266 Adams County Regional Medical Center 185 Adena Greenfield Medical Center 090 Adena Medical Center 026 Adena Pike Medical Center 183 Advanced Specialty Hospital of Greenbriar Rehabilitation 446 Affinity Medical Center 119 Affinity Medical Center - Doctors Campus 120 Akron Children's Hospital 003 Akron General Edwin Shaw Rehab 196 Akron General Medical Center 002 Alliance Community Hospital 005 Alliance Primary Care, Inc. 430 Appalachian Behavioral Healthcare - Cambridge Campus 271 Ashtabula County Medical Center 008 Atrium Medical Center 126 Aultman Hospital 023 Aultman Orrville Hospital 138 Aultman West 242 Bariatric Care Center of Ohio 224 Barnesville Hospital 011 Bedford Medical Center Campus 013 Beeghly Oaks 226 Belmont Community Hospital 014 Belmont Pines Hospital 210 Berger Health System 039 Bethesda Arrow Springs 262 Bethesda Butler Hospital 354 Bethesda North Hospital 197 Bethesda Oak Hospital 027 Blanchard Valley Health System 425 Blanchard Valley Hospital 082 Bluffton Hospital 017 Bucyrus Community Hospital 020 Cabell Huntington Hospital 360 Cambridge Health & Rehab. Center 350 Chalmers P. Wylie VA Ambulatory Care Center 218 Champaign Mercy Health Services, McAuley Center 297 Cincinnati Children's Hospital Medical Center 028 Cincinnati Children's Liberty Campus 363 Cleveland Clinic 041 Cleveland Clinic Children's Hospital For Rehabilitation 223 CMH Regional Health System - Clinton Memorial Hospital 188 Columbus Community Hospital 061 OHA Data Dictionary Hospital ID's, Updated 5/27/14 Page 28 of 48

29 Community Health Partners, East Campus 107 Community Hospitals & Wellness Centers - Archbold Hospital 429 Community Hospitals & Wellness Centers-Bryan Hospital 019 Community Hospitals & Wellness Centers - Montpelier 408 Community Memorial Hospital 094 Coshocton County Memorial Hospital 067 Cottingham Retirement 214 Dayton Children's Hospital 070 Dayton Heart Hospital 215 Dayton Rehab Institute 203 Dayton VA Medical Center 217 Deaconess Health Care 401 Deaconess Hospital 030 Deaconess Hospital - Cleveland 043 Deaconess Long Term Care of Ohio 332 Dearborne County Hospital 261 Dettmer Hospital 170 Diley Ridge Medical Center 139 Doctors Hospital North 058 Doctors Hospital of Nelsonville 132 Doctors Hospital Ohio Health 264 Drake Center, Inc. 219 Drake Pavilion at the Christ Hospital 428 Dublin Methodist Hospital 216 Dupont Hospital 179 East Liverpool City Hospital 079 East Ohio Regional Hospital 117 Elmwood Healthcare Center At the Springs 244 EMH Amherst Hospital 006 Euclid Hospital 081 Fairfield Medical Center 100 Fairview Hospital 044 Fayette County Memorial Hospital 181 Fayette Memorial Hospital 254 Firelands Regional Medical Center 152 Firelands Regional Medical Center - South Campus 153 Fisher-Titus Medical Center 134 Fort Hamilton Hospital 092 Forum Health 343 Forum Health Western Reserve Care System-Southside 192 Fox Run Hospital 221 Franciscan at St. John 293 Franciscan Health System of Dayton 278 Fulton County Health Center 182 Galion Community Hospital 085 Gateway Rehab 236 Genesis Healthcare System/Bethesda 194 Genesis Healthcare System/Good Samaritan 195 Glenbeigh Health Sources 227 OHA Data Dictionary Hospital ID's, Updated 5/27/14 Page 29 of 48

30 Good Samaritan Hospital 071 Good Samaritan Hospital 031 Good Samaritan Western Ridge 184 Grace Hospital 045 Grady Memorial Hospital 076 Grand Lake Health System 159 Grandview Medical Center 072 Grant Medical Center 059 Greene Memorial Hospital 190 Hardin Memorial Hospital 097 Harrison Community Hospital 021 Harrison MediCenter 263 Health Recovery Services 241 HealthSouth Rehabilitation Hospital At Drake 494 Heartland Behavioral Healthcare 230 Heather Hill Care Communities 318 Henry County Hospital 131 Highland District Hospital 095 Hillcrest Hospital 122 Hillside Rehabilitation Hospital 205 Hocking Valley Community Hospital 104 Holzer Gallipolis 086 Holzer Medical Center-Jackson 229 Huron Hospital 046 Institute For Orthopedic Surgery 432 Kettering Behavioral Medicine Center 238 Kettering Medical Center 098 Kindred Gateway Hospital of Cleveland 409 Kindred Hospital Dayton 402 Kindred Hospital Lima 232 King's Daughters Medical Center Kentucky 250 King's Daughters Medical Center Ohio 495 Knox Community Hospital 130 Lake Health Tripoint Medical Center 141 Lakewood Hospital 099 Licking Memorial Hospital 133 LifeCare Hospital of Dayton 311 Lima Memorial Health System 101 Lindner Center of HOPE 303 Lodi Community Hospital 103 Louis Stokes Cleveland VA Medical Center 259 Lutheran Hospital 047 Lutheran Hospital of Indiana 147 Madison County Hospital 105 Magruder Hospital 146 Mahoning Valley Hospital - Trumbull Campus 426 Margaret Mary Hospital 265 Marietta Memorial Hospital 113 Marion General Hospital 116 OHA Data Dictionary Hospital ID's, Updated 5/27/14 Page 30 of 48

31 Marymount Hospital 087 Mary Rutan Hospital 015 McCullough-Hyde Memorial Hospital 140 MedCenter Hospital 115 MedCentral Health System 068 MedCentral - Mansfield Hospital 110 MedCentral - Shelby Hospital 155 Medical Center of Newark 361 Medina Hospital 123 Memorial Hospital of Union County 118 Mental Health Services for Clark County 208 Mercer Health 056 Mercy Allen Hospital 136 Mercy Health Anderson Hospital 034 Mercy Healthcare Center 165 Mercy Health Clermont Hospital 012 Mercy Health Fairfield Hospital 206 Mercy Health Mt. Airy Hospital - CLOSED 035 Mercy Health Western Hills Hospital 036 Mercy Hospital of Defiance 272 Mercy Hospital of Hamilton 093 Mercy Medical Center 024 Mercy Memorial Hospital 173 Mercy Regional Medical Center 106 Mercy St. Anne Hospital 237 Mercy St. Charles Hospital 137 Mercy St. Vincent Medical Center 168 Mercy Tiffin Hospital 163 Mercy Willard Hospital 187 MetroHealth System 042 Miami Valley Hospital 073 Miami Valley Hospital South 144 Morrow County Hospital 129 Mount Carmel East 198 Mount Carmel New Albany Surgical Hospital 353 Mount Carmel St. Ann's 066 Mount Carmel West 060 Mt. Orab Medical Center 128 Nationwide Children's Hospital 057 Neil Kennedy Recovery Unit 435 Northside Medical Center 200 Oak Hill Community Medical Center 135 OhioHealth O'Bleness Hospital 009 Ohio Hospital for Psychiatry 357 Ohio Valley Medical Center 274 Paulding County Hospital 143 Peoples Hospital 111 PHS Mt. Sinai University Circle 048 Pleasant Valley Hospital 492 OHA Data Dictionary Hospital ID's, Updated 5/27/14 Page 31 of 48

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