VT_PUF_FIELD_PROPERTIES

Size: px
Start display at page:

Download "VT_PUF_FIELD_PROPERTIES"

Transcription

1 *Use for Vermont Inpatient, Outpatient and Emergency Department Tables HOSPITAL_NUMBER HOSPITAL_NUMBER integer 4 YES ADMISSION_TYPE ADMISSION_TYPE integer 1 YES ADMISSION_SOURCE ADMISSION_SOURCE integer 2 YES AGE_GROUP Age Group integer 2 YES ZIP_CODE_GROUP Most Zip code groups are the first 3 digits of the ZIP code, ZIP codes between and are grouped into " " text 7 YES SEX SEX integer 1 YES DISCHARGE_STATUS DISCHARGE_STATUS integer 2 YES PRINCIPAL_PAYMENT_SOURCE PRINCIPAL_PAYMENT_SOURCE integer 2 YES TOTAL_CHARGES TOTAL_CHARGES decimal 11 NO SCU_DAYS NUMBER OF DAYS IN SPECIAL CARE UNIT, Includes all CCU, ICU & other SCU integer 2 NO DRG DIAGNOSIS RELATED GROUP integer 3 YES MDC MAJOR DIAGNOSTIC CATEGORY integer 2 YES DX1 PRINCIPAL_DIAGNOSIS text 5 ICD-9-CM DX2 SECOND_DIAGNOSIS text 5 ICD-9-CM DX3 THIRD_DIAGNOSIS text 5 ICD-9-CM DX4 FOURTH_DIAGNOSIS text 5 ICD-9-CM DX5 FIFTH_DIAGNOSIS text 5 ICD-9-CM DX6 SIXTH_DIAGNOSIS text 5 ICD-9-CM DX7 SEVENTH_DIAGNOSIS text 5 ICD-9-CM DX8 EIGHTH_DIAGNOSIS text 5 ICD-9-CM DX9 NINTH_DIAGNOSIS text 5 ICD-9-CM DX10 TENTH_DIAGNOSIS text 5 ICD-9-CM DX11 11th Diagnosis Text 5 ICD-9-CM DX12 12th Diagnosis Text 5 ICD-9-CM DX13 13th Diagnosis Text 5 ICD-9-CM DX14 14th Diagnosis Text 5 ICD-9-CM DX15 15th Diagnosis Text 5 ICD-9-CM DX16 16th Diagnosis Text 5 ICD-9-CM DX17 17th Diagnosis Text 5 ICD-9-CM DX18 18th Diagnosis Text 5 ICD-9-CM DX19 19th Diagnosis Text 5 ICD-9-CM DX20 20th Diagnosis Text 5 ICD-9-CM PX1 Principal Procedure Text 4 ICD-9-CM PX2 Second Procedure Text 4 ICD-9-CM PX3 Third Procedure Text 4 ICD-9-CM PX4 Fourth Procedure Text 4 ICD-9-CM PX5 Fifth Procedure Text 4 ICD-9-CM PX6 Sixth Procedure Text 4 ICD-9-CM PX7 Seventh Procedure Text 4 ICD-9-CM PX8 Eighth Procedure Text 4 ICD-9-CM PX9 Ninth Procedure Text 4 ICD-9-CM PX10 Tenth Procedure Text 4 ICD-9-CM PX11 11th Procedure Text 4 ICD-9-CM PX12 12th Procedure Text 4 ICD-9-CM PX13 13th Procedure Text 4 ICD-9-CM VT_PUF

2 PX14 14th Procedure Text 4 ICD-9-CM PX15 15th Procedure Text 4 ICD-9-CM PX16 16th Procedure Text 4 ICD-9-CM PX17 17th Procedure Text 4 ICD-9-CM PX18 18th Procedure Text 4 ICD-9-CM PX19 19th Procedure Text 4 ICD-9-CM PX20 20th Procedure Text 4 ICD-9-CM E-code E-code Text 5 ICD-9-CM HSA4 HOSPITAL_SERVICE_AREA or HSA4. Note: Hospital Service Areas were redefined in June HSA values in the 2003 dataset cannot be compared to HSA values in earlier public use datasets. See HSA_Definition for more PATIENT DAYS information. integer 2 YES (DISCHARGE DATE minus ADMISSION DATE) 1 if discharged on date of admission or on day after admission Length of stay greater than 255 days was recoded to 255. integer 5 NO SAME DAY FLAG SAME DAY FLAG integer 1 YES DRG_GROUPER_VERSION Version Number corresponding with effective discharges within a date range integer 2 YES CCSDX CCS DIAGNOSIS (DX) GROUP integer 4 YES CCSDXGRP CCS DX HIGH LEVEL GROUP integer 2 YES CCSPX CCS PROCEDURE (PX) GROUP integer 3 YES CCSPXGRP CCS PX HIGH LEVEL GROUP integer 2 YES YEAR OF DISCHARGE For 2000 and later, full data year (1999 and prior was 2 digits) integer 4 NO RECORD NUMBER RECORD NUMBER integer 6 NO ERFLAG had an associated Emergency Room revenue record integer 1 YES PATIENT_TYPE Inpatient, Outpatient or Emergency Dept. text 1 YES VT_PUF

3 HOSPITAL_NUMBER HOSP_NO Hospital Number Integer 4 No HOSP_DESC Hospital Name Text 42 No ADMISSION_TYPE ADMIN_TYPE_NO Admission Type Number Integer 1 No ADMIN_TYPE_DESC Admission Type Description Text 25 No ADMISSION_SOURCE ADMIN_SRC_NO Admission Source Number Integer 2 No ADMIN_SRC_DESC Admission Source Description Text 44 No AGE_GROUP AGE_GRP_NO Age Group Number Integer 2 No AGE_GRP_DESC Age Group Range Text 11 No ZIP_CODE_GROUP ZIP_GRP_NO Zip Code Number Text 7 No ZIP_GRP_DESC Zip Code Description Text 27 No SEX SEX_NO Sex Number Integer 1 No SEX_DESC Sex Description Text 7 No DISCHARGE_STATUS DISCH_NO Discharge Number Integer 2 No DISCH_DESC Discharge Description Text 44 No PRINCIPAL_PAYMENT_SOURCE PRINC_PAY_SRC_NO Principal Payment Source Number Integer 2 No PRINC_PAY_SRC_DESC Principal Payment Source Description Text 22 No DRG DRG_NO Diagnosis Related Group Number Integer 3 No MDC_NO Major Diagnostic Category Number Integer 2 No DRG_DESC Diagnosis Related Group Description Text 65 No DRG_M_S Diagnosis Group Medical or Surgical Text 1 Yes MDC MDC_NO Major Diagnostic Category Number Integer 2 No MDC_CAT_NAME Major Diagnostic Category Description Text 40 No Code Tables

4 HSA4 HSA4_NO Home Service Area 4 Number Integer 2 No HSA4_DESC Home Service Area For Description 16 No SAME DAY FLAG SAME_DAY_NO Same Day Number Integer 1 No SAME_DAY_DESC Discharged the same day or not Text 45 No DRG_GROUPER_VERSION VERSION_NUM Number of Version Integer 2 No VERSION_RANGE Date Range of the Version Text No CCSDX CCSDX CCS Diagnostic Code Integer 4 No CCSDX_SING_LVL_LBL CCS Diagnostic Single Level Lablel Text 115 No CCSDXGRP CCSDX CCS Diagnostic Code Integer 4 No CCSGRP CCS Diagnostic Group Number Integer 2 No CCSGRPLBL CCS Diagnostic Group Label Text 50 No CCSPX CCSPX CCS Procedure Code Integer 3 No CCSPX_SING_LVL_LBL CCS Procedure Single Level Label Text 92 No CCSPXGRP CCSPX CCS Procedure Code Integer 3 No CCSPXGRP CCS Procedure Group Integer 2 No CCSPXGRPLBL CCS Procedure Group Label 46 No ERFLAG ERFLAG_NO Emergency Room Flag Number Integer 1 No ERFLAG_DESC ER Flag Description Text 46 No PATIENT_TYPE PAT_TYPE_NO Patient Type Number Integer 1 No PAT_TYPE_DESC Patient Type Description Text 120 No Code Tables

5 DRG_M_S DRG_M_S Diagnosis Related Group Medical or Surgery Letter Text 1 No DRG_M_S_DESC Diagnosis Related Group Medical or Surgery Description Text 8 No HSA_TOWNS HSA4_NO Home Service Area 4 Number Integer 2 CTC County Town Code Integer 4 COUNTY County Name Text 10 TOWN_NAME Town Name Text 23 Sub-Code Tables

ICD-10 Frequently Asked Questions

ICD-10 Frequently Asked Questions Below are some frequently asked questions (FAQs). Please refer to this FAQ often as updates will be made regularly. Last updated 11/30/2015. The US Department of Health and Human Services (HHS) has mandated

More information

How To Get A Blue Cross Code Change

How To Get A Blue Cross Code Change OVERVIEW 1. What is an ICD Code? The International Classification of Diseases (ICD) code set is used primarily to report medical diagnosis and inpatient procedures. ICD codes are mandated by the Centers

More information

Item Seq # Data Element Format Position Position. Locator

Item Seq # Data Element Format Position Position. Locator 1 Provider Number (Medicare/VHI) PIC X(6) 1 6 Medicare Provider Number or number assigned by VHI. 2 Provider NPI PIC X(10) 7 16 Provider's NPI 56 3 Patient Control Number PIC X(20) 17 36 Patient Control

More information

Title: Coding and Documentation for Inpatient Services

Title: Coding and Documentation for Inpatient Services Title: Coding and Documentation for Effective Date: 2/01; Rev. 6/03, 7/05 POLICY: Diagnoses and procedures will be coded utilizing the International Classification of Diseases, Ninth Revision, Clinical

More information

Coding with. Snayhil Rana

Coding with. Snayhil Rana Coding with ICD-9-CM CM Snayhil Rana ICD-9-CM CM Index Pre-Test Introduction to ICD-9-CM Coding The Three Volumes of the ICD-9-CM ICD-9-CM Coding Conventions Other ICD-9-CM Sections ICD-9-CM for Claim

More information

How to Calculate the Probabilities of Winning the Nine PowerBall Prize Levels:

How to Calculate the Probabilities of Winning the Nine PowerBall Prize Levels: How to Calculate the Probabilities of Winning the Nine PowerBall Prize Levels: Powerball numbers are drawn from two sets of numbers. Five numbers are drawn from one set of 59 numbered white balls and one

More information

ICD 10 Code Set Update National Association of Health Data Organizations October 14, 2010

ICD 10 Code Set Update National Association of Health Data Organizations October 14, 2010 ICD 10 Code Set Update National Association of Health Data Organizations October 14, 2010 Hetty Khan, BSN, MSN Health Informatics Specialist Classifications and Public Health Data Standards National Center

More information

Below are some frequently asked questions that may assist your practice.

Below are some frequently asked questions that may assist your practice. Dear Providers: With the recent announcement in the delay for the implementation for ICD-10-CM/PCS we wanted to provide an update on Blue Cross and Blue Shield of Vermont s (BCBSVT) implementation. We

More information

ICD-10-CM and ICD-10-PCS Frequently asked questions for HIM and Patient Financial Services Leaders

ICD-10-CM and ICD-10-PCS Frequently asked questions for HIM and Patient Financial Services Leaders ICD-10-CM and ICD-10-PCS Frequently asked questions for HIM and Patient Financial Services Leaders Executive questions What is the current status of ICD-10? The U.S. Department of Health and Human Services

More information

MINI-SENTINEL COMMON DATA MODEL DATA QUALITY REVIEW AND CHARACTERIZATION PROCESS AND PROGRAMS

MINI-SENTINEL COMMON DATA MODEL DATA QUALITY REVIEW AND CHARACTERIZATION PROCESS AND PROGRAMS MINI-SENTINEL COMMON DATA MODEL DATA QUALITY REVIEW AND CHARACTERIZATION PROCESS AND PROGRAMS Program Package version: 3.2 Prepared by the Mini-Sentinel Operations Center May 2014 Mini-Sentinel is a pilot

More information

Molina Healthcare Post ICD 10 FAQ

Molina Healthcare Post ICD 10 FAQ Molina Healthcare Post ICD 10 FAQ On March 31, 2014, the Senate voted to approve a bill to delay the implementation of ICD-10-CM/ PCS by at least one year. President Obama signed the bill into law on April

More information

Instructions for Completing the CMS 1500 Claim Form

Instructions for Completing the CMS 1500 Claim Form Instructions for Completing the CMS 1500 Claim Form The Center of Medicaid and Medicare Services (CMS) form 1500 must be used to bill SFHP for medical services. The form is used by Physicians and Allied

More information

INTRODUCTION TO THE HCUP STATE INPATIENT DATABASES (SID)

INTRODUCTION TO THE HCUP STATE INPATIENT DATABASES (SID) HEALTHCARE COST AND UTILIZATION PROJECT HCUP A FEDERAL-STATE-INDUSTRY PARTNERSHIP IN HEALTH DATA Sponsored by the Agency for Healthcare Research and Quality INTRODUCTION TO THE HCUP STATE INPATIENT DATABASES

More information

What is Data Analytics and How Does it Help Prepare Providers for ICD-10?

What is Data Analytics and How Does it Help Prepare Providers for ICD-10? What is Data Analytics and How Does it Help Prepare Providers for ICD-10? June 2013 Kim Charland, BA, RHIT, CCS Senior Vice President of Clinical Consulting Services Panacea Healthcare Solutions, Inc.

More information

OUTPUT DATA DICTIONARY

OUTPUT DATA DICTIONARY INPATIENT OUTPUT DATA DICTIONARY Version 1.0 2014 SPARCS Inpatient Output Page 1 Prepared By: Bureau of Health Informatics Office of Quality and Patient Safety New York State Department of Health Phone:

More information

Math Card Games to Print and Play

Math Card Games to Print and Play Math Card Games to Print and Play For School or Home Education by Teresa Evans Copyright 200 Teresa Evans. All rights reserved. Permission is given for the making of copies for use in the home or classroom

More information

Cognos Web-based Analytic Tool Overview

Cognos Web-based Analytic Tool Overview Cognos Web-based Analytic Tool Overview Market, Quality and Physician Data Analysis with Drill-thru Feature Mari Tietze, PhD, RN-BC Director, Nursing Research and Informatics DFWHC ERF 2009 1 UB-04 Source

More information

COM Compliance Policy No. 3

COM Compliance Policy No. 3 COM Compliance Policy No. 3 THE UNIVERSITY OF ILLINOIS AT CHICAGO NO.: 3 UIC College of Medicine DATE: 8/5/10 Chicago, Illinois PAGE: 1of 7 UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE CODING AND DOCUMENTATION

More information

Appendix 6.2 Data Source Described in Detail Hospital Data Sets

Appendix 6.2 Data Source Described in Detail Hospital Data Sets Appendix 6.2 Data Source Described in Detail Hospital Data Sets Appendix 6.2 Data Source Described in Detail Hospital Data Sets Source or Site Hospital discharge data set Hospital admissions reporting

More information

Instructions for Completing the UB-04 Claim Form

Instructions for Completing the UB-04 Claim Form Instructions for Completing the UB-04 Claim Form The UB04 claim form is used to submit claims for inpatient and outpatient services by institutional facilities (for example, outpatient departments, Rural

More information

Unity Point Health PROBLEM LISTS IN THE ELECTRONIC HEALTH RECORD

Unity Point Health PROBLEM LISTS IN THE ELECTRONIC HEALTH RECORD Unity Point Health PROBLEM LISTS IN THE ELECTRONIC HEALTH RECORD Introduction The problem list is a critical part of electronic documentation and serves as a communication tool between all care providers.

More information

Introduction of a Dedicated Admissions Nurse to Improve Access to Care for Surgical Patients

Introduction of a Dedicated Admissions Nurse to Improve Access to Care for Surgical Patients Introduction of a Dedicated Admissions Nurse to Improve Access to Care for Surgical Patients Editor s Note: In Introduction of a Dedicated Admissions Nurse to Improve Access to Care for Surgical Patients

More information

The All-Payer Claims Database Release 2.0 Documentation Guide Medical Claims File December 2013

The All-Payer Claims Database Release 2.0 Documentation Guide Medical Claims File December 2013 The All-Payer Claims Database Release 2.0 Documentation Medical Claims File December 2013 Deval L. Patrick, Governor Commonwealth of Massachusetts Áron Boros, Executive Director Center for Health Information

More information

Are You a Hospital Inpatient or Outpatient?

Are You a Hospital Inpatient or Outpatient? Are You a Hospital Inpatient or Outpatient? If You Have Medicare Ask! Revised May 2014 Did you know that even if you stay in a hospital overnight, you might still be considered an outpatient? Your hospital

More information

1. Coverage Indicator Enter an "X" in the appropriate box.

1. Coverage Indicator Enter an X in the appropriate box. CMS 1500 Claim Form FIELD NAME INSTRUCTIONS 1. Coverage Indicator Enter an "X" in the appropriate box. 1a. Insured's ID Number Enter the patient's nine-digit Medical Assistance identification number (SSN).

More information

Iowa Healthcare Collaborative (IHC) Iowa Report. Data Sources / Tools / Methods

Iowa Healthcare Collaborative (IHC) Iowa Report. Data Sources / Tools / Methods Iowa Healthcare Collaborative (IHC) Iowa Report Data Sources / Tools / Methods Table of Contents Introduction... 3 Background and Analytical Methods... 3 CMS Hospital Compare Process, Outcomes, Utilization,

More information

Billing Manual for In-State Long Term Care Nursing Facilities

Billing Manual for In-State Long Term Care Nursing Facilities Billing Manual for In-State Long Term Care Nursing Facilities Medical Services North Dakota Department of Human Services 600 E Boulevard Ave, Dept 325 Bismarck, ND 58505 September 2003 INTRODUCTION The

More information

How To Compare A Small Group Plan In Massachusetts

How To Compare A Small Group Plan In Massachusetts Non- ER Medical Individual/ Family HMO Value 250 $15 $100 $250 $100 No 26% Basic 25 $25 $125 $500 $100 No $2,500/$5,000 17% 500 after after after $500/$1,000 8% 1000 after after after 1 (baseline) * after

More information

ICD-10: Prepare, Implement, and Train

ICD-10: Prepare, Implement, and Train ICD-10: Prepare, Implement, and Train Source Medical Solutions, Inc. October 2013 For more information, please visit www.sourcemed.net or call 866-687-2300 1 Executive Summary There are numerous documents

More information

BASIC MEDICAL RECORD DEPARTMENT PROCEDURES

BASIC MEDICAL RECORD DEPARTMENT PROCEDURES BASIC MEDICAL RECORD DEPARTMENT PROCEDURES 1 Four essential Medical Record Department procedures: 1. Admission procedure and the master patient index (MPI). 2. Discharge procedure. 3. Disease classification

More information

Notice of Rulemaking Hearing. Department of Commerce and Insurance Insurance Division

Notice of Rulemaking Hearing. Department of Commerce and Insurance Insurance Division Notice of Rulemaking Hearing Department of Commerce and Insurance Insurance Division There will be a hearing before the Insurance Division of the Department of Commerce and Insurance ( Division ) to consider

More information

STATE OF MARYLAND KIDNEY DISEASE PROGRAM UB-04. Billing Instructions. for. Freestanding Dialysis Facility Services. Revised 9/1/08.

STATE OF MARYLAND KIDNEY DISEASE PROGRAM UB-04. Billing Instructions. for. Freestanding Dialysis Facility Services. Revised 9/1/08. STATE OF MARYLAND KIDNEY DISEASE PROGRAM UB-04 Billing Instructions for Freestanding Dialysis Facility Services Revised 9/1/08 Page 1 of 13 UB04 Instructions TABLE of CONTENTS Introduction 4 Sample UB04

More information

HEALTH INSURANCE CLAIM FORM APPROVED BY THE BERMUDA HEALTH COUNCIL 10/09

HEALTH INSURANCE CLAIM FORM APPROVED BY THE BERMUDA HEALTH COUNCIL 10/09 HEALTH INSURANCE CLAIM FORM APPROVED BY THE BERMUDA HEALTH COUNCIL 10/09 1. NAME OF INSURANCE COMPANY PLEASE PRINT OR TYPE IN UPPERCASE LETTERS 1a. INSURED S CERTIFICATE NUMBER ARGUS BF&M COLONIAL FM GEHI

More information

Monterey County HEALTH INFORMATION MANAGEMENT CODING SUPERVISOR

Monterey County HEALTH INFORMATION MANAGEMENT CODING SUPERVISOR Monterey County 50T22 HEALTH INFORMATION MANAGEMENT CODING SUPERVISOR DEFINITION Under direction, supervises the work of staff who review, interpret, code and abstract medical records information according

More information

UB-04 Claim Form Instructions

UB-04 Claim Form Instructions UB-04 Claim Form Instructions FORM LOCATOR NAME 1. Billing Provider Name & Address INSTRUCTIONS Enter the name and address of the hospital/facility submitting the claim. 2. Pay to Address Pay to address

More information

Data Report on Spinal Cord Injury

Data Report on Spinal Cord Injury Indiana State Department of Health Injury Prevention Program Data prepared by Jodi Hackworth and Joan Marciniak December 12, 27 DATA HIGHLIGHTS Data Report on Spinal Cord Injury The leading cause of spinal

More information

Ambulatory Surgical Treatment Center Data System User Manual

Ambulatory Surgical Treatment Center Data System User Manual DIVISION OF HEALTH F STATISTICS Tennessee Department of Health Ambulatory Surgical Treatment Center Data System User Manual CMS-1500 and UB-04 Reporting 2007 1 Ambulatory Surgical Treatment Center Data

More information

ICD-10 Action Plan: Your 12-Step Transition Plan for ICD-10. Written by the AMA CPT Medical Informatics Department

ICD-10 Action Plan: Your 12-Step Transition Plan for ICD-10. Written by the AMA CPT Medical Informatics Department ICD-10 Action Plan: Your 12-Step Transition Plan for ICD-10 Written by the AMA CPT Medical Informatics Department P R A C T I C E T O O L S E P T E M B E R 2 0 1 2 This resource is for educational purposes

More information

Completing a Paper UB-04 Form

Completing a Paper UB-04 Form Completing a Paper UB-04 Information in this policy does not apply to members with the Choice or Choice Plus products offered through Passport Connect S. For UnitedHealthcare s related policies/procedures,

More information

Glossary. Adults: Individuals ages 19 through 64. Allowed amounts: See prices paid. Allowed costs: See prices paid.

Glossary. Adults: Individuals ages 19 through 64. Allowed amounts: See prices paid. Allowed costs: See prices paid. Glossary Acute inpatient: A subservice category of the inpatient facility clams that have excluded skilled nursing facilities (SNF), hospice, and ungroupable claims. This subcategory was previously known

More information

Support: Andrew Gardner Clinical Data manager Mount Auburn Hospital Email: agardner@mah.harvard.edu Tel: 617-441-1625 Pager: 6707

Support: Andrew Gardner Clinical Data manager Mount Auburn Hospital Email: agardner@mah.harvard.edu Tel: 617-441-1625 Pager: 6707 Support: Andrew Gardner Clinical Data manager Mount Auburn Hospital Email: agardner@mah.harvard.edu Tel: 617-441-1625 Pager: 6707 Mount Auburn Hospital Case Management Department PROCESS STEP See page...

More information

EVEREST INSURANCE COMPANY OF CANADA ACCIDENT CLAIM FORM INSTRUCTIONS

EVEREST INSURANCE COMPANY OF CANADA ACCIDENT CLAIM FORM INSTRUCTIONS ACCIDENT CLAIM FORM INSTRUCTIONS Everest Insurance Company of Canada must receive your completed claim forms within thirty (30) days of the accident occurring. Complete the attached Sport Accident Claims

More information

MENTAL HEALTH / SUBSTANCE ABUSE TREATMENT CLAIM FORM

MENTAL HEALTH / SUBSTANCE ABUSE TREATMENT CLAIM FORM MENTAL HEALTH / SUBSTANCE ABUSE TREATMENT CLAIM FORM DIRECTIONS FOR COMPLETION If you are in treatment with a non-participating ValueOptions provider and your provider has indicated that you will be responsible

More information

Reimbursement and Claims Submission Changes for Nursing Home Provided Non-emergency Transportation for Nursing Home Residents

Reimbursement and Claims Submission Changes for Nursing Home Provided Non-emergency Transportation for Nursing Home Residents Update February 2010 No. 2010-05 Affected Programs: BadgerCare Plus Standard Plan, BadgerCare Plus Benchmark Plan, Medicaid To: Nursing Homes, HMOs and Other Managed Care Programs Reimbursement and Claims

More information

Medical Billing and ICD-10 Codes

Medical Billing and ICD-10 Codes 1. What is the purpose of changing from ICD-9 to ICD-10? a. To improve clinical data collection and more adequately describe the services provided to policyholders and members in a more organized and detailed

More information

Massachusetts Small Group Plan Design Comparison April 1, 2014 Plan Year or Calendar Year Available for All Plans

Massachusetts Small Group Plan Design Comparison April 1, 2014 Plan Year or Calendar Year Available for All Plans Non- ER Medical Individual/ Family HMO Value 250 Basic 25 $15 $100 $100 No $25 $125 $500 $100 No $2,500/$5,000 26% 17% 500 after after after $500/$1,000 8% 1000 after after after 1 (baseline) 1000 Low

More information

ICD-10 Transition Overview

ICD-10 Transition Overview ICD-10 Transition Overview Donna Pickett, MPH, RHIA OSELS/National Center for Health Statistics Centers for Disease Control and Prevention U.S. Department of Health and Human Services Centers for Disease

More information

A Primer on Ratio Analysis and the CAH Financial Indicators Report

A Primer on Ratio Analysis and the CAH Financial Indicators Report A Primer on Ratio Analysis and the CAH Financial Indicators Report CAH Financial Indicators Report Team North Carolina Rural Health Research and Policy Analysis Center Cecil G. Sheps Center for Health

More information

2009 Emergency Department

2009 Emergency Department 2009 Emergency Department Hospital Utilization Report Prepared by Vermont Department of Health Vermont Department of Banking, Insurance, Securities and Health Care Administration 2009 Vermont Emergency

More information

Procedures for Coding Inpatient Medical Record Cases for the CCS Examination

Procedures for Coding Inpatient Medical Record Cases for the CCS Examination Procedures for Coding Inpatient Medical Record Cases for the CCS Examination Instructions and official guidelines for coding medical records are included in the following resources: ICD-10-CM/PCS, CPT,

More information

Kentucky Inpatient and Outpatient Data Coordinator s Manual For Hospitals

Kentucky Inpatient and Outpatient Data Coordinator s Manual For Hospitals Kentucky Inpatient and Outpatient Coordinator s Manual For Hospitals Revised December 1, 2014 Collection Help Desk 1-888-992-4320 www.kyipop.org Contents KY IPOP Coordinator s Manual for Hospitals Highlight

More information

tblexplanationofbenefits Rejection Group Reason Code Remark Code

tblexplanationofbenefits Rejection Group Reason Code Remark Code 001 Denied. Care beyond first 20 visits or 60 days requires authorization. A1, 45 002 Denied. Report of Accident (ROA) payable once per claim. Previous payment has been made. B13, A1, 23 003 Initial office

More information

Using Data to Understand the Medicare Spending Per Beneficiary Measure

Using Data to Understand the Medicare Spending Per Beneficiary Measure Using Data to Understand the Medicare Spending Per Beneficiary Measure Mary Wheatley, AAMC Jacqueline Matthews, Cleveland Clinic Keely Macmillan, Partners Healthcare December 17, 2013 Webinar Details The

More information

AUIC CORE HEALTH INSURANCE SALES SCRIPT. AGENT DOCUMENTATION ONLY. NOT FOR DISTRIBUTION.

AUIC CORE HEALTH INSURANCE SALES SCRIPT. AGENT DOCUMENTATION ONLY. NOT FOR DISTRIBUTION. NOTE to Agent: (1) Agent is required to be licensed in each state they are representing AUIC Core Health Insurance including USFIC. (2) Limited Medical Indemnity Insurance is NOT Major Medical or Health

More information

3. ROUNDING OFF DECIMAL NUMBERS TO THE NEAREST TENTH

3. ROUNDING OFF DECIMAL NUMBERS TO THE NEAREST TENTH 3. ROUNDING OFF DECIMAL NUMBERS TO THE NEAREST TENTH Material: Decimal Board and materials Small gold circle Prepared problems Paper and pencil Presentation: 1. Form a number on the board with discs: 0.68.

More information

How to Calculate the Probabilities of Winning the Eight LUCKY MONEY Prize Levels:

How to Calculate the Probabilities of Winning the Eight LUCKY MONEY Prize Levels: How to Calculate the Probabilities of Winning the Eight LUCKY MONEY Prize Levels: LUCKY MONEY numbers are drawn from two sets of numbers. Four numbers are drawn from one set of 47 numbered white balls

More information

Revenue Integrity Boot Camp. Coding. Agenda

Revenue Integrity Boot Camp. Coding. Agenda Annie Lee Sallee MBA, RHIT, CPC, CPMA AHIMA Approved ICD-10-CM/PCS Trainer Revenue Cycle Education Specialist Home Town Health Jenan Custer CPC, CCS AHIMA Approved ICD-10-CM/PCS Trainer and Ambassador

More information

professional billing module

professional billing module professional billing module Professional CMS-1500 Billing Module Coding Requirements...2 Evaluation and Management Services...2 Diagnosis...2 Procedures...2 Basic Rules...3 Before You Begin...3 Modifiers...3

More information

Monitoring Coding Compliance

Monitoring Coding Compliance Monitoring Coding Compliance Richard F. Averill, M.S. Coding compliance refers to the process of insuring that the coding of diagnoses and procedures complies with all coding rules and guidelines. Detection,

More information

TECHNICAL HANDBOOK FOR ENVIRONMENTAL HEALTH AND ENGINEERING VOLUME II - HEALTH CARE FACILITIES PLANNING PART 11 - FACILITIES PLANNING GUIDELINES

TECHNICAL HANDBOOK FOR ENVIRONMENTAL HEALTH AND ENGINEERING VOLUME II - HEALTH CARE FACILITIES PLANNING PART 11 - FACILITIES PLANNING GUIDELINES CHAPTER 11-5 - COST ANALYSIS METHODOLOGY - DIRECT VERSUS CONTRACT INPATIENT CARE 11-5.1 PURPOSE..................... (11-5) 1 11-5.2 INTRODUCTION.................. (11-5) 1 11-5.3 METHODOLOGY...................

More information

Inpatient Transfers, Discharges and Readmissions July 19, 2012

Inpatient Transfers, Discharges and Readmissions July 19, 2012 Inpatient Transfers, Discharges and Readmissions July 19, 2012 Discharge Status Codes Two-digit code Identifies where the patient is at conclusion of encounter Visit Inpatient stay End of billing cycle

More information

CANCER CLAIM FORM. CAF001CA-13v4

CANCER CLAIM FORM. CAF001CA-13v4 CANCER CLAIM FORM Failure to complete all sections may result in a delay in processing this claim. To prevent delays, please provide documentation from your healthcare provider to support this claim. Please

More information

ICD-10 FAQ. How Long Has ICD-9-CM Been In Use?

ICD-10 FAQ. How Long Has ICD-9-CM Been In Use? ICD-10 FAQ How Long Has ICD-9-CM Been In Use? What Code Set Does ICD-9-CM Define? What Code Set Does ICD-10 Define? When was ICD-10-CM Created? What agency maintains ICD-10? Why is ICD-10 better than ICD-9?

More information

Research & Hennepin Health

Research & Hennepin Health Research & Hennepin Health 1 Research & Publication Team Committee within the ACO Goal: To coordinate and prioritize research and publication about Hennepin Health by internal and external partners; to

More information

ICD-10: Facts for Hospitals

ICD-10: Facts for Hospitals ICD-10: Facts for Hospitals July 16, 2015 Shana Olshan Director, National Standards Group Centers for Medicare and Medicaid Services 1 Today s Presentation Topics ICD-10-CM and ICD-10-PCS overview ICD-10

More information

CODING. Neighborhood Health Plan 1 Provider Payment Guidelines

CODING. Neighborhood Health Plan 1 Provider Payment Guidelines CODING Policy The terms of this policy set forth the guidelines for reporting the provision of care rendered by NHP participating providers, including but not limited to use of standard diagnosis and procedure

More information

All Patient Refined DRGs (APR-DRGs) An Overview. Presented by Treo Solutions

All Patient Refined DRGs (APR-DRGs) An Overview. Presented by Treo Solutions All Patient Refined DRGs (APR-DRGs) An Overview Presented by Treo Solutions Presentation Highlights History of inpatient classification systems APR-DRGs: what they are, how they work, and why they are

More information

DC Medicaid EAPG Training

DC Medicaid EAPG Training DC Medicaid EAPG Training Provider Training 2013 Xerox Corporation. All rights reserved. Xerox and Xerox Design are trademarks of Xerox Corporation in the United States and/or other countries. Agenda Project

More information

ICD-10 Preparation for Dental Providers. July 2014

ICD-10 Preparation for Dental Providers. July 2014 ICD-10 Preparation for Dental Providers July 2014 What is ICD-10? The International Classification of Diseases (ICD) is a set of codes used worldwide to classify medical diagnoses and inpatient procedures.

More information

FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS

FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS Attached is a form to file a Certificate of Merger pursuant to section 608.4382, Florida Statutes. This form is basic and may not meet all merger needs.

More information

Truven Health Analytics: Market Expert Inpatient Volume Projection Methodology

Truven Health Analytics: Market Expert Inpatient Volume Projection Methodology Truven Health Analytics: Market Expert Inpatient Volume Projection Methodology Truven s inpatient volume forecaster produces five and ten year volume projections by DRG and zip code. Truven uses two primary

More information

UB-92 Billing Instructions for Inpatient Chemical Dependency Services

UB-92 Billing Instructions for Inpatient Chemical Dependency Services UB-92 Billing Instructions for Inpatient Chemical Dependency Services General Instructions The placing authority (county or tribe) authorizes Chemical Dependency services for eligible recipients. Bill

More information

INDEMNITY AGREEMENT FOR SURETY BAIL BOND ACCREDITED SURETY AND CASUALTY CO., INC.

INDEMNITY AGREEMENT FOR SURETY BAIL BOND ACCREDITED SURETY AND CASUALTY CO., INC. INDEMNITY AGREEMENT FOR SURETY BAIL BOND ACCREDITED SURETY AND CASUALTY CO., INC. The undersigned, called First Party, make application to called Second Party, for execution by ACCREDITED SURETY AND CASUALTY

More information

ICD-10 User Guide July 2015

ICD-10 User Guide July 2015 ICD-10 User Guide July 2015 Contents Introduction... 3 Set up the Crosswalk parameter... 3 Set up the ICD-10 compliance date for an insurance carrier... 4 Add the employer insurance... 6 New ICD Search

More information

Ambulatory Surgery Center (ASC) Billing Instructions

Ambulatory Surgery Center (ASC) Billing Instructions All related services performed by an ambulatory surgery center must be billed on the UB04 claim form following the instructions listed below. Tips Claim Form Completion Claims for ASC covered services

More information

Risk Adjustment Data Validation Study Frequently Asked Questions

Risk Adjustment Data Validation Study Frequently Asked Questions Risk Adjustment Data Validation Study Frequently Asked Questions MEDICAL RECORD SUBMISSION Q1: Can medical groups gather all the medical records for the data validation and send them all at once? A1: Please

More information

California Maternal Data Center Data Submission Process and Data Specifications June 20, 2014

California Maternal Data Center Data Submission Process and Data Specifications June 20, 2014 California Maternal Data Center Data Submission Process and Data Specifications June 20, 2014 Thank you for participating in the CMQCC California Maternal Data Center (CMDC). All data file submissions

More information

Use and Integration of Freely Available U.S. Public Use Files to Answer Pharmacoeconomic Questions: Deciphering the Alphabet Soup

Use and Integration of Freely Available U.S. Public Use Files to Answer Pharmacoeconomic Questions: Deciphering the Alphabet Soup Use and Integration of Freely Available U.S. Public Use Files to Answer Pharmacoeconomic Questions: Deciphering the Alphabet Soup Prepared by Ovation Research Group for the National Library of Medicine

More information

ABA NBDS NATIONAL BURN DATA STANDARD: DATA DICTIONARY

ABA NBDS NATIONAL BURN DATA STANDARD: DATA DICTIONARY ABA NBDS NATIONAL BURN DATA STANDARD: DATA DICTIONARY Revision - June 2015 Section A National Burn Data Standard Data Tools Page 1 of 159 TABLE OF CONTENTS INTRODUCTION... 4 NATIONAL BURN DATA STANDARD...

More information

ICD Codes in State Medicaid Dental Claims Submission

ICD Codes in State Medicaid Dental Claims Submission ICD Codes in State Medicaid Dental Claims Submission Dental Informatics Center for Informatics and Standards Practice Institute February 2015 Disclaimer This presentation is for educational purposes only

More information

MUST BE SUBMITTED IN WRITING AND MUST BE RECEIVED OR POSTMARKED NO LATER THAN SEPTEMBER

MUST BE SUBMITTED IN WRITING AND MUST BE RECEIVED OR POSTMARKED NO LATER THAN SEPTEMBER Pat Quinn, Governor Julie Hamos, Director 201 South Grand Avenue East Telephone: (217) 785-0710 Springfield, Illinois 62763-0002 TTY: (800) 526-5812 August 28, 2013 The Rehab Institute ATTN: Chief Executive

More information

MUST BE SUBMITTED IN WRITING AND MUST BE RECEIVED OR POSTMARKED NO LATER THAN SEPTEMBER

MUST BE SUBMITTED IN WRITING AND MUST BE RECEIVED OR POSTMARKED NO LATER THAN SEPTEMBER Pat Quinn, Governor Julie Hamos, Director 201 South Grand Avenue East Telephone: (217) 785-0710 Springfield, Illinois 62763-0002 TTY: (800) 526-5812 August 28, 2013 HealthSouth Tri State Rehab Hospital

More information

Surgeon and Radiological Services Billing for Laparoscopic Adjustable Gastric Band Procedures

Surgeon and Radiological Services Billing for Laparoscopic Adjustable Gastric Band Procedures Surgeon and Radiological Services Billing for Laparoscopic Adjustable Gastric Band Procedures Table 1: Surgeon Billing for Laparoscopic Adjustable Gastric Band Procedures 2012 Medicare Payment 2 43770

More information

CATASTROPHIC INMATE MEDICAL INSURANCE (CIMI) FACT SHEET

CATASTROPHIC INMATE MEDICAL INSURANCE (CIMI) FACT SHEET CATASTROPHIC INMATE MEDICAL INSURANCE (CIMI) FACT SHEET THE PROBLEM Skyrocketing health care costs combined with the responsibility to pay for inmate medical care have created serious budgetary problems

More information

Pennsylvania Department Of Human Services ESC Error Status Code Descriptions 201 BILLING PROVIDER IDENTIFICATION NUMBER IS MISSING FROM CLAIM 202

Pennsylvania Department Of Human Services ESC Error Status Code Descriptions 201 BILLING PROVIDER IDENTIFICATION NUMBER IS MISSING FROM CLAIM 202 Pennsylvania Department Of Human Services ESC Error Status Code Descriptions 201 BILLING PROVIDER IDENTIFICATION NUMBER IS MISSING FROM CLAIM 202 BILLING PROVIDER IDENTIFICATION NUMBER IS IN INVALID FORMAT

More information

BILL PAY DATA DICTIONARY. Physician Bill Redefine Area

BILL PAY DATA DICTIONARY. Physician Bill Redefine Area BILL PAY DATA DICTIONARY Name START END FIELD Case Number 1 9 CHAR/9 BIL-HIS-CASE-NO Unique Number Assigned To Each Case By The Responsible District Office Payee Number 10 18 CHAR/9 BIL-HIS-PAYEE-NO Unique

More information

Understanding Your Medical Bills. Sinai Hospital of Baltimore. Rubin Institute for Advanced Orthopedics

Understanding Your Medical Bills. Sinai Hospital of Baltimore. Rubin Institute for Advanced Orthopedics Understanding Your Medical Bills at the Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore Rubin Institute for Advanced Orthopedics Rubin Institute for Advanced Orthopedics At the Rubin

More information

Chapter 26 ALARM SYSTEMS. ARTICLE I Fire Alarm Systems

Chapter 26 ALARM SYSTEMS. ARTICLE I Fire Alarm Systems 26-1 ALARM SYSTEMS 26-1 Chapter 26 ALARM SYSTEMS 26-1. Definitions. ARTICLE I Fire Alarm Systems 26-2. Required inspections and information. 26-3. False alarms. 26-4. Fees. [HISTORY: Adopted by the Township

More information

Hospital Statement of Cost OHF Page 1 Illinois Department of Public Aid, Office of Health Finance, 201 S. Grand Ave. E., Springfield, IL 62763

Hospital Statement of Cost OHF Page 1 Illinois Department of Public Aid, Office of Health Finance, 201 S. Grand Ave. E., Springfield, IL 62763 Hospital Statement of Cost OHF Page 1 Illinois Department of Public Aid, Office of Health Finance, 201 S. Grand Ave. E., Springfield, IL 62763 General Information Name of Hospital: Provena United Samaritans

More information

Appendix 14: Obtaining Data on Opioid Poisoning

Appendix 14: Obtaining Data on Opioid Poisoning : Obtaining Data on Opioid Poisoning Obtaining Hospital Data on Nonfatal Opioid Poisoning Data on the number of nonfatal opioid overdoses can often be obtained from hospitals serving your community. Forming

More information

Hospital Billing & Coding Certification Certified Professional Coder-Hospital Outpatient (CPC-H)

Hospital Billing & Coding Certification Certified Professional Coder-Hospital Outpatient (CPC-H) Academy of Medical Professions, Inc. Brunswick Business Center 18 Pleasant Street, Suite 210; Brunswick, ME 04011 www.academyofmedicalprofessions.com 1-866-516-8274. 207-721-0714. 207-449-1242 (fax) info@academyofmedicalprofessions.com

More information

Software Installation Guide for z/os Batch

Software Installation Guide for z/os Batch Medicare Severity Diagnosis Related Groups (MS-DRG) Software Software Installation Guide for ICD-10-CM v33.0 October 2015 PBL-036 October 2015 Table of Contents Preface... vii Chapter 1: Introduction...

More information

Regulatory Compliance Policy No. COMP.RCC 4.71 Title:

Regulatory Compliance Policy No. COMP.RCC 4.71 Title: I. SCOPE: Regulatory Compliance Policy No. COMP.RCC 4.71 Page: 1 of 12 This policy applies to (1) Tenet Healthcare Corporation and its wholly-owned subsidiaries and affiliates (each, an Affiliate ); (2)

More information

HEALTH INFORMATION MANAGEMENT CODER I/II

HEALTH INFORMATION MANAGEMENT CODER I/II Monterey County I 50T02 II 50T03 HEALTH INFORMATION MANAGEMENT CODER I/II DEFINITION Under general supervision, reviews, interprets, codes and abstracts medical records information according to standard

More information

IWCC 50 ILLINOIS ADMINISTRATIVE CODE 7110 7110.90. Section 7110.90 Illinois Workers' Compensation Commission Medical Fee Schedule

IWCC 50 ILLINOIS ADMINISTRATIVE CODE 7110 7110.90. Section 7110.90 Illinois Workers' Compensation Commission Medical Fee Schedule Section 7110.90 Illinois Workers' Compensation Commission Medical Fee Schedule a) In accordance with Sections 8(a), 8.2 and 16 of the Workers' Compensation Act [820 ILCS 305/8(a), 8.2 and 16] (the Act),

More information

VOLUME II/MA, MT 49 05/15 SECTION 2166-1

VOLUME II/MA, MT 49 05/15 SECTION 2166-1 2166 - (TMA) POLICY STATEMENT Transitional Medical Assistance (TMA) provides continued Medicaid coverage for up to 12 months for Parent/Caretaker with Child(ren) AUs that become ineligible because of changes

More information

Compliance Strategies

Compliance Strategies VOL. 24 NO. 13 JULY 16, 2012 COMMITTED TO ENHANCING THE HEALTH INFORMATION PROFESSION WWW.FORTHERECORDMAG.COM Compliance Strategies for the 72-Hour Rule Medicare s three-day payment window has reemerged

More information

DISCHARGE ABSTRACTS DATABASE (HOSPITAL SEPARATIONS) DATA DICTIONARY

DISCHARGE ABSTRACTS DATABASE (HOSPITAL SEPARATIONS) DATA DICTIONARY DISCHARGE ABSTRACTS DATABASE (HOSPITAL SEPARATIONS) DATA DICTIONARY Includes discharges, transfers and deaths of in-patients from acute care hospitals in BC, including day surgeries. Fields are available

More information

Inpatient EHR Implementation and Lessons Learned

Inpatient EHR Implementation and Lessons Learned Inpatient EHR Implementation and Lessons Learned LCDR Robin Bartlett, PharmD, NCPS Clinical Applications Coordinator Cherokee Indian Hospital April 2008 Objectives Provide overview of relationship between

More information