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The data in this column indicates if the patient's level of consciousness was alert (normal) during the admission time period.
The data in this column indicates if the patient's level of consciousness was abnormal (Vigilant (Hyperalert), Lethargic (drowsy, easily aroused) or Stupor (difficult to arouse) or Coma (unarousable) during the admission period.
A preliminary calculation made prior to determining the CMG group. Age is computed on the basis of the difference between the Admission Date (Item 12) and the Birth Date (Item 6).
Calculated atherosclerotic cardiovascular disease (ASCVD) risk score.
Values: Ex — 21.7
Source: Million Hearts Data Registry
The value in this field indicates the type of birth date that was submitted: full, month and year or year only.
The CMS Certification Number (CCN) of the facility calculated by the ASAP system.
The Case-Mix Group code that is calculated from the data submitted to the NACD.
The version code of the CMG Grouper on the NACD.
A preliminary calculation made prior to determining the CMG group. The cognitive score is based upon 5 variables that are taken from Item 39 on the IRF-PAI form.
The value of the HIPPS (Health Insurance Prospective Payment System) code calculated by the state system using the OASIS PPS dll for this assessment.
The version of the HIPPS (Health Insurance Prospective Payment System) code calculated.
A preliminary calculation made prior to determining the CMG group. The motor score is based upon 12 variables that are taken from Item 39 on the IRF-PAI form.
The amount of the capitated payment bill submitted by the managed care entity to the state.
The date that the managed care entity submitted the capitated payment bill to the state.
The charge amount (rounded to whole dollars) for the cardiac catheterization lab related to the beneficiary's stay.
The charge amount (rounded to whole dollars) for cardiology services and electrocardiogram(s) provided during the beneficiary's stay.
The code used to identify that the care improvement model is being used for bundling payments.
The code used to identify that the care improvement model is being used for bundling payments
The code used to identify that the care improvement model is being used for bundling payments.
The code used to identify that the care improvement model is being used for bundling payments.
The National Provider Identifier (NPI) number of the Home Health Agency (HHA) or Hospice rendering Medicare services during the period the physician is providing care plan oversight (CPO).
Care Planning Lock Date
Care Preferences Section Notes
The amount paid by the beneficiary for the non-institutional Part B (carrier, or DMERC) claim.
The CMS National Provider Identifier (NPI) number assigned to the billing provider
The amount of the cash deductible as submitted on the claim.
This variable is the beneficiary’s liability under the annual Part B deductible for all line items on the claim; it is the sum of all line-level deductible amounts. (variable called LINE_BENE_PTB_DDCTBL_AMT)
The Part B deductible applies to both institutional (e.g., HOP) and non-institutional (e.g., Carrier and DME) services.
Carrier-generated code describing whether the Part B claim is an original debit, full credit, or replacement debit.
The code on a non-institutional claim indicating to whom payment was made or if the claim was denied.
Effective with Version H, the amount of a payment made on behalf of a Medicare bene- ficiary by a primary payer other than Medicare, that the provider is applying to covered Medicare charges on a non-institutional claim.
NOTE: During the Version H conversion, this field was populated with data throughout history (back to service year 1991) by summing up the line item primary payer amounts.
Variable indicates whether or not the provider accepts assignment for the noninstitutional claim.
The unique physician identification number (UPIN) of the physician who referred the beneficiary to the physician who performed the Part B services.
The provider identification number (PIN) of the physician/supplier (assigned by the MAC) who referred the beneficiary to the physician who ordered these services.
This field identifies the Site of Service National Provider Identifier (NPI).
The base number of units assigned to the line item anesthesia procedure on the carrier claim (non-DMERC).
The profiling identification number (PIN) of the physician/supplier (assigned by the carrier) who performed the service for this line item on the carrier claim (non-DMERC).
Clinical lab charge amount on the Carrier line.
The code used to track health professional shortage area (HPSA) and physician scarcity bonus payments on carrier claims.
This field represents the National Provider Identifier (NPI) of the Medicare Diabetes Prevention Program (MDPP) Coach.
The count of the total units associated with services needing unit reporting such as transportation, miles, anesthesia time units, number of services, volume of oxygen or blood units.
This is a line item field on the carrier claim (non-DMERC) and is used for both allowed and denied services.
Code indicating the units associated with services needing unit reporting on the line item for the carrier claim (non-DMERC).
The National Provider Identifier (NPI) assigned to the performing provider.
The provider identification number (PIN) of the physician/supplier (assigned by the Medicare Administrative Contractor [MAC]) who performed the service for this line item.
The ZIP code of the physician/supplier who performed the Part B service for this line item on the carrier claim (non-DMERC).
The unique physician identification number (UPIN) of the physician who performed the service for this line item on the carrier claim (non-DMERC).
NPIs replaced UPINs as the standard provider identifiers beginning in 2007. The UPIN is almost never populated after 2009.
Source: NCH
Code denoting the carrier-specific locality used for pricing the service for this line item on the carrier claim (non-DMERC).
Code identifying the type of provider furnishing the service for this line item on the carrier claim.
Code identifying the type of provider furnishing the service for this line item on the carrier claim.
The code on the carrier (non-DMERC) line item that identifies the line items that have been paid a reduced fee schedule amount (65%, 75% or 85%) because a physician's assistant performed the service.
The pharmacy's internal invoice number on pharmaceutical claims.