Medicare MedPAR, Inpatient, Outpatient RIF and LDS files: “V” in the fifth position of the Provider Number

Purpose

Beginning in 2008, some hospital provider numbers appearing in the claims contain a “V” in the fifth position of the six-digit Medicare Provider Number. Usually, the fifth position is a number, not a character. These hospital provider numbers appear in the MedPAR, Inpatient and Outpatient files for both RIF and LDS versions.  ResDAC recommends that researchers remove these claims.

Current Version Date:
12/15/2016

Starting in 2008, some institutional files contained Medicare Provider Numbers with a “V” in the fifth position.  These provider numbers represent Veterans Administration (VA) Demonstration claims.  A full explanation is found in the CMS Internet Only Manuals, 100-04 Claims Processing Manual, Chapter 37 – Department of Veterans Affairs (VA) Claims Adjudication Services Project.

These VA records are found in the RIF and LDS versions of the MedPAR, Inpatient, and Outpatient files.

File

2008

2009

2010

2011

2012

2013

2014

IP RIF (claims)

<100

<600

<500

0

<100

0

<400

MedPAR RIF

0

<600

<500

0

<100

0

<1,000

OP RIF (claims)

<100

<3,400

<2,000

0

0

0

0

Table 1. Number of observations (claims or stays) with provider number containing “V” in 5th position (rounded to the nearest 100)
Recommendation:

ResDAC recommends excluding these claims from the utilization files because these records don’t represent all the services provided to Medicare beneficiaries at VA hospitals.