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

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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	2012	2014
IP RIF (claims)	<100	<600	<500	<100	<400
MedPAR RIF	0	<600	<500	<100	<1,000
OP RIF (claims)	<100	<3,400	<2,000	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.

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Article Information

Author:

Faith Asper, MHS, CIPP/G

Acknowledgements:

ResDAC would also like to acknowledge David Lanctin and Xuanzi (Shirley) Qin, Research Assistant for her analytical assistance with this article.

Level:

Intermediate

Topic:

Data Files or Variables

Program:

Medicare

Category:

Medicare Fee-For-Service Claims

Disclaimer:

The process and materials mentioned as part of this KnowledgeBase article are current, as of the publication date on the article, to the best of our knowledge. The examples provided are correct in the aggregate but may not apply to every subgroup or circumstance that a researcher may wish to study. It is up to the researcher to conduct analysis and confirm that the patterns described in this KnowledgeBase article apply to his/her particular study. If your research findings appear to contradict the advice provided, please contact ResDAC at resdac@umn.edu.