This code represents a factor that specifies the amount of any Ambulatory payment classification (APC) discount. The discounting factor is applied to a line item with a service indicator (part of the REV_CNTR_PMT_MTHD_IND_CD) of 'T'. The flag is applicable when more than one significant procedure is performed.
**If there is no discounting the factor will be 1.0.**
This field is populated for those claims that are required to process through Outpatient prospective payment system (PPS or OPPS) PRICER software. The type of bills (TOB) required to process through are: 12X, 13X, 14X (except Maryland providers, Indian Health Providers, hospitals located in American Samoa, Guam and Saipan and Critical Access Hospitals (CAH)); 76X; 75X and 34X if certain HCPCS are on the bill; and any outpatient type of bill with a condition code '07' and certain HCPCS. These claim types could have lines that are not required to price under OPPS rules so those lines would not have data in this field.
Additional exception: Virgin Island hospitals and hospitals that furnish only inpatient Part B services with dates of service 1/1/02 and forward.
It has been discovered that this field may be populated with data on claims with dates of service prior to 7/00 (implementation of Claim Line Expansion OPPS/HHPPS). The original understanding of the new revenue center fields was that data would be populated on claims with dates of service 7/00 and forward.
Data has been found in claims with dates of service prior to 7/00 because the Standard Systems have processed any claim coming in 7/00 and after, meeting the above criteria, through the Outpatient Code Editor (OCE) regardless of the dates of service.
|2||(1.0+Discounting fraction (0.5) (Number of units-1))/U|
|3||Terminated procedure discount (currently 0.5)/Number of units|
|4||(1+Discounting fraction (0.5))/Number of units|
|5||Discounting fraction (currently 0.5)|
|6||Terminated procedure discount (currently 0.5)*Discounting fraction (0.5)/Number of units|
|7||Discounting fraction (0.5)(1+Discounting fraction (0.5))/Number of units|
|8||2.0/Number of units|
|D||Discounting fraction (currently 0.5)|
|U||Number of units|
|T||Terminated procedure discount (currently 0.5)