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The data in this column indicates the patient's level of bowel continence.
The data in this column indicates the patient's bowel continence level.
The data in this column indicates whether a bowel toileting program is being utilized to manage the resident's bowel continence.
The data in this column indicates whether constipation is present.
A flag to indicate whether the beneficiary had the Home and community based services (HCBS) Non-Health Home Chronic Condition “Aged”; most recent in the calendar year.
A flag to indicate whether the beneficiary had the Home and Community Based Services (HCBS) Non-Health Home Chronic Condition “Autism Spectrum Disorder”; most recent in the calendar year.
A flag to indicate whether the beneficiary had the Home and Community Based Services (HCBS) Non-Health Home Chronic Condition “Brain Injury”; most recent in the calendar year.
A flag to indicate whether the beneficiary had the Home and Community Based Services (HCBS) Non-Health Home Chronic Condition “Developmental Disabilities”; most recent in the calendar year.
A flag to indicate whether the beneficiary had the Home and Community Based Services (HCBS) Non-Health Home Chronic Condition “Disabled Other”; most recent in the calendar year.
A flag to indicate whether the beneficiary had the Home and Community Based Services (HCBS) Non-Health Home Chronic Condition “HIV/AIDS”; most recent in the calendar year.
A flag to indicate whether the beneficiary had the Home and Community Based Services (HCBS) Non-Health Home Chronic Condition “Intellectual Disabilities”; most recent in the calendar year.
A flag to indicate whether the beneficiary had the Home and Community Based Services (HCBS) Non-Health Home Chronic Condition Mental Illness and/or Serious Emotional Disturbance; most recent in the calendar year.
A flag to indicate whether the beneficiary had the Home and Community Based Services (HCBS) Non-Health Home Chronic Condition “Physical Disabilities”; most recent in the calendar year.
A flag to indicate whether the beneficiary had the Home and Community Based Services (HCBS) Non-Health Home Chronic Condition “Technology Dependent/Medically Fragile”; most recent in the calendar year.
This variable uniquely identifies prescribers found in the proprietary HCIdea™ Prescriber Database.
HCIdea has prescriber information from a variety of data sources, including the NPPES directory (the National Plan and Provider Enumeration System, which assigns a unique NPI to each provider), the Drug Enforcement Administration (through data files known as the Controlled Substances Act Registrants), and SureScripts (a nationwide eprescribing network). Using these input files, it is generally possible to identify a unique provider using an NPI, DEA number, and/or UPIN number.
Source: HCIdea™ Prescriber Database
A fourth modifier to the Healthcare Common Procedure Coding System (HCPCS) procedure code to make it more specific than the first, second, or third modifier codes to identify the revenue center or line item services for the encounter record.
A fourth modifier to the Healthcare Common Procedure Coding System (HCPCS) procedure code to make it more specific than the first, second, or third modifier codes identify the revenue center or line item services for the claim.
A first modifier to the Healthcare Common Procedure Coding System (HCPCS) procedure code to enable a more specific procedure identification for the revenue center or line item service for the encounter record.
A first modifier to the Healthcare Common Procedure Coding System (HCPCS) procedure code to enable a more specific procedure identification for the revenue center or line item service for the claim.
A second modifier to the Healthcare Common Procedure Coding System (HCPCS) procedure code to make it more specific than the first modifier code to identify the revenue center or line item service for the encounter record.
A second modifier to the Healthcare Common Procedure Coding System (HCPCS) procedure code to make it more specific than the first modifier code to identify the revenue center or line item service for the claim.
A third modifier to the Healthcare Common Procedure Coding System (HCPCS) procedure code to make it more specific than the first or second modifier codes to identify the revenue center or line item services for the encounter record.
A third modifier to the Healthcare Common Procedure Coding System (HCPCS) procedure code to make it more specific than the first or second modifier codes to identify the revenue center or line item services for the claim.
This code indicates whether the beneficiary included on the claim has a Health Care Acquired Condition (HAC)
The Health Care Common Procedure Coding System (HCPCS) is a collection of codes that represent procedures, supplies, products and services which may be provided to Medicare beneficiaries and to individuals enrolled in private health insurance programs. The codes are divided into three levels, or groups as described below.
In the Institutional Claim Revenue Center Files, this variable can indicate the specific case-mix grouping that Medicare used to pay for skilled nursing facility (SNF), home health, or inpatient rehabilitation facility (IRF) services (see Note 2 below).
Level I
Codes and descriptors copyrighted by the American Medical Association's Current Procedural Terminology, Fourth Edition (CPT-4). These are 5-position numeric codes representing physician and non-physician services.
**** Note 1: **** CPT-4 codes including both long and short descriptions shall be used in accordance with the CMS/AMA agreement. Any other use violates the AMA copyright.
Level II
Includes codes and descriptors copyrighted by the American Dental Association's Current Dental Terminology, Fifth Edition (CDT-5). These are 5-position alpha-numeric codes comprising the D series. All other level II codes and descriptors are approved and maintained jointly by the alpha- numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). These are 5-position alpha-numeric codes representing primarily items and non-physician services that are not represented in the level I codes.
Level III
Codes and descriptors developed by Medicare carriers (currently known as Medicare Administrative Contractors; MACs) for use at the local (MAC) level. These are 5-position alpha-numeric codes in the W, X, Y or Z series representing physician and non-physician services that are not represented in the level I or level II codes.
**** Note 2: ****
This field may contain information regarding case-mix grouping that Medicare used to pay for SNF, home health, or IRF services. These groupings are sometimes known as Health Insurance Prospective Payment System (HIPPS) codes. This field will contain a HIPPS code if the revenue center code (REV_CNTR) equals 0022 for SNF care, 0023 for home health, or 0024 for IRF care. For home health claims, please also see the revenue center APC/HIPPS code variable (REV_CNTR_APC_HIPPS_CD).
A free-form text field to indicate the health home program that authorized payment for the service on the claim. The name entered should be the name that the state uses to uniquely identify the team. A “Health Home Entity” can be a designated provider (e.g., physician, clinic, behavioral health organization), a health team which links to a designated provider, or a health team (physicians, nurses, behavioral health professionals).
A monthly flag to indicate whether the beneficiary participated in the Health Home program. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary participated in the Health Home program. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary participated in the Health Home program. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary participated in the Health Home program. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary participated in the Health Home program. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary participated in the Health Home program. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary participated in the Health Home program. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary participated in the Health Home program. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary participated in the Health Home program. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary participated in the Health Home program. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary participated in the Health Home program. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary participated in the Health Home program. There are separate variables for each of the 12 months during the year.
A unique identification number assigned by the state to the beneficiary’s primary care manager for the Health Home in which the beneficiary is enrolled in the calendar year; most recent in the calendar year.
This code indicates whether the claim is submitted by a provider or provider group enrolled in the Health Home care model. Health home providers provide service for patients with chronic illnesses.
The National Provider ID (NPI) of the health home provider.
Number of months the beneficiary was enrolled in a Health Insuring Organization (HIO) Managed Care Plan in the calendar year.
Indicates the frequency the patient needs someone to help them when they read instructions, pamphlets, or other written material from their doctor or pharmacy.
This column documents, at the time of admission, how often the patient need to have someone help them when they read instructions, pamphlets, or other written material from their doctor or pharmacy.
This column documents, at the time of discharge, how often the patient need to have someone help them when they read instructions, pamphlets, or other written material from their doctor or pharmacy.
Number of months the beneficiary was enrolled in a Health or Medical Home in the calendar year.
The Healthcare Common Procedure Coding System (HCPCS) is a collection of codes that represent procedures, supplies, products and services which may be provided to Medicare beneficiaries and to individuals enrolled in private health insurance programs. The codes are divided into three levels, or groups, as described below (in COMMENT).
In the Institutional Encounter Revenue Center Files, this variable can indicate the specific case-mix grouping that Medicare used to pay for skilled nursing facility (SNF), home health, or inpatient rehabilitation facility (IRF) services (see Note 2 in COMMENT section below).
The Healthcare Common Procedure Coding System (HCPCS) is a collection of codes that represent procedures, supplies, products and services which may be provided to Medicare beneficiaries and to individuals enrolled in private health insurance programs. The codes are divided into three levels, or groups, as described below (in COMMENT).
In the Institutional Encounter Revenue Center Files, this variable can indicate the specific case-mix grouping that Medicare used to pay for skilled nursing facility (SNF), home health, or inpatient rehabilitation facility (IRF) services (see Note 2 in COMMENT section below).
Deafness and Hearing Impairment - Combined Medicare & Medicaid Claims, First Ever Occurrence Date
Deafness and Hearing Impairment - Medicaid Only Claims, First Ever Occurrence Date