ÐÏà¡±á>þÿ #BDþÿÿÿ !"#$%&'()*+,-./0123456789:;<=>?@Aÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿì¥Á‹b ø¿¾jbjbªª ºmÈmÈ »ÿÿÿÿÿÿˆTäHHH˜àìÌAä:¦ô[:.\"P\P\P\P\P\P\±³³³³³³,àR2æßP\P\P\P\P\ßîkP\P\ôîkîkîkP\îP\P\±îkdÄ( ¼P\±îkîkJµ\µ¼è[ØReÆH>`°ù·Bµ¼üS 0:;¸zîk„µ¼îkäädHääHMassachusetts Executive Office of Health and Human Services Division of Health Care Finance and Policy FY2007 Inpatient Hospital Discharge Database Documentation Manual Data Issued: September 2008 Manual Revised: June 19, 2009 Division of Health Care Finance and Policy Two Boylston Street Boston, Massachusetts02116-4704 HYPERLINK "http://www.mass.gov/dhcfp" http://www.mass.gov/dhcfp Table of Contents Page Introduction 1 Compact Disk (CD) File Specification 2 SECTION I. GENERAL DOCUMENTATION 3 PART A. BACKGROUND INFORMATION 4 General Documentation Overview 4 Quarterly Reporting Periods 5 Development of the FY2007 HDD Database 6 DRG Grouper Methodology 7 PART B. DATA 10 Data Quality Standards 11 General Definitions 13 General Data Caveats 14 Specific Data Elements 16 Existing Data Elements 16 New Data Elements 19 Important Note Regarding Use of Race Code 22 Expanded Race & Ethnicity Data Collection 23 DHCFP Calculated Fields 35 PART C. HOSPITAL RESPONSES 36 Summary of Hospitals’ FY2007 Verification Report Responses 37 List of Error Categories 43 Summary of Reported Discrepancies by Category 44 Index of Hospitals Reporting Data Discrepancies 47 Individual Hospital Discrepancy Documentation 48 PART D. CAUTIONARY USE HOSPITALS 69 PART E. HOSPITALS SUBMITTING DATA FOR FY2007 71 List of Hospitals Submitting Data for FY2007 72 Hospitals with No Data Submissions for FY2007 74 Discharge Totals and Charges by Quarter 75 Table of Contents Page PART F. SUPPLEMENTARY INFORMATION 84 Supplement I – List of Type A and Type B Errors 85 Supplement II – Content of Hospital Verification Report Package 88 Supplement III – Hospital Addresses, DPH ID, ORG ID & Service Site Numbers 89 Supplement IV – Mergers, Name Changes, Closures, Conversions, and Non-Acute Care Hospitals 95 Supplement V – Alphabetical Source of Payment List 102 Supplement VI – Numerical Source of Payment List 112 SECTION II. TECHNICAL DOCUMENTATION 121 PART A. CALCULATED FIELD DOCUMENTATION 123 Age Calculation 123 Newborn Age 124 Preoperative Days 125 Length of Stay (LOS) Calculation 126 Length of Stay (LOS) Routine 127 Unique Health Information (UHIN) Sequence Number 128 Days Between Stays 129 PART B. DATA FILE SUMMARY 131 Discharge File Table FY2007 133 Revenue File Table FY2007 140 Data Code Tables FY2007 141 PART C. REVENUE CODE MAPPINGS 154 INTRODUCTION This documentation manual consists of two sections, General Documentation and Technical Documentation. This documentation Manual is for use with the HDD FY2007 database. The FY2007 HDD data was made available as of July 7, 2008. Section I. General Documentation The General Documentation for the Fiscal Year 2007 Hospital Discharge Database includes background on its development and the DRG Groupers, and is intended to provide users with an understanding of the data quality issues connected with the data elements they may decide to examine. This document contains hospital-reported discrepancies received in response to the data verification process. It also includes supplements listing the hospitals within the database, information on mergers, name changes, closures, conversion, and non-acute care hospitals, and alphabetical and numerical payer source lists. Please note that major changes to the data base went into effect beginning October 1, 2006. Implementation of the changes occurred in two phases. Changes to the record layout only began on October 1, 2006, for Quarter 1. Error edits for the new fields began on January 1, 2007, for Quarter 2. The January, February and March data submissions were processed with edits that counted toward submission pass/fail. Section II. Technical Documentation The Technical Documentation includes information on the fields calculated by the Division of Health Care Finance & Policy (DHCFP), and a data file summary section describing the hospital data that is contained in the file. The data file section contains the Discharge File Table (formerly the record layout), Revenue File Table, and Data Code Tables. Also included are revenue code mappings. For your reference, CD Specifications are listed in the following section to provide the necessary information to enable users to access files. Please note that as of October 1, 1999, certain regulatory changes were made to the format of the data. Please note that significant changes have been made to the Discharge File Table for FY2007. New fields and values have been added. Please see the new Discharge File Table in Part B. of the Technical Documentation section. Copies of Regulation 114.1 CMR 17.00: Requirement for the Submission of Hospital Case Mix and Charge Data and Regulation 114.5 CMR 2.00: Disclosure of Hospital Case Mix and Charge Data may be obtained by logging on to the Division’s web site at HYPERLINK "http://www.mass.gov/dhcfp/" http://www.mass.gov/dhcfp/, or by faxing a request to the Division at 617-727-7662, or by emailing a request to the Division at HYPERLINK "mailto:Public.Records@state.ma.us" Public.Records@state.ma.us. CD SPECIFICATIONS Hardware Requirements: * CD ROM Device * Hard Drive with 1.60 GB of space available CD Contents: * This CD contains the “Final / Full Year” 2007 Hospital Inpatient Discharge Data Product. It contains two Microsoft Access data base (MDB) files. The first file is the Discharge Table and contains one record per discharge. The second file is the Revenue Code Table that contains one record per revenue code reported for each discharge. The ProviderControlID and DischargeID are key fields on both tables to be utilized for linkage purposes. As an approved applicant, or its agent, you are reminded that you are bound by your application and confidentiality agreement to secure this data in a sufficient manner, so as to protect the confidentiality of the data subjects. File Naming Conventions: This CD contains self-extracting compressed files, using the file-naming convention below. “Hosp_Inpatient_Discharge_2007_L1_zipped.exe” will expand out to “Hosp_Inpatient_Discharge_2007_L1.mdb” “Hosp_Inpatient_Services_2007_zipped.exe” will expand out to “Hosp_Inpatient_Services_2007.mdb” In the above examples, 2007 represents Hospital Fiscal Year 2007 and L1 represents Level 1. To extract data from the CD and put it on your hard drive, select the CD file you need and double click on it. You will be prompted to enter the name of the target destination. SECTION I. GENERAL DOCUMENTATION PART A. BACKGROUND INFORMATION General Documentation Overview Quarterly Reporting Periods Development of the FY2007 HDD Data Base DRG Grouper Methodology PART A. BACKGROUND INFORMATION GENERAL DOCUMENTATION OVERVIEW The General Documentation consists of six sections: PART A. BACKGROUND INFORMATION: Provides information on the quarterly reporting periods, the development of the FY2007 hospital case mix database, and the DRG methodology used. PART B. DATA: Describes the basic data quality standards as contained in Regulation 114.1 CMR 17.00: Requirement for the Submission of Hospital Case Mix and Charge Data, some general data definitions, general data caveats, and information on specific data elements. Case mix data plays a vital and growing role in health care research and analysis. To ensure the database is as accurate as possible, the DHCFP strongly encourages hospitals to verify the accuracy of their data. A standard Verification Report Response Form is issued by the Division, and is used by each hospital to verify the accuracy of their data as it appears on their FY2007 Final Case-mix Verification Report. If a hospital finds data discrepancies, the DHCFP requests that the hospital submit written corrections that provide an accurate profile of that hospital’s discharges. Part C of the general documentation details hospital responses. PART C. HOSPITAL RESPONSES: Details hospital responses received as a result of the data verification process. From this section users can also learn which hospitals did not verify their data. This section contains the following lists and charts: Summary of Hospitals’ FY2007 Verification Report Responses List of Error Categories Summary of Reported Discrepancies by Category Index of Hospitals Reporting Discrepancies Individual Hospital Discrepancy Documentation PART D. CAUTIONARY USE HOSPITALS: Lists the hospitals for which the Division did not receive four (4) quarters of acceptable hospital discharge data, as specified under Regulation 114.1 CMR 17.00. PART E. HOSPITALS SUBMITTING DATA: Lists all hospitals submitting data for FY2007, and those that failed to provide any FY2007 data. Also lists hospital discharge and charge totals by quarter for data submissions. PART F. SUPPLEMENTARY INFORMATION: Provides Supplements I through VIII listed in the Table of Contents. Contains specific information on types of errors, hospital locations, and identification numbers. PART A. BACKGROUND INFORMATION 2. QUARTERLY REPORTING PERIODS Massachusetts hospitals are required to file case-mix data which describes various characteristics of their patient population, as well as the charges for services provided to their patients in accordance with Regulation 114.1 CMR 17.00. Hospitals report data to the Division on a quarterly basis. For the 2007 period, these quarterly reporting intervals were as follows: Quarter 1: October 1, 2006 – December 31, 2006 Quarter 2: January 1, 2007 – March 31, 2007 Quarter 3: April 1, 2007 – June 30, 2007 Quarter 4: July 1, 2007 – September 30, 2007 PART A. BACKGROUND INFORMATION 3. DEVELOPMENT OF THE FISCAL YEAR 2007 DATABASE Please note that the Division issued new submission specifications that took effect on October 1, 2006 for the FY2007 data base. The new specifications changed the database significantly. There are both new fields and new code values, as well as changes to certain existing code values. Further details are provided under the Data File contents section. In 2001, the Division significantly restructured its Information System that produces the Hospital Case Mix and Charge Database. Two of the Division’s objectives were to improve operational efficiency as well as to improve the quality of the database for data users. Improved data cleaning, integrity checks, and modification to the file structure were just a few ways we worked to improve the database. Additions that went into effect on October 1, 2001 included an ER indicator and an Observation indicator. Further detail is provided under the Data File Contents section. Six Fiscal Year 2007 data levels have been created to correspond to the levels in Regulation 114.5 CMR 2.00; “Disclosure of Hospital Case Mix and Charge Data”. (Please note that in the past, for the lower levels of data, deniable elements were not included in the database at all. This year, the deniable elements will merely be suppressed.) The user will have access to deniable data elements depending on the level of data for which they have been approved, and as specified for the various levels below. Higher levels contain an increasing number of the data elements defined as “Deniable Data Elements” in Regulation 114.5 CMR 2.00. The deniable data elements include: medical record number, billing number, Medicaid Claim Certificate Number (Medicaid Recipient ID number), unique health information (UHIN) number, date of admission, date of discharge, date of birth, date(s) of surgery, and the unique physician number (UPN). The six levels include: LEVEL I Contains all case mix data elements, except the deniable data elements LEVEL II Contains all Level I data elements, plus the UPN LEVEL III Contains all Level I data elements, plus the patient UHIN, the mother’s UHIN, an admission sequence number for each UHIN admission record, and may include the number of days between inpatient stays for each UHIN record. LEVEL IV Contains all Level I data elements, plus the UPN, the UHIN, the mother’s UHIN, an admission sequence number for each UHIN admission record, and may include the number of days between inpatient stays for each UHIN record. LEVEL V Contains all Level IV data elements, plus the date of admission, date of discharge, and the date(s) of surgery. LEVEL VI Contains all of the deniable data elements except the patient identifier component of the Medicaid recipient ID number. PART A. BACKGROUND INFORMATION 4. DRG GROUPERS: The FY2007 Hospital Discharge database has been grouped with 4 groupers: 1) All Patient Version 12.0 2) All Patient Version 21.0 3) All Patient Refined Version 20.0 4) Centers for Medicare and Medicaid Services (CMS) V24.0 Beginning in October 1991, the DHCFP began using 3M’s All-Patient Grouper to classify all patient discharges for hospital’s profiles of discharges and for the yearly database. This change in the grouping methodology was made because the All-Patient DRG better represented the general population and provided improvements in areas such as Newborns and the HIV population. As part of the landmark health care reform legislation passed in April 2006, as well as careful consideration of the analytic work the Division is mandated to perform, the hospital discharge database contains one new grouping classification: Centers for Medicare and Medicaid Services (CMS) Version 24.0. Additionally, the All Patient Refined Grouper was upgraded from Version 15.0 to Version 20.0. Two All Patient DRG groupers were dropped: V14.1 and V18.0. The All Patient-DRG methodology (Version 12.0, and 21.0) as well as the All Patient Refined DRG methodology (Version 20.0) is not totally congruent with the ICD-9-CM procedure and diagnosis codes in effect for this fiscal year. Therefore, it was necessary to convert some ICD-9-CM codes to those acceptable to these groupers. The DHCFP mapped the applicable ICD-9-CM codes into a clinically representative code using the historical mapper utility provided by 3M Health Information Systems. This conversion was done internally for the purpose of DRG assignment and in no way alters the original ICD-9-CM codes that appear on the database. These codes remain on the database as they were reported by the hospitals. The Division uses the version of the CMS grouper compatible with the fiscal year. Consequently, mapping ICD-9-CM codes is not necessary for this grouping system. There are several birth weight options within the 3M Grouper software for determining newborn DRG assignment. Option 5, which determines the newborn DRG by inferring the birth weight from the ICD-9-CM code, is used as the birth weight option in implementations of groupers AP V12.0, V21.0 and APR V20.0. Birth Weight option is not applicable to the CMS grouper. DRGs and the Verification Report Process The hospital’s profile of discharges, grouped by APR 20.0, is part of the verification report. Hospitals only comment on this grouped profile. PART A. BACKGROUND INFORMATION 4. DRG GROUPERS - Continued: All Patient Refined Grouper (3M APR-DRG 20.0) The All Patient Refined DRGs (3M APR-DRG) are a severity/risk adjusted classification system that provide a more effective means of adjusting for patient differences. APR-Version 20.0 replaces the previously used APR V15.0. The 3M APR-DRGs expand the basic DRG structure by adding four subclasses to each illness and risk of mortality. Severity of illness and risk of mortality relate to distinct patient attributes. Severity of illness relates to the extent of physiologic decompensation or organ system loss of function experience by the patient, while risk of mortality relates to the likelihood of dying. For example, a patient with acute cholecystitis as the only secondary diagnosis is considered a major severity of illness but a minor risk of mortality. The severity of illness is major since there is significant organ system loss of function associated with acute cholecystitis. However, it is unlikely that the acute cholecystitis alone will result in patient mortality and thus, the risk of mortality for this patient is minor. If additional diagnoses are present along with the acute cholecystitis, patient severity of illness and risk of mortality may increase. For example, if peritonitis is present along with the acute cholecystitis, the patient is considered an extreme severity of illness and a major risk of mortality. Since severity of illness and risk of mortality are distinct patient attributes, separate subclasses are assigned to a patient for severity of illness and risk of mortality. Thus, in the APR-DRG system, a patient is assigned three distinct descriptors: The base APR-DRG (e.g., APR-DRG 194 – Heart Failure or APR-DRG 440 – Kidney Transplant) The severity of illness subclass The risk of mortality subclass The four severity of illness subclasses and the four risk of mortality subclasses are numbered sequentially from 1 to 4 indicating respectively, can not be assigned, minor, moderate, major, or extreme severity of illness or risk of mortality. For a handful of discharges, the risk of mortality and/or the severity of illness indicator(s) can not be assigned due to data or ICD-9-CM coding errors. In these cases, the risk of mortality and/or the severity of illness indicator(s) are assigned a code of ‘0’. DRG Groupers: All Patient Refined Grouper V. 20.0 - Continued The Division’s FY 2007 Discharge Database contains the APR- DRG 20.0, the APR-MDC 20.0, the severity subclass, and the mortality subclass. For applications such as evaluating resource use or establishing patient care guidelines, the 3M APR-DRGs in conjunction with severity of illness subclass is used. The severity subclass data can be found in the Discharge File Table Summary in the variable named “APR – V20 Severity Level”.1 For evaluating patient mortality, the 3M APR-DRG in conjunction with the risk of mortality subclass is used. The mortality subclass data can be found in the Discharge File Table in the variable named “APR – V20 Mortality Level”. Please note that the Division maintains listings of the DRG numbers and associated descriptions for all DRG Groupers included in the database. These are available upon request. Massachusetts-specific cost weights were developed for the All Patient Refined DRG Grouper (Version 20.0) and may be utilized with the information contained in the database. PART B. DATA 1. Data Quality Standards 2. General Definitions 3. General Data Caveats 4. Specific Data Elements PART B. DATA 1. DATA QUALITY STANDARDS The Case Mix Requirement Regulation 114.1 CMR 17.00 requires hospitals to submit case mix and charge data to the Division 75 days after each quarter. The quarterly data is edited for compliance with regulatory requirements, as specified in Regulation 114.1 CMR 17.00: Requirement for the Submission of Hospital Case Mix and Charge Data, using a one percent error rate. The one percent error rate is based upon the presence of Type A and Type B errors as follows: Type A: One error per discharge causes rejection of discharge. Type B: Two errors per discharge cause rejection of discharge. If one percent or more of the discharges are rejected, the entire submission is rejected by the DHCFP. These edits primarily check for valid codes, correct formatting, and presence of the required data elements. Please see Supplement I for a list of data elements categorized by error type. Each hospital receives a quarterly error report displaying invalid discharge information. Quarterly data which does not meet the one percent compliance standard must be resubmitted by the individual hospital until the standard is met. Verification Report Process The verification report process is intended to present the hospitals with a profile of their individual data as reported and retained by the Division. The purpose of this process is to function as a quality control measure for hospitals. It allows the hospitals the opportunity to review the data they have provided to the Division and affirm its accuracy. The Verification Report itself is a series of frequency reports covering the selected data elements including the number of discharges, amount of charges by accommodation and ancillary center, and listing of Diagnostic Related Groups (DRGs). Please refer to Supplement II for a description of the Verification Report contents. PART B. DATA 1. DATA QUALITY STANDARDS Verification Report Process – Continued The Verification Report is produced after a hospital has successfully submitted the four quarters of data. The hospital is then asked to review and verify the data contained within the report. Hospitals need to affirm to the Division that the data reported is accurate or to identify any discrepancies. All hospitals are strongly encouraged to closely review their report for inaccuracies and to make corrections so that subsequent quarters of data will be accurate. Hospitals are then asked to certify the accuracy of their data by completing a Case Mix Verification Report Response Form. The Verification Report Response Form allows for two types of responses as follows: “A” Response: By checking this category, a hospital indicates its agreement that the data appearing on the Verification Report is accurate and that it represents the hospital’s case mix profile. “B” Response: By checking this category, a hospital indicates that the data on the report is accurate except for the discrepancies noted. If any data discrepancies exist (e.g., a “B” response), the Division requests that hospitals provide written explanations of the discrepancies, so that they may be included in this General Documentation Manual. Note: The verification reports are available for review. Please direct requests to the attention of Public Records by facsimile to fax # 617-727-7662. PART B. DATA 2. GENERAL DEFINITIONS Before turning to a description of the specific data elements, several basic definitions (as contained in Regulation 114.1 CMR 17.00: Requirement for the Submission of Hospital Case Mix and Charge Data) should be noted. Case Mix Data Case specific, diagnostic discharge data which includes both clinical data, such as medical reason for admission, treatment, and services provided to the patient, and duration and status of the patient’s stay in the hospital; and socio-demographic data such as sex, race, expected payer, and patient zip code. Charge Data The full, undiscounted total and service-specific charges billed by the hospital to the general public. Ancillary Services The services and their definitions as specified in the DHCFP Hospital Uniform Reporting Manual (HURM) s. 3243, promulgated under 114.1 CMR 4.00. Reporting codes are defined in 114.1 CMR 17.06 (2)(c), and include physical therapy, laboratory, and respiratory services. Routine Services The services and their definitions as specified in DHCFP’s HURM s. 3241, promulgated under 114.1 CMR 4.00. Reporting codes are defined in 114.1 CMR 17.06(2)(a) and include medical/surgical, obstetrics, and pediatrics. Special Care Units The units which provide patient care of a more intensive nature than provided to the usual medical, obstetrical, or pediatric patient. These units are staffed with specially trained nursing personnel, and contain monitoring and specialized support equipment for patients who require intense, comprehensive care. Leave of Absence Days The number of days of a patient’s absence during a hospital stay, with physician approval, but without formal discharge and readmission to the facility. PART B. DATA 3. GENERAL DATA CAVEATS The following general data caveats have been developed from the Division’s Case Mix Data Advisory Group, staff members at the Massachusetts Hospital Association (MHA), the Massachusetts Health Data Consortium (MHDC), and the numerous admitting, medical records, financial, administrative, and data processing personnel who call to comment on the Division’s procedural requirements. Information may not be entirely consistent from hospital to hospital due to differences in: Collection and Verification of Patient supplied information before or at admission; Medical record coding, consistency, and/or completeness; Extent of hospital data processing capabilities; Flexibility of hospital data processing systems; Varying degrees of commitment to quality of merged case mix and charge data; Capacity of financial processing system to record late occurring charges on the Division of Health Care Finance and Policy’s electronic submission; Non-comparability of data collection and reporting. Case Mix Data In general terms, the case mix data is derived from patient discharge summaries, which can be traced to information gathered upon admission, or from information entered by admitting and attending physicians into the medical record. The quality of the case mix data is dependent upon hospital data collection policies and coding practices of the medical record staff, as well as the DRG optimizing software used by the hospital. PART B. DATA 3. GENERAL DATA CAVEATS - Continued Charge Data Issues to consider with charge data: A few hospitals do not have the capacity to add late occurring charges to their electronic submission within the present time frames for submitting data. In some hospitals, “days billed” or “accommodation charges” may not equal the length of the patient’s stay in the hospital. One should note that charges are a reflection of the hospital’s pricing strategy and may not be indicative of the cost of patient care delivery. Expanded Data Elements Care should also be used when examining data elements that have been expanded, especially when analyzing multi-year trends. In order to maintain consistency across years, it may be necessary to merge some of the expanded codes. For example, the Patient Disposition codes were expanded as of January 1, 1994 to include a new code for “Discharged/Transferred to a Rehab Hospital”. Prior to this quarter, these discharges would have been reported under the code “Discharged/Transferred to Chronic or Rehab Hospital” which itself was changed to “Discharged/Transferred to Chronic Hospital”. If examining these codes across years, one will need to combine the “rehab” and “chronic” codes in the data beginning January 1, 1994. PART B. DATA 4. SPECIFIC DATA ELEMENTS The purpose of the following section is to provide the user with an explanation of some of the data elements included in Regulation 114.1 CMR 17.00, and to give a sense of their reliability. a. Existing Data Elements DPH Hospital ID Number – REPLACED with Org ID for FY2007 The Massachusetts Department of Public Health’s four-digit identification number. (See Supplement III). Please note that DPH Hospital ID number has been replaced with Org ID for FY2007, beginning October 1, 2006. Patient Race The accuracy of the reporting of this data element for any given hospital is difficult to ascertain. Therefore, the user should be aware that the distribution of patients for this data element may not represent an accurate grouping of the hospital’s population. Leave of Absence (LOA) Days Hospitals are required to report these days to the Division, if they are used. At present, the Division is unable to verify the use of these days if they are not reported, nor can the Division verify the number reported if a hospital does provide the information. Therefore, the user should be aware that the validity of this category relies solely on the accuracy of a given hospital’s reporting practices. Principal External Cause of Injury Code The ICD-9-CM code categorizes the event and condition describing the principal external cause of injuries, poisonings, and adverse effects. Unique Physician Number (UPN) The encrypted Massachusetts Board of Registration in Medicine’s license number for the attending and operating physician. Physicians that do not have Board of Registration in Medicine license numbers that are submitted in the Hospital Discharge Database as DENSG, PODTR, and OTHER (codes for Dental Surgeon, Podiatrist, and Other physician) appear in the AttendingPhysID and OperatingPhysID fields as MMMMM or MMMMM3?. MIDWIF (the code for Midwife) appears in the AttendingPhysID and OperatingPhysID fields as K##### or K######. PART B. DATA 4. SPECIFIC DATA ELEMENTS a. Existing Data Elements - Continued Payer Codes In January 1994, payer information was expanded to include payer type and payer source. Payer type is the general payer category, such as HMO, Commercial, or Workers’ Compensation. Payer source is the specific health care coverage plan, such as Harvard Pilgrim Health Plan or Aetna Life Insurance. Over the years, payer type and payer source codes have been further expanded and updated to reflect the current industry. Effective October 1, 1997, payer type codes started to include Point-Of-Service Plan (POS) and Exclusive Provider Organization (EPO). Effective October 1, 1999, payer type codes were updated for #21 – Commonwealth PPO to Type E – PPO (formerly type C – BCBS). Also effective on this date, payer source codes were expanded to include: 203 – Principal Financial Group; 204 – Christian Brothers; and 271 – Hillcrest HMO. This year, the Division added a new Payer Type ‘Q’ for the Commonwealth Care category, and new Payer Sources for the Commonwealth Care plans. A complete listing of Payer types and sources, including the new codes, can be found in this manual under Part F. Supplementary Information. Source of Admission In January 1994, three new sources of admission were added: ambulatory surgery, observation, and extramural birth (for newborns). The codes were further expanded effective October 1, 1997, to better define each admission source. Physician referral was further clarified as “Direct Physician Referral” (versus calling a health plan for an HMO Referral or Direct Health Plan Referral”). “Clinic Referral” was separated into “Within Hospital Clinic Referral” and “Outside Hospital Clinic Referral”. And “Emergency Room Transfer was further delineated to include “Outside Hospital Emergency Room Transfers” and “Walk-In/Self-Referrals”. (The latter was added to reflect the fact that Walk-In/Self-Referrals are a common source of admission in hospital emergency rooms.) Effective October 1, 1999, the Division added a new data element, Secondary Source of Admission, as well as a new source of admission code, “Transfer from Within Hospital Emergency Room”, These additions were intended to accommodate those patients with two sources of admission (for example, patients transferred twice prior to being admitted). It is important to note that the code “Transfer from Within” is intended to be used as a Secondary Source of PART B. DATA 4. SPECIFIC DATA ELEMENTS a. Existing Data Elements - Continued Source of Admission Admission only, except in cases where the hospital is unable to determine the originating or primary source of admission. Patient Disposition Six new discharge/transfer categories were added in January 1994 and October 1997. 1) Code 05: To another type of institution for inpatient care or referred for outpatient services to another institution; 2) Code 08: To home under care of a Home IV Drug Therapy Provider; 3) Code 13: To rehab hospital 4) Code 14: To rest home 5) Code 50: Discharged to Hospice – Home (added 10/1/97) 6) Code 51: Discharged to Hospice Medical Facility (added 10/1/97) Accommodation and Ancillary Revenue Codes Accommodation and Ancillary Revenue Codes have been expanded to coincide with the current UB-92 Revenue Codes. Effective October 1, 1997, new Accommodation Revenue codes were added for Chronic (code 192), Subacute (code 196), Transitional Care Unit (TCU) (code 197), and for Skilled Nursing Facility (SNF) (code 198). Also, effective in 1998, Ancillary Revenue Code 760 was separated into individual UB-92 components which include Treatment Room (code 761), Observation Room (code 762), and Other Observation Room (code 769). Please note that the required standard unit of service for codes 762 and 769 is “hours”. Unique Health Identification Number (UHIN) The patient’s social security number is reported as a nine-digit number, which is then encrypted by the Division into a Unique Health Information Number (UHIN). Therefore, a social security number is never considered a case mix data element. Only the UHIN is considered a database element and only the encrypted number is used by the Division. Please note that per regulation 114.1 CMR 17.00, the number reported for the patient’s social security number should be the patient’s social security number, not the social security number of some other person, such as the husband or wife of the patient. Likewise, the social security number for the mother of a newborn should not be reported in this field, as there exists a separate field designated for social security number of the newborn’s mother. PART B. DATA 4. SPECIFIC DATA ELEMENTS b. New Data Elements (as of October 1, 2006) Effective October 1, 2006, the following new data elements were added to Regulation 114.1 CMR 17.00. Additionally, new code values were added for race and patient status. Please note that implementation took place in two phases. Race: Previously there was a single field to report patient race. Beginning this year, there are three fields to report race. Race 1, Race 2, and Other Race (a free text field for reporting any additional races). Also, race codes have been updated. Please see the Data Codes section for a listing of updated values. These are consistent with both the federal OMB standards and code set values, and the EOHHS Standards for Massachusetts. Hispanic Indicator: A flag to indicate whether the patient is or is not Hispanic/Latino/Spanish. Ethnicity: Three fields – separate from patient race -- to report patient ethnicity. Ethnicity 1, Ethnicity 2, and Other Ethnicity (a free text field for reporting additional ethnicities). Please see the Data Codes section for a listing of the 33 ethnicities. Homeless Indicator: A flag to indicate whether the patient is or is not known to be homeless. Condition Present on Admission Indicator: This is a qualifier for each diagnosis code (Primary, Diagnosis I – XIV, and primary E-Code field) indicating onset of diagnosis preceded or followed admission. Permanent & Temporary US Patient Address: Patient address now includes the following fields: Patient Street Address Patient City/Town Patient State Permanent Patient Country (ISO-3166) New Zip Code Requirements: Zip codes must be 0’s if unknown or if the patient country is not the United States. New Patient Status Values: Please see data codes section for new values. Values were updated to be consistent with UB-92 standards. HCF Organization ID: This replaces the MDPH Hospital Computer #. Previously this was reported for ED data only. Transfer Hospital Org ID: Organization ID of the transferring hospital, if any. Hospital Service Site Reference: OrgID for site of service. Surgeon License Number & Date: Expanded from 3 to 15 procedures. New Data Elements (as of October 1, 2001) Effective October 1, 2001, two new data elements were added to Regulation 114.1 CMR 17.00 – en ER indicator and an Observation indicator. ER Indicator A flag to indicate whether the patient was admitted from the hospital’s emergency department. Observation Indicator A flag to indicate whether the patient was admitted from the hospital’s outpatient observation department. New Payer Sources The following new payer sources were added as of October 1, 2001: 207 – Network Health (Cambridge Health Alliance MCD Program) 208 – HealthNet Boston (Boston Medical Center MCD Program) 272 – Auto Insurance 990 – Free Care – co-pay, deductible, or co-insurance (for use with #143) New Payer Type One new payer type was added – Auto Insurance (Code T – Abbreviation AI). New Data Elements (as of October 1, 1999) Effective October 1, 1999, several new data elements were added to Regulation 114.1 CMR 17.00. They are as follows. Secondary Source of Admission A code indicating the source of referring or transferring the patient to inpatient status in the hospital. The Primary Source of Admission is the originating, referring, or transferring facility or primary referral source causing the patient to enter the hospital’s care. The secondary source of admission is the secondary referring or transferring source for the patient. For example, if a patient has been transferred from a SNF to the hospital’s Clinic and is then admitted, the Primary Source of Admission is reported as “5 – Transfer from a SNF” and the Secondary Source of Admission is reported as “Within Hospital Clinic Referral”. PART B. DATA 4. SPECIFIC DATA ELEMENTS New Data Elements (as of October 1, 1999) – Continued Do Not Resuscitate (DNR) Status A status indicating that the patient had a physician order not to resuscitate or the patient had a status of receiving palliative care only. Do not resuscitate status means not to revive a patient from potential or apparent death or that a patient was being treated with comfort measures only. Mother’s Social Security Number (for infants up to one year old) The social security number of the patient’s mother reported as a nine-digit number for newborns or for infants less than 1 year old. The mother’s social security number is encrypted into a Unique Health Information Number (UHIN) and is never considered a case mix data element. Only the UHIN is considered a database element and only this encrypted number is used by the Division. Mother’s Medical Record Number (for newborns born in the hospital) The medical record number assigned within the hospital to the newborn’s mother. This medical record number distinguishes the patient’s mother and the patient’s mother’s hospital record(s) from all others in that institution. Facility Site Number A hospital determined number used to distinguish multiple sites that fall under one organizational ID number. Organization ID A unique facility number assigned by the Division. Associated Diagnosis 9 – 14 This data element has been expanded to allow for up to 14 diagnoses. Nurse Midwife Code for ATT and OP MD License Field Other Caregiver Field The primary caregiver responsible for the patient’s care other than the attending physician, operating room physician, or nurse midwife as specified in the Regulation. Other caregiver includes resident, intern, nurse practitioner, and physician’s assistant. Attending, Operating, and Additional Caregiver National Provider Identifier Fields Please note that these are not yet part of the database. They are just placeholders for when they are implemented. These data elements will be required when available on a national basis. PART B. DATA c. Important Note Regarding the Use of Race Codes Beginning in FY07, the Division will use the federal OMB standard race codes and code set values. These are also consistent with the EOHHS standards for Massachusetts. There are now three fields for reporting race. Race 1 and Race 2 require the use of one of the 2-digit codes (R1-R5) in the table below. Other Race is a free text field for reporting additional races. Please see the following table for new HCF Race Codes: New Race CodeDescriptionR1American Indian /Alaska NativeR2AsianR3Black/African AmericanR4Native Hawaiian or Other Pacific IslanderR5WhiteR9Other RaceUnknowUnknown/not specified Race Code Data for FY2006 and prior years If you have used data in previous years, you may have noted that the Race_Code information in the Inpatient file prior to FY2000 was inconsistent with the way the data was reported to the Division. Furthermore, the Inpatient data product was inconsistent with other data products, such as the Outpatient Observation data product. In FY2000, we corrected this inconsistency by standardizing the Race Code as the following table shows. Please note that to compare pre-FY2000 Inpatient data to data submitted between FY2000 – FY2006, you will have to standardize using the translation table below. Race CodeDescriptionPre-2000 Inpatient FIPA Code1WhiteWhite2BlackBlack3AsianOther4HispanicUnknown5American IndianAmerican Indian6OtherAsian9UnknownHispanic *This format is consistent across all Division data products for these fiscal years, except pre-2000 Inpatient, and was the same format as reported to the Division. PART B. DATA d. Expanded Race and Ethnicity Data Collection Beginning in FY2007, the Division expanded its reporting requirements for Race and added new fields for reporting Ethnicity. Previously, the requirements included only one Race field with seven choices for reporting race: White, Black, Asian, Hispanic, American Indian, Unknown, and Other. For FY2007, the number of Race fields increased from one to three race fields and Hispanic was separated from Race to its own data element, the Hispanic Indicator. Also, Ethnicity was added as a new reporting requirement. Three new Ethnicity fields were added, each allowing up to 33 different Ethnicity choices for reporting. Hospitals were required by the Division to implement these changes for the Hospital Discharge Data for FY2007 data (October 1, 2006 – September 30, 2007). Hospitals are required to report at least Race 1, Hispanic Y/N and Ethnicity 1 and can provide additional race or ethnicity information in the other fields. Modifications to reporting Race data were one of many major changes in addition to new data field requirements for hospitals reporting FY2007 discharge data. As a result of the significant changes that hospitals and hospital vendors needed to make for the FY2007 data, the Division phased in the implementation process. This transitional approach allowed hospitals to implement new collection processes as well as make the necessary programming changes to submit the new information. The structure of the new fields was required in the data layout beginning FY2007 Quarter 1 (October 1, 2006). However, race and ethnicity data were not required to be reported in the data fields until Quarter 3 (April 1, 2007) to allow for hospitals to complete programming changes and staff training. Hospitals have shown steady improvement over the year for both Inpatient and the ED Discharge Data since the new race and ethnicity data was required for reporting for the quarter beginning April 1, 2007. Overall, Race 1 and the Hispanic Indicator are complete without missing data for Q3 and Q4. Only one hospital has reported an incorrect value for Race 1 for Inpatient Hospital Discharge Data (HDD) across the year due to technical reporting problems. There are only two ED hospitals that reported a significant percent of “Unknown Race” or “Other Race”, one that reported close to 50% “Unknown Race” and the other that reported greater than 50% “Unknown” and “Other Race” (when combined) throughout the year. Hospital reporting for Ethnicity shows a larger number of hospitals consistently reporting a higher number of discharges with missing, “American” or “Unknown” throughout the year for both Inpatient and ED. For Q3 & Q4 Ethnicity reporting, there are only 6 hospitals that have no missing data or American values and also have low numbers for “Unknown.” PART B. DATA d. Expanded Race and Ethnicity Data Collection Highlights of FY07 Q3 & Q4 Inpatient Statewide Breakout for Race, Hispanic Indicator, Ethnicity (ED similar): Race 1: 80% White, 7% Black/African American, 6% Unknown, 6% Other, Asian 2% Hispanic Indicator: 7% Hispanic Yes Ethnicity 1: 45% American, 21% Unknown/Blank, 13% European, 6% Other, 3% African American, 3% Puerto Rican Highlights of FY07 Q3 & Q4 Inpatient Free Text Race and Ethnicity Fields: When Race 1 is Unknown, Race free text field is: 88% blank, 5% unknown, 2% declined, 3% other When Race 1 is Other, Race free text is: 34% Hispanic, 11% of blank, 19% unknown, 9% other When Ethnicity 1 is Unknown, Ethnicity free text is: 94% blank, 2% is unknown, 2% declined When Ethnicity 1 is Other, Ethnicity free text is: 24% blank, 30% declined, 22% other, 3% unknown, 3% American, 2% Irish (in combination with some other ethnicity) When Ethnicity 1 is American, Ethnicity free text is: 95% blank, 4% unknown When Ethnicity 1 is American, Ethnicity 2 is: 92% blank, 4% unknown, 2% European Highlights Data Quality for Inpatient Race 1, Ethnicity 1 and Hispanic Indicator: One hospital reported greater than 70% of American Indian for Q1-Q4 for inpatient data (This hospital has been contacted to correct this issue.) Race 1 and Hispanic Indicator Q3 & Q4: No hospitals with missing data Race 1 Unknown Q3 & Q4: Only one hospital had > 20% (This hospital has been contacted to correct this issue.) Ethnicity 1 missing for Q3 and Q4: Only six hospitals reported >20% missing for Q3 and/or Q4 Ethnicity 1 Unknown for Q3 and Q4: Eight hospitals reported >25% unknown ethnicity PART B. DATA d. Expanded Race and Ethnicity Data Collection Overview of Race, Ethnicity & Hispanic Indicator Reporting FY2007 (Note: Data not required until Q3) ElementIssueDataQ1Q2Q3Q4 RACE 1Missing DataHDDSix hospitals with 100% missing; four w/ 40-69% missing data. Five hospitals with 100% missing; one with 62% missing data. No hospitals with > 5% missing dataNo hospitals with > 5% missing dataEDEleven hospitals with 100% missing; three w/ 31-86% missing data.Four hospitals with 100% missing; one with 76% missing data; No hospitals with > 5% missing dataNo hospitals with > 5% missing dataUnknownHDDSix hospitals with 34-100% reporting unknown; all other below 15%One hospital with 21% reporting unknown; all others below 20%One hospital reporting 25% unknown; all others 19% or belowOne hospital reporting 25% unknown; all others below 16%EDFour hospitals with 39-99% reporting unknown; all others below 18%Three hospitals reporting 31-47% unknown; all others below 18%Four hospitals reporting 23-44% unknown; all others less than 15%Four hospitals reporting 21-44%; all others reporting below 15%OtherHDDNo hospitals reporting > 10% otherNo hospitals reporting > 10% otherNo hospitals with > 10%otherNo hospitals with >10% otherEDFour hospitals reporting between 25-45% otherThree hospitals reporting between 25-27% otherTwo hospitals reporting between 27-29% otherTwo hospitals reporting between 26-30% otherIncorrect ValueHDDOne hospital reporting 54% R1-American Indian/Alaska NativeOne hospital reporting 66% R1One hospital reporting 80% R1One hospital reporting 82% R1ETHNICITY 1Missing DataHDD51 hospitals with 90%+ missing data; three w/65-87% missing20 hospitals with 90%+ missing data; 14 w/20-89% missingFive hospitals with 10-59% missing dataSeven hospitals with 15-50% missing dataED42 hospitals with 90% or more missing data; five w/53-86% missing14 hospitals with 90%+missing data; 12 w/18-75% missingThree hospitals with 26-47% missing dataFive hospitals with 10-39% missing dataUnknownHDDEight hospitals with 90% or more unknown Ethnicity; four hospitals have 64-85%; three w/16-35% unknown.Three hospitals with 77-80% unknown Ethnicity; 18 hospitals with 20-50%; 13 with 11-19% unknown. Three hospitals with 83-100% unknown; 19 with 20-54% unknown; ten with <20% unknown.Three hospitals with 82-100% unknown; eight with 20-56% unknown; 18 with <20% unknown.ED12 hospitals 97-100% unknown; three with 40-86% unknown; one w/15% unknown.One hospital w/100% unknown; five w/20-75%; seven with < 17%Two hospitals w/97-100%; five w/35-75%; five <17% unknownOne hospital w/100%; two w/34-46%; four <13% unknownOtherHDDOne hospital reported high other 41% Two hospitals w/high other 21% and 35%Three hospitals with high other 32-63%; one w/11% Three hospitals reported high other 32-63%;EDThree w/ 93, 37 and 12%Three w/36-61%; two w/11%Three w/24-42%; one w/12%Three w/25-42%; two w/11%AmericanHDDFive hospitals > 50%18 hospitals > 50%43 hospitals > 50%45 hospitals > 50%EDFive hospitals reporting > 50% AmericanEight reporting 80-97% American;14 w/51-77%Five with >90%; 34 w/50-87%Fourteen w/83-95%; 29 w/51-79%PART B. DATA d. Expanded Race and Ethnicity Data Collection Overview of Race, Ethnicity & Hispanic Indicator Reporting FY2007 – Cont’d (Note: Data not required until Q3) ElementIssueDataQ1Q2Q3Q4HISPANIC INDICATORMissing DataHDD46 hospitals with 90%+ missing data; Nine with 48-89% missingEleven hospitals with 90%+ missing data; 11 hospitals w/10-61% missingNo hospitals with > 5% missing dataNo hospitals with > 5% missing dataED38 hospitals with 90%+ missing data; Ten with 20-89% missingNine hospitals with 90%+ missing data; Nine with 36-76% No hospitals with > 5% missing dataNo hospitals with > 5% missing data PART B. DATA d. Expanded Race and Ethnicity Data Collection FY2007 & FY2008* Statewide Distribution of Race 1 INPATIENTQ3 FY2007Q4 FY2007Q3 & Q4 FY2007FY2008*CodeDescriptionNumberPercentNumberPercentNumberPercentNumberPercent-Blank / Invalid250.01%170.01%420.01%140.00%R1American Indian/ Alaska Native4320.20%4200.20%8520.20%7200.09%R2Asian4,7342.20%4,9112.32%9,6452.26%20,2192.41%R3Black / African American14,0826.55%14,2836.75%28,3656.65%57,0016.79%R4Native Hawaiian or Other Pacific Islander1150.05%660.03%1810.04%2700.03%R5White171,68679.81%168,55079.63%340,23679.72%676,08780.48%R9Other Race12,1305.64%11,7305.54%23,8605.59%44,0125.24%UnknowUnknown11,9215.54%11,6825.52%23,6035.53%41,7794.97%Total215,125100.00%211,659100.00%426,784100.00%840,102100.00%*Preliminary data FY2006 Statewide Distribution of Race 1 – for comparison INPATIENTQ1Q2Q3,4FY2006HDDEDHDDEDHDDEDHDDEDBlank0.00%0.01%0.00%0.01%0.00%0.33%0.00%0.18%1 – White78.93%72.32%78.94%71.31%78.49%72.33%78.71%72.22%2 – Black6.26%9.41%6.16%9.56%6.09%9.10%6.15%9.30%3 – Asian1.90%1.43%1.92%1.48%2.00%1.45%1.95%1.45%4 – Hispanic6.70%10.13%6.64%10.65%6.70%10.13%6.68%10.27%5 – American Indian0.06%0.11%0.06%0.12%0.52%0.11%0.29%0.11%6 – Other3.60%3.66%3.78%3.73%3.64%3.56%3.67%3.63%9 – Unknown2.55%2.95%2.50%3.14%2.59%2.99%2.55%3.02%All Races100.00%100.00%100.00%100.00%100.00%100.00%100.00%100.00% PART B. DATA d. Expanded Race and Ethnicity Data Collection FY2007 & FY2008* Statewide Distribution of Race 2 INPATIENTQ3 FY2007Q4 FY2007Q3 & Q4 FY2007FY2008*CodeDescriptionNumberPercentNumberPercentNumberPercentNumberPercent-Blank / Invalid183,76385.42%178,57884.37%362,34184.90%717,71385.43%R1American Indian/ Alaska Native1130.05%960.05%2090.05%3460.04%R2Asian5610.26%6610.31%1,2220.29%2,2440.27%R3Black / African American2,9511.37%3,8261.81%6,7771.59%15,0111.79%R4Native Hawaiian or Other Pacific Islander140.01%220.01%360.01%580.01%R5White17,4738.12%17,7088.37%35,1818.24%63,5587.57%R9Other Race1,1850.55%1,2270.58%2,4120.57%3,8300.46%UnknowUnknown9,0654.21%9,5414.51%18,6064.36%37,3424.44%Total 215,125100.00%211,659100.00%426,784100.00%840,102100.00%*Preliminary data PART B. DATA d. Expanded Race and Ethnicity Data Collection FY2007 & FY2008* Statewide Distribution of Ethnicity 1 INPATIENTQ3 FY2007Q4 FY2007Q3 & Q4 FY2007FY2008*CodeDescriptionNumberPercentNumberPercentNumberPercentNumberPercentAMERCNAmerican95,90144.58%95,58545.16%191,48644.87%424,18850.49%2108-9European27,99513.01%27,77713.12%55,77213.07%125,11614.89%UNKNOWUnknown41,67919.37%35,28416.67%76,96318.03%98,07411.67%OTHEROther13,4416.25%12,5675.94%26,0086.09%44,3395.28%2058-6African American6,8403.18%7,2673.43%14,1073.31%29,8613.55%2180-8Puerto Rican5,1962.42%5,3432.52%10,5392.47%22,5182.68%PORTUGPortugese3,4051.58%3,3221.57%6,7271.58%14,4141.72%EASTEUEastern European2,7211.26%2,6041.23%5,3251.25%11,4271.36%-Blank4,9082.28%7,5433.56%12,4512.92%9,8391.17%2184-0Dominican1,5650.73%1,7130.81%3,2780.77%7,1610.85%2028-9Asian1,3470.63%1,3080.62%2,6550.62%5,3390.64%BRAZILBrazilian1,0150.47%1,1390.54%2,1540.50%4,8620.58%2071-9Haitian9030.42%1,0600.50%1,9630.46%4,3790.52%CVERDNCape Verdean9000.42%9850.47%1,8850.44%4,0390.48%RUSSIARussian8880.41%9270.44%1,8150.43%3,8850.46%2034-7Chinese7820.36%8060.38%1,5880.37%3,7750.45%2060-2African7500.35%8070.38%1,5570.36%3,6060.43%2118-8Middle Eastern7500.35%7610.36%1,5110.35%2,9750.35%2029-7Asian Indian5030.23%6130.29%1,1160.26%2,4940.30%2161-8Salvadoran3860.18%5690.27%9550.22%2,3920.28%CARIBICaribbean Island4660.22%4940.23%9600.22%2,1400.25%2047-9Vietnamese4160.19%4510.21%8670.20%2,0570.24%2157-6Guatemalan4510.21%5210.25%9720.23%1,9880.24%2033-9Cambodian3910.18%4110.19%8020.19%1,7150.20%2165-9South American (not otherwise specified)2830.13%3240.15%6070.14%1,3760.16%2148-5Mexican, Mexican American, Chicano2640.12%3270.15%5910.14%1,2120.14%2169-1Columbian1950.09%2790.13%4740.11%1,1240.13%2158-4Honduran1780.08%2280.11%4060.10%9150.11%2040-4Korean1350.06%1610.08%2960.07%7170.09%2155-0Central American (not otherwise specified)1150.05%1230.06%2380.06%5810.07%2182-4Cuban1400.07%1340.06%2740.06%5640.07%2039-6Japanese750.03%750.04%1500.04%4370.05%2036-2Filipino900.04%960.05%1860.04%3730.04%2041-2Laotian510.02%550.03%1060.02%2200.03%TOTAL215,125100.00%211,659100.00%426,784100.00%840,102100.00%*Preliminary data PART B. DATA d. Expanded Race and Ethnicity Data Collection FY2007 & FY2008* Statewide Distribution of Ethnicity 2 INPATIENTQ3 FY2007Q4 FY2007Q3 & Q4 FY2007FY2008*CodeDescriptionNumberPercentNumberPercentNumberPercentNumberPercent-Blank / Invalid19,297089.70%190,55190.03%383,52189.86%758,94890.34%2108-9European8,4343.92%8,2503.90%16,6843.91%30,7243.66%UNKNOWUnknown6,2882.92%6,0652.87%12,3532.89%24,6652.94%AMERCNAmerican2,8591.33%2,7751.31%5,6341.32%11,0171.31%OTHEROther1,9320.90%1,2810.61%3,2130.75%4,1350.49%EASTEUEastern European6480.30%6760.32%1,3240.31%2,3840.28%PORTUGPortugese4240.20%3700.17%7940.19%1,8570.22%2058-6African American2760.13%2360.11%5120.12%9450.11%2180-8Puerto Rican2440.11%2730.13%5170.12%9000.11%RUSSIARussian1650.08%1580.07%3230.08%6210.07%2184-0Dominican1170.05%1170.06%2340.05%4110.05%2118-8Middle Eastern840.04%1070.05%1910.04%3940.05%2047-9Vietnamese510.02%770.04%1280.03%3030.04%2034-7Chinese560.03%680.03%1240.03%2820.03%2060-2African670.03%610.03%1280.03%2400.03%2161-8Salvadoran350.02%470.02%820.02%2400.03%2071-9Haitian600.03%680.03%1280.03%2370.03%CARIBICaribbean Island440.02%450.02%890.02%2340.03%CVERDNCape Verdean370.02%720.03%1090.03%2190.03%BRAZILBrazilian580.03%380.02%960.02%2050.02%2028-9Asian320.01%370.02%690.02%1880.02%2165-9South American (not otherwise specified)310.01%330.02%640.02%1350.02%2029-7Asian Indian360.02%310.01%670.02%1260.01%2148-5Mexican, Mexican American, Chicano380.02%300.01%680.02%1110.01%2157-6Guatemalan200.01%360.02%560.01%1030.01%2158-4Honduran250.01%250.01%500.01%820.01%2169-1Columbian180.01%290.01%470.01%730.01%2033-9Cambodian190.01%290.01%480.01%710.01%2155-0Central American (not otherwise specified)130.01%110.01%240.01%560.01%2182-4Cuban150.01%170.01%320.01%540.01%2040-4Korean60.00%120.01%180.00%410.00%2039-6Japanese40.00%120.01%160.00%400.00%2036-2Filipino90.00%140.01%230.01%320.00%2041-2Laotian100.00%80.00%180.00%290.00%Total215,125100.00%211,659100.00%426,784100.00%840,102100.00%*Preliminary data PART B. DATA d. Expanded Race and Ethnicity Data Collection FY2007 & FY2008* Statewide Distribution of Hispanic Indicator INPATIENTQ3 FY2007Q4 FY2007Q3 & Q4 FY2007FY2008*CodeDescriptionNumberPercentNumberPercentNumberPercentNumberPercent-Blank / Invalid460.02%490.02%950.02%1810.02%NNo200,59793.25%196,49892.84%397,09593.05%779,99692.85%YYes14,4826.73%15,1127.14%29,5946.94%59,9257.13%TOTAL 215,125100.00%211,659100.00%426,784100.00%840,102100.00%*Preliminary data PART B. DATA d. Expanded Race and Ethnicity Data Collection Summary of Free Text Fields FY2007 HDD - Distribution of Free Text where Race 1 = Unknown CodeQ1Q2Q3Q4Q3 & 4FY2007Blank99.72%97.78%88.24%87.13%87.69%93.22%Unknown0.09%0.62%4.22%5.04%4.63%2.49%Other0.01%0.02%2.90%2.68%2.79%1.40%Declined0.00%0.08%2.11%2.31%2.21%1.12%Hispanic0.02%0.21%0.46%0.81%0.64%0.38%Spanish0.04%0.36%0.48%0.35%0.42%0.31%American0.00%0.01%0.00%0.01%0.01%0.00%All others combined0.11%0.92%1.59%1.66%1.63%1.07%Total100.00%100.00%100.00%100.00%100.00%100.00% FY2007 HDD - Distribution of Free Text where Race 1 = Other CodeQ1Q2Q3Q4Q3 & 4FY2007Blank78.63%60.32%13.39%9.19%11.29%40.38%Hispanic13.48%20.35%32.47%36.06%34.27%25.59%Unknown5.43%10.19%23.91%15.91%19.91%13.86%Other0.18%0.91%7.48%11.04%9.26%4.91%“2”0.00%0.87%3.90%5.95%4.93%2.68%Mixed0.00%0.01%4.36%4.59%4.48%2.24%“O”1.52%0.72%1.20%1.40%1.30%1.21%Spanish0.02%1.09%1.71%1.97%1.84%1.20%“U”0.08%0.77%1.64%1.50%1.57%1.00%Dominican0.02%0.11%1.59%1.83%1.71%0.89%Puerto0.01%0.21%1.18%1.37%1.28%0.69%Cape V0.04%0.43%0.76%1.39%1.08%0.66%Brazil0.05%0.30%0.54%0.64%0.59%0.38%Portug0.02%0.24%0.26%0.43%0.35%0.24%"6"0.00%0.06%0.35%0.44%0.40%0.21%All others combined0.53%3.43%5.70%6.28%5.99%3.99%Total100.00%100.00%100.00%100.00%100.00%100.00% FY2007 HDD - Distribution of Free Text Where Ethnicity 1 = Unknown CodeQ1Q2Q3Q4Q3 & 4FY2007Blank87.14%92.20%93.72%93.66%93.69%91.58%Unknown12.32%4.67%1.80%1.94%1.87%5.33%Declined0.14%0.73%1.76%1.38%1.57%1.01%Other0.00%0.00%1.06%1.43%1.25%0.62%Unavailable0.25%1.54%0.28%0.16%0.22%0.52%Swedish Plusn/an/a0.15%0.19%0.17%0.09%Scottish Plusn/an/a0.12%0.10%0.11%0.06%Unable to answern/an/a0.07%0.07%0.07%0.03%All others combined0.15%0.86%1.03%1.08%1.06%0.77%Total100.00%100.00%100.00%100.00%100.00%100.00% PART B. DATA d. Expanded Race and Ethnicity Data Collection Summary of Free Text Fields – Cont’d HDD FY2007 - Distribution of Free Text Where Ethnicity 1 = Other CodeQ1Q2Q3Q4Q3 & 4FY2007Blank72.70%35.58%24.54%23.82%24.18%29.75%Declined0.12%0.13%26.84%32.69%29.77%22.28%Other0.04%0.81%20.92%22.13%21.53%16.27%Unknown0.16%9.65%4.61%2.20%3.41%4.31%American5.15%9.54%3.71%1.59%2.65%4.08%Irish Plus6.62%10.25%2.57%1.89%2.23%3.98%Italian Plus4.16%6.48%1.82%1.38%1.60%2.66%Jewish Plus0.75%2.40%1.47%1.30%1.39%1.52%English Plus1.35%3.25%1.06%0.54%0.80%1.28%French Plus1.19%1.58%0.85%1.11%0.98%1.10%Canadian Plus0.32%0.89%1.00%1.22%1.11%1.01%American Plus*0.40%0.37%0.15%1.71%0.93%0.77%White0.16%0.78%1.18%0.29%0.74%0.71%French Candian Plus0.44%0.97%0.60%0.68%0.64%0.68%Swedish Plus0.20%1.10%0.51%0.41%0.46%0.56%Polish Plus0.44%0.96%0.45%0.24%0.35%0.46%Greek Plus0.36%0.91%0.36%0.33%0.35%0.44%German Plus0.44%0.99%0.31%0.25%0.28%0.42%Scottish Plus0.48%0.78%0.30%0.29%0.30%0.39%Indian Plus0.32%0.42%0.44%0.34%0.39%0.39%Spanish Plus0.55%0.73%0.16%0.14%0.15%0.28%Dutch Plus0.00%0.32%0.30%0.20%0.25%0.25%Lithuanian Plus0.04%0.19%0.19%0.25%0.22%0.20%Hispan0.04%0.34%0.19%0.14%0.17%0.19%Native American0.00%0.18%0.24%0.17%0.21%0.18%Armenian Plus0.20%0.36%0.11%0.09%0.10%0.15%All others combined3.37%10.04%5.12%4.60%4.86%5.69%Total100.00%100.00%100.00%100.00%100.00%100.00% FY2007 HDD - Distribution of Free Text Where Ethnicity 1 = American CodeQ1Q2Q3Q4Q3 & 4FY2007Blank99.62%94.09%94.89%95.07%94.98%95.08%Unknown0.11%5.13%3.49%3.45%3.47%3.60%White0.00%0.01%0.16%0.13%0.15%0.11%American0.01%0.01%0.06%0.03%0.05%0.03%Other0.00%0.01%0.04%0.02%0.03%0.02%Declined0.00%0.00%0.04%0.02%0.03%0.02%Hispan0.00%0.00%0.00%0.01%0.01%0.00%All others combined0.26%0.75%1.32%1.28%1.30%1.13%Total100.00%100.00%100.00%100.00%100.00%100.00% PART B. DATA d. Expanded Race and Ethnicity Data Collection Summary of Free Text Fields – Cont’d FY2007 HDD - Distribution of Ethnicity 2 where Ethnicity 1 = American CodeQ1Q2Q3Q4Q3 & 4FY2007Blank93.44%88.41%91.35%91.85%91.60%91.07%Unknown5.01%7.01%4.40%4.35%4.38%4.94%2108-9 - European 0.29%2.20%2.30%1.92%2.11%2.02%American0.85%1.57%1.08%1.08%1.08%1.17%Other0.08%0.09%0.22%0.13%0.18%0.15%East E0.01%0.21%0.15%0.14%0.15%0.15%Portu0.03%0.15%0.14%0.13%0.14%0.13%All others combined0.31%0.36%0.37%0.39%0.38%0.37%Total100.00%100.00%100.00%100.00%100.00%100.00% PART B. DATA e. DHCFP Calculated Fields Admission Sequence Number This calculated field indicates the chronological order of admissions for patients with multiple inpatient stays. A match with the UHIN only, is used to make the determination that a patient has had multiple stays.** Days Between UHIN Stays This calculated field indicates the number of days between each discharge and each consecutive admission for applicable patients. Again, a match with the UHIN only, is used to make a determination that a patient has been readmitted. (Please read the comments below.)** Analysis of UHIN data by the Division has turned up problems with some of the reported data. For a small number of hospitals, little or no UHIN data exists, as these hospitals failed to report patients’ social security numbers (SSN). Other hospitals reported the same SSN repeatedly, resulting in numerous admissions for one UHIN. In other cases, the demographic information (age, sex, etc.) was not consistent when a match did exist with the UHIN. Some explanations for this include assignment of a mother’s SSN to her infant or assignment of a spouse’s SSN to a patient. This demographic analysis shows a probable error rate in the range of 2% – 10%. In the past, the DHCFP has found that, on average, 91% if the SSNs submitted are valid when edited for compliance with rules issued by the Social Security Administration. Staff continually monitors the encryption process to ensure that duplicate UHINs are not inappropriately generated, and that recurring SSNs consistently encrypt to the same UHIN. Only valid SSNs are encrypted to a UHIN. It is valid for hospitals to report that the SSN is unknown. In these cases, the UHIN appears as ‘000000001’. Invalid SSNs are assigned 7 or 8 dashes and an error code. The list of error codes is as follows: ssn_empty = 1 ssn_notninechars = 2 ssn_allcharsequal = 3 ssn_firstthreecharszero = 4 ssn_midtwocharszero = 5 ssn_lastfourcharszero = 6 ssn_notnumeric = 7 ssn_rangeinvalid = 8 ssn_erroroccurred = 9 ssn_encrypterror = 10 **Based on these findings, the DHCFP strongly suggests that users perform some qualitative checks of the data prior to drawing conclusions about that data. PART C. HOSPITAL RESPONSES Summary of Hospitals’ FY2007 Final Verification Report Responses List of Error Categories Summary of Reported Discrepancies By Category Index of Hospitals Reporting Data Discrepancies Individual Hospital Discrepancy Documentation PART C. HOSPITAL RESPONSES Summary of Hospitals’ FY 2007 Final Verification Report Responses ORG IDHOSPITAL NAME‘A’‘B’NONECOMMENTS1Anna Jaques Hospital X2Athol Memorial Hospital X5Baystate Franklin Medical Center X See comments.6Baystate Mary Lane X See comments.4Baystate Medical Center X See comments.7Berkshire Medical Center X10Beth Israel Deaconess Medical Center X53Beth Israel Deaconess – Needham X See comments.16Boston Medical Center X22Brigham and Women’s Hospital X25Brockton Hospital X See comments.27Cambridge Health Alliance Hospitals X39Cape Cod Hospital X42Caritas Carney Hospital X PART C. HOSPITAL RESPONSES Summary of Hospitals’ FY 2007 Final Verification Report Responses ORG IDHOSPITAL NAME‘A’‘B’NONECOMMENTS62Caritas Good Samaritan Medical Center X4460Caritas Good Sam. Medical Ctr. – Norcap Lodge Campus X75Caritas Holy Family Hospital X41Caritas Norwood Hospital & Med. Ctr. X 114Caritas Saint Anne’s Hospital X See comments.126Caritas St. Elizabeth’s Medical Center X 46Children’s Hospital Boston X132Clinton Hospital X50Cooley Dickinson Hospital X51Dana-Farber Cancer Institute X57Emerson Hospital X8Fairview Hospital X40Falmouth Hospital X59Faulkner Hospital X See comments.PART C. HOSPITAL RESPONSES Summary of Hospitals’ FY 2007 Final Verification Report Responses ORG IDHOSPITAL NAME‘A’‘B’NONECOMMENTS66Hallmark Health – Lawrence Memorial Hospital Campus X141Hallmark Health – Melrose-Wakefield Hospital Campus X68Harrington Memorial Hospital X71Health Alliance Hospitals, Inc. X See comments.73Heywood Hospital X 77Holyoke Medical Center X 78Hubbard Regional Hospital X See comments.79Jordan Hospital X See comments.81Lahey Clinic X83Lawrence General Hospital X See comments.85Lowell General Hospital X88Martha’s Vineyard Hospital X89Massachusetts Eye and Ear Infirmary X91Massachusetts General Hospital X See comments.PART C. HOSPITAL RESPONSES Summary of Hospitals’ FY 2007 Final Verification Report Responses ORG IDHOSPITAL NAME‘A’‘B’NONECOMMENTS118Mercy Medical Center - Providence X119Mercy Medical Center – Springfield X70Merrimack Valley Hospital X49MetroWest Medical Center X97Milford Regional Medical Center X98Milton Hospital X99Morton Hospital and Medical Center X 100Mount Auburn Hospital X See comments.101Nantucket Cottage Hospital X See comments.52Nashoba Valley Medical Center X103New England Baptist Hospital X See comments.105Newton-Wellesley Hospital X106Noble Hospital X See comments. PART C. HOSPITAL RESPONSES Summary of Hospitals’ FY 2007 Final Verification Report Responses ORG IDHOSPITAL NAME‘A’‘B’NONECOMMENTS107North Adams Regional Hospital X116North Shore Medical Center X109Northeast Health System – Addison Gilbert Campus X110Northeast Health System – Beverly Campus X112Quincy Medical Center X127Saint Vincent Hospital at Worcester Medical Center X See comments.115Saints Memorial Medical Center X122South Shore Hospital X123Southcoast Hospitals Group – Charlton Memorial Campus X124Southcoast Hospitals Group – St. Luke’s Campus X145Southcoast Hospitals Group – Tobey Hospital Campus X129Sturdy Memorial Hospital X104Tufts Medical Center XPART C. HOSPITAL RESPONSES Summary of Hospitals’ FY 2007 Final Verification Report Responses ORG IDHOSPITAL NAME‘A’‘B’NONECOMMENTS133U Mass. Marlborough Hospital X See comments.131U Mass. Memorial Medical Center X See comments.139U Mass. Wing Memorial Hospital X See comments.138Winchester Hospital X * Hospitals with no verification received were strongly pursued to verify their data. Each hospital was contacted numerous times via telephone and letter and given ample opportunity to respond. As of the cutoff date, however, the Division had not received a Verification Response Form from the hospital. PART C. HOSPITAL RESPONSES 2. LIST OF ERROR CATEGORIES Source of Admission Type of Admission Discharges by Month Primary Payer Type Diagnosis Codes per Discharge Patient Disposition Gender Procedure Codes per Discharge Race Age Top 20 E-Codes AP 12 MDCs Ranked AP 14 MDCs Ranked APR 15 MDCs Ranked AP 18 MDCs Ranked Top 20 AP 12 DRGs Top 20 AP 14 DRGs Top 20 APR 15 DRGs Top 20 AP 18 DRGs Length of Stay Ancillary Services Routine Accommodation Special Care Accommodation Ancillary Services Charges Routine Accommodation Charges Special Care Accommodation Charges PART C. HOSPITAL RESPONSES 3. SUMMARY OF REPORTED DISCREPANCIES BY CATEGORY HospitalSource of AdmissionType of AdmissionDischarges by MonthPrimary PayerPatient DispositionGenderRaceBaystate FranklinXBaystate MaryLaneXBaystate Medical CenterXBeth Israel Deaconess - Needham XFaulknerXXXHealth AllianceXLawrence GeneralXMass. GeneralXNantucketXXXXXNobleXUMass. WingX PART C. HOSPITAL RESPONSES 3. SUMMARY OF REPORTED DISCREPANCIES BY CATEGORY (Continued) HospitalRace / EthnicityEthnicityHispanic IndicatorAgeAP 20 MDCsTop 20 AP 20 DRGsLength of StayFaulknerXHolyokeXMass. GeneralXXXNantucketXXXNew England BaptistXXNobleXXUMass. MemorialXXUMass. WingXXX PART C. HOSPITAL RESPONSES 3. SUMMARY OF REPORTED DISCREPANCIES BY CATEGORY (Continued) HospitalAncillary Services DischargesRoutine Accommod. DischargesSpecial Care Accommod.Ancillary Services ChargesRoutine Accomm. ChargesSpecial Care Accomm. ChargesCondition Present On AdmissionCaritas St. Anne’sXHealth AllianceXJordanXLawrence GeneralXNantucketXNobleXXSt. VincentXXXUMass. MarlboroughXUMass. MemorialXUMass. WingXX PART C. HOSPITAL RESPONSES 4. INDEX OF HOSPITALS REPORTING DATA DISCREPANCIES FY2007 Hospital Page Baystate Franklin 36 Baystate Mary Lane 37 Baystate Medical Center 38 Beth Israel Deaconess – Needham 39 Brockton 40 Caritas St. Anne’s 41 Faulkner 42 Health Alliance 43 Holyoke Medical Center 44 Hubbard Regional 45 Jordan 46 Lawrence General 47 Massachusetts General Hospital 48 Mount Auburn 49 Nantucket Cottage 50 New England Baptist 51 Noble 52 Saint Vincent 53 UMass. Marlborough 54 UMass. Memorial 55 UMass. Wing 56 PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Baystate Franklin Medical Center Baystate Franklin submitted an “A” response, with the following comment: Disposition codes 05 and 06 appear to be inverted; an update to our software caused the mistake. FY08 information will be correct. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Baystate Mary Lane Hospital Baystate Mary Lane Hospital submitted an “A” response, with the following comment: Disposition codes 05 and 06 appear to be inverted; an update to our software caused the mistake. FY08 information will be correct. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Baystate Medical Center Baystate Medical Center submitted an “A” response, with the following comment: Disposition codes 05 and 06 appear to be inverted; An update to our software caused the mistake. FY08 information will be correct. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Beth Israel Deaconess Hospital - Needham Beth Israel Deaconess Hospital Needham reported one discrepancy in the area of Source of Admissions. The hospital submitted the following comment: Based on your discussion with our HIM Coder last week, we are noting that our statistics here at the hospital indicate the total number of discharges to be 2,530, not 2,524 indicated in your Report #001, Source of Admissions Frequency Report. We realize that this discrepancy of 6 cases does affect most of the reports in the profile, not just the one listed above. We will be working with you to monitor these numbers on a quarterly basis as we move forward. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Brockton Hospital Brockton Hospital submitted a “B” response with the following comment: Brockton Hospital has successfully submitted the FY 2007 Inpatient Casemix Discharge Data and confirms the data to be accurate. The data has not been validated with the State’s annual report verification process, since the State was only able to supply a 3 quarters report. The 3 quarters reported by the state is accurate and reflects the hospital’s volume and statistics for FY2007. When the full FY2007 data is available from the state, Brockton Hospital will gladly review its accuracy. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Caritas St. Anne’s Hospital Caritas St. Anne’s Hospital submitted an “A” response with the following comment: We have reviewed our ancillary charges compared to last year. The totals this year are lower due to our increase in the length of stay per the Fiscal Dept. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Faulkner Hospital Faulkner Hospital reported discrepancies in the areas of Source of Admissions, Patient Disposition, Discharges by Race, Discharges by Ethnicity, and Discharges by Race/Ethnicity. The hospital submitted the following comment: Faulkner Hospital had only 106 discharges directly from Special Care (ICU) whereas DHCFP summarized 472 discharges. However, if DHCFP’s report is capturing #discharges that had any Special Care charges on them, then I would agree with DHCFP. My disagreement with the other 5 reports is that the data was not reported consistently across all 4 quarters. The race/ethnicity collection process became more refined midyear as did any POA criteria. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Health Alliance Hospitals, Inc. Health Alliance reported discrepancies in the areas of Source of Admissions and Condition Present on Admission. No further details were provided. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Holyoke Medical Center Holyoke Medical Center reported one discrepancy in the area of Discharges by Hispanic Indicator. The hospital submitted the following comment: Please note that there is a discrepancy in the 1st quarter data between the number of discharges submitted by Holyoke Medical Center and the number of discharges returned to us for review on the Verification Report. I have determined that there are 25 discharges involving the Hispanic Indicator that we submitted; however because these were not being “counted” for the 1st and 2nd quarters, they were apparently not screened by the Division. Our total number of discharges submitted for Quarter 1 equaled 1,922 while the Detailed Verification Report for that quarter and that of the Verification Report equals 1,897. The approximate difference in charges is $825,983.00. Following the 1st quarter submission, our IS support staff, in conjunction with Meditech, was able to put in place the variables necessary to capture the Hispanic Indicator data for submission for the remaining quarters of FY2007. The total discharges submitted by this facility for the remaining quarters, match those on the Verification report. Please take the above information into consideration in the analysis of our data. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Hubbard Regional Hospital Hubbard Regional Hospital submitted a “B” response, however, no further details were provided. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Jordan Hospital Jordan Hospital reported discrepancies in the area of Condition Present on Admission. The hospital submitted the following comment: Per your request, I am writing with an explanation for our missing present on admission indicators (POA) on Jordan Hospital’s fiscal year 2007 data. Jordan encountered a software bug that wiped out POA indicators entered by coders in our code finder software when the patient data got filed into our core HCIS. Unfortunately, the bug went undetected throughout most of the fiscal year. By the time it was discovered and corrected, the volume of patients affected was too high for Jordan to be able to afford to correct. Thank you for your understanding in this matter. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Lawrence General Hospital Lawrence General Hospital reported discrepancies in the areas of Source of Admissions and Condition Present on Admission. The hospital submitted the following comment: I believe there is an error in Q2 on Report 001 – Source of Admissions Frequency. The 1,841 patients listed as “M – Walk-in/Self-referral” should be listed as “R – Within Hospital Emergency Room Transfer”. This would be consistent with the other three quarters. I also want to submit a caveat regarding Report 021 – Condition Present on Admission. Collecting this relatively new data element and applying uniform data definitions is still evolving. The accuracy of the data will improve as hospital staff become more experienced in applying the definitions correctly. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Massachusetts General Hospital Massachusetts General Hospital reported discrepancies in the areas of Discharges by Race, Discharges by Ethnicity, Discharges by Race/Ethnicity, and Discharges by Patient Hispanic Indicator. The hospital submitted the following comment: I have reviewed the fiscal year 2007 Inpatient Hospital Discharge Data and Verifications Reports and found errors in the Race and Ethnicity for quarters 1 and 2 of FY 2007. These quarters were submitted prior to the implementation of stricter edits for many of the fields. We attempted unsuccessfully to re-submit these quarters last week. The Race and Ethnicity fields are un-reported on the verification reports for Quarter 1 in the vast majority of cases and for roughly half of the cases in Quarter 2. For Quarter 1, the old race fields would have been used for submission but something should have been reported. For quarter 2, there would have been a combination of old and new data which should have been reported with the new format. Since it is impossible to re-submit this data because of the incomplete Present on Admission data for this time period, the data is signed-off with the caveat that Race and Ethnicity are under-reported for this time period. Thank you for the opportunity to comment on this issue. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Mount Auburn Hospital Mount Auburn Hospital an “A” response, with the following comment: I have reviewed the inpatient verification report for FY2007 for Mount Auburn Hospital, and have verified what I could. Because there are so many new items to be verified, all of which involve complex custom reports to be written, I cannot verify all of the data elements. The data elements I am having trouble with are in customer defined screens, since Meditech does not build additional data elements to add to its standard unless it is mandated nationally. Discharges by Race – I can verify only the first race listed. Discharges by Ethnicity – cannot verify Discharges by Race/Ethnicity – I have asked for a report to be written, hoping to get an answer to this and to the two above in the one report. Discharges by Patient Hispanic Indicator – report not written Condition Present on Admission – I need a report written for this. We have a backlog of reports to be written, so for the ones I have not already asked for I can put in the queue; however, in looking at the data without the backing of reports, I can say that it looks reasonable. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Nantucket Cottage Hospital Nantucket Cottage Hospital reported discrepancies in the areas of: Source of Admissions, Discharges by Month, Patient Disposition, Discharges by Race, Discharges by Ethnicity, Discharges by Age, Type of Admissions, Discharges by Race/Ethnicity, Discharges by Patient Hispanic Indicator, and Routine Accommodation Services by Discharges. The hospital submitted the following comment: Thank you for the opportunity to verify the Inpatient Case Mix Data for FY 2007. The hospital’s census information indicates a discrepancy of 6 cases for FY2007. The census indicates a total of 666 discharges as compared with the 660 submitted. The 6 case discrepancy were all part of the 4th Qtr. Failed submission. Following are the areas addressed: Source of Admission – We had no extramural births. I will ask the registration supervisor to reclassify those 8 cases to maintain data integrity. The total newborn deliveries based on discharge data = 147, not 108 as reported. However, since the total overall discharges have a discrepancy of only 6 cases, I believe that the 39 births were not appropriately classified and are contained in the other source of admission data categories. Type of Admission – is accurate with the exception of the 4th Qtr. Newborn discharges which should reflect 36 discharges not 33 as reported. This adjustment brings the overall total to 666. Discharges by Month – is accurate with the exception of the failed 4th Qtr. July = 66 not 64 as submitted. August = 68 not 65 as submitted and September = 58 not 57 as submitted. Patient Disposition Frequency – 4th Qtr. Adjustments: (01) – 159 to 164/ (20) – 2 to 3/Total – 186 to 192. Adjustments to totals: (01) – 526 to 531/ (20) 12 to 13/Gtotal – 660 to 666. Race Disposition – 4th Qtr. Adjustments: R3 – 1 to 8/R5 – 53 to 160/R9 3 to 18/Unknow – 2 to 1/Total – 61 to 189. Adjustments to totals: R3 – 26 to 33/ R5 – 289 to 396/R9 – 18 to 33/Unknow 2 to 1/Gtotal – 340 to 468. Race/Ethnicity 1 Frequency Report – 4th Qtr. Additions: R3: mercn – 1 to 6/R3:Caribi – 0 to 2/R5: Amercn – 47 to 97/R5: Brazil – 1 to 6/R5: Easteu – 0 to 5/R5: Unknow – 2 to 3/R9: Dominican – 0 to 3/R9: Brazil – 0 to 1/Unknow:Unknow – 1 to 4/Total – 61 to 135. Gtotal – 340 to 414. Patient Hispanic Indicator Frequency Report – 4th Qtr. Additions: N – 59 to 111/Y – 2 to 14/Total – 61 to 125. Gtotal – 340 to 404. Discharge by Age Category – 4th Qtr accurate except 65+ yrs – 65 to 71. Gtotal – 660 to 666. Routine accommodation Services by DC Report – Total adjustments: 0111 – M/S = 355 to 372 / 0112 – OB = 157 to 147 / Gtotal = 660 to 666. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION New England Baptist Hospital New England Baptist Hospital reported discrepancies in the areas of Discharges by Race/Ethnicity and Discharges by Patient Hispanic Indicator. The hospital submitted the following comment: New England Baptist Hospital would like to add the following comments to FY 2007 Quarters 1 and Quarter 2. The edits for Race and Ethnicity from Fiscal Year 2007 Quarters 1 and 2 from New England Baptist Hospital passed in the original submissions. However, these files needed to be resubmitted and subsequently failed the edits due to a change in the Division’s program prior to the resubmission. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Noble Hospital Noble Hospital reported discrepancies in the areas of Discharges by Month, Top 20 APR 20 DRGs with Total Discharges, APR 20 MDCs Listed in Rank Order, Routine Accommodation Services by Discharges, and Condition Present on Admission. The hospital submitted the following comment: I submitted the FY07 Inpatient Hospital Discharge Data Verification Response form on 5/30/08. Here is the detail of why we had some discrepancies. With regard to the CPOA data, we have no reports available for verifying those numbers. With regard to the MDC and DRG discrepancies, we are using Grouper 25 and the state used only APR 20 this year. Because of this difference and the fact that we can no longer access Grouper 24, we are unable to verify and explain the discrepancies. The Routine Accommodation Services by Discharges seems to be off due to the ICU not appearing on the report. All the other accommodations tie out. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION Saint Vincent Hospital Saint Vincent Hospital reported discrepancies in the areas of Routine Accommodation by Charges, Routine Accommodation Services by Discharges, and Condition Present on Admission. No further details were provided. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION UMass. Marlborough Hospital UMass. Marlborough Hospital reported discrepancies in the area of Ancillary Services By Charges. No further details were provided. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION UMass. Memorial Medical Center UMass. Memorial Medical Center reported discrepancies in the areas of Discharges by Ethnicity, Discharges by Race/Ethnicity, and Condition Present on Admission. The hospital noted the following: Discharges by Race/Ethnicity – Ethnicity data is missing when race is reported. Condition Present on Admission – Total volumes do not correlate to admissions. PART C. HOSPITAL RESPONSES 5. INDIVIDUAL HOSPITAL DISCREPANCY DOCUMENTATION UMass. Wing Memorial Hospital UMass. Wing Memorial Hospital reported discrepancies in the areas of Discharges by Race, Discharges by Ethnicity, Discharges by Race/Ethnicity, Discharges by Patient Hispanic Indicator, Ancillary Services by Discharges, and Condition Present on Admission. The hospital submitted the following comments: Sections 007b, 008a, 008b, & 0010 – Q1 total is not broken out by Race. Sections 009a & 009b – Q1 total is not broken out by Race. Q2 does not sum to 695. I would assume that the difference should be in the AMERCN category (009a) or the European category (009b). Section 009b – Q1 and A2 total is not broken out by Race. Section 0015 – The YTD total in incorrect. The total should be 31,572 not 7,476. Section 021 – Q1 is showing the diagnoses as not reported or invalid. Q2-Q4 shows the majority of the Diagnoses as “Yes”. PART D. CAUTIONARY USE HOSPITALS PART D. CAUTIONARY USE HOSPITALS Previous year’s data contained a separate file for the failed submissions. Beginning with FY2000, the database contains all submissions together, both passed and failed submissions for all hospitals within the database. The failed submissions are marked with an asterisk for easy identification. In 2001, the database file added a supplementary report, “Top Errors”, listing all top errors by hospitals. This list contains top errors for both passed and failed submissions. Although this is not a cautionary use listing, its purpose is to provide the user with an overview of all hospitals’ top errors, not just the failed submissions. There are two cautionary use hospitals for FY2007. Jordan Hospital – The files submitted failed as a result of the hospital being unable to collect present on admission data for Q2, Q3, & Q4. Massachusetts Eye and Ear Infirmary – Errors in all 4 quarters were mainly caused by some invalid accommodation revenue codes, some missing dates of principal procedures, as well as errors with the new data elements such as missing and/or invalid condition present on admission and attending and operating physician data. PART E. HOSPITALS SUBMITTING DATA FOR FY2007 List of Hospitals Submitting Data for FY2007 Hospitals with No Data Submissions Discharge Totals and Charges for Hospitals Submitting Data by Quarter PART E. HOSPITALS SUBMITTING DATA FOR FY2007 1. LIST OF HOSPITALS SUBMITTING DATA FOR FY2007 Anna Jaques Hospital Athol Memorial Hospital Baystate Franklin Baystate Mary Lane Baystate Medical Center Berkshire Medical Center Beth Israel Deaconess Medical Center Beth Israel Deaconess - Needham Boston Medical Center – Harrison Avenue Campus Brigham and Women’s Hospital Brockton Hospital Cambridge Health Alliance - Cambridge Cape Cod Hospital Caritas Carney Hospital Caritas Good Samaritan Medical Center Caritas Good Samaritan Medical Center – Norcap Lodge Campus Caritas Holy Family Hospital and Medical Center Caritas Norwood Hospital Caritas St. Anne’s Hospital Caritas St. Elizabeth’s Medical Center Children’s Hospital Boston Clinton Hospital Cooley Dickinson Hospital Dana-Farber Cancer Institute Emerson Hospital Fairview Hospital Falmouth Hospital Faulkner Hospital Hallmark Health System – Lawrence Memorial Hospital Campus Hallmark Health System – Melrose-Wakefield Hospital Campus Harrington Memorial Hospital Health Alliance Hospitals Heywood Hospital Holyoke Medical Center Hubbard Regional Hospital Jordan Hospital Lahey Clinic – Burlington Lawrence General Hospital Lowell General Hospital Martha’s Vineyard Hospital PART E. HOSPITALS SUBMITTING DATA FOR FY2007 1. LIST OF HOSPITALS SUBMITTING DATA FOR FY2007 - Continued Massachusetts Eye and Ear Infirmary Massachusetts General Hospital Mercy Medical Center – Providence Behavioral Health Hospital Campus Mercy Medical Center – Springfield Campus Merrimack Valley Hospital MetroWest Medical Center Milford Regional Medical Center Milton Hospital Morton Hospital and Medical Center Mount Auburn Hospital Nantucket Cottage Hospital Nashoba Valley Medical Center New England Baptist Hospital Newton-Wellesley Hospital Noble Hospital North Adams Regional Hospital North Shore Medical Center Northeast Health System – Addison Gilbert Campus Northeast Health System – Beverly Campus Quincy Medical Center Saint Vincent Hospital at Worcester Medical Center Saints Memorial Medical Center South Shore Hospital Southcoast Hospitals Group – Charlton Memorial Campus Southcoast Hospitals Group – St. Luke’s Campus Southcoast Hospitals Group – Tobey Hospital Campus Sturdy Memorial Hospital Tufts Medical Center UMass. Marlborough Hospital UMass. Memorial Medical Center UMass. Wing Memorial Hospital Winchester Hospital PART E. HOSPITALS SUBMITTING DATA FOR FY2007 2. LIST OF HOSPITALS WITH NO DATA FOR FY2007 The Division is pleased to announce that all Massachusetts acute care hospitals reported case mix and charge data for FY2007. Note: Part D. Cautionary Use Hospitals contains information on hospitals with missing or problematic quarters. For FY2007, there were two cautionary use hospitals. See section for details. PART E. HOSPITALS SUBMITTING DATA FOR FY2007 3. DISCHARGE TOTALS AND CHARGES FOR HOSPITALS SUBMITTING DATA – BY QUARTER The following is a list of hospitals submitting data with discharge totals and charges by quarter. It is included here as a means of enabling users to crosscheck the contents of the electronic data file they receive. TOTAL HOSPITAL DISCHARGES & CHARGES BY QUARTER Qtr Hospital NameORG ID #Total DischargesTotal Charges1Anna Jaques Hospital12,074$21,839,1992Anna Jaques Hospital1,986$21,026,7793Anna Jaques Hospital2,037$22,302,0804Anna Jaques Hospital2,045$21,013,519Totals8,142$86,181,5771Athol Memorial Hospital2248$3,036,5462Athol Memorial Hospital263$3,876,0693Athol Memorial Hospital215$2,938,0034Athol Memorial Hospital246$3,048,853Totals972$12,899,4711Baystate Franklin Medical Center51,141$13,559,4572Baystate Franklin Medical Center1,188$14,615,4493Baystate Franklin Medical Center1,213$13,859,0354Baystate Franklin Medical Center1,269$14,048,724Totals4,811$56,082,6651Baystate Mary Lane6412$3,109,8772Baystate Mary Lane443$3,583,8743Baystate Mary Lane457$3,788,7904Baystate Mary Lane407$3,258,567Totals1,719$13,741,1081Baystate Medical Center49,526$202,879,0672Baystate Medical Center9,524$194,394,5093Baystate Medical Center9,778$194,921,4574Baystate Medical Center9,780$191,115,631Totals38,608$783,310,6641Berkshire Health Systems – Berkshire73,17750,695,0112Berkshire Health Systems – Berkshire3,22851,506,6023Berkshire Health Systems – Berkshire3,26152,763,5464Berkshire Health Systems – Berkshire3,34851,116,908Totals13,014206,082,0671Beth Israel Deaconess – Needham53668$7,569,9802Beth Israel Deaconess – Needham652$7,312,2713Beth Israel Deaconess – Needham624$7,136,7814Beth Israel Deaconess – Needham580$6,697,831Totals2,524$28,716,8631Beth Israel Deaconess Medical Center109,633$245,819,7492Beth Israel Deaconess Medical Center9,665$250,451,8913Beth Israel Deaconess Medical Center10,382$258,931,1854Beth Israel Deaconess Medical Center10,359$259,281,147Totals40,039$1,014,483,972PART E. HOSPITALS SUBMITTING DATA FOR FY2007 TOTAL HOSPITAL DISCHARGES & CHARGES BY QUARTER Qtr Hospital NameORG ID #Total DischargesTotal Charges1Boston Medical Center – Harrison Ave.167,076136,238,0612Boston Medical Center – Harrison Ave.7,376145,718,9803Boston Medical Center – Harrison Ave.7,477163,953,1824Boston Medical Center – Harrison Ave.7,532167,638,606Totals29,461613,548,8291Brigham and Women’s Hospital2212,810$530,035,3882Brigham and Women’s Hospital12,643$509,983,3133Brigham and Women’s Hospital13,161$517,573,9694Brigham and Women’s Hospital13,289$518,553,956Totals51,903$2,076,146,6261Brockton Hospital253,037$36,529,4942Brockton Hospital4,002$46,400,6353Brockton Hospital3,946$46,269,6344Brockton Hospital3,973$44,167,762Totals14,958$173,367,5251Cambridge Health Alliance-Cambridge274,26949,528,8672Cambridge Health Alliance-Cambridge4,47659,045,0133Cambridge Health Alliance-Cambridge4,22258,466,6804Cambridge Health Alliance-Cambridge4,37256,974,431Totals17,339224,014,9911Cape Cod Hospital393,940$72,945,6272Cape Cod Hospital4,063$74,467,6713Cape Cod Hospital4,293$71,876,2584Cape Cod Hospital4,534$79,475,531Totals16,830$298,765,0871Caritas Carney Hospital421,650$22,309,0172Caritas Carney Hospital1,701$24,864,1913Caritas Carney Hospital1,706$22,478,1434Caritas Carney Hospital1,670$22,066,957Totals6,727$91,718,3081Caritas Good Samaritan Medical Ctr.623,246$36,604,5902Caritas Good Samaritan Medical Ctr.3,269$38,758,9463Caritas Good Samaritan Medical Ctr.3,338$37,429,7504Caritas Good Samaritan Medical Ctr.3,314$35,584,936Totals13,167$148,378,2221Caritas Good Sam. - Norcap Lodge4460594$1,950,0352Caritas Good Sam. - Norcap Lodge616$2,057,8483Caritas Good Sam. - Norcap Lodge601$1,959,2324Caritas Good Sam. - Norcap Lodge668$2,189,074Totals2,479$8,156,1891Caritas Holy Family Hospital752,855$36,175,4282Caritas Holy Family Hospital2,904$36,119,4343Caritas Holy Family Hospital2,815$35,300,1204Caritas Holy Family Hospital2,785$33,441,165Totals11,359$141,036,147 PART E. HOSPITALS SUBMITTING DATA FOR FY2007 TOTAL HOSPITAL DISCHARGES & CHARGES BY QUARTER Qtr Hospital NameORG ID #Total DischargesTotal Charges1Caritas Norwood Hospital413,121$39,417,3782Caritas Norwood Hospital3,307$41,243,6493Caritas Norwood Hospital3,447$41,804,8874Caritas Norwood Hospital3,116$36,734,415Totals12,991$159,200,3291Caritas St. Anne’s Hospital1141,412$21,333,7522Caritas St. Anne’s Hospital1,551$21,612,2593Caritas St. Anne’s Hospital1,585$21,659,1464Caritas St. Anne’s Hospital1,420$20,253,371Totals5,968$84,858,5281Caritas St. Elizabeth’s Hospital1263,633$67,582,9922Caritas St. Elizabeth’s Hospital3,771$69,001,6323Caritas St. Elizabeth’s Hospital3,564$68,547,3234Caritas St. Elizabeth’s Hospital3,612$65,013,409Totals14,580$270,145,3561Children’s Hospital Boston464,355$161,648,9072Children’s Hospital Boston4,339$164,874,1273Children’s Hospital Boston4,320$180,149,5614Children’s Hospital Boston4,316$168,563,118Totals17,330$675,235,7131Clinton Hospital132323$5,085,0812Clinton Hospital373$7,167,3833Clinton Hospital376$7,456,1564Clinton Hospital321$6,481,766Totals1,393$26,190,3861Cooley Dickinson Hospital502,210$31,140,8032Cooley Dickinson Hospital2,289$33,513,2173Cooley Dickinson Hospital2,327$32,672,7224Cooley Dickinson Hospital2,093$30,827,039Totals8,919$128,153,7811Dana-Farber Cancer Institute51260$19,059,5512Dana-Farber Cancer Institute243$15,370,0643Dana-Farber Cancer Institute223$14,433,2114Dana-Farber Cancer Institute256$13,624,364Totals982$62,487,1901Emerson Hospital572,237$36,365,0502Emerson Hospital2,309$35,344,7893Emerson Hospital2,283$35,115,2714Emerson Hospital2,262$34,478,523Totals9,091$141,303,6331Fairview Hospital8344$3,168,5972Fairview Hospital335$3,032,5723Fairview Hospital330$2,868,1234Fairview Hospital342$3,224,127Totals1,351$12,293,419 PART E. HOSPITALS SUBMITTING DATA FOR FY2007 TOTAL HOSPITAL DISCHARGES & CHARGES BY QUARTER Qtr. Hospital NameORG ID #Total DischargesTotal Charges1Falmouth Hospital401,689$24,213,4602Falmouth Hospital1,538$22,204,9803Falmouth Hospital1,596$22,984,1724Falmouth Hospital1,763$23,344,847Totals6,586$92,747,4591Faulkner Hospital592,098$43,802,4252Faulkner Hospital2,068$43,733,0573Faulkner Hospital2,003$42,665,8124Faulkner Hospital2,000$39,733,941Totals8,169$169,935,2351Hallmark Health – Lawrence Memorial661,336$18,211,1352Hallmark Health – Lawrence Memorial1,430$18,459,4723Hallmark Health – Lawrence Memorial1,449$19,766,3764Hallmark Health – Lawrence Memorial1,246$17,813,829Totals5,461$74,250,8121Hallmark Health – Melrose-Wakefield1412,882$30,576,5382Hallmark Health – Melrose-Wakefield2,831$32,286,8943Hallmark Health – Melrose-Wakefield2,835$32,583,7344Hallmark Health – Melrose-Wakefield2,793$31,877,993Totals11,341$127,325,1591Harrington Memorial Hospital68863$9,426,4292Harrington Memorial Hospital834$8,857,0563Harrington Memorial Hospital757$7,779,3244Harrington Memorial Hospital706$7,225,407Totals3,160$33,288,2161Health Alliance Hospitals, Inc.712,20829,235,1892Health Alliance Hospitals, Inc.2,24829,361,3243Health Alliance Hospitals, Inc.2,15928,524,8404Health Alliance Hospitals, Inc.2,11925,033,491Totals8,734$112,154,8441Heywood Hospital731,244$12,989,1272Heywood Hospital1,285$14,785,8873Heywood Hospital1,217$13,863,8744Heywood Hospital1,253$13,322,077Totals4999$54,970,9651Holyoke Medical Center771,897$20,671,4552Holyoke Medical Center2,024$22,740,9773Holyoke Medical Center1,929$21,362,1434Holyoke Medical Center1,850$19,272,385Totals7,700$84,046,9601Hubbard Regional Hospital78316$2,350,6582Hubbard Regional Hospital335$2,519,8493Hubbard Regional Hospital286$2,154,3574Hubbard Regional Hospital297$2,215,048Totals1,234$9,239,912 PART E. HOSPITALS SUBMITTING DATA FOR FY2007 TOTAL HOSPITAL DISCHARGES & CHARGES BY QUARTER Qtr. Hospital NameORG ID #Total DischargesTotal Charges1Jordan Hospital792,870$30,546,4692Jordan Hospital2,989$32,312,7083Jordan Hospital3,023$31,976,6124Jordan Hospital2,843$31,488,856Totals11,725$126,324,6451Lahey Clinic Burlington815,08699,803,0242Lahey Clinic Burlington5,189107,666,5753Lahey Clinic Burlington5,358108,467,9474Lahey Clinic Burlington5,166103,396,317Totals20,799419,333,8631Lawrence General Hospital833,262$34,692,1202Lawrence General Hospital3,188$37,121,6433Lawrence General Hospital3,053$35,876,8324Lawrence General Hospital3,065$35,586,327Totals12,568$143,276,9221Lowell General Hospital853,056$34,885,4312Lowell General Hospital3,291$38,261,4223Lowell General Hospital3,134$34,787,1094Lowell General Hospital3,061$34,717,818Totals12,542$142,651,7801Martha’s Vineyard Hospital88283$4,350,6612Martha’s Vineyard Hospital259$3,757,3593Martha’s Vineyard Hospital330$5,042,7844Martha’s Vineyard Hospital344$5,432,145Totals1,216$18,582,9491Mass. Eye and Ear Infirmary89331$6,622,4172Mass. Eye and Ear Infirmary241$4,155,8923Mass. Eye and Ear Infirmary322$6,683,8694Mass. Eye and Ear Infirmary311$6,713,914Totals1,205$24,176,0921Massachusetts General Hospital9112,367$606,076,5322Massachusetts General Hospital12,336$607,364,6623Massachusetts General Hospital12,768$608,791,5564Massachusetts General Hospital12,660$576,995,211Totals50,131$2,399,227,9611Mercy Medical Center - Providence118932$12,874,0912Mercy Medical Center - Providence955$14,249,1623Mercy Medical Center - Providence981$14,026,0914Mercy Medical Center - Providence936$13,846,755Totals3,804$54,996,0991Mercy Medical Center - Springfield1193,209$55,830,3522Mercy Medical Center - Springfield3,123$57,979,1833Mercy Medical Center - Springfield3,226$58,514,8274Mercy Medical Center - Springfield3,066$53,324,059Totals12,624$225,648,421PART E. HOSPITALS SUBMITTING DATA FOR FY2007 TOTAL HOSPITAL DISCHARGES & CHARGES BY QUARTER Qtr. Hospital NameORG ID #Total DischargesTotal Charges1Merrimack Valley Hospital701,088$16,100,0962Merrimack Valley Hospital1,053$15,560,2213Merrimack Valley Hospital1,073$17,539,5174Merrimack Valley Hospital1,029$15,814,562Totals4,243$65,014,3961MetroWest Medical Center. 493,93957,442,2672MetroWest Medical Center. 4,20862,591,6933MetroWest Medical Center. 4,10558,736,0394MetroWest Medical Center. 3,59648,587,751Totals15,848227,357,7501Milford Regional Medical Center972,294$33,920,6372Milford Regional Medical Center2,420$37,020,5653Milford Regional Medical Center2,288$35,592,4804Milford Regional Medical Center2,355$33,911,919Totals9,357$140,445,6011Milton Hospital981,067$16,123,0692Milton Hospital1,192$17,420,7313Milton Hospital1,180$18,528,0864Milton Hospital1,111$16,870,733Totals4,550$68,942,6191Morton Hospital991,970$19,211,8252Morton Hospital2,077$21,468,1403Morton Hospital1,959$19,696,0764Morton Hospital1,965$18,847,436Totals7,971$79,223,4771Mount Auburn Hospital1003,535$46,644,3572Mount Auburn Hospital3,743$48,376,5063Mount Auburn Hospital3,644$47,104,7414Mount Auburn Hospital3,542$44,020,898Totals14,464$186,146,5021Nantucket Cottage Hospital101143$1,163,6002Nantucket Cottage Hospital140$1,338,8273Nantucket Cottage Hospital191$1,072,7794Nantucket Cottage Hospital186$1,481,698Totals660$5,056,9041Nashoba Valley Hospital52586$8,218,9552Nashoba Valley Hospital629$9,418,4093Nashoba Valley Hospital543$7,691,7474Nashoba Valley Hospital513$6,767,559Totals2,271$32,096,6701New England Baptist Hospital1031,790$39,565,3712New England Baptist Hospital1,804$40,567,3963New England Baptist Hospital1,841$41,141,5574New England Baptist Hospital1,703$37,876,030Totals7,138$159,150,354 PART E. HOSPITALS SUBMITTING DATA FOR FY2007 TOTAL HOSPITAL DISCHARGES & CHARGES BY QUARTER Qtr. Hospital NameORG ID #Total DischargesTotal Charges1Newton-Wellesley Hospital1054,214$63,265,0782Newton-Wellesley Hospital4,412$66,556,0213Newton-Wellesley Hospital4,615$70,869,6774Newton-Wellesley Hospital4,472$66,222,458Totals17,713$266,913,2341Noble Hospital106824$12,603,0502Noble Hospital879$14,034,5553Noble Hospital865$12,658,1134Noble Hospital846$12,212,267Totals3,414$51,507,9851North Adams Regional Hospital107909$12,458,8932North Adams Regional Hospital911$12,688,5713North Adams Regional Hospital892$11,473,9224North Adams Regional Hospital909$12,124,070Totals3,621$48,745,4561North Shore Medical Center 1165,51077,253,9212North Shore Medical Center 5,85383,166,4973North Shore Medical Center 5,78488,354,5944North Shore Medical Center 5,47583,876,615Totals22,622332,651,6271Northeast Health – Addison Gilbert109630$6,591,2652Northeast Health – Addison Gilbert675$7,548,5943Northeast Health – Addison Gilbert654$7,232,1134Northeast Health – Addison Gilbert648$7,027,984Totals2,607$28,399,9561Northeast Health – Beverly1104,428$46,727,9522Northeast Health – Beverly4,493$46,376,2563Northeast Health – Beverly4,431$46,741,9234Northeast Health – Beverly4,359$48,208,867Totals17,711$188,054,9981Quincy Medical Center1121,909$25,940,5612Quincy Medical Center1,981$27,500,9613Quincy Medical Center1,742$24,909,3404Quincy Medical Center1,668$23,723,646Totals7,300$102,074,5081Saint Vincent Hospital at Worcester1274,476$79,790,1302Saint Vincent Hospital at Worcester4,615$83,255,6513Saint Vincent Hospital at Worcester 4,606$85,850,4604Saint Vincent Hospital at Worcester4,348$78,104,930Totals18,045$327,001,1711Saints Memorial Medical Center1152,038$24,038,9252Saints Memorial Medical Center1,994$24,638,3133Saints Memorial Medical Center2,013$24,874,1214Saints Memorial Medical Center2,067$24,054,105Totals8,112$97,605,464 PART E. HOSPITALS SUBMITTING DATA FOR FY2007 TOTAL HOSPITAL DISCHARGES & CHARGES BY QUARTER Qtr. Hospital NameORG ID #Total DischargesTotal Charges1South Shore Hospital1225,671$67,876,6002South Shore Hospital5,993$72,313,9073South Shore Hospital5,835$70,536,0604South Shore Hospital5,830$69,550,969Totals23,329$280,277,5361Southcoast Hospitals Group - Charlton1234,345$75,711,5272Southcoast Hospitals Group - Charlton4,336$79,691,3743Southcoast Hospitals Group - Charlton4,249$76,901,6224Southcoast Hospitals Group - Charlton4,134$68,305,125Totals17,064$300,609,6481Southcoast Hospitals Group – St. Luke’s1244,431$59,096,0822Southcoast Hospitals Group – St. Luke’s4,813$68,137,9633Southcoast Hospitals Group – St. Luke’s4,553$62,949,1084Southcoast Hospitals Group – St. Luke’s4,502$59,575,989Totals18,299$249,759,1421Southcoast Hospitals Group – Tobey1451,097$13,479,7492Southcoast Hospitals Group – Tobey970$13,147,9003Southcoast Hospitals Group – Tobey1,039$12,904,8814Southcoast Hospitals Group – Tobey972$11,323,966Totals4,078$50,856,4961Sturdy Memorial Hospital1291,704$18,397,2782Sturdy Memorial Hospital1,726$19,099,4473Sturdy Memorial Hospital1,680$18,901,5344Sturdy Memorial Hospital1,703$18,837,825Totals6,813$75,236,0841Tufts Medical Center1044,360$138,125,6502Tufts Medical Center4,239$145,067,7093Tufts Medical Center4,336$191,393,5084Tufts Medical Center4,388$167,938,121Totals17,323$642,524,9881UMass. Marlborough Hospital133924$15,056,4342UMass. Marlborough Hospital909$14,167,2123UMass. Marlborough Hospital1,003$16,176,6844UMass. Marlborough Hospital892$14,025,205Totals3,728$59,425,5351UMass. Memorial Medical Center13110,684317,980,9052UMass. Memorial Medical Center10,830332,461,1393UMass. Memorial Medical Center11,328338,372,2354UMass. Memorial Medical Center10,910338,947,427Totals43,7521,327,761,7061UMass. Wing Memorial Hospital139718$6,569,4192UMass. Wing Memorial Hospital695$9,618,2823UMass. Wing Memorial Hospital655$9,103,0814UMass. Wing Memorial Hospital677$9,069,118Totals2,745$34,359,900 PART E. HOSPITALS SUBMITTING DATA FOR FY2007 TOTAL HOSPITAL DISCHARGES & CHARGES BY QUARTER Qtr. Hospital NameORG ID #Total DischargesTotal Charges1Winchester Hospital1383,259$23,963,3712Winchester Hospital3,513$25,671,6553Winchester Hospital3,614$26,372,5104Winchester Hospital3,471$25,703,780Totals13,857$101,711,316TOTALS849,290$17,377,587,963Total DischargesTotal Charges PART F. SUPPLEMENTARY INFORMATION Supplement I Type A Errors and Type B Errors Supplement II Content of Hospital Verification Report Package Supplement III Hospital Addresses, DPH ID, ORG ID & Service Site ID Numbers Supplement IV Mergers, Name Changes, Closures, Conversions & Non-Acute Care Hospitals Supplement V Alphabetical Source of Payment List Supplement VI Numerical Source of Payment List SUPPLEMENT I. LIST OF TYPE ‘A’ AND TYPE ‘B’ ERRORS TYPE ‘A’ ERRORS: Record Type Submitter Name Receiver ID DPH Hospital Computer Number Type of Batch Period Starting Date Period Ending Date Medical Record Number Patient Sex Patient Birth Date Admission Date Discharge Date Primary Source of Payment Patient Status Billing Number Primary Payer Type Secondary Payer Type Mother’s Medical Record Number Primary National Payer Identification Number Secondary National Payer Identification Number Revenue Code Units of Service Total Charges (by Revenue Code) Principal Diagnosis Code Associate Diagnosis Code (I – XIV) Number of ANDS Principal Procedure Code Significant Procedure Code I Significant Procedure Code II Significant Procedure Code III-XIV Physical Record Count Record Type 2X Count Record Type 3X Count Record Type 4X Count Record Type 5X Count Record Type 6X Count SUPPLEMENT I. LIST OF TYPE ‘A’ AND TYPE ‘B’ ERRORS TYPE ‘A’ ERRORS – Continued: Total Charges: Special Services Total Charges: Routine Services Total Charges: Ancillaries Total Charges: (ALL CHARGES) Number of Discharges Total Charges: Accommodations Total Charges: Ancillaries Submitter Employer Identification Number (EIN) Number of Providers on Electronic submission Count of Batches ED Flag Observation Flag HCF Org ID MA Transfer Hospital Org ID Hospital Service Site Reference TYPE ‘B’ ERRORS: Patient Race Type of Admission Source of Admission Patient Zip Code Veteran Status Patient Social Security Number Birth Weight – grams Employer Zip Code Mother’s Social Security Number Facility Site Number External Cause of Injury Code Attending Physician License Number Operating Physician License Number Other Caregiver Attending Physician National Provider Identifier (NPI) ATT NPI Location Code Operating Physician National Provider Identifier (NPI) Operating NPI Location Code Additional Caregiver National Provider Identifier Date of Principal Procedure Date of Significant Procedures (I & II) Race 1, 2 & Other Race Hispanic Indicator Ethnicity 1, 2 & Other Ethnicity TYPE ‘B’ ERRORS: Continued Condition Present on Admission Primary Diagnosis, Associate Diagnoses I – XIV, & Primary E-Code Significant Procedure Date Operating Physician for Significant Procedure Permanent Patient Street Address, City/Town, State, Zip Code Patient Country Temporary Patient Street Address, City/Town, State, Zip Code SUPPLEMENT II. CONTENT OF HOSPITAL VERIFICATION PACKAGE The Hospital Verification Report* includes the following frequency distribution tables: Source of Admissions Type of Admissions Discharges by Month Primary Payer Type Patient Disposition Discharges by Gender Discharges by Race Discharges by Race/Ethnicity Discharges by Ethnicity Discharges by Patient Hispanic Indicator Discharges by Age MDC’s Listed in Rank Order (APR 20) Top 20 DRGs with Most Total Discharges (APR 20) Length of Stay Ancillary Services by Discharges Routine Accommodation Services by Discharges Special Care Accommodation by Discharges Ancillary Services by Charges Routine Accommodation by Charges Special Care Accommodation Services by Charges Condition Present on Admission Verification Response Forms: Completed by hospitals after data verification and returned to the DHCFP. *NOTE: Hospital discharges were grouped with All Patient-DRG Groupers, Version 12.0, 14.0, 18.0, and 21.0. A discharge report showing counts by DRG for both groupers was supplied to hospitals for verification. SUPPLEMENT III. HOSPITAL ADDRESSES, DPH ID, ORG ID & SERVICE SITE ID NUMBERS Current Organization NameHospital AddressIdOrg HospIdOrg FilerDPH IDSite Number*Anna Jaques Hospital25 Highland Ave. Newburyport, MA 01950112006Athol Memorial Hospital2033 Main Street Athol, MA 01331222226Baystate Franklin Medical Center164 High Street Greenfield, MA 01301552120Baystate Mary Lane85 South Street Ware, MA 01082662148Baystate Medical Center3601 Main Street Springfield, MA 01107-1116442339Berkshire Medical Center – Berkshire Campus725 North Street Pittsfield, MA 01201630972313Berkshire Medical Center – Hillcrest Campus165 Tor Court Rd. Pittsfield, MA 012016309722319Beth Israel Deaconess Hospital – Needham148 Chestnut Street Needham, MA 0219253532054Beth Israel Deaconess Medical Center330 Brookline Avenue Boston, MA 022158702102069Boston Medical Center – Harrison Avenue Campus88 East Newton Street Boston, MA 021183107162307Boston Medical Center – East Newton Campus3107162084144Brigham and Women’s Hospital75 Francis Street Boston, MA 0211522222921Brockton Hospital680 Centre Street Brockton, MA 0240225252118Cambridge Health Alliance – Cambridge Campus65 Beacon Street Somerville, MA 021433108272108Cambridge Health Alliance – Somerville Campus3108272001143* For data users trying to identify specific care sites, use site number. However, if site number is blank, use IdOrgFiler. Current Organization NameHospital AddressIdOrg Hosp IdOrg FilerDPH IDSite Number*Cambridge Health Alliance – Whidden Memorial Campus3108272046142Cape Cod Hospital27 Park Street Hyannis, MA 0260139392135Caritas Carney Hospital2100 Dorchester Avenue Dorchester, MA 0212442422003Caritas Good Samaritan Medical Center235 North Pearl Street Brockton, MA 023018701622101Caritas Good Samaritan Med. Ctr. – Norcap Lodge Campus71 Walnut Avenue Foxboro, MA 02035870144602KGHCaritas Holy Family Hospital and Medical Center70 East Street Methuen, MA 0184475752225Caritas Norwood Hospital800 Washington Street Norwood, MA 0206241412114Caritas St. Elizabeth’s Hospital736 Cambridge Street Brighton, MA 021351261262085Children’s Hospital Boston300 Longwood Avenue Boston, MA 02115 46462139Clinton Hospital201 Highland Street Clinton, MA 015101321322126Cooley Dickinson Hospital30 Locust Street Northampton, MA 01060-500150502155Dana-Farber Cancer Institute44 Binney Street Boston, MA 0211551512335Emerson HospitalRoute 2 Concord, MA 0174257572018* For data users trying to identify specific care sites, use site number. However, if site number is blank, use IdOrgFiler. Current Organization NameHospital AddressIdOrg HospIdOrg FilerDPH IDSite Number*Fairview Hospital29 Lewis Avenue Great Barrington, MA 01230882052Falmouth Hospital100 Ter Heun Drive Falmouth, MA 0254040402289Faulkner Hospital1153 Centre Street Jamaica Plain, MA 0213059592048Hallmark Health System – Lawrence Memorial Campus170 Governors Avenue Medford, MA 021553111662038Hallmark Health System – Melrose-Wakefield Campus585 Lebanon Street Melrose, MA 0217631111412058Harrington Memorial Hospital100 South Street Southbridge, MA 0155068682143Health Alliance Hospitals, Inc.60 Hospital Road Leominster, MA 01453-800471712034Health Alliance Hospital – Burbank Campus717120348548Health Alliance Hospital – Leominster Campus717121278509Heywood Hospital242 Green Street Gardner, MA 0144073732036Holyoke Medical Center575 Beech Street Holyoke, MA 0104077772145Hubbard Regional Hospital340 Thompson Road Webster, MA 0157078782157Jordan Hospital275 Sandwich Street Plymouth, MA 0236079792082Kindred Hospital - Boston1515 Comm. Ave. Boston, MA 021351361362091Kindred Hospital Boston – North Shore15 King Street Peabody, MA 019601351352171* For data users trying to identify specific care sites, use site number. However, if site number is blank, use IdOrgFiler. Current Organization NameHospital AddressIdOrg HospIdOrg FilerDPH IDSite Number*Lahey Clinic – Burlington Campus41 Mall Road Burlington, MA 018056546812033Lahey Clinic North Shore 65468120334448Lawrence General HospitalOne General Street Lawrence, MA 01842-038983832099Lowell General Hospital295 Varnum Avenue Lowell, MA 0185485852040Marlborough Hospital57 Union Street Marlborough, MA 01752-99811331332103Martha’s Vineyard HospitalLinton Lane Oak Bluffs, MA 0255788882042Massachusetts Eye & Ear Infirmary243 Charles Street Boston, MA 02114-309689892167Massachusetts General Hospital55 Fruit Street Boston, MA 0211491912168Mercy Medical Center - Providence Behavioral Health Hospital1233 Main Street Holyoke, MA 0104065471182150Mercy Medical Center– Springfield Campus271 Carew Street Springfield, MA 0110265471192149Merrimack Valley Hospital140 Lincoln Avenue Haverhill, MA 01830-679870702131MetroWest Medical Center – Framingham Campus115 Lincoln Street Framingham, MA 017013110492020MetroWest Medical Center – Leonard Morse Campus67 Union Street Natick, MA 0176031104572039457Milford Regional Medical Center14 Prospect Street Milford, MA 0175797972105Milton Hospital199 Reedsdale Rd. Milton, MA 0218698982227Morton Hospital and Medical Center88 Washington Street Taunton, MA 0278099992022* For data users trying to identify specific care sites, use site number. However, if site number is blank, use IdOrgFiler. Current Organization NameHospital AddressIdOrg HospIdOrg FilerDPH IDSite Number*Mount Auburn Hospital330 Mt. Auburn St. Cambridge, MA 022381001002071Nantucket Cottage Hospital57 Prospect Street Nantucket, MA 025541011012044Nashoba Valley Medical Center 200 Groton Road Ayer, MA 0143252522298New England Baptist Hospital125 Parker Hill Avenue Boston, MA 021201031032059Newton-Wellesley Hospital2014 Washington Street Newton, MA 021621051052075Noble Hospital115 West Silver Street Westfield, MA 010861061062076North Adams Regional HospitalHospital Avenue North Adams, MA 012471071072061North Shore Medical Center – Salem Campus81 Highland Ave. Salem, MA 019703451162014North Shore Medical Center – Union Campus500 Lynnfield Street Lynn, MA 01904-1424345116 Formerly #320733Northeast Health System– Addison Gilbert Campus298 Washington Street Gloucester, MA 0193031121092016Northeast Health System – Beverly Campus85 Herrick Street Beverly, MA 0191531121102007Quincy Medical Center114 Whitwell Street Quincy, MA 021691121122151Saint Anne’s Hospital795 Middle Street Fall River, MA 027211141142011Saint Vincent Hospital at Worcester Medical Center20 Worcester Ctr. Blvd. Worcester, MA 016081271272128* For data users trying to identify specific care sites, use site number. However, if site number is blank, use IdOrgFiler. Current Organization NameHospital AddressIdOrg HospIdOrg FilerDPH IDSite Number*Saints Memorial Medical CenterOne Hospital Drive Lowell, MA 018521151152063South Shore Hospital55 Fogg Road South Weymouth, MA 021901221222107Southcoast Hospitals Group – Charlton Memorial Campus363 Highland Avenue Fall River, MA 0272031131232337Southcoast Hospitals Group - St. Luke’s Campus101 Page Street New Bedford, MA 0274031131242010Southcoast Hospitals Group – Tobey Hospital Campus43 High Street Wareham, MA 0257131131452106Sturdy Memorial Hospital211 Park Street Attleboro, MA 027031291292100Tufts Medical Center750 Washington Street Boston, MA 021111041042299U.Mass. Memorial Medical Center – Memorial Campus120 Front Street Worcester, MA 01608 31151312841 Formerly #2124130UMass. Memorial Medical Center – University Campus31151312841Winchester Hospital41 Highland Avenue Winchester, MA 018901381382094Wing Memorial Hospital and Medical Centers40 Wright Street Palmer, MA 01069-11871391392181* For data users trying to identify specific care sites, use site number. However, if site number is blank, use IdOrgFiler. SUPPLEMENT IV. MERGERS, NAME CHANGES, CLOSURES, CONVERSIONS, AND NON-ACUTE CARE HOSPITALS MERGERS – ALPHABETICAL LIST Name of New EntityNames of Original EntitiesDATEBerkshire Health System-Berkshire Medical Center -Hillcrest Hospital -Fairview HospitalJuly 1996Beth Israel Deaconess Medical Center-Beth Israel Hospital -N.E. Deaconess HospitalOctober 1996Boston Medical Center -Boston University Med. Ctr. -Boston City Hospital -Boston Specialty/RehabJuly 1996Cambridge Health Alliance NOTE: As of July 2001, Cambridge Health Alliance included Cambridge, Somerville, Whidden, & Malden’s 42 Psych beds. Malden now closed. Cambridge & Somerville submitted data separately in the past. This year they are submitting under one name. In future years, they may use the Facility Site Number to identify each individual facility’s discharges.-Cambridge Hospital -Somerville HospitalJuly 1996Good Samaritan Medical Center-Cardinal Cushing Hospital -Goddard Memorial October 1993Hallmark Health Systems NOTE: As of July 2001 includes only Lawrence Memorial & Melrose-Wakefield-Lawrence Memorial -Hospital Malden Hospital -Unicare Health Systems (Note: Unicare was formed in July 1996 as a result of the merger of Melrose-Wakefield and Whidden Memorial Hospital) October 1997Health Alliance Hospitals, Inc.-Burbank Hospital -Leominster HospitalNovember 1994Lahey Clinic-Lahey -Hitchcock (NH)January 1995Medical Center of Central Massachusetts-Holden District Hospital -Worcester Hahnemann -Worcester MemorialOctober 1989MetroWest Medical Center-Leonard Morse Hospital -Framingham Union January 1992 SUPPLEMENT IV. MERGERS, NAME CHANGES, CLOSURES, CONVERSIONS, AND NON-ACUTE CARE HOSPITALS MERGERS – ALPHABETICAL LIST Name of New EntityNames of Original EntitiesDateNortheast Health Systems-Beverly Hospital -Addison Gilbert HospitalOctober 1996North Shore Medical Center-North Shore Medical Center (dba Salem Hospital) and -Union Hospital NOTES: 1. Salem Hospital merged with North Shore Children’s Hospital in April 1988 2. Lynn Hospital merged with Union Hospital in 1986 to form AtlanticareMarch 2004 Saints Memorial Medical Center-St. John’s Hospital -St. Joseph’s HospitalOctober 1992Sisters of Providence Health System-Mercy Medical Center -Providence HospitalJune 1997Southcoast Health Systems-Charlton Memorial Hospital -St. Luke’s Hospital -Tobey HospitalJune 1996UMass. Memorial Medical Center-UMMC -Memorial -Memorial-HahnemannApril 1999 SUPPLEMENT IV. MERGERS, NAME CHANGES, CLOSURES, CONVERSIONS, AND NON-ACUTE CARE HOSPITALS MERGERS – CHRONOLOGICAL LIST DateEntity Names1986Atlanticare (Lynn & Union)April 1988Salem (North Shore Children’s and Salem)October 1989Medical Center Central Mass (Holden, Worcester, Hahnemann and Worcester MemorialJanuary 1992MetroWest (Framingham Union and Leonard Morse)October 1992Saints Memorial (St. John’s and St. Joseph’s)October 1993Good Samaritan (Cardinal Cushing and Goddard Memorial)November 1994Health Alliance (Leominster and Burbank)January 1995Lahey Hitchcock (Lahey & Hitchcock (NH))June 1996Southcoast Health System (Charlton, St. Luke’s and Tobey)July 1996Berkshire Medical Center (Berkshire Medical Center and Hillcrest)July 1996Cambridge Health Alliance (Cambridge and Somerville)July 1996Boston Medical Center (University and Boston City)July 1996UniCare Health Systems (Melrose-Wakefield and Whidden)October 1996Northeast Health Systems (Beverly and Addison-Gilbert)October 1996Beth Israel Deaconess Medical Center (Deaconess and Beth Israel)June 1997Mercy (Mercy and Providence)October 1997Hallmark Health System, Inc. (Lawrence Memorial, Malden, UniCare [formerly Melrose-Wakefield and Whidden])April 1998UMass. Memorial Medical Center (UMMC, Memorial and Memorial-Hahnemann)July 2001Cambridge Health Alliance (Cambridge, Somerville, Whidden and Malden’s 42 Psych beds)July 2001Hallmark Health now only Melrose Wakefield and Lawrence MemorialJune 2002CareGroup sold Deaconess-Waltham to a private developer who leased the facility back to Waltham Hosp. (new name)July 2002Deaconess-Glover now under a new parent: Beth Israel Deaconess (was under CareGroup parent)March 2004North Shore Medical Center (dba Salem) and Union merge (still North Shore Medical Center) SUPPLEMENT IV. MERGERS, NAME CHANGES, CLOSURES, CONVERSIONS, AND NON-ACUTE CARE HOSPITALS NAME CHANGES Name of New EntityOriginal EntitiesDateBaystate Mary LaneMary Lane HospitalBeth Israel Deaconess Medical Center-Beth Israel Hospital -New England Deaconess HospitalBeth Israel Deaconess Needham -Glover Memorial -Deaconess-Glover HospitalJuly 2002Boston Medical Center – Harrison Avenue CampusBoston City Hospital University HospitalBoston Regional Medical CenterNew England Memorial HospitalNow Closed.Cambridge Health Alliance – (now includes Cambridge, Somerville & Whidden)Cambridge Hospital Somerville HospitalCambridge Health Alliance – Malden & WhiddenHallmark Health Systems – Malden & WhiddenMalden now closed.Cape Cod Health Care SystemsCape Cod Hospital Falmouth HospitalCaritas Good Samaritan Medical CenterCardinal Cushing Hospital Goddard Memorial HospitalCaritas Norwood, Caritas Southwood, Caritas Good Samaritan Medical CenterNorwood Hospital Southwood Hospital Good Samaritan Med. Ctr.Caritas St. Elizabeth’s Medical CenterSt. Elizabeth’s Medical CenterChildren’s Hospital BostonChildren’s HospitalFebruary 2004Hallmark Health Lawrence Memorial Hospital & Hallmark Health Melrose-Wakefield HospitalLawrence Memorial Hospital Melrose-Wakefield HospitalHoly Family HospitalBon Secours HospitalKindred Hospitals – Boston & North ShoreVencor Hospitals – Boston & North ShoreLahey Clinic HospitalLahey Hitchcock ClinicMetroWest Medical Center – Framingham Union Hospital & Leonard Morse HospitalFramingham Union Hospital Leonard Morse Hospital / Columbia MetroWest Medical CenterMerrimack Valley HospitalHaverhill Municipal (Hale) HospitalEssent Health Care purchased this facility in September 2001 SUPPLEMENT IV. MERGERS, NAME CHANGES, CLOSURES, CONVERSIONS, AND NON-ACUTE CARE HOSPITALS NAME CHANGES Name of New EntityOriginal EntitiesDateMilford Regional Medical CenterMilford-Whitinsville HospitalNashoba Valley HospitalNashoba Community Hospital Deaconess-Nashoba Nashoba Valley Medical CenterJanuary 2003Northeast Health SystemsBeverly Hospital Addison Gilbert HospitalNorth Shore Medical Center - SalemSalem Hospital North Shore Children’s HospitalNorth Shore Medical Center - UnionUnion HospitalQuincy HospitalQuincy City HospitalSouthcoast Health SystemsCharlton Memorial Hospital St. Luke’s Hospital Tobey HospitalTufts Medical CenterTufts New England Medical Center, New England Medical CenterJanuary 2008UMass. Memorial – Clinton HospitalClinton HospitalUMass. Memorial – Health Alliance HospitalHealth Alliance Hospitals, Inc.UMass. Memorial – Marlborough HospitalMarlborough HospitalUMass. Memorial – Wing Memorial HospitalWing Memorial HospitalWaltham HospitalWaltham-Weston Hospital Deaconess Waltham HospitalJune 2002. Now closed. SUPPLEMENT IV. MERGERS, NAME CHANGES, CLOSURES, CONVERSIONS, AND NON-ACUTE CARE HOSPITALS CLOSURES DateHospital NameCommentsJune 1989Sancta MariaSeptember 1990Mass. OsteopathicJune 1990HuntOutpatient only now.July 1990St. Luke’s MiddleboroughSeptember 1991Worcester CityMay 1993AmesburyJuly 1993Saint Margaret’sJune 1994HeritageJune 1994WinthropOctober 1994St. Joseph’sDecember 1994LudlowOctober 1996ProvidenceNovember 1996Goddard1996LynnJanuary 1997Dana Farber Inpatient acute beds now at Brigham & Women’sMarch 1997BurbankFebruary 1999Boston RegionalApril 1999MaldenAugust 1999SymmesJuly 2003Waltham NOTE: Subsequent to closure, some hospitals may have reopened for used other than an acute hospital (e.g., health care center, rehabilitation hospital, etc.) SUPPLEMENT IV. MERGERS, NAME CHANGES, CLOSURES, CONVERSIONS, AND NON-ACUTE CARE HOSPITALS CONVERSIONS & NON-ACUTE CARE HOSPITALS HOSPITALCOMMENTSFairlawn HospitalConverted to non-acute care hospitalHeritage HospitalConverted to non-acute care hospitalVencor – Kindred Hospital BostonNon-acute care hospitalVencor – Kindred Hospital North ShoreNon-acute care hospital SUPPLEMENT V. ALPHABETICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION137AARP/Medigap supplement **7COM71ADMAREPPO51Aetna Life Insurance7COM161Aetna Managed Choice POSDCOM-MC22Aetna Open Choice PPODCOM-MC272Auto InsuranceTAI138Banker’s Life and Casualty Insurance **7COM139Banker’s Multiple Line **7COM2Bay State – a product of HMO BlueCBCBS-MC136BCBS Medex **6BCBS11Blue Care ElectCBCBS-MC46Blue CHiP (BCBS Rhode Island)8HMO160Blue Choice (incl. Healthflex Blue) - POSCBCBS-MC142Blue Cross Indemnity6BCBS50Blue Health Plan for Kids6BCBS52Boston Mutual Insurance7COM154BCBS Other (not listed elsewhere) ***6BCBS155Blue Cross Managed Care Other (not listed elsewhere) ***CBCBS-MC151CHAMPUS5GOV204Christian Brothers Employee7COM30CIGNA (Indemnity)7COM250CIGNA HMODCOM-MC171CIGNA POSDCOM-MC87CIGNA PPODCOM-MC140Combined Insurance Company of America**7COM300CommCare: BMC HealthNet Plan/Commonwealth Care – General Classification (For use only when no specific level for this plan can be identified)QCommCare301CommCare: BMC HealthNet Plan/Commonwealth Care – Plan Type IQCommCare302CommCare: BMC HealthNet Plan/Commonwealth Care – Plan Type IIQCommCare303CommCare: BMC HealthNet Plan/Commonwealth Care – Plan Type IIIQCommCare304CommCare: BMC HealthNet Plan/Commonwealth Care–Plan Type IVQCommCare SUPPLEMENT V. ALPHABETICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION400CommCare: Cambridge Network Health Forward – General Classification (For use only when no specific level for this plan can be identified)QCommCare401CommCare: Cambridge Network Health Forward – Plan Type IQCommCare402CommCare: Cambridge Network Health Forward – Plan Type IIQCommCare403CommCare: Cambridge Network Health Forward – Plan Type IIIQCommCare404CommCare: Cambridge Network Health Forward – Plan Type IVQCommCare500CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care – General Classification (For use only when no specific level for this plan can be identified)QCommCare501CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care – Plan 1 (Group No. 4445077)QCommCare502CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care – Plan 2 (Group No. 4455220)QCommCare503CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care – Plan 3 (Group No. 4455221)QCommCare504CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care – Plan 4 (Group No. 4455222)QCommCare600CommCare: Neighborhood Health Plan– General Classification (For use only when no specific level for this plan can be identified)QCommCare601CommCare: Neighborhood Health Plan – NHP Commonwealth Care Plan – Plan Type I (9CC1)QCommCare602CommCare: Neighborhood Health Plan – NHP Commonwealth Care Plan – Plan Type II (9CC2)QCommCare SUPPLEMENT V. ALPHABETICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION603CommCare: Neighborhood Health Plan – NHP Commonwealth Care Plan – Plan Type III (9CC3)QCommCare604CommCare: Neighborhood Health Plan – NHP Commonwealth Care Plan – Plan Type IV (9CC4)QCommCare21Commonwealth PPOCBCBS-MC44Community Health Plan8HMO13Community Health Plan Options (New York)JPOS42ConnectiCare of Massachusetts8HMO54Continental Assurance Insurance7COM69Corporate Health Insurance Liberty Plan7COM4Fallon Community Health Plan (includes Fallon Plus, Fallon Affiliates, Fallon UMass.)8HMO167Fallon POSJPOS67First Allmerica Financial Life Insurance7COM181First Allmerica Financial Life Insurance EPODCOM-MC27First Allmerica Financial Life Insurance PPODCOM-MC152Foundation0OTH143Free Care9FC990Free Care – co-pay, deductible, or co-insurance (when billing for free care services use #143)9FC88Freedom CareEPPO153Grant0OTH162Great West Life POSDCOM-MC28Great West Life PPODCOM-MC89Great West/NE Care7COM55Guardian Life Insurance7COM23Guardian Life Insurance Company PPODCOM-MC56Hartford L&A Insurance7COM200Hartford Life Insurance Co **7COM1Harvard Community Health Plan8HMO20HCHP of New England (formerly RIGHA)8HMO37HCHP-Pilgrim HMO (integrated product)8HMO208HealthNet (Boston Medical Center MCD Program)BMCD-MC14Health new England Advantage POSJPOS SUPPLEMENT V. ALPHABETICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION38Health New England Select (self-funded)8HMO24Health New England, Inc.8HMO45Health Source New Hampshire8HMO98Healthy Start9FC251Healthsource CMHC HMO8HMO164Healthsource CMHC Plus POSJPOS49Healthsource CMHC Plus PPOEPPO72Healthsource New Hampshire7COM165Healthsource New Hampshire POS (Self-funded)JPOS90Healthsource Preferred (self-funded)EPPO271Hillcrest HMO8HMO81HMO BlueCBCBS-MC130Invalid (replaced by #232 and 233)12Invalid (replaced by #49)53Invalid (no replacement)117Invalid (no replacement)123Invalid (no replacement)92Invalid (replaced by # 84, 166, 184)105Invalid (replaced by #111)32Invalid (replaced by #157 and 158)41Invalid (replaced by #157)15Invalid (replaced by #158)29Invalid (replaced by #171 and 250)16Invalid (replaced by #172)124Invalid (replaced by #222)126Invalid (replaced by #230)122Invalid (replaced by #234)6Invalid (replaced by #251)76Invalid (replaced by #270)26Invalid (replaced by #75)5Invalid (replaced by #9)61Invalid (replaced by #96)68Invalid (replaced by #96)60Invalid (replaced by #97)57John Hancock Life Insurance7COM82John Hancock PreferredDCOM-MC169Kaiser Added ChoiceJPOS40Kaiser Foundation8HMO58Liberty Life Insurance7COM85Liberty Mutual7COM SUPPLEMENT V. ALPHABETICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION59Lincoln National Insurance7COM19Matthew Thornton8HMO103Medicaid (includes MassHealth)4MCD107Medicaid Managed Care – Community Health PlanBMCD-MC108Medicaid Managed Care – Fallon Community Health PlanBMCD-MC109Medicaid Managed Care – Harvard Community Health PlanBMCD-MC110Medicaid Managed Care – Health New EnglandBMCD-MC111Medicaid Managed Care – HMO BlueBMCD-MC112Medicaid Managed Care – Kaiser Foundation PlanBMCD-MC113Medicaid Managed Care – Neighborhood Health PlanBMCD-MC115Medicaid Managed Care – Pilgrim Health CareBMCD-MC114Medicaid Managed Care – United Health Plans of NE (Ocean State Physician’s Plan)BMCD-MC119Medicaid Managed Care Other (not listed elsewhere) ***BMCD-MC106Medicaid Managed Care-Central Mass. Health CareBMCD-MC104Medicaid Managed Care-Primary Care Clinician (PCC)BMCD-MC116Medicaid Managed Care – Tufts Associated Health PlanBMCD-MC118Medicaid Mental Health & Substance Abuse Plan – Mass Behavioral Health PartnershipBMCD-MC121Medicare3MCR220Medicare HMO – Blue Care 65FMCR-MC125Medicare HMO – Fallon Senior PlanFMCR-MC221Medicare HMO – Harvard Community Health Plan 65FMCR-MC SUPPLEMENT V. ALPHABETICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION223Medicare HMO – Harvard Pilgrim Health Care of New England Care PlusFMCR-MC230Medicare HMO – HCHP First SeniorityFMCR-MC127Medicare HMO – Health New England Medicare Wrap **FMCR-MC222Medicare HMO – Healthsource CMHCFMCR-MC212Medicare HMO – Healthsource CMHC Central Care Supplement **FMCR-MC128Medicare HMO – HMO Blue for Seniors **FMCR-MC129Medicare HMO – Kaiser Medicare Plus Plan **FMCR-MC234Medicare HMO – Managed Blue for SeniorsFMCR-MC132Medicare HMO – Matthew Thornton Senior PlanFMCR-MC211Medicare HMO – Neighborhood Health Plan Senior Health Plus **FMCR-MC134Medicare HMO – Other (not listed elsewhere) ***FMCR-MC131Medicare HMO – Pilgrim Enhance 65 **FMCR-MC210Medicare HMO – Pilgrim Preferred 65 **FMCR-MC231Medicare HMO – Pilgrim PrimeFMCR-MC232Medicare HMO – Seniorcare DirectFMCR-MC233Medicare HMO – Seniorcare PlusFMCR-MC224Medicare HMO – Tufts Medicare Preferred HMOFMCR-MC225Medicare HMO – US HealthcareFMCR-MC133Medicare HMO – Tufts Medicare Supplement (TMS)FMCR-MC43MEDTAC8HMO96Metrahealth (United Care of NE)7COM158Metrahealth – HMO (United Care of NE)DCOM-MC SUPPLEMENT V. ALPHABETICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION172Metrahealth – POS (United Care of NE)DCOM-MC157Metrahealth – PPO (United Care of NE)DCOM-MC201Mutual of Omaha **7COM62Mutual of Omaha Insurance7COM33Mutual of Omaha PPODCOM-MC47Neighborhood Health Plan8HMO3Network Blue (PPO)CBCBS-MC207Network Health (Cambridge Health Alliance MCD Program)BMCD-MC91New England Benefits7COM63Mutual of Omaha Insurance7COM64New York Life Care Indemnity (New York Life Insurance)7COM34New York Life Care PPODCOM-MC202New York Life Insurance **7COM159None (Valid only for secondary source of payment)NNONE31One Health Plan HMO (Great West Life)DCOM-MC77Options for Healthcare PPOEPPO147Other Commercial Insurance (not listed elsewhere) ***7COM199Other EPO (not listed elsewhere) ***KEPO144Other Government5GOV148Other HMO (not listed elsewhere) ***8HMO141Other Medigap (not listed elsewhere)7COM150Other Non-Managed Care (not listed elsewhere) ***0OTH99Other POS (not listed elsewhere) ***JPOS156Out of State BCBS6BCBS120Out-of-State Medicaid5GOV135Out-of-State Medicare3MCR65Paul Revere Life Insurance7COM78Phoenix Preferred PPODCOM-MC10Pilgrim Advantage - PPOEPPO39 Pilgrim Direct8HMO8Pilgrim Health Care8HMO95Pilgrim Select - PPOEPPO183Pioneer Health Care EPOKEPO79Pioneer Health Care PPOEPPO SUPPLEMENT V. ALPHABETICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION25Pioneer Plan8HMO149PPO and Other Managed Care (not listed elsewhere) ***EPPO203Principal Financial Group (Principal Mutual Life)7COM184Private Healthcare Systems EPOKEPO166Private Healthcare Systems POSJPOS84Private Healthcare Systems PPOEPPO75Prudential Healthcare HMODCOM-MC17Prudential Healthcare POSDCOM-MC18Prudential Healthcare PPODCOM-MC66Prudential Insurance7COM93Psychological Health Plan EPPO101Quarto Claims7COM168Reserved173-180Reserved185-198Reserved205-209Reserved213-219Reserved226-229Reserved235-249Reserved252-269Reserved145Self-Pay1SP94Time Insurance Co7COM100Transport Life Insurance7COM7Tufts Associated Health Plan8HMO80Tufts Total Health Plan PPOEPPO97Unicare7COM182Unicare Preferred Plus Managed Access EPODCOM-MC270Unicare Preferred Plus PPODCOM-MC70Union Labor Life Insurance7COM86United Health & Life PPO (Subsidiary of United Health Plans of NE)EPPO73United Health and Life (subsidiary of United Health Plans of NE)7COM9United Health Plan of New England (Ocean State)8HMO74United Healthcare Insurance Company7COM SUPPLEMENT V. ALPHABETICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION35United Healthcare Insurance Company – HMO (new for 1997)DCOM-MC163United Healthcare Insurance Company – POS (new for 1997)DCOM-MC36United Healthcare Insurance Company – PPO (new for 1997)DCOM-MC48US Healthcare8HMO83US Healthcare Quality Network Choice-PPOEPPO170US Healthcare Quality POSJPOS102Wausau Insurance Company7COM146Worker’s Compensation2WOR ** Supplemental Payer Source ***Please list under the specific carrier when possible SUPPLEMENT V. ALPHABETICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SUPPLEMENTAL PAYER SOURCES USE AS SECONDARY PAYER SOURCE ONLY SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION137AARP/Medigap Supplement7COM138Banker’s Life and Casualty Insurance7COM139Bankers Multiple Line7COM136BCBS Medex6BCBS140Combined Insurance Company of America7COM200Hartford Life Insurance Company7COM127Medicare HMO – Health New England Medicare WrapFMCR-MC212Medicare HMO – Healthsource CMHC Central Care SupplementFMCR-MC128Medicare HMO – HMO Blue for SeniorsFMCR-MC129Medicare HMO-Kaiser Medicare Plus PlanFMCR-MC131Medicare HMO – Pilgrim Enhance 65FMCR-MC210Medicare HMO-Pilgrim Preferred 65FMCR-MC201Mutual of Omaha7COM211Neighborhood Health Plan Senior Health PlusFMCR-MC202New York Life Insurance Company7COM141Other Medigap (not listed elsewhere) ***7COM133Medicare HMO – Tufts Medicare Supplement (TMS)FMCR-MC SUPPLEMENT VI. NUMERICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION1Harvard Community Health Plan8HMO2Bay State – a product of HMO BlueCBCBS-MC3Network Blue (PPO)CBCBS-MC4Fallon Community Health Plan (includes Fallon Plus, Fallon Affiliates, Fallon UMass)8HMO5Invalid (replaced by #9)6Invalid (replaced by #251)7Tufts Associated Health Plan8HMO8Pilgrim Health Care8HMO9United Health Plan of New England (Ocean State)8HMO10Pilgrim Advantage - PPOEPPO11Blue Care ElectCBCBS-MC12Invalid (replaced by #49)13Community Health Plan Options (New York)JPOS14Health New England Advantage POSJPOS15Invalid (replaced by #158)16Invalid (replaced by #172)17Prudential Healthcare POSDCOM-MC18Prudential Healthcare PPODCOM-MC19Matthew Thornton8HMO20HCHP of New England (formerly RIGHA)8HMO21Commonwealth PPOCBCBS-MC22Aetna Open Choice PPODCOM-MC23Guardian Life Insurance Company PPODCOM-MC24Health New England Inc.8HMO25Pioneer Plan8HMO26Invalid (replaced by #75)27First Allmerica Financial Life Insurance PPODCOM-MC28Great West Life PPODCOM-MC29Invalid (replaced by #171 & 250)30CIGNA (Indemnity)7COM31One Health Plan HMO (Great West Life)DCOM-MC32Invalid (replaced by #157 & 158) SUPPLEMENT VI. NUMERICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION33Mutual of Omaha PPODCOM-MC34New York Life Care PPODCOM-MC35United Healthcare Insurance Company – HMO (new for 1997)DCOM-MC36United Healthcare Insurance Company - PPO (new for 1997)DCOM-MC37HCHP-Pilgrim HMO (integrated product)8HMO38Health new England Select (self-funded)8HMO39Pilgrim Direct8HMO40Kaiser Foundation8HMO41Invalid (replaced by #157)42ConnectiCare of Massachusetts8HMO43MEDTAC8HMO44Community Health Plan8HMO45Health Source New Hampshire8HMO46Blue ChiP (BCBS Rhode Island)8HMO47Neighborhood Health Plan8HMO48US Healthcare8HMO49Healthsource CMHC Plus PPOEPPO50Blue Health Plan for Kids6BCBS51Aetna Life Insurance7COM52Boston Mutual Insurance7COM53Invalid (no replacement)54Continental Assurance Insurance7COM55Guardian Life Insurance7COM56Hartford L&A Insurance7COM57John Hancock Life Insurance7COM58Liberty Life Insurance7COM59Lincoln National Insurance7COM60Invalid (replaced by #97)61Invalid (replaced by #96)62Mutual of Omaha Insurance7COM63New England Mutual Insurance7COM64New York Life Care Indemnity (New York Life Insurance)7COM65Paul Revere Life Insurance7COM SUPPLEMENT VI. NUMERICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION66Prudential Insurance7COM67First Allmerica Financial Life Insurance7COM68Invalid (replaced by #96)69Corporate Health Insurance Liberty Plan7COM70Union Labor Life Insurance7COM71ADMAREPPO72Healthsource New Hampshire7COM73United Health and Life (subsidiary of United Health Plans of NE)7COM74United Healthcare Insurance Company7COM75Prudential Healthcare HMODCOM-MC76Invalid (replaced by #270)77Options for Healthcare PPOEPPO78Phoenix Preferred PPODCOM-MC79Pioneer Health Care PPOEPPO80Tufts Total Health Plan PPOEPPO81HMO BlueCBCBS-MC82John Hancock PreferredDCOM-MC83US Healthcare Quality Network Choice - PPOEPPO84Private Healthcare Systems PPOEPPO85Liberty Mutual7COM86United Health & Life PPO (subsidiary of United Health Plans of NE)EPPO87CIGNA PPODCOM-MC88Freedom CareEPPO89Great West/NE Care7COM90Healthsource Preferred (self-funded)EPPO91New England Benefits7COM92Invalid (replaced by #84, 166, 184)93Psychological Health PlanEPPO94Time Insurance Co7COM95Pilgrim Select - PPOEPPO96Metrahealth (United Health Care of NE)7COM97Unicare7COM SUPPLEMENT VI. NUMERICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION98Healthy Start9FC99Other POS (not listed elsewhere) ***JPOS100Transport Life Insurance7COM101Quarto Claims7COM102Wausau Insurance Company7COM103Medicaid (includes MassHealth)4MCD104Medicaid Managed Care-Primary Care Clinician (PCC)BMCD-MC105Invalid (replaced by #111)106Medicaid Managed Care-Central Mass Health CareBMCD-MC107Medicaid Managed Care-Community Health PlanBMCD-MC108Medicaid Managed Care-Fallon Community Health PlanBMCD-MC109Medicaid Managed Care-Harvard Community Health PlanBMCD-MC110Medicaid Managed Care-Health New EnglandBMCD-MC111Medicaid Managed Care-HMO BlueBMCD-MC112Medicaid Managed Care-Kaiser Foundation PlanBMCD-MC113Medicaid Managed Care-Neighborhood Health PlanBMCD-MC114Medicaid Managed Care-United Health Plans of NE (Ocean State Physician’s Plan)BMCD-MC115Medicaid Managed Care-Pilgrim Health CareBMCD-MC116Medicaid Managed Care-Tufts Associated Health PlanBMCD-MC117Invalid (no replacement)118Medicaid Mental Health & Substance Abuse Plan – Mass Behavioral Health PartnershipBMCD-MC119Medicaid Managed Care Other (not listed elsewhere) ***BMCD-MC120Out-Of-State Medicaid5GOV121Medicare3MCR122Invalid (replaced by #234)123Invalid (no replacement)124Invalid (replaced by #222)125Medicare HMO – Fallon Senior PlanFMCR-MC126Invalid (replaced by #230)127Medicare HMO – Health New England Medicare Wrap **FMCR-MC128Medicare HMO – HMO Blue for Seniors **FMCR-MC129Medicare HMO – Kaiser Medicare Plus PlanFMCR-MCSUPPLEMENT VI. NUMERICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION130Invalid (replaced by #232 and 233)131Medicare HMO – Pilgrim Enhance 65 **FMCR-MC132Medicare HMO – Matthew Thornton Senior PlanMCR-MC133Medicare HMO – Tufts Medicare Supplement (TMS)FMCR-MC134Medicare HMO – Other (not listed elsewhere)FMCR-MC135Out-Of-State Medicare3MCR136BCBS Medex **6BCBS137AARP/Medigap Supplement **7COM138Banker’s Life and Casualty Insurance **7COM139Bankers Multiple Line **7COM140Combined Insurance Company of America **7COM141Other Medigap (not listed elsewhere) ***7COM142Blue Cross Indemnity6BCBS143Free Care9FC144Other Government5GOV145Self-Pay1SP146Worker’s Compensation2WOR147Other Commercial (not listed elsewhere) ***7COM148Other HMO (not listed elsewhere) ***8HMO149PPO and Other Managed Care (not listed elsewhere) ***EPPO150Other Non-Managed Care (not listed elsewhere) ***0OTH151CHAMPUS5GOV152Foundation0OTH153Grant0OTH154BCBS Other (not listed elsewhere) ***6BCBS155Blue Cross Managed Care Other (not listed elsewhere) ***CBCBS-MC156Out of State BCBS6BCBS157Metrahealth – PPO (United Health Care of NE)DCOM-MC158Metrahealth – HMO (United Health Care of NE)DCOM-MC159None (valid only for secondary source of payment)NNONE160Blue Choice (includes Healthflex Blue) - POSCBCBS-MC161Aetna Managed Choice POSDCOM-MC162Great West Life POSDCOM-MC SUPPLEMENT VI. NUMERICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION163United Healthcare Insurance Company – POS (new for 1997)DCOM-MC164Healthsource CMHC Plus POSJPOS165Healthsource New Hampshire POS (self-funded)JPOS166Private Healthcare Systems POSJPOS167Fallon POSJPOS168Reserved169Kaiser Added ChoiceJPOS170US Healthcare Quality POSJPOS171CIGNA POSDCOM-MC172Metrahealth – POS (United Health Care NE)DCOM-MC173-180Reserved181First Allmerica Financial Life Insurance EPODCOM-MC182Unicare Preferred Plus Managed Access EPODCOM-MC183Pioneer Health Care EPOKEPO184Private Healthcare Systems EPOKEPO185-198Reserved199Other EPO (not listed elsewhere) ***KEPO200Hartford Life Insurance Co **7COM201Mutual of Omaha **7COM202New York Life Insurance **7COM203Principal Financial Group (Principal Mutual Life)7COM204Christian Brothers Employee7COM207Network Health (Cambridge Health Alliance MCD Program)BMCD-MC208HealthNet (Boston Medical Center MCD Program)BMCD-MC205-209Reserved210Medicare HMO – Pilgrim Preferred 65 **FMCR-MC211Medicare HMO – Neighborhood Health Plan Senior Health Plus **FMCR-MC212Medicare HMO – Healthsource CMHC Central Care Supplement **FMCR-MC213-219Reserved220Medicare HMO – Blue Care 65FMCR-MC221Medicare HMO – Harvard Community Health Plan 65FMCR-MC222Medicare HMO – Healthsource CMHCFMCR-MCSUPPLEMENT VI. NUMERICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION223Medicare HMO – Harvard Pilgrim Health Care of New England Care PlusFMCR-MC224Medicare HMO – Tufts Secure HorizonsFMCR-MC225Medicare HMO – US HealthcareFMCR-MC2236-229Reserved230Medicare HMO – HCHP First SeniorityFMCR-MC231Medicare HMO – Pilgrim PrimeFMCR-MC232Medicare HMO – Seniorcare DirectFMCR-MC233Medicare HMO – Seniorcare PlusFMCR-MC234Medicare HMO – Managed Blue for SeniorsFMCR-MC235-249Reserved250CIGNA HMODCOM-MC251Healthsource CMHC HMO8HMO252-269Reserved270UniCare Preferred Plus PPODCOM-MC271Hillcrest HMO8HMO272Auto InsuranceTAI300CommCare: BMC HealthNet Plan/Commonwealth Care – General Classification (For use only when no specific level for this plan can be identified)QCommCare301CommCare: BMC HealthNet Plan/Commonwealth Care – Plan Type IQCommCare302CommCare: BMC HealthNet Plan/Commonwealth Care – Plan Type IIQCommCare303CommCare: BMC HealthNet Plan/Commonwealth Care – Plan Type IIIQCommCare304CommCare: BMC HealthNet Plan/Commonwealth Care – Plan Type IVQCommCare400CommCare: Cambridge Network Health Forward – General Classification (For use only when no specific level for this plan can be identified)QCommCare401CommCare: Cambridge Network Health Forward – Plan Type IQCommCare402CommCare: Cambridge Network Health Forward – Plan Type IIQCommCare SUPPLEMENT VI. NUMERICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION403CommCare: Cambridge Network Health Forward – Plan Type IIIQCommCare404CommCare: Cambridge Network Health Forward – Plan Type IVQCommCare500CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care – General Classification (For use only when no specific level for this plan can be identified)QCommCare501CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care – Plan 1 (Group No. 4445077)QCommCare502CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care – Plan 2 (Group No. 4455220)QCommCare503CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care – Plan 3 (Group No. 4455221)QCommCare504CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care – Plan 4 (Group No. 4455222)QCommCare600CommCare: Neighborhood Health Plan– General Classification (For use only when no specific level for this plan can be identified)QCommCare601CommCare: Neighborhood Health Plan – NHP Commonwealth Care Plan – Plan Type I (9CC1)QCommCare602CommCare: Neighborhood Health Plan – NHP Commonwealth Care Plan – Plan Type II (9CC2)QCommCare603CommCare: Neighborhood Health Plan – NHP Commonwealth Care Plan – Plan Type III (9CC3)QCommCare604CommCare: Neighborhood Health Plan – NHP Commonwealth Care Plan – Plan Type IV (9CC4)QCommCare990Free Care – co-pay, deductible, or co-insurance (when billing for free care services use #143)9FC ** Supplemental Payer Source *** Please list under the specific carrier when possible SUPPLEMENT VI. NUMERICAL SOURCE OF PAYMENT LIST Effective October 1, 1997 SUPPLEMENTAL PAYER SOURCES USE AS SECONDARY PAYER SOURCE ONLY SOURCE PAY CODESOURCE OF PAYMENT DEFINITIONSMATCHING PAYER TYPE CODEPAYER TYPE ABBREVIATION127Medicare HMO – Health New England Medicare WrapFMCR-MC128Medicare HMO – HMO Blue for SeniorsFMCR-MC129Medicare HMO – Kaiser Medicare Plus PlanFMCR-MC131Medicare HMO – Pilgrim Enhance 65FMCR-MC133Medicare HMO – Tufts Medicare Supplement (TMS)FMCR-MC136BCBS Medex6BCBS137AARP/Medigap Supplement7COM138Banker’s Life & Casualty Insurance7COM139Bankers Multiple Line7COM140Combined Insurance Company of America7COM141Other Medigap (not listed elsewhere) ***7COM200Hartford Life Insurance Co.7COM201Mutual of Omaha7COM202New York Life Insurance Company7COM210Medicare HMO – Pilgrim Preferred 65FMCR-MC211Neighborhood Health Plan Senior Health PlusFMCR-MC212Medicare HMO – Healthsource CMHC Central Care SupplementFMCR-MC SECTION II. TECHNICAL DOCUMENTATION PART A. CALCULTED FIELD DOCUMENTATION 1. Age Calculation 2. Newborn Age 3. Preoperative Days 4. Length of Stay (LOS) Calculation 5. Length of Stay (LOS) Routine 6. Unique Health Information Number 7. Days Between Stays SECTION II. TECHNICAL DOCUMENTATION For your information, we have included a page of physical specifications for the data file at the beginning of this manual. Please refer to CD Specifications on page 2 for further details. Technical Documentation included in this section of the manual is as follows: Part A. Calculated Field Documentation Part B. Data File Summary Part C. Revenue Code Mappings Record layout gives a description of each field along with the starting and ending positions. A copy of this layout accompanies this manual for the users’ review. Calculated fields are age, newborn age in weeks, preoperative days, length of stay, Unique Health Information Number (UHIN), and days between stays. Each description has three parts: First is a description of any Conventions. For example, how are missing values used? Second is a Brief Description of how the fields are calculated. This description leaves out some of the detail. However, with the first section it gives a good working knowledge of the field. Third is a Detailed Description of how the calculation is performed. This description follows the code very closely. PART A. CALCULATED FIELD DOCUMENTATION AGE CALCULATION Conventions: 1) Age is calculated if the date of birth and admission date are valid. If either one is invalid, then ‘999’ is placed in this field. 2) Discretion should be used whenever a questionable age assignment is noted. Researchers are advised to consider other data elements (i.e., if the admission type is newborn) in their analysis of this field. Brief Description: Age is calculated by subtracting the date of birth from the admission date. Detailed Description: 1) If the patient has already had a birthday for the year, his or her age is calculated by subtracting the year of birth from the year of admission. If not, then the patient’s age is the year of admission minus the year of birth, minus one. 2) If the age is 99 (the admission date is a year before the admission date or less) and the MDC is 15 (the patient is a newborn), then the age is assumed to be zero. PART A. CALCULATED FIELD DOCUMENTATION NEWBORN AGE Conventions: Newborn age is calculated to the nearest week (the remainder is dropped). Thus, newborns zero to six days old are considered to be zero weeks old. Discharges that are not newborns have ‘99’ in this field. Brief Description: Discharges less than one year old have their age calculated by subtracting the date of birth from the admission date. This gives the patient’s age in days. This number is divided by seven, the remainder is dropped. Detailed Description: If a patient is 1 year old or older, the age in weeks is set to ‘99’. If a patient is less than 1 year old then: Patients’ age is calculated in days using the Length of Stay (LOS) routine, described herein. Number of days in step ‘a’ above is divided by seven, and the remainder is dropped. PART A. CALCULATED FIELD DOCUMENTATION PREOPERATIVE DAYS Conventions: A procedure performed on the day of admission will have preoperative days set to zero. One performed on the day after admission will have preoperative days set to 1, etc. A procedure performed on the day before admission will have preoperative days set to negative one (-1). Preoperative days are set to 0000 when preoperative days are not applicable. For procedures performed before the day of admission, a negative sign (-) will appear in the first position of the preoperative day field. Brief Description: Preoperative days are calculated by subtracting the patient’s admission date from the surgery date. Detailed Description: 1) If there is no procedure date, or if the procedure date or admission date is invalid, or if the procedure date occurs after the discharge date, then preoperative days is set to 0000. 2) Otherwise preoperative days are calculated using the Length of Stay (LOS) Routine, as described herein. PART A. CALCULATED FIELD DOCUMENTATION LENGTH OF STAY (LOS) CALCULATION Conventions: Same day discharges have a length of stay of 1 day. Brief Description: Length of Stay (LOS) is calculated by subtracting the admission date from the discharge date (and then subtracting Leave of Absence Days (LOA) days). If the result is zero (for same day discharges), then the value is changed to 1. Detailed Description: 1) The length of stay is calculated using the LOS routine. 2) If the value is zero, then it is changed to a 1. PART A. CALCULATED FIELD DOCUMENTATION LENGTH OF STAY (LOS) ROUTINE Conventions: None. Brief Description: 1) Length of Stay (LOS) is calculated by subtracting the admission date from the Discharge Date and then subtracting the Leave of Absence from the total. If either date is invalid, length of stay = 0. 2) Days are accumulated a year at a time, until both dates are in the same year. At this point, the algorithm may have counted beyond the ending date or may still fall short of it. The difference is added (or subtracted) to give the correct LOS. PART A. CALCULATED FIELD DOCUMENTATION UNIQUE HEALTH INFORMATION NUMBER (UHIN) VISIT SEQUENCE NUMBER Conventions: If the Unique Health Information Number (UHIN) is undefined (not reported, unknown or invalid), the sequence number is set to zero. Brief Description: The Sequence Number is calculated by sorting the file by UHIN, admission date, and discharge date. The sequence number is then calculated by incrementing a counter for each UHIN’s set of admissions. Detailed Description: UHIN Sequence Number is calculated by sorting the entire database by UHIN, admission date, then discharge date (both dates are sorted in ascending order). If the UHIN is undefined (not reported, unknown or invalid), the sequence number is set to zero. If the UHIN is valid, the sequence number is calculated by incrementing a counter from 1 to nnnn, where a sequence number of 1 indicates the first admission for the UHIN, and nnnn indicates the last admission for the UHIN. If a UHIN has 2 admissions on the same day, the discharge date is used as the secondary sort key. PART A. CALCULATED FIELD DOCUMENTATION DAYS BETWEEN STAYS Conventions: 1) If the UHIN is undefined (not reported unknown or invalid), the days between stays is set to zero. 2) If the previous discharge date is greater than the current admission date or the previous discharge date or current admission date is invalid (i.e., 03/63/95), DAYS BETWEEN STAYS is set to ‘9999’ to indicate an error. Brief Description: The Days Between Stays is calculated by sorting the file by UHIN, admission date, and discharge date. For UHINs with two or more admissions, the calculation subtracts the previous discharge date from the current admission date to find the Days Between Stays. Detailed Description: The Days Between Stays data element is calculated by sorting the entire database by UHIN, and sequence number. If the UHIN is undefined (not reported, unknown or invalid), the Days Between Stays is set to zero. If the UHIN is valid and this is the first occurrence of the UHIN, the discharge date is saved (in the event there is another occurrence of the UHIN). In this case, the Days Between Stays is set to zero. PART A. CALCULATED FIELD DOCUMENTATION 7. DAYS BETWEEN STAYS (continued) 4) If a second occurrence of the UHIN is found, Days Between Stays is calculated by finding the number of days between the previous discharge date and the current admission date, with the following caveats: A) If the previous discharge date is greater than the current admission date; OR B) The previous discharge date or current admission date is invalid, (i.e., 03/63/95), Days Between Stays is set to ‘9999’ to indicate an error. 5) Step 4 is repeated for all subsequent re-admissions until the UHIN changes. 6) The method used to calculate Length of Stay is also used to calculate Days Between Stays. 7) If the Discharge Date on the first admission date is the same as the admission date on the first re-admission, Days Between Stays is set to zero. This situation occurs for transfer patients, as well as for women admitted into the hospital with false labor. PART B. DATA FILE SUMMARY 1. Discharge File Table FY2007 2. Revenue File Table FY2007 3. Data Code Tables FY2007 PART B. DATA FILE SUMMARY The following is a list of the contents of the FIPA Layout. The data is separated into a Discharge File and a Revenue File. Passed and Failed data are included together in each file. The failed discharges are flagged for easy identification. See Data Elements: Flag to indicate if Discharge passed edits, SubmissionPassedFlag. Linkage between the Discharge File and the Revenue File can be accomplished using the RecordType20ID. The SubmissionControlID identifies a unique collection of discharges from a provider – i.e., a specific data submission for a specific hospital and quarter. It is important to note that the data set may vary depending on what level data you have received. Please also note that the FIPA file has been cleaned. Bad character data have been replaced with underscores. Bad numeric data and bad dates have been replaced with nulls. The following files are included in the electronic files along with the Hospital Discharge Data: Top Errors Report Record Layout Total Charges & Discharges by Hospital 1. FY2007 Discharge File Table – 1 Record per Discharge Please note changes made during FY2007. #Data ElementColumn1RecordType20ID*RecordType20ID*2SubmissionControlID**SubmissionControlID**3Submission YearYear4Submission QuarterQuarter5Discharge IDDischargeID6Hospital Organization IDIdOrgHosp7Filing Organization IDIdOrgFiler8Site Organization IDIdOrgSite9Site NumberSite Number10Sex of PatientSex11Transfer Organization IDIdOrgTransfer12Patient’s Resident Street AddressPermanentPatientStreetAddress13Patient’s Resident CityPermanentPatientCity14Patient’s Resident StatePermanentPatientState15Patient's Resident Zip CodePermanentPatientZIPCode16Patient’s Resident CountryPermanentPatientCountry17Patient’s Temporary Street AddressTemporaryUSPatientStreetAddress18Patient’s Temporary CityTemporaryUSPatientCity19Patient’s Temporary StateTemporaryUSPatientState20Patient’s Temporary ZIP CodeTemporaryUSPatientZIPCode21Patient's Employer's ZIP CodeEmployerZIPCode22Homeless IndicatorHomelessIndicator23Newborn AgeNewborn Age24Calculated AgeAge25Newborn Birth Weight (in grams)Birthweight26Veterans StatusVeteransStatus27DNR StatusDNRStatus28Race1 of PatientRace129Race2 of PatientRace230Other Race of PatientOtherRace31Hispanic IndicatorHispanicIndicator32Ethnicity1 of PatientEthnicity133Ethnicity2 of PatientEthnicity234Other Ethnicity of PatientOtherEthnicity35Nature of the Patient AdmissionAdmissionType *formerly dischargeid **formerly providercontrolid 1. FY2007 Discharge File Table – 1 Record per Discharge - Continued #Data ElementColumn36Primary Source of Patient AdmissionAdmissionSourceCode137Secondary Source of Patient AdmissionAdmissionSourceCode238Outcome of Patients HospitalizationPatientStatus39Anticipated SOURCE of Hospital Expense ReimbursementPayerCode140Anticipated TYPE of Hospital Expense ReimbursementPrimaryPayerType41Secondary SOURCE of Hospital Expense ReimbursementPayerCode242Secondary TYPE of Hospital ReimbursementSecondaryPayerType43Day of week patient was AdmittedAdmissionDayOfWeek44Day of week patient was DischargedDischargeDayOfWeek45Calculated Length of StayLengthOfStay46Administratively Necessary DaysNumberOfANDs47Leave of Absence DaysLeaveOfAbsenceDays48NbrOfDiagnosisCodesNumberOfDiagnosisCodes49NbrOfProcedureCodesNumberOfProcedureCodes50Patient's Medical Record NumberMedicalRecordNumber51Billing NumberHospBillNo52Unique Patient IdentifierUHIN53Patient's BirthdateDOB54Mothers Unique Patient IdentifierMotherSSN55Mothers Medical Record NumberMotherMedicalRecordNumber56Days Between StaysDaysBetweenStays57Re-Admission SequenceUHIN_SequenceNo58Date of Hospital AdmissionAdmissionDate59Month of Hospital AdmissionAdmissionMonth60Date of Hospital DischargeDischargeDate61Month of Hospital DischargeDischargeMonth62Period (Quarter) Starting DatePeriodStartingDate63Period (Quarter) Ending DatePeriodEndingDate64Attending Physician NPIAttendingPhysNPI65Attending Physician NPI Location CodeAttendingPhysNPILocationCode66Operating Physician NPIOperatingPhysNPI67Operating Physician NPI Location CodeOperatingPhysNPILocationCode68Other Care Giver CodeOtherCareGiverCode69Other Care Giver NPIOtherCareGiverNPI70Other Care Giver NPI Location CodeOtherCareGiverNPILocCode 1. FY2007 Discharge File Table – 1 Record per Discharge - Continued #Data ElementColumn71Total Charges for Routine Accom. Revenue CentersTotalChargesRoutine72Total Charges for Special Accom. Revenue CentersTotalChargeSpecial73Total Charges for all Revenue CentersTotalChargesAll74Total Charges for Ancillary Revenue CentersTotalChargesAncillaries75Flag to indicate if discharge passed editsDischargePassed76SubmissionPassedFlagSubmissionPassedFlag77ED FlagEDFlagCode78Outpatient Observation Stay FlagOutpatntObsrvStayFlagCode79Special Condition IndicatorSpecialConditionIndicator80EcodeEcode81ConditionPresentECodeConditionPresentECode82ConditionPresent1ConditionPresent183ConditionPresent2ConditionPresent284ConditionPresent3ConditionPresent385ConditionPresent4ConditionPresent486ConditionPresent5ConditionPresent587ConditionPresent6ConditionPresent688ConditionPresent7ConditionPresent789ConditionPresent8ConditionPresent890ConditionPresent9ConditionPresent991ConditionPresent10ConditionPresent1092ConditionPresent11ConditionPresent1193ConditionPresent12ConditionPresent1294ConditionPresent13ConditionPresent1395ConditionPresent14ConditionPresent1496ConditionPresent15ConditionPresent1597Principal ICD-9 Diagnosis CodeDiagnosisCode198Associated ICD-9 Diag Code IDiagnosisCode299Associated ICD-9 Diag Code IIDiagnosisCode3100Associated ICD-9 Diag Code IIIDiagnosisCode4101Associated ICD-9 Diag Code IVDiagnosisCode5102Associated ICD-9 Diag Code VDiagnosisCode6103Associated ICD-9 Diag Code VIDiagnosisCode7104Associated ICD-9 Diag Code VIIDiagnosisCode8105Associated ICD-9 Diag Code VIIIDiagnosisCode9106Associated ICD-9 Diag Code IXDiagnosisCode10107Associated ICD-9 Diag Code XDiagnosisCode11108Associated ICD-9 Diag Code XIDiagnosisCode12 FY2007 Discharge File Table – 1 Record per Discharge – Continued #Data ElementColumn 109Associated ICD-9 Diag Code XIIDiagnosisCode13110Associated ICD-9 Diag Code XIIIDiagnosisCode14111Associated ICD-9 Diag Code XIVDiagnosisCode15112Principal ICD-9 Procedure CodeProcedureCode1113Principal Procedure DateProcedureDate1114Significant ICD-9 Procedure Code IProcedureCode2115Procedure I DateProcedureDate2116Significant ICD-9 Procedure II CodeProcedureCode3117Procedure II DateProcedureDate3118Significant ICD-9 Procedure III CodeProcedureCode4119Procedure III DateProcedureDate4120Significant ICD-9 Procedure IV CodeProcedureCode5121Procedure IV DateProcedureDate5122Significant ICD-9 Procedure V CodeProcedureCode6123Procedure V DateProcedureDate6124Significant ICD-9 Procedure VI CodeProcedureCode7125Procedure VI DateProcedureDate7126Significant ICD-9 Procedure VII CodeProcedureCode8127Procedure VII DateProcedureDate8128Significant ICD-9 Procedure VIII CodeProcedureCode9129Procedure VIII DateProcedureDate9130Significant ICD-9 Procedure IX CodeProcedureCode10131Procedure IX DateProcedureDate10132Significant ICD-9 Procedure X CodeProcedureCode11133Procedure X DateProcedureDate11134Significant ICD-9 Procedure XI CodeProcedureCode12135Procedure XI DateProcedureDate12136Significant ICD-9 Procedure XII CodeProcedureCode13137Procedure XII DateProcedureDate13138Significant ICD-9 Procedure XIII CodeProcedureCode14139Procedure XIII DateProcedureDate14140Significant ICD-9 Procedure XIV CodeProcedureCode15141Procedure XIV DateProcedureDate15142Number of days in hospital when FIRST procedure performedPreoperativeDays1143Number of days in hospital when SECOND procedure performedPreoperativeDays2144Number of days in hospital when THIRD procedure performedPreoperativeDays31. FY2007 Discharge File Table – 1 Record per Discharge - Continued #Data ElementColumn145V 20 Major Diagnosis Group (MDC)V20_MDC146V 20 Diagnosis Related Group (DRG)V20_DRG147V 20 DRG Return CodeV20_ReturnCode148V 20 First O.R. Procedure Code used by GrouperV20_ORProcedureCode1149V 20 Second O.R. Procedure Code used by GrouperV20_ORProcedureCode2150V 20 Third O.R. Procedure Code used by GrouperV20_ORProcedureCode3151V 20 First Non-O.R. Procedure Code used by GrouperV20_NonORProcedureCode1152V 20 Second Non-O.R. Procedure Code used by GrouperV20_NonORProcedureCode2153V 20 First Diagnosis Code, other than principal code, that was used by GrouperV20_DiagnosisCode1154V 20 Second Diagnosis Code, other than principal code, that was used by GrouperV20_DiagnosisCode2155V 20 Third Diagnosis Code, other than principal code, that was used by GrouperV20_DiagnosisCode3156V 20 Severity Code used by GrouperV20_Severity157V 20 Severity Diagnosis Buffer Code used by GrouperV20_SeverityDiagnosisBuffer158V 20 Mortality Code used by GrouperV20_Mortality159V 20 Mortality Diagnosis Buffer used by GrouperV20_MortalityDiagnosisBuffer160V AP 12 Major Diagnosis Group (MDC)V12_MDC161V AP 12 Diagnosis Related Group (DRG)V12_DRG162V AP 12 DRG Return CodeV12_ReturnCode163V AP 12 First O.R. Procedure Code used by GrouperV12_ORProcedureCode1164V AP 12 Second O.R. Procedure Code used by GrouperV12_ORProcedureCode2165V AP 12 Third O.R. Procedure Code used by GrouperV12_ORProcedureCode3166V AP 12 First Non-O.R. Procedure Code used by GrouperV12_NonORProcedureCode1167V AP 12 Second Non-O.R. Procedure Code used by GrouperV12_NonORProcedureCode2168V AP 12 First Diagnosis Code, other than principal code, that was used by GrouperV12_DiagnosisCode1169V AP 12 Second Diagnosis Code, other than principal code, that was used by GrouperV12_DiagnosisCode2170V AP 12 Third Diagnosis Code, other than principal code, that was used by GrouperV12_DiagnosisCode3171V AP 12 Diagnosis Code used by Grouper to satisfy Completion/Comorbidity CriteriaV12_DiagnosisCodeComplication172V AP 12 Major Complication/Comorbidity IndicatorV12_Complication1. FY2007 Discharge File Table – 1 Record per Discharge - Continued #Data ElementColumn173V AP 12 Trauma Registry IndicatorV12_TraumaRegistryIndicator174V AP 21 Major Diagnosis Group (MDC)V21_MDC175V AP 21 Diagnosis Related Group (DRG)V21_DRG176V AP 21 DRG Return CodeV21_ReturnCode177V AP 21 First O.R. Procedure Code used by GrouperV21_ORProcedureCode1178V AP 21 Second O.R. Procedure Code used by GrouperV21_ORProcedureCode2179V AP 21 Third O.R. Procedure Code used by GrouperV21_ORProcedureCode3180V AP 21 First Non-O.R. Procedure Code used by GrouperV21_NonORProcedureCode1181V AP 21 Second Non-O.R. Procedure Code used by GrouperV21_NonORProcedureCode2182V AP 21 First Diagnosis Code, other than principal code, that was used by GrouperV21_DiagnosisCode1183V AP 21 Second Diagnosis Code, other than principal code, that was used by GrouperV21_DiagnosisCode2184V AP 21 Third Diagnosis Code, other than principal code, that was used by GrouperV21_DiagnosisCode3185V AP 21 Diagnosis Code used by Grouper to satisfy Completion/Comorbidity CriteriaV21_DiagnosisCodeComplication186V AP 21 Major Complication/Comorbidity IndicatorV21_Complication187V AP 21 Trauma Registry IndicatorV21_TraumaRegistryIndicator188V AP 21 Congenital Malformation Registry IndicatorV21_CongenitalMalformationRegistryIndicator189CMS 24 Major Diagnosis Group (MDC)VHAF24_MDC190CMS 24 Diagnosis Related Group (DRG)VHAF24_DRG191CMS 24 DRG Return CodeVHAF24_ReturnCode192CMS 24 First O.R. Procedure Code used by GrouperVHAF24_ORProcedureCode1193CMS 24 Second O.R. Procedure Code used by GrouperVHAF24_ORProcedureCode2194CMS 24 Third O.R. Procedure Code used by GrouperVHAF24_ORProcedureCode3195CMS 24 First Non-O.R. Procedure Code used by GrouperVHAF24_NonORProcedureCode1196CMS 24 Second Non-O.R. Procedure Code used by GrouperVHAF24_NonORProcedureCode2197CMS 24 Third Non-O.R. Procedure Code used by Grouper VHAF24_NonORProcedureCode3 FY2007 Discharge File Table – 1 Record per Discharge – Continued #Data ElementColumn198CMS 24 Diagnosis Code used by Grouper to satisfy Complication CriteriaVHAF24_DiagnosisCodeComplication199CMS 24 Diagnosis Code used by Grouper to satisfy Complication/CoMorbidity CriteriaVHAF24_ComplicationCoMorbidity200Attending Physician NumberEncryptedAttendingPhysicianNumber201Operating PhysicianP NumberEncryptedOperatingPhysicianP202Operating PhysicianP1 NumberEncryptedOperatingPhysicianP1203Operating PhysicianP2 NumberEncryptedOperatingPhysicianP2204Operating PhysicianP3 NumberEncryptedOperatingPhysicianP3205Operating PhysicianP4 NumberEncryptedOperatingPhysicianP4206Operating PhysicianP5 NumberEncryptedOperatingPhysicianP5207Operating PhysicianP6 NumberEncryptedOperatingPhysicianP6208Operating PhysicianP7 NumberEncryptedOperatingPhysicianP7209Operating PhysicianP8 NumberEncryptedOperatingPhysicianP8210Operating PhysicianP9 NumberEncryptedOperatingPhysicianP9211Operating PhysicianP10 NumberEncryptedOperatingPhysicianP10212Operating PhysicianP11 NumberEncryptedOperatingPhysicianP11213Operating PhysicianP12 NumberEncryptedOperatingPhysicianP12214Operating PhysicianP13 NumberEncryptedOperatingPhysicianP13215Operating PhysicianP14 NumberEncryptedOperatingPhysicianP14 PART B. DATA FILE SUMMARY 2. FY2007 Revenue File Table - 1 Record per Revenue Code reported for each discharge #Data ElementColumn1RecordType20IDRecordType20ID2ServiceIDServiceID3SubmissionControlIDSubmissionControlID4Revenue Code TypeTypeofService5LineItemSequence6UB-92 Revenue Code RevenueCode7Units of Service for Revenue Center UnitsOfService8Charges for Revenue Center TotalCharges PART B. DATA FILE SUMMARY 3. INPATIENT DATA CODE TABLES The following are the code tables for all data elements requiring codes not otherwise specified in 114.1 CMR 17.00. Please note that the Source of Payment Code Table and the Supplemental Payer Source Code Table appears as Supplements in Part F of this manual. Patient Sex Codes: * SEX CODE* Patient Sex DefinitionMMaleFFemaleUUnknown Patient Race Codes: Patient Race Codes Race CodeDescriptionR1American Indian /Alaska NativeR2AsianR3Black/African AmericanR4Native Hawaiian or Other Pacific IslanderR5WhiteR9Other RaceUnknowUnknown/not specified Type of Admission Codes: * TYPEADM CODE*Type of Admission Definition1Emergency2Urgent3Elective4Newborn5Information Unavailable PART B. DATA FILE SUMMARY 3. INPATIENT DATA CODE TABLES (Continued) Source of Admission Codes: * SRCADM CODE* Source of Admission Definition0Information not available1Direct Physician Referral2Within Hospital Clinic Referral3Direct Health Plan Referral / HMO Referral4Transfer from an Acute Hospital5Transfer from a Skilled Nursing Facility (SNF)6Transfer from Intermediate Care Facility (ICF)7Outside Hospital Emergency Room Transfer8Court/Law Enforcement9Other (to include Level 4 Nursing Facility)LOutside Hospital Clinic ReferralMWalk-In / Self-ReferralRWithin Hospital Emergency Room TransferTTransfer from Another Institution’s Ambulatory SurgeryWExtramural BirthXObservationYWithin Hospital Ambulatory Surgery Transfer * SRCADM CODE* Source of Admission Definition – Newborn OnlyZInformation Not Available – NewbornANormal DeliveryBPremature DeliveryCSick BabyDExtramural Birth PART B. DATA FILE SUMMARY 3. INPATIENT DATA CODE TABLES (Continued) Patient Status Codes: Departure Status CodeDeparture Status Description01Discharged/transferred to home or self-care (routine discharge)02Discharged/transferred to another short-term general hospital03Discharged/transferred to Skilled Nursing Facility (SNF)04Discharged/transferred to Intermediate Care Facility (ICF)05Discharged/transferred to another type of institution for inpatient care or referred for outpatient services to another institution06Discharged/transferred to home under care of organized home health service organization07Left Against Medical Advice08Discharged/transferred to home under care of a Home IV Drug Therapy Provider09Not Used10Discharged/transferred to chronic hospital11Discharged/transferred to mental health hospital12Discharge Other13Discharged/transferred to rehab hospital14Discharged/transferred to rest home15Discharged to shelter20Expired (or did not recover – Christian Science Patient)50Discharged to Hospice-Home51Discharged to Hospice Medical Facility43Discharged/transferred to federal healthcare facility62Discharged/transferred to an inpatient rehabilitation facility (IRF) including rehabilitation distinct part units of a hospital.63Discharge/transfer to a Medicare certified long term care hospital.65Discharged/transferred to psychiatric hospital or psychiatric distinct part unit of a hospital.66Discharged/transferred to a Critical Access Hospital (CAH). PART B. DATA FILE SUMMARY 3. INPATIENT DATA CODE TABLES (Continued) Payer Type Codes: *PAYER TYPE CODEPayer Type Abbreviation* Payer Type Definition1SPSelf-Pay2WORWorker’s Compensation3MCRMedicareFMCR-MCMedicare Managed Care4MCDMedicaidBMCD-MCMedicaid Managed Care5GOVOther Government Payment6BCBSBlue CrossCBCBS-MCBlue Cross Managed Care7COMCommercial InsuranceDCOM-MCCommercial Managed Care8HMOHealth Maintenance Organization9FCFree Care0OTHOther Non-Managed Care PlansEPPOPPO and Other Managed Care Plans Not Elsewhere ClassifiedJPOSPoint-Of-Service PlanKEPOExclusive Provider OrganizationTAIAuto InsuranceNNoneNone (Valid only for Secondary Payer)QCommCareCommonwealth Care Plans PART B. DATA FILE SUMMARY 3. INPATIENT DATA CODE TABLES (Continued) Veteran’s Status Codes: *VESTA CODE* Veterans Status Definition1YES2NO (includes never a military, currently in active duty, national guard or revisit with 6 months or less active duty)3Not applicable4Not Determined (unable to obtain information) DNR Codes: * DNR CODEDo Not Resuscitate Status Definition1DNR Order Written2Comfort Measures Only3No DNR Order or comfort measures ordered Patient Hispanic Indicator Valid EntriesDefinitionYPatient is Hispanic/Latino/Spanish.NPatient is not Hispanic/Latino/Spanish. Patient Homeless Indicator Valid EntriesDefinitionYPatient is known to be homeless.NPatient is not known to be homeless. PART B. DATA FILE SUMMARY 3. INPATIENT DATA CODE TABLES (Continued) Patient Ethnicity Code Ethnicity Code Ethnicity Definition2182-4Cuban2184-0Dominican2148-5Mexican, Mexican American, Chicano2180-8Puerto Rican2161-8Salvadoran2155-0Central American (not otherwise specified)2165-9South American (not otherwise specified)2060-2African2058-6African AmericanAMERCNAmerican2028-9Asian2029-7Asian IndianBRAZILBrazilian2033-9CambodianCVERDNCape VerdeanCARIBICaribbean Island2034-7Chinese2169-1Columbian2108-9European2036-2Filipino2157-6Guatemalan2071-9Haitian2158-4Honduran2039-6Japanese2040-4Korean2041-2Laotian2118-8Middle EasternPORTUGPortugueseRUSSIARussianEASTEUEastern European2047-9VietnameseOTHEROther EthnicityUNKNOWUnknown/not specified PART B. DATA FILE SUMMARY 3. INPATIENT DATA CODE TABLES (Continued) Routine Accommodations: Revenue CenterRevenue CodeUnits of Service1.Medical/Surgical111 (Includes codes: 111, 121, 131, 141, 151)Days2.Obstetrics112 (Includes codes: 112, 122, 132, 142, 152)Days3.Pediatrics113 (Includes codes: 113, 123, 133, 143, 153)Days4.Psychiatric114 (Includes codes: 114, 124, 134, 144, 154)Days5.Hospice115 (Includes codes: 115, 125, 135, 145, 155)Days6.Detoxification116 (Includes codes: 116, 126, 136, 146, 156)Days7.Oncology117 (Includes codes: 117, 127, 137, 147, 157)Days8.Rehabilitation118 (Includes codes: 118, 128, 138, 148, 158)Days9.Other119 (Includes codes: 119, 129, 139, 149, 159)Days10.Nursery170 (Includes codes: 170, 171, 172, 179)Days11.Chronic192Days12.Subacute196Days13.TCU197Days14.SNF198Days PART B. DATA FILE SUMMARY 3. INPATIENT DATA CODE TABLES (Continued) Special Care Accommodations: Revenue CenterRevenue CodeUnits of Service1.Neo-Natal ICU175 (Includes codes: 173 & 174)Days2.Medical / Surgical ICU200 (Includes codes: 201 & 202)Days3.Pediatric ICU203Days4.Psychiatric ICU204Days5.Post Care ICU206Days6.Burn Unit207Days7.Trauma Unit208Days8.Other ICU209Days9.Coronary Care Unit210Days10.Myocardial Infarction211Days11.Pulmonary Care212Days12.Heart Transplant213Days13.Post Coronary Care214Days14.Other Coronary Care219Days PART B. DATA FILE SUMMARY 3. INPATIENT DATA CODE TABLES (Continued) Ancillary Services: Revenue CenterRevenue CodeUnits of Service1.Special Charges220Zeros2.Incremental Nursing Charge Rate230Zeros3.All Inclusive Ancillary240Zeros4.Pharmacy250Zeros5.IV Therapy260Zeros6.Medical / Surgical Supplies and Devices270Zeros7.Oncology280Zeros8.Durable Medical Equipment290Zeros9.Laboratory300Zeros10.Laboratory Pathological310Zeros11.Diagnostic Radiology320Zeros12.Therapeutic Radiology330Zeros13.Nuclear Medicine340Zeros14.CAT Scan350Zeros15.Operating Room Services360Zeros16.Anesthesia370Zeros17.Blood380Zeros18.Blood Storage and Processing390Zeros19.Other Imaging Services400Zeros20.Respiratory Services410Zeros PART B. DATA FILE SUMMARY 3. INPATIENT DATA CODE TABLES (Continued) Ancillary Services: Revenue CenterRevenue CodeUnits of Service21.Physical Therapy420Zeros22.Occupational Therapy430Zeros23.Speech-Language Pathology440Zeros24.Emergency Room450Zeros25.Pulmonary Function460Zeros26.Audiology470Zeros27.Cardiology480Zeros28.Ambulatory Surgical Care490Zeros29.Outpatient Services500Zeros30.Clinics510Zeros31.Free-standing Clinic520Zeros32.Osteopathic Services530Zeros33.Ambulance540Zeros34.Skilled Nursing550Zeros35.Medical Social Services560Zeros36.Home Health Aide (Home Health)570Zeros37.Other Visits (Home Health)580Zeros38.Units of Service (Home Health)590Zeros39.Oxygen (Home Health)600Zeros40.MRI610Zeros41.Medical/ Surgical Supplies – Extension of 270620Zeros42.Drugs Requiring Specific Identification630Zeros PART B. DATA FILE SUMMARY 3. INPATIENT DATA CODE TABLES (Continued) Ancillary Services: Revenue CenterRevenue CodeUnits of Service43.Home IV Therapy Services640Zeros44.Hospice Services650Zeros45.Respite Care (HHA Only)660Zeros46.Not Assigned67047.Not Assigned68048.Not Assigned69049.Cast Room700Zeros50.Recovery Room710Zeros51.Labor Room / Delivery720Zeros52.EKG/ECG (Electrocardiogram)730Zeros53.EEG (Electroencephalogram)740Zeros54.Gastro-Intestinal Services750Zeros55.General Treatment or Observation Room760Zeros56.Treatment Room761Zeros57.Observation Room762Zeros58.Other Observation Room769Zeros59.Preventive Care Services770Zeros60.Not Assigned780Zeros61.Lithotripsy790Zeros62.Inpatient Renal Dialysis800Zeros63.Organ Acquisition810Zeros64.Hemodialysis – Outpatient or Home820Zeros65.Peritoneal Dialysis – Outpatient or Home830Zeros66.Continuous Ambulatory Peritoneal Dialysis – Outpatient or Home840Zeros67.Continuous Cycling Peritoneal Dialysis – Outpatient or Home850Zeros68.Invalid (Reserved for Dialysis – National Assignment)860PART B. DATA FILE SUMMARY 3. INPATIENT DATA CODE TABLES (Continued) Ancillary Services: Revenue CenterRevenue CodeUnits of Service69.Invalid (Reserved for Dialysis – National Assignment)870Zeros70.Miscellaneous Dialysis880Zeros71.Other Donor Bank890Zeros72.Psychiatric / Psychological Treatments900Zeros73.Psychiatric / Psychological Services910Zeros74.Other Diagnostic Services920Zeros75.Not Assigned930Zeros76.Other Therapeutic Services940Zeros77.Other950Zeros78.Professional Fees960 (Includes codes: 960, 961, 962, 963, 964, 969)Zeros79.Professional Fees970 Includes codes: 970, 971, 972, 973, 974, 975, 976, 977, 978, 979)Zeros80.Professional Fees980 Includes codes: 980, 981, 982, 983, 984, 985, 986, 987, 988, 989)Zeros81.Patient Convenience Items990Zeros PART B. DATA FILE SUMMARY 3. INPATIENT DATA CODE TABLES (Continued) Other Caregiver Codes: * OTH CARE CODE* Type of Other Caregiver Definition1Resident2Intern3Nurse Practitioner4Not Used5Physician Assistant PART C. REVENUE CODE MAPPINGS PART C. REVENUE CODE MAPPINGS ANCILLARY SERVICES Effective January 1, 1994, amendments to Regulation 114.1 CMR 17.00 were adopted to require the use of the UB-92 revenue codes. As a result, all ancillary service revenue code subcategories are now mapped to the UB-92 major classification heading for that revenue center. For example, codes 251-259 map to code 250. For periods ending December 31, 1993 and earlier, the following tables identify how the UB-92 revenue codes are mapped in the case mix database. 250 PHARMACY: 250 Pharmacy 251 General 252 Generic Drugs 253 Non-Generic Drugs 254 Blood Plasma 255 Blood-Other Components 256 Experimental Drugs 257 Non-Prescription 258 IV Solution 259 Other 260 IV THERAPY 270 MEDICAL / SURGICAL SUPPLIES: 270 General Medical Surgical Supplies 272 Sterile Supply 273 Take Home Supply 274 Prosthetic Devices 275 Pace Maker 277 Oxygen-Take Home 278 Other Implants 279 Other Devices 290 Durable Medical Equipment 291 Rental DME 292 Purchase DME 299 Other Equipment PART C. REVENUE CODE MAPPINGS 300 LABORATORY: 300 General Laboratory 301 Chemistry 302 Immunology 303 Renal Patient (Home) 304 Non-Routine Dialysis 305 Hematology 306 Bacteriology & Microbiology 307 Urology 309 Other Lab 310 Lab-Pathological 311 Cytology 312 Histology 314 Biopsy 319 Other Path. Lab 971 Lab. Professional Fees 320 DIAGNOSTIC RADIOLOGY: 320 General 321 Angiocardiograph 324 Chest X-Ray 329 Other 400/409 Other Imaging Services 401 Mammography 402 Ultrasound 972 Diagnostic Radiology Professional Fees THERAPEUTIC RADIOLOGY: 330 General 331 Chemotherapy-Inject 332 Chemotherapy-Oral 333 Radiation Therapy 335 Chemotherapy-IV 339 Other 973 Therapeutic Radiology Professional Fees PART C. REVENUE CODE MAPPINGS 340 NUCLEAR MEDICINE: 340 General 341 Diagnostic 342 Therapeutic 349 Other Nuclear Medicine 974 Nuc. Medicine Professional Fees 350 CAT SCAN: 350 General 351 Head Scan 352 Body Scan 359 Other 360 OPERATING ROOM: 360 General 361 Minor Surgery 362 Organ Transplant (except Kidney) 367 Kidney Transplant 369 Other 975 Operating Room Professional Fees 370 ANESTHESIOLOGY: 370 General 374 Acupuncture 379 Other 963 Anesthesiology Professional Fees (MD) 964 Anesthesiology Professional Fees (RN) 380 BLOOD: 380 General 381 Packed Cells 382 Whole Blood 389 Other PART C. REVENUE CODE MAPPINGS 390 BLOOD STORAGE, PROCESSING, AND ADMINISTRATION: 390 General ***391 Blood/Administration 399 Other 410 RESPIRATORY THERAPY: 410 General 412 Inhalation Services 413 Hyperbaric Oxygen Therapy 419 Other 976 Respiratory Therapy Professional Therapy 420 PHYSICAL THERAPY: 420 General 429 Other 977 Physical Therapy Professional Fees 430 OCCUPATIONAL THERAPY: 430 General 439 Other 978 Occupational Therapy Professional Fees 440 SPEECH THERAPY: 440 General 449 Other 979 Speech Therapy Professional Fees 450 EMERGENCY ROOM: 450 General 459 Other 981 Emergency Room Professional Fees 460 PULMONARY FUNCTION: 460 General 469 Other PART C. REVENUE CODE MAPPINGS 470 AUDIOLOGY: 470 General 471 Diagnostic 472 Treatment 479 Other 480 CARDIAC CATHETERIZATION: 480 General 481 Cardiac Catheterization Lab 482 Stress Test 489 Other 540 AMBULANCE: 540 General 541 Supplies 542 Medical Treatment 543 Heart Mobile 544 Oxygen 545 Air Ambulance 549 Other 710 RECOVERY ROOM: 710 General 719 Other 720 LABOR AND DELIVERY: 720 General 721 Labor 722 Delivery 723 Circumcision 724 Birthing Center 729 Other PART C. REVENUE CODE MAPPINGS 730 EKG/ECG: 730 General 731 Holter Monitor 739 Other 985 EKG Professional Fees 740 EEG: 740 General 749 Other 922 Electromyogram 986 EEG Professional Fees 800 RENAL DIALYSIS: 800 General 801 Inpatient Dialysis 802 Inpatient Peritoneal (non CAPD) 805 Training Hemodialysis 806 Training Peritoneal Dialysis 807 Under Arrangement In House 808 Continuous Ambulatory Peritoneal Dialysis Training 809 In Unit Lab-Routine 810 Self Care Dialysis Unit 811 Hemodialysis-Self Care 812 Peritoneal Dialysis-Self Care 813 Under Arrangement In House-Self Care 814 In Unit Lab-Self-Care 880 Miscellaneous Dialysis 881 Ultrafiltration 860 KIDNEY ACQUISITION: 860 General 861 Monozygotic Sibling 862 Dizygotic Sibling 863 Genetic Parent 864 Child 865 Non-Relating Living 866 Cadaver PART C. REVENUE CODE MAPPINGS 900 PSYCHOLOGY AND PSYCHIATRY: 900 General 901 Electroshock Treatment 902 Milieu Therapy 903 Play Therapy 909 Other 910 Psychology/Psychiatry Services 911 Rehabilitation 912 Day Care 913 Night Care 914 individual Therapy 915 Group Therapy 916 Family Therapy 917 Bio Feedback 918 Testing 919 Other 961 Psychiatry Professional Fees 950 OTHER: 280 Oncology ***490 Ambulatory Surgery ***499 Other Ambulatory Surgery ***510 Clinic ***511 Chronic Pain Center ***512 Dental Clinic ***519 Other Clinic 530 General Osteopathic Services 531 Osteopathic Therapy 539 Other Osteopathic Therapy 560 Medical Social Services 700 Cast Room-General 709 Cast Room-Other 750/759 Gastro-Intestinal Services 890/899 Other Donor Bank 891 Bone Donor 892 Organ Donor 893 Skin Donor PART C. REVENUE CODE MAPPINGS 950 OTHER (Continued): 920/929 Other Diagnostic Services 921 Peripheral Vascular Lab 940/949 Other Therapeutic Services 941 Recreational Therapy 942 Educational Therapy 943 Cardiac Rehabilitation 960 General Professional Fees 962 Opthamology 969 Other Professional Therapy 984 Medical Social Services 987 Hospital Visit 988 Consultation 989 Private Duty Nurse ***Please Note: These Revenue Centers should be reported only for those patients admitted to the hospital subsequent to surgical day care. PART C. REVENUE CODE MAPPINGS The following ancillary revenue codes (and their related subcategories) are not valid pursuant to Regulation 114.1 CMR 17.00 and are not used for reporting charges on the case mix data. These revenue codes relate either to outpatient services or to non-patient care. 500 Outpatient Services 520 Free Standing Clinic 530 Osteopathic Services 550 Skilled Nursing 570 Home Health Aid 580 Other Visits (Home Health) 590 Units Of Service (Home Health) 600 Oxygen (Home Health) 640 Home IV Therapy Services 660 Respite Care (HHA only) 820 Hemodialysis-Outpatient or Home 830 Peritoneal Dialysis-Outpatient or Home 840 Continuous Ambulatory Peritoneal Dialysis-Outpatient or Home 850 Continuous Cycling Peritoneal Dialysis-Outpatient or Home 860 Reserved for Dialysis (National Assignment) 870 Reserved for Dialysis (National Assignment) 990 Patient Convenience Items PAGE PAGE 40 June 2009 General Documentation FY2007 Inpatient Hospital Discharge Database Technical Documentation FY2007 Inpatient Hospital Discharge Database g¯°ìíîWX€™š›ž¯°ºÀ,Päû* M Hp9JKUZ[¸mù)6ÀÁéêëõêß×ÌÄÀ¸À¸²¸Àª£——Š—À—À—À—£——À—À—ÀƒÀƒÀ¸Àx¸²¸jhµNÁUhµNÁ5\ hµNÁaJ hµNÁ>*aJ hµNÁaJ hµNÁaJ hµNÁ>*aJ hµNÁCJ,aJ, hµNÁ0JjhµNÁUhµNÁhµNÁCJaJhµNÁ5CJ4\aJ4hµNÁCJ$aJ$hµNÁ5CJ@\aJ@hµNÁ5CJ0\aJ0hµNÁ6CJ ]aJ /<ghijk†š¯°±²Îìíîïðñòóôõö÷"6V÷÷÷÷÷÷÷÷÷ò÷÷÷÷÷òòòòòòòòòòòòògdµNÁ$a$gdµNÁ½þþVW›œž°¿À×Ø,Pu˜Äãäû 7 U úúõõõõóóéãéãéáØØØØÒÍÈÈÈ &F Æ„h^„h &F ÆJ ÆJ ÆJ„h^„h$a$gdµNÁU t ’ Û ) * M ‹ ¬ ß GHpq£Õ678KZ[úõõõõõïêåååååãêïïÞÞÞããÙãã$a$ &F &F Æ„h^„h &F &F[ƒ¸û2 O µ î %&QR~˜¯ËôOlmµØùúúôôêôôôôôôôôåååååååãúÞÞÞ &F &F „„h^„`„h„h^„h Æùú !&'()67A¡¢@AeïðéêÊË»¼½Ðùóóññññïñññíññññíñññññññññï„h^„h„ ^„ lmœž¸¹¾ÐÑæ'2Úñv* + P q ò 1!g!†!"+"i"È"$/$º%Õ%‘'²'X(z(2)T)**!*"*&*A*B*¼+{,|,œ,,¡,Í,Î,Ï,4.x0Ë0194üôüéôãôüÜüÔüÔüÔüÌüÆ¾µÆµÆµÆµÆ©Æ©ÆµÆµÆµÆµÆüÜÆµŸµüÜüÜÆµŸµÆüÆü˜ühµNÁ56hµNÁ5>*\aJhµNÁ56\]aJhµNÁ5\aJhµNÁCJ aJ hµNÁaJhµNÁCJaJhµNÁ5>*\hµNÁ5\ hµNÁ0JjáhµNÁUjhµNÁUhµNÁ<ÐÑèéù&'45óôÙÚóôOP‘¸¹övw) + ýýýýýýýýýýýýýýýýøòýøòýéýçá ÆàÀ!$„^„a$„ ^„ &F + M N O P Q q r ‘ Õ í î öðððååå××××å &F ÆàÀ!$If ÆàÀ!$If ÆàÀ! $ ÆàÀ!a$î ï ñ !!1!2!f!g!"",#-#¹%Š„{„q„„„„„„„„ &F ÆàÀ! $ ÆàÀ!a$ ÆàÀ!ukdÐ$$IfT–lÖÖ”ÿP¼ ÖÖ ÿàààÖ0ÿÿÿÿÿÿö6ÖÿÖÿÖÿÖÿ4Ö l`Ö ÿàààaöpÖ ÿàààŠT ¹%º%´&µ&ð& '7'b''‘'W(X(1)2)ÿ)*!*"*B*C*¹+º+ì+í+ùùùïïïïïåùùùùùùÜÓÍÍÇÍÍÍ ÆJ ÆJ$ ÆJa$ $ ÆàÀ!a$ ÆàÀ!„h^„h &F ÆàÀ! 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