CODE TABLES - APPENDIX - MedPAR R2K - FY14 Proposed Rule   [April 2013]                                                                                                                     
                                                                                                                         
                                                                                                 

MEDPAR Beneficiary Age  
                                                     Age is grouped by the following values:   
         						 	 1 = less than 25                             
           							 2 = 25 - 44                                  
          					 		 3 = 45 - 64                                  
           							 4 = 65 - 69                                  
           							 5 = 70 - 74                                  
           							 6 = 75 - 79                                  
           							 7 = 80 - 84                                  
         							 8 = 85 - 89                                  
           							 9 = 90 and over                              

                                                    The beneficiary's age as of date of admission.
                                                             
                                                                                                                                                              
BENE_MDCR_STUS_TB                                      CWF Beneficiary Medicare Status Table                                                   

                  10 = Aged without ESRD                                                                                                                      
                 11 = Aged with ESRD                                                                                                                          
                 20 = Disabled without ESRD                                                                                                                   
                 21 = Disabled with ESRD                                                                                                                      
                 31 = ESRD only                                                                                                                               

               

BENE_RACE_TB                                           Beneficiary Race Table                                                                  

                  0 = Unknown                                                                                                                                 
                 1 = White                                                                                                                                    
                 2 = Black                                                                                                                                    
                 3 = Other                                                                                                                                    
                 4 = Asian                                                                                                                                    
                 5 = Hispanic                                                                                                                                 
                 6 = North American Native                                                                                                                    


               
BENE_SEX_IDENT_TB                                      Beneficiary Sex Identification Table                                                    

                  1 = Male                                                                                                                                    
                 2 = Female                                                                                                                                   
                 0 = Unknown                                                                                                                                  


               
CLM_ADMTG_DGNS_VRSN_TB                                 Claim Admitting Diagnosis Version Code Table                                            

                 Valid Values:                                                                                                                                
                 9 = ICD-9                                                                                                                                    
                 0 = ICD-10                                                                                                                                   

               
CLM_CARE_IMPRVMT_MODEL_TB                              Claim Care Improvement Model Table                                                      

                 61 = CLAIM CARE IMPROVEMENT MODEL 1                                                                                                          
                 62 = CLAIM CARE IMPROVEMENT MODEL 2                                                                                                          
                 63 = CLAIM CARE IMPROVEMENT MODEL 3                                                                                                          
                 64 = CLAIM CARE IMPROVEMENT MODEL 4                                                                                                          

CLM_DGNS_VRSN_TB                                       Claim Diagnosis Version Code Table                                                      

                 Valid Values:                                                                                                                                
                 9 = ICD-9                                                                                                                                    
                 0 = ICD-10                                                                                                                                   

CLM_HRR_PRTCPNT_IND_TB                                 Claim HRR Participant Indicator Code Table                                              

                 0 = Not participating                                                                                                                        
                 1 = Participating and not equal to 1.0000                                                                                                    
                 2 = Participating and equal to 1.0000                                                                                                        

              
CLM_PRCDR_VRSN_TB                                      Claim Procedure Version Code Table                                                      

                 Valid Values:                                                                                                                                
                 9 = ICD-9                                                                                                                                    
                 0 = ICD-10                                                                                                                                   

               
                                                                         

               
CLM_SRC_IP_ADMSN_TB                                    Claim Source Of Inpatient Admission Table                                               

                         **For Inpatient/SNF Claims:**                                                                                                        
                                                                                                                                                              
                                                                                                                                                              
                 0 = ANOMALY: invalid value, if present,                                                                                                      
                 translate to '9'                                                                                                                             
                 1 = Non-Health Care Facility Point of Origin                                                                                                 
                 (Physician Referral) - The patient was                                                                                                       
                 admitted to this facility upon an order                                                                                                      
                 of a physician.                                                                                                                              
                 2 = Clinic referral - The patient was                                                                                                        
                 admitted upon the recommendation of                                                                                                          
                 this facility's clinic physician.                                                                                                            
                 3 = HMO referral - Reserved for national                                                                                                     
                 assignment. (eff. 3/08)                                                                                                                      
                 Prior to 3/08, HMO referral - The patient                                                                                                    
                 was admitted upon the recommendation of                                                                                                      
                 an health maintenance organization (HMO)                                                                                                     
                 physician.                                                                                                                                   
                 4 = Transfer from hospital (Different Facility) -                                                                                            
                 The patient was admitted to this facility                                                                                                    
                 as a hospital transfer from an acute care                                                                                                    
                 facility where he or she was an inpatient.                                                                                                   
                 5 = Transfer from a skilled nursing                                                                                                          
                 facility (SNF) or Intermediate Care Facility                                                                                                 
                 (ICF) - The patient was admitted to this                                                                                                     
                 facility as a transfer from a SNF or ICF                                                                                                     
                 where he or she was a resident.                                                                                                              
                 6 = Transfer from another health care                                                                                                        
                 facility - The patient was admitted                                                                                                          
                 to this facility as a transfer from                                                                                                          
                 another type of health care facility                                                                                                         
                 not defined elsewhere in this code list                                                                                                      

                      where he or she was an inpatient.                                                                                                       
                 7 = Emergency room - The patient was                                                                                                         
                 admitted to this facility after receiving                                                                                                    
                 services in this facility's emergency                                                                                                        
                 room department. Obsolete - eff. 7/1/10                                                                                                      
                 8 = Court/law enforcement - The patient was                                                                                                  
                 admitted upon the direction of a                                                                                                             
                 court of law or upon the request of                                                                                                          
                 a law enforcement agency's representative.                                                                                                   
                 Includes transfers from incarceration facilities.                                                                                            
                 9 = Information not available -  The means                                                                                                   
                 by which the patient was admitted is                                                                                                         
                 not known.                                                                                                                                   
                 A = Reserved for National Assignment. (eff. 3/08)                                                                                            
                 Prior to 3/08 defined as: Transfer from a Critical                                                                                           
                 Access Hospital - patient was admitted/referred                                                                                              
                 to this facility as a transfer from a Critical                                                                                               
                 Access Hospital.                                                                                                                             
                 B = Transfer from Another Home Health Agency -                                                                                               
                 The patient was admitted to this home                                                                                                        
                 health agency as a transfer from another                                                                                                     
                 home health agency.(Discontinued July 1,2010-                                                                                                
                 See Condition Code 47)                                                                                                                       
                 C = Readmission to Same Home Health Agency -                                                                                                 
                 The patient was readmitted to this home                                                                                                      
                 health agency within the same home health                                                                                                    
                 episode period. (Discontinued July 1,2010)                                                                                                   
                 D = Transfer from hospital inpatient in the                                                                                                  
                 same facility resulting in a separate                                                                                                        
                 claim to the payer - The patient was                                                                                                         
                 admitted to this facility as a transfer                                                                                                      
                 from hospital inpatient within this                                                                                                          
                 facility resulting in a separate                                                                                                             
                 claim to the payer.          
		E - Transfer from Ambulatory Surgery Center (Effective 10/1/2007)
		Inpatient: The patient was admitted to this facility as a transfer from an ambulatory surgery center.

		F- Transfer from Hospice and is Under a Hospice Plan of Care or Enrolled in a Hospice Program (Effective 10/1/2007)
		Inpatient: The patient was admitted to this facility as a transfer from a hospice.
                                                                                                                
                 ---------------------------------------                                                                                                      
                 **For Newborn Type of Admission**                                                                                                            
                                                                                                                                                              
                 1 = Normal delivery - A baby delivered with                                                                                                  
                 out complications.  Obsolete eff. 10/1/07                                                                                                    
                 2 = Premature delivery - A baby delivered                                                                                                    
                 with time and/or weight factors                                                                                                              
                 qualifying it for premature status.                                                                                                          
                 Obsolete eff. 10/1/07                                                                                                                        
                 3 = Sick baby - A baby delivered with                                                                                                        
                 medical complications, other than those                                                                                                      
                 relating to premature status. Obsolete eff. 10/1/07                                                                                          

                  4 = Extramural birth - A baby delivered in                                                                                                  
                 a nonsterile environment.  Obsolete eff. 10/1/07                                                                                             
                 5 = Born Inside this Hospital - eff. 10/1/07                                                                                                 
                 6 = Born Outside of this Hospital - eff. 10/1/07                                                                                             
                 7-9 = Reserved for national assignment.                                                                                                  

               
CLM_VBP_PRTCPNT_IND_TB                                 Claim VBP Participant Indicator Table                                                   

                  Y = Participating in Hospital Value Based Purchasing                                                                                        
                 N = Not participating in Hospital Value Based Purchasing                                                                                     
                 Blank = same as 'N'                                                                                                                          

               
GEO_SSA_STATE_TB                                       State Table                                                                             

                  01 = Alabama                                                                                                                                
                 02 = Alaska                                                                                                                                  
                 03 = Arizona                                                                                                                                 
                 04 = Arkansas                                                                                                                                
                 05 = California                                                                                                                              
                 06 = Colorado                                                                                                                                
                 07 = Connecticut                                                                                                                             
                 08 = Delaware                                                                                                                                

                  09 = District of Columbia                                                                                                                   
                 10 = Florida                                                                                                                                 
                 11 = Georgia                                                                                                                                 
                 12 = Hawaii                                                                                                                                  
                 13 = Idaho                                                                                                                                   
                 14 = Illinois                                                                                                                                
                 15 = Indiana                                                                                                                                 
                 16 = Iowa                                                                                                                                    
                 17 = Kansas                                                                                                                                  
                 18 = Kentucky                                                                                                                                
                 19 = Louisiana                                                                                                                               
                 20 = Maine                                                                                                                                   
                 21 = Maryland                                                                                                                                
                 22 = Massachusetts                                                                                                                           
                 23 = Michigan                                                                                                                                
                 24 = Minnesota                                                                                                                               
                 25 = Mississippi                                                                                                                             
                 26 = Missouri                                                                                                                                
                 27 = Montana                                                                                                                                 
                 28 = Nebraska                                                                                                                                
                 29 = Nevada                                                                                                                                  
                 30 = New Hampshire                                                                                                                           
                 31 = New Jersey                                                                                                                              
                 32 = New Mexico                                                                                                                              
                 33 = New York                                                                                                                                
                 34 = North Carolina                                                                                                                          
                 35 = North Dakota                                                                                                                            
                 36 = Ohio                                                                                                                                    
                 37 = Oklahoma                                                                                                                                
                 38 = Oregon                                                                                                                                  
                 39 = Pennsylvania                                                                                                                            
                 40 = Puerto Rico                                                                                                                             
                 41 = Rhode Island                                                                                                                            
                 42 = South Carolina                                                                                                                          
                 43 = South Dakota                                                                                                                            
                 44 = Tennessee                                                                                                                               
                 45 = Texas                                                                                                                                   
                 46 = Utah                                                                                                                                    
                 47 = Vermont                                                                                                                                 
                 48 = Virgin Islands                                                                                                                          
                 49 = Virginia                                                                                                                                
                 50 = Washington                                                                                                                              
                 51 = West Virginia                                                                                                                           
                 52 = Wisconsin                                                                                                                               
                 53 = Wyoming                                                                                                                                 
                 54 = Africa                                                                                                                                  

                  55 = California                                                                                                                             
                 56 = Canada & Islands                                                                                                                        
                 57 = Central America and West Indies                                                                                                         
                 58 = Europe                                                                                                                                  
                 59 = Mexico                                                                                                                                  
                 60 = Oceania                                                                                                                                 
                 61 = Philippines                                                                                                                             
                 62 = South America                                                                                                                           
                 63 = U.S. Possessions                                                                                                                        
                 64 = American Samoa                                                                                                                          
                 65 = Guam                                                                                                                                    
                 66 = Commonwealth of the Northern Marianas Islands                                                                                           
                 67 = Texas                                                                                                                                   
                 68 = Florida (eff. 10/2005)                                                                                                                  
                 69 = Florida (eff. 10/2005)                                                                                                                  
                 70 = Kansas (eff. 10/2005)                                                                                                                   
                 71 = Louisiana (eff. 10/2005)                                                                                                                
                 72 = Ohio (eff. 10/2005)                                                                                                                     
                 73 = Pennsylvania (eff. 10/2005)                                                                                                             
                 74 = Texas (eff. 10/2005)                                                                                                                    
                 80 = Maryland (eff. 8/2000)                                                                                                                  
                 97 = Northern Marianas                                                                                                                       
                 98 = Guam                                                                                                                                    
                 99 = With 000 county code is American Samoa;                                                                                                 
                 otherwise unknown                                                                                                                            

               
MEDPAR_ADMSN_DAY_TB                                    MEDPAR Admission Day Code Table                                                         

                 1 = Sunday                                                                                                                                   
                 2 = Monday                                                                                                                                   
                 3 = Tuesday                                                                                                                                  
                 4 = Wednesday                                                                                                                                
                 5 = Thursday                                                                                                                                 
                 6 = Friday                                                                                                                                   
                 7 = Saturday                                                                                                                                 

               
MEDPAR_BENE_DEATH_DT_VRFY_TB                           MEDPAR Beneficiary Death Date Verified Code Table                                       

                 V = Date of death verified (EDB received DOD from SSA's                                                                                      
                 MBR)                                                                                                                                         
                 B = Date of death taken from claim (EDB received DOD                                                                                         
                 from claim)                                                                                                                                  
                 N = Date of death not verified (neither V or B                                                                                               
                 applicable, but claim status code indicated death)                                                                                           
                 Space = No date of death indicated                                                                                                           

               
MEDPAR_BENE_DSCHRG_STUS_TB                             MEDPAR Beneficiary Discharge Status Code Table                                          

                 A = Discharged alive (claim status code other than 20 or                                                                                     
                 30)                                                                                                                                          
                 B = Discharged dead                                                                                                                          
                 C = Still a patient                                                                                                                          

               
MEDPAR_BENE_PRMRY_PYR_TB                               MEDPAR Beneficiary Primary Payer Code Table                                             

                 A = Working aged bene/spouse with eghp                                                                                                       
                 B = ESRD bene in 18-month coordination period with eghp                                                                                      
                 C = Conditional Medicare payment; future reimbursement                                                                                       
                 expected                                                                                                                                     
                 D = Auto no-fault or any liability insurance                                                                                                 
                 E = Worker's compensation                                                                                                                    
                 F = Phs or other federal agency (other than dept of                                                                                          
                 veterans affairs)                                                                                                                            
                 G = Working disabled                                                                                                                         
                 H = Black lung                                                                                                                               
                 I = Dept of veterans affairs                                                                                                                 
                 J = Any liability insurance                                                                                                                  
                 Z/BLANK = Medicare is primary payer                                                                                                          

               
MEDPAR_CRED_RCVD_RPLCD_DVC_TB                          MEDPAR Credit Received from Manufacturer for Replaced Medical Device Switch             

                 Y = The claim involved a credit from                                                                                                         
                 the device manufacturer for a                                                                                                                
                 Replaced Medical Device.                                                                                                                     
                 N = The claim did not involve a credit from                                                                                                  
                 the device manufacturer for a                                                                                                                
                 Replaced Medical Device.                                                                                                                     

               
MEDPAR_CRNRY_CARE_IND_TB                               MEDPAR Coronary Care Indicator Code Table                                               

                 BLANK = No coronary care indication                                                                                                          
                 0 = General (revenue code 0210)                                                                                                              
                 1 = Myocardial (revenue code 0211)                                                                                                           
                 2 = Pulmonary care (revenue code 0212)                                                                                                       
                 3 = Heart transplant (revenue code 0213)                                                                                                     
                 4 = Intermediate CCU (revenue code 0214)                                                                                                     

               
MEDPAR_ESRD_COND_TB                                    MEDPAR ESRD Condition Code Table                                                        

                 00 = No ESRD Condition Codes                                                                                                                 
                 70 = Self-Administered Epo                                                                                                                   
                 71 = Full Care In Unit                                                                                                                       
                 72 = Self-Care In Unit                                                                                                                       
                 73 = Self-Care Training                                                                                                                      
                 74 = Home Dialysis                                                                                                                           
                 75 = Home Dialysis/100% Reimbursement                                                                                                        
                 76 = Backup-In-Facility Dialysis                                                                                                             

               
MEDPAR_ESRD_SETG_IND_TB                                MEDPAR ESRD Setting Indicator Code Table                                                

                 00 = Ip renal dialysis-general (revenue code 0800)                                                                                           
                 01 = Ip renal dialysis-hemodialysis (revenue code 0801)                                                                                      
                 02 = Ip renal dialysis-peritoneal (non-capd: revenue                                                                                         
                 code 0802)                                                                                                                                   
                 03 = Ip renal dialysis-capd (revenue code 0803)                                                                                              
                 04 = Ip renal dialysis-ccpd (revenue code 0804)                                                                                              
                 09 = Ip renal dialysis-other (revenue code 0809)                                                                                             
                 20 = Hemodialysis-op-general (revenue code 0820)                                                                                             
                 21 = Hemodialysis-op-hemodialysis/composite (revenue code                                                                                    
                 0821)                                                                                                                                        
                 22 = Hemodialysis-op-home supplies (revenue code 0822)                                                                                       
                 23 = Hemodialysis-op-home equipment (revenue code 0823)                                                                                      
                 24 = Hemodialysis-op-maintenance/100% (revenue code 0824)                                                                                    
                 25 = Hemodialysis-op-support services (revenue code 0825)                                                                                    
                 29 = Hemodialysis-op-other (revenue code 0829)                                                                                               
                 30 = Peritoneal-op/home-general (revenue code 0830)                                                                                          
                 31 = Peritoneal-op/home-peritoneal/composite (revenue                                                                                        
                 32 = Peritoneal-op/home-home supplies (revenue code 0832)                                                                                    
                 33 = Peritoneal-op/home-home equipment (revenue code                                                                                         
                 0833)                                                                                                                                        
                 34 = Peritoneal-op/home-maintenance/100% (revenue code                                                                                       
                 0834)                                                                                                                                        
                 35 = Peritoneal-op/home-support services (revenue code                                                                                       
                 0835)                                                                                                                                        
                 39 = Peritoneal-op/home-other (revenue code 0839)                                                                                            
                 40 = Capd-op-capd/general (revenue code 0840)                                                                                                
                 41 = Capd-op-capd/composite (revenue code 0841)                                                                                              
                 42 = Capd-op-home supplies (revenue code 0842)                                                                                               
                 43 = Capd-op-home equipment (revenue code 0843)                                                                                              
                 44 = Capd-op-maintenance/100% (revenue code 0844)                                                                                            
                 45 = Capd-op-support services (revenue code 0845)                                                                                            
                 49 = Capd-op-other (revenue code 0849)                                                                                                       
                 50 = Ccpd-op-ccpd/general (revenue code 0850)                                                                                                
                 51 = Ccpd-op-ccpd/composite (revenue code 0851)                                                                                              
                 52 = Ccpd-op-home supplies (revenue code 0852)                                                                                               
                 53 = Ccpd-op-home equipment (revenue code 0853)                                                                                              
                 54 = Ccpd-op-maintenance/100% (revenue code 0854)                                                                                            
                 55 = Ccpd-op-support services (revenue code 0855)                                                                                            
                 59 = Ccpd-op-other (revenue code 0859)                                                                                                       
                 80 = Miscellaneous dialysis-general (revenue code 0880)                                                                                      
                 81 = Miscellaneous dialysis-ultrafiltration (revenue code                                                                                    
                 0881)                                                                                                                                        

                 89 = Miscellaneous dialysis-other (revenue code 0889)                                                                                        
                 BLANK = No ESRD setting indication                                                                                                           

               
MEDPAR_GHO_PD_TB                                       MEDPAR GHO Paid Code Table                                                              

                 1 = GHO has paid the provider                                                                                                                
                 Blank Or 0 = GHO has not paid the provider                                                                                                   

               
MEDPAR_ICU_IND_TB                                      MEDPAR Intensive Care Unit (ICU) Indicator Code                                         

                 0 = General (revenue center 0200)                                                                                                            
                 1 = Surgical (revenue center 0201)                                                                                                           
                 2 = Medical (revenue center 0202)                                                                                                            
                 3 = Pediatric (revenue center 0203)                                                                                                          
                 4 = Psychiatric (revenue center 0204)                                                                                                        

               
MEDPAR_INFRMTL_ENCTR_IND_TB                            MEDPAR Informational Encounter Indicator Code                                           

                 Y = Beneficiary enrolled in MCO                                                                                                              
                 N = Beneficiary not enrolled in MCO                                                                                                          

               
MEDPAR_MA_TCHNG_IND_TB                                 MEDPAR MA Teaching indicator Code                                                       

                 Y = Claim includes request for supplemental                                                                                                  
                 IME/DGME/N&AH payment.                                                                                                                       
                 N = Claim does not include request for supplemental                                                                                          
                 IME/DGME/N&AH payment.                                                                                                                       

               
MEDPAR_OBSRVTN_TB                                      MEDPAR Credit Received from Manu1facturer for Replaced Medical Device Switch             

                 Y = The claim involved treatment or observation in                                                                                           
                 an observation room.                                                                                                                         
                 N = The claim did not involve treatment or                                                                                                   
                 observation in an observation room.                                                                                                          

               
MEDPAR_OP_SRVC_IND_TB                                  MEDPAR Outpatient Services Indicator Codode Table                                       

                 0 = No outpatient services/ambulatory surgical care                                                                                          
                 (revenue code other than 049X, 050X)                                                                                                         
                 1 = Outpatient services (revenue code 050X)                                                                                                  
                 2 = Ambulatory surgical care (revenue code 049X)                                                                                             
                 3 = Outpatient services and ambulatory surgical care                                                                                         
                 (revenue codes 049X and 050X)                                                                                                                

               
MEDPAR_ORGN_ACQSTN_IND_TB                              MEDPAR Organ Acquisition Indicator Code  Table                                          

                 K1 = General classification (revenue code 0810)                                                                                              
                 K2 = Living donor kidney (revenue code 0811)                                                                                                 
                 K3 = Cadaver donor kidney (revenue code 0812)                                                                                                
                 K4 = Unknown donor kidney (revenue code 0813)                                                                                                
                 K5 = Other kidney acquisition (revenue code 0814)                                                                                            
                 H1 = Cadaver donor heart (revenue code 0815)                                                                                                 
                 H2 = Other heart acquisition (revenue code 0816)                                                                                             
                 L1 = Donor liver (revenue code 0817)                                                                                                         
                 01 = Other organ acquisition (revenue code 0819)                                                                                             
                 02 = General acquisition (revenue code 0890)                                                                                                 
                 B1 = Bone donor bank (revenue code 0891)                                                                                                     
                 03 = Organ donor bank other than kidney (revenue code 0892)                                                                                  
                 S1 = Skin donor bank (revenue code 0893)                                                                                                     
                 04 = Other donor bank (revenue code 0899)                                                                                                    
                 BLANK = No organ acquisition indication                                                                                                      

               
MEDPAR_PHRMCY_IND_TB                                   MEDPAR Pharmacy Indicator Code Table                                                    

                 0 = No drugs (revenue code other than those listed below)                                                                                    
                 1 = General drugs and/pr IV therapy (revenue code 025x,                                                                                      
                 026x)                                                                                                                                        
                 2 = Erythropoietin (epoetin:  revenue code 0630, 0635,                                                                                       
                 0637, 0639)                                                                                                                                  
                 3 = Blood clotting drugs (revenue code 0636)                                                                                                 
                 4 = General drugs and/or IV therapy; and epoetin                                                                                             
                 (combination of values 1 and 2)                                                                                                              
                 5 = General drugs and/or IV therapy; and blood clotting                                                                                      
                 drugs (combination of values 1 and 3)                                                                                                        

               
MEDPAR_PPS_IND_TB                                      MEDPAR PPS Indicator Code Table                                                         

                 0 = Non PPS                                                                                                                                  
                 2 = PPS                                                                                                                                      

               
MEDPAR_PROD_RPLCMT_LIFECYC_TB                          MEDPAR Product Replacement within Lifecycle Switch                                      

                 Y = Claim involves the replacement of a product                                                                                              
                 earlier than scheduled due to apparent malfunction.                 N = C                                                                    
                 N = Claim does not involve the replacement of a product                                                                                      
                 earlier than scheduled due to apparent malfunction.                 N = C                                                                    

               
MEDPAR_PROD_RPLCMT_RCLL_TB                             MEDPAR Product Replacement for known Recall Switch                                      

                 Y = Claim involves the replacement of a product                                                                                              
                 due to a recall of the product by the manufacturer                                                                                           
                 or by the FDA.                                                                                                                               
                 N = Claim does not involve the replacement of a product                                                                                      
                 due to a recall of the product by the manufacturer                                                                                           
                 or by the FDA.                                                                                                                               

               
MEDPAR_PRVDR_NUM_SPCL_UNIT_TB                          MEDPAR Provider Number Special Unit Code                                                

                 M = PPS-exempt psychiatric unit in CAH                                                                                                       
                 R = PPS-exempt rehabilitation unit in CAH                                                                                                    
                 S = PPS-exempt psychiatric unit                                                                                                              
                 T = PPS-exempt rehabilitation unit                                                                                                           
                 U = Swing-bed short-term/acute care hospital                                                                                                 
                 W = Swing-bed long-term hospital                                                                                                             
                 Y = Swing-bed rehabilitation hospital                                                                                                        
                 Z = Swing-bed rural primary care hospital; eff                                                                                               
                 10/97 changed to critical access hospitals                                                                                                   
                 Blanks = Not PPS-exempt or swing-bed designation                                                                                             

               
MEDPAR_RDLGY_CT_SCAN_IND_TB                            MEDPAR Radiology CT Scan Indicator Switch Code Table                                    

                 0 = No  radiology CT scan (revenue code not 035X)                                                                                            
                 1 = Yes radiology CT scan (revenue code 035X)                                                                                                

               
MEDPAR_RDLGY_DGNSTC_IND_TB                             MEDPAR Radiology Diagnostic Indicator Switch Code Table                                 

                 0 = No  radiology-diagnostic (revenue code not 032x)                                                                                         
                 1 = Yes radiology-diagnostic (revenue code 032x)                                                                                             

               
MEDPAR_RDLGY_NUCLR_MDCN_IND_TB                         MEDPAR Radiology Nuclear Medicine Indicator Switch Code Table                           

                 0 = No  nuclear medicine (revenue code not 034x)                                                                                             
                 1 = Yes nuclear medicine (revenue code 034x)                                                                                                 

               
MEDPAR_RDLGY_ONCLGY_IND_TB                             MEDPAR Radiology Oncology Indicator Switch Code Table                                   

                 0 = No  radiology-oncology (revenue code not 028x)                                                                                           
                 1 = Yes radiology-oncology (revenue code 028x)                                                                                               

               
MEDPAR_RDLGY_OTHR_IMGNG_IND_TB                         MEDPAR Radiology Other Imaging Indicator Code Table                                     

                 0 = No  other imaging services (revenue code not 040x)                                                                                       
                 1 = Yes other imaging services (revenue code 040x)                                                                                           

               
MEDPAR_RDLGY_THRPTC_IND_TB                             MEDPAR Radiology Therapeutic Indicator Code Table                                       

                 0 = No  radiology-therapeutic (revenue code not 033X)                                                                                        
                 1 = Yes radiology-therapeutic (revenue code 033X)                                                                                            

               
MEDPAR_SRGCL_PRCDR_IND_TB                              MEDPAR Surgical Procedure Indicator  Switch Code Table                                  

                 0 = No  surgery indicated                                                                                                                    
                 1 = Yes surgery indicated                                                                                                                    

               
MEDPAR_SS_LS_SNF_IND_TB                                MEDPAR Short Stay/Long Stay/SNF  Indicator Code Table                                   

                 N = SNF Stay (Prvdr3 = 5, 6, U, W, Y, or Z)                                                                                                  
                 S = Short-Stay (Prvdr3 = 0, M, R, S, T)                                                                                                      
                 L = Long-Stay (All Others)                                                                                                                   

               
MEDPAR_TRNSPLNT_IND_TB                                 MEDPAR Transplant Indicator Code Table                                                  

                 0 = No organ or kidney transplant                                                                                                            
                 (revenue code not 0362 or 0367)                                                                                                              
                 2 = Organ transplant other than kidney (revenue code                                                                                         
                 0362)                                                                                                                                        
                 7 = Kidney transplant (revenue code 0367)                                                                                                    

                             NCH_CLM_TYPE_TB                                        NCH Claim Type Table                                                                    

                  10 = HHA claim                                                                                                                              
                 20 = Non swing bed SNF claim                                                                                                                 
                 30 = Swing bed SNF claim                                                                                                                     
                 40 = Outpatient claim                                                                                                                        
                 50 = Hospice claim                                                                                                                           
                 60 = Inpatient claim                                                                                                                         
                 61 = Inpatient 'Full-Encounter' claim                                                                                                        
                 62 = Medicare Advantage IME/GME Claims                                                                                                       
                 63 = Medicare Advantage (no-pay) claims                                                                                                      
                 64 = Medicare Advantage (paid as FFS) claims                                                                                                 
                 71 = RIC O local carrier non-DMEPOS claim                                                                                                    
                 72 = RIC O local carrier DMEPOS claim                                                                                                        
                 81 = RIC M DMERC non-DMEPOS claim                                                                                                            
                 82 = RIC M DMERC DMEPOS claim                                                                                                                
                                                                                                                                                              
                 NOTE:  In the data element NCH_CLM_TYPE_CD                                                                                                   
                 (derivation rules) the numbers for these claim                                                                                               
                 types need to be changed - dictionary reflects                                                                                               
                 61 for all three.                                                                                                                            

               
PTNT_DSCHRG_STUS_TB                                    Patient Discharge Status Table                                                          

                  01 = Discharged to home/self care (routine                                                                                                  
                 charge).                                                                                                                                     
                 02 = Discharged/transferred to other short term                                                                                              
                 general hospital for inpatient care.                                                                                                         
                 03 = Discharged/transferred to skilled                                                                                                       
                 nursing facility (SNF) with Medicare                                                                                                         
                 certification in anticipation of covered                                                                                                     
                 skilled care -- (For hospitals with an                                                                                                       
                 approved swing bed arrangement, use Code                                                                                                     
                 61 - swing bed.  For reporting discharges/                                                                                                   
                 transfers to a non-certified SNF, the                                                                                                        
                 hospital must use Code 04 - ICF.                                                                                                             
                 04 = Discharged/transferred to a facility that                                                                                               
                 provides custodial or supportive care (includes                                                                                              
                 intermediate care facilities (ICF).  Also used                                                                                               
                 to designate patients that are dischared/trans-                                                                                              

                       ferred to a nursing facility with neither                                                                                              
                 Medicare nor Medicaid certification and for                                                                                                  
                 discharges/transfers to Assisted Living Facilities.                                                                                          
                 05 = Discharged/transferred to a designated cancer                                                                                           
                 center or children's hospital (eff. 10/09). Prior                                                                                            
                 to 10/1/09, discharged/transferred to another type                                                                                           
                 of institution for inpatient care (including                                                                                                 
                 distinct parts).  NOTE:  Effective 1/2005,                                                                                                   
                 psychiatric hospital or psychiatric distinct                                                                                                 
                 part unit of a hospital will no longer be                                                                                                    
                 identified by this code.  New code is '65'.                                                                                                  
                 06 = Discharged/transferred to home care of                                                                                                  
                 organized home health service organization                                                                                                   
                 in anticipation of covered skilled care.                                                                                                     
                 07 = Left against medical advice or discontinued                                                                                             
                 care.                                                                                                                                        
                 08 = Discharged/transferred to home under                                                                                                    
                 care of a home IV drug therapy provider.                                                                                                     
                 (discontinued effective 10/1/05)                                                                                                             
                 09 = Admitted as an inpatient to this                                                                                                        
                 hospital (effective 3/1/91).  In situa-                                                                                                      
                 tions  where a patient is admitted before                                                                                                    
                 midnight of the third day following the                                                                                                      
                 day of an outpatient service, the out-                                                                                                       
                 patient services are considered inpatient.                                                                                                   
                 20 = Expired                                                                                                                                 
                 21 = Discharged/transferred to Court/Law                                                                                                     
                 Enforcement.                                                                                                                                 
                 30 = Still patient.                                                                                                                          
                 40 = Expired at home (Hospice claims only).                                                                                                  
                 41 = Expired in a medical facility such as                                                                                                   
                 hospital, SNF, ICF, or freestanding                                                                                                          
                 hospice. (Hospice claims only)                                                                                                               
                 42 = Expired - place unknown (Hospice claims                                                                                                 
                 only)                                                                                                                                        
                 43 = Discharged/transferred to a federal hospital                                                                                            
                 (eff. 10/1/03). Discharges and transfers to a                                                                                                
                 government operated health facility such as a                                                                                                
                 Department of Defense hospital, a Veteran's                                                                                                  
                 Administration hospital or a Veteran's Administration                                                                                        
                 nursing facility. To be used whenever the destination                                                                                        
                 at discharge is a federal health care facility,                                                                                              
                 whether the patient lives there or not.                                                                                                      
                 50 = Hospice - home (eff. 10/96)                                                                                                             
                 51 = Hospice - medical facility (certified) providing                                                                                        
                 hospice level of care                                                                                                                        

                  61 = Discharged/transferred within this insti-                                                                                              
                 tution to a hospital-based Medicare                                                                                                          
                 approved swing bed (eff. 9/01)                                                                                                               
                 62 = Discharged/transferred to an inpatient                                                                                                  
                 rehabilitation facility including distinct                                                                                                   
                 parts units of a hospital.                                                                                                                   
                 (eff. 1/2002)                                                                                                                                
                 63 = Discharged/transferred to a Medicare certified                                                                                          
                 long term care hospital. (eff. 1/2002)                                                                                                       
                 64 = Discharged/transferred to a nursing facility                                                                                            
                 certified under Medicaid but not certified under                                                                                             
                 Medicare (eff. 10/2002)                                                                                                                      
                 65 = Discharged/Transferred to a psychiatric                                                                                                 
                 hospital or psychiatric distinct unit of a                                                                                                   
                 hospital (these types of hospitals were                                                                                                      
                 pulled from patient/discharge status code                                                                                                    
                 '05' and given their own code). (eff. 1/2005).                                                                                               
                 66 = Discharged/transferred to a Critical Access                                                                                             
                 Hospital (CAH) (eff. 1/1/06)                                                                                                                 
                 70 = Discharged/transferred to another type of health                                                                                        
                 care institution not defined elsewhere in code                                                                                               
                 list.                                                                                                                                        
                 71 = Discharged/transferred/referred to another                                                                                              
                 institution for outpatient services as                                                                                                       
                 specified by the discharge plan of care                                                                                                      
                 (eff. 9/01) (discontinued effective 10/1/05)                                                                                                 
                 72 = Discharged/transferred/referred to this                                                                                                 
                 institution for outpatient services as                                                                                                       
                 specified by the discharge plan of care                                                                                                      
                 (eff. 9/01) (discontinued effective 10/1/05)                                                                                                 

