Day of the Week Admission Charges by Summary Revenue Codes Month of Admission Total Charges Admission Source Days in Special Units i.e., ICU, CCU, etc. Admission Type Patient Age at Admission in Years Physician Specialty Code Five year groupings except less than 5 years, which is As adopted by the AMA reported as one” for children under one year of “under age and to four” for children one to four years of “one age; over 84 years is reported in and over” category) “85 Health Care Professional Classification i.e., Attending, Other Patient Gender Patient Race/Ethnicity County of Patient’s Residence Patient Reason for Visit Please select one (1) of the following hospital characteristics: Diagnosis Codes Procedure Codes Teaching Status of the Facility E-codes Trauma Level AHRQ Broad Level Diagnostic Categories Level of Perinatal Service AHRQ Detailed Diagnostic Categories Urban/Rural Status of Health Care Facility on MSA, Non-MSA County Status Patient Discharge Status Primary Expected Payer Classification Bed Size Based on Licensed Beds i.e., Medicare, Medicaid, Insurance, HMO, Self-Pay, 100 beds or less, 101 299 beds, 300 or more beds – Indigent, TriCare, Worker’s Compensation and Other Part IV: Ambulatory Surgery, Imaging, and Other Services/Equipment Requiring a Certificate of Need Encounter-Level Data Day of the Week Admission Diagnosis Codes Month of Admission Procedure Codes
Day of the Week Admission Charges by Summary Revenue Codes Month of Admission Total Charges Admission Source Days in Special Units i.e., ICU, CCU, etc. Admission Type Patient Age at Admission in Years Five year groupings except less than 5 years, which is reported as “under one” for children under one year of age and “one to four” for children one to four years of age; over 84 years is reported in “85 and over” category) Physician Specialty Code As adopted by the AMA Health Care Professional Classification i.e., Attending, Other Patient Gender Patient Race/Ethnicity County of Patient’s Residence Patient Reason for Visit Please select one (1) of the following hospital characteristics: Diagnosis Codes Procedure Codes Teaching Status of the Facility E-codes Trauma Level AHRQ Broad Level Diagnostic Categories Level of Perinatal Service AHRQ Detailed Diagnostic Categories Urban/Rural Status of Health Care Facility on MSA, Non-MSA County Status Patient Discharge Status Primary Expected Payer Classification i.e., Medicare, Medicaid, Insurance, HMO, Self-Pay, Indigent, TriCare, Worker’s Compensation and Other Bed Size Based on Licensed Beds 100 beds or less, 101 – 299 beds, 300 or more beds Part IV: Ambulatory Surgery, Imaging, and Other Services/Equipment Requiring a Certificate of Need Encounter-Level Data Day of the Week Admission Diagnosis Codes Month of Admission Procedure Codes
Application%20for%20Encounter%20Level%20%28UB%29%20Data%20072014.docx