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12/11/2011
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PROVIDER PROVIDE_ID UNIQSAMPID ELIG_DSCHG FIRSTNAME MIDDLEINIT LASTNAME GENDER

AGE_CODE STREET CITY STATE ZIP PHONE ADM_DATE DISDATE

ADM_SOURCE DIS_STATUS DOS PRA

Fields Research field names

are in column 1 and should PROVIDER PROVIDE_ID UNIQSAMPID ELIG_DSCHG

not be altered.

HCAHPS XML FIELD

provider-

NAMES (HCAHPS XML FILE provider-id number-eligible-discharge

name

LAYOUT VERSION 3.3)

Unique number

ROW 3 AND DOWN IN EACH Valid 6 digit

assigned by the

COLUMN ARE THE Name of the Medicare # OF ELIGIBLE DISCHARGE

hospital to

DESCRIPTION Hospital Provider (TOTAL POSSIBLE SAMPLE)

identify the

/CODE CHOICES Number.

sample/patient







*changes are Bold, Italicized and Underlined

FIRSTNAME MIDDLEINIT LASTNAME GENDER AGE_CODE STREET CITY STATE ZIP









5 digit

codes 1-15 zip:

99999



1 - Male 0 - Under 18



2 - Female 1 - 18 to 24





M - Missing 2 - 25 to 29



3 - 30 to 34



4 - 35 to 39



5 - 40 to 44





6 - 45 to 49





7 - 50 to 54



8 - 55 to 59



9 - 60 to 64



10 - 65 to 69

11 - 70 to 74

12 - 75 to 79

13 - 80 to 84

14 - 85 to 89

15 - 90 or older



M - Missing/Unknown

PHONE ADM_DATE DISDATE ADM_SOURCE







admitted date discharge-date *admission-source





include area

code:

MM/DD/YYYY MM/DD/YYYY 1 - The patient was admitted to this facility

999-999-9999





2 - The patient was admitted to this facility



4 - Transfer from a hospital (Different Facility)





5 - Transfer from a SNF or ICF



6 - Transfer from another Health Care Facility



8 - Court/law Enforcement



9 - Information not available

D - Transfer from one distinct unit of the hospital to

another distinct unit of the same hospital resulting in a

separate claim to the payer

E - Transfer from Ambulatory Surgery Center







Note: Valid values 1 and 2 have the same definition



CMS has removed "7 - Emergency room"

DIS_STATUS DOS







*discharge-status *Determination of Service Line









1 = V.28, V.27, V.26 or V.25 MS-

1 = Home care or self care

DRG codes





2 = Another short-term general hospital 2 = CMS V.24 DRG codes

3 = Mix of V.28, V.27, V.26, V.25,

3 = Skilled nursing facility or V.24 codes based on payer

source

4 = Intermediate care facility 4 = ICD-9 codes

5 = Discharge/transfer to a designated cancer

5 = Hospital unit

center or children’s hospital

6 = Home with home health services 6 = New York State DRGs

7 = Other – Approved Exceptions

7 = Left against medical advice

Request only



20 = Expired



21 - Discharged/transferred to court/law

enforcement

41 = Expired in medical facility



43 = Federal healthcare facility



50 = Hospice – home

51 = Hospice – medical facility

61 = SNF swing bed within hospital

62 = Inpatient rehabilitation facility

63 = Long-term care hospital

64 = Certified Medicaid nursing facility



65 = Psychiatric hospital or psychiatric unit



66 = Critical Access Hospital

70 = Discharge/transfer to health care institution

not defined elsewhere in the code list

PRA







*service line





principal-reason-admission

Assigned by utilizing

information contained in the

V.28 MS-DRG Codes. While

V.28 Medicare Severity

Diagnosis Related Group (MS-

DRG) codes are the preferred

method for determining the

patient’s service line, CMS also

allows the following

methodologies to be used: V.26

MS-DRG codes; V.25 MS-DRG

codes; V.24 CMS-DRG codes;

Mix of V.28, V.27, V.26, V.25,

V.24 codes based on payer

source; ICD-9 codes; hospital

unit; and New York State



1 – Maternity Care





2 – Medical



3 – Surgical



M – Missing


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