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Tip: Inpatient and Institutional Definition Expansion

Tip: Inpatient and Institutional Definition Expansion

Number

0087

Submitting Entity (SE)

All Submitting entities

Add Date

Jul 15, 2021

Update Date

Dec 30, 2021 May 18, 2023 Nov 15, 2023 Dec 20, 2024

Update

Included in November 2023 data tips email

Included in the January 2025 data tips email.

Description

The logic originally populated the fields below for inpatient stays only. To align with the APCD Council recommendations and data provided by other submitting entities, the definition is being expanded for some fields to cover all institutional claims (outpatient visits, home health stays, inpatient stays, and long-term care stays) not just inpatient stays.

–MC023, MC039, MC058-MC058L, MC092 MC094, MC154-MC166 – expanded to include institutional claims

–MC018, MC019, MC020, MC022, MC069, MC071 – remain inpatient only

Active/Resolved

Active

Action / Resolution

The inclusion of institutional claims in the fields above is required for ALL submitting entities beginning in March 2022. Data received prior to that will retain the original data definition/mapping.

Category 1

Institutional Claim Identification

Category 2

Data Quality

Tip / Issue

Tip