Tip: Inpatient claims identification

Number	0170
Submitting Entity (SE)	All
Add Date	Nov 14, 2024
Update Date	//
Update	Included in December 2024 data tips email.
Description	This tip provides data users with resources to identify/select inpatient claims in APCD data: Which variable(s) or combination of variables should we use to distinguish inpatient claims within this table? The best way to identify an inpatient claim is to use Type of Bill (MC036). https://achiapcd.atlassian.net/wiki/spaces/ADRS/pages/396099919/MC036. Revenue Codes (MC054) can supplement this selection. https://achiapcd.atlassian.net/wiki/spaces/ADRS/pages/396165474/MC054 How can the discharge date for an inpatient stay be determined? If final discharge status (MC023) indicates the member has been discharged and the Discharge date (MC069) is not populated, use Service To date (MC060). What is the best approach to identify the discharge date for an inpatient stay in Medicare inpatient claims data (apcd_mcr_inp_clm)? Use NCH_BENE_DSCHRG_DT and reference this information: https://resdac.org/cms-data/variables/nch-beneficiary-discharge-date
Active/Resolved	Active
Action / Resolution
Category 1	Inpatient claims
Category 2	Medicare
Tip / Issue	Tip