URSA-CORE-912: SNF Services Without SNF Encounter

Measure Description

Among medical billing or claims service line items with a place of service or HCPCS code indicating a skilled nursing facility setting, the percentage of those documents that are not associated with an skilled nursing facility encounter. A positive result suggests missing data needed to identify a SNF encounter on that date.

Metadata

• Measure Type: Rate Measure
• Temporal Structure: Event
• Component Class: Normal-Form
• Denominator Case Field: Document ID
• Target Direction: Down

Denominator Description

Institutional and professional billing or claims service line items with a place of service code indicating a skilled nursing facility setting (POS = 31) or a HCPCS code indicating nursing facility setting evaluation and management.

Numerator Description

Denominator observations not matched to a corresponding skilled nursing facility encounter