[DM/URSA-CORE] Data Mart for Emergency Department Visit Parent Encounters

Object Description

One record per emergency department visit parent encounter -- encounters, including hospital inpatient encounters, that involve a patient stay in the hospital emergency room.

Metadata

• Table Name: ursa.dm_ursa_core_004
• Layer: DATA_MART
• Object Type: Single Stack
• Temporal Class: Event
• Case ID: Encounter ID
• Event Date: Encounter Start Date
• Primary Key: Encounter ID

Published Fields

• Data Model Keys

  • Encounter ID -- The internal database identifier (used, e.g., for joins and primary keys) for the encounter. (See also [URSA-CORE] Encounter)
  • Patient ID -- The internal database identifier (used, e.g., for joins and primary keys) for the patient. This value is typically mastered, i.e., all records for the same patient, regardless of the source data system from which that record originated, should have the same Patient ID value. (Note that while the mastered Patient ID value might resemble a local identifier used in one of the upstream data sources, this does not indicate any special priority of that source system in determining the characteristics of the patient.) (See also [URSA-CORE] Patient)
  • Encounter Primary Payor ID -- Data model key for the primary payor documented in the billing for an encounter.
  • Encounter Primary Plan ID -- Data model key for the primary plan documented in the billing for an encounter.
  • Facility Provider ID -- The internal database identifier (used, e.g., for joins and primary keys) for the facility provider. (See also [URSA-CORE] Facility Provider)
  • Attending Provider ID -- The internal database identifier (used, e.g., for joins and primary keys) for the attending provider. (See also [URSA-CORE] Attending Provider)

• Date Fields

  • Encounter Start Date
  • Encounter End Date
  • Encounter LOS in Elapsed Midnights
  • Encounter LOS in Distinct Calendar Days

• Encounter Fields

  • Is Patient Admitted to Observation
  • Is Patient Admitted to Hospital Inpatient

• Provider Fields

  • Facility Provider Description
  • Facility Provider Primary NUCC Provider Taxonomy Code
  • Facility Provider Primary NUCC Provider Taxonomy Description
  • Attending Provider Description
  • Attending Provider Primary NUCC Provider Taxonomy Code
  • Attending Provider Primary NUCC Provider Taxonomy Description

• Insurance Fields

  • Primary Payor Description
  • Primary Plan Description
  • Primary Plan Financial Class Description
  • Is Primary Plan Financial Class Commercial
  • Is Primary Plan Financial Class Medicare FFS
  • Is Primary Plan Financial Class Medicare Advantage
  • Is Primary Plan Financial Class Medicaid

• Diagnosis Fields

  • Principal Discharge Diagnosis ICD-10-CM Code
  • Principal Discharge Diagnosis ICD-10-CM Description
  • Principal Discharge Diagnosis WHO ICD-10 Chapter Description
  • Principal Discharge Diagnosis WHO ICD-10 Block Description
  • Principal Discharge Diagnosis AHRQ CCS Single-Level Diagnosis Category Code
  • Principal Discharge Diagnosis AHRQ CCS Single-Level Diagnosis Category Description
  • Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Code
  • Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Description
  • Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 2 Code
  • Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 2 Description
  • Principal Discharge Diagnosis ICD-9-CM Code
  • Principal Discharge Diagnosis ICD-9-CM Description

• Billing and Claims Fields

  • CMS Admit Source Code -- The standard 1-character CMS Admit Source code; e.g., 1 = Physician Referral, 2 = Clinic Referral, etc.
  • CMS Admit Source Description
  • CMS Admit Type Code -- The standard single-digit CMS inpatient admission type code found on Inpatient and Skilled Nursing Facility claims; ; 1 = Emergency, 2 = Urgent, 3 = Elective, 4 = Newborn, 5 = Trauma Center, 9 = Information Not Available.
  • CMS Admit Type Description
  • CMS Place of Service Code -- The standard CMS 2-digit Place of Service code; e.g., 01 = Pharmacy, 02 = Telehealth, etc.
  • CMS Place of Service Description
  • CMS Patient Discharge Status Code -- The standard 2-digit CMS Patient Discharge Status code; 01 = Discharged to Home or Self Care, etc. Patient Discharge Status codes should include leading zeros.
  • CMS Patient Discharge Status Description

• Financial Fields

  • Primary Plan Allowed Amount -- The maximum amount that the payor agrees to pay the provider for a service or product, typically governed by a contract. The Allowed Amount for a claim or billing record is calculated by adding the Contractual Adjustment Amount (which is typically negative) to the Charge Amount. Adding the total Non-Contractual Adjustment Amount to the Allowed Amount yields the Total Due Amount. On billing records, which may identify up to three plans responsible for payment, the Primary Plan Allowed Amount, Secondary Plan Allowed Amount, and Tertiary Plan Allowed Amount fields identify the amounts paid by the primary, secondary, and tertiary plans listed on the bill, respectively. (See also [URSA-CORE] Charge Amount, [URSA-CORE] Contractual Adjustment Amount, [URSA-CORE] Non-Contractual Adjustment Amount, [URSA-CORE] Total Due Amount)
  • Primary Plan Paid Amount -- The amount actually paid by the health plan to the provider for a service or product. Subtracting the plan paid amount from the total due amount typically yields the patient responsibility amount. On billing records, which may identify up to three plans responsible for payment, the Primary Plan Paid Amount, Secondary Plan Paid Amount, and Tertiary Plan Paid Amount fields identify the amounts paid by the primary, secondary, and tertiary plans listed on the bill, respectively; the total paid by any and all plans on a bill is identified by the Any Plan Paid Amount field.
  • Total Plan Paid Amount from All Plans
  • Patient Paid Amount -- The amount paid by the patient to the provider for health care services or products.

Foreign Keys

• pat_id → ursa.no_ursa_core_pat_001.pat_id
• enc_primary_payor_id → ursa.no_ursa_core_struct_004.payor_id
• enc_primary_plan_id → ursa.no_ursa_core_struct_005.plan_id
• facility_prov_id → ursa.no_ursa_core_prov_001.prov_id
• attending_prov_id → ursa.no_ursa_core_prov_001.prov_id