[DM/URSA-CORE] Data Mart for URSA-CORE Surgery Encounters

Object Description

One record per encounter for any of the following encounter types: (1) hospital inpatient admission encounters with Is Surgical Encounter = TRUE; (2) ambulatory surgical center encounters; (3) hospital outpatient surgery encounters.

Metadata

• Table Name: ursa.dm_ursa_core_006
• 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)
  • Primary HCPCS Procedure Provider ID

• Date Fields

  • Encounter LOS in Elapsed Midnights
  • Is Same Day Discharge
  • Encounter Start Date
  • Encounter End Date

• Encounter Fields

  • Surgery Encounter Setting Category
  • Is Patient Discharged Home or Home with Home Health
  • Is Hospital Inpatient Admission Encounter
  • Is Ambulatory Surgical Center Encounter
  • Is Hospital Outpatient Surgery Encounter
  • Is Emergency Department Parent Encounter
  • Is Observation Stay Parent Encounter
  • Is MSK Related Encounter

• Provider Fields

  • Facility Provider Description
  • Facility Provider Primary NUCC Provider Taxonomy Code
  • Facility Provider Primary NUCC Provider Taxonomy Description
  • Facility Provider Practice Address State Abbreviation
  • Facility Provider Practice Address ZIP Code 5-Digit
  • Attending Provider Description
  • Attending Provider Primary NUCC Provider Taxonomy Code
  • Attending Provider Primary NUCC Provider Taxonomy Description

• Insurance Fields

  • Encounter Primary Payor Description
  • Encounter Primary Plan Description
  • Encounter Primary Plan Financial Class Description

• Clinical Services Fields

  • Primary HCPCS Procedure HCPCS Code
  • Primary HCPCS Short Description
  • Primary HCPCS Long Description
  • Is Primary HCPCS Procedure Surgical
  • Primary Surgical Procedure HCPCS Category
  • Is Primary HCPCS Surgical Procedure of Musculoskeletal System
  • Primary HCPCS MSK Surgical Procedure Category
  • Primary HCPCS AHRQ CCS Single-Level Procedure Category Code
  • Primary HCPCS AHRQ CCS Single-Level Procedure Category Description
  • Principal ICD Procedure ICD-10-PCS Code
  • Principal ICD Procedure ICD-10-PCS Description
  • Is Principal ICD-10-PCS Operation of Musculoskeletal System
  • Principal ICD-10-PCS AHRQ CCS Single-Level Procedure Category Code
  • Principal ICD-10-PCS AHRQ CCS Single-Level Procedure Category Description
  • Principal ICD-10-PCS AHRQ CCS Multi-Level Procedure Category Tier 1 Code
  • Principal ICD-10-PCS AHRQ CCS Multi-Level Procedure Category Tier 1 Description
  • Principal ICD-10-PCS AHRQ CCS Multi-Level Procedure Category Tier 2 Code
  • Principal ICD-10-PCS AHRQ CCS Multi-Level Procedure Category Tier 2 Description
  • Surgery Encounter Hip-Knee Category

• Diagnosis Fields

  • Principal Discharge Diagnosis ICD-10-CM Code
  • Principal Discharge Diagnosis ICD-10-CM Description
  • Is Principal Discharge Diagnosis Musculoskeletal System
  • 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

• Billing and Claims Fields

  • Ursa Hospital Admission Condition-Treatment Type Tier 1 Category -- A brief description, suitable for use in a chart or data table, identifying the type of admission using the Ursa Hospital Admission Condition-Treatment Type Tier 1 classification system. (See also [URSA-CORE] Ursa Hospital Admission Condition-Treatment Type)
  • MS-DRG Code -- The standard 3-digit Medicare Severity Diagnosis Related Group code; MS-DRG codes should include leading zeros.
  • MS-DRG Description -- The natural language description of a standard 3-digit Medicare Severity Diagnosis Related Group code.
  • MS-DRG MDC Code
  • MS-DRG MDC Description
  • Is MS-DRG MDC Code Musculoskeletal System
  • APR-DRG Code -- The standard 3-digit All Patient Refined Diagnosis Related Group code; APR-DRG codes should include leading zeros, and do not include the Severity of Illness or Risk of Mortality modifiers.
  • 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 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 Place of Service Description
  • CMS Place of Service Code -- The standard CMS 2-digit Place of Service code; e.g., 01 = Pharmacy, 02 = Telehealth, etc.
  • 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.

• Validation Only Fields

  • Is Any Total Hip or Knee Replacement
  • Is MSDRG for Hip or Knee Replacement
  • Is Principal ICD-10 PCS AHRQ CCS Single Level Category Total Knee
  • Is Principal ICD-10 PCS AHRQ CCS Single Level Category Total Hip
  • Is Primary HCPCS AHRQ CCS Single Level Category Total Knee
  • Is Primary HCPCS AHRQ CCS Single Level Category Total Hip

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
• primary_hcpcs_proc_prov_id → ursa.no_ursa_core_prov_001.prov_id
• enc_id → ursa.dm_ursa_core_012.enc_id