[NO/URSA-CORE] MAO-004 Diagnoses

Object Description

One record per final action MAO-004 diagnosis code obtained from the reconciliation of MAO-004 (or commercial MA plan equivalent) data to final action status.

Metadata

• Table Name: ursa.no_ursa_core_cond_008
• Layer: NATURAL_OBJECT
• Object Type: Single Stack
• Temporal Class: Event
• Case ID: Record ID
• Event Date: Claim Covered Start Date
• Primary Key: Record ID

Published Fields

• Data Model Keys

  • Record ID
  • 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)
  • Payor ID -- The identifier for the health insurance organization associated with the current record.
  • Claim ID -- The internal database identifier (used, e.g., for joins and primary keys) for the claim. (See also [URSA-CORE] Claim)
  • Diagnosis Line Number -- The integer-valued ordinal representing the position of a diagnosis on a claim, bill, encounter, or other master record. May not necessarily match the analogous value in the source data for the same record. Typically, the diagnosis in the first position is considered the principal diagnosis, though this is not an absolute rule, and the Is Principal Diagnosis field should be used to identify the principal diagnosis.
  • Document ID
  • Source ID -- The identifier for the original source data system from which the current record originated.

• Source Local Keys

  • Source Local Record ID -- The internal database identifier for the record in the source data system this record originated from.
  • Source Local Patient ID -- The internal database identifier for the patient in the source data system this record originated from. (See also [URSA-CORE] Patient)

• Date Fields

  • Claim Covered Start Date -- The start date of services covered by a claim.
  • Claim Covered End Date -- The end date of services covered by a claim.
  • Last CMS MAO-004 Encounter Submitted Date -- The most recent date a MAO-004 encounter record was submitted to CMS for a given patient-date-diagnosis code triple.
  • CMS MAO-004 Report Date -- This field contains the same values as the CMS MAO-004 header record "Report Date" field, which the CMS documentation defines as: "The last date of the submission month".

• Operations Support Fields

  • Last CMS MAO-004 Encounter ICN

• Diagnosis Fields

  • Diagnosis ICD-10-CM Code -- The standard ICD-10-CM diagnosis code; e.g., A00 = Cholera. ICD-10-CM diagnosis codes longer than 3 digits must include a decimal point after the 3rd digit.
  • Diagnosis ICD-10-CM Description

• Insurance Fields

  • Is CMS MAO-004 Allowed Diagnosis
  • CMS MAO-004 Service Type Code
  • CMS MAO-004 Service Type Description
  • CMS MAO-004 Allowed or Disallowed Reason Code
  • CMS MAO-004 Allowed or Disallowed Reason Description

• Metadata Fields

  • Record Last Updated Datetime -- The date and time the current record was last updated in the original data source.
  • Source Data Effective Datetime -- The "as of" date and time of the original source data system at the moment the current record was extracted. For example, if a snapshot of the data in a production system is taken at 12:05 AM on the first of each month and used to generate a package of flat files that are eventually loaded into the Ursa Studio client database later that month, the Source Data Effective Datetime of all records in that month's package will be 12:05 AM on the first. Not to be confused with Record Last Updated Datetime. (See also [URSA-CORE] Record Last Updated Datetime)

Foreign Keys

• pat_id → ursa.no_ursa_core_pat_001.pat_id

Dedicated Precursors

• [NO/URSA-CORE] MAO-004 Diagnoses, Precursor 1 (All Source Records): One record per final action MAO-004 diagnosis code obtained from the reconciliation of MAO-004 (or commercial MA plan equivalent) data to final action status; collected from all sources.