URSA-CORE-932: Excess Principal Diagnoses

  • Published on Apr 10, 2026
  • 2 minute(s) read
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Measure Description

Among institutional claim or bill headers and professional claim or bill service line items, the percentage with 2 or more principal diagnoses.

Metadata

  • Measure Identifier: URSA-CORE-932
  • Measure Type: Rate Measure
  • Temporal Structure: Event
  • Component Class: Normal-Form
  • Denominator Case Field: Document ID
  • Target Direction: Down

Denominator Description

One per institutional claim or bill headers or professional claim or bill service line items.

Numerator Description

One per denominator observation with 2 or more principal diagnoses.

Published Fields

  • Data Model Keys

    • Document ID -- The internal database identifier (used, e.g., for joins and primary keys) for the document. (See also [URSA-CORE] Document)
    • Claim ID -- The internal database identifier (used, e.g., for joins and primary keys) for the claim. (See also [URSA-CORE] Claim)
    • Professional Claim Service Line Item ID -- The identifier for a service line item on an institutional or professional claim.
    • Bill ID -- The identifier for a professional or institutional bill header record; Bill ID values are consistent over the lifetime of a bill, including when a bill is adjusted. On a claim record, this field refers to the bill sent to the plan that originated the claim record.
    • Professional Bill Service Line Item ID -- The identifier for a service line item on an institutional or professional bill.
    • Service Line Number -- The integer-valued ordinal representing the position of a service line item in a claim, bill, encounter, or other master record. May not necessarily match the analogous value in the source data for the same record.
    • 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.
    • Plan ID -- The identifier for a particular health insurance plan product offered by a payor.
    • Payor ID -- The identifier for the health insurance organization associated with the current record.
    • Source ID -- The identifier for the original source data system from which the current record originated.

  • Date Fields

    • Segment Start Date -- The start date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
    • Segment End Date -- The end date of the reporting segment. (See also [URSA-CORE] Reporting Segment)

  • Diagnosis Fields

    • ICD-10-CM Code
    • ICD-10-CM Description

  • Metadata Fields

    • Document Type Description

  • Measure Fields

    • Count Principal Diagnoses
    • Denominator