URSA-PHF-046: Percent of Surgery Encounters Discharged Home

Measure Description

Among surgery encounters, the percent of patients discharged home or home with home health

Metadata

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

Denominator Description

One per surgery encounter; excludes surgery encounters without an encounter end date.

Numerator Description

Surgery encounters with a CMS Patient Discharge Status Code indicating the patient was discharged home or home with home health.

Published Fields

• Data Model Keys

  • Encounter ID
  • Patient ID
  • Encounter Primary Payor ID
  • Encounter Primary Plan ID
  • Facility Provider ID
  • Attending Provider ID
  • Primary HCPCS Procedure Provider ID

• Date Fields

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

• 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
  • MS-DRG Code
  • MS-DRG Description
  • MS-DRG MDC Code
  • MS-DRG MDC Description
  • Is MS-DRG MDC Code Musculoskeletal System
  • APR-DRG Code
  • CMS Admit Type Code
  • CMS Admit Type Description
  • CMS Admit Source Code
  • CMS Admit Source Description
  • CMS Place of Service Description
  • CMS Place of Service Code
  • CMS Patient Discharge Status Code
  • CMS Patient Discharge Status Description

• Financial Fields

  • Primary Plan Allowed Amount
  • Primary Plan Paid Amount
  • Total Plan Paid Amount from All Plans
  • Patient Paid Amount

• 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

• Measure Fields

  • Denominator
  • Numerator