URSA-CORE-911: ED Visit Services Without ED Visit

Measure Description

Among medical billing or claims service line items with a place of service code, HCPCS code, or revenue center code indicating an emergency department setting, the percentage of those documents that are not associated with an emergency department encounter. A positive result suggests missing data needed to identify an emergency department visit on that date.

Metadata

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

Denominator Description

Institutional and professional claims or billing service line items with a place of service code indicating an emergency department setting (POS = 23), a HCPCS code indicating emergency department evaluation and management, or a revenue center code indicating emergency department setting care.

Numerator Description

Denominator observations not matched to a corresponding emergency department visit encounter