HSP_CLP_CMS_LINE

Description: |
This table contains claim line information for claims associated with the hospital account/liability bucket. For uniform medical billing (UB) claims, this table contains pre-processing charge information, which is used in the creation of UB claim lines. Post-processing claim line data for UB claims is stored in the HSP_CLP_REV_CODE table. For CMS claims, this table contains the post-processing claim line data.

Primary Key

Column Name | Ordinal Position |
--- | --- | ---
CLAIM_PRINT_ID | 1 |
LINE | 2 |

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | CLAIM_PRINT_ID | NUMERIC | No |
The ID of the claim record associated with a single hospital account or liability bucket.
2 | LINE | INTEGER | No |
The line number of one of the multiple values associated with a specific group of data within this record.
3 | REIMB_AMT | NUMERIC | No |
Stores the reimbursement amount for claim line.
4 | REIMB_METHOD_C_NAME | VARCHAR | No |
Stores the reimbursement method.
May contain organization-specific values: No
Category Entries:
Charge Entry Line Calculation
Invoice Line Calculation
Invoice Bundle Calculation
APC
5 | FROM_SERV_DT | DATETIME | No |
Stores the from date for a claim line. For services that do not span multiple days, the service date will be held here.
6 | TO_SERV_DT | DATETIME | No |
Stores the through date for a claim line.
7 | POS_TYPE_PER_TX | VARCHAR | No |
Stores the place of service type per transaction.
8 | TOS_C_NAME | VARCHAR | No |
Stores the type of service for the claim line.
May contain organization-specific values: Yes
Category Entries:
Medical Care
Surgery
Consultation
Diagnostic Radiology
Diagnostic Laboratory
Therapeutic Radiology
Anesthesia
Assistant at Surgery
Other Medical Items or Services
Whole Blood
Used Durable Medical Equipment (DME)
Ambulatory Surgical Center (Facility usage for Surgical Services)
Hospice (Obsolete, Discontinued 1/95)
ESRD Supplies
Monthly Capitation Payment for Dialysis
Kidney Donor
Pneumococcal/Flu Vaccine
Second Opinion on Elective Surgery (Obsolete)
Third Opinion on Elective Surgery (Obsolete)
Diagnostic Medical (Obsolete)
Ancillaries, Hospital and Nursing Home (Obsolete)
Drug Services (Obsolete)
Accommodations, Hospital and Nursing Home (Obsolete)
Dental (Obsolete)
Vision Care and Cataract Lens (Obsolete)
Nuclear Medicine (Obsolete)
Diagnostic X-Ray (Professional) (Obsolete)
Rental of DME
Radiation Therapy (Professional) (Obsolete)
Diagnostic Lab (Professional) (Obsolete)
Diagnostic Medical (Professional) (Obsolete)
DME Purchase (Obsolete)
CRD Equipment (Obsolete)
Pre-Admission Testing (Obsolete)
EPSDT
High Risk Screening Mammography
Low Risk Screening Mammography
Ambulance
Enteral/Parenteral Nutrients/Supplies
Immunosuppressive Drugs
Diabetic Shoes
Hearing Items and Services
Lump Sum Purchase of DME, Prostethics, Orthotics
Vision Items or Services
Surgical Dressings or Other Medical Supplies
Psychological Therapy
Occupational Therapy
Physical Therapy
Medication (Obsolete)
Chiropractic Care
DME Prescription
9 | PROC_ID_PROC_NAME | VARCHAR | No |
The name of each procedure.
10 | PROC_DESC | VARCHAR | No |
Stores the procedure description.
11 | HCPCS_CODES | VARCHAR | No |
Stores the Healthcare Common Procedure Coding System code for the claim line.
12 | PROF_CLM_MODIFIERS | VARCHAR | No |
Stores modifiers on the claim line.
13 | DX_MAP | VARCHAR | No |
Comma-delimited list of diagnosis pointers for the claim line.
14 | QUANTITY | NUMERIC | No |
Stores the quantity associated with the claim line.
15 | OVRD_REV_CODE_ID | NUMERIC | No |
Stores the override revenue code.
16 | OVRD_REV_CODE_ID_REVENUE_CODE_NAME | VARCHAR | No |
The name of the revenue code.
17 | CHARGE_AMT | NUMERIC | No |
Stores the charge amount for the claim line.
18 | INS_DUE_AMT | NUMERIC | No |
Stores the insurance amount due for the claim line.
19 | PAT_DUE_AMT | NUMERIC | No |
Stores the patient amount due for the claim line.
20 | NON_CVD_AMT | NUMERIC | No |
Stores the non-covered amount for the claim line.
21 | PAYMENT_AMT | NUMERIC | No |
Stores the payment amount for the claim line.
22 | INSURANCE_PAID_AMT | NUMERIC | No |
Stores the insurance amount paid for the claim line.
23 | PAT_PAID_AMT | NUMERIC | No |
Stores the patient amount paid for the claim line.
24 | ADJUSTMENT_AMT | NUMERIC | No |
Stores the adjustment amount for the claim line.
25 | PRINT_DESCRIPTIO_YN | VARCHAR | No |
This controls procedure description printing for professional claims.
May contain organization-specific values: No
Category Entries:
No
Yes
26 | REV_LOCATION_ID_LOC_NAME | VARCHAR | No |
The name of the revenue location.
27 | DEPT_ID_EXTERNAL_NAME | VARCHAR | No |
The external name of the department record. This is often used in patient correspondence such as reminder letters.
28 | PX_START_DT | DATETIME | No |
Start date for timed procedures.
29 | PX_STOP_DT | DATETIME | No |
Stop date for timed procedures.
30 | PX_START_TM | DATETIME (Local) | No |
Start time for timed procedures.
31 | PX_STOP_TM | DATETIME (Local) | No |
Stop time for timed procedures.
32 | LINE_COMMENT | VARCHAR | No |
Comment for the line.
33 | LINE_POS_ID_LOC_NAME | VARCHAR | No |
The name of the revenue location.
34 | CMS_CODE_TYPE_C_NAME | VARCHAR | No |
Stores the code type for the transaction level Healthcare Common Procedure Coding System code override. If a procedure has been assigned to the line without setting the override, this column will be left blank.
May contain organization-specific values: Yes
Category Entries:
CPT(R)
HCPCS
ADA
ASA
SKS
THL
CBV
VT
ZA
CCSD
OPCS
35 | CMS_REND_PROV_ID_PROV_NAME | VARCHAR | No |
The name of the service provider. This item may be hidden in a public view of the CLARITY_SER table.
36 | CMS_MOLDX_TEST_CODE | VARCHAR | No |
Holds the auxiliary procedure code for a CMS line.
37 | CMS_AUXPX_CD_TYPE_C_NAME | VARCHAR | No |
Holds the type of auxiliary procedure code when one is applicable to a CMS line.
May contain organization-specific values: No
Category Entries:
Laboratory Test Code
Molecular Diagnostic Test Code
38 | CMS_PRIOR_AUTH | VARCHAR | No |
Stores the prior-authorization number for a service line.
39 | CMS_REF_NUM | VARCHAR | No |
Stores the referral number for a service line.
40 | CMS_LINKED_AUTH_ID | NUMERIC | No |
Stores the professional billing charge level linked authorization ID.
41 | CMS_MEDICARE_PAID_AMT | NUMERIC | No |
For eMedNY 150003 claims, this is the amount that Medicare paid for this service line. This appears in field 24K (SVC_LN_INFO_2.LN_MCR_PAID_AMT). The EMEDNY_MEDICARE_PLANS profile variable can be used to control which coverages count as Medicare coverages.
42 | INVOICE_GRP_LN | VARCHAR | No |
The group line number on the invoice record that corresponds to the data in INVOICE_CLM_LN.