AP_CLAIM_TX_HX

Description: |
This table contains the history of service line changes for accounts payable claim records.

Primary Key

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

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | CLAIM_ID | NUMERIC | No |
The unique identifier for the claim record.
2 | LINE | INTEGER | No |
The line number for the information associated with this record. Multiple pieces of information can be associated with this record.
3 | TX_HX_TIME_SAVE_TM | DATETIME (Local) | No |
The time the record was saved.
4 | TX_HX_PROC_ID_PROC_NAME | VARCHAR | No |
The name of each procedure.
5 | TX_HX_SVC_FROM_DT | DATETIME | No |
Transaction history service from date.
6 | TX_HX_SVC_TO_DT | DATETIME | No |
Transaction history service to date.
7 | TX_HX_PROC_HX | NUMERIC | No |
The history of the procedure on previous versions of the service line.
8 | TX_HX_DX_CODES | VARCHAR | No |
The history of diagnosis codes on previous versions of the service line.
9 | TX_HX_AMT_BILLED | NUMERIC | No |
The history of the amount billed on previous versions of the service line.
10 | TX_HX_ALLOWED_AMT | NUMERIC | No |
The history of the allowed amount on previous versions of the service line.
11 | TX_HX_PAT_AMT | NUMERIC | No |
Patient portion of the bill.
12 | TX_HX_WITHHOLDINGS | NUMERIC | No |
The history of the withheld amount on previous versions of the service line.
13 | TX_HX_DISCOUNTS | NUMERIC | No |
The history of the discount amount on previous versions of the service line.
14 | TX_HX_NET_PAYABLE | NUMERIC | No |
The history of the net payable amount on previous versions of the service line.
15 | TX_HX_NUM_ID | NUMERIC | No |
Transaction history number in the claim procedure history.
16 | TX_HX_TX_TYPE_C_NAME | VARCHAR | No |
AP claims transaction type (for procedure history).
May contain organization-specific values: No
Category Entries:
Charge
Payment
Adjustment
AP Claim Tx
AP Claim Refund Tx
AP Claim DRG Tx
Pharmacy Claim Tx
17 | TX_HX_MED_ID_MEDICATION_NAME | VARCHAR | No |
The name of this medication record.
18 | TX_HX_REV_CODE_ID_PROC_NAME | VARCHAR | No |
The name of each procedure.
19 | TX_HX_SVC_START_TM | DATETIME (Local) | No |
Transaction history service start time.
20 | TX_HX_SVC_END_TIME | DATETIME (Local) | No |
Transaction history service end time.
21 | TX_HX_SVC_ELPSD_TM | INTEGER | No |
Transaction history service elapsed time.
22 | TX_HX_DRG_CODE_ID | VARCHAR | No |
Diagnosis Related Group (DRG) code history item.
23 | TX_HX_DRG_CODE_ID_DRG_NAME | VARCHAR | No |
The name of the Diagnoses Related Group name.
24 | PX_HX_EOB_COMMENT | VARCHAR | No |
Claim procedure history Explanation of Benefits (EOB) comments.
25 | TX_HX_POS_TYPES_C_NAME | VARCHAR | No |
Claim procedure history place of service types.
May contain organization-specific values: Yes
Category Entries:
Telehealth - Provided in Patient's Home
Office
Home
Assisted Living Facility
Group Home
Mobile Unit
Temporary Lodging
Walk-in Retail Health Clinic
Place of Employment - Worksite
Off Campus - Outpatient Hospital
Urgent Care Facility
Inpatient Hospital
On Campus - Outpatient Hospital
Emergency Room - Hospital
Ambulatory Surgical Center
Birthing Center
Military Treatment Facility
Outreach Site/Street
Skilled Nursing Facility
Nursing Facility
Custodial Care Facility
Hospice
Adult Living Care Facility
Ambulance - Land
Ambulance - Air or Water
Independent Clinic
Federally Qualified Health Center
Inpatient Psychiatric Facility
Psychiatric Facility - Partial Hospitalization
Community Mental Health Center
Intermediate Care Facility/ Individuals with Intellectual Disabilities
Residential Substance Abuse Treatment Facility
Psychiatric Residential Treatment Center
Non-residential Substance Abuse Treatment Facility
Non-residential Opioid Treatment Facility
Mass Immunization Center
Comprehensive Inpatient Rehabilitation Facility
Comprehensive Outpatient Rehabilitation Facility
End-Stage Renal Disease Treatment Facility
Programs of All-Inclusive Care for the Elderly (PACE) Center
Public Health Clinic
Rural Health Clinic
Independent Laboratory
Other Place of Service
Pharmacy
Telehealth - Provided Other than in Patient's Home
School
Homeless Shelter
Indian Health Service Free-standing Facility
Indian Health Service Provider-based Facility
Tribal 638 Free-standing Facility
Tribal 638 Provider-based Facility
Prison/Correctional Facility
26 | TX_HX_TOS_C_NAME | VARCHAR | No |
Claim procedure history type of service.
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
27 | TX_HX_PRIM_INS_AMT | NUMERIC | No |
Insurance amount from primary for history.
28 | TX_HX_PRIM_PAT_PRT | NUMERIC | No |
Patient portion from primary for history.
29 | PX_HX_OVRID_AMT_C | NUMERIC | No |
Procedure history for override allowed amounts.
30 | PX_HX_OVRID_RSN_C_NAME | VARCHAR | No |
Reason the allowed amount was overridden.
May contain organization-specific values: Yes
31 | TX_HX_ALLW_CODES_C_NAME | VARCHAR | No |
Procedure history allowed codes.
May contain organization-specific values: No
Category Entries:
Contracted Rate Payment
Payment as per Appeals Review Committee
Payment as per Duality Review Committee
Claim Denied
Procedure Denied
Secondary Claim Rate
32 | PROC_HX_PAT_CODE_C_NAME | VARCHAR | No |
Procedure history patient portion codes.
May contain organization-specific values: No
Category Entries:
Co-ins
Copay
Not Covered
No Patient Payment
33 | TX_HX_CMPTD_WTHLD | NUMERIC | No |
Computed withholding history.
34 | TX_HX_WTHLD_MTHD_C_NAME | VARCHAR | No |
Withhold method history.
May contain organization-specific values: No
Category Entries:
Percentage of Net Insurance
Fixed Amount
Extension
None
Percentage of Allowed Amount
35 | TX_HX_WTHLD_RATE | VARCHAR | No |
Withhold rate history.
36 | TX_HX_INS_AMT | NUMERIC | No |
Net insurance amount history.
37 | TX_HX_NET_INS_AMT | NUMERIC | No |
Net Insurance amount history
38 | TX_HX_COMPUTED_ADJ | NUMERIC | No |
Computed adjustment history.
39 | TX_HX_ACTUAL_ADJ | NUMERIC | No |
Actual adjustment history.
40 | TX_HX_ADJ_REASON_C_NAME | VARCHAR | No |
Adjustment reason history.
May contain organization-specific values: Yes
Category Entries:
Procedure is capitated
Coordination of Benefits
Maintenance of Benefits
Allowed exceeds amount patient paid
Pay by DRG
41 | TX_HX_CODE_EDT_SAV | NUMERIC | No |
Transaction history code edit savings.
42 | TX_HX_U_AND_C_AMT | NUMERIC | No |
Usual and customary amount history.
43 | TX_HX_CONTRACT_AMT | NUMERIC | No |
Contractual amount history.
44 | TX_HX_DISALOWED_AMT | NUMERIC | No |
Disallowed amount history.
45 | TX_HX_NOT_COVERED | NUMERIC | No |
Not covered history.
46 | TX_HX_DEDUCTIBLE | NUMERIC | No |
The history of the deductible amount on previous versions of the service line.
47 | TX_HX_COPAY | NUMERIC | No |
The history of the copay amount on previous versions of the service line.
48 | TX_HX_COINS | NUMERIC | No |
Co-insurance history.
49 | TX_HX_PAT_TOTAL | NUMERIC | No |
Patient total history.
50 | TX_HX_BFR_BEN_PEN | NUMERIC | No |
History before benefit penalty.
51 | TX_HX_AFTR_BEN_PEN | NUMERIC | No |
History after benefit penalty.
52 | TX_HX_EXCD_BEN_AMT | NUMERIC | No |
Exceeded benefit amount history.
53 | TX_HX_OVRIDE_DIS_C_NAME | VARCHAR | No |
Override disallowed reason history.
May contain organization-specific values: Yes
54 | TX_HX_OVRD_DA_AMT | NUMERIC | No |
Override disallowed amount history.
55 | TX_HX_OVRD_NC_AMT | NUMERIC | No |
Override not covered amount history.
56 | TX_HX_OVRD_DEDUCT | NUMERIC | No |
Override deductible history.
57 | TX_HX_OVRIDE_COINS | NUMERIC | No |
Override co-insurance history.
58 | TX_HX_OVRIDE_COPAY | NUMERIC | No |
Override copay history.
59 | TX_HX_OVRD_PTAMT_C_NAME | VARCHAR | No |
Override patient amount reason history.
May contain organization-specific values: Yes
60 | TX_HX_OVRD_PATPO | NUMERIC | No |
Override patient portion history.
61 | TX_HX_COB_SAV_AMT | NUMERIC | No |
Coordination of Benefits (COB) Saving amount history.
62 | TX_HX_OVRD_BEN_AMT | NUMERIC | No |
Override exceeded benefit amount for transaction history.
63 | TX_HX_PRICE_ATTR_C_NAME | VARCHAR | No |
Pricing attribute for transaction history.
May contain organization-specific values: Yes
Category Entries:
PCP
Specialist
64 | TX_HX_PAT_OUTOF_PC | NUMERIC | No |
Patient out of pocket history.
65 | TX_HX_SAVED_DT | DATETIME | No |
The date the transaction history was saved.
66 | TX_HX_USER_ID | VARCHAR | No |
Specifies the transaction history user.
67 | TX_HX_USER_ID_NAME | VARCHAR | No |
The name of the user record. This name may be hidden.
68 | TX_HX_UBC_REVCOD_ID | VARCHAR | No |
This column holds the transaction history for revenue codes in UB Claims. It stores the record ID (this is found in the revenue code master file; it is not the actual revenue code) for revenue codes that were previously entered on the claim.
69 | TX_HX_UBC_REVCOD_ID_REVENUE_CODE_NAME | VARCHAR | No |
The name of the revenue code.
70 | TX_HX_REIMB_AMT | NUMERIC | No |
Healthcare reimbursement amount history.
71 | TX_HX_OVRD_RIMB_AMT | NUMERIC | No |
Override reimbursement amount history.
72 | TX_HX_SYS_ADJ_RSN_C_NAME | VARCHAR | No |
System adjustment reason history.
The category values for this column were already listed for column: TX_HX_ADJ_REASON_C_NAME
73 | TX_HX_AFT_BEN_PEN_OVRIDE | NUMERIC | No |
Override after benefits penalty history.
74 | TX_HX_AFT_BEN_PEN_OVRIDE_RSN_C_NAME | VARCHAR | No |
Override after benefits penalty reason history. This should be translated using ZC_PEN_AFT_BEN_OVRIDE_RSN.
May contain organization-specific values: Yes
75 | TX_HX_COB_SAVINGS_PAYOUT | NUMERIC | No |
COB savings payout history