INVOICE_APC

Description: |
The INVOICE_APC table contains information on payment classifications.

Primary Key

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

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | INVOICE_ID | NUMERIC | No |
The unique ID of the invoice record.
2 | LINE | INTEGER | No |
The line number of the payment classification type for this invoice record.
3 | PC_TYPE_C_NAME | VARCHAR | No |
The type of payment classification that appears on the invoice (i.e. CPT™, APC, etc.)
May contain organization-specific values: No
Category Entries:
Ambulatory Payment Classification
Home Health
CPT
Ambulatory Patient Grouping
MDS RUG Code
Inpatient Rehabilitation Facility
4 | PC_CODE | VARCHAR | No |
The payment classification code that appears on the invoice.
5 | PC_MODIFIER | VARCHAR | No |
The payment classification modifier that appears on the invoice.
6 | PC_SERVICE_DATE | DATETIME | No |
The service date the services were performed on.
7 | PC_PMT_STAT_IND_C_NAME | VARCHAR | No |
The status indicator for this payment classification.
May contain organization-specific values: No
Category Entries:
S (Significant Procedures)
T (Surgical Services)
V (Medical Visits)
X (Ancillary Services)
P (Partial Hospitalization or Intensive Outpatient Program)
N (Incidental Services)
E (Not Allowed under APC or Not Covered)
C (Inpatient Services Not Payable under APC)
A (Miscellaneous Non-PPS)
F (Acquisition of Corneal Tissue)
G (Current Drug/Biological Pass-Through)
H (Device Pass-Through)
J (New Drug/Biological Pass-Through)
K (Non Pass-Through Drug/Biological)
B (Not Recognized by OPPS for Part B)
D (Discontinued Codes)
L (Influenza/Pneumonia Vaccine)
M (Not Billable to the FI)
Q (Packaged Services Subject to Separate Payment)
Y (Non-Implantable Durable Medical Equipment)
Q1 (STV-Packaged Codes)
Q2 (T-Packaged Codes)
Q3 (Codes paid through a composite APC)
R (Blood and blood products)
U (Brachytherapy Sources)
J1 (Services paid through a comprehensive APC)
J2 (Services that may be paid through a comprehensive APC)
Q4 (Conditionally packaged laboratory tests)
E1 (Items and services not covered by Medicare)
E2 (Items and services without price or claim data)
H1 (Non-Opioid Devices for Post-Surgical Pain Relief)
K1 (Non-Opioid Drugs/Biologicals for Post-Surgical Pain Relief)
S1 (Skin Substitute Product Paid Separately)
8 | PC_ETR_LIST | VARCHAR | No |
The transaction record that appears on the invoice.
9 | PC_ORIG_REIMB_AMT | NUMERIC | No |
The payment classification reimbursement amount that appears on the invoice.
10 | PC_REIMB_AMT | NUMERIC | No |
The payment classification expected reimbursement amount that appears on the invoice.
11 | PC_QUANTITY | NUMERIC | No |
The payment classification quantity that appears on the invoice.