|
Name |
Type |
Discontinued? |
|
1 |
TX_ID |
NUMERIC |
No |
|
|
|
The unique ID of the AP Claim procedure transaction. |
|
|
2 |
PROC_ID_PROC_NAME |
VARCHAR |
No |
|
|
|
The name of each procedure. |
|
|
3 |
SVC_FROM_DATE |
DATETIME |
No |
|
|
|
The beginning service date for the procedure on the accounts payable claim record. |
|
|
4 |
SVC_TO_DATE |
DATETIME |
No |
|
|
|
The ending service date for the procedure on the accounts payable claim record. |
|
|
5 |
MODIFIERS |
VARCHAR |
No |
|
|
|
A list of modifiers used with the procedure on the accounts payable claim record. |
|
|
6 |
BILLED_AMT |
NUMERIC |
No |
|
|
|
The amount billed for the procedure on the accounts payable claim record. |
|
|
7 |
ALLOWED_AMT |
NUMERIC |
No |
|
|
|
The allowed amount calculated for the procedure on the accounts payable claim record. |
|
|
8 |
NET_PAYABLE |
NUMERIC |
No |
|
|
|
The net payable amount for the procedure on the accounts payable claim record. |
|
|
9 |
POS_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
The category value associated with the place of service type of the procedure on the accounts payable claim record. |
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 |
|
|
10 |
OVERRIDE_ALLD_AMT |
NUMERIC |
No |
|
|
|
The override allowed amount for the procedure on the accounts payable claim record. |
|
|
11 |
OVERRIDE_REASON_C_NAME |
VARCHAR |
No |
|
|
|
The category value associated with the reason for the override. |
May contain organization-specific values: Yes |
|
|
12 |
TYPE_OF_SERVICE_C_NAME |
VARCHAR |
No |
|
|
|
The category ID of the type of service associated with the procedure on the accounts payable claim record. |
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 |
|
|
13 |
PRIM_INS_AMOUNT |
NUMERIC |
No |
|
|
|
For non-primary claims (e.g. secondary), the sum of the insurance amounts paid by previous payors. |
|
|
14 |
PRIM_PAT_PORTION |
NUMERIC |
No |
|
|
|
For non-primary claims (e.g. secondary), the sum of all patient portion amounts specified by previous payors. |
|
|
15 |
PROC_INSURANCE_AMT |
NUMERIC |
No |
|
|
|
The calculated insurance amount for the procedure on the accounts payable claim record. |
|
|
16 |
NET_INSURANCE_AMT |
NUMERIC |
No |
|
|
|
The net insurance amount for this procedure on the accounts payable claim record. |
|
|
17 |
WITHHOLD_METHOD_C_NAME |
VARCHAR |
No |
|
|
|
The category value representing the method of withholding an amount for this procedure. |
May contain organization-specific values: No |
Category Entries: |
Percentage of Net Insurance |
Fixed Amount |
Extension |
None |
Percentage of Allowed Amount |
|
|
18 |
WITHHOLD_RATE |
NUMERIC |
No |
|
|
|
The rate to be withheld for this procedure. |
|
|
19 |
COMP_WITHHOLDING |
NUMERIC |
No |
|
|
|
The computed withholding amount for the procedure on the accounts payable claim record. |
|
|
20 |
COMP_ADJUSTMENT |
NUMERIC |
No |
|
|
|
The computed adjustment amount for the procedure on the accounts payable claim record. |
|
|
21 |
ACTUAL_ADJUSTMENT |
NUMERIC |
No |
|
|
|
The actual adjustment taken for this procedure on the accounts payable claim record. |
|
|
22 |
ADJUST_REASON_C_NAME |
VARCHAR |
No |
|
|
|
The category value of the reason for the adjustment to this procedure on the accounts payable claim record. |
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 |
|
|
23 |
ADJ_BILLED_AMT |
NUMERIC |
No |
|
|
|
The adjusted billed amount after refund for the procedure on the accounts payable claim record. |
|
|
24 |
ADJ_ALLOWED_AMT |
NUMERIC |
No |
|
|
|
The adjusted allowed amount after refund for the procedure on the accounts payable claim record. |
|
|
25 |
ADJ_PAT_PORTION |
NUMERIC |
No |
|
|
|
The adjusted patient portion after refund for the procedure on the accounts payable claim record. |
|
|
26 |
ADJ_INS_AMT |
NUMERIC |
No |
|
|
|
The adjusted insurance amount after refund for the procedure on the accounts payable claim record. |
|
|
27 |
ADJ_ADJUSTMENT |
NUMERIC |
No |
|
|
|
The adjusted adjustment amount after refund for the procedure on the accounts payable claim record. |
|
|
28 |
ADJ_NET_INS |
NUMERIC |
No |
|
|
|
The adjusted net insurance amount after refund for the procedure on the accounts payable claim record. |
|
|
29 |
ADJ_WITHHOLDING |
NUMERIC |
No |
|
|
|
The adjusted withholding amount after refund for the procedure on the accounts payable claim record. |
|
|
30 |
ADJ_NET_PAYABLE |
NUMERIC |
No |
|
|
|
The adjusted net payable amount after refund for the procedure on the accounts payable claim record. |
|
|
31 |
PAT_PORTION |
NUMERIC |
No |
|
|
|
The patient portion for the procedure on the accounts payable claim record. |
|
|
32 |
REVENUE_CODE_ID_PROC_NAME |
VARCHAR |
No |
|
|
|
The name of each procedure. |
|
|
33 |
QUANTITY |
NUMERIC |
No |
|
|
|
The quantity (number of units, procedures, etc.) billed on this service line. |
|
|
34 |
REFUND_REVERSAL_ID |
NUMERIC |
No |
|
|
|
The unique ID of the reversal procedure transaction for refund. |
|
|
35 |
REFUND_ADJT_ID |
NUMERIC |
No |
|
|
|
The unique ID of the adjustment procedure transaction for refund. |
|
|
36 |
EOB_COMMENT |
VARCHAR |
No |
|
|
|
The claim code (explanation of benefit code) comment on the procedure. |
|
|
37 |
UC_VALUE |
NUMERIC |
No |
|
|
|
The usual and customary amount for the procedure. |
|
|
38 |
CONTRACT_ALLOWED |
NUMERIC |
No |
|
|
|
The contractual allowed amount for the procedure. |
|
|
39 |
OVRD_DISALW_RSN_C_NAME |
VARCHAR |
No |
|
|
|
The category ID of the reason for overriding the disallowed amount on the procedure. |
May contain organization-specific values: Yes |
|
|
40 |
OVRD_DISALW_AMT |
NUMERIC |
No |
|
|
|
The override disallowed amount for the procedure. |
|
|
41 |
DISALW_AMT |
NUMERIC |
No |
|
|
|
The disallowed amount for the procedure. |
|
|
42 |
OVRD_NOT_CVD |
NUMERIC |
No |
|
|
|
The override not covered amount for the procedure. |
|
|
43 |
OVRD_DEDUCTIBLE |
NUMERIC |
No |
|
|
|
The override deductible amount for the procedure. |
|
|
44 |
OVRD_COINS |
NUMERIC |
No |
|
|
|
The override coinsurance amount for the procedure. |
|
|
45 |
OVRD_COPAY |
NUMERIC |
No |
|
|
|
The override copay amount for the procedure. |
|
|
46 |
NON_CVD_AMT |
NUMERIC |
No |
|
|
|
The non-covered amount for the procedure. |
|
|
47 |
DEDUCTIBLE |
NUMERIC |
No |
|
|
|
The deductible amount for the procedure. |
|
|
48 |
COPAYMENT |
NUMERIC |
No |
|
|
|
The copayment amount for the procedure. |
|
|
49 |
COINSURANCE |
NUMERIC |
No |
|
|
|
The coinsurance amount for the procedure. |
|
|
50 |
PATIENT_TOT |
NUMERIC |
No |
|
|
|
The total patient portion for the procedure. |
|
|
51 |
OVRD_PAT_RSN_C_NAME |
VARCHAR |
No |
|
|
|
The category ID of the reason for overriding the patient portion on the procedure. |
May contain organization-specific values: Yes |
|
|
52 |
OVRD_PAT_PORT |
NUMERIC |
No |
|
|
|
The override patient portion amount for the procedure. |
|
|
53 |
PRICING_ATTR_C_NAME |
VARCHAR |
No |
|
|
|
The category ID of the pricing attribute for the procedure (used in conjunction with the vendor contract). |
May contain organization-specific values: Yes |
Category Entries: |
PCP |
Specialist |
|
|
54 |
PENALTY_BEF_BEN |
NUMERIC |
No |
|
|
|
The before benefits provider penalty amount for the procedure. |
|
|
55 |
PENALTY_AFT_BEN |
NUMERIC |
No |
|
|
|
The after benefits provider penalty amount for the procedure. |
|
|
56 |
EXCEEDED_BEN_AMT |
NUMERIC |
No |
|
|
|
The amount on the procedure that exceeds benefits. |
|
|
57 |
COB_SAVING_AMT |
NUMERIC |
No |
|
|
|
The Coordination of Benefits (COB) savings amount for the procedure. |
|
|
58 |
PAT_OUT_OF_POCKET |
NUMERIC |
No |
|
|
|
The total patient out-of-pocket amount for the procedure. |
|
|
59 |
SUB_PEN_ADJ_STR |
VARCHAR |
No |
|
|
|
The submission penalty adjudication string for the procedure. |
|
|
60 |
ALLOWED_CODE_C_NAME |
VARCHAR |
No |
|
|
|
The allowed code for the procedure (e.g., claim denied, procedure denied, contracted rate payment). |
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 |
|
|
61 |
WITHHOLDING |
NUMERIC |
No |
|
|
|
The withholding amount for the procedure. |
|
|
62 |
TX_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
The category ID that indicates the type of procedure. Only AP claim types should appear in this table (e.g. AP claim, AP claim refund, AP claim DRG). |
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 |
|
|
63 |
DRG_ID |
VARCHAR |
No |
|
|
|
The unique ID of Diagnosis Related Group (DRG) code for the procedure. |
|
|
64 |
DRG_ID_DRG_NAME |
VARCHAR |
No |
|
|
|
The name of the Diagnoses Related Group name. |
|
|
65 |
PAT_PORT_CODE_C_NAME |
VARCHAR |
No |
|
|
|
The category ID of the type of patient payment for the procedure (e.g., coinsurance, copay, not covered). |
May contain organization-specific values: No |
Category Entries: |
Co-ins |
Copay |
Not Covered |
No Patient Payment |
|
|
66 |
DISCOUNT |
NUMERIC |
No |
|
|
|
The discount amount for the procedure. |
|
|
67 |
SECONDARY_DISC_AMT |
NUMERIC |
No |
|
|
|
The amount of additional discount on a secondary claim. |
|
|
68 |
PRIMARY_FACTORS |
NUMERIC |
No |
|
|
|
The amount on a non-primary (e.g. secondary) claim that was paid/handled by the primary payor. |
|
|
69 |
SEC_PROV_RESP |
NUMERIC |
No |
|
|
|
The secondary denied amount if the service is denied to provider responsibility. |
|
|
70 |
UNCVRD_EOB_CODE_ID_EOB_CODE_NAME |
VARCHAR |
No |
|
|
|
The name of the processing code. |
|
|
71 |
DISC_EOB_CODE_ID_EOB_CODE_NAME |
VARCHAR |
No |
|
|
|
The name of the processing code. |
|
|
72 |
PRICE_USING_C_NAME |
VARCHAR |
No |
|
|
|
The category ID of the method used to price the service (e.g. Revenue code, HCPCS code, DRG code). This is set only for UB claims. |
May contain organization-specific values: No |
Category Entries: |
HCPCS CODE |
REVENUE CODE |
DRG CODE |
|
|
73 |
STATUS_C_NAME |
VARCHAR |
No |
|
|
|
The category ID of the procedure's status. |
May contain organization-specific values: No |
Category Entries: |
Denied |
Deleted |
|
|
74 |
CVG_ID |
VARCHAR |
No |
|
|
|
The ID of the coverage used to pay the procedure on the claim. |
|
|
75 |
APC_CODE_ID |
VARCHAR |
No |
|
|
|
The unique ID of the Ambulatory Payment Classification (APC) code that mapped to the procedure. |
|
|
76 |
APC_PRICE |
NUMERIC |
No |
|
|
|
The Ambulatory Payment Classification (APC) price for the procedure. |
|
|
77 |
OVRD_EXCD_BEN_AMT |
NUMERIC |
No |
|
|
|
The override exceeded benefit amount for the procedure. |
|
|
78 |
COB_SAVINGS_PAYOUT |
NUMERIC |
No |
|
|
|
The Coordination of Benefits (COB) savings member payout. |
|
|
79 |
PAT_PAY_ADJ_STR |
VARCHAR |
No |
|
|
|
The patient payment adjudication string. |
|
|
80 |
ALWD_AMT_ADJ_STR |
VARCHAR |
No |
|
|
|
The allowed amount adjudication string. |
|
|
81 |
CMG_MATCHED_ID |
VARCHAR |
No |
|
|
|
Stores the matched component group for referral bed days for this service. |
|
|
82 |
CMG_MATCHED_ID_COMPONENT_GRP_NAME |
VARCHAR |
No |
|
|
|
The name of the component group |
|
|
83 |
NPR_BDTABLE_LINE |
NUMERIC |
No |
|
|
|
The line number of the bed days mapping table in the Tapestry Profile (I NPR 41040) on which the procedure matched. |
|
|
84 |
REL_WT_BED_DAY |
NUMERIC |
No |
|
|
|
Relative weight of the bed day type mapped to this service. |
|
|
85 |
RFL_MATCHED_ID |
NUMERIC |
No |
|
|
|
Referral matched for service. |
|
|
86 |
TOD_MATCHED_ID |
NUMERIC |
No |
|
|
|
Bed day type matched for service. |
|
|
87 |
TOD_MATCHED_ID_BED_DAY_TYPE_NAME |
VARCHAR |
No |
|
|
|
The name of the bed day type record (i.e. ICU or non-authorized.) |
|
|
88 |
WEIGHT_BED_DAYS |
NUMERIC |
No |
|
|
|
Weight of bed days for service. |
|
|
89 |
UBC_REVENUE_CODE_ID |
NUMERIC |
No |
|
|
|
The unique identifier of the revenue code/procedure associated with the accounts payable claim record. |
|
|
90 |
UBC_REVENUE_CODE_ID_REVENUE_CODE_NAME |
VARCHAR |
No |
|
|
|
The name of the revenue code. |
|
|
91 |
CLAIM_ID |
NUMERIC |
No |
|
|
|
The claim to which this service associated. For most claim services, this column is equivalent to joining this table's TX_ID column to AP_CLAIM_PROC_IDS.TX_ID and retrieving AP_CLAIM_PROC_IDS.CLAIM_ID. For services related to Cost Sharing Reduction (CSR), this column is equivalent to joining this table's TX_ID column to AP_CLAIM_PROC_IDS_CSR.TX_ID and retrieving AP_CLAIM_PROC_IDS_CSR.CLAIM_ID. To retrieve the ordering of service lines on a claim, join to AP_CLAIM_PROC_IDS or AP_CLAIM_PROC_IDS_CSR as appropriate and retrieve the LINE column. |
|
|
92 |
PEN_AFT_BEN_COMPUTED |
NUMERIC |
No |
|
|
|
The after benefits provider penalty amount for the procedure, as computed by the system. |
|
|
93 |
PEN_AFT_BEN_OVRIDE |
NUMERIC |
No |
|
|
|
The after benefits provider penalty amount for the procedure, as overridden by the user. |
|
|
94 |
PEN_AFT_BEN_OVRIDE_RSN_C_NAME |
VARCHAR |
No |
|
|
|
The reason given for setting the provider penalty after benefits override, if any. This should be translated using ZC_PEN_AFT_BEN_OVRIDE_RSN. |
May contain organization-specific values: Yes |
|
|
95 |
POS_TYPE_SRC_C_NAME |
VARCHAR |
No |
|
|
|
Source of the procedure's Place of Service type |
May contain organization-specific values: No |
Category Entries: |
Profile |
User |
Batch Type Definition |
|
|
96 |
OVERRIDE_UC_VALUE |
NUMERIC |
No |
|
|
|
The amount that overrides the usual and customary amount for the procedure. |
|
|