|
Name |
Type |
Discontinued? |
|
1 |
TX_ID |
NUMERIC |
No |
|
|
|
The unique identifier for the transaction record. |
|
|
2 |
REPRICED_ALLOWED_AMT |
NUMERIC |
No |
|
|
|
The allowed amount for the procedure that was received from the most recent repricer. |
|
|
3 |
REPRICED_DISALLOWED_AMT |
NUMERIC |
No |
|
|
|
The disallowed amount for the procedure that was received from the most recent repricer. |
|
|
4 |
UPN_CODE |
VARCHAR |
No |
|
|
|
UPN (Universal Product Number) code for the procedure on a claim. |
|
|
5 |
UPN_QTY |
INTEGER |
No |
|
|
|
Quantity of UPN code for the procedure on a claim. |
|
|
6 |
UPN_DESC |
VARCHAR |
No |
|
|
|
Description of the UPN code for the procedure on a claim. |
|
|
7 |
UPN_QUAL_C_NAME |
VARCHAR |
No |
|
|
|
Qualifier code of the UPN code for the procedure on a claim. |
May contain organization-specific values: No |
Category Entries: |
EAN/UCC-13 |
EAN/UCC-8 |
HIBC (Health Care Industry Bar Code) |
Customer Order Number |
GTIN-14 |
UCC-12 |
|
|
8 |
UPN_UNIT_C_NAME |
VARCHAR |
No |
|
|
|
Unit of measurement for UPN code for the procedure on a claim. |
May contain organization-specific values: No |
Category Entries: |
Milliliters |
Milligrams |
Grams |
International Units |
Units |
|
|
9 |
PAID_CLM_FILE_NOT_CVD_AMT |
NUMERIC |
No |
|
|
|
The not covered amount from the claim's source file. This is only populated for externally-paid claims loaded from claims files. |
|
|
10 |
PAID_CLM_FILE_DEDUCT_AMT |
NUMERIC |
No |
|
|
|
The deductible amount from the claim's source file. This is only populated for externally-paid claims loaded from claims files. |
|
|
11 |
PAID_CLM_FILE_COINS_AMT |
NUMERIC |
No |
|
|
|
The coinsurance amount from the claim's source file. This is only populated for externally-paid claims loaded from claims files. |
|
|
12 |
PAID_CLM_FILE_COPAY_AMT |
NUMERIC |
No |
|
|
|
The copay amount from the claim's source file. This is only populated for externally-paid claims loaded from claims files. |
|
|
13 |
PAID_CLM_FILE_INS_AMT |
NUMERIC |
No |
|
|
|
The insurance amount from the claim's source file. This is only populated for externally-paid claims loaded from claims files. |
|
|
14 |
PAT_ID |
VARCHAR |
No |
|
|
|
Patient associated with the transaction. |
|
|
15 |
RECORD_STATUS_C_NAME |
VARCHAR |
No |
|
|
|
This column displays the transaction record status. |
May contain organization-specific values: No |
Category Entries: |
Active |
Inactive |
Deleted |
Inactive and Deleted |
Hidden |
Inactive and Hidden |
Deleted and Hidden |
Inactive Deleted and Hidden |
|
|
16 |
QUAL_AMT |
NUMERIC |
No |
|
|
|
Amount used for computing benefits for limiting patient portion. |
|
|
17 |
QUAL_AMT_FEE_SCHEDULE_MAP_ID |
NUMERIC |
No |
|
|
|
Fee schedule map used for limiting patient portion. |
|
|
18 |
QUAL_AMT_FEE_SCHEDULE_MAP_ID_FEE_SCHEDULE_MAP_NAME |
VARCHAR |
No |
|
|
|
The name for the fee schedule map record. |
|
|
19 |
QUAL_AMT_FEE_SCHEDULE_ID |
NUMERIC |
No |
|
|
|
Fee schedule used for limiting patient portion. |
|
|
20 |
QUAL_AMT_FEE_SCHEDULE_ID_FEE_SCHEDULE_NAME |
VARCHAR |
No |
|
|
|
The name of each fee schedule. |
|
|
21 |
QUAL_AMT_NETWORK_LEVELS_C_NAME |
VARCHAR |
No |
|
|
|
Network level used for limiting patient portion. |
May contain organization-specific values: Yes |
Category Entries: |
Not Leveled |
|
|
22 |
QUAL_AMT_SKIP_YN |
VARCHAR |
No |
|
|
|
Whether to skip this service for limiting the patient portion. |
May contain organization-specific values: No |
Category Entries: |
No |
Yes |
|
|
23 |
QUAL_AMT_NETWORK_ID |
VARCHAR |
No |
|
|
|
Network ID used for limiting patient portion. |
|
|
24 |
QUAL_AMT_NETWORK_ID_NETWORK_NAME |
VARCHAR |
No |
|
|
|
|
25 |
QUAL_AMT_OVERRIDE |
NUMERIC |
No |
|
|
|
Override for the qualifying amount for computing benefits for limiting patient portion. |
|
|
26 |
INVOICE_EXTERNAL_AMOUNT |
NUMERIC |
No |
|
|
|
The service line price that is manually entered by an end user based on an invoice or externally calculated amount. |
|
|
27 |
SUB_PEN_ADJ_DATE_TYPE_C |
INTEGER |
No |
|
|
|
The date type used when calculating timely filing (submission penalty). |
|
|
28 |
OVERRIDE_CONTRACTUAL_VALUE |
NUMERIC |
No |
|
|
|
The override contractual allowed amount. This is only used in Adjudication review for display and calculations in pricing card. |
|
|
29 |
HIPPS_PROC_CODE |
VARCHAR |
No |
|
|
|
|
30 |
HIPPS_CODE_PC_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
Service-line HIPPS Code Type. This qualifies the HIPPS Code to a Prospective Payment System (PPS). |
May contain organization-specific values: No |
Category Entries: |
Ambulatory Payment Classification |
Home Health |
CPT |
Ambulatory Patient Grouping |
MDS RUG Code |
Inpatient Rehabilitation Facility |
|
|
31 |
PRICER_MSG_ID |
NUMERIC |
No |
|
|
|
The most recent Epic Pricer message record that was used to price the service. |
|
|
32 |
PRICER_DISTRIBUTION_AMT |
NUMERIC |
No |
|
|
|
For HIPPS-based pricing, Epic Pricer will return a claim-level allowed amount. This amount is then distributed to Room & Board service lines, based on the billed amount. |
|
|
33 |
ALWD_AMT_STOP_LOSS_CNCT_DATE |
DATETIME |
No |
|
|
|
This column stores the contact date associated with the stop loss term record (NSL) that was used in determining the allowed amount of this service line. |
|
|
34 |
ALWD_AMT_ADJ_CMP_CNCT_DATE |
DATETIME |
No |
|
|
|
The contact date of the component record used to calculate the allowed amount of the service line on the AP Claim. |
|
|
35 |
ALWD_AMT_TIERED_CMP_INDEX_ID |
VARCHAR |
No |
|
|
|
The CMP & CMG Index (CMI) record of the tiered component used to calculate the allowed amount of the service line on the AP Claim. |
|
|
36 |
ALWD_AMT_TIERED_CMP_INDEX_ID_COMPONENT_INDEX_NAME |
VARCHAR |
No |
|
|
|
The name of the component index record |
|
|
37 |
ALWD_AMT_TIERED_PX_LN |
INTEGER |
No |
|
|
|
The line of the matched tiered procedure used to calculate the allowed amount of the service line on the AP Claim. |
|
|
38 |
SUB_PEN_ADJ_PCT_USED |
NUMERIC |
No |
|
|
|
The reimbursement percentage used to calculate timely filing (submission penalty). |
|
|
39 |
SUB_PEN_ADJ_CNTRCT_OR_PRFL |
VARCHAR |
No |
|
|
|
Whether vendor contracts ("Contract") or the Tapestry Profile ("Profile") was used to calculate timely filing (submission penalty). |
|
|
40 |
SUB_PEN_ADJ_LAG_DAYS |
INTEGER |
No |
|
|
|
The difference in days between date received and date serviced for calculating timely filing (submission penalty). |
|
|
41 |
SUB_PEN_ADJ_DISCNT_AMT |
NUMERIC |
No |
|
|
|
The discounted amount used in calculating timely filing (submission penalty). |
|
|
42 |
SUB_PEN_ADJ_RULE_ID |
VARCHAR |
No |
|
|
|
The rule ID used if timely filing (submission penalty) setting was used and a rule was matched. |
|
|
43 |
SUB_PEN_ADJ_RULE_ID_RULE_NAME |
VARCHAR |
No |
|
|
|
|
44 |
SUB_PEN_ADJ_TMLY_FILE_YN |
VARCHAR |
No |
|
|
|
Set to "Y" if timely filing (submission penalty) setting was used but no rule matched. Otherwise, set to "N". |
|
|
45 |
ALWD_AMT_ADJ_CMG_LN |
INTEGER |
No |
|
|
|
The line of the component group used to calculate the allowed amount of the service line on the AP Claim. |
|
|
46 |
ADDL_ADJ_AMT |
NUMERIC |
No |
|
|
|
Stores the total additional adjustments that apply to the allowed amount on a service. |
|
|
47 |
ORIGINAL_DOWNCODED_PROC_ID_PROC_NAME |
VARCHAR |
No |
|
|
|
The name of each procedure. |
|
|
48 |
ORIGINAL_DOWNCODED_QUAL_AMT |
NUMERIC |
No |
|
|
|
Qualifying payment amount for the original code before it went through EDC downcoding. |
|
|
49 |
AUTH_REQ_YN |
VARCHAR |
No |
|
|
|
Whether a service required authorization when it was last adjudicated. |
The category values for this column were already listed for column: QUAL_AMT_SKIP_YN |
|
|
50 |
SUGGESTED_AUTH_FOUND_YN |
VARCHAR |
No |
|
|
|
Whether a service found a suggested authorization when it was last adjudicated. |
The category values for this column were already listed for column: QUAL_AMT_SKIP_YN |
|
|
51 |
IS_CONTRACT_CAPITATED_YN |
VARCHAR |
No |
|
|
|
Whether the contract line matched to this service during adjudication has a service type of capitated. |
The category values for this column were already listed for column: QUAL_AMT_SKIP_YN |
|
|
52 |
COMPUTED_PRIOR_INS_AMT |
NUMERIC |
No |
|
|
|
Prior insurance amount computed based on the claim-level prior insurance amount and allocated to this service. |
|
|
53 |
COMPUTED_PRIOR_PAT_PORTION |
NUMERIC |
No |
|
|
|
Prior patient portion computed based on the claim-level prior patient portion and allocated to this service. |
|
|
54 |
ORIG_CD_WORKFLOW_C_NAME |
VARCHAR |
No |
|
|
|
Workflow that changed the original code. |
May contain organization-specific values: No |
Category Entries: |
EDC Analyzer |
Epic Pricer |
|
|
55 |
PAID_CLM_FILE_WITHHOLD_AMT |
NUMERIC |
No |
|
|
|
The withholding amount from the file for an externally paid claim. |
|
|
56 |
PAID_CLM_FILE_COB_AMT |
NUMERIC |
No |
|
|
|
The COB amount from the file for an externally paid claim. |
|
|
57 |
PAID_CLM_FILE_ADJ_AMT |
NUMERIC |
No |
|
|
|
The adjustment amount from the file for an externally paid claim. |
|
|
58 |
PAID_CLM_FILE_VEN_PENALTY_AMT |
NUMERIC |
No |
|
|
|
The vendor penalty amount from the file for an externally paid claim. |
|
|
59 |
PAID_CLM_FILE_DISCOUNT_AMT |
NUMERIC |
No |
|
|
|
The discount from the file for an externally paid claim. |
|
|
60 |
PAID_CLM_FILE_HRA_AMT |
NUMERIC |
No |
|
|
|
The HRA amount from the file for an externally paid claim. |
|
|