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_PEND_CODES	VARCHAR	No
	Will be deprecated in Februrary '25- use the table CLM_TX_HX_PEND_CODES instead. Stores the claim code history for each service line.
4	TX_HX_TIME_SAVE_TM	DATETIME (Local)	No
	The time the record was saved.
5	TX_HX_PROC_ID_PROC_NAME	VARCHAR	No
	The name of each procedure.
6	TX_HX_SVC_FROM_DT	DATETIME	No
	Transaction history service from date.
7	TX_HX_SVC_TO_DT	DATETIME	No
	Transaction history service to date.
8	TX_HX_PROC_HX	NUMERIC	No
	The history of the procedure on previous versions of the service line.
9	TX_HX_DX_CODES	VARCHAR	No
	The history of diagnosis codes on previous versions of the service line.
10	TX_HX_AMT_BILLED	NUMERIC	No
	The history of the amount billed on previous versions of the service line.
11	TX_HX_ALLOWED_AMT	NUMERIC	No
	The history of the allowed amount on previous versions of the service line.
12	TX_HX_PAT_AMT	NUMERIC	No
	Patient portion of the bill.
13	TX_HX_WITHHOLDINGS	NUMERIC	No
	The history of the withheld amount on previous versions of the service line.
14	TX_HX_DISCOUNTS	NUMERIC	No
	The history of the discount amount on previous versions of the service line.
15	TX_HX_NET_PAYABLE	NUMERIC	No
	The history of the net payable amount on previous versions of the service line.
16	TX_HX_NUM_ID	NUMERIC	No
	Transaction history number in the claim procedure history.
17	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
18	TX_HX_MED_ID_MEDICATION_NAME	VARCHAR	No
	The name of this medication record.
19	TX_HX_REV_CODE_ID_PROC_NAME	VARCHAR	No
	The name of each procedure.
20	TX_HX_MED_TYPE_C_NAME	VARCHAR	No
	Transaction history medication type. May contain organization-specific values: No Category Entries: Acute Chronic PAT
21	TX_HX_SVC_START_TM	DATETIME (Local)	No
	Transaction history service start time.
22	TX_HX_SVC_END_TIME	DATETIME (Local)	No
	Transaction history service end time.
23	TX_HX_SVC_ELPSD_TM	INTEGER	No
	Transaction history service elapsed time.
24	TX_HX_DRG_CODE_ID	VARCHAR	No
	Diagnosis Related Group (DRG) code history item.
25	TX_HX_DRG_CODE_ID_DRG_NAME	VARCHAR	No
	The name of the Diagnoses Related Group name.
26	PX_HX_EOB_COMMENT	VARCHAR	No
	Claim procedure history Explanation of Benefits (EOB) comments.
27	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
28	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
29	TX_HX_PRIM_INS_AMT	NUMERIC	No
	Insurance amount from primary for history.
30	TX_HX_PRIM_PAT_PRT	NUMERIC	No
	Patient portion from primary for history.
31	PX_HX_OVRID_AMT_C	NUMERIC	No
	Procedure history for override allowed amounts.
32	PX_HX_OVRID_RSN_C_NAME	VARCHAR	No
	Reason the allowed amount was overridden. May contain organization-specific values: Yes
33	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
34	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
35	TX_HX_CMPTD_WTHLD	NUMERIC	No
	Computed withholding history.
36	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
37	TX_HX_WTHLD_RATE	VARCHAR	No
	Withhold rate history.
38	TX_HX_INS_AMT	NUMERIC	No
	Net insurance amount history.
39	TX_HX_NET_INS_AMT	NUMERIC	No
	Net Insurance amount history
40	TX_HX_COMPUTED_ADJ	NUMERIC	No
	Computed adjustment history.
41	TX_HX_ACTUAL_ADJ	NUMERIC	No
	Actual adjustment history.
42	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
43	TX_HX_CODE_EDT_SAV	NUMERIC	No
	Transaction history code edit savings.
44	TX_HX_U_AND_C_AMT	NUMERIC	No
	Usual and customary amount history.
45	TX_HX_CONTRACT_AMT	NUMERIC	No
	Contractual amount history.
46	TX_HX_DISALOWED_AMT	NUMERIC	No
	Disallowed amount history.
47	TX_HX_NOT_COVERED	NUMERIC	No
	Not covered history.
48	TX_HX_DEDUCTIBLE	NUMERIC	No
	The history of the deductible amount on previous versions of the service line.
49	TX_HX_COPAY	NUMERIC	No
	The history of the copay amount on previous versions of the service line.
50	TX_HX_COINS	NUMERIC	No
	Co-insurance history.
51	TX_HX_PAT_TOTAL	NUMERIC	No
	Patient total history.
52	TX_HX_BFR_BEN_PEN	NUMERIC	No
	History before benefit penalty.
53	TX_HX_AFTR_BEN_PEN	NUMERIC	No
	History after benefit penalty.
54	TX_HX_EXCD_BEN_AMT	NUMERIC	No
	Exceeded benefit amount history.
55	TX_HX_OVRIDE_DIS_C_NAME	VARCHAR	No
	Override disallowed reason history. May contain organization-specific values: Yes
56	TX_HX_OVRD_DA_AMT	NUMERIC	No
	Override disallowed amount history.
57	TX_HX_OVRD_NC_AMT	NUMERIC	No
	Override not covered amount history.
58	TX_HX_OVRD_DEDUCT	NUMERIC	No
	Override deductible history.
59	TX_HX_OVRIDE_COINS	NUMERIC	No
	Override co-insurance history.
60	TX_HX_OVRIDE_COPAY	NUMERIC	No
	Override copay history.
61	TX_HX_OVRD_PTAMT_C_NAME	VARCHAR	No
	Override patient amount reason history. May contain organization-specific values: Yes
62	TX_HX_OVRD_PATPO	NUMERIC	No
	Override patient portion history.
63	TX_HX_COB_SAV_AMT	NUMERIC	No
	Coordination of Benefits (COB) Saving amount history.
64	TX_HX_OVRD_BEN_AMT	NUMERIC	No
	Override exceeded benefit amount for transaction history.
65	TX_HX_PRICE_ATTR_C_NAME	VARCHAR	No
	Pricing attribute for transaction history. May contain organization-specific values: Yes Category Entries: PCP Specialist
66	TX_HX_PAT_OUTOF_PC	NUMERIC	No
	Patient out of pocket history.
67	TX_HX_SAVED_DT	DATETIME	No
	The date the transaction history was saved.
68	TX_HX_USER_ID	VARCHAR	No
	Specifies the transaction history user.
69	TX_HX_USER_ID_NAME	VARCHAR	No
	The name of the user record. This name may be hidden.
70	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.
71	TX_HX_UBC_REVCOD_ID_REVENUE_CODE_NAME	VARCHAR	No
	The name of the revenue code.
72	TX_HX_REIMB_AMT	NUMERIC	No
	Healthcare reimbursement amount history.
73	TX_HX_OVRD_RIMB_AMT	NUMERIC	No
	Override reimbursement amount history.
74	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
75	TX_HX_AFT_BEN_PEN_OVRIDE	NUMERIC	No
	Override after benefits penalty history.
76	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
77	TX_HX_COB_SAVINGS_PAYOUT	NUMERIC	No
	COB savings payout history