HSP_CLAIM_APC_GRP_META
Description:
Table for Ambulatory Payment Classification (APC) grouping metadata. Holds information such as the instant of grouping, the payment classification method, and, if grouped by Epic, the mapping and locale records used.

Primary Key
Column Name Ordinal Position
CLAIM_PRINT_ID 1
LINE 2

Column Information
Name Type Discontinued?
1 CLAIM_PRINT_ID NUMERIC No
This column stores the unique identifier for the claim print record associated with a single hospital account/bucket.
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 AMB_GROUPING_DTTM DATETIME (UTC) No
Holds the date & time that this claim was grouped, via Epic or a third-party.
4 APC_EPIC_PMT_CLASS_GRP_C_NAME VARCHAR No
This item stores the payment classification used during grouping, such as for Medicare or TRICARE. If grouping by Epic, it will be one of the values in the release range from Payment Classification Category (I PCD 101), excluding value 100. If grouping through an external system, it will hold a value of 100-External System. If there is no value in this item (from pre-existing data), then the default method is set to 1-Medicare APC if APC Data Source (I CLP 390) is set to 1-Epic, or 100-External System if the grouping source is set to 101-External System (APC) or 103-External System (APG).
May contain organization-specific values: Yes
Category Entries:
Medicare PPS
Tricare PPS
NY Medicaid EPS
Medicare SNF PPS PDPM
External System
5 APC_EPIC_PCM_ID VARCHAR No
This item stores the payment classification mapping record used if ambulatory payment classification (APC) grouping was done by Epic.
6 APC_EPIC_PCM_ID_PCM_NAME VARCHAR No
The name of the payment classification mapping.
7 APC_EPIC_PMT_CLASS_RATE_C_NAME VARCHAR No
This item stores the payment classification category used to determine the reimbursement weights and rates for APC codes if APC grouping was done by Epic. For example, if a commercial payer was configured to group by Medicare's logic, but reimburse based on their own set of rates, I CLP 392 would be set to 1-Medicare, and this item would be set to the customer-released category corresponding to this third party. If left blank, the category shown in I CLP 392 is used.
The category values for this column were already listed for column: APC_EPIC_PMT_CLASS_GRP_C_NAME