HSP_CLP_CMS_LINE
Description:
This table contains claim line information for claims associated with the hospital account/liability bucket. For uniform medical billing (UB) claims, this table contains pre-processing charge information, which is used in the creation of UB claim lines. Post-processing claim line data for UB claims is stored in the HSP_CLP_REV_CODE table. For CMS claims, this table contains the post-processing claim line data.

Primary Key
Column Name Ordinal Position
CLAIM_PRINT_ID 1
LINE 2

Column Information
Name Type Discontinued?
1 CLAIM_PRINT_ID NUMERIC No
The ID of the claim record associated with a single hospital account or liability bucket.
2 LINE INTEGER No
The line number of one of the multiple values associated with a specific group of data within this record.
3 REIMB_AMT NUMERIC No
Stores the reimbursement amount for claim line.
4 REIMB_METHOD_C_NAME VARCHAR No
Stores the reimbursement method.
May contain organization-specific values: No
Category Entries:
Charge Entry Line Calculation
Invoice Line Calculation
Invoice Bundle Calculation
APC
5 FROM_SERV_DT DATETIME No
Stores the from date for a claim line. For services that do not span multiple days, the service date will be held here.
6 TO_SERV_DT DATETIME No
Stores the through date for a claim line.
7 POS_TYPE_PER_TX VARCHAR No
Stores the place of service type per transaction.
8 TOS_C_NAME VARCHAR No
Stores the type of service for the claim line.
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
9 PROC_ID NUMERIC No
Stores the internal procedure ID.
10 PROC_DESC VARCHAR No
Stores the procedure description.
11 HCPCS_CODES VARCHAR No
Stores the Healthcare Common Procedure Coding System code for the claim line.
12 PROF_CLM_MODIFIERS VARCHAR No
Stores modifiers on the claim line.
13 DX_MAP VARCHAR No
Comma-delimited list of diagnosis pointers for the claim line.
14 QUANTITY NUMERIC No
Stores the quantity associated with the claim line.
15 OVRD_REV_CODE_ID NUMERIC No
Stores the override revenue code.
16 OVRD_REV_CODE_ID_REVENUE_CODE_NAME VARCHAR No
The name of the revenue code.
17 CHARGE_AMT NUMERIC No
Stores the charge amount for the claim line.
18 INS_DUE_AMT NUMERIC No
Stores the insurance amount due for the claim line.
19 PAT_DUE_AMT NUMERIC No
Stores the patient amount due for the claim line.
20 NON_CVD_AMT NUMERIC No
Stores the non-covered amount for the claim line.
21 PAYMENT_AMT NUMERIC No
Stores the payment amount for the claim line.
22 INSURANCE_PAID_AMT NUMERIC No
Stores the insurance amount paid for the claim line.
23 PAT_PAID_AMT NUMERIC No
Stores the patient amount paid for the claim line.
24 ADJUSTMENT_AMT NUMERIC No
Stores the adjustment amount for the claim line.
25 PRINT_DESCRIPTIO_YN VARCHAR No
This controls procedure description printing for professional claims.
May contain organization-specific values: No
Category Entries:
No
Yes
26 REV_LOCATION_ID NUMERIC No
Revenue location for the line.
27 DEPT_ID NUMERIC No
Department of service for the line.
28 PX_START_DT DATETIME No
Start date for timed procedures.
29 PX_STOP_DT DATETIME No
Stop date for timed procedures.
30 PX_START_TM DATETIME (Local) No
Start time for timed procedures.
31 PX_STOP_TM DATETIME (Local) No
Stop time for timed procedures.
32 LINE_COMMENT VARCHAR No
Comment for the line.
33 LINE_POS_ID NUMERIC No
Place of service ID.
34 CMS_CODE_TYPE_C_NAME VARCHAR No
Stores the code type for the transaction level Healthcare Common Procedure Coding System code override. If a procedure has been assigned to the line without setting the override, this column will be left blank.
May contain organization-specific values: Yes
Category Entries:
CPT(R)
HCPCS
ADA
ASA
SKS
THL
CBV
VT
ZA
CCSD
35 CMS_REND_PROV_ID VARCHAR No
This item holds the line level rendering provider for American National Standards Institute claims. Professional claims will use this value to print the claim and line rendering provider loops.
36 CMS_MOLDX_TEST_CODE VARCHAR No
Holds the auxiliary procedure code for a CMS line.
37 CMS_AUXPX_CD_TYPE_C_NAME VARCHAR No
Holds the type of auxiliary procedure code when one is applicable to a CMS line.
May contain organization-specific values: No
Category Entries:
Laboratory Test Code
Molecular Diagnostic Test Code
38 CMS_PRIOR_AUTH VARCHAR No
Stores the prior-authorization number for a service line.
39 CMS_REF_NUM VARCHAR No
Stores the referral number for a service line.
40 CMS_LINKED_AUTH_ID NUMERIC No
Stores the professional billing charge level linked authorization ID.
41 CMS_MEDICARE_PAID_AMT NUMERIC No
For eMedNY 150003 claims, this is the amount that Medicare paid for this service line. This appears in field 24K (SVC_LN_INFO_2.LN_MCR_PAID_AMT). The EMEDNY_MEDICARE_PLANS profile variable can be used to control which coverages count as Medicare coverages.
42 INVOICE_GRP_LN VARCHAR No
The group line number on the invoice record that corresponds to the data in INVOICE_CLM_LN.