|
Name |
Type |
Discontinued? |
|
1 |
PRICER_MSG_ID |
NUMERIC |
No |
|
|
|
The unique identifier for the Pricer Message record. |
|
|
2 |
PRICE_SUM_ALLOW |
NUMERIC |
No |
|
|
|
Returned allowed amount from pricing summary data. |
|
|
3 |
PRICE_SUM_PMT |
NUMERIC |
No |
|
|
|
Returned payment amount from pricing summary data. This is a calculation of the allowed amount minus coinsurance/deductible. |
|
|
4 |
PRICE_SUM_DEDUCT |
NUMERIC |
No |
|
|
|
Returned deductible amount from pricing summary data. |
|
|
5 |
PRICE_SUM_COINS |
NUMERIC |
No |
|
|
|
Returned coinsurance amount from pricing summary data. |
|
|
6 |
PRICE_SUM_OUTLIER |
NUMERIC |
No |
|
|
|
Returned outlier amount from pricing summary data. |
|
|
7 |
PRICE_SUM_HCPCS_RTN_C_NAME |
VARCHAR |
No |
|
|
|
The returned HCPCS Pricer return code from pricing summary data. |
May contain organization-specific values: No |
Category Entries: |
Priced Normally |
Review Needed for Co-Surgeon |
Review Needed for Assistant At Surgery |
Not Covered |
Paid in Other Services |
Missing HCPCS Code |
Fee Schedule Amount is 0 |
Priced by Percentage of Billed |
Priced by Percentage of Cost |
Reporting Purposes |
HCPCS Code Not Found in Fee Schedule |
HCPCS and POS Type Do Not Match |
Missing Required Modifier |
Missing Ambulance Pickup Zipcode |
Missing Anesthesia Time in Minutes |
Service Date Prior to HCPCS Effective Date |
Team Surgeon Distribution Required |
More Than 5 Surgeries |
Missing Physician |
Invalid Units for Bilateral Codes |
Invalid Modifiers |
CBSA Not Found |
Wage Index Not Found |
NOC Not Found for NDC |
Price by Medicare Contractor Review |
Generic bad request |
|
|
8 |
PRICE_SUM_FSC_AMT |
NUMERIC |
No |
|
|
|
Returned fee schedule amount from pricing summary data. |
|
|
9 |
IS_NON_FACILITY_RATE_YN |
VARCHAR |
No |
|
|
|
Indicator for whether the service is paid using the non-facility rate in the Medicare Physician Fee Schedule. |
May contain organization-specific values: No |
Category Entries: |
No |
Yes |
|
|
10 |
ALLOWED_AMT_BEFORE_ADJ |
NUMERIC |
No |
|
|
|
Medicare fee schedule allowed amount before any pricing adjustments. |
|
|
11 |
UNITS_APPLIED |
NUMERIC |
No |
|
|
|
Number of units applied to the base fee schedule rate to determine the Medicare allowed amount. |
|
|
12 |
PRICE_SUM_CLAIM_DRG |
VARCHAR |
No |
|
|
|
The DRG code used by the Epic Pricer to price a claim. |
|
|