APCD Encounter ID Methodology Enhancements
Often times, there is a series of claims for the same inpatient stay, which vary across multiple care settings (Emergency Room->IP Admission -> others –>Continued IP stay). Instead of only generating a single encounter activity to the inpatient facility, these different activities were often generating a claim and an encounter. This methodology has been enhanced […]
APCD 837 ER Claims: Care Settings Updated Based on Revenue Codes
There are observed claims which have an ER revenue code on the claim, but which have a point of sale or type of bill code that is assigned a “Hospital Outpatient” care setting. These ER Revenue codes are: 0450, 0451, 0452, 0456, 0459, 0981. This is the standard set of revenue codes used throughout state […]
