LDS Inpatient Data Dictionary - Centers for Medicare and ...

No.

Field Short Name

1 DSYSRTKY 2 CLAIMNO 3 PROVIDER 4 THRU_DT 5 RIC_CD 6 CLM_TYPE 7 QUERY_CD 8 FAC_TYPE 9 TYPESRVC 10 FREQ_CD 11 FI_NUM 12 NOPAY_CD 13 PMT_AMT 14 PRPAYAMT 15 PRPAY_CD 16 ACTIONCD 17 PRSTATE 18 ORGNPINM 19 AT_UPIN 20 AT_NPI 21 OP_UPIN 22 OP_NPI 23 OT_UPIN 24 OT_NPI 25 MCOPDSW 26 STUS_CD 27 PPS_IND 28 TOT_CHRG 29 ADMSN_DT 30 TYPE_ADM 31 SRC_ADMS 32 PTNTSTUS 33 PER_DIEM 34 DED_AMT 35 COIN_AMT 36 BLDDEDAM 37 PCCHGAMT 38 NCCHGAMT 39 PPS_CPTL 40 CPTL_FSP 41 CPTLOUTL

LDS Inpatient Data Dictionary

Field Long Name

Base Claim File

Label

DESY_SORT_KEY

LDS Beneficiary ID

CLAIM_NO

Claim number

PRVDR_NUM

Provider Number

CLM_THRU_DT NCH_NEAR_LINE_REC_IDENT_CD

Claim Through Date (Determines Year of Claim) NCH Near Line Record Identification Code

NCH_CLM_TYPE_CD

NCH Claim Type Code

CLAIM_QUERY_CODE CLM_FAC_TYPE_CD

Claim Query Code Claim Facility Type Code

CLM_SRVC_CLSFCTN_TYPE_CD

Claim Service classification Type Code

CLM_FREQ_CD

Claim Frequency Code

FI_NUM

FI Number

CLM_MDCR_NON_PMT_RSN_CD

Claim Medicare Non Payment Reason Code

CLM_PMT_AMT

Claim Payment Amount

NCH_PRMRY_PYR_CLM_PD_AMT

NCH Primary Payer Claim Paid Amount

NCH_PRMRY_PYR_CD

NCH Primary Payer Code

FI_CLM_ACTN_CD

FI Claim Action Code

PRVDR_STATE_CD

NCH Provider State Code

ORG_NPI_NUM

Organization NPI Number

AT_PHYSN_UPIN

Claim Attending Physician UPIN Number

AT_PHYSN_NPI

Claim Attending Physician NPI Number

OP_PHYSN_UPIN

Claim Operating Physician UPIN Number

OP_PHYSN_NPI

Claim Operating Physician NPI Number

OT_PHYSN_UPIN

Claim Other Physician UPIN Number

OT_PHYSN_NPI

Claim Other Physician NPI Number

CLM_MCO_PD_SW

Claim MCO Paid Switch

PTNT_DSCHRG_STUS_CD

Patient Discharge Status Code

CLM_PPS_IND_CD

Claim PPS Indicator Code

CLM_TOT_CHRG_AMT

Claim Total Charge Amount

CLM_ADMSN_DT

Claim Admission Date

CLM_IP_ADMSN_TYPE_CD

Claim Inpatient Admission Type Code

CLM_SRC_IP_ADMSN_CD

Claim Source Inpatient Admission Code

NCH_PTNT_STATUS_IND_CD

NCH Patient Status Indicator Code

CLM_PASS_THRU_PER_DIEM_AMT

Claim Pass Thru Per Diem Amount

NCH_BENE_IP_DDCTBL_AMT

NCH Beneficiary Inpatient Deductible Amount

NCH_BENE_PTA_COINSRNC_LBLTY_AM NCH Beneficiary Part A Coinsurance Liability Amount

NCH_BENE_BLOOD_DDCTBL_LBLTY_AM NCH Beneficiary Blood Deductible Liability Amount

NCH_PROFNL_CMPNT_CHRG_AMT

NCH Professional Component Charge Amount

NCH_IP_NCVRD_CHRG_AMT

NCH Inpatient Noncovered Charge Amount

CLM_TOT_PPS_CPTL_AMT

Claim Total PPS Capital Amount

CLM_PPS_CPTL_FSP_AMT

Claim PPS Capital FSP Amount

CLM_PPS_CPTL_OUTLIER_AMT

Claim PPS Capital Outlier Amount

Page 1 of 20

Type Length

NUM

9

NUM

12

CHAR

10

DATE

8

CHAR

1

CHAR

2

CHAR

1

CHAR

1

CHAR

1

CHAR

1

CHAR

5

CHAR

2

NUM

12

NUM

12

CHAR

1

CHAR

1

CHAR

2

CHAR

10

CHAR

12

CHAR

12

CHAR

12

CHAR

12

CHAR

12

CHAR

12

CHAR

1

CHAR

2

CHAR

1

NUM

12

DATE

8

CHAR

1

CHAR

1

CHAR

1

NUM

12

NUM

12

NUM

12

NUM

12

NUM

12

NUM

12

NUM

12

NUM

12

NUM

12

No.

Field Short Name

42 DISP_SHR

43 IME_AMT

44 CPTL_EXP

45 HLDHRMLS

46 DRGWTAMT

47 UTIL_DAY

48 COIN_DAY

49 LRD_USE

50 NUTILDAY

51 BLDFRNSH

52 NCOVFROM

53 NCOVTHRU

54 EXHST_DT

55 DSCHRGDT

56 DRG_CD

57 OUTLR_CD

58 OUTLRPMT

59 ADMTG_DGNS_CD

60 ADMTG_DGNS_VRSN_CD

61 PRNCPAL_DGNS_CD

62 PRNCPAL_DGNS_VRSN_CD

63 ICD DGNS CD1

64 ICD DGNS VRSN CD1

65 CLM POA IND SW1

66 ICD DGNS CD2

67 ICD DGNS VRSN CD2

68 CLM POA IND SW2

69 ICD DGNS CD3

70 ICD DGNS VRSN CD3

71 CLM POA IND SW3

72 ICD DGNS CD4

73 ICD DGNS VRSN CD4

74 CLM POA IND SW4

75 ICD DGNS CD5

76 ICD DGNS VRSN CD5

77 CLM POA IND SW5

78 ICD DGNS CD6

79 ICD DGNS VRSN CD6

80 CLM POA IND SW6

81 ICD DGNS CD7

82 ICD DGNS VRSN CD7

83 CLM POA IND SW7

LDS Inpatient Data Dictionary

Field Long Name CLM_PPS_CPTL_DSPRPRTNT_SHR_AMT CLM_PPS_CPTL_IME_AMT CLM_PPS_CPTL_EXCPTN_AMT CLM_PPS_OLD_CPTL_HLD_HRMLS_AMT CLM_PPS_CPTL_DRG_WT_NUM CLM_UTLZTN_DAY_CNT BENE_TOT_COINSRNC_DAYS_CNT BENE_LRD_USED_CNT CLM_NON_UTLZTN_DAYS_CNT NCH_BLOOD_PNTS_FRNSHD_QTY NCH_VRFD_NCVRD_STAY_FROM_DT NCH_VRFD_NCVRD_STAY_THRU_DT NCH_BENE_MDCR_BNFTS_EXHTD_DT_I NCH_BENE_DSCHRG_DT CLM_DRG_CD CLM_DRG_OUTLIER_STAY_CD NCH_DRG_OUTLIER_APRVD_PMT_AMT ADMTG_DGNS_CD ADMTG_DGNS_VRSN_CD PRNCPAL_DGNS_CD PRNCPAL_DGNS_VRSN_CD ICD_DGNS_CD1 ICD_DGNS_VRSN_CD1 CLM_POA_IND_SW1 ICD_DGNS_CD2 ICD_DGNS_VRSN_CD2 CLM_POA_IND_SW2 ICD_DGNS_CD3 ICD_DGNS_VRSN_CD3 CLM_POA_IND_SW3 ICD_DGNS_CD4 ICD_DGNS_VRSN_CD4 CLM_POA_IND_SW4 ICD_DGNS_CD5 ICD_DGNS_VRSN_CD5 CLM_POA_IND_SW5 ICD_DGNS_CD6 ICD_DGNS_VRSN_CD6 CLM_POA_IND_SW6 ICD_DGNS_CD7 ICD_DGNS_VRSN_CD7 CLM_POA_IND_SW7

Label Claim PPS Capital Disproportionate Share Amount Claim PPS Capital IME Amount Claim PPS Capital Exception Amount Claim PPS Old Capital Hold Harmless Amount Claim PPS Capital DRG Weight Number Claim Utilization Day Count Beneficiary Total Coinsurance Days Count Beneficiary LRD Used Count Claim Non Utilization Days Count NCH Blood Pints Furnished Quantity NCH Verified Noncovered Stay From Date NCH Verified Noncovered Stay Through Date NCH Beneficiary Medicare Benefits Exhausted Date NCH Beneficiary Discharge Date Claim Diagnosis Related Group Code Claim Diagnosis Related Group Outlier Stay Code NCH DRG Outlier Approved Payment Amount Claim Admitting Diagnosis Code Claim Admitting Diagnosis Code Diagnosis Version Code (ICD-9 or ICD-10) Primary Claim Diagnosis Code Primary Claim Diagnosis Code Diagnosis Version Code (ICD-9 or ICD-10) Claim Diagnosis Code I Claim Diagnosis Code I Diagnosis Version Code (ICD-9 or ICD-10) Claim Diagnosis Code I Diagnosis Present on Admission Indicator Code Claim Diagnosis Code II Claim Diagnosis Code II Diagnosis Version Code (ICD-9 or ICD-10) Claim Diagnosis Code II Diagnosis Present on Admission Indicator Code Claim Diagnosis Code III Claim Diagnosis Code III Diagnosis Version Code (ICD-9 or ICD-10) Claim Diagnosis Code III Diagnosis Present on Admission Indicator Code Claim Diagnosis Code IV Claim Diagnosis Code IV Diagnosis Version Code (ICD-9 or ICD-10) Claim Diagnosis Code IV Diagnosis Present on Admission Indicator Code Claim Diagnosis Code V Claim Diagnosis Code V Diagnosis Version Code (ICD-9 or ICD-10) Claim Diagnosis Code V Diagnosis Present on Admission Indicator Code Claim Diagnosis Code VI Claim Diagnosis Code VI Diagnosis Version Code (ICD-9 or ICD-10) Claim Diagnosis Code VI Diagnosis Present on Admission Indicator Code Claim Diagnosis Code VII Claim Diagnosis Code VII Diagnosis Version Code (ICD-9 or ICD-10) Claim Diagnosis Code VII Diagnosis Present on Admission Indicator Code

Page 2 of 20

Type NUM NUM NUM NUM NUM NUM NUM NUM NUM NUM DATE DATE DATE DATE CHAR CHAR NUM CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR

Length 12 12 12 12 8 3 3 3 5 3 8 8 8 8 3 1 12 7 1 7 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1

No.

Field Short Name

84 ICD DGNS CD8

85 ICD DGNS VRSN CD8

86 CLM POA IND SW8

87 ICD DGNS CD9

88 ICD DGNS VRSN CD9

89 CLM POA IND SW9

90 ICD DGNS CD10

91 ICD DGNS VRSN CD10

92 CLM POA IND SW10

93 ICD DGNS CD11

94 ICD DGNS VRSN CD11

95 CLM POA IND SW11

96 ICD DGNS CD12

97 ICD DGNS VRSN CD12

98 CLM POA IND SW12

99 ICD DGNS CD13

100 ICD DGNS VRSN CD13

101 CLM POA IND SW13

102 ICD DGNS CD14

103 ICD DGNS VRSN CD14

104 CLM POA IND SW14

105 ICD DGNS CD15

106 ICD DGNS VRSN CD15

107 CLM POA IND SW15

108 ICD DGNS CD16

109 ICD DGNS VRSN CD16

110 CLM POA IND SW16

111 ICD DGNS CD17

112 ICD DGNS VRSN CD17

113 CLM POA IND SW17

114 ICD DGNS CD18

115 ICD DGNS VRSN CD18

116 CLM POA IND SW18

117 ICD DGNS CD19

118 ICD DGNS VRSN CD19

119 CLM POA IND SW19

120 ICD DGNS CD20

121 ICD DGNS VRSN CD20

122 CLM POA IND SW20

123 ICD DGNS CD21

124 ICD DGNS VRSN CD21

125 CLM POA IND SW21

LDS Inpatient Data Dictionary

Field Long Name ICD_DGNS_CD8 ICD_DGNS_VRSN_CD8 CLM_POA_IND_SW8 ICD_DGNS_CD9 ICD_DGNS_VRSN_CD9 CLM_POA_IND_SW9 ICD_DGNS_CD10 ICD_DGNS_VRSN_CD10 CLM_POA_IND_SW10 ICD_DGNS_CD11 ICD_DGNS_VRSN_CD11 CLM_POA_IND_SW11 ICD_DGNS_CD12 ICD_DGNS_VRSN_CD12 CLM_POA_IND_SW12 ICD_DGNS_CD13 ICD_DGNS_VRSN_CD13 CLM_POA_IND_SW13 ICD_DGNS_CD14 ICD_DGNS_VRSN_CD14 CLM_POA_IND_SW14 ICD_DGNS_CD15 ICD_DGNS_VRSN_CD15 CLM_POA_IND_SW15 ICD_DGNS_CD16 ICD_DGNS_VRSN_CD16 CLM_POA_IND_SW16 ICD_DGNS_CD17 ICD_DGNS_VRSN_CD17 CLM_POA_IND_SW17 ICD_DGNS_CD18 ICD_DGNS_VRSN_CD18 CLM_POA_IND_SW18 ICD_DGNS_CD19 ICD_DGNS_VRSN_CD19 CLM_POA_IND_SW19 ICD_DGNS_CD20 ICD_DGNS_VRSN_CD20 CLM_POA_IND_SW20 ICD_DGNS_CD21 ICD_DGNS_VRSN_CD21 CLM_POA_IND_SW21

Claim Diagnosis Code VIII

Label

Claim Diagnosis Code VIII Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code VIII Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code IX

Claim Diagnosis Code IX Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code IX Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code X

Claim Diagnosis Code X Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code X Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code XI

Claim Diagnosis Code XI Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XI Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code XII

Claim Diagnosis Code XII Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XII Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code XIII

Claim Diagnosis Code XIII Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XIII Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code XIV

Claim Diagnosis Code XIV Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XIV Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code XV

Claim Diagnosis Code XV Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XV Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code XVI

Claim Diagnosis Code XVI Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XVI Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code XVII

Claim Diagnosis Code XVII Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XVII Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code XVIII

Claim Diagnosis Code XVIII Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XVIII Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code XIV

Claim Diagnosis Code XIV Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XIV Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code XX

Claim Diagnosis Code XX Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XX Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code XXI

Claim Diagnosis Code XXI Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XXI Diagnosis Present on Admission Indicator Code

Page 3 of 20

Type CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR

Length 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1

No.

Field Short Name

126 ICD DGNS CD22

127 ICD DGNS VRSN CD22

128 CLM POA IND SW22

129 ICD DGNS CD23

130 ICD DGNS VRSN CD23

131 CLM POA IND SW23

132 ICD DGNS CD24

133 ICD DGNS VRSN CD24

134 CLM POA IND SW24

135 ICD DGNS CD25

136 ICD DGNS VRSN CD25

137 CLM POA IND SW25

138 FST_DGNS_E_CD

139 FST_DGNS_E_VRSN_CD

140 ICD DGNS E CD1

141 ICD DGNS E VRSN CD1

142 CLM E POA IND SW1

143 ICD DGNS E CD2

144 ICD DGNS E VRSN CD2

145 CLM E POA IND SW2

146 ICD DGNS E CD3

147 ICD DGNS E VRSN CD3

148 CLM E POA IND SW3

149 ICD DGNS E CD4

150 ICD DGNS E VRSN CD4

151 CLM_E_POA_IND_SW4

152 ICD DGNS E CD5

153 ICD DGNS E VRSN CD5

154 CLM_E_POA_IND_SW5

155 ICD DGNS E CD6

156 ICD DGNS E VRSN CD6

157 CLM_E_POA_IND_SW6

158 ICD DGNS E CD7

159 ICD DGNS E VRSN CD7

160 CLM_E_POA_IND_SW7

161 ICD DGNS E CD8

162 ICD DGNS E VRSN CD8

163 CLM_E_POA_IND_SW8

164 ICD DGNS E CD9

165 ICD DGNS E VRSN CD9

166 CLM_E_POA_IND_SW9

167 ICD DGNS E CD10

LDS Inpatient Data Dictionary

Field Long Name ICD_DGNS_CD22 ICD_DGNS_VRSN_CD22 CLM_POA_IND_SW22 ICD_DGNS_CD23 ICD_DGNS_VRSN_CD23 CLM_POA_IND_SW23 ICD_DGNS_CD24 ICD_DGNS_VRSN_CD24 CLM_POA_IND_SW24 ICD_DGNS_CD25 ICD_DGNS_VRSN_CD25 CLM_POA_IND_SW25 FST_DGNS_E_CD FST_DGNS_E_VRSN_CD ICD_DGNS_E_CD1 ICD_DGNS_E_VRSN_CD1 CLM_E_POA_IND_SW1 ICD_DGNS_E_CD2 ICD_DGNS_E_VRSN_CD2 CLM_E_POA_IND_SW2 ICD_DGNS_E_CD3 ICD_DGNS_E_VRSN_CD3 CLM_E_POA_IND_SW3 ICD_DGNS_E_CD4 ICD_DGNS_E_VRSN_CD4 CLM_E_POA_IND_SW4 ICD_DGNS_E_CD5 ICD_DGNS_E_VRSN_CD5 CLM_E_POA_IND_SW5 ICD_DGNS_E_CD6 ICD_DGNS_E_VRSN_CD6 CLM_E_POA_IND_SW6 ICD_DGNS_E_CD7 ICD_DGNS_E_VRSN_CD7 CLM_E_POA_IND_SW7 ICD_DGNS_E_CD8 ICD_DGNS_E_VRSN_CD8 CLM_E_POA_IND_SW8 ICD_DGNS_E_CD9 ICD_DGNS_E_VRSN_CD9 CLM_E_POA_IND_SW9 ICD_DGNS_E_CD10

Claim Diagnosis Code XXII

Label

Claim Diagnosis Code XXII Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XXII Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code XXIII

Claim Diagnosis Code XXIII Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XXIII Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code XXIV

Claim Diagnosis Code XXIV Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XXIV Diagnosis Present on Admission Indicator Code

Claim Diagnosis Code XXV

Claim Diagnosis Code XXV Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis Code XXV Diagnosis Present on Admission Indicator Code First Claim Diagnosis E Code

First Claim Diagnosis E Code Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis E Code I

Claim Diagnosis E Code I Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis E Code I Diagnosis Present on Admission Indicator Code

Claim Diagnosis E Code II

Claim Diagnosis E Code II Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis E Code II Diagnosis Present on Admission Indicator Code

Claim Diagnosis E Code III

Claim Diagnosis E Code III Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis E Code III Diagnosis Present on Admission Indicator Code

Claim Diagnosis E Code IV

Claim Diagnosis E Code IV Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis E Code IV Diagnosis Present on Admission Indicator Code

Claim Diagnosis E Code V

Claim Diagnosis E Code V Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis E Code V Diagnosis Present on Admission Indicator Code

Claim Diagnosis E Code VI

Claim Diagnosis E Code VI Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis E Code VI Diagnosis Present on Admission Indicator Code

Claim Diagnosis E Code VII

Claim Diagnosis E Code VII Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis E Code VII Diagnosis Present on Admission Indicator Code

Claim Diagnosis E Code VIII

Claim Diagnosis E Code VIII Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis E Code VIII Diagnosis Present on Admission Indicator Code

Claim Diagnosis E Code VIX

Claim Diagnosis E Code VIX Diagnosis Version Code (ICD-9 or ICD-10)

Claim Diagnosis E Code VIX Diagnosis Present on Admission Indicator Code

Claim Diagnosis E Code X

Page 4 of 20

Type CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR

CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR

Length 7 1 1 7 1 1 7 1 1 7 1

1 7 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7 1 1 7

No.

Field Short Name

168 ICD DGNS E VRSN CD10

169 CLM_E_POA_IND_SW10

170 ICD DGNS E CD11

171 ICD DGNS E VRSN CD11

172 CLM_E_POA_IND_SW11

173 ICD DGNS E CD12

174 ICD DGNS E VRSN CD12

175 CLM_E_POA_IND_SW12

176 ICD_PRCDR_CD1

177 ICD_PRCDR_VRSN_CD1

178 PRCDR_DT1

179 ICD_PRCDR_CD2

180 ICD_PRCDR_VRSN_CD2

181 PRCDR_DT2

182 ICD_PRCDR_CD3

183 ICD_PRCDR_VRSN_CD3

184 PRCDR_DT3

185 ICD_PRCDR_CD4

186 ICD_PRCDR_VRSN_CD4

187 PRCDR_DT4

188 ICD_PRCDR_CD5

189 ICD_PRCDR_VRSN_CD5

190 PRCDR_DT5

191 ICD_PRCDR_CD6

192 ICD_PRCDR_VRSN_CD6

193 PRCDR_DT6

194 ICD_PRCDR_CD7

195 ICD_PRCDR_VRSN_CD7

196 PRCDR_DT7

197 ICD_PRCDR_CD8

198 ICD_PRCDR_VRSN_CD8

199 PRCDR_DT8

200 ICD_PRCDR_CD9

201 ICD_PRCDR_VRSN_CD9

202 PRCDR_DT9

203 ICD_PRCDR_CD10

204 ICD_PRCDR_VRSN_CD10

205 PRCDR_DT10

206 ICD_PRCDR_CD11

207 ICD_PRCDR_VRSN_CD11

208 PRCDR_DT11

209 ICD_PRCDR_CD12

LDS Inpatient Data Dictionary

Field Long Name ICD_DGNS_E_VRSN_CD10 CLM_E_POA_IND_SW10 ICD_DGNS_E_CD11 ICD_DGNS_E_VRSN_CD11 CLM_E_POA_IND_SW11 ICD_DGNS_E_CD12 ICD_DGNS_E_VRSN_CD12 CLM_E_POA_IND_SW12 ICD_PRCDR_CD1 ICD_PRCDR_VRSN_CD1 PRCDR_DT1 ICD_PRCDR_CD2 ICD_PRCDR_VRSN_CD2 PRCDR_DT2 ICD_PRCDR_CD3 ICD_PRCDR_VRSN_CD3 PRCDR_DT3 ICD_PRCDR_CD4 ICD_PRCDR_VRSN_CD4 PRCDR_DT4 ICD_PRCDR_CD5 ICD_PRCDR_VRSN_CD5 PRCDR_DT5 ICD_PRCDR_CD6 ICD_PRCDR_VRSN_CD6 PRCDR_DT6 ICD_PRCDR_CD7 ICD_PRCDR_VRSN_CD7 PRCDR_DT7 ICD_PRCDR_CD8 ICD_PRCDR_VRSN_CD8 PRCDR_DT8 ICD_PRCDR_CD9 ICD_PRCDR_VRSN_CD9 PRCDR_DT9 ICD_PRCDR_CD10 ICD_PRCDR_VRSN_CD10 PRCDR_DT10 ICD_PRCDR_CD11 ICD_PRCDR_VRSN_CD11 PRCDR_DT11 ICD_PRCDR_CD12

Label Claim Diagnosis E Code X Diagnosis Version Code (ICD-9 or ICD-10) Claim Diagnosis E Code X Diagnosis Present on Admission Indicator Code Claim Diagnosis E Code XI Claim Diagnosis E Code XI Diagnosis Version Code (ICD-9 or ICD-10) Claim Diagnosis E Code XI Diagnosis Present on Admission Indicator Code Claim Diagnosis E Code XII Claim Diagnosis E Code XII Diagnosis Version Code (ICD-9 or ICD-10) Claim Diagnosis E Code XII Diagnosis Present on Admission Indicator Code Claim Procedure Code I Claim Procedure Code I Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code I Date Claim Procedure Code II Claim Procedure Code II Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code II Date Claim Procedure Code III Claim Procedure Code III Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code III Date Claim Procedure Code IV Claim Procedure Code IV Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code IV Date Claim Procedure Code V Claim Procedure Code V Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code V Date Claim Procedure Code VI Claim Procedure Code VI Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code VI Date Claim Procedure Code VII Claim Procedure Code VII Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure CodeVII Date Claim Procedure Code VIII Claim Procedure Code VIII Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code VIII Date Claim Procedure Code IX Claim Procedure Code IX Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code IX Date Claim Procedure Code X Claim Procedure Code X Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code X Date Claim Procedure Code XI Claim Procedure Code XI Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XI Date Claim Procedure Code XII

Page 5 of 20

Type CHAR CHAR CHAR CHAR CHAR CHAR CHAR CHAR

CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR

Length 1 1 7 1 1 7 1 1

7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7

No.

Field Short Name

210 ICD_PRCDR_VRSN_CD12

211 PRCDR_DT12

212 ICD_PRCDR_CD13

213 ICD_PRCDR_VRSN_CD13

214 PRCDR_DT13

215 ICD_PRCDR_CD14

216 ICD_PRCDR_VRSN_CD14

217 PRCDR_DT14

218 ICD_PRCDR_CD15

219 ICD_PRCDR_VRSN_CD15

220 PRCDR_DT15

221 ICD_PRCDR_CD16

222 ICD_PRCDR_VRSN_CD16

223 PRCDR_DT16

224 ICD_PRCDR_CD17

225 ICD_PRCDR_VRSN_CD17

226 PRCDR_DT17

227 ICD_PRCDR_CD18

228 ICD_PRCDR_VRSN_CD18

229 PRCDR_DT18

230 ICD_PRCDR_CD19

231 ICD_PRCDR_VRSN_CD19

232 PRCDR_DT19

233 ICD_PRCDR_CD20

234 ICD_PRCDR_VRSN_CD20

235 PRCDR_DT20

236 ICD_PRCDR_CD21

237 ICD_PRCDR_VRSN_CD21

238 PRCDR_DT21

239 ICD_PRCDR_CD22

240 ICD_PRCDR_VRSN_CD22

241 PRCDR_DT22

242 ICD_PRCDR_CD23

243 ICD_PRCDR_VRSN_CD23

244 PRCDR_DT23

245 ICD_PRCDR_CD24

246 ICD_PRCDR_VRSN_CD24

247 PRCDR_DT24

248 ICD_PRCDR_CD25

249 ICD_PRCDR_VRSN_CD25

250 PRCDR_DT25

251 DOB_DT

LDS Inpatient Data Dictionary

Field Long Name ICD_PRCDR_VRSN_CD12 PRCDR_DT12 ICD_PRCDR_CD13 ICD_PRCDR_VRSN_CD13 PRCDR_DT13 ICD_PRCDR_CD14 ICD_PRCDR_VRSN_CD14 PRCDR_DT14 ICD_PRCDR_CD15 ICD_PRCDR_VRSN_CD15 PRCDR_DT15 ICD_PRCDR_CD16 ICD_PRCDR_VRSN_CD16 PRCDR_DT16 ICD_PRCDR_CD17 ICD_PRCDR_VRSN_CD17 PRCDR_DT17 ICD_PRCDR_CD18 ICD_PRCDR_VRSN_CD18 PRCDR_DT18 ICD_PRCDR_CD19 ICD_PRCDR_VRSN_CD19 PRCDR_DT19 ICD_PRCDR_CD20 ICD_PRCDR_VRSN_CD20 PRCDR_DT20 ICD_PRCDR_CD21 ICD_PRCDR_VRSN_CD21 PRCDR_DT21 ICD_PRCDR_CD22 ICD_PRCDR_VRSN_CD22 PRCDR_DT22 ICD_PRCDR_CD23 ICD_PRCDR_VRSN_CD23 PRCDR_DT23 ICD_PRCDR_CD24 ICD_PRCDR_VRSN_CD24 PRCDR_DT24 ICD_PRCDR_CD25 ICD_PRCDR_VRSN_CD25 PRCDR_DT25 DOB_DT

Label Claim Procedure Code XII Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XII Date Claim Procedure Code XIII Claim Procedure Code XIII Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XIII Date Claim Procedure Code XIV Claim Procedure Code XIV Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XIV Date Claim Procedure Code XV Claim Procedure Code XV Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XV Date Claim Procedure Code XVI Claim Procedure Code XVI Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XVI Date Claim Procedure Code XVII Claim Procedure Code XVII Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XVII Date Claim Procedure Code XVIII Claim Procedure Code XVIII Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XVIII Date Claim Procedure Code XIX Claim Procedure Code XIX Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XIX Date Claim Procedure Code XX Claim Procedure Code XX Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XX Date Claim Procedure Code XXI Claim Procedure Code XXI Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XXI Date Claim Procedure Code XXII Claim Procedure Code XXII Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XXII Date Claim Procedure Code XXIII Claim Procedure Code XXIII Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XXIII Date Claim Procedure Code XXIV Claim Procedure Code XXIV Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XXIV Date Claim Procedure Code XXV Claim Procedure Code XXV Claim Procedure Version Code (ICD-9 or ICD-10) Claim Procedure Code XXV Date LDS Age Category

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Type CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE CHAR CHAR DATE NUM

Length 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 7 1 8 1

No.

Field Short Name

252 GNDR_CD

253 RACE_CD

254 CNTY_CD

255 STATE_CD

256 CWF_BENE_MDCR_STUS_CD

1 DSYSRTKY 2 CLAIMNO 3 RLTCNDSQ 4 THRU_DT 5 CLM_TYPE 6 RLT_COND

1 DSYSRTKY 2 CLAIMNO 3 RLTOCRSQ 4 THRU_DT 5 CLM_TYPE 6 OCRNC_CD 7 OCRNCDT

1 DSYSRTKY 2 CLAIMNO 3 RLTVALSQ 4 THRU_DT 5 CLM_TYPE 6 VAL_CD 7 VAL_AMT

1 DSYSRTKY 2 CLAIMNO 3 CLM_LN 4 THRU_DT 5 CLM_TYPE 6 REV_CNTR 7 HCPCS_CD 8 REV_UNIT 9 REV_RATE

LDS Inpatient Data Dictionary

Field Long Name GNDR_CD BENE_RACE_CD BENE_CNTY_CD BENE_STATE_CD CWF_BENE_MDCR_STUS_CD

DESY_SORT_KEY CLAIM_NO RLT_COND_CD_SEQ CLM_THRU_DT NCH_CLM_TYPE_CD CLM_RLT_COND_CD

DESY_SORT_KEY CLAIM_NO RLT_OCRNC_CD_SEQ CLM_THRU_DT NCH_CLM_TYPE_CD CLM_RLT_OCRNC_CD CLM_RLT_OCRNC_DT

DESY_SORT_KEY CLAIM_NO RLT_VAL_CD_SEQ CLM_THRU_DT NCH_CLM_TYPE_CD CLM_VAL_CD CLM_VAL_AMT

DESY_SORT_KEY CLAIM_NO CLM_LINE_NUM CLM_THRU_DT NCH_CLM_TYPE_CD REV_CNTR HCPCS_CD REV_CNTR_UNIT_CNT REV_CNTR_RATE_AMT

Gender Code from Claim

Label

Race Code from Claim

County Code from Claim (SSA)

State Code from Claim (SSA)

CWF Beneficiary Medicare Status Code

Condition Code File LDS Beneficiary ID LDS Claim Number Claim Related Condition Code Sequence Claim Through Date (Determines Year of Claim) NCH Claim Type Code Claim Related Condition Code

Occurrence Code File LDS Beneficiary ID LDS Claim Number Claim Related Occurrence Code Sequence Claim Through Date (Determines Year of Claim) NCH Claim Type Code Claim Related Occurrence Code Claim Related Occurrence Date

Value Code File LDS Beneficiary ID LDS Claim Number Claim Related Value Code Sequence Claim Through Date (Determines Year of Claim) NCH Claim Type Code Claim Value Code Claim Value Amount

Revenue Center File LDS Beneficiary ID LDS Claim Number Claim Line Number Claim Through Date (Determines Year of Claim) NCH Claim Type Code Revenue Center Code Revenue Center HCFA Common Procedure Coding System Revenue Center Unit Count Revenue Center Rate Amount

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Type CHAR CHAR CHAR CHAR CHAR

Length 1 1 3 2 2

NUM

9

NUM

12

CHAR

2

DATE

8

CHAR

2

CHAR

2

NUM

9

NUM

12

CHAR

2

DATE

8

CHAR

2

CHAR

2

DATE

8

NUM

9

NUM

12

CHAR

2

DATE

8

CHAR

2

CHAR

2

NUM

12

NUM

9

NUM

12

NUM

3

DATE

8

CHAR

2

CHAR

4

CHAR

5

NUM

8

NUM

12

No.

Field Short Name

10 REV_CHRG

11 REV_NCVR

12 REVDEDCD

13 APCHIPPS

LDS Inpatient Data Dictionary

Field Long Name REV_CNTR_TOT_CHRG_AMT REV_CNTR_NCVRD_CHRG_AMT REV_CNTR_DDCTBL_COINSRNC_CD REV_CNTR_APC_HIPPS_CD

Label Revenue Center Total Charge Amount Revenue Center Non-Covered Charge Amount Revenue Center Deductible Coinsurance Code Revenue Center APC/HIPPS

Type NUM NUM CHAR CHAR

Length 12 12 1 5

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