Types of Ambulatory Surgery and Other Outpatient Services Collected by the Partner

The Minnesota Hospital Association (MHA) processes data on ambulatory surgery and other outpatient services such as imaging for North Dakota. MHA identifies outpatient data by the Uniform Billing Form 04 (UB-04) bill type as specified below:

• Ambulatory Surgery (bill type 83x)
• Outpatient Stay (bill type 13x)
• Critical Access Hospital (bill type 85x)

The bill type must have a last digit indicating a final claim (1), interim last claim (4), late charges (5), or replacement adjustment claim (7).

Ambulatory surgery records must have an accompanying CPT procedure and revenue center code as specified below:

• CPT Codes: 10021-36414, 36417-69999, 93451-93462, 93501-93533, G0104, G0105, G0297
• Revenue center codes:
  • 0360-0369 for operating room services
  • 0480-0481 for cardiology diagnostics
  • 0490-0499 for ambulatory surgery care
  • 0722 for delivery room
  • 0750-0759 for gastrointestinal services
  • 0761 for treatment room
  • 0790-0799 0799 for extracorporeal shock wave therapy (lithotripsy).

Imaging records must have an accompanying revenue center code as specified below:

• Revenue center codes:
  • 0320-0329 for diagnostic radiology
  • 0350-0359 for CT scans
  • 0400-0409 for other imaging services
  • 0610-0619 for magnetic resonance technology.

Outpatient Data File Provided to HCUP by the Partner

Beginning in data year 2014, MHA has provided their complete outpatient file to HCUP. Prior to data year 2014, MHA selected ambulatory surgery records from their broader outpatient data set when providing the data to HCUP. The ambulatory surgery flag provided by MHA is used to set the HCUP data element STATE_AS.

Selection of Records for Inclusion in the SASD

All records identified by MHA as ambulatory surgery are included in the SASD (STATE_AS=1 based on the ambulatory surgery flag). Any other nonemergent outpatient records (STATE_ED not equal 1) also are included in the SASD.

Additionally, any records in the SASD that also have evidence of emergency department services based on the HCUP criteria (HCUP data element HCUP_ED > 0), are also included in the HCUP State Emergency Department Databases (SEDD). These records will have the same value for the HCUP data element KEY.

Types of Facilities Included in the Files Provided to HCUP by the Partner

MHA collects data on outpatient services performed in hospital-owned facilities in North Dakota. Data from ambulatory surgery facilities that are not owned by a hospital are not included.

Identification of Hospital-Owned Ambulatory Surgery and Other Types of Outpatient Facilities in the SASD

The designation of a facility as hospital-owned is specific to its financial relationship with a hospital that provides inpatient care and not related to its physical location. Hospital-owned ambulatory surgery and other outpatient care facilities may be contained within the hospital, physically attached to the hospital, or located in a different geographic area. The designation as hospital-owned means that HCUP can identify that the hospital is billing for this service.

Starting in data year 2018, the HCUP data element HOSPITAL_OWNED can be used to identify hospital-owned facilities with ambulatory surgery and possibly other outpatient care data in the SASD. A facility is considered hospital-owned (HOSPITAL_OWNED = 1) if any one of the following is true:

• The facility is listed in the American Hospital Association (AHA) Annual Survey Database^TM.
• The facility is not listed in the AHA database, but the facility provides inpatient discharge data to HCUP.
• Documentation provided by the data source clearly indicates that the facility is hospital-owned.

If the facility in the SASD does not meet any of the above criteria, it is marked as not being owned by a hospital (HOSPITAL_OWNED = 0). Not all hospitals report to the AHA, so there is a possibility that some facilities marked with HOSPITAL_OWNED=0 are hospital-owned.

From data year 1998-2018, the HCUP data element was called FREESTANDING. A facility is considered hospital-owned (FREESTANDING = 0) if any one of the following is true:

• The facility is listed in the American Hospital Association (AHA) Annual Survey Database^TM.
• The facility is not listed in the AHA database, but the facility provides inpatient discharge data to HCUP.
• Documentation provided by the data source clearly indicates that the facility is hospital-owned.

If the facility in the SASD does not meet any of the above criteria, it is marked as not being owned by a hospital (FREESTANDING = 1). Not all hospitals report to the AHA, so there is a possibility that some facilities marked with FREESTANDING=1 are hospital-owned.

Exclusion of Records During HCUP Data Processing

Beginning with 2016 data, records with a discharge disposition of "still a patient" are retained in the HCUP SASD. Prior to 2016 data, these records were excluded.

Beginning in 2010, records with a designation of "admitted as an inpatient" are retained in the SASD, even though this rarely occurs. Prior to 2010, records with a designation of "admitted as an inpatient" were excluded from the files.