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

The South Carolina Revenue and Fiscal Affairs Office collects data on the following types of ambulatory surgery and other outpatient services:

• Outpatient surgery defined by HCPCS procedure codes 10021-69999 or 93501- 93572
• Emergency room services defined by revenue codes 045x
• Labor and delivery defined by revenue codes 072x
• Radiation therapy defined by revenue codes 0330, 0333 or 0339
• Chemotherapy defined by revenue codes 0331, 0332 or 0335
• Imaging defined by revenue codes 035x, 040x, or 061x
• Lithotripsy and extra-corporeal shock wave therapy defined by revenue codes 079x
• Observation services defined by revenue codes 076X.

Outpatient Data File Provided to HCUP by the Partner

Beginning in data year 2014, the South Carolina Budget and Control Board has provided their complete outpatient data, in a single file, to HCUP. Prior to data year 2014, the South Carolina Budget and Control Board provided data to HCUP in three separate files. One file contained information from hospital-owned ambulatory facilities. The second file contains ambulatory surgery data from nonhospital-owned facilities. The third file contains ED visits to hospital-owned EDs, excluding records that have total charges less than $50.

The content of the data file(s) from hospital-owned facilities varies by data year:

• For data years 2012 and 2013, the South Carolina Budget and Control Board provided HCUP with one data file including all of their ambulatory surgery records and a second file with observation services records. Records with both services were included in both files.
• Prior to data year 2012, the South Carolina Budget and Control Board provided HCUP with a data file specific to ambulatory surgery. Observation services were only included if they were reported on the same record as an ambulatory surgery.

Selection of Records for Inclusion in the SASD

All records identified by South Carolina as ambulatory surgery are included in the SASD (STATE_AS=1 based on HCPCS procedure codes 10021-69999 or 93501- 93572).

Additionally, any record in the SASD that also have evidence of ED 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

Outpatient data collection began July 1, 1995. All facilities providing data are required to be licensed under the State Certificate of Need and Health Facility Licensure Act. The data include outpatient records from South Carolina hospitals and records from South Carolina nonhospital-owned ambulatory surgery centers. The South Carolina Health Facility Licensure Act defines an ambulatory surgery center as a self-contained entity that is organized, administered, equipped, and operated exclusively for the purpose of performing surgical procedures or related care, for treatment, and for procedures and/or services for which patients are scheduled to arrive, receive surgery, or receive related care, treatment, procedures and/or services and be discharged on the same day.

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 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.