Source Files

The Wisconsin Department of Health Services collects an outpatient file that includes ambulatory surgery (AS), emergency department (ED), observation, therapies, laboratory and radiology, other outpatient services, and recurring outpatient services, such as chemotherapy. Identification of the type of service is based on a record type indicator:

• Ambulatory surgery (record type 1)
• Emergency department (record type 2)
• Observation (record type 3)
• Therapies (record type 4)
• Laboratory and radiology (record type 5)
• Other outpatient (record type 6)
• Recurring outpatient services such as chemotherapy (record type 7).
  • Beginning in data year 2018, record type 7 was eliminated. Records involving only minor procedures were no longer collected.

Wisconsin defines an ED visit as any record with revenue codes 0450, 0451, 0452, or 0459. When an ED visit results in transfer to observation care, the record is submitted as an ED record with all applicable revenue codes included on the record. When an ED visit results in an inpatient discharge or an outpatient surgery, the facility can choose to submit the ED services as a separate record or to combine them with the inpatient or outpatient surgery record. Medicare requires critical access hospitals to bill ED services separate from the inpatient record. Wisconsin honors this requirement.

Wisconsin masks abortion-related ICD-9-CM, ICD-10-CM/PCS, and CPT diagnosis and procedure codes to remove the distinction between spontaneous and induced abortions.

Selection of Records for Inclusion in the SEDD

Wisconsin provides HCUP with one outpatient file which includes ED records. Prior to 2018, the file contained records for other nonemergent outpatient services. Beginning in 2018, Wisconsin filters out services typically rendered in small hospital emergency rooms such as chemotherapy, therapeutic injections, wound care, and dressing changes. All records identified by Wisconsin as ED are included in the SEDD (HCUP data element STATE_ED=1 based on record type 2).

Additionally, any other records with evidence of ED services that are flagged by the variable HCUP_ED (i.e., HCUP_ED>0) during HCUP processing are included in the SEDD. If a record in the SASD also has evidence of ED services based on the HCUP criteria (HCUP data element HCUP_ED not equal to 0), then the SASD record is also included in the SEDD. These records will have the same value for the HCUP data element KEY.

SEDD records with evidence of other types of outpatient services, such as lab/radiology, can be identified by the data element OPService.

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

Wisconsin collects ED data from all hospital-owned EDs in the State.

A comparison of the number of hospitals included in the SEDD and the number of hospitals reported in the AHA Annual Survey is available starting in data year 2010.

Hospital-owned EDs do not always report data for a full calendar year. Some open or close during the year; others have technical problems that prevent them from reporting data for all months in a year.

Exclusion of Records During HCUP Processing

Records with a discharge disposition of "still a patient" are excluded from the HCUP SEDD. Beginning in 2010, records with a designation of "admitted as an inpatient" are retained in the SEDD, even though this rarely occurs. Prior to 2010, records with a designation of "admitted as an inpatient" were excluded from the files.