|TOTCHG - Total charges, cleaned|
|State Specific Notes|
TOTCHG contains the edited total charges. The original value provided by the data source is retained in the data element TOTCHG_X. How total charges are edited depends on the year of the data.
Beginning in the 1998 HCUP databases, the following edits are applied to total charges (TOTCHG):
In the 1988-1997 HCUP databases, the following edits are applied to total charges (TOTCHG):
Generally, total charges (TOTCHG and TOTCHG_X) do not include professional fees and non-covered charges. If the source provides total charges with professional fees, then the professional fees are removed from the charge during HCUP processing. In a small number of HCUP databases, professional fees cannot be removed from total charges because the data source cannot provide the information. Please check the state-specific notes for information on which states are affected.
Emergency department charges incurred prior to admission to the hospital may be included in total charges (TOTCHG and TOTCHG_X). Medicare requires a bundled bill for Medicare patients admitted to the hospital through the emergency department. Other payers may or may not have similar requirements.
|State Specific Notes|
According to Colorado, hospital based physician fees are excluded from total charges (TOTCHG and TOTCHG_X).
The coding of TOTCHG and TOTCHG_X in Florida is inconsistent with the coding of total charges in other states. In Florida, total charges may include professional fees. In all other HCUP states, either professional fees are not included in the supplied total charges or the professional fees are subtracted from the total during HCUP processing.
Use the variable PROFEE to identify records for which the total charges include professional fees. PROFEE is a required submission field for ambulatory surgery data in Florida. PROFEE indicates whether or not professional fees for radiology services are included in total charges (TOTCHG and TOTCHG_X).
Iowa includes professional fees in its total charges if the hospital combines hospital and professional bills. Professional fees are subtracted from total charges (TOTCHG and TOTCHG_X) during HCUP processing to make Iowa total charges comparable to data from other states. Due to an error in processing the outpatient data in 2004, professional fees were NOT subtracted from the total charges. Users can correct this by subtracting non-covered charges (CHG16) and professional fees (CHG17) from the total charges (TOTCHG and TOTCHG_X). Beginning in 2005, professional fees and non-covered items are excluded from the total charges (TOTCHG and TOTCHG_X).
Beginning in 2007, Maryland included the records from all other outpatients, Greenbaum cancer center, and UMMS shock trauma in the unified AS and ED outpatient data file. Total changes associated with some of these new records were smaller than $100. During the HCUP processing, these values were categorized in "Inconsistent", which resulted in increasing the frequency associated with it.
Beginning in 2006, Maryland stopped providing total charges. This data element is created based on charges associated with revenue code 0001 during the HCUP data processing.
Maryland excluded the following from total charges:
In 2006, two Michigan hospitals submitted TOTCHG_X with implied decimals. The problem begins in March for one hospital and in July for the other. During processing we fixed the problem data for both TOTCHG_X and TOTCHG.
For the 1988-1993 HCUP files, New York supplied their Master File which consists of Discharge Data Abstracts (DDA) matched to Uniform Billing Forms (UBF) for inpatient stays. Information on total charges is included in the UBF part of the record. Due to an administrative change in the collection of billing records for 1989, a large percentage of the DDAs could not be matched to a UBF. When there was no match, charge information is missing. The match rate improves over time and stabilizes after 1991. The percentage of DDA records that have a matching UBF record in the Master File is as follows:
Beginning in the 1994 data, hospitals submitted discharge records to New York in a new format, using Universal Data Set (UDS) specifications. This format combines the old UBF and DDA data into a single submission record.
Adjustment to Charges for Interim Bills
Beginning in 1996, professional fees and charges for patient convenience items were subtracted from the reported total charges during HCUP processing to make South Carolina total charges (TOTCHG and TOTCHG_X) comparable to data from other states.
Prior to 1996, only professional fees were subtracted from the reported total charges because the source did not supply an itemized charge for patient convenience items.
In 2006, total charges were not included on South Carolina SASD or SEDD because of a problem with a major data vendor in the state.
The total charges for South Carolina freestanding clinic data may include professional fees and charges for patient convenience items. South Carolina did not supply detailed charges with the freestanding clinic data. Professional fees and charges for patient convenience items could not be subtracted from total charges (TOTCHG and TOTCHG_X) during HCUP processing as was done with the South Carolina inpatient and hospital-based ambulatory surgery data.
Charges associated with the professional fees and non-covered items (revenue code centers 096X, 097X, 098X, and 099X) have been removed from total charges.
Please use the 1997 data for DSHOSPID="408" with caution. Based on a cursory review of the hospital's data, the following problems were identified:
Prior to 2006, Wisconsin may have included professional fees and convenience items in its total charges. Hospitals are instructed to remove these fees from total charges, but some hospitals do not subtract them and others have had difficulties with their accounting software. There is no way to determine which hospitals did or did not include these items.
Hospitals are not required to report total charges for stays over 100 days.
|Internet Citation: HCUP Central Distributor SASD Description of Data Elements - All States. Healthcare Cost and Utilization Project (HCUP). April 2008. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/db/vars/sasddistnote.jsp?var=totchg.|
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|Last modified 4/11/08|