|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.
A few states have a large number of discharges (20%-30%) with total charges less than $25. HCUP edit check TCHG01 sets TOTCHG to inconsistent (.C) on these records. An investigation of this situation reveals no specific pattern. The low values generally occur in all hospitals, but may be more pronounced in a handful of hospitals. The discharges with low total charges are commonly associated with simple diagnoses or procedures (e.g., attention to surgical dressing/suture, otitis media, acute URI, acute pharyngitis, limited or comprehensive interview, and skin suture). They do not occur for one particular payer type and do not appear to be copay amounts. Please consult the state-specific Data Quality Reports available under Summary Statistics.
|State Specific Notes
Beginning in 2008, Arizona provided charge information in addition to total charges. We were able to conclude that charges for professional fees and patient convenience items are included in the Arizona total charges. Any charges for professional fees and convenience items were subtracted from the reported total charges during HCUP processing to make Arizona total charges (TOTCHG and TOTCHG_X) comparable to data from other states.
Prior to 2008, Arizona documentation did not indicate whether charges for professional fees and patient convenience items are included in its total charges for hospital emergency department data.
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.
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).
For the 2003 data year, Maine did not provide any charge information on their inpatient or outpatient files. This includes the detail charge records as well as the various total charge data elements (i.e., total charge, total professional fees, and total ancillary charges). This restriction is due to changes in Maineās data release policies.
Beginning in 2000, total charges (TOTCHG and TOTCHG_X) were collected from the patient summary record and not the detail charge and revenue code array. Prior to 2000, total charges (TOTCHG and TOTCHG_X) were identified by revenue code "001" and extracted from the detail charge and revenue code array.
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:
Prior to 1993, Massachusetts included professional fees in its detailed and total charges, if these were included by the hospital. Hospitals are allowed, but not required, to report these professional fees in the charge fields. Individual facilities decide which professional fees are included and where. There is no way to determine which hospitals did or did not include professional fees.
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.
Charges associated with the professional fees and non-covered items (revenue code centers 096X, 097X, 098X, and 099X) have been removed from total charges.
Beginning in 2002, professional fees were subtracted from the reported total charges during HCUP processing to make Utah total charges (TOTCHG and TOTCHG_X) comparable to data from other states. Utah indicates that for the majority of the discharges, the reported total charge includes professional fees. Utah reports the total charge for the UB-92 revenue code "001" if the hospital provides individual revenue codes to the data organization; otherwise the total charge is the hospital-reported total. For the hospitals that do not provide individual revenue codes, Utah does not have any means of determining whether or not professional charges are included. Prior to 2002, professional fees were not subtracted from the total charges (TOTCHG and TOTCHG_X). To make the total charges comparable to data from other states, professional fees (CHG2) should be subtracted from total charges (TOTCHG and TOTCHG_X). In all years, it is possible that charges for patient convenience items are included in total charges (TOTCHG and TOTCHG_X). There is no means of determining whether these charges are included.
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 SEDD Description of Data Elements - All States. Healthcare Cost and Utilization Project (HCUP). September 2008. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/db/vars/sedddistnote.jsp?var=totchg.
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|Last modified 9/11/08