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Central Distributor SID: Description of Data Elements
This section describes how HCUP data elements are coded, restrictions on their use, their uniform values, and State-specific coding practices.
 
TOTCHG - Total charges, cleaned
 
Documentation Sections:
General Notes
Uniform Values
State Specific Notes
General 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):

  • Values are rounded to the nearest dollar; and
  • Zero charges are set to missing (.);
  • If total charges are excessively low (ETCHG01) or high (ETCHG02), then TOTCHG is set to inconsistent (.C). The limits for excessively low and high total charges vary for inpatient and outpatient databases.
    • For inpatient data, the allowable values for total charges vary by year: total charges are allowed to be between $25 and $1.0 million, inclusive in 1998 to 2006; between $100 and $1.5 million, inclusive, in 2007 to 2010; between $100 and $5.0 million beginning in 2011 data; and between $100 and $10.0 million beginning in 2016 data.
    • For outpatient data, the allowable values for total charges vary by year: total charges are allowed to be between $25 and $50,000, inclusive, in 1998 to 2006; between $100 and $75,000, inclusive, in 2007 to 2010; and between $100 and $950,000 beginning in 2011 data.

In the 1988-1997 HCUP databases, the following edits are applied to total charges (TOTCHG):

  • Values are rounded to the nearest dollar; and
  • Zero charges are set to missing (.);
  • Negative charges are set to invalid (.A); and
  • For HCUP inpatient databases, if charges per day (TOTCHG/LOS) are unjustifiably low (ED911) or high (ED921), then TOTCHG is set to inconsistent (.C).
  • For HCUP outpatient databases, if total charges are excessively low (ED912) or high (ED922), then TOTCHG is set to inconsistent (.C). (SASD)

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.

 
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Uniform Values
 
VariableDescriptionValueValue Description
TOTCHGTotal charges, cleanedDollarsTotal Charge rounded
.Missing
.AInvalid
.BUnavailable from source (coded in 1988-1997 data only)
.CInconsistent: beginning with 1998 data, ETCHG01, ETCHG02; in 1998-1997 data, ED911, ED912, ED921, ED922
 
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State Specific Notes

Arizona

Beginning in 1996, Arizona included charges for professional fees and patient convenience items in its 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.

Due to an error in HCUP processing in 1996, some types of professional fees were not subtracted from total charges (TOTCHG and TOTCHG_X). The types of professional fees that were not subtracted include hospital visits, consultations, private duty nurses, EKGs, EEGs, and medical social services. Charges for these services were coded on 24% of the 1996 discharges, with a mean charge of $216 and a range from $1 to $5,718. Total charges (TOTCHG and TOTCHG_X) can be corrected by subtracting the detail charge, CHG61. No other years need correction.

Beginning in 1997, all reported professional fees and patient convenience items were subtracted from total charges (TOTCHG and TOTCHG_X).



Arizona

In 1996 only, total charges (TOTCHG and TOTCHG_X) can be corrected by subtracting the detail charge, CHG61. No other years need correction.



Arkansas

Total charges in the 2008 Arkansas SID are not rounded to the nearest dollar.



California

California supplied total charges only for the last 365 days of the stay for stays of more than one year (365 days). If the supplied length of stay was greater than 365 days, cleaned total charges, TOTCHG, was set to missing (.) and uncleaned total charges, TOTCHG_X, retained the supplied total charge. Due to an error in HCUP processing, cleaned total charges, TOTCHG, were not set to missing in the 1998-1999 HCUP files.

Some hospitals in California (including all Kaiser and Shriner hospitals) were exempted from reporting total charges. For those hospitals, TOTCHG and TOTCHG_X were missing (.).

Source documentation indicated that hospital-based physician fees were not included in the reported total charges.

No Charges

The source reported total charges with the value of 1 for discharges with no charges ($0). These records include live donors and courtesy or research patients. Values of 1 were verified with the hospital by the source.

Prior to 1995, total charges were set to missing (TOTCHG and TOTCHG_X = .) for these records during HCUP processing. Beginning in 1995, only TOTCHG was set to missing (.) [invalid (.A) for 2008-2012 data] and TOTCHG_X retained the value of 1. Due to an error in HCUP processing, cleaned total charges, TOTCHG, were not set to missing in the 1998-1999 HCUP files.



Colorado

According to Colorado, hospital based physician fees are excluded from total charges (TOTCHG and TOTCHG_X).



Iowa

Beginning in 1993, Iowa includes professional fees in its total charges if the hospital combines hospital and professional bills. From 1993 to 2002, professional fees were 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 inpatient data in 2003-2004, 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).

Prior to 1993, it was optional for hospitals to report total charges to the hospital association:

  • The availability of total charges varies by hospital.
  • Some hospitals have missing (.) total charges (TOTCHG and TOTCHG_X) on a large percentage of records.


Kansas

It was optional for hospitals to provide total charges to the hospital association. Approximately 5% to 25% of the discharges are missing total charges.

Some hospitals report total charges of $1.00 for all discharges. For 1993-1994, the $1.00 charges are included in the HCUP data. Beginning with 1995, total charges of $1.00 in the Kansas inpatient data were set to missing (.).

Some smaller hospitals have data systems that allow a maximum of 5 digits for total charges. For these hospitals, total charges of $100,000 or greater are coded as $99,999.

Due to an error in 1994 HCUP processing, TOTCHG values of "invalid" (.A) were recoded to TOTCHG values of "missing" (.).



Maryland

Total charges in the 2008 Maryland SID are not rounded to the nearest dollar.

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:

  • Physician charges and
  • Charges not regulated by the Health Services Cost Review Commission (for example, telephone service, television charges or private duty nursing charges).


Massachusetts

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.



Massachusetts

From 1988 to 1993, total charges (TOTCHG and TOTCHG_X) are the sum of detailed charges, excluding the "unknown revenue center" charge (CHG43).

Beginning in 1994, an "unknown revenue center" charge was not included in the detailed charges. Total charges (TOTCHG and TOTCHG_X) equal the sum of all supplied detailed charges.



Michigan

In 2006, four Michigan hospitals submitted TOTCHG_X with implied decimals. The problem begins in March for one hospital and in July for the other three facilities. During processing we fixed the problem data for both TOTCHG_X and TOTCHG.



Mississippi

Charges for processional fees and patient convenience items were subtracted from the reported total charges during HCUP processing to make Mississippi total charges (TOTCHG and TOTCHG_X) comparable to data from other states.



Nevada

Prior to 2007, the total charges for Nevada are the charges reported for UB-92 revenue center "0001". Beginning in 2007, the total charges were the charges reported for UB-04 revenue center "0001". Fewer than 1% of discharges include professional fees (revenue codes, 096x, 097x and 098x) in the total charge field. Prior to 2006, professional fees were subtracted from the total charges. Beginning in 2006, professional fees were included in TOTCHG.



New Mexico

The original New Mexico inpatient file contained outpatient records from HOSPID=35020. During the creation of the 2011 New Mexico SID these outpatient records, identified by a length of stay of 0 days, were excluded. This approach also eliminated any inpatient discharges with same day stays for this hospital. Any analysis using the 2011 New Mexico SID should be aware that this hospital is missing information on same day stays.



New York

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:

1988 77.2%
1989 26.3%
1990 62.8%
1991 93.7%
1992 91.8%
1993 95.5%.

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

  • For 1988-1993, when the length of stay from the Discharge Data Abstract did not equal the length of the billing period from the Uniform Billing Form, total charges (TOTCHG) were set to missing (.) because this billing information pertained only to the billing period, not the complete inpatient stay. However, TOTCHG_X contains the original value from the billing record.
  • Beginning in 1994, billing dates were not reported by New York and the adjustment to charge details (CHGn, RATEn, UNITn, REVCDn) was not made.


Oregon

Kaiser hospitals are exempt from reporting total charges. As a result, TOTCHG and TOTCHG_X are missing (.) for Kaiser Hospitals in Oregon.

Beginning in the 1995 data, some hospitals did not report total charges (TOTCHG and TOTCHG_X) on charity bills since there are no charges to the patient.



Rhode Island

Charges for patient convenience items were subtracted from the reported total charges during HCUP processing to make Rhode Island total charges (TOTCHG and TOTCHG_X) comparable to data from other states.



South Carolina

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.



South Dakota

Charges for professional fees (detail charge CHG16), professional component charges (detail charge CHG23), and non-covered charges (detail charge CHG15) were subtracted from the reported total charges during HCUP processing to make South Dakota total charges (TOTCHG and TOTCHG_X) comparable to data from other states.



Utah

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).



West Virginia

Total charges in the 2008 West Virginia SID are not rounded to the nearest dollar.

West Virginia has rate setting. The data source confirms that the all covered charges are included in the total charge (TOTCHG).



Wisconsin

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.



Wisconsin

An error during HCUP processing of 1993 discharges caused negative values of total charges (TOTCHG) to be set to missing (.) instead of invalid (.A). For other years, negative values of TOTCHG were processed correctly.


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Internet Citation: HCUP Central Distributor SID Description of Data Elements - All States. Healthcare Cost and Utilization Project (HCUP). August 2008. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/db/vars/siddistnote.jsp?var=totchg.
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Last modified 8/12/08