KnowledgeBase Articles
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Date Information in the Limited Data Set (LDS) Claims Files
The availability of exact dates of service in the Limited Data Set ( LDS ) Standard Analytical Files (SAF) will depend on the year(s) of interest. The SAFs are also known as the claims files. Please note that the below availability of dates only applies ...
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Overview of the NPPES/NPI Downloadable File
The National Provider Identifier The National Provider Identifier ( NPI ) is unique identification number for health care providers, including both organizations and individuals. The NPI is a 10-position numeric identifier that allows researchers to ...
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Part D Formulary Information in the CMS Data Files
Background Detailed information about Medicare Part D drug plan formularies is available in two CMS data files. There are important differences in the files that are outlined below, including whether or not the files can be linked to other data sources. ...
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Identifying Multiple Claims for a Hospital or Skilled Nursing Facility Stay
Each record in the Inpatient and SNF claim files represents a unique claim and not necessarily the entire hospital or SNF stay. This may be the case with longer hospital or SNF stays. Note that the majority of the time in the inpatient file, there will ...
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Creation of the fiscal year cost report files
The federal fiscal year files cover the time period beginning 10/1 and ending 9/30 of the following year. CMS assigns the cost report to a fiscal year based on the provider defined cost report fiscal year begin date. For example, if a provider's cost ...
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The Home Health Outcome and Assessment Information Set (OASIS)
The Home Health Outcome and Assessment Information Set (OASIS) contain data items that were developed for measuring patient outcomes for the purpose of performance improvement in home health care. OASIS data items address socio-demographic, environmental, ...
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Present on Admission (POA) / E-code Data Indicator Data Anomaly
CMS investigated a reported POA / e-code data error. This error in the POA indicator was caused by OIS edits during ICD-10 format preparation in which e-codes were inadvertently shifted and relocated on the formatted claim. This subsequently caused a ...
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Medicare and Medicaid Statistical Resources
Looking for statistics on the Medicare or Medicaid programs or their beneficiaries? We can recommend several places to start your search. CMS Website- Statistics, Trends and Reports section Review the Statistics, Trends and Reports sub-heading on the ...
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Bundled Payments for Care Improvement (BPCI)
Requesting Reuse of CMS Data from a BPCI DUA BPCI applicants that are interested to reuse the data received as part of the Bundled Payments for Care Improvement initiative for a different research purpose can apply for a new LDS DUA. Requests for a new ...
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Difference between Proposed and Final Rule Files
A number of CMS Limited Data Set ( LDS ) files are released first as a Proposed Rule file and then as a Final Rule file. These files include the MedPAR, Hospital Outpatient Prospective Payment System ( OPPS ), Hospital Outpatient Prospective Payment ...
