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The Medicare Inpatient (encounter) file contains Medicare Advantage plan paid records for inpatient hospital stays.

What does this file include? (variable highlights)

  • Admission, discharge dates
  • diagnosis (ICD diagnosis) codes
  • procedure (ICD procedure) codes
  • diagnostic related group (DRG) codes
  • patient discharge status code
  • organization NPI
  • Part C/Medicare Advantage benefit package and contract number
  • Revenue center codes, dates, unit counts
  • No payment variables are available

Special considerations

  • Many Medicare Advantage Plans offer extra coverage in addition to services covered under traditional fee-for-service Medicare (vision, hearing, dental, and/or health and wellness programs). Encounter will include records fo these additional items and services provided under the plan.
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