The Inpatient file contains final action fee-for-service claims data submitted by inpatient hospital providers for reimbursement of facility costs. Medicare Institutional provider numbers are not encrypted; however, physician identifiers, e.g. NPIs or UPINs are encrypted.
This file includes:
- diagnosis (ICD-9 diagnosis),
- procedure (ICD-9 procedure code),
- Medicare Severity Diagnosis Related Group (MS-DRG),
- dates of service,
- reimbursement amount,
- hospital provider number, and
- beneficiary demographic information
Additionally, this file includes revenue center information. The Revenue Center Codes provide details on charges, such as those for emergency room (ER) and emergency department (ED) charges.
• Clinical outcome studies that require diagnosis and procedure codes or length of hospital stay
• Evaluations of cost, including charges and Medicare program payments
• Analysis of specific service utilization by charge amount, such as emergency room use
Need to link IP data to other utilization file types and enrollment data