Atrial Fibrillation End-of-Year Indicator

SAS Name
ATRIAL_FIB

This variable indicates whether a beneficiary met the Chronic Condition Data Warehouse (CCW) criteria for atrial fibrillation as of the end of the calendar year.

Comments

The CCW’s chronic condition flags require beneficiaries to satisfy both claims criteria (a minimum number/type of claims that have the proper diagnosis codes and occurred within a specified time period) and coverage criteria (FFS Part A and Part B coverage during the entire specified time period).

For atrial fibrillation, beneficiaries must have at least one inpatient claim or two Part B institutional or non-institutional (carrier) claims with an atrial fibrillation code in the first or second position during the 1-year reference period. When 2 claims are required, they must occur at least one day apart.

The CCW’s criteria were developed after reviewing validated algorithms from the research literature and criteria used by other federal data sources. You can find more detailed information on the criteria on the CCW website: https://www.ccwdata.org/web/guest/condition-categories

Source: CCW (derived)

ResDAC Comments

From CY 2017 to CY 2021, the MBSF: Chronic Conditions segment also has a newer (CC30) version. The algorithm used to create the Atrial Fibrillation End-of-Year Indicator variable in the CC30 version includes more DX codes, an increased reference period, an increased claim requirement, and the search includes additional DX code positions.

Code Code value
0 Beneficiary did not meet claims criteria or have sufficient fee-for-service (FFS)
coverage
1 Beneficiary met claims criteria but did not have sufficient FFS coverage
2 Beneficiary did not meet claims criteria but had sufficient FFS coverage
3 Beneficiary met claims criteria and had sufficient FFS coverage