Updated research request forms and data security approval requirement effective 4/24/23
This variable is contained in the following files:
SAS Name
OIP_COV_DAYS
This variable is the count of covered days in the non-acute inpatient hospital setting for the year. This variable equals the sum of the CLM_UTLZTN_DAY_CNT variables on the source claims.
These “other” inpatient (OIP) claims are a subset of the claims in the IP data file consisting of data from IP settings such as long-term care hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, and other types of IP facilities such as children’s hospitals or cancer centers
We consider fully covered days, days where the beneficiary was liable for coinsurance, and lifetime reserve days to all be Medicare-covered days. Non-covered days, leave of absence days, and the day of discharge or death are not included. The algorithm for OIP_COV_DAYS includes only claims that ended during the calendar year (using the CLM_THRU_DT) where the payment amount was >= $0.
There are two cost/use categories from the IP data files: Acute and the OIP.
Medicare payments are described in detail in a series of Medicare Payment Advisory Commission (MedPAC) documents called “Payment Basics” (reference: http://www.medpac.gov/-documents- /payment-basics).
Also in the Medicare Learning Network (MLN) “Payment System Fact Sheet Series” (reference the list of MLN publications at: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-NetworkMLN/…).
Source: CCW (derived)