Tools for More Accurate Inpatient Cost Estimates with HCUP ...

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CHGn Description UB-92 Revenue Codes ClusterCHG20 Special charges 220-229 SCUCHG21 Nursing acuity charges 230, 231-235, 239 SCUCHG22 All Inclusive Ancillary 240-249 ANCCHG23 Pharmacy charges250, 253-256, 258, 634-636,251, 252, 257, 259, 630-633, 637 DRUGCHG24 IV Therapy charges 260-264, 269, 640-649 THERCHG25 Supplies charges 270-279, 621-624 ORCHG26 Oncology charges 280, 289 OANCCHG27 Equipment charges 290-299 THERCHG28 Laboratory charges300-309, 310, 311, 312,314, 319 LABCHG29 Radiology - Diagnostic charges 320, 321-324, 329 RADCHG30 Radiology - Therapeutic services charges 330, 333, 339 RADCHG31 Chemotherapy charges 331, 332, 335 CLINCHG32 Linear Accelerator not specified RADCHG33 Nuclear medicine charges 340-349 RADCHG34 CT scan charges 350-359 RADCHG35 Operating room charges 360-369 ORCHG36 Anesthesia charges 370-379 ORCHG37 Blood charges 380-389, 390-399, 999 OANCCHG38 Other Imaging charges 404-403, 409 RADCHG39 PET Scan charges 404 RADCHG40 Respiratory therapy charges 410-413, 419 THERCHG41 Physical therapy charges 420-429 THERCHG42 Occupational therapy charges 430-439 THERCHG43 Speech and Audiology charges 440-449. 470-479 THERCHG44 Emergency room charges 450-459 ORCHG45 Pulmonary function charges 460-469 THERCHG46 Cardiology charges 480, 482-489 OANCCHG47 Cath lab charges 481 ORCHG48 Ambulatory surgical care (ASC) charges 490-499 ORCHG49 Outpatient services - general charges 500, 509, 761 CLINCHG50 Outpatient Clinic services charges 510-517, 519 CLINCHG51 Outpatient Clinic - freestanding charges 520-523, 526, 529 CLINCHG52 Other Inpatient services charges530-539, 560-569, 700, 709,780-789, 920-929 OANCCHG53 Ambulance services charges 540-549 CLINCHG54 Skilled Nursing charges 550-559 OANCCHG55 Home Health Agency (HHA) charges570-572, 579, 580-583, 589,590, 599, 600-604, 609,660-663, 669 OANCCHG56 MRI charges 610-619 RADCHG57 Hospice charges 650-659 CLINCHG58 Outpatient Special Resident charges 670-672, 679 CLINCHG59 Recovery room charges 710-719 ORCHG60 Labor room/delivery charges 720-729 NUR18
CHGn Description UB-92 Revenue Codes ClusterCHG61 EKG charges 730-739 RADCHG62 EEG charges 740-749 RADCHG63 Gastro Intestinal charges 750-759 OANCCHG64 Observation Beds charges 760, 762, 769 ORCHG65 Preventative Care services charges 770, 779 CLINCHG66 Vaccine Administration charges 771 CLINCHG67 Lithotripsy charges 790-799 THERCHG68 Renal Dialysis - Inpatient charges 800-804, 809 THERCHG69 Organ acquisition charges 810-814, 819 OANCCHG70 Dialysis Outpatient charges820-825 829, 830-835, 839,840-845, 849, 850-855, 859,880-882, 889 THERCHG71 Psychiatric/Psychol services charges 900-907, 909-919 CLINCHG72 Other Therapy Rehabilitation charges 940-942, 946-947, 949 CLINCHG73 Cardiac rehabilitation charges 943 CLINCHG74 Alcohol and Drug rehabilitation charges 944-945 CLINCHG75Professional fees - Providers and Other Specialistscharges 960-964, 969 IgnoreCHG76 Professional fees - Therapies and Lab charges 971-979 IgnoreCHG77Professional fees - Other and Outpatient servicescharges 981-989 IgnoreCHG78 Patient Convenience charges 990-998 IgnoreTable A8: Map of South Dakota Bucket Charges to Cost-Center ClustersCHGn Description UB-92 Revenue Codes ClusterCHG1 Room 10x-16x, 190-199, 230, 232, 235, 239 RBUCHG2 Nursery 17x, 231 NURCHG3 Intensive Care Unit 20x, 21x, 233, 234 SCUCHG4 Pharmacy 250-252, 254-259, 63x DRUGCHG5 Medical/Surgical Supplies 27x, 290-0293, 299, 62x ORCHG6 Laboratory 30x, 31x LABCHG7 MRI and CAT Scans 35x, 61x RADCHG8 Therapeutic Radiology 33x RADCHG9 Other imaging services 32x, 40x RADCHG10 Nuclear Medicine 34x RADCHG11 Operating Room 36x ORCHG12 Anesthesia 37x ORCHG13 Respiratory Therapy 41x THERCHG14 Physical Therapy/OT/Speech 42x, 43x, 44x THERCHG15 Uncovered 253, 99x ANCCHG16 Professional Fees 96x, 97x, 98x IgnoreCHG17 Treatment or Observation Room 76x CLINCHG18 Ambulatory Surgical Care 49x ORCHG19 Emergency Room 45x OR19
Page 1 and 2: HCUP Methods Series
Page 3 and 4: TABLE OF CONTENTSEXECUTIVE SUMMARY
Page 5 and 6: EXECUTIVE SUMMARYBackgroundThe Agen
Page 7 and 8: possible to form a more accurate es
Page 9 and 10: Cluster #ClusterAbbreviationCMSCost
Page 11 and 12: • A case was considered invalid i
Page 13 and 14: • Appendicitis and other appendic
Page 15 and 16: UB-04 Revenue CodeCluster041x: Resp
Page 17 and 18: CHGnDescription13UB-04RevenueCodesC
Page 20 and 21: CHGn Revenue Codes DescriptionClust
Page 24 and 25: CHGn Description UB-92 Revenue Code
Page 26 and 27: DRGDischargesRelativeCostBased onCo
Page 50 and 51: Appendix C: Cost Adjustment Factors
Page 52 and 53: DXCCS1DischargesRelative CostBased
Page 58: Appendix D: ErrataThis report, The

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