/* SHORT TITLE: Codebook for Patient Quest-Separate Billing Doctors,T1-T6*/ ******************************************************************************** * W E S T A T C O D E B O O K * * ----------- --------------- * * * * STUDY OF HEALTH CARE COSTS * * PUBLIC USE - SEPARATE BILLING PROVIDER (C2-C5,D2-D5) * * 30 JUNE 1994 * ******************************************************************************** ******************************************************************************** * W E S T A T C O D E B O O K * * ----------- --------------- * * * * STUDY OF HEALTH CARE COSTS * * PUBLIC USE - SEPARATE BILLING PROVIDER (C2-C5,D2-D5) * * 30 JUNE 1994 * ******************************************************************************** (0) 27 Jun. 1994 Record 01 STUDY OF HEALTH CARE COSTS PUBLIC USE - SEPARATE BILLING PROVIDER (C2-C5,D2-D5) 30 JUNE 1994 Question Column Name Number(s) ________ _________ PATID 001-009 PATIENT ID __________ 000000001- 999999999 = RANDOMLY ASSIGNED SEQUENTIAL NUMBER REC 010-011 RECORD NUMBER _____________ 01 = NUMBER SSUBREC 012-013 SUBRECORD NUMBER ________________ 01-99 = SUBRECORD NUMBER SFORM 014 QUESTIONNAIRE TYPE __________________ A = TIME 1 ADULT QUESTIONNAIRE B = TIME 2 ADULT QUESTIONNAIRE C = TIME 3 ADULT QUESTIONNAIRE G = TIME 4 ADULT QUESTIONNAIRE H = TIME 5 ADULT QUESTIONNAIRE I = TIME 6 ADULT QUESTIONNAIRE D = TIME 1 PEDIATRIC QUESTIONNAIRE E = TIME 2 PEDIATRIC QUESTIONNAIRE F = TIME 3 PEDIATRIC QUESTIONNAIRE J = TIME 4 PEDIATRIC QUESTIONNAIRE K = TIME 5 PEDIATRIC QUESTIONNAIRE L = TIME 6 PEDIATRIC QUESTIONNAIRE FOR EACH INPATIENT/NURSING HOME STAY RECORDED DURING AN INTERVIEW, THE RESPONDENT WAS ASKED IF THERE WERE ANY MEDICAL OR OUTSIDE FACILITIES WHO PROVIDED CARE DURING THAT INPATIENT/NURSING HOME STAY WHO WERE PAID SEPARATELY FOR THAT FOR THAT HOSPITAL/NURSING HOME STAY; OR, IF THERE WERE ANY DOCTORS OR PLACES THAT SENT A SEPARATE BILL FOR THAT STAY. IF THE RESPONSE WAS YES, UP TO FOUR SEPARATE BILLING PROVIDERS WERE COLLECTED FOR THE STAY. EACH OF THE SEPARATE BILLING PROVIDERS REPORTED FOR THE STAY HAVE BEEN RECORDED ON A SEPARATE RECORD. HOWEVER, THE CHARGES REPRESENT AN AGGREGATED AMOUNT AND DO NOT REFLECT AMOUNTS FOR INDIVIDUAL SEPARATE BILLING PROVIDERS (UNLESS ONLY ONE WAS COLLECTED FOR THE STAY). THE SOURCES OF PAYMENT ALSO REPRESENT AN AGGREGATED RESPONSE FOR THE STAY. (1) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ SFPART 015-016 QUESTIONNAIRE QUESTION ______________________ C2 = SEPARATE BILLING PROVIDER - FIRST LISTED - INPATIENT STAY C3 = SEPARATE BILLING PROVIDER - SECOND LISTED - INPATIENT STAY C4 = SEPARATE BILLING PROVIDER - THIRD LISTED - INPATIENT STAY C5 = SEPARATE BILLING PROVIDER - FOURTH LISTED - INPATIENT STAY NOTE: NURSING HOME STAYS WERE NOT COLLECTED IN THE PEDIATRIC QUESTIONNAIRES. D2 = SEPARATE BILLING PROVIDER - FIRST LISTED - NURSING HOME STAY D3 = SEPARATE BILLING PROVIDER - SECOND LISTED - NURSING HOME STAY D4 = SEPARATE BILLING PROVIDER - THIRD LISTED - NURSING HOME STAY D5 = SEPARATE BILLING PROVIDER - FOURTH LISTED - NURSING HOME STAY PROVID 017-023 WHAT IS THE NAME, ADDRESS AND TELEPHONE NUMBER OF THESE DOCTORS OR PLACES? ___________________________________________________________________________ 0000001- 9999996 = RANDOMLY ASSIGNED PROVIDER ID NUMBER 9999997 = REFUSED 9999998 = DK 9999999 = NOT ASCERTAINED SRBEGDT (024-029) STARTING WITH THE MOST RECENT STAY: ON WHAT DATE DID YOU (MOST RECENTLY) ENTER THE NURSING HOME/FACILITY? _______________________ CODER: IF SBEGYR EQUALS 97, 98 OR 99, CODE 99 IN SBEGMO AND SBEGDY. SRBEGMO 024-025 BEGIN MONTH OF STAY ___________________ + = INAPPLICABLE, CODED C2, C3, C4 OR C5 IN SFPART 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (2) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ SRBEGDY 026-027 BEGIN DAY OF STAY _________________ + = INAPPLICABLE, CODED C2, C3, C4 OR C5 IN SFPART 01-31 = DAY 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED SRBEGYR 028-029 BEGIN YEAR OF STAY __________________ + = INAPPLICABLE, CODED C2, C3, C4 OR C5 IN SFPART 89-91 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED SRENDDT (030-035) ON WHAT DATE WERE YOU (MOST RECENTLY DISCHARGED) FROM THE NURSING HOME/FACILITY? CODER: IF SRENDYR EQUALS 97, 98 OR 99, CODE 99 IN SRENDMO AND SRENDDY. SRENDMO 030-031 MONTH OF DISCHARGE __________________ 01-12 = MONTH 95 = STILL IN HOSPITAL/NURSING HOME 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED SRENDDY 032-033 DAY OF DISCHARGE ________________ 01-31 = DAY 95 = STILL IN HOSPITAL/NURSING HOME 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (3) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ SRENDYR 034-035 YEAR OF DISCHARGE _________________ 91-92 = YEAR 95 = STILL IN HOSPITAL/NURSING HOME 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HSPNIT 036-038 HOW MANY NIGHTS WERE YOU IN THE HOSPITAL FOR THIS STAY? ________________________________________________________ + = INAPPLICABLE, CODED D2, D3, D4 OR D5 IN SFPART. 000 = NONE 001-120 = NIGHTS 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED SREASON1 039-040 PROVIDER SPECIALTY __________________ + = INAPPLICABLE, CODED D2, D3, D4 OR D5 IN SFPART 01-86 = USE CODES IN APPENDIX 15 91 = OTHER SPECIFIED 92 = RESPONSE DESCRIBES CONDITION, TREATMENT 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED SREASON2 041-042 ALWAYS BLANK ____________ + = ALWAYS BLANK SREASON3 043-044 ALWAYS BLANK ____________ + = ALWAYS BLANK SREASON4 045-046 ALWAYS BLANK ____________ + = ALWAYS BLANK (4) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ CON_CD (047-056) WHAT WAS THE CONDITION THAT LED YOU TO ENTER THE HOSPITAL? NOTE ABOUT MEDICAL CODES: MEDICAL CODES ARE STORED IN 5 COLUMN FIELDS. THE DECIMAL POINT IS IMPLIED BETWEEN THE THIRD AND FOURTH COLUMNS. AN X OR XX AT THE END OF A MEDICAL CODE IS USED AS (A) PLACE HOLDER(S). FOR EXAMPLE: THE CODE "41010" SHOULD BE READ AS "410.10"; THE CODE "VF29X" SHOULD BE READ AS "VF2.9"; THE CODE "311XX" SHOULD BE READ AS "311". CONCD1 047-051 CONDITION 1 ___________ CODER: CODES ASSIGNED BY MEDICAL CODERS USING INTERNATIONAL CLASSIFICATION OF DISEASE, 9TH REVISION, CLINICAL MODIFICATION, 3RD EDITION, 1989. + = INAPPLICABLE, CODED 03, 04, 97, 98 OR 99 IN SREASON1 FOR CORRESPONDING HOSPITAL STAY; OR CODED D2, D3, D4 OR D5 IN SFPART. AAAAA-ZZZZZ = ICD - 9-CM/CODES 00001-99990 = ICD - 9-CM/CODES 99997 = REFUSED 99998 = DK 99999 = NOT ASCERTAINED CONCD2 052-056 CONDITION 2 ___________ CODER: CODES ASSIGNED BY MEDICAL CODERS USING INTERNATIONAL CLASSIFICATION OF DISEASE, 9TH REVISION, CLINICAL MODIFICATION, 3RD EDITION, 1989. + = INAPPLICABLE, CODED 03, 04, 97, 98 OR 99 IN SREASON1 FOR CORRESPONDING HOSPITAL STAY; OR CODED D2, D3, D4 OR D5 IN SFPART; OR ONLY ONE CONDITION LISTED AAAAA-ZZZZZ = ICD - 9-CM/CODES 00001-99990 = ICD - 9-CM/CODES (5) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ PROCCD1 057-061 OPERATION/SURGICAL PROCEDURE 1 ______________________________ CODER: CODES ASSIGNED BY MEDICAL CODERS USING INTERNATIONAL CLASSIFICATION OF DISEASE, 9TH REVISION, CLINICAL MODIFICATION, 3RD EDITION, 1989. + = INAPPLICABLE, CODED 03, 04, 97, 98 OR 99 IN SREASON1 FOR CORRESPONDING HOSPITAL STAY; OR CODED D2, D3, D4 OR D5 IN SFPART. AAAAA-ZZZZZ = ICD - 9-CM/CODES 00001-99990 = ICD - 9-CM/CODES 99997 = REFUSED 99998 = DK 99999 = NOT ASCERTAINED PROCCD2 062-066 OPERATION/SURGICAL PROCEDURE 2 ______________________________ CODER: CODES ASSIGNED BY MEDICAL CODERS USING INTERNATIONAL CLASSIFICATION OF DISEASE, 9TH REVISION, CLINICAL MODIFICATION, 3RD EDITION, 1989. + = INAPPLICABLE, CODED 03, 04, 97, 98 OR 99 IN SREASON1 FOR CORRESPONDING HOSPITAL STAY; OR CODED D2, D3, D4 OR D5 IN SFPART; OR ONLY ONE PROCEDURE LISTED AAAAA-ZZZZZ = ICD - 9-CM/CODES 00001-99990 = ICD - 9-CM/CODES SHH_MED 067 ALWAYS BLANK ____________ + = ALWAYS BLANK SHH_PER 068 ALWAYS BLANK ____________ + = ALWAYS BLANK SHH_HOUS 069 ALWAYS BLANK ____________ + = ALWAYS BLANK SHH_COUN 070 ALWAYS BLANK ____________ + = ALWAYS BLANK (6) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ SHH_MEAL 071 ALWAYS BLANK ____________ + = ALWAYS BLANK SHH_OTH 072 ALWAYS BLANK ____________ + = ALWAYS BLANK OSCODE 073-074 ALWAYS BLANK ____________ + = ALWAYS BLANK SDRUGCD 075-078 ALWAYS BLANK ____________ + = ALWAYS BLANK SRE_EVNT 079-084 ALWAYS BLANK ____________ + = ALWAYS BLANK HRDYWK 085-087 ALWAYS BLANK ____________ + = ALWAYS BLANK SRE_DOL 088-093 HOW MUCH DID YOU OR WILL YOU PAY FOR THIS CARE? CODER: CODE AMOUNTS IN WHOLE DOLLARS. 000000 = NOTHING 000001-999996 = AMOUNT IN DOLLARS 999997 = REFUSED 999998 = DK 999999 = NOT ASCERTAINED (7) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ SRE_UC 094 ALWAYS BLANK ____________ + = ALWAYS BLANK SMELSPY 095 IS SOMEONE ELSE PAYING (AN ADDITIONAL AMOUNT) FOR THIS CARE? _____________________________________________________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP SRE_CAID - SRE_EOS WHOELSE (096-103) WHO ELSE IS PAYING FOR THIS CARE? (CODE ALL THAT APPLY.) CODER: AT LEAST ONE ITEM MUST BE CIRCLED. IF NONE ARE CIRCLED, CODE 9 FOR EACH ITEM. IF AT LEAST ONE IS CIRCLED, CODE 1 FOR ALL CIRCLED ITEM(S). CODE 2 FOR ALL UNCIRCLED ITEM(S). SRE_CAID 096 MEDICAID ________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN SMELSPY 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED SRE_PUB 097 OTHER PUBLIC ASSISTANCE _______________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN SMELSPY 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (8) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ SRE_PRVI 098 PRIVATE INSURANCE _________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN SMELSPY 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED SRE_CARE 099 MEDICARE ________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN SMELSPY 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED SRE_RES 100 ALWAYS BLANK ____________ + = ALWAYS BLANK SRE_OTHR 101 OTHER SPECIFIED _______________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN SMELSPY 1 = CIRCLED * 2 = NOT CIRCLED * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP SRE_EOS (9) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ SRE_EOS 102-103 OTHER SPECIFIED CODE ____________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN SMELSPY; OR CODED 2, 7, 8 OR 9 IN SRE_OTHR 01 = RESEARCH STUDY 03 = FLAT FEE 05 = GAY AIDS TASK FORCE/AIDS NETWORK 14 = FAMILY MEMBER/FRIEND 29 = COMMUNITY HEALTH PROJECT 46 = PROVIDER 47 = PRIVATE CHARITY 50 = DRUG COMPANY 91 = OTHER SPECIFIED 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED SRE_NOPY 104-105 WHY WAS THERE NO (ADDITIONAL) PAYMENT? _______________________________________ + = INAPPLICABLE, CODED 1 IN SMELSPY 01 = FREE FROM PROVIDER 02 = PAID IN FULL 03 = CAN'T AFFORD TO PAY 05 = RESEARCH STUDY 06 = GOVT AGENCY/GOVT FUNDED: LOCAL, CITY, COUNTY, STATE, FEDERAL 18 = INCLUDED IN OTHER FEE/FLAT FEE 91 = OTHER SPECIFIED 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED SBPS 106 ALWAYS BLANK ____________ + = ALWAYS BLANK (10) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ SHSTAYFG 107-110 UNIQUE STAY FLAG (DERIVED) __________________________ EACH REPORTED INPATIENT HOSPITAL AND NURSING HOME STAY IS ASSIGNED A UNIQUE STAY NUMBER USING THE VARIABLE SHSTAYFG. THE STAY NUMBERS ARE UNIQUE THROUGHOUT ALL SIX INTERVIEWS BUT THEY ARE NOT NECESSARILY ASSIGNED IN ORDER FROM THE FIRST STAY REPORTED TO THE LAST. THIS VARIABLE IS ALSO ASSIGNED TO ALL EVENTS IN THE SEPARATELY BILLING DOCTOR (SBD) FILES. A SEPARATELY BILLING DOCTOR OR "SEPARATE BILLING DOCTOR" IS ONE WHO PROVIDES CARE TO A PATIENT DURING AN INPATIENT OR NURSING HOME STAY BUT BILLS THE PATIENT SEPARATELY FOR SERVICES RENDERED. ANESTHESIOLOGISTS AND RADIOLOGISTS COMMONLY FALL INTO THIS CATEGORY. ALTHOUGH THE MAJORITY OF SBD'S ARE MEDICAL DOCTORS, THEY MAY ALSO INCLUDE OTHER TYPES OF MEDICAL PRACTITION INCLUSION OF SHSTAYFG ON THESE FILES ENABLES THE USER TO LINK AN SBD EVENT TO THE INPATIENT OR NURSING HOME STAY IN WHICH THE SERVICE WAS PROVIDED. 0001-9999 = STAY NUMBER ICTMFLG 111-116 ALWAYS BLANK ____________ + = ALWAYS BLANK ANOSTYF1 117-118 ALWAYS BLANK ____________ + = ALWAYS BLANK ANOSTYF2 121-124 ALWAYS BLANK ____________ + = ALWAYS BLANK AGE 125-126 ALWAYS BLANK ____________ + = ALWAYS BLANK EMPYD 127 ALWAYS BLANK ____________ + = ALWAYS BLANK (11) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HRSEPM 128-130 ALWAYS BLANK ____________ + = ALWAYS BLANK RELAT 131-132 ALWAYS BLANK ____________ + = ALWAYS BLANK INSURFLG 133 SOURCE OF PAYMENT FOR EVENT DISCREPANT WITH OVERALL INSURANCE COVERAGE (DERIVED) ________________________________________________________________________________ + = INAPPLICABLE 1 = SOP DISCREPANT WITH PATIENT'S OVERALL INSURANCE COVERAGE FOR THIS SFPART (12) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ INDEX OF VARIABLES PAGE 001 Variable Name Column Numbers Record Number Codebook Page No. ------------- -------------- ------------- ----------------- ===== A ===== AGE 125-126 Record 01 011 ANOSTYF1 117-118 Record 01 011 ANOSTYF2 121-124 Record 01 011 ===== C ===== CON_CD (047-056) Record 01 005 CONCD1 047-051 Record 01 005 CONCD2 052-056 Record 01 005 ===== E ===== EMPYD 127 Record 01 011 ===== H ===== HRDYWK 085-087 Record 01 007 HRSEPM 128-130 Record 01 012 HSPNIT 036-038 Record 01 004 ===== I ===== ICTMFLG 111-116 Record 01 011 INSURFLG 133 Record 01 012 ===== O ===== OSCODE 073-074 Record 01 007 ===== P ===== PATID 001-009 Record 01 001 PROCCD1 057-061 Record 01 006 PROCCD2 062-066 Record 01 006 PROVID 017-023 Record 01 002 ===== R ===== REC 010-011 Record 01 001 RELAT 131-132 Record 01 012 ===== S ===== SBPS 106 Record 01 010 SDRUGCD 075-078 Record 01 007 INDEX OF VARIABLES PAGE 002 Variable Name Column Numbers Record Number Codebook Page No. ------------- -------------- ------------- ----------------- ===== S ===== SFORM 014 Record 01 001 SFPART 015-016 Record 01 002 SHH_COUN 070 Record 01 006 SHH_HOUS 069 Record 01 006 SHH_MEAL 071 Record 01 007 SHH_MED 067 Record 01 006 SHH_OTH 072 Record 01 007 SHH_PER 068 Record 01 006 SHSTAYFG 107-110 Record 01 011 SMELSPY 095 Record 01 008 SRBEGDT (024-029) Record 01 002 SRBEGDY 026-027 Record 01 003 SRBEGMO 024-025 Record 01 002 SRBEGYR 028-029 Record 01 003 SRE_CAID 096 Record 01 008 SRE_CARE 099 Record 01 009 SRE_DOL 088-093 Record 01 007 SRE_EOS 102-103 Record 01 010 SRE_EVNT 079-084 Record 01 007 SRE_NOPY 104-105 Record 01 010 SRE_OTHR 101 Record 01 009 SRE_PRVI 098 Record 01 009 SRE_PUB 097 Record 01 008 SRE_RES 100 Record 01 009 SRE_UC 094 Record 01 008 SREASON1 039-040 Record 01 004 SREASON2 041-042 Record 01 004 SREASON3 043-044 Record 01 004 SREASON4 045-046 Record 01 004 SRENDDT (030-035) Record 01 003 SRENDDY 032-033 Record 01 003 SRENDMO 030-031 Record 01 003 SRENDYR 034-035 Record 01 004 SSUBREC 012-013 Record 01 001 ===== W ===== WHOELSE (096-103) Record 01 008