>> Okay. So, first I want to go through the base claim file portion and
talk about what useful information there might be there. Well, first of
all, the encrypted BENE_ID which you will use to link across records for
the same individual. Then, the beneficiary demographics are in the carrier
file up until a few years ago, they were not. They were only in the
beneficiary summary file, and so you had to do the link to get the
demographics into the carrier file. But now, all of this demographic
information is in the base claim file portion of the carrier file. There’s
information about the claim because in addition to those dates I showed
you for each line item, a claim may spend more than one day. So, there’s
a claim from-date and a claim through date, and we’ll see this in the
exercise. Not every claim is for one day, and obviously not only for one
I mentioned earlier the claim diagnosis codes but now, after–beginning
in 2007, there are up to eight diagnoses. Thank goodness. They’re still
ICD-9-CM codes. I really do plan to retire before the data have the ICD-10
codes. I just can’t handle it. I don’t know about you. How many of you
were–how shall I phrase it? The whole world is using ICD-10 codes, right?
I mean, who uses ICD-10 codes in the United States? What large government
organization? Who? The VA? No. The VA is still ICD-9. The CDC and the
National Center for Health Statistics, all the death data has been coded
in ICD-10 since 1998. The world uses ICD-10, okay? So CMS is only now
14 years behind, but I’m not saying bad things because the change is so
radical, I mean, you’re used to seeing if you know the ICD-9 codes to seeing
numbers, now they have alphanumerics. So when I look up pneumonia, my
favorite 481, I don’t know where it is. It’s I–I don’t even remember.
But, yeah. So the transition is going to be, you know, difficult and I
really do plan to retire before the CMS data are available for 2014.
I was going to mention, one or the–oh, I know, a political story. I was
thinking not to do any but I just remembered, the change from ICD-9 to ICD-10
will cost money, right? I mean, there will be a–there’s going to be a
big disruption. There was a period I would say like six months ago where
there were some news stories where the Republicans, bless their heart, were
blaming Obama for adopting ICD-10. Now, the whole world, you know,
Zimbabwe, Albania, everybody uses ICD-10, and parts of our own government
do. But Obama was getting criticized for causing additional expenditures
by adopting ICD-10. The world gets crazy.
Okay, the final thing I would note here because you will see this frequently
is there’s this funny diagnosis of XX000, and that’s for a laboratory test.
So, again, don’t get thrown by that if you see it today or when you go home.
Yes, a good question. The question is if a claim from and the claim through
date are different, is it possible to find out actually when the test was
done? Yes, because the test will be a line item. And the line item will
have a claim from and a claim through date and those will be the same, okay?
And we’ll see this afternoon how infrequently they are different. And
there are times when they may be different, but I won’t tell you why because
I want you to tell me during the exercise. But yes, you could find a precise
date of a laboratory test when you’ve got a claim that spans a period, okay?
Any other comments or questions?