

Skilled Nursing Facility RIF

Source

https://www.resdac.org/cms-data/files/snf-encounter

Overview

The Skilled Nursing Facility (SNF) file contains final action, fee-for-service, claims data submitted by SNF providers.

This file includes:

• diagnosis (ICD-9 diagnosis), and
• procedure (ICD-9 procedure code),
• dates of service,
• reimbursement amount,
• SNF provider number, and
• beneficiary demographic information.

Availability: CY 1999 - 2015

The 12-month run-off final action claims for 2016 will be available in the beginning of 2018.

Data Documentation

Skilled Nursing Facility RIF

Index	SAS Name	Variable Name	Limitation	Code Table
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID	*
3	RIC_CD	NCH Near Line Record Identification Code		*
4	CLM_TYPE	NCH Claim Type Code		*
5	FROM_DT	Claim From Date
6	THRU_DT	Claim Through Date
7	WKLY_DT	NCH Weekly Claim Processing Date
8	FI_CLM_PROC_DT	FI Claim Process Date
9	QUERY_CD	Claim Query Code		*
10	PROVIDER	Provider Number		*
11	FAC_TYPE	Claim Facility Type Code		*
12	TYPESRVC	Claim Service Classification Type Code		*
13	FREQ_CD	Claim Frequency Code		*
14	FI_NUM	FI Number		*
15	NOPAY_CD	Claim Medicare Non Payment Reason Code		*
16	PMT_AMT	Claim Payment Amount	*
17	PRPAYAMT	NCH Primary Payer Claim Paid Amount*
18	PRPAY_CD	NCH Primary Payer Code		*
19	ACTIONCD	FI or MAC Claim Action Code		*
20	PRSTATE	NCH Provider State Code		*
21	ORGNPINM	Organization NPI Number
22	AT_UPIN	Claim Attending Physician UPIN Number
23	AT_NPI	Claim Attending Physician NPI Number
24	AT_PHYSN_SPCLTY_CD	Claim Attending Physician Specialty Code		*
25	OP_UPIN	Claim Operating Physician UPIN Number
26	OP_NPI	Claim Operating Physician NPI Number
27	OT_NPI	Claim Other Physician NPI Number
28	OT_UPIN	Claim Other Physician UPIN Number
29	OP_PHYSN_SPCLTY_CD	Claim Operating Physician Specialty Code		*
30	OT_PHYSN_SPCLTY_CD	Claim Other Physician Specialty Code		*
31	RNDRNG_PHYSN_NPI	Claim Rendering Physician NPI Number
32	RNDRNG_PHYSN_SPCLTY_CD	Claim Rendering Physician Specialty Code		*
33	MCOPDSW	Claim MCO Paid Switch	*	*
34	STUS_CD	Patient Discharge Status Code		*
35	PPS_IND	Claim PPS Indicator Code		*
36	TOT_CHRG	Claim Total Charge Amount	*	*
37	ADMSN_DT	Claim Admission Date
38	TYPE_ADM	Claim Inpatient Admission Type Code		*
39	SRC_ADMS	Claim Source Inpatient Admission Code		*
40	PTNTSTUS	NCH Patient Status Indicator Code		*
41	DED_AMT	NCH Beneficiary Inpatient Deductible Amount		*
42	COIN_AMT	NCH Beneficiary Part A Coinsurance Liability Amount		*
43	BLDDEDAM	NCH Beneficiary Blood Deductible Liability Amount		*
44	NCCHGAMT	NCH Inpatient Noncovered Charge Amount		*
45	TDEDAMT	NCH Inpatient Total Deduction Amount		*
46	CPTL_FSP	Claim PPS Capital FSP Amount		*
47	CPTLOUTL	Claim PPS Capital Outlier Amount		*
48	DISP_SHR	Claim PPS Capital Disproportionate Share Amount
49	IME_AMT	Claim PPS Capital IME Amount
50	CPTL_EXP	Claim PPS Capital Exception Amount		*
51	HLDHRMLS	Claim PPS Old Capital Hold Harmless Amount
52	UTIL_DAY	Claim Utilization Day Count
53	COIN_DAY	Beneficiary Total Coinsurance Days Count
54	NUTILDAY	Claim Non Utilization Days Count
55	BLDFRNSH	NCH Blood Pints Furnished Quantity
56	QLFYFROM	NCH Qualified Stay From Date
57	QLFYTHRU	NCH Qualify Stay Through Date
58	NCOVFROM	NCH Verified Noncovered Stay From Date
59	NCOVTHRU	NCH Verified Noncovered Stay Through Date
60	CARETHRU	NCH Active or Covered Level Care Thru Date
61	EXHST_DT	NCH Beneficiary Medicare Benefits Exhausted Date
62	DSCHRGDT	NCH Beneficiary Discharge Date
63	DRG_CD	Claim Diagnosis Related Group Code
64	ADMTG_DGNS_CD	Claim Admitting Diagnosis Code
65	PRNCPAL_DGNS_CD	Claim Principal Diagnosis Code
66	ICD_DGNS_CD1	Claim Diagnosis Code I
67	ICD_DGNS_CD2	Claim Diagnosis Code II
68	ICD_DGNS_CD3	Claim Diagnosis Code III
69	ICD_DGNS_CD4	Claim Diagnosis Code IV
70	ICD_DGNS_CD5	Claim Diagnosis Code V
71	ICD_DGNS_CD6	Claim Diagnosis Code VI
72	ICD_DGNS_CD7	Claim Diagnosis Code VII
73	ICD_DGNS_CD8	Claim Diagnosis Code VIII
74	ICD_DGNS_CD9	Claim Diagnosis Code IX
75	ICD_DGNS_CD10	Claim Diagnosis Code X
76	ICD_DGNS_CD11	Claim Diagnosis Code XI
77	ICD_DGNS_CD12	Claim Diagnosis Code XII
78	ICD_DGNS_CD13	Claim Diagnosis Code XIII
79	ICD_DGNS_CD14	Claim Diagnosis Code XIV
80	ICD_DGNS_CD15	Claim Diagnosis Code XV
81	ICD_DGNS_CD16	Claim Diagnosis Code XVI
82	ICD_DGNS_CD17	Claim Diagnosis Code XVII
83	ICD_DGNS_CD18	Claim Diagnosis Code XVIII
84	ICD_DGNS_CD19	Claim Diagnosis Code XIX
85	ICD_DGNS_CD20	Claim Diagnosis Code XX
86	ICD_DGNS_CD21	Claim Diagnosis Code XXI
87	ICD_DGNS_CD22	Claim Diagnosis Code XXII
88	ICD_DGNS_CD23	Claim Diagnosis Code XXIII
89	ICD_DGNS_CD24	Claim Diagnosis Code XXIV
90	ICD_DGNS_CD25	Claim Diagnosis Code XXV
91	FST_DGNS_E_CD	First Claim Diagnosis E Code
92	ICD_DGNS_E_CD1	Claim Diagnosis E Code I
93	ICD_DGNS_E_CD2	Claim Diagnosis E Code II
94	ICD_DGNS_E_CD3	Claim Diagnosis E Code III
95	ICD_DGNS_E_CD4	Claim Diagnosis E Code IV
96	ICD_DGNS_E_CD5	Claim Diagnosis E Code V
97	ICD_DGNS_E_CD6	Claim Diagnosis E Code VI
98	ICD_DGNS_E_CD7	Claim Diagnosis E Code VII
99	ICD_DGNS_E_CD8	Claim Diagnosis E Code VIII
100	ICD_DGNS_E_CD9	Claim Diagnosis E Code IX
101	ICD_DGNS_E_CD10	Claim Diagnosis E Code X
102	ICD_DGNS_E_CD11	Claim Diagnosis E Code XI
103	ICD_DGNS_E_CD12	Claim Diagnosis E Code XII
104	ICD_PRCDR_CD1	Claim Procedure Code I
105	PRCDR_DT1	Claim Procedure Code I Date
106	ICD_PRCDR_CD2	Claim Procedure Code II
107	PRCDR_DT2	Claim Procedure Code II Date
108	ICD_PRCDR_CD3	Claim Procedure Code III
109	PRCDR_DT3	Claim Procedure Code III Date
110	ICD_PRCDR_CD4	Claim Procedure Code IV
111	PRCDR_DT4	Claim Procedure Code IV Date
112	ICD_PRCDR_CD5	Claim Procedure Code V
113	PRCDR_DT5	Claim Procedure Code V Date
114	ICD_PRCDR_CD6	Claim Procedure Code VI
115	PRCDR_DT6	Claim Procedure Code VI Date
116	ICD_PRCDR_CD7	Claim Procedure Code VII
117	PRCDR_DT7	Claim Procedure Code VII Date
118	ICD_PRCDR_CD8	Claim Procedure Code VIII
119	PRCDR_DT8	Claim Procedure Code VIII Date
120	ICD_PRCDR_CD9	Claim Procedure Code IX
121	PRCDR_DT9	Claim Procedure Code IX Date
122	ICD_PRCDR_CD10	Claim Procedure Code X
123	PRCDR_DT10	Claim Procedure Code X Date
124	ICD_PRCDR_CD11	Claim Procedure Code XI
125	PRCDR_DT11	Claim Procedure Code XI Date
126	ICD_PRCDR_CD12	Claim Procedure Code XII
127	PRCDR_DT12	Claim Procedure Code XII Date
128	ICD_PRCDR_CD13	Claim Procedure Code XIII
129	PRCDR_DT13	Claim Procedure Code XIII Date
130	ICD_PRCDR_CD14	Claim Procedure Code XIV
131	PRCDR_DT14	Claim Procedure Code XIV Date
132	ICD_PRCDR_CD15	Claim Procedure Code XV
133	PRCDR_DT15	Claim Procedure Code XV Date
134	ICD_PRCDR_CD16	Claim Procedure Code XVI
135	PRCDR_DT16	Claim Procedure Code XVI Date
136	ICD_PRCDR_CD17	Claim Procedure Code XVII
137	PRCDR_DT17	Claim Procedure Code XVII Date
138	ICD_PRCDR_CD18	Claim Procedure Code XVIII
139	PRCDR_DT18	Claim Procedure Code XVIII Date
140	ICD_PRCDR_CD19	Claim Procedure Code XIX
141	PRCDR_DT19	Claim Procedure Code XIX Date
142	ICD_PRCDR_CD20	Claim Procedure Code XX
143	PRCDR_DT20	Claim Procedure Code XX Date
144	ICD_PRCDR_CD21	Claim Procedure Code XXI
145	PRCDR_DT21	Claim Procedure Code XXI Date
146	ICD_PRCDR_CD22	Claim Procedure Code XXII
147	PRCDR_DT22	Claim Procedure Code XXII Date
148	ICD_PRCDR_CD23	Claim Procedure Code XXIII
149	PRCDR_DT23	Claim Procedure Code XXIII Date
150	ICD_PRCDR_CD24	Claim Procedure Code XXIV
151	PRCDR_DT24	Claim Procedure Code XXIV Date
152	ICD_PRCDR_CD25	Claim Procedure Code XXV
153	PRCDR_DT25	Claim Procedure Code XXV Date
154	DOB_DT	Date of Birth from Claim (Date)
155	GNDR_CD	Gender Code from Claim		*
156	RACE_CD	Race Code from Claim		*
157	CNTY_CD	County Code from Claim (SSA)
158	STATE_CD	State Code from Claim (SSA)		*
159	ZIP_CD	Zip Code of Residence from Claim
160	CLM_MDCL_REC	Claim Medical Record Number
161	CLM_TRTMT_AUTHRZTN_NUM	Claim Treatment Authorization Number		*
170	ACO_ID_NUM	Claim Accountable Care Organization (ACO) Identification Number

Revenue Center File

Index	SAS Name	Variable Name	Limitation	Code Table
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID	*
3	THRU_DT	Claim Through Date
4	CLM_LN	Claim Line Number
5	CLM_TYPE	NCH Claim Type Code		*
6	REV_CNTR	Revenue Center Code		*
7	HCPCS_CD	Revenue Center HCFA Common Procedure Coding System
8	MDFR_CD1	HCPCS Initial Modifier Code
9	MDFR_CD2	HCPCS Second Modifier Code
10	MDFR_CD3	HCPCS Third Modifier Code
11	REV_UNIT	Revenue Center Unit Count
12	REV_RATE	Revenue Center Rate Amount
13	REV_CHRG	Revenue Center Total Charge Amount	*	*
14	REV_NCVR	Revenue Center Non-Covered Charge Amount		*
15	REVDEDCD	Revenue Center Deductible Coinsurance Code		*
16	REV_CNTR_NDC_QTY	Revenue Center NDC Quantity
17	REV_CNTR_NDC_QTY_QLFR_CD	Revenue Center NDC Quantity Qualifier Code		*
18	RNDRNG_PHYSN_UPIN	Revenue Center Rendering Physician UPIN
19	RNDRNG_PHYSN_NPI	Revenue Center Rendering Physician NPI
20	RNDRNG_PHYSN_SPCLTY_CD	Rendering Physician Specialty Code		*
21	IDENDC	Revenue Center IDE, NDC, or UPC Number
22	REV_CNTR_PRCNG_IND_CD	Revenue Center Pricing Indicator Code		*
23	THRPY_CAP_IND_CD1	Revenue Center Therapy Cap Indicator 1 Code		*
24	THRPY_CAP_IND_CD2	Revenue Center Therapy Cap Indicator 2 Code		*

Condition Code File

Index	SAS Name	Variable Name	Limitation	Code Table
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID	*
3	CLM_TYPE	NCH Claim Type Code		*
4	RLTCNDSQ	Claim Related Condition Code Sequence
5	RLT_COND	Claim Related Condition Code		*

Occurence Code File

Index	SAS Name	Variable Name	Limitation	Code Table
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID	*
3	CLM_TYPE	NCH Claim Type Code		*
4	RLTOCRSQ	Claim Related Occurrence Code Sequence
5	OCRNC_CD	Claim Related Occurrence Code		*
6	OCRNCDT	Claim Related Occurrence Date

Span Code File

Index	SAS Name	Variable Name	Limitation	Code Table
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID	*
3	CLM_TYPE	NCH Claim Type Code		*
4	RLTSPNSQ	Claim Related Span Code Sequence
5	SPAN_CD	Claim Occurrence Span Code		*
6	SPANFROM	Claim Occurrence Span From Date
7	SPANTHRU	Claim Occurrence Span Through Date

Value Code File

Index	SAS Name	Variable Name	Limitation	Code Table
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID	*
3	CLM_TYPE	NCH Claim Type Code		*
4	RLTVALSQ	Claim Related Value Code Sequence
5	VAL_CD	Claim Value Code		*
6	VAL_AMT	Claim Value Amount		*

Demonstrations/Innovations Code File

Index	SAS Name	Variable Name	Limitation	Code Table
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID	*
3	CLM_TYPE	NCH Claim Type Code		*
4	DEMO_ID_SQNC_NUM	Demonstration sequence number
5	DEMO_ID_NUM	Demonstration number		*
6	DEMO_INFO_TXT	Demo information text