Utilization Flags

<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"> <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"> <html lang="en"> <head><script type="text/javascript" src="/_static/js/bundle-playback.js?v=HxkREWBo" charset="utf-8"></script> <script type="text/javascript" src="/_static/js/wombat.js?v=txqj7nKC" charset="utf-8"></script> <script>window.RufflePlayer=window.RufflePlayer||{};window.RufflePlayer.config={"autoplay":"on","unmuteOverlay":"hidden"};</script> <script type="text/javascript" src="/_static/js/ruffle/ruffle.js"></script> <script type="text/javascript"> __wm.init("https://web.archive.org/web"); __wm.wombat("http://www.hcup-us.ahrq.gov/toolssoftware/util_flags/utilflag.jsp","20150905212913","https://web.archive.org/","web","/_static/", "1441488553"); </script> <link rel="stylesheet" type="text/css" href="/_static/css/banner-styles.css?v=S1zqJCYt" /> <link rel="stylesheet" type="text/css" href="/_static/css/iconochive.css?v=3PDvdIFv" />  <title>Utilization Flags</title> <link rel="stylesheet" href="/web/20150905212913cs_/http://www.hcup-us.ahrq.gov/HCUP_US.css"> <meta name="keywords" content="hcup, healthcare cost and utilization project, health, healthcare, health statistics, data analysis, analysis, data collection, data processing, databases, research"> <link rel="icon" type="image/vnd.microsoft.icon" href="/web/20150905212913im_/http://www.hcup-us.ahrq.gov/HCUPnetTree.ico" sizes="16x16 32x32 48x48 64x64"> <link rel="shortcut icon" href="/web/20150905212913im_/http://www.hcup-us.ahrq.gov/toolssoftware/util_flags/images/favicon.ico"/>  <script type="text/javascript"> var steering = false; var team = false; var partner = false; var nhqrdr = false; </script> <script type="text/javascript" src="/web/20150905212913js_/http://www.hcup-us.ahrq.gov/menu/c_config.js"></script> <script type="text/javascript" src="/web/20150905212913js_/http://www.hcup-us.ahrq.gov/menu/c_smartmenus.js"></script>  </head> <body> <div id="skipmenu"> <a href="#skip" class="skippy">Skip Navigation</a> <a name="top"></a> </div> <div id="hideShow"> <table summary="layout" width="100%" cellspacing="2" cellpadding="0" border="0"> <tr> <td align="center" class="logoPanel" bgcolor="#006699"> <div id="logo"> <a href="/web/20150905212913/http://www.hcup-us.ahrq.gov/"><img src="/web/20150905212913im_/http://www.hcup-us.ahrq.gov/images/HCUP_logo/hcuplogo_smaller_final.jpg" alt="Healthcare Cost and Utilization Project logo"></a> </div> </td> <td bgcolor="#66cccc" class="bannerPanel"><br> <div class="bannertitleinteriorpgs">Utilization Flags</div> <div class="bannertext">Utilization Flag software is one of the HCUP tools that can be applied to HCUP and other similar databases. These tools are created by AHRQ through a Federal-State-Industry partnership.</div> </td> <td bgcolor="#66cccc" valign="middle" class="searchPanel"> <form method="get" action="/web/20150905212913/http://www.hcup-us.ahrq.gov/search/Search.action"> <table cellpadding="0px" cellspacing="0px"> <tr> <td class="searchBox"> <input type="text" name="query"> </td> <td valign="middle" class="searchIcon"> <input type="image" src="/web/20150905212913im_/http://www.hcup-us.ahrq.gov/images/search-icon2.png" placeholder="Search" alt="search" class="search-icon" title="Search" width="10" height="11"> </td> </tr> </table> </form> </td> </tr> <tr> <td width="122" bgcolor="#66cccc"> </td> <td width="100%" colspan="2"><ul id="Menu1" class="MM"> <li><a href="/web/20150905212913/http://www.hcup-us.ahrq.gov/"><br/>Home</a> <ul> <li><a class="NOLINK">What is HCUP?</a> <ul> <li><a href="/web/20150905212913/http://www.hcup-us.ahrq.gov/overview.jsp">Overview of HCUP</a></li> <li><a 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HCUP databases, tools, and software inform decision making at the national, State, and community levels. <br><br> Contents:<a name="return"></a> <ul> <li><a href="#overview">Overview of Utilization Flags</a></li> <li><a href="#purpose">Purpose</a></li> <li><a href="#description">Description</a></li> <li><a href="#data">Data Elements Required for Assigning the Utilization Flags</a></li> <li><a href="#download">Downloading Information</a></li> <li><a href="#questions">Questions?</a></li> </ul> </div> </td></tr> <tr><td> </td></tr> <tr><td> <div class="texttitle"><a name="overview">Overview of Utilization Flags</a></div><div class="pagetext"> <br> The Utilization Flag software creates 30 data elements that reveal additional information about use of health care services. By combining information from ICD-9-CM procedure codes and Uniform Billing (UB-04) revenue codes, it is possible to obtain a more complete picture of utilization of services rendered in health care settings such as hospitals, emergency departments, and ambulatory surgery centers. <br><br> This documentation provides an overview of the following: <ul> <li>The different types of utilization flags </li> <li>Data elements required for assigning the utilization flags </li> <li>Downloadable, electronic files that contain the SAS and SPSS programs to create the utilization flags.</li> </ul> Detailed documentation is available under the HCUP Methods Series Report 2006-04 <a href="/web/20150905212913/http://www.hcup-us.ahrq.gov/reports/methods/2006_4.pdf" target="_blank">Development of Utilization Flags for Use with UB-92 Administrative Data </a>(PDF file, 258 KB) and accompanying <a href="/web/20150905212913/http://www.hcup-us.ahrq.gov/reports/methods/2006_4_appendice.pdf" target="_blank">Appendices: A-F</a> (PDF file, 452 KB). This Methods Series details the initial development of the utilization flags. Revenue code categories are reviewed annually and updated as appropriate. </div></td></tr> <tr><td> </td></tr> <tr><td align="left" class="pagetext"><a href="#return">Return to Contents</a></td></tr> <tr><td> </td></tr> <tr><td> <div class="texttitle"><a name="purpose">Purpose</a></div><div class="pagetext"> <br> The Utilization Flags can be employed to study issues such as use of intensive care units and to more reliably examine utilization of diagnostic and therapeutic services, beyond the information that can be gleaned from ICD-9-CM procedure codes. A broad range of services, from simple diagnostic tests to resource-intense procedures, occur in the inpatient and outpatient hospital setting. In administrative health care data based on claims, use of services may be reported using ICD-9-CM procedure codes, charges to the revenue centers of the hospital in which services were performed, or both. ICD-9-CM procedure codes provide information on health care services, but there is concern about under-reporting certain procedures, such as non-invasive, diagnostic services. In addition, ICD-9-CM codes do not provide information on some services, such as stays in intensive care units (ICU) and psychiatric units. UB-04 revenue codes identify services and accommodations using revenue codes that are accompanied by charge information specific to the revenue center. Detailed charges based on revenue codes provide additional evidence that the patient received a specific service. </div></td></tr> <tr><td> </td></tr> <tr><td align="left" class="pagetext"><a href="#return">Return to Contents</a></td></tr> <tr><td> </td></tr> <tr><td> <div class="texttitle"><a name="description">Description</a></div><div class="pagetext"> <br> Using a combination of the UB-04 revenue codes, ICD-9-CM procedure codes, and Clinical Classifications Software (CCS) procedure categories, 30 utilization flags were developed for a range of services. The following table lists the flags by type:</div> <br><br> <table width="75%" class="pagetext" align="center" border="1" cellspacing="2" cellpadding="2"> <tr> <td colspan="2" align="center"><strong>Utilization Flags</strong></td> </tr> <tr> <td colspan="2"><strong>Accommodation</strong></td> </tr> <tr> <td>     Intensive Care Unit (ICU)</td> <td>Coronary Care Unit (CCU)</td> </tr> <tr> <td>     Newborn Level II</td> <td>Newborn Level III</td> </tr> <tr> <td>     Newborn Level IV</td> <td> </td> </tr> <tr> <td colspan="2"><strong>Cardiac Services</strong></td> </tr> <tr> <td>     Cardiac Catheterization Lab</td> <td>Cardiac Stress Test</td> </tr> <tr> <td>     Echocardiogram</td> <td>Electrocardiogram (EKG)</td> </tr> <tr> <td colspan="2"><strong>Imaging and Diagnostic Tests</strong></td> </tr> <tr> <td>     Computed Tomography (CT) Scan</td> <td>Chest X-Ray</td> </tr> <tr> <td>     Electroencephalogram (EEG)</td> <td>Ultrasound</td> </tr> <tr> <td>     Magnetic Resonance Technology (MRT)</td> <td>Nuclear Medicine</td> </tr> <tr> <td colspan="2"><strong>Devices</strong></td> </tr> <tr> <td>     Pacemaker</td> <td>Other Implants</td> </tr> <tr> <td colspan="2"><strong>Therapeutic Services</strong></td> </tr> <tr> <td>     Lithotripsy</td> <td>Occupational Therapy</td> </tr> <tr> <td>     Physical Therapy </td> <td>Respiratory Therapy</td> </tr> <tr> <td>     Therapeutic Radiology and Chemotherapy </td> <td>Renal Dialysis</td> </tr> <tr> <td>     Speech-Language Pathology </td> <td>Erythropoietin (EPO)</td> </tr> <tr> <td>     Mental Health and Substance Abuse </td> <td>Blood</td> </tr> <tr> <td colspan="2"><strong>Other</strong></td> </tr> <tr> <td>     Emergency Department</td> <td>Observation Room</td> </tr> <tr> <td>     Organ Acquisition </td> <td> </td> </tr> </table> </div></td></tr> <tr><td> </td></tr> <tr><td align="left" class="pagetext"><a href="#return">Return to Contents</a></td></tr> <tr><td> </td></tr> <tr><td> <div class="texttitle"><a name="data">Data Elements Required for Assigning the Utilization Flags</a></div> <div class="pagetext"> <br> Both SAS and SPSS programs are available for assigning the utilization flags to administrative databases. The following table lists the required data elements. <br><br> <strong>Data Elements Required for Assigning the Utilization Flags</strong></div> <br> <table width="90%" class="pagetext" border="1" cellspacing="2" cellpadding="2"> <tr> <td><strong>Data Elements</strong></td> <td><strong>Description</strong></td> </tr> <tr> <td>KEY</td> <td>Unique record identifier</td> </tr> <tr> <td>REVCD1-REVCDn</td> <td>Array of dimension n of four-character UB-04 revenue codes, including the leading zero. The assignment program allows the user to specify the length of the array. UB-04 revenue codes are updated by National Uniform Billing Committee. The Utilization Flag software is valid for revenue codes beginning October 1993.</td> </tr> <tr> <td>PR1-PRn</td> <td>Array of dimension n of ICD-9-CM procedure codes, decimals removed. The assignment program allows the user to specify the length of the array. The ICD-9-CM codes are revised every October. New codes are added, existing codes are deleted, and definitions of current codes are changed. The Utilization Flag software is valid for ICD-9-CM procedure codes beginning October 1993. </td> </tr> <tr> <td>PRCCS1-PRCCSn</td> <td>Array of dimension n of AHRQ CCS procedure categories. The length of the array must be the same as the length of the ICD-9-CM procedure array. The program to assign the procedure CCS is available at <a href="/web/20150905212913/http://www.hcup-us.ahrq.gov/tools_software.jsp">http://www.hcup-us.ahrq.gov/tools_software.jsp.</a></td> </tr> <tr> <td>NPR</td> <td>NPR indicates the total number of ICD-9-CM procedure codes reported on the discharge record. For example, if a discharge record has five procedures reported, then NPR equals five. The value on NPR is never larger than the dimension of the array of ICD-9-CM procedures.</td> </tr> </table> <div class="pagetext"> <br><br> The SAS utilization flag assignment program allows the revenue codes either to be included in the same file as the procedure codes and CCS, or to be in a separate file. In the HCUP State databases available for purchase through the <a href="/web/20150905212913/http://www.hcup-us.ahrq.gov/tech_assist/centdist.jsp">HCUP Central Distributor,</a> the revenue codes are stored in a separate file. The SPSS version of the program requires that the revenue codes be included in the same file as the procedure codes. The SAS and SPSS programs assign the 30 utilization flags, output the resulting data set, and calculate summary and detailed statistics for each flag. </div></td></tr> <tr><td> </td></tr> <tr><td align="left" class="pagetext"><a href="#return">Return to Contents</a></td></tr> <tr><td> </td></tr> <tr><td> <div class="texttitle"><a name="download">Downloading Information</a></div><div class="pagetext"> <br> <strong>Note: There are no new revenue or procedure codes for FY 2014.</strong> <br><br> <strong>Shift-click from this Web page:</strong> Your browser should support loading the software for Utilization Flags and the technical documentation from this Web page. To download the files from this Web page, click on the following links with the right mouse button and select "Save Link As" (Netscape) or "Save Target As" (Internet Explorer). After saving a file, find the file by using Windows® Explorer (Windows® 98/95/NT) or File Manager (Windows® 3.x) and then open it by double-clicking on it. <br><br> <i>Detailed Description of the Utilization Flags</i> <ul> Methods Series Report #2006-04 <a href="/web/20150905212913/http://www.hcup-us.ahrq.gov/reports/methods/2006_4.pdf" target="_blank">Development of Utilization Flags for Use with UB-92 Administrative Data</a> (PDF file, 258 KB)<br> <a href="/web/20150905212913/http://www.hcup-us.ahrq.gov/reports/methods/2006_4_appendice.pdf" target="_blank">Appendices: A-F</a> (PDF file, 452 KB). This Methods Series details the initial development of the utilization flags. Revenue code categories included in the SAS and SPSS programs are reviewed annually and updated as appropriate. </ul> <i>Software Program Files</i> <ul> <a href="SASUtilizationFlagsPGMJuly2013.zip">SAS software programs</a> (in ZIP format).<br> <a href="SPSSUtilizationFlagsPGMJuly2013.zip">SPSS software programs</a> (in ZIP format). </ul> </div></td></tr> <tr><td align="left" class="pagetext"><a href="#return">Return to Contents</a></td></tr> <tr><td> </td></tr> <tr><td> <div class="texttitle"><a name="questions">Questions?</a></div><div class="pagetext"> <br> Questions regarding the Utilization Flag software may be directed to HCUP User Support through the following channels: <ul> <li>e-mail: <a href="https://web.archive.org/web/20150905212913/mailto:hcup@ahrq.gov">hcup@ahrq.gov</a></li> <li>Phone (toll free): 1-866-290-HCUP. </li> </ul> </div></td></tr> <tr><td> </td></tr> <tr><td align="left" class="pagetext"><a href="#return">Return to Contents</a></td></tr> <tr><td> </td></tr> </table> <hr width="75%" align="center" class="hrruleblue"> <table width="100%"> <tr> <td align="center" class="citationtext"> Internet Citation: Utilization Flags. Healthcare Cost and Utilization Project (HCUP). June 2015. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/toolssoftware/util_flags/utilflag.jsp. </td> </tr> <tr> <td align="center" class="citationtext"> <a href="/web/20150905212913/http://www.hcup-us.ahrq.gov/viewing_prntg.jsp">Are you having problems viewing or printing pages on this Website?</a> </td> </tr> <tr> <td align="center" class="citationtext"> If you have comments, suggestions, and/or questions, please contact <a href="https://web.archive.org/web/20150905212913/mailto:hcup@ahrq.gov">hcup@ahrq.gov.</a> </td> </tr> <tr> <td align="center" class="citationtext"> <a href="https://web.archive.org/web/20150905212913/http://www.ahrq.gov/policy/electronic/privacy/index.html" target="_blank">Privacy Notice</a>, <a href="https://web.archive.org/web/20150905212913/http://www.hhs.gov/plugins.html" target="_blank">Viewers & Players</a> </td> </tr> <tr> <td align="center" class="citationtext">Last modified 6/8/15</td> </tr> </table> </body> </html>

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