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Operating Disproportionate Share Amount

This is one component of the total amount that is payable on prospective payment system (PPS) claims and reflects the DSH (disproportionate share hospital) payments for operating expenses (such as labor) for the claim. NOTE: This field is a sum of the CLM_VAL.CLM_VAL_AMT amounts where CLM_VAL_CD is the disproportionate share code.

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath 
ExplanationOfBenefit.adjudication.where(
  category.coding.where(
    system = 'https://bluebutton.cms.gov/fhir/CodeSystem/Adjudication' and
      code = 'CLM_OPRTNL_DSPRTNT_AMT'
  ).exists()
).amount.value
Coverage / Claim Type
  • Inpatient
Sources
  • FISS
  • NCH
Derived
True
Profiles
  • CMS

Example 

14.14

Mappings

CCLF
  • CCLF1.CLM_OPRTNL_DSPRPRTNT_AMT
CCW
  • DSH_OP_CLM_VAL_AMT

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