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Claim Total PPS Capital Amount

CLM_MDCR_IP_PPS_CPTL_TOT_AMT

THE TOTAL AMOUNT THAT IS PAYABLE FOR CAPITAL PPS FOR THE CLAIM. THIS IS THE SUM OF THE CAPITAL HOSPITAL SPECIFIC PORTION, FEDERAL SPECIFIC PORTION, OUTLIER PORTION, DISPROPORTIONATE SHARE PORTION, INDIRECT MEDICAL EDUCATION PORTION, EXCEPTION PAYMENTS, AND HOLD HARMLESS PAYMENTS. [NCH]

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath 
ExplanationOfBenefit.adjudication.where(
  category.coding.where(
    system = 'https://bluebutton.cms.gov/fhir/CodeSystem/Adjudication' and
      code = 'CLM_MDCR_IP_PPS_CPTL_TOT_AMT'
  ).exists()
).amount.value
Coverage / Claim Type
  • Inpatient
  • SNF
Source View
V2_MDCR_CLM_INSTNL
Source Column
CLM_MDCR_IP_PPS_CPTL_TOT_AMT
Sources
  • FISS
  • NCH
Profiles
  • CMS

Example 

11.11

Mappings

CCW
  • CLM_TOT_PPS_CPTL_AMT

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