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Claim PPS Capital Outlier Amount

CLM_MDCR_IP_PPS_OUTLIER_AMT

EFFECTIVE 3/2/92, THE AMOUNT OF THE OUTLIER PORTION OF THE PPS PAYMENT FOR CAPITAL. [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_OUTLIER_AMT'
  ).exists()
).amount.value
Coverage / Claim Type
  • Inpatient
  • SNF
Source View
V2_MDCR_CLM_INSTNL
Source Column
CLM_MDCR_IP_PPS_OUTLIER_AMT
Sources
  • FISS
  • NCH
Profiles
  • CMS

Example 

40.11

Mappings

CCW
  • CLM_PPS_CPTL_OUTLIER_AMT

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