410 Ind. Admin. Code 15-3-1

Current through October 31, 2024
Section 410 IAC 15-3-1 - Definitions

Authority: IC 16-21-6-9

Affected: IC 16-21-6

Sec. 1.

As used in 410 IAC 15-3: "Ancillary service charges" means the difference between total service charges per stay and the daily service charges.

"Average patient length of stay by patient diagnosis" means the arithmetic mean of the total of all patient lengths of stay for a given patient diagnosis for each major payor category reported in days.

"Daily service charge" means the charge billed to a patient for a day of stay in a facility without any ancillary services provided.

"Discharges by patient diagnosis" means the count of discharges from a given fiscal period for each patient diagnosis/major payor category combination, where the primary payor has been used to determine assignment of each discharge to the appropriate major payor category.

"Major payor category" means categories of payors for Medicare, Medicaid, and all other payors (including, but not limited to, commercial insurance, Blue Cross, CHAMPUS, self-insured groups, HMOs and other prepaid groups, other government programs, individuals, and all others).

"Patient diagnosis" means the principal diagnosis recorded for billing purposes at the discharge of a patient.

"Preoperative preparation time by surgical procedure" means the average length of time in days between admit date and date of the first surgical procedure performed on the patient as counted based on the hospital's policy for daily charge purposes.

"Primary payor" means the first category of major payor categories which receives the bill for a patient stay.

"Surgical procedure" means a procedure reported as surgery for the purposes of billing.

410 IAC 15-3-1

Indiana State Department of Health; 410 IAC 15-3-1; filed Jan 31, 1985, 3:30 pm: 8 IR 592; readopted filed Jul 11, 2001, 2:23 p.m.: 24 IR 4234; readopted filed May 22, 2007, 1:44 p.m.: 20070613-IR-410070141RFA; readopted filed Jul 14, 2011, 11:42 a.m.: 20110810-IR-410110253RFA
Readopted filed 9/13/2017, 4:08 p.m.: 20171011-IR-410170339RFA