Types of Ambulatory Surgery and Other Outpatient Services Collected by the Partner

The Florida Agency for Health Care Administration (AHCA) defines an ambulatory surgery encounter as meeting all of the following criteria:

• The procedure is surgical in nature.
• The visit is not an emergency.
• The procedure is performed on an outpatient basis.
• The procedure is performed in the general operating room, ambulatory surgery room, endoscopy unit, lithotripsy or cardiac catheterization laboratory.
• At least one procedure falls into one of the following Current Procedural Terminology (CPT®) code ranges: 10021-69999, 92920-92998 (range was 92980-92998 between 2010 and 2011), or 93451-93599.

This definition includes but is not limited to cardiac catheterization, percutaneous transluminal coronary angioplasty, and endoscopy, gastrointestinal, and lithotripsy procedures. Venipuncture does not meet the Florida definition of an ambulatory surgery encounter, even though codes 36415 and 36416 are contained within the reportable range of 10021-69999. Visits for the sole purpose of drawing blood for laboratory services are not considered an ambulatory surgery encounter.

AHCA includes a type of service indicator in their source data. Encounters that fit the above criteria have a service type of "1". The service type is assigned by the treating facility.

Outpatient Data File Provided to HCUP by the Partner

The Florida AHCA provides HCUP with a separate ambulatory surgery file, which includes encounter-level data for ambulatory surgery and other outpatient services (service type 1 described above).

Selection of Records for Inclusion in the SASD

All records identified by AHCA as ambulatory surgery are included in the SASD (STATE_AS=1 based on service type 1).

Additionally, any record in the SASD that also have evidence of ED services based on the HCUP criteria (HCUP data element HCUP_ED > 0), are also included in the HCUP State Emergency Department Databases (SEDD). These records will have the same value for the HCUP data element KEY.

Types of Facilities Included in the Files Provided to HCUP by the Partner

AHCA collects data on outpatient services performed in hospital-owned and nonhospital-owned ambulatory surgery centers, lithotripsy centers, and cardiac catheterization laboratories. Nonhospital-owned facilities include physician-owned facilities.

AHCA provides an indication of the facility type. This information is stored in the HCUP data element OPservice with the following facilities identified:

• Hospital (value 23)
• Ambulatory surgery center (value 14)
• Cardiac catheterization laboratories (value 64)
• Lithotripsy center (value 66).

AHCA also identifies the type of facility using the first 2 to 4 digits of the Florida hospital identifier (stored in the HCUP data element DSHOSPID) as specified below:

• Hospital-based facilities
• First four digits of DSHOSPID = "0010"
• First four digits of DSHOSPID = "0011"
• First four digits of DSHOSPID = "0012"
• First two digits of DSHOSPID = "23"
• Nonhospital-based facilities
• Ambulatory surgery centers
  • First four digits of DSHOSPID = "0000"
  • First two digits of DSHOSPID = "14"
• Radiation therapy centers (included only until December 2002)
  • First four digits of DSHOSPID ="0020"
• Cardiac catheterization laboratories
  • First four digits of DSHOSPID = "0050"
• Lithotripsy centers
  • First four digits of DSHOSPID = "0052"

Identification of Hospital-Owned Ambulatory Surgery and Other Types of Outpatient Facilities in the SASD

The designation of a facility as hospital-owned is specific to its financial relationship with a hospital that provides inpatient care and not related to its physical location. Hospital-owned ambulatory surgery and other outpatient care facilities may be contained within the hospital, physically attached to the hospital, or located in a different geographic area. The designation as hospital-owned means that HCUP can identify that the hospital is billing for this service.

Starting in data year 2018, the HCUP data element HOSPITAL_OWNED can be used to identify hospital-owned facilities with ambulatory surgery and possibly other outpatient care data in the SASD. A facility is considered hospital-owned (HOSPITAL_OWNED = 1) if any one of the following is true:

• The facility is listed in the American Hospital Association (AHA) Annual Survey Database^TM.
• The facility is not listed in the AHA database, but the facility provides inpatient discharge data to HCUP.
• Documentation provided by the data source clearly indicates that the facility is hospital-owned.

If the facility in the SASD does not meet any of the above criteria, it is marked as not being owned by a hospital (HOSPITAL_OWNED = 0). Not all hospitals report to the AHA, so there is a possibility that some facilities marked with HOSPITAL_OWNED=0 are hospital-owned.

From data year 1998-2018, the HCUP data element was called FREESTANDING. A facility is considered hospital-owned (FREESTANDING = 0) if any one of the following is true:

• The facility is listed in the American Hospital Association (AHA) Annual Survey Database^TM.
• The facility is not listed in the AHA database, but the facility provides inpatient discharge data to HCUP.
• Documentation provided by the data source clearly indicates that the facility is hospital-owned.

If the facility in the SASD does not meet any of the above criteria, it is marked as not being owned by a hospital (FREESTANDING = 1). Not all hospitals report to the AHA, so there is a possibility that some facilities marked with FREESTANDING=1 are hospital-owned.

Exclusion of Records During HCUP Processing

Beginning with 2016 data, records with a discharge disposition of "still a patient" are retained in the HCUP SASD. Prior to 2016 data, these records were excluded.

Beginning in 2010, records with a designation of "admitted as an inpatient" are retained in the SASD, even though this rarely occurs. Prior to 2010, records with a designation of "admitted as an inpatient" were excluded from the files.