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

The South Dakota Association of Healthcare Organizations (SDAHO) collects data on ambulatory surgery and other outpatient services such as observation services, therapy, laboratory, and emergency department visits. SDAHO defines outpatient record types as follows:

• Beginning with 2013 data, an emergency department (ED) visit is defined by revenue codes 0450-0459 or 0681-0689. Prior to 2013, an ED visit is defined by revenue codes 0450-0459 or Current Procedural Terminology (CPT®) codes 99281-99285 and 99291.
• Ambulatory surgery defined by revenue codes 0360-0369 for operating room services, 0480 for cardiology, 0481 for cardiac catheterization lab, 0490-0499 for ambulatory surgery care, or 0750-0759 for gastrointestinal services
• Observation services defined by revenue codes 0760 specialty services, 0762 for observation services, or 0769 for other specialty services
• Therapies defined by revenue codes 0410-0419 for respiratory services, 0420-0429 for physical therapy, 0430-0439 for occupational therapy, 0440-0449 for speech therapy, 0930-0932 for medical rehabilitation day services, or 0940-952 for other therapeutic services
• Outpatient laboratory and radiology defined by revenue codes 0300-0309 for laboratory, 0320-0329 for diagnostic radiology, 0330-0339 for therapeutic radiology, 0340-0349 for nuclear medicine, 0350-359 for computerized tomography (CT) scans, 0400-0409 for other imaging, 0610-0619 for magnetic resonance technology, 0730-0739 for electrocardiogram, 0740 for electroencephalogram, or 0920-0929 exclusively for other diagnostic services
• Other outpatient defined by revenue codes 0380-0399 for blood, 0460-0469 for pulmonary function, 0470-0479 for audiology, 0510-0519 for clinic, 0520-0529 for clinic, 0640-0649 for home IV therapy, 0650-0659 for hospice services, 0660-0669 for respite care, 0770-0771 for preventive care service, 0820-0829 for hemodialysis, 0830-0859 for peritoneal dialysis, or 0880-0889 exclusively for miscellaneous dialysis.

Outpatient Data File Provided to HCUP by the Partner

SDAHO provides all of their outpatient records except those identified only as other outpatient. Beginning in data year 2013, SDAHO provides five separate flags that identify the five types of outpatient services (emergency department, ambulatory surgery, observation, therapy, and laboratory). These record types are concatenated and stored in the HCUP data element OPservice. The record type is also used to assign the HCUP data elements STATE_AS (ambulatory surgery record) and STATE_OS (observation record).

Selection of Records for Inclusion in the SASD

All records identified by SDAHO as ambulatory surgery are included in the SASD (STATE_AS=1 based on the ambulatory surgery flag). In addition, any other nonemergent outpatient records (STATE_ED not equal to 1 or) also are included in the SASD.

Additionally, any records in the SASD that also have evidence of emergency department 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

SDAHO collects data on ambulatory surgery and other outpatient services performed in hospital-owned facilities. SDAHO does not collect data from ambulatory surgery facilities that are not owned by a hospital.

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 Data 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.