Central Distributor SEDD: Description of Data Elements

ASOURCE - Admission source, uniform coding

Documentation Sections:

The Uniform Billing UB-04 Specifications changed coding specifications for Source of Admission to Point of Origin for Admission or Visit. While this change was scheduled to start as of October 1, 2007, the change-over date was not universally followed. During HCUP processing, coding was examined by hospital and information was stored in ASOURCEUB92/ASOURCE_X and PointOfOriginUB04/PointOfOrigin_X as most appropriate. Sometimes there was not a succinct change from one coding scheme to another. Original source values are retained in ASOURCE_X and PointOfOrigin_X if there is any question about the coding. Regardless of which variables are reported, the best source for identifying admissions through the emergency department (ED) is the HCUP data element HCUP_ED which looks across admission source, point of origin, and ED charges to identify ED admissions.

Three HCUP data elements contain information on the source of admission:

ASOURCEUB92 (available beginning in 2002 data) indicates the source of admission and uses the same coding as the source of admission data element on the UB-92 claim form. ASOURCEUB92 has more detailed categories for routine admissions and transfers from other health facilities than the HCUP data element ASOURCE. Some states do not provide enough detail in the coding of the source of admission to accurately code ASOURCEUB92. For these states, the data element ASOURCEUB92 is not available.
ASOURCE (available for all data years) indicates the source of the admission (emergency department; transfer from a hospital; routine, birth and other; etc.) recoded into HCUP uniform values. Routine, birth, and other (ASOURCE=5) include referrals from physicians, clinics, and HMOs. Transfer from a hospital may include transfers within the same hospital as well as transfers between hospitals. If the data source does not provide the admission source, then beginning in the 1998 data, ASOURCE is not present on the HCUP files. In the 1988-1997 data, ASOURCE is retained on the HCUP files and is set to unavailable from source (.B).
ASOURCE_X (available beginning in 1998 data) retains the source of admission as provided by the data source. The original values have not been recoded into uniform HCUP values and are source-specific. ASOURCE_X is available for all states that provide HCUP with information on admission source.

If the state includes enough detail in the coding of the source of admission to accurately code ASOURCEUB92, then the HCUP data element ASOURCE is coded from ASOURCEUB92 as specified below. Otherwise, ASOURCE is coded from ASOURCE_X and specifications are listed under State Specific Notes.

Coding of ASOURCEUB92 into ASOURCE
ASOURCEUB92		ASOURCE
Value	Description	Value	Description
7	Emergency room	1	Emergency department
4	Transfer from an acute care hospital	2	Another hospital
A	Transfer from a rural primary care hospital
D	Transfer from one distinct unit of the hospital to another distinct unit of the same hospital resulting in a separate claim to the payer
5	Transfer from a skilled nursing facility	3	Other health facility including long-term care
6	Transfer from another health care facility
B	Transfer From Another Home Health Agency
C	Readmission to Same Home Health Agency
8	Court/Law enforcement	4	Court/Law enforcement
1	Physician referral	5	Routine including births and other sources
2	Outpatient or Clinic
3	HMO
1	Normal delivery (if ATYPE = 4)
2	Premature delivery (if ATYPE = 4)
3	Sick baby (if ATYPE = 4)
4	Extramural birth (if ATYPE = 4)
Blank	Unknown, Missing, Invalid	.	Missing

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Uniform Values

Variable	Description	Value	Value Description
ASOURCE	Admission source, uniform coding	1	Emergency department
		2	Another hospital
		3	Another health facility including long term care
		4	Court/Law enforcement
		5	Routine, birth, and other
		.	Missing
		.A	Invalid
		.B	Unavailable from source (coded in 1988-1997 data only)

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State Specific Notes

Kentucky

Kentucky
(Prior to 2002)
ASOURCE_X		ASOURCE
Value	Description	Value	Description
07	Emergency room	1	Emergency department
04	Transfer from hospital	2	Another hospital
A	Transfer from critical care hospital	2	Another hospital
05	Transfer from SNF	3	Other health facility including long-term care
06	Transfer from another health care facility	3	Other health facility including long-term care
08	Court/Law enforcement	4	Court/Law enforcement
01	Physician referral	5	Routine including births and other sources
02	Clinic referral
03	HMO referral
11	Normal delivery
12	Premature delivery
13	Sick baby
14	Extramural birth
09, 19, Blank	Missing	.	Missing
Any values not documented by the data source		.A	Invalid

Maine

Maine
(Prior to 2002)
ASOURCE_X		ASOURCE
Value	Description	Value	Description
7	Emergency room	1	Emergency department
4	Transfer from a hospital	2	Another hospital
5	Transfer from a skilled nursing facility	3	Other health facility including long-term care
6	Transfer from another facility	3	Other health facility including long-term care
8	Court/Law enforcement	4	Court/Law enforcement
1	Physician referral	5	Routine including births and other sources
2	Clinic referral
3	HMO referral
9, Blank	Information not available, Missing	.	Missing
Any other values not documented by the data source		.A	Invalid

Maryland

Maryland changed the coding of admission source in July 2001. From July 2001 to December 2001, some hospitals may be using the old coding scheme.

Maryland
(Valid July 2001 - June 2018)
ASOURCE_X		ASOURCE
Value	Description	Value	Description
01	Another acute care OP ED or Freestanding ED	1	Emergency department
02	Emergency room of same hospital	1	Emergency department
--		2	Another hospital
03	Admitted from Skilled Nursing Facility: a Medicare-certified nursing facility in anticipation of skilled care	3	Other health facility including long-term care
04	Admitted from another health-related institution (domiciliary care, psychiatric hospital, mental retardation facility, halfway house, etc.)
10	Chronic hospital
11	From Long Term Care Facility: a facility that provides acute inpatient care with an average length of stay of 25 days or greater (effective 7/1/15)
--		4	Court/Law enforcement
05	Admitted from home (includes physician office or any other noninstitutional source)	5	Routine including births and other sources
06	Other
07	Clinic of another acute general hospital
08	Clinic of same hospital
09, 99, 00, Blank	Unknown/not applicable	.	Missing
Any values not documented by the data source		.A	Invalid

Maryland

Beginning in 2007, Maryland included the records from all other outpatients, Greenbaum cancer center, and UMMS shock trauma in the unified AS and ED outpatient data file. The inclusion of these new records resulted in increasing the frequencies of records categorized in ASOURCE = 1, Emergency department, and ASOURCE = 5, Routine including births and other sources.

Maryland does not report this data element for emergency department records. Beginning in 2003 HCUP processing, a small number of ambulatory surgery records were placed in the SEDD due to HCUP guidelines. Consequently, these records contain valid data using Maryland ambulatory surgery coding definitions.

Massachusetts

Massachusetts
ASOURCE_X		ASOURCE
Value	Description	Value	Description
7	Outside hospital emergency room	1	Emergency department
4	Transfer from an acute hospital	2	Another hospital
5	Transfer from a skilled nursing facility (SNF)	3	Other health facility including long-term care
6	Transfer from Intermediate Care Facility (ICF)
F	Transfer from a Hospice Facility
T	Transfer from another institution's ambulatory surgery (SDS)
Y	Within hospital ambulatory surgery transfer (SDS transfer)
F	Transfer from Hospice Facility
8	Court/Law enforcement	4	Court/Law enforcement
1	Direct physician referral	5	Routine including births and other sources
2	Within hospital clinic referral
3	Direct health plan referral / HMO referral
L	Outside hospital clinic referral
M	Walk-in / Self Referral
9	Other
E	EMS transport decision
A	Normal delivery
B	Premature delivery
C	Sick baby
D	Extramural birth
-, 0, Z, Blank	Missing	.	Missing
Any values not documented by the data source		.A	Invalid
There is not enough detail in the coding of ASOURCE_X to code the HCUP variable ASOURCEUB92.

Nebraska

Nebraska
(Prior to 2002)
ASOURCE_X		ASOURCE
Value	Description	Value	Description
7	Emergency room	1	Emergency department
4	Transfer from hospital	2	Another hospital
A	Transfer from critical access hospital	2	Another hospital
6	Transfer from another health care facility other than an acute care facility	3	Other health facility including long-term care
B	Transfer from another home health agency
C	Readmission to same home health agency
1	Physician referral	5	Routine including births and other sources
2	Clinic referral
3	HMO referral
1	Normal delivery (if ATYPE=4)
2	Premature (if ATYPE=4)
3	Sick baby (if ATYPE=4)
4	Extramural birth (if ATYPE=4)
9, Blank	Missing	.	Missing
Any values not documented by the data source		.A	Invalid

South Carolina

Prior to 2002, South Carolina did not provide enough detail in the coding of ASOURCE_X to code the HCUP variable ASOURCEUB92.

South Carolina
(Prior to 2002)
ASOURCE_X		ASOURCE
Value	Description	Value	Description
7	Emergency room	1	Emergency department
4	Transfer from hospital	2	Another hospital
A	Transfer from a rural primary care hospital	2	Another hospital
5	Transfer from a skilled nursing facility	3	Other health facility including long-term care
6	Transfer from another health care facility	3	Other health facility including long-term care
8	Court/Law enforcement	4	Court/Law enforcement
1	Physician referral	5	Routine including births and other sources
2	Clinic referral
3	HMO referral
1	Normal delivery (if ATYPE=4)
2	Premature delivery (if ATYPE=4)
3	Sick baby (if ATYPE=4)
4	Extramural birth (if ATYPE=4)
0, 9, Blank	Information not available, Missing	.	Missing
Any values not documented by the data source		.A	Invalid

Utah

Utah
(Prior to 2002)
ASOURCE_X		ASOURCE
Value	Description	Value	Description
7	Emergency room	1	Emergency department
4	Transfer from hospital	2	Another hospital
5	Transfer from a skilled nursing facility	3	Other health facility including long-term care
6	Transfer from another health care facility	3	Other health facility including long-term care
8	Court/Law enforcement	4	Court/Law enforcement
1	Physician Referral	5	Routine including births and other sources
2	Clinic referral
3	HMO referral
1	Normal newborn (if ATYPE=4) (This is not available in the SASD)
2	Premature delivery (if ATYPE=4) (This is not available in the SASD)
3	Sick baby (if ATYPE=4) (This is not available in the SASD)
4	Extramural birth (if ATYPE=4) (This is not available in the SASD)
0	Newborn
9, Blank	Unknown, Missing	.	Missing
Any values not documented by the data source		.A	Invalid
SID and SEDD: Admission source information was provided in two fields; one for newborns and one for all other patients. ASOURCE_X was assigned as follows: If a newborn record (ATYPE=4) then ASOURCE_X = the newborn admission source, Else ASOURCE_X = the admission source for non-newborns. SASD: Only the non-newborn admission source was provided.

Vermont

Vermont
(Prior to 2002)
ASOURCE_X		ASOURCE
Value	Description	Value	Description
7	Emergency room	1	Emergency department
4	Transfer from hospital	2	Another hospital
A	Transfer from critical access hospital	2	Another hospital
5	Transfer from a skilled nursing facility	3	Other health facility including long-term care
6	Transfer from another health care facility	3	Other health facility including long-term care
8	Court/Law enforcement	4	Court/Law enforcement
1	Physician Referral	5	Routine including births and other sources
2	Clinic referral
3	HMO referral
1	Normal newborn (if ATYPE=4)
2	Premature delivery (if ATYPE=4)
3	Sick baby (if ATYPE=4)
4	Extramural birth (if ATYPE=4)
9, Blank	Missing	.	Missing
Any values not documented by the data source		.A	Invalid

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Central Distributor SEDD: Description of Data Elements