Procedures
This module is designed to consume well-known procedure codes such as CPT and ICD. This data is important to
MPOG as it allows researchers to easily identify operations and other procedures. These codes are commonly
found in an institution’s professional fee and hospital discharge billing systems.
Target Summary
Column Name
Global_Patient_ID
Patient_ID
Visit_ID
Operation_ID
Invoice_ID
Procedure_Code_ID
Procedure_Source_Type
Date_of_Service_Start
Date_of_Service_End
Date_of_Admission
Date_of_Discharge
Procedure_Code
Procedure_Lexicon
Procedure_Code_Priority
Was_Primary_Procedure
Total_Anesthesia_Units
Data Type
string
string
string
string
string
string
string
datetime
datetime
datetime
datetime
string
string
integer
boolean
integer
Description
Cross-system patient identifier, typically MRN
Local patient identifier
The visit or stay during which the procedure occurred
The operation during which the procedure occurred
The invoice the procedure was charged on
A unique identifier for the specific charge
Professional fee vs. hospital discharge
The time the procedure occurred or started
The time the procedure ended
The time when the patient was admitted
The time when the patient was discharged
The actual procedure code (e.g. 00222)
The dictionary the code belongs to (e.g. CPT)
The relative importance/rank of the procedure
True = Primary, False = not primary, null = unknown
Total anesthesia units (for anesthesia charges only)
Examples
The following link will open an Excel spreadsheet that describes a few possible results sets that the adapter can
return. These results sets are meant as guidelines and do not represent requirements. You should return as much
data that exists in the data source.
Procedure Examples
Note that the spreadsheet contains comments scattered throughout the result sets. These comments might
provide helpful insights into how adapters can differ. Also, the spreadsheets contain randomly generated data and
therefore likely won’t make sense.
Column Descriptions
Highlighted descriptions indicate columns that are generally important to the MPOG importer. It is a good idea to
include these whenever possible.
Global_Patient_ID
An identifier used to identify the patient across the institution. Typically this is a medical record number.
Patient_ID
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An identifier from the source system that uniquely identifies the patient the procedure was performed on.
Patient_ID can be the same as Global_Patient_ID if the source system uses the same identifier (e.g. billing systems
commonly use MRN to identify patients).
Visit_ID
An identifier that links the procedure code to a patient visit. If your system does not support the “visit” concept or
this link is not explicit in the data, this can be left blank.
Operation_ID
An identifier that links the procedure code to a specific operation. This only applies to procedures that were
performed during an operation. This field should be filled only when an EXPLICIT link is in the source system. See
the “Do Not Create Data Links” section for additional details.
Invoice_ID
The invoice identifier that the procedure code appears on. This obviously only applies to data from billing systems.
Procedure_Code_ID
An identifier that uniquely identifies the procedure code in the source system. Procedure codes should be unique
across patient, time, and procedure code. If no such identifier exists leave this field blank.
Procedure_Source_Type
Describes where the data originated. This column will be mapped to several MPOG concepts that include
“Anesthesia Pro-Fee Billing”, “Surgery Pro-Fee Billing”, and “Hospital Discharge Billing”.
Date_of_Service_Start
The date and time when the procedure was performed. This can also represent when the procedure was started.
Date_of_Service_End
The date and time when the procedure was finished. This generally only applies to time-based charges like
anesthesiologists’ professional fee charges. If not available, this field can be left blank or use the same value as
“Date_of_Service_Start”.
Date_of_Admission
The date the patient was admitted to the institution.
Date_of_Discharge
The date the patient was discharged from the institution
Procedure_Code
The code representing the procedure performed. This is the one column that is required in all cases.
Procedure_Lexicon
The dictionary from which the procedure code was taken. This field will be mapped to available MPOG concepts
such as “CPT”, “ICD-9”, or “ICD-10”.
Procedure_Code_Priority
The relative importance or ranking of the procedure compared to others performed. This generally applies to
procedures performed during an operation.
Was_Primary_Procedure
Whether the procedure was considered the primary procedure of an operation. This field overlaps with
“Procedure_Code_Priority” (e.g. IF Procedure_Code_Priority = 1 THEN Was_Primary_Procedure = TRUE). However,
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not all systems assign a priority, so this can be used to make the distinction between primary and secondary
procedures.
Total_Anesthesia_Units
The total number of time units charged by the anesthesiology provider. This only applies to time-based, anesthesia
procedure codes.
Tips & Recommendations
The most important fields in this module to fill in are Global_Patient_ID or Patient_ID, Date_of_Service_Start, and
Procedure_Code. This can be considered the absolute minimum in most cases, but other columns should be filled
in where possible.
It is usually a good idea to use your billing system as a source of data, even if it is available elsewhere. Given that
the codes in the billing system are financially critical, they are almost guaranteed to be the most accurate.
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Procedure Modifiers
This module is used to import billing modifiers on procedure codes. Common billing modifiers are small two
character codes such as “QS” or “GC”.
Target Summary
Column Name
Global_Patient_ID
Patient_ID
Visit_ID
Operation_ID
Invoice_Number
Procedure_Code_ID
Procedure_Source_Type
Date_of_Service_Start
Date_of_Service_End
Date_of_Admission
Date_of_Discharge
Procedure_Code
Procedure_Code_Lexicon
Modifier_Code_Lexicon
Modifier_Code
Data Type
string
string
string
string
string
string
string
datetime
datetime
datetime
datetime
string
string
string
string
Description
Cross-system patient identifier, typically MRN
Local patient identifier
The visit or stay during which the procedure occurred
The operation during which the procedure occurred
The invoice the procedure was charged on
A unique identifier for the specific charge
Professional fee vs. hospital discharge
The time the procedure occurred or started
The time the procedure ended
The time when the patient was admitted
The time when the patient was discharged
The given procedure code (e.g. 00222)
The dictionary the procedure belongs to (e.g. CPT)
The dictionary the modifier belongs to
The given modifier code (e.g. QS)
Examples
The following link will open an Excel spreadsheet that describes a few possible results sets that the adapter can
return. These results sets are meant as guidelines and do not represent requirements. You should return as much
data that exists in the data source.
Procedure Modifier Examples
Note that the spreadsheet contains comments scattered throughout the result sets. These comments might
provide helpful insights into how adapters can differ. Also, the spreadsheets contain randomly generated data and
therefore likely won’t make sense.
Column Descriptions
Global_Patient_ID
An identifier used to identify the patient across the institution. Typically this is a medical record number.
Patient_ID
An identifier from the source system that uniquely identifies the patient the procedure was performed on.
Patient_ID can be the same as Global_Patient_ID if the source system uses the same identifier (e.g. billing systems
commonly use MRN to identify patients).
Visit_ID
An identifier that links the procedure code to a patient visit. If your system does not support the “visit” concept or
this link is not explicit in the data, this can be left blank.
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Operation_ID
An identifier that links the procedure code to a specific operation. This only applies to procedures that were
performed during an operation. This field should be filled only when an EXPLICIT link is in the source system. See
the “Do Not Create Data Links” section for additional details.
Invoice_ID
The invoice identifier that the procedure code appears on. This obviously only applies to data from billing systems.
Procedure_Code_ID
An identifier that uniquely identifies the procedure code in the source system. Procedure codes should be unique
across patient, time, and procedure code. If no such identifier exists leave this field blank.
Procedure_Source_Type
Describes where the data originated. This column will be mapped to several MPOG concepts that include
“Anesthesia Pro-Fee Billing”, “Surgery Pro-Fee Billing”, and “Hospital Discharge Billing”.
Date_of_Service_Start
The date and time when the procedure was performed. This can also represent when the procedure was started.
Date_of_Service_End
The date and time when the procedure was finished. This generally only applies to time-based charges like
anesthesiologists’ professional fee charges. If not available, this field can be left blank or use the same value as
“Date_of_Service_Start”.
Procedure_Code
The code representing the procedure performed.
Procedure_Lexicon
The dictionary from which the procedure code was taken. This field will be mapped to available MPOG concepts
such as “CPT”, “ICD-9”, or “ICD-10”.
Modifier_Code_Lexicon
The dictionary from which the modifier code was taken. This field will be mapped to available MPOG concepts
such as “CPT” or “HCPCS”.
Modifier_Code
The actual code for the modifier. Examples include “QS” or “GC”.
Tips & Recommendations
Procedure modifiers are not used that often in research requests and therefore this module can be considered
low-priority. Of course, it should be implemented whenever possible.
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Diagnoses
Target Summary
Column Name
Global_Patient_ID
Patient_ID
Visit_ID
Operation_ID
Invoice_Number
Procedure_Code_ID
Procedure_Code
Diagnosis_Code_ID
Diagnosis_Source_Type
Date_of_Service_Start
Date_of_Service_End
Date_of_Admission
Date_of_Discharge
Date_of_Diagnosis_Start
Date_of_Diagnosis_End
Diagnosis_Code
Diagnosis_Lexicon
Diagnosis_Code_Priority
Was_Primary_Diagnosis
Present_On_Admission
Data Type
string
string
string
string
string
string
string
string
string
datetime
datetime
datetime
datetime
datetime
datetime
string
string
integer
boolean
boolean
Description
Cross-system patient identifier, typically MRN
Local patient identifier
The visit or stay during which the procedure occurred
The operation during which the procedure occurred
The invoice the procedure was charged on
A unique identifier for an associated procedure
An associated procedure for the diagnosis
A unique identifier for the specific charge
Professional fee vs. hospital discharge
The time the procedure occurred or started
The time the procedure ended
The time when the patient was admitted
The time when the patient was discharged
The time when the diagnosis began
The time when the diagnosis ended
The given diagnosis code (e.g. 275.1)
The dictionary the code belongs to (e.g. ICD-9)
The relative importance/rank of the procedure
True = primary, False = not primary, null = unknown
Whether the diagnosis was present on admission
Examples
The following link will open an Excel spreadsheet that describes a few possible results sets that the adapter can
return. These results sets are meant as guidelines and do not represent requirements. You should return as much
data that exists in the data source.
Diagnosis Examples
Note that the spreadsheet contains comments scattered throughout the result sets. These comments might
provide helpful insights into how adapters can differ. Also, the spreadsheets contain randomly generated data and
therefore likely won’t make sense.
Column Descriptions
Global_Patient_ID
An identifier used to identify the patient across the institution’s systems. Typically this is a medical record number.
Patient_ID
An identifier from the source system that uniquely identifies the patient the procedure was performed on.
Patient_ID can be the same as Global_Patient_ID if the source system uses the same identifier (e.g. billing systems
commonly use MRN to identify patients).
Visit_ID
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An identifier that links the diagnosis code to a patient visit. If your system does not support the “visit” concept or
this link is not explicit in the data, this can be left blank.
Operation_ID
An identifier that links the diagnosis code to a specific operation. This only applies to procedures that were
performed during an operation. This field should be filled only when an EXPLICIT link is in the source system. See
the “Do Not Create Data Links” section for additional details.
Invoice_ID
The invoice identifier that the diagnosis code appears on. This obviously only applies to data from billing systems.
Procedure_Code_ID
An identifier that uniquely identifies a related procedure code in the source system. Procedure codes should be
unique across patient, time, and procedure code. If no such identifier exists leave this field blank.
Procedure_Code
A procedure code related to this diagnosis. Where not available or applicable, leave this blank. When used, this is
typically a CPT or ICD procedure code.
Diagnosis_Code_ID
An identifier that uniquely identifies the diagnosis code in the source system. Diagnosis codes should be unique
across patient, time, and diagnosis code. If no such identifier exists leave this field blank.
Diagnosis_Source_Type
Describes where the data originated. This field will be mapped to several MPOG concepts that include “Anesthesia
Pro-Fee Billing”, “Surgery Pro-Fee Billing”, and “Hospital Discharge Billing”.
Date_of_Service_Start
The date and time when the procedure was performed. This can also represent when the procedure was started.
Date_of_Service_End
The date and time when the procedure was finished. This generally only applies to time-based charges like
anesthesiologists’ professional fee charges. If not available, this field can be left blank or use the same value as
“Date_of_Service_Start”.
Date_of_Admission
The date the patient was admitted to the institution.
Date_of_Discharge
The date the patient was discharged from the institution
Date_of_Diagnosis_Start
The time when the given diagnosis was made or when the condition started.
Date_of_Diagnosis_End
The time when the given diagnosis or condition ended.
Diagnosis_Code
The code representing the given diagnosis.
Diagnosis_Lexicon
The dictionary the “Diagnosis_Code” belongs to. Typically this is either “ICD-9” or “ICD-10”.
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Diagnosis_Code_Priority
The relative importance or ranking of the procedure compared to others performed. This generally applies to
procedures performed during an operation. If this does not
Was_Primary_Diagnosis
Whether the diagnosis was considered the primary diagnosis of an operation. This field overlaps with
“Diagnosis_Code_Priority” (e.g. IF Diagnosis _Code_Priority = 1 THEN Was_Primary_ Diagnosis = TRUE). However,
not all systems assign a priority, so this can be used to make the distinction between primary and secondary
diagnoses.
Present_On_Admission
Whether the diagnosis was present on admission. This is generally only found in data from hospital discharge
billing.
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