Claim Line SkEdit Code SkEffective From DtEffective To DtLoad Info SkSource Code SkTenant SkValid From TsValid To Ts
| Atomic Warehouse Model Data Model |
| Description | The result of a validation test that is performed on a claim line using an outpatient code editor (OCE). The OCE processes HCPCS/CPT procedures for the claim line, evaluating the procedure codes, revenue codes, and modifiers. |
| Attributes | |
| Claim Line Sk |
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| Edit Code Sk |
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| Effective From Dt |
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| Effective To Dt |
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| Load Info Sk |
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| Source Code Sk |
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| Tenant Sk |
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| Valid From Ts |
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| Valid To Ts |
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| Relationship | |
 Claim Line OCE Edit_Claim Line_FK |
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| Primary Key | |
 Claim Line OCE Edit PK |
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| Dependencies | |
 |
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| Reverse Dependencies | |
 |
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| Attribute Details |
Claim Line Sk
| Description | Surrogate key for the anchor entity. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Edit Code Sk
| Description | Indicates the nature of the outpatient code editor (OCE) edit for the claim line that results from processing the HCPCS/CPT procedures for a record after evaluating all the codes, revenue codes, and modifiers. The codes listed as examples are not an exhaustive or current list, refer to OPPS Final Rule. Outpatient code editor (OCE) edits also exist at the pre-procedure level. For example: Invalid diagnosis code Diagnosis and age conflict Diagnosis and sex conflict Medicare secondary payer alert E-code as reason for visit Invalid procedure code Procedure and age conflict |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Effective From Dt
| Description | Establishes a period where a set of attributes are true according to the business. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Date [DATE] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Effective To Dt
| Description | Ends a period of effectivity. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Date [DATE] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Load Info Sk
| Description | The surrogate key of the load information entry describing the details regarding the loading of the row. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Source Code Sk
| Description | The origin of the data identifying the actual load source, vendor, manual key entry, or context of the data in a specific row in the database. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Tenant Sk
| Description | The surrogate key of the entry identifying the legal owner of the data. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Valid From Ts
| Description | Establishes a period where a set of attributes are true in the source system. This would be populated with the transaction timestamp and would be used for the snapshot date. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Timestamp [TIMESTAMP] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Valid To Ts
| Description | Ends a period of validity. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Timestamp [TIMESTAMP] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
| Relationship Details |
Claim Line OCE Edit_Claim Line_FK
| Is Identifying Relationship | true |
| Child Table | Claim Line OCE Edit |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Claim Line |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
| Primary Key Details |
Claim Line OCE Edit PK
| Key Attribute | Claim Line Sk |
| Key Attribute | Edit Code Sk |
| Key Attribute | Valid From Ts |
| Atomic Warehouse Model Data Model |