TS2

Provider Supplemental Summary Information

Pos: 007

Max: 1

Detail - Optional

Loop: 2000

Elements: 19


User Option (Usage): Situational
To provide supplemental summary control information by provider fiscal year and bill type

Element Summary:

 

Ref

Id

Element Name

Req

Type

Min/Max

Usage

 

TS201

782

Monetary Amount
Description: Monetary amount
Industry: Total DRG Amount
Use this monetary amount for the total DRG amount.
For Medicare, this includes: operating federal-specific amount, operating hospital-specific amount, operating Indirect Medical Education amount, and operating Disproportionate Share Hospital amount. It does not include any operating outlier amount.

O

R

1/18

Situational

 

TS202

782

Monetary Amount
Description: Monetary amount
Industry: Total Federal Specific Amount
Use this monetary amount for the total federal-specific amount.

O

R

1/18

Situational

 

TS203

782

Monetary Amount
Description: Monetary amount
Industry: Total Hospital Specific Amount
Use this monetary amount for the total hospital-specific amount.

O

R

1/18

Situational

 

TS204

782

Monetary Amount
Description: Monetary amount
Industry: Total Disproportionate Share Amount
Use this monetary amount for the total disproportionate share amount.

O

R

1/18

Situational

 

TS205

782

Monetary Amount
Description: Monetary amount
Industry: Total Capital Amount
Use this monetary amount for the total capital amount.
For Medicare, this includes: capital federal-specfic amount, hospital federal-specfic amount, hold harmless amount, Indirect Medical Education amount, Disproportionate Share Hospital amount, and the exception amount. It does not include any capital outlier amount.

O

R

1/18

Situational

 

TS206

782

Monetary Amount
Description: Monetary amount
Industry: Total Indirect Medical Education Amount
Use this monetary amount for the total indirect medical education amount.

O

R

1/18

Situational

 

TS207

380

Quantity
Description: Numeric value of quantity
Industry: Total Outlier Day Count
Use this number for the total number of outlier days.

O

R

1/15

Situational

 

TS208

782

Monetary Amount
Description: Monetary amount
Industry: Total Day Outlier Amount
Use this monetary amount for the total day outlier amount.

O

R

1/18

Situational

 

TS209

782

Monetary Amount
Description: Monetary amount
Industry: Total Cost Outlier Amount
Use this monetary amount for the total cost outlier amount.

O

R

1/18

Situational

 

TS210

380

Quantity
Description: Numeric value of quantity
Industry: Average DRG Length of Stay
Use this number for the DRG average length of stay.

O

R

1/15

Situational

 

TS211

380

Quantity
Description: Numeric value of quantity
Industry: Total Discharge Count
Use this number for the total number of discharges.
For Medicare, this is the discharge count produced by PPS PRICER SOFTWARE.

O

R

1/15

Situational

 

TS212

380

Quantity
Description: Numeric value of quantity
Industry: Total Cost Report Day Count
Use this number for the total number of cost report days.

O

R

1/15

Situational

 

TS213

380

Quantity
Description: Numeric value of quantity
Industry: Total Covered Day Count
Use this number for the total number of covered days.

O

R

1/15

Situational

 

TS214

380

Quantity
Description: Numeric value of quantity
Industry: Total Noncovered Day Count
Use this number for the total number of non-covered days.

O

R

1/15

Situational

 

TS215

782

Monetary Amount
Description: Monetary amount
Industry: Total MSP Pass-Through Amount
Use this amount for is the total MSP pass through amount calculated for a non-Medicare payer.

O

R

1/18

Situational

 

TS216

380

Quantity
Description: Numeric value of quantity
Industry: Average DRG weight
Use this number for the average DRG weight.

O

R

1/15

Situational

 

TS217

782

Monetary Amount
Description: Monetary amount
Industry: Total PPS Capital FSP DRG Amount
Use this monetary amount for the total PPS capital, federal-specific portion DRG amount.

O

R

1/18

Situational

 

TS218

782

Monetary Amount
Description: Monetary amount
Industry: Total PPS Capital HSP DRG Amount
Use this monetary amount for the total PPS capital, hospital-specific portion DRG amount.

O

R

1/18

Situational

 

TS219

782

Monetary Amount
Description: Monetary amount
Industry: Total PPS DSH DRG Amount
Use this monetary amount for the total PPS disproportionate share, hospital DRG amount.

O

R

1/18

Situational


Semantics:

1.

TS201 is the total diagnosis related group (DRG) amount.

2.

TS202 is the total federal specific amount.

3.

TS203 is the total hospital specific amount.

4.

TS204 is the total disproportionate share amount.

5.

TS205 is the total capital amount.

6.

TS206 is the total indirect medical education amount.

7.

TS207 is the total number of outlier days.

8.

TS208 is the total day outlier amount.

9.

TS209 is the total cost outlier amount.

10.

TS210 is the diagnosis related group (DRG) average length of stay.

11.

TS211 is the total number of discharges.

12.

TS212 is the total number of cost report days.

13.

TS213 is the total number of covered days.

14.

TS214 is total number of non-covered days.

15.

TS215 is the total Medicare Secondary Payer (MSP) pass- through amount calculated for a non-Medicare payer.

16.

TS216 is the average diagnosis-related group (DRG) weight.

17.

TS217 is the total prospective payment system (PPS) capital, federal-specific portion, diagnosis-related group (DRG) amount.

18.

TS218 is the total prospective payment system (PPS) capital, hospital-specific portion, diagnosis-related group (DRG) amount.

19.

TS219 is the total prospective payment system (PPS) disproportionate share, hospital diagnosis-related group (DRG) amount.


Notes:

1. Use the TS2 segment only after a TS3 segment. This segment provides summary information specific to an iteration of the LX loop (Table 2). This segment is expected to be used only for Medicare Part A claims.
2. All situational quantities and amounts in this segment are required when the value of the item is different than zero. Each total is for that provider for this type of bill for this fiscal period.

Example:

TS2*59786*55375.77~



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