DPC Data Update and Enhanced Data Fields

[Data at the Point of Care (DPC) Community]

Hello DPC Community,

Weekly data updates resumed

On January 2, 2023, we announced that data loads from our upstream data partner were paused to complete an effort to improve data sharing services and resolve historical year-end data issues. We are happy to announce that these efforts have been completed and the DPC API (Data at the Point of Care) will resume getting weekly updated Medicare data starting February 2, 2023 at 1:16 PM, EST. 

Enhancements to data fields 

Also, we are now providing additional data in our API:

• Claim Query Code: A code indicating the type of claim record being processed with respect to payment (debit/credit indicator; interim/final indicator). This data element appears as an extension in the EOB billablePeriod attribute. 
  • Before: This data element has appeared in the Explanation of Benefit (EOB) resource for Inpatient, Outpatient and SNF claim types. 
  • Now:  The Claim Query Code will also appear in the EOB resource for Hospice and HHA claim types. 

• Carrier Claim Billing NPI Number: The CMS National Provider Identifier (NPI) number assigned to the billing provider. 
  • Before: Was not available in DPC.
  • Now: Available in DPC. This data element will appear in the Explanation of Benefit (EOB) resource for Carrier claims. This data element has been mapped into the EOB provider attribute.

• Coverage Start and End Date: Dates indicating the start and end of Medicare coverage. Supplied in the Coverage resource in the period.start and period.end attributes. 
  • Before: The start date was the earliest start date across all of a Medicare user's coverages (e.g. the earliest start date across their part A, B and D coverage). End date was not available. 
  • Now: The start date for each individual coverage type (part A, B and D) is now available. If applicable, end date for each individual coverage type is also available.

• Claim Diagnosis Related Group Code (DRG): Supplied in Inpatient and SNF claim types, in the eob.diagnosis.packageCode attribute.
  • Before: was 3 characters. 
  • Now: 4 characters.

Questions or concerns?

Email us at DPC...@cms.hhs.gov or reply here.

Thanks!

The DPC Team