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1. Hospital Commitment Form.
   hcup-us.ahrq.gov/datainnovations/clinicalcontentenhancementtoolkit/mn10.jsp
   August 01, 2014 - Hospital Commitment Form. … DATA VISUALIZATIONS DATA QUERY TOOLS Hospital Commitment Form … HOSPITAL COMMITMENT FORM MINNESOTA HOSPITAL ASSOCIATION AGENCY FOR HEALTHCARE RESEARCH AND QUALITY … ________________________________________________(Phone/Email) Please sign and return this form. … _____________________________________ Internet Citation: Hospital Commitment Form

2. HOSPITAL COMMITMENT FORM (pdf file)
   hcup-us.ahrq.gov/datainnovations/clinicalcontentenhancementtoolkit/mn10.pdf
   June 21, 2014 - HOSPITAL COMMITMENT FORM HOSPITAL COMMITMENT FORM MINNESOTA HOSPITAL ASSOCIATION AGENCY FOR … ________________________________________________(Phone/Email) Please sign and return this form.

3. SID File Composition - New York
   hcup-us.ahrq.gov/db/state/siddist/siddist_filecompny.jsp
   August 01, 2006 - This format combines the old Uniform Billing Forms (UBFs) and Discharge Data Abstracts (DDAs) data into … supplied their Master File which consisted of Discharge Data Abstracts (DDAs) matched to Uniform Billing Forms

4. ___APS-DRGs-Weights_Public.book (pdf file)
   hcup-us.ahrq.gov/db/nation/nis/APS-DRGs%20V23%20Weights%20Manual.pdf
   August 01, 2006 - THIS APPENDIX INCLUDES: • Organization Change of Information Form • Product Manual Feedback Form PS-DRGs … ® Normalized Weights User’s Guide 16 Appendix A: HSS Forms Organization Change of Information Form … Product Manual Feedback Form A PRODUCT MANUAL FEEDBACK FORM Use the feedback form below to provide … PS-DRGs® Normalized Weights User’s Guide 18 Appendix A: HSS Forms Product Manual Feedback Form A … Organization Change of Information Form Product Manual Feedback Form Contact Information Manual

5. FAQs About Collection of REL - For Patients (pdf file)
   hcup-us.ahrq.gov/datainnovations/raceethnicitytoolkit/ca5.pdf
   June 16, 2014 - Hospitals can attach this list of questions and answers to registration forms that patients fill out

6. APS-DRGs-Weights_Public.book (pdf file)
   hcup-us.ahrq.gov/db/nation/nis/APS-DRGs%20V22%20Weights%20Manual.pdf
   March 01, 2005 - ® Normalized Weights User’s Guide 16 Appendix A: HSS Forms Organization Change of Information Form … S-DRGs® Normalized Weights User’s Guide 17 Appendix A: HSS Forms Product Manual Feedback Form AP … PRODUCT MANUAL FEEDBACK FORM Use the feedback form below to provide HSS with your feedback. … S-DRGs® Normalized Weights User’s Guide 18 Appendix A: HSS Forms Product Manual Feedback Form AP … Organization Change of Information Form Product Manual Feedback Form Contact Information Manual

7. Clinical Classifications for Health Policy Research: Hospital Inpatient Statistics, 1995
   hcup-us.ahrq.gov/reports/natstats/his95/appcb.htm
   February 11, 2011 - Other acute and subacute - 4110 4118 41181 41189 forms … atherosclerosis - 4140 41400 41401 41405 V4582 7.2.4.5 Other forms

8. Enhancing the Clinical Content of Administrative Data - Present on Admission (POA) Toolkit: Data Standards and Transmission Tools
   hcup-us.ahrq.gov/datainnovations/clinicaldata/tkds.jsp
   July 01, 2016 - (refer to Appendix I, page 95 for guidelines on coding and reporting POA on the UB-04 and 837 claim forms

9. HCUP SASD 2004 Comparison Report - IM (pdf file)
   hcup-us.ahrq.gov/reports/methods/2010_04.pdf
   January 01, 2010 - Records included in the 2007 SASD-CD are derived from the UB04/CMS1450 forms for hospital-based ambulatory … centers and the CMS 1500 form for freestanding ambulatory surgery centers. … (1.8%), 234: Pathology (less than one percent), 240: Medications (Injections, infusions and other forms … interview; evaluation; consultation) 0.1% 4 240 240: Medications (Injections, infusions and other forms … therapeutic nervous system procedures 0.3% 5 240 240: Medications (Injections, infusions and other forms

10. Microsoft Word - 2011_02.doc (pdf file)
    hcup-us.ahrq.gov/reports/methods/2011_02.pdf
    January 01, 2011 - Records included in the 2008 SASD-CD are derived from the UB04/CMS1450 forms for hospital-based ambulatory … centers and the CMS 1500 form for freestanding ambulatory surgery centers. … (1.9%), 234: Pathology (less than one percent), 240: Medications (Injections, infusions and other forms … : Pathology 0.7% 3 232 232: Anesthesia 0.3% 4 240 240: Medications (Injections, infusions and other forms … 231 231: Other therapeutic procedures 0.0% 7 240 240: Medications (Injections, infusions and other forms

11. Microsoft Word - Del #57.05 Comp Rpt for Multi-state AS File CD Final_092311.doc (pdf file)
    hcup-us.ahrq.gov/reports/methods/2011_07.pdf
    January 01, 2011 - Records included in the 2009 SASD-CD are derived from the UB04/CMS1450 forms for hospital-owned ambulatory … centers and the CMS 1500 form for freestanding ambulatory surgery centers. … 77: Proctoscopy and anorectal biopsy 2.2% 3 240 240: Medications (Injections, infusions and other forms … Gastrostomy; temporary and permanent 0.4% 5 240 240: Medications (Injections, infusions and other forms … interview; evaluation; consultation) 0.1% 4 240 240: Medications (Injections, infusions and other forms

12. Enhancing the Clinical Content of Administrative Data - Present on Admission (POA) Background
    hcup-us.ahrq.gov/datainnovations/clinicaldata/poaback.jsp
    July 01, 2016 - (refer to Appendix I, page 95 for guidelines on coding and reporting POA on the UB-04 and 837 claim forms

13. FAQs about the Collection of Patient Race, Ethnicity, and Language - For Patients
    hcup-us.ahrq.gov/datainnovations/raceethnicitytoolkit/ca5.jsp
    November 01, 2014 - Hospitals can attach this list of questions and answers to registration forms that patients fill out

14. Chronic Condition Indicator (CCI) for ICD-9-CM
    hcup-us.ahrq.gov/toolssoftware/chronic/chronic.jsp
    May 01, 2016 - Examples of chronic conditions include conditions such as malignancies, diabetes, most forms of mental … illness, hypertension, many forms of heart disease, and congenital anomalies.

15. Hospital Inpatient Statistics, 1996
    hcup-us.ahrq.gov/reports/natstats/his96/table1b.htm
    January 01, 1996 - $4,985 $8,203 3.1 0.4 49.2 65.1 7.2.4.3 Other acute and subacute forms … $6,353 $13,323 $28,805 4.7 1.1 62.0 66.1 7.2.4.5 Other forms

16. FAQs for Using Clinically Enhanced Claims Data to Guide Selection of Coronary Procedures (pdf file)
    hcup-us.ahrq.gov/datainnovations/clinicalcontentenhancementtoolkit/ny14.pdf
    March 20, 2012 - study the comparative effectiveness of alternative NYSDOH Updated FAQs March 20, 2012 Page 2 forms … test results requested for this project will be mapped to corresponding LOINC codes using mapping forms

17. Application Hcup Articleoftheyear 2024 25 (pdf file)
    hcup-us.ahrq.gov/pdf/Application_HCUP_ArticleoftheYear_2024_25.pdf
    January 01, 2024 - Please submit this form in PDF with the additional application materials specified below. … Application Materials Nomination packages must include the following: • A completed application form … designated author and responses to how the article meets core criteria detailed in the nomination form … HCUP Award for Outstanding Research Nomination Form https://www.hcup-us.ahrq.gov/news/awards.jsp … HCUP Award for Outstanding Research Nomination Form: Criteria 3.

18. Microsoft Word - deliverable57_02_CD_V2.doc (pdf file)
    hcup-us.ahrq.gov/reports/methods/2009_03.pdf
    January 01, 2009 - Records included in the 2006 SASD-CD are derived from the UB92 and the CMS 1500 form (which are the … standard billing forms used by most hospitals). … bacterial smear, culture, toxicology) 0.2% 6 240 240: Medications (Injections, infusions and other forms … interview, evaluation, consultation) 0.1% 4 240 240: Medications (Injections, infusions and other forms … therapeutic nervous system procedures 0.1% 6 240 240: Medications (Injections, infusions and other forms

19. Frequently Asked Questions for Coronary Procedures Project
    hcup-us.ahrq.gov/datainnovations/clinicalcontentenhancementtoolkit/ny14.jsp
    September 01, 2014 - datasets created for this project will be used to study the comparative effectiveness of alternative forms … laboratory test results requested for this project will be mapped to corresponding LOINC codes using mapping forms

20. Ahrqfinalreportvhi (pdf file)
    hcup-us.ahrq.gov/datainnovations/clinicaldata/AHRQFINALREPORTVHI.pdf
    December 01, 2009 - ________________________________________________________________ Adding Clinical Data Final Report Form … ________________________________________________________________ Adding Clinical Data Final Report Form … ________________________________________________________________ Adding Clinical Data Final Report Form … ________________________________________________________________ Adding Clinical Data Final Report Form … ________________________________________________________________ Adding Clinical Data Final Report Form