To “activate” a person (and to count on a workload report) a visit must be workload-reportable. That means generally that it was a face-to-face encounter with an approved provider.
The specific criteria for determining a workload-reportable visit can be found in the NPIRS Basic Business Rules [PDF - 557Kb].
In general, the fields involved are:
Direct Outpatient – |
Service Type, Service Category, Clinic, Provider, Location of Encounter, and starting in FY08: Diagnosis (ICD9) |
Contract Outpatient – |
CHS Provider Type |
Direct Inpatient – |
Service Type, Service Category and starting in FY08: Diagnosis (ICD9) |
Contract Inpatient – |
CHS Provider Type |
Dental – |
ADA codes |