Information Bulletin, December 2009

Contact us at:

E-mail: sparcs.submissions@health.ny.gov
Phone: (518) 473- 8144 or (800) 638-3808


Reminder: Physician License Numbers
Change in Timeframe for Source of Payment Typology Reporting
New Submission Compliance Reports on the HCS
Continue to Correct Potential Duplicate Records
2008 Annual Data Reconciliation Process
New Codes for H1N1
Season's Greetings

Reminder: Physician License Numbers

Please note that, beginning January 1, 2010, all facilities must reach the 90% accuracy level on the physician license pre-edit report for their data files to be accepted by the SPARCS mainframe edit program. The pre-edit report compares the reported Attending, Operating, and Other Physician License Numbers to the current NYS Education Department License file. The Pre-edit Physician License Report is created after a file is submitted using the test (T) or the production (P) indicator. If the file is a test submission and fails the 90% criterion, it will still be processed on the mainframe for the remaining edits. Conversely, if the file is a production submission and it fails the physician license pre-edit, it will not be processed on the mainframe. Thus, it is important to correct any physician license numbers. Please refer to the May 19, 2009 announcement letter and the October 2009 Information Bulletin for more information.

Change in Timeframe for Source of Payment Typology Reporting

Unfortunately, a large number of facilities have not submitted the new Source of Payment Typology data elements to SPARCS as of November 30, 2009. A change in the due date for submitting these new data elements is necessary to allow facilities more time to work on submitting this information to SPARCS. The new date for the submission of these data elements is July 1, 2010. There will be no exceptions. The new Source of Payment Typology data elements will be used by the Department of Health for rate-setting purposes. In October 2008, letters were sent to all SPARCS Coordinators announcing the change. This announcement letter can be found at: www.health.state.ny.us/statistics/sparcs/x12-837/announcement_letters.htm. A successful transition is defined as having at least one submission successfully pass the SPARCS production file edits for these new data elements by July 1, 2010.

New Submission Compliance Reports on the HCS

In December 2009, new submission compliance reports were posted to the Health Commerce System (HCS) on the SPARCS submission results page. Each individual facility report shows the actual submitted records, the expected number of records to be submitted (based on the average of the prior year's reporting history), and the percentage of the previous year's average for each appropriate type of data (Inpatient, Ambulatory Surgery and Emergency Department) that is to be submitted to SPARCS. The report also displays extensions and exceptions that have been requested and granted for each facility. This report will be posted monthly and used for the annual audit reconciliation process.

Continue to Correct Potential Duplicate Records

Facilities should continue to investigate and correct any potential duplicates in their SPARCS data from 2007 and forward. Most commonly a potential duplicate record was created when a new record was submitted with modifications to one of the key data elements; potential duplicate record contains predominately the same information (same individual/ same visit date) as a record already accepted into the SPARCS Masterfile. Most often, a slight change was made to the patient control number or medical record number, which is part of the key. Thus, the record has been accepted into the master file for a patient occurrence that was already reported. Unfortunately, analysis of the potential duplicates reveals that complex medical cases are disproportionately represented among duplicate records. A report has been developed and posted on the SPARCS Quality Report section on the HCS to help facilities determine if the identified records are truly duplicates. Facilities must review the SPARCS quality reports and correct or remove any potential duplicate records. If you have any questions on the removal of potential duplicates, contact us using the email or phone numbers listed above.

Researches should be assured that the Department of Health has taken steps to remove the potential duplicates from any files distributed for use. In terms of volume, the potential duplicates vary per discharge year. In general, the records being removed represent less than one percent of the total inpatient records and less than one percent of the total outpatient records.

2008 Annual Data Reconciliation Process

The 2008 compliance process has been completed. Facilities that have not submitted the appropriate amount of Inpatient, Ambulatory Surgery or Emergency Department data, or have failed to notify SPARCS of circumstances that caused a change in the number of records submitted, have been notified and will receive a Statement of Deficiency (SOD). Facilities must submit a Plan of Correction (POC) to SPARCS detailing how to bring the facility into compliance for the outstanding records. If there are any questions on this process, please call the SPARCS Administrative Unit.

New Codes for H1N1

As a reminder, the American Medical Association (AMA) issued an update concerning the coding of the H1N1 vaccination and administration of the vaccination. They have added CPT code 90470 and added a description change for code 90663. The addition of code 90470 did not make it in time to be in the 2010 CPT book from AMA. Please see the link below for instructions on how to code when the H1N1 vaccination is given. These codes were effective on 9/29/09.

www.ama-assn.org/ama/pub/h1n1/resources/cpt-codes.shtml

  • Influenza Immunizations CPT Codes
    • 90470-H1N1 immunization administration (intramuscular, intranasal), including counseling when performed
    • 90663-Influenza virus vaccine, pandemic formulation, H1N1
  • Influenza ICD9-CM Diagnosis Code
    • Beginning on October 1, 2009, health care facilities are to identify the H1N1 flu using the ICD-9 diagnosis code 488.1 for influenza due to identified novel H1N1 influenza virus.

Season's Greetings

The SPARCS staff would like to take this opportunity to thank all the facilities for their continued work that has made SPARCS successful for 30 years. We would also like to wish you and your families a wonderful holiday season and a new year filled with good health and happiness.