Information Bulletin, November 26, 2007


New Reporting Cycle for 2008
Acute Myocardial Infarction (AMI) Reporting Deadline
DPRB 2008 Schedule
Changes in data elements for 2008
Resources

New Reporting Cycle for 2008

In order to streamline the reporting timeframe for the inpatient, ambulatory surgery and emergency department data reporting, SPARCS is changing the reporting cycle for all submissions to be the on the same cycle as the inpatient reporting cycle. This is a 60 day reporting cycle for discharges. Thus, 95% of all discharge/visit data should be submitted to SPARCS within 60 days from the date of discharge/visit. This change will take effect on January 1, 2008. SPARCS will be monitoring for 95% of the discharges based on a 12-month moving average.

Data Submission Cycle Example
Inpatient
Ambulatory Surgery
Emergency Department   
95% of discharges due within 60 days.   
Remaining 5% due by June 30th
of the following year.

January discharges
due by March 31st.

Acute Myocardial Infarction (AMI) Reporting Deadline

A joint project with the NYS DOH Cardiac Services Program and SPARCS announced three new data elements in January 2007 to be reported effective July, 2007. In this announcement, a six month transitional period was granted for data collection. This transition period is coming to a close; the SPARCS/AMI data elements, Heart Rate and Blood Pressure (Systolic and Diastolic), must be reported on all discharges with AMI Principal Procedures 410.0x- 410.9x starting January 1, 2008. Any record with a discharge year of 2007 and forward with a principal procedure of AMI will be rejected without the values for Heart Rate and Blood Pressure effective on January 1, 2008.

DPRB 2008 Schedule

The Data Protection Review Board (DPRB) approves the release of SPARCS identifying data elements for inpatient, ambulatory surgery and emergency department data. Any users interested in accessing SPARCS data containing identifying data elements must submit an application. A new application form and instructions are available at: www.nyhealth.gov/statistics/sparcs/dprb. All applicants must be available in person or by phone to answer Board question regarding their application. The following schedule is for 2008.

Application Due Meeting Date
November 12, 2007      
January 21, 2008
April 28, 2008
July 28, 2008
January 9, 2008
April 2, 2008
July 9, 2008
October 8, 2008

Changes in Data Elements for 2008

SPARCS is committed to addressing the needs of the data submitters and the data users. In doing this, we are addressing changes to three data elements; Principal Expected Reimbursement, Procedure Time and the Outpatient's Principal Procedure Code (ICD-9-CM). Beginning with January 1, 2008, the following changes are being made:

  • Required Expected Principal Reimbursement for Emergency Department Discharges
    The Expected Principal Reimbursement data element will now be required for Emergency Department discharges. (Previously this was only reported for Inpatient and Ambulatory Surgery). This will be used for rate calculations and other analysis within the Department related to payment source. Effective July 1, 2008 this will become a hard edit and emergency department records will fail without the Expected Principal Reimbursement in the NTE segment. This edit will be effective January 1, 2008 for all dates of discharge.

    Expected Principal Reimbursement
    Required for All Discharges Position in X12-837
    Inpatient, Ambulatory Surgery,      
    Emergency Department
    2300 Loop,NTE segment
    (same for Inpatient and Outpatient)
    1-2, A/N
  • Procedure Time moved to NTE segment
    This data element, previously called 'Operating Room Time', has been collected by SPARCS since 1994 for ambulatory surgery discharges using a "value code=83" and a "value amount". This data element is used for analysis during the rate setting process. The procedure time can be linked to the probability of complications and costs. Unfortunately, NUBC has assigned a new value to code 83 (Life Time Reserve Days) and SPARCS must move this data element to the note section (NTE) of the X12-837 format. This change will become effective on January 1, 2008 for any date of discharge. You will no longer need the value code of "83"; simply move the procedure time amount into the NTE section in the positions 17-19. Submissions during January - June 30, 2008 will be a transition period; SPARCS will first look for the Procedure Time in the NTE section, if it is not in this section, SPARCS will look in the value code and amount fields. Effective July 1, 2008 this will become a hard edit and ambulatory surgery records will fail without the procedure time in the NTE segment. This edit will be effective for all dates of discharge.

    SPARCS 2300 NTE SEGMENT OUTPATIENT LAYOUT
    Description Position Length Format
    Expected Principal Reimbursement   

    Method of Anesthesia
    Patient's Race
    Patient's Ethnicity
    Heart Rate
    Blood Pressure - Systolic
    Blood Pressure - Diastolic
    Procedure Time
    1-2

    3-4
    5-6
    7-7
    8-10
    11-13
    14-16
    17-19
    2

    2
    2
    1
    3
    3
    3
    3
    A/N

    A/N
    A/N
    A/N
    A/N
    A/N
    A/N
    A/N
    Effective 1/1/08. Required on ED
    discharges 2008 starting 7/1/08.







    Effective 1/1/08. Required on
    ALL discharges 2008 starting 7/1/08.
  • Removal of edit for Principal Procedure (ICD-9-CM) Code reporting on Outpatient discharges
    Most payers do not require the ICD-9-CM procedure codes on their outpatient bills. In order to be consistent with the practices within the outpatient setting, SPARCS will no longer have a hard edit on the ICD-9-CM procedure code for ambulatory surgery and emergency department claims effective January 1, 2008 for any date of discharge. If you continue to submit this data element on your file, it will not fail the record; SPARCS will not edit the values in the outpatient file.

Resources

The new ICD-9-CM Reporting Guidelines for 2007, effective October 1, 2007, is available at: www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/icdguide07.pdf. This guideline reference can assist with many aspects of the ICD-9-CM diagnosis codes; there are sections on conventional coding, disease-specific coding, selection of the principal diagnosis and guidance on diagnosis coding and reporting for outpatient series. In addition, "Appendix I: Present on Admission Reporting Guidelines" outlines examples for reporting this data element and lists the codes that are exempt from reporting for this data element.