Information Bulletin, October 2001


Data Submissions
HIPAA News
SPARCS System Issues
SPARCS News

Data Submissions

Once again hospitals, clinics, and vendors should be congratulated for another successful year of data submissions. For submissions through the month of September approximately 99% of projected 2000 SPARCS data has been posted to SPARCS master files. SPARCS staff is continuing to contact those facilities identified with possible data shortfalls. We anticipate publishing the 2000 Annual Report Series (ARS) data tables with data submitted through the month of October. The ARS publication will note those facilities with a shortfall along with an explanation, which will be posted on the SPARCS public web site.

There are a few facilities that have data shortfalls at this time because their original or corrected data has not been submitted to SPARCS. Should you have any questions concerning the status of your 2000 data, please do not hesitate to contact the SPARCS Administrative Unit. You can also visit the SPARCS Public Web site to see the status of your inpatient and outpatient master file submissions.

HIPAA News

The Health Insurance Portability and Accountability Act (HIPAA) final rule on Transactions and Code Sets takes effect in one year on October 16, 2002. Though SPARCS is not a covered entity we intend to accept the HIPAA claim / encounter transaction standard (837) to comply with SPARCS requirements. We expect to start testing the 837 transaction in the spring of 2002. We understand that providers and vendors need sufficient development time to make the necessary system changes. To that end our public Web site has been updated to include the necessary documentation to submit an 837 to SPARCS. Included is a mapping of current data elements (in the body of the SPARCS Input Documentation), and ANSI ASC X12 syntax with detailed coding instructions ( Inpatient 837 Addendum and Outpatient Addendum).

The SPARCS production process will be coordinated with the national HIPAA implementation schedule. SPARCS will continue to accept Version 5 and 6 submission files along with 837 formatted files after October 16, 2002.

In a change from previous Universal Data Set for Institutional (UDS/IP) Task Force meetings we are in the process of organizing the next meeting for early November. Payers are working together to provide a forum to discuss obstacles to implementation of the transactions and final rules on October 16, 2002. Any providers interested in sharing their implementation experience to date as part of this meeting should contact the SPARCS Administrative Unit. Past UDS/IP meetings have been more focused on disseminating information about HIPAA. This meeting will focus on more operational issues. Current members of the UDS/IP task force will be contacted by e-mail and by letter with the agenda and the date in November. Anyone else interested in information about this next meeting should contact the SPARCS Administrative Unit at sparcs@health.state.ny.us. Remember together our accomplishments can truly be remarkable.

SPARCS System Issues

Changes to the ICD-9-CM reference file took effect October 1. Any new diagnosis or procedure codes must be reported for all discharges after that date.

Recently, there was a question about one of our edits that was not clearly explained in our documentation. At issue was the reporting of e-codes when one of the following diagnosis codes is present: 995.0, 995.1, 995.3, or 995.89. In this case the reporting of an appropriate e-code is NOT optional. What is optional is where the e-code may be reported. If the e-code was a result of an incorrect medicinal substance and/or substance incorrectly administered, then the e-code should be reported in the External Cause-of-Injury field. If the e-code was as a result of a correct medicinal substance properly administered, then the e-code should be reported in the Other Diagnosis Code field. Appendix N of the SPARCS Documentation has been changed to further clarify the SPARCS edit in this situation.

In continuation of proactive data analysis activities, SPARCS staff will be contacting hospitals with suspected anomalies with data reported to SPARCS. SPARCS staff investigates eporting patterns that vary significantly from statewide averages. The two data elements that are currently being nalyzed are the Patient Status and the Unique Personal Identifier. SPARCS staff are trying to determine if the anomaly is due to unusual business circumstances or are in fact reporting problems. One of the enhancements on the drawing board for the SPARCS system is to make the supporting reports on these anomalies available through the Health Provider Network (HPN). This enhancement to our secured HPN application will be announced in a future bulletin. Hospitals having recommendations for development of pertinent hospital specific data quality reports should contact SPARCS Administrative Unit sparcs@health.state.ny.us. As always, we appreciate your cooperation.

SPARCS News

As of October 16, 2001, Gail Chase will be retiring from state service and from the SPARCS Administrative Unit. Gail has been a loyal member of the SPARCS Unit for many years and her contributions to SPARCS Users will be missed. We hope you join us in wishing her well in her retirement.