Information Bulletin, October 2009


Physician License Numbers
Correction of Potential Duplicate Records
Audit Process Leading to Statement of Deficiency
NUBC Changes for October 1, 2009
Reminder of Source of Payment Typology Reporting
SPARCS 30th Anniversary Commemoration

Physician License Numbers

The SPARCS Unit recently examined the reporting accuracy of Attending, Operating, and Other Physician License Numbers, as submitted by healthcare facilities for 2007, 2008, and 2009. The analysis revealed reporting accuracy issues in many facilities. Although there has been some improvement over the past few months, it is necessary for all facilities to reach and maintain a 90% level of accuracy in reporting physician license numbers.

In order to improve reporting accuracy, two summary reports have been added to the Health Commerce System (HCS). The first report is a "Pre-edit Physician License Report". This report is for each data submission sent to SPARCS. Information can be found at: www.health.state.ny.us/statistics/sparcs/x12-837/announcement_letters.htm.

The second report, the "Physician License Quality Report", is located in the SPARCS Quality Reports section of the HCS. Reports are available for calendar years 2007, 2008, and 2009 and are refreshed each month following the monthly data update.

Please note that beginning January 1, 2010, all facilities must reach the 90% accuracy level on the pre-edit report for their data file to be accepted by the mainframe edit program.

Correction of Potential Duplicate Records

A second quality initiative focuses on the elimination of "potential duplicate records" found in the SPARCS database. An analysis of SPARCS data determined that approximately half of the facilities report a small number discharges multiple times. These duplicate records contain highly similar information. The slight differences in reporting commonly involve one of the following data elements: patient control number, medical record number, unique personal identification number, and insurance policy identification number. A quality report has been developed and posted 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 duplicate records.

Audit Process Leading to Statement of Deficiency

In 2007, audit compliance resulted in several facilities receiving a Statement of Deficiency (SOD) for failure to submit the correct amount of SPARCS information. Two facilities received civil penalties and paid the associated fine for failure to submit data to SPARCS. The 2008 audit compliance process is nearing completion. Any facility with outstanding records needs to submit their information as soon as possible.

NUBC Changes for October 1, 2009

The following changes to Patient Discharge Status/Disposition coding have been implemented and are effective October 1, 2009:

Code      Status/Disposition
01 Definition Redefined Effective 10/1/09:  
Discharge to Home or Self Care (Routine Discharge)
USAGE NOTE:  Includes discharge to home; home on oxygen if DME only; any other DME only; group home, foster care, independent living and other residential care arrangements; outpatient programs, such as partial hospitalization or outpatient chemical dependency programs.

04 Definition Redefined Effective 10/1/09:  
Discharged/transferred to a Facility that Provides Custodial or Supportive Care (ICF is no longer used in NYS)
USAGE NOTE:  Includes intermediate care facilities (ICFs) if specifically designated at the state level. Also used to designate patients that are discharged/transferred to a nursing facility with neither Medicare nor Medicaid certification and for discharges/transfers to Assisted Living Facilities.

SPARCS Notation: NYS no longer has the ICF designation for nursing homes. This code should be used for State Designated ALPs only. A list of facilities can be found at: www.health.state.ny.us/facilities/assisted_living/licensed_programs_residences.htm.

21 Effective 10/1/09:  
Discharged/transferred to Court/Law Enforcement
USAGE NOTE:  Includes transfers to incarceration facilities such as jail, prison or other detention facilities.

For a complete description of all the current and discontinued Patient Discharge Status/Disposition Codes, please refer to the updated Appendix C on the SPARCS website at www.health.state.ny.us/statistics/sparcs/sysdoc/appc.htm. Additional information is also available through a set of FAQs appearing on the SPARCS website at: www.nyhealth.gov/statistics/sparcs/faqs/.

Reminder of Source of Payment Typology Reporting

In order to align payer information with existing insurance structures and programs, SPARCS has added a new source of payment variable developed by the Public Health Data Standards Consortium (PHDSC). 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. As noted in the announcement letter, the SPARCS data system was able to accept these new data elements beginning July 1, 2009, and all facilities are expected to completely transition to the new Source of Payment Typology by December 31, 2009. A successful transition is defined as having at least one submission successfully pass the SPARCS production file edits for these new data elements. Please keep in mind that effective January 1, 2010, Source of Payment Typology must be reported on all claims with discharge years of 2010 and beyond.

SPARCS 30th Anniversary Commemoration

On October 7, 2009, members of the Data Protection Review Board, past and present staff, and other invited guests were honored at a SPARCS 30th Anniversary Commemoration. Presentations were made on the history of the system and the major milestones of the past 30 years.

It was noted that over its first 30 years, SPARCS has been transformed from a vision of a few forward-thinking individuals to an elaborate data repository comprising millions of records across an ever expanding breadth of healthcare services. SPARCS now serves as a core component of the informational infrastructure of many important areas of healthcare provision within New York State. Congratulations to all the healthcare facilities for making this a truly invaluable data system and a significant achievement for New York State.