Information Bulletin, September 2002


Data Submissions
Ambulatory Surgery and Emergency Department Data Collection
HIPAA Compatibility Testing
ICD-9-CM Reference File
Patient Status Code Issue
Regulatory Changes
Patient Safety Data Initiative

Data Submissions

Once again hospitals and vendors should be congratulated for another successful year of data submissions. For data received through the month of September approximately 98% of projected 2001 SPARCS data has been posted to the SPARCS master files. Facilities identified with possible data shortfalls are being contacted by SPARCS staff. We anticipate publishing the 2001 Annual Report with data submitted through the month of November. The ARS publication will note those facilities with a shortfall along with an explanation, which will also be posted on the SPARCS public web site.

There are facilities that currently have data shortfalls because their original or corrected data has not been submitted to SPARCS. Should you have any questions concerning the status of your 2001 data, please do not hesitate to contact the SPARCS Administrative Unit. Just as a reminder, the status of your inpatient and outpatient master file submissions is available on our Audit and Submission History Report page on our public web site.

The Health Provider Network (HPN) is the secured submission vehicle maintained and used by the Department, including SPARCS, for submission of electronic data. As we get ready to receive HIPAA compatible submissions, the submission of data electronically is a key factor in the projected savings that HIPAA will bring to the Health Care Industry. It is important to note that SPARCS will only accept HIPAA compatible submissions for inpatient, ambulatory surgery, and soon emergency department submissions via the HPN. Any New York State providers not already using the HPN to submit data to SPARCS are encouraged to call your friendly SPARCS Administrative Unit person to get connected.

Ambulatory Surgery and Emergency Department Data Collection

Governor Pataki signed legislation in September 2001 to authorize the collection of emergency department data. In collaboration with other bureaus within the Department of Health, Greater New York Hospital Association (GNYHA) and the Healthcare Association of New York State (HANYS) a series of industry outreach meeting were held last spring to solicit industry input into the system design. The result will be a system that uses HIPAA standards to satisfy Department needs. We also want to thank the New York State chapter of the American College of Emergency Physicians (ACEP) and the New York Health Information Management Association (NYHIMA) for their contributions to this development initiative.

At each of the outreach meetings, the industry made it clear that the collection of emergency department data by SPARCS needed to fit into their current business processes. The implication for SPARCS was that emergency department data would be coming from two sources.

The data for patients that receive emergency department services and are admitted for acute care as an inpatient are already collected by SPARCS. For this situation, there are no changes to the SPARCS system.

The data for patients that receive emergency services from a hospital's emergency department and are discharged from that emergency department will reside on the hospital's outpatient billing system. That is also the source for our current ambulatory surgery data. This will require classment of the data requirements for ambulatory surgery and emergency department data. The classment process necessitates the changes to the ambulatory surgery data collection system that were announced in our June Bulletin. For all 2003 discharges the new requirements for submission of ambulatory surgery data will be in effect. For the 2003 calendar year, SPARCS will continue to edit prior years ambulatory surgery data submissions as they are today, unless the additional data requirements are provided. Any provider wanting to test their changes for ambulatory surgery data submissions should contact the SPARCS Administrative Unit staff at your earliest convenience.

Testing for emergency department data collection will begin sometime in the first quarter of 2003. The specifics for testing emergency department data collection will be announced in a future bulletin.

HIPAA Compatibility Testing

SPARCS will accept a HIPAA compatible claim format (837) to meet all inpatient, ambulatory surgery, and soon to be collected emergency department data. We have contracted with Orion Systems to map the 837-formatted submissions for use in our application system. Our requirements for the 837-format are posted on our public web site. Any provider wanting to test their SPARCS HIPAA compatible data submissions should contact the Administrative Unit at your earliest convenience.

ICD-9-CM Reference File

Changes to the ICD-9-CM reference file will take effect October 1, 2002. Any new diagnosis or procedure codes must be reported for all discharges after that date.

Patient Status Code Issue

The National Uniform Billing Committee (NUBC) approved a new Patient Status code (64 - Discharged / Transferred to a nursing facility certified under Medicaid, but not certified under Medicare). One of the conditions for Medicaid certification of nursing homes in New York State is Medicare certification. Since this new code is not applicable to New York State providers, it will not be valid on the SPARCS system. Any provider that discharges a patient to an out-of-state nursing home for which this code might apply should contact the SPARCS Administrative Unit.

Regulatory Changes

The supporting regulations for the Emergency Department Data Collection System are currently under an internal review at the Department of Health in preparation for review by the Public Health Council and State Hospital Review and Planning Council. This process will solicit additional comments by the public in regards to the proposed amendments to the SPARCS regulations. Once the internal review process has been completed, SPARCS will post a copy of the proposed regulations on our public web site and will announce the date that these regulations will be considered for review by the Public Health Council.

Patient Safety Data Initiative

The DOH Patient Safety Center is working with the SPARCS Bureau to identify opportunities to improve the utility of SPARCS data for purposes of quality of care improvement. The mission of the Patient Safety Center, created when Governor Pataki signed into law the Patient Health Information and Quality Improvement Act of 2000, is to maximize patient safety, reduce medical errors, and improve the quality of health care by improving systems of data reporting, collection, analysis, and dissemination.

The Center and the SPARCS Bureau have begun a collaborative effort to review SPARCS data and identify ways it can be used to help achieve the Center's mission. The Center is interested in your perspective. Suggestions are welcomed and should be sent to Keith W. Servis, Deputy Director of the Patient Safety Center, NYS Department of Health, 161 Delaware Avenue, Delmar, New York 12054, or at kws04@health.state.ny.us. Both the Center and the Bureau look forward to continuing to work with the hospital and health data communities to improve our use of data for informed decision making.