July 11, 2006 - 837 Announcement Letter

Re: Requirement for all 2007 SPARCS discharges to be submitted in the X12- 837 format starting in July 2007

Dear Hospital CEO / Health Facility Administrator:

As you know, your facility submits data electronically to the Department of Health's Statewide Planning and Research Cooperative System (SPARCS); a dataset that represents your facility and the health services it provides within the health system in New York State. What you may not realize, SPARCS was created to reflect information on a medical bill, specifically adopting the National Uniform Billing Committee (NUBC) standards. In order for SPARCS to continue making significant and progressive changes, we must adjust for changes in the national billing formats. Thus, SPARCS must make modifications for the new uniform bill (UB04), which requires the National Provider ID for all providers and other modifications. In order to capture this information electronically, SPARCS must move forward and require the X12-837 electronic format of the uniform bill, instead of the Version 5/6 of the older uniform bill (UB92).

We are hopeful that most facilities are already submitting claims in the X12-837 format; in fact, Medicare already requires claims to be submitted in this format for payment. More importantly, SPARCS already accepts submissions in the X12-837 format. However, we recognize that system changes must take place on both your end and our end to adjust for the National Provider ID and other modifications.

In order to allow time for the system changes, and to have all data for 2007 in the same X12-837 format, we are extending the due date of SPARCS data submissions for discharges beginning in January of 2007 to July 31, 2007. All Inpatient, Ambulatory Surgery and Emergency Department data submissions for 2007 discharges must be submitted in the X12-837 format starting on July 1, 2007. (The Version 5/6 electronic format will not be available after June 30, 2007.)

Although typically changes to SPARCS are associated with the Health Information Management (HIM) or Medical Records Department, we anticipate that much of the work associated with this requirement will fall on the Information Systems or IT area of your facility. If not already in place, it would be helpful for a "SPARCS Team" (consisting the appropriate contact in: Patient Accounts, HIM, IT, Quality and Finance members) be developed at your facility that can address changes and new modifications coming to SPARCS.

Your guidance in providing timely, accurate, and complete SPARCS data is greatly appreciated. If you have any questions, please contact us at (518) 473-8144 or sparcs@health.state.ny.us.

Sincerely,

Laura K. Dellehunt
Director, SPARCS Administrative Unit
Bureau of Biometrics and Health Statistics

cc: SPARCS Representative