Information Bulletin, July 1997
1996 Data Submissions|
Payer ID Codes
1996 Data Submissions
Our congratulations to all those providers and their vendors for another successful year of SPARCS submissions. Current submissions account for 96% of the expected data. This indicates that most facilities were able to submit their data consistent with the June 30th regulatory deadline. Those facilities still experiencing problems with their 1996 SPARCS submissions are being contacted to determine the nature of the problem and when compliance with Department regulations can be expected.
The more data submitted, the more will be available for users throughout the Department of Health and the health care industry. Little or no data on file creates obvious case mix problems for the facility and region as well as the overall statewide casemix. We anticipate submission levels to be sufficient to publish the 1996 SPARCS Annual Report later this fall. In addition, we publish statewide audit counts on the Department's Web site. This will alert interested parties about the completeness of SPARCS data. Therefore, even though the June 30th data has passed, SPARCS data can still be submitted. It is in the best interest of all concerned that accurate and complete data be submitted to SPARCS.Outpatient Data
According to Section 755.1 of the Public Health Law ambulatory surgery is defined as the following:
An Ambulatory Surgery service is a service organized to provide those surgical procedures which need to be performed for safety reasons in an operating room on anesthetized patients requiring a stay of less than 24 hours duration. These procedures do not include those outpatient surgical procedures which can be performed safely in a private physician's office or in an outpatient treatment room.
This is the legislative mandate SPARCS uses to define what data it should collect for outpatient surgery services. It has come to SPARCS attention that this definition may be lending itself to various interpretations. For instance, When does the 24 hours begin or end? Is it when the patient is checked in our when the procedure starts? Does the 24 hours end when the physician signs off on the discharge or when the patient leaves the facility? Is pre- or post-surgery observation time part of this 24 hours? Do different payers interpret this 24-hour time frame differently?
SPARCS also sees a need to define treatment rooms versus operating rooms. Are some operating rooms used interchangeably as treatment rooms because of physical limitations within the facility?
SPARCS would like to get your input into this matter. Please let us know your concerns regarding the application of this definition at your facility.Internet News
Downloading from the Web will soon be the primary option for obtaining information you have previously been receiving from SPARCS in hard copy. HCNAPPS software Version 4.13 will be among the materials available for downloading. The steps can be found in the 'help me' file that will accompany the file to be downloaded. No matter whether you have DOS, Windows 3.1X, or Windows 95, downloading files from the Web can be a painless and rewarding experience.
The strength of this media will enable us to make updates available immediately without having to undertake the expensive and time-consuming steps involved in mailing these materials. The download steps require that you click on a couple of commands and follow a simple sequence of steps. We invite you to familiarize yourself with the Department of Health's Web site: www.health.state.ny.us. As always, we welcome your response and hope that you share our enthusiasm for this exciting new delivery of SPARCS information.
For those who have access to the Internet, the New York State Department of Education Web sites has Online License Verification for the various professions. Searching can be done by the individual's name or license number at: www.nysed.gov.Payer ID Codes
In 1996 SPARCS adopted the Department of Insurance National Association of Insurance Company (NAIC) codes as the standard for commercial company codes. Soon after we published our 1996 guidelines it was brought to our attention the Envoy-NEIC codes were used by many of the hospitals for electronic coding of commercial carriers. Last April the Universal Data Set Task Force for Institutional Providers approved the inclusion of NEIC codes as an acceptable way of identifying commercial companies on the SPARCS data base. Since many of the hospitals use carriers identified by these codes, it was felt that NEIC codes would enhance the accuracy and comprehensiveness of SPARCS commercial payer identifiers.
Current SPARCS edits allow for the reporting of numeric codes and alpha-numeric codes beginning with "X" or "Y". While we continue our analysis to establish more specific edits, accurate reporting of these acceptable codes is recommended in order to enhance the value of your current data. Remember SPARCS data is yours to use. If the only acceptable codes are unsupported alpha-numeric NEIC codes, the 98999 code may still be reported, but we urge that you use this generic code very sparingly.Neonatal Birthweight
A study of the birthweights reported to SPARCS for 1995 newborns showed
that about 8% of hospitals reporting newborns record birthweight in
increments of 10 grams, and about 30% report in increments of 5 grams.
The intent of SPARCS is collect data consistently and accurately across
the state. We ask that the neonatal birthweights be reported
as recorded exactly on the medical record.