Information Bulletin, March 1996

Data Quality
Edit Change for E-codes

Data Quality

As information systems have become more established in generating SPARCS data in the UDS format, completeness of reporting is becoming less of a problem. This has allowed the SPARCS staff to focus more attention on the issue of data quality. In this and future bulletins, results of our data quality investigations will be published in an effort to promote standard reporting practices across the state. It continues to be our goal to standardize how data is reported to SPARCS to ensure the a high quality of data for users of SPARCS data. Listed below are two deviations from what we would consider to be a standard reporting practice:

  1. In reviewing 1995 discharges for newborns and mothers, several facilities did not enter a "V27" diagnosis code on each of the mother's records indicating "outcome of delivery". This is not in accordance with recommended ICD-9-CM coding guidelines.
  2. As part of the reporting requirements for the Unique Personal Identifier, it is necessary for facilities to include the first two characters of a patient's name. Several facilities are using mnemonics, such as "BB" for baby boy or "FE" for female, instead of real first names for newborn patients Coding guidelines for unnamed newborns are under development and will be published in future SPARCS correspondences.
Edit Change for E-codes

We want to thank NYHIMA for their cooperation and patience in helping us identify the problems with our existing e-code edits. The edit, as described below, has been implemented effective February 26, 1996. This change is a further refinement to an earlier change made to our e-code edits. We hope that these changes more closely reflect the proper medical coding practices for e-codes and will result in a higher quality of data being reported to SPARCS. This change will also be published by NYHIMA as well as in the next release of the SPARCS documentation.

As part of an ongoing effort to make SPARCS edits reliable and consistent with common ICD-9-CM coding guidelines, two exception situations have been identified to us by NYHIMA. Listed below is a description of the problem and the solution implemented in the current SPARCS edits for e-codes:

  • Previous Edit Description

    Whenever a principal or other diagnosis code in the range of 800-999.99 is reported, the SPARCS edits require:

    an e-code be reported in the External Cause-of-Injury field, and

    adverse affect (correct medicinal substance properly administered) codes E930-E949.9 must be reported in only the Other Diagnosis Code fields.

  • Coding Exceptions Resolved in this New Edit

    Exception 1:

    Problem: Certain codes - 990, 995.2, 995.4, 995.60-995.69 - do NOT always have e-codes that could be associated with these diagnoses. Therefore, it is a problem to have SPARCS require an e-code to be reported in the External Cause-of-Injury field when one of these diagnosis codes is reported as a Principal or Other.

    Resolution: External Cause-of-Injury field will not be required when 990, 995.2, 995.4, or 995.60-995.69 are reported in principal or other diagnosis fields.

    Exception 2:

    Problem: When diagnosis codes 995.0, 995.1, 995.3, or 995.89 are reported it is possible that the appropriate associated e-code that could be reported is an adverse affect (correct medicinal substance properly administered) code, E930- E949.9, which should be reported in an Other Diagnosis Code field. Under these circumstances no e-code would need to be reported in the External Cause-of-Injury field, OR

    When diagnosis codes 995.0, 995.1, 995.3, or 995.89 are reported, it is also possible that the condition is due to an injury/poisoning (incorrect medicinal substance and/or substance incorrectly administered), which means that an e-code other than E930-E949.9 must be reported in the External Cause-of-Injury field.

    Resolution: When diagnosis codes 995.0, 995.1, 995.3, or 995. 89 are reported, the appropriate e-codes must be reported in either the External Cause-of-Injury or in Other Diagnosis fields.

    Note:   Please note that when principal and other diagnosis codes in the range of 800-999.99 not specifically clarified in Exceptions 1 and 2 are reported, SPARCS will still require the reporting of the External Cause-of-Injury.