59B-9.034. Reporting Instructions  

Effective on Monday, January 1, 2018
  • 1(1) Ambulatory Surgical centers shall report data for all non-emergency visits for surgical procedures or services performed in the operating room, ambulatory surgical care, cardiology (27cardiac catheterization and 30percutaneous transluminal coronary angioplasty (PTCA)35), 36gastro intestinal, extra-corporeal shock wave treatment (lithotripsy) 43surgery, and endoscopy corresponding to the following 50Current Procedural Terminology (CPT) and corresponding HCPCS 57Codes. 58For hospitals reporting type of service “1”, ambulatory surgical procedures, report CPT codes in the reportable range 75defined in paragraphs 7859B-9.034(1)(a), 79(b), F.A.C., 81having revenue charges for 36XX, 48XX, 49XX, 75XX or 79XX as used in the UB-04. Visits without these revenue charges should not be reported even if the CPT codes are in the reportable range. Type of service “2”, Emergency Room, visits are not restricted to a CPT-HCPCS reportable range and should report all procedure codes.

    136(a) 10021 through 69999. Including surgery, cardiac catheterization, endoscopy procedures, and lithotripsy 148revenue associated procedure codes152.

    153(b) 92920 through 92998 and 93451 through 93533. Includes percutaneous transluminal coronary angioplasty (PTCA) and Cardiac Catheterization.

    170(c) Exclude visits where the primary reason for the visit is venipuncture for laboratory services.

    185(d) Report one record for each visit, except pre-operation visits may be combined with the record of the associated ambulatory surgery visit. See subsection 20959B-9.031(11), 210F.A.C.

    211(2) Emergency Departments (ED) shall report data for:

    219(a) Emergency department visits in which emergency department registration occurs for the purpose of seeking emergency care services, including observation, and the patient is not admitted for inpatient care at the reporting entity.

    252(b) The CPT-HCPCS codes representing the services provided as part of the emergency department visit. CPT-HCPCS codes are reported in the ‘OTHER CPT-HCPCS’ fields (1-30) and are not restricted to the CPT-HCPCS reportable range defined in paragraph 28959B-9.034(1)(a), 290F.A.C., for an ambulatory surgical center.

    296(c) An Emergency Department Evaluation and Management Procedure code representing the patient’s acuity as part of the emergency department visit.

    316(d) An ED visit occurs even if the only service provided to a registered patient is triage or screening. If a registered patient leaves prior to being seen by a physician, report the discharge status as “07” “AMA/discontinued care” and charges if incurred. Report zero if charges are not incurred.

    366(e) Do not include visits for registrations that occur in the Emergency Department when the hospital central registration department is closed unless emergency services are provided.

    392(3) Hospitals shall exclude records of any patient visit in which the outpatient and inpatient billing record is combined because the patient was admitted to inpatient care within a facility at the same location per Section 428408.061(3), F.S.

    430(4) For each patient visit, ambulatory centers shall report all services provided using procedural codes specified in Rules 44859B-9.037 449and 45059B-9.038, 451F.A.C.

    452(5) 453An individual approved by the Agency 459must submit a zipped XML file by Internet according to the specifications in paragraphs (a) through (c), below.

    477(a) Internet Transmission. The Internet address for receipt of ambulatory patient data is 490https://apps.ahca.myflorida.com/patientdata/491.

    492(b) Data 494reported for visits occurring before first quarter 2018 502to the Internet address shall be electronically transmitted with the zipped ambulatory data in a XML file using the Ambulatory Patient Data XML Schema available at http://ahca.myflorida.com/xmlschemas/AS10-2.xsd. 529The Ambulatory Data XML Schema (effective 10/01/2015) is incorporated by reference and available at 543http://www.flrules.org/Gateway/reference.asp?No=Ref-08832545.

    546(c) 547Beginning with first quarter 2018 data reporting period as defined in paragraph 55959B-9.033(1)(c), 560F.A.C., Ambulatory patient data must be submitted using Ambulatory Patient Data XML Schema AS10-3, available at: http://ahca.myflorida.com/xmlschemas/AS10-3.xsd, The Ambulatory patient Data XML AS10-3 Schema (effective 01/01/2018) is incorporated by reference at 591http://www.flrules.org/Gateway/reference.asp?No=Ref-08833593. 594The data in the XML file shall contain the data elements, codes and standards required in Rules 61159B-9.037 612and 61359B-9.038, 614F.A.C.

    615Rulemaking Authority 617408.15(8) FS. 619Law Implemented 621408.061, 622408.062, 623408.063 FS. 625History–New 1-1-10, Formerly 62859B-9.015, 629Amended 12-5-10, 10-1-15, 1-1-18.