The rule amendments add inpatient data elements, modify inpatient data elements and codes, and modify inpatient data formats related to the reporting of present at admission data.

OTHER AGENCIES AND ORGANIZATIONS

RULE NO: RULE TITLE
59E-7.012: Inpatient Data Reporting and Audit Procedures
59E-7.014: Inpatient Data Format - Data Elements, Codes and Standards
PURPOSE AND EFFECT: The rule amendments add inpatient data elements, modify inpatient data elements and codes, and modify inpatient data formats related to the reporting of present at admission data.
SUBJECT AREA TO BE ADDRESSED: The agency is proposing amendments to Rules 59E-7.012 and 59E-7.014, F.A.C., that modify inpatient data reporting requirements.
SPECIFIC AUTHORITY: 408.061(1)(a), 408.061(2), 408.08(2), 408.08(5) FS.
LAW IMPLEMENTED: 408.05(3)(l)1. FS.
A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: December 13, 2006, 10:00 a.m.
PLACE: Agency for Health Care Administration, Building 3, First Floor Conference Rooms A, 2727 Mahan Drive, Tallahassee, Florida 32308
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Lisa Rawlins, Bureau Chief, Florida Center for Health Information and Policy Analysis, Building 3, 2727 Mahan Drive, Tallahassee, Florida 32308

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

59E-7.012 Inpatient Data Reporting and Audit Procedures.

(1) through (7) No change.

(8)(a) No change.

(b) Data submitted to the Internet address shall be electronically transmitted with the inpatient data in the XML file using the Inpatient Data XML schema available at http://ahca.myflorida.com. The Inpatient Data XML Schema is incorporated by reference.

(c) No change.

(9) through (12) No change.

Specific Authority 408.061(1)(e), 408.15(8) FS. Law Implemented 408.061, 408.08(1), (2), 408.15 (11) FS. History–New 12-15-96, Amended 1-4-00, 7-11-01, 7-12-05,_______.

 

59E-7.014 Inpatient Data Format – Data Elements, Codes and Standards.

(1) No change.

(2)(a) through (o) No change.

(p) Present on at Admission Indicator for Principal Diagnosis Code, Present on Admission for Other Diagnosis Code (1), Present on at Admission Indicator for Other Diagnosis Code (2), Present on at Admission Indicator (3), Present on at Admission Indicator for Other Diagnosis Code (4), Present on at Admission Indicator for Other Diagnosis Code (5), Present on at Admission Indicator for Other Diagnosis Code (6), Present on at Admission Indicator for Other Diagnosis Code (7), Present on at Admission Indicator for Other Diagnosis Code (8), Present on at Admission Indicator for Other Diagnosis Code (9), Present on at Admission Indicator for Other Diagnosis Code (10), Present on at Admission Indicator for Other Diagnosis Code (11), Present on at Admission Indicator for Other Diagnosis Code (12), Present on at Admission Indicator for Other Diagnosis Code (13), Present on at Admission Indicator for Other Diagnosis Code (14), Present on at Admission Indicator for Other Diagnosis Code (15), Present on at Admission Indicator for Other Diagnosis Code (16), Present on at Admission Indicator for Other Diagnosis Code (17), Present on at Admission Indicator for Other Diagnosis Code (18), Present on at Admission Indicator for Other Diagnosis Code (19), Present on at Admission for Other Diagnosis Code (20), Present on at Admission Indicator for Other Diagnosis Code (21), Present on at Admission Indicator for Other Diagnosis Code (22), Present on at Admission Indicator for Other Diagnosis Code (23), Present on at Admission Indicator for Other Diagnosis Code (24), Present on at Admission Indicator for Other Diagnosis Code (25), Present on at Admission Indicator for Other Diagnosis Code (26), Present on at Admission Indicator for Other Diagnosis Code (27), Present on at Admission Indicator for Other Diagnosis Code (28), Present on at Admission Indicator for Other Diagnosis Code (29), and Present on at Admission Indicator for Other Diagnosis Code (30), Present on Admission Indicator for External Cause of Injury Code (1), Present on Admission Indicator for External Cause of Injury Code (2), and Present on Admission Indicator for External Cause of Injury Code (3). (30) A code differentiating whether the condition represented by the corresponding Principal Diagnosis Code (n), Other Diagnosis Code other diagnosis code (o) (1) through (30), and External Cause of Injury Code (ww) (1) through (3) (30) was present on at admission or whether the condition developed after admission as determined by the physician, medical record, or nature of the condition. No entry is permitted when the condition is exempt from reporting or present on admission is not applicable for the cause of injury category. A required entry if the corresponding other diagnosis non-exempt code is reported. Where required, this must be a one (1) character alpha one digit code as follows:

1. Y 1 – Yes – Present at the time of inpatient admission. The condition was present at admission including chronic conditions diagnosed during the hospitalization, an outcome of delivery, or a reason for admission.

2. N 2 – No – Not present at the time of inpatient admission. The condition was not present at admission such as an acute condition that develops after admission or an exacerbation of a chronic condition that develops after admission.

3. U – Unknown 3 – Uncertain – Documentation is insufficient to determine if condition is present on admission. The status of the condition cannot be determined from the medical record, nature of the condition, or after requesting a determination from the patient’s physician.

4. W – Clinically Undetermined – Provider is unable to clinically determine whether condition was present at admission or not.

(q) through (xx) No change.

(3) No change.

Specific Authority 408.061(1)(e), 408.15(8) FS. Law Implemented 408.061 FS. History–New 12-15-96, Amended 7-11-01, 7-12-05, __________.