Building Blocks for Health Data Standards Health Care Service: Data Reporting Guide By Bob Davis March 18, 2004.

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Presentation transcript:

Building Blocks for Health Data Standards Health Care Service: Data Reporting Guide By Bob Davis March 18, 2004

Heath Care Service: Data Reporting Guide Objective: Maintain a standardized format and data content for reporting health care service data that is compatible with the 837 Health Claim transaction set standards identified by the Health Insurance Portability and Accountability Act (HIPAA) Accomplishments: Published first version of guide in 2003

Standards Level Setting 4010 Version –View of ANSI ASC X12 standard as of October 1997 –HIPAA Version 4050 Version –View of ANSI ASC X12 standard as of October 2001 –Current Health Care Service: Data Reporting Guide

Standards Level Setting 5010 Version –View of ANSI ASC X12 standard as of October 2003 –Health Care Service: Data Reporting Guide in development –Synchronizing with Health Care Claim Guides

On the Development Dock for Health Care Service: Data Reporting Guide Highlights of Planned 5010 Changes –Support being added for ICD-10-CM Diagnosis Codes –Support being added for ICD-10-PCS Procedure codes –Additional “slots” for reporting external cause of injury codes being included. –A separate “slot” for reporting admitting diagnosis and the Patient’s Reason for Visit being included. NOTE: All the above changes also being included in the health care claim guides

On the Development Dock for Health Care Service: Data Reporting Guide Highlights of Change (cont) –Support being added for National Provider Identifier –Refining situational notes in accordance with ANSI ASC X12N TG4 implementation guide guidelines If not required, do not send If not required, may be provided at the sender’s discretion

On the Development Dock for Health Care Service: Data Reporting Guide Highlights of Change (cont) –Synchronizing of the Health Care Service: Data Reporting Guide with the Health Care Claim guides where appropriate. –Working with NUBC to better clarify ambiguous definitions (i.e. inpatient & outpatient)

Unanswered Questions Should the next release of the HCSDRG include support for professional services? Should the next release of the HCSDRG include support for more clinical data? Should the next release of the HCSDRG include support for the diagnosis indicator for external cause of injury codes?

Summary 5010 Version of Health Care Service: Data Reporting Guide in progress & help appreciated. Draft for review and comment expected by end of July Constantly seeking input and comment on clarity and content of the Health Care Service: Data Reporting Guide.

Health Care Service: Data Reporting Guide Work Group Members Roxanne Andrews, Senior Service Fellow Agency for Healthcare Research and Quality (AHRQ) Ginger Cox, Research Analyst II California Office of Statewide Health Planning and Development (OSHPD) Jason Goldwater, Health Insurance Specialist Centers for Medicare and Medicaid Services (CMS) Marjorie Greenberg, Chief, Classifications and Public Health Data Standards Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS) Vicki Hohner, Senior Consultant Fox Systems, Inc. Alana Knudson-Buresh, Senior Health Informatics Specialist National Association of Health Data Organizations Denise Love, Executive Director National Association of Health Data Organizations (NAHDO) Jane McGinnis, Managed Care Epidemiologist Nebraska Health and Human Services System Kathleen Nardini, Research Analyst National Association of State Alcohol and Drug Abuse Directors (NASADAD) Judy Parlato, Clinical Advisor Massachusetts Division of Health Care Finance and Policy Dan Pollock, Medical Epidemiologist Centers for Disease Control and Prevention Russ Scarato, Economist Health Resources and Services Administration (HRSA) Claudia Steiner, Senior Research Physician Agency for Healthcare Research and Quality (AHRQ) Charles Wentzel, Statistician Pennsylvania Health Care Cost Containment Council Michelle Williamson, Health Informatics Specialist Centers for Disease Control and Prevention CDC) National Center for Health Statistics (NCHS) Your Name Awaits

Bob Davis, Consultant Ph-consortium-l-hcsdr