Updating the Health Care Service Data Reporting Guide (HCSDRG) Webinar June 12, 2013 Robert Davis, Standards Consultant

What is the Health Care Service Data Reporting Guide? X12N standard for reporting health care services data (electronic data interchange) X12N standard for reporting health care services data (electronic data interchange) HIPAA compatible (but not compliant) HIPAA compatible (but not compliant) Standardized data requirements & content using X12N 837 health claim transaction set standard Standardized data requirements & content using X12N 837 health claim transaction set standard Modeled after UB-92 Data Content Standards & HIPAA Institutional Claims Format Standard (837) because that is where our data source took us Modeled after UB-92 Data Content Standards & HIPAA Institutional Claims Format Standard (837) because that is where our data source took us

Health Care Service Data Reporting Guide: Some Particulars Outreach to Public Health Community facilitated by Public Health Data Standards Consortium (PHDSC) reporting guide work group Outreach to Public Health Community facilitated by Public Health Data Standards Consortium (PHDSC) reporting guide work group Approved by X12N as an official work product of the Healthcare Claims Work Group Approved by X12N as an official work product of the Healthcare Claims Work Group Developed in collaboration with the PHDSC Developed in collaboration with the PHDSC

Why is the Guide Needed? Many statewide discharge data programs are planning to migrate to the X12N 837 electronic standard Many statewide discharge data programs are planning to migrate to the X12N 837 electronic standard  Eases burden on hospitals  Faster, cleaner data The HIPAA designated 837 guide for institutional services does not include key data elements for public health reporting The HIPAA designated 837 guide for institutional services does not include key data elements for public health reporting

HIGH-PRIORITY DATA ELEMENTS COLLECTED BY STATES IDENTIFIED IN NAHDO SURVEY (note: Yellow highlighted data elements supported by the HCSDRG & Underlined elements ONLY supported by the HCSDRG) PATIENT DEMOGRAPHICSPATIENT STATUSCLINICAL LINKAGEFINANCIAL Race and Ethnicity County Code Marital Status Preferred Language Spoken Occupation and industry E-coding (number) Pharmacy Values/HCPCS Gestational. Age Birthweight Admitting vitals Unique patient ID Physician IDs Mothers Med Record # EMS Run # Present on Admission Flag DNR Patient Functional Status Source of Payment Typology Total provider paid amt

Data Elements Gained Using the HCSRG Race & Ethnicity Race & Ethnicity Mother’s Medical Record Number Mother’s Medical Record Number County of Patient County of Patient Occupation and Industry Codes Occupation and Industry Codes Preferred Language Spoken Preferred Language Spoken Marital Status Marital Status

Why is the Guide Needed? Provides standards-based alternative for designing new state and federal data systems (i.e., NYS Emergency Department Data Collection System) Provides standards-based alternative for designing new state and federal data systems (i.e., NYS Emergency Department Data Collection System) Fosters standard data across states Fosters standard data across states  Standard format  Standard data content  Standard approaches to new technology advances (i.e., XML)

X12 Versioning Level Setting with X12 Terminology Level Setting with X12 Terminology – 4050 – October 2002 – 5010 – October 2003 – 6020 – October is the version now being implemented for HIPAA compliance 5010 is the version now being implemented for HIPAA compliance Once again, the HCSDRG is a HIPAA compatible NOT a HIPAA compliant standard Once again, the HCSDRG is a HIPAA compatible NOT a HIPAA compliant standard

Gap Assist Tool Web Site: Web Site: – – Click on Gap Assist tool link to access the application Overview Overview – A visual tool that maps the Health Care Service Data Reporting Guide to various standards, most notably ANSI X12. This is done for all three versions of the HCSDRG. Demo of Gap Assist Tool Demo of Gap Assist Tool

Contact Information Consortium Website Bob Davis