Mo. Code Regs. tit. 19 § 10-33.040
Current through Register Vol. 50, No. 1, January 2, 2025
PURPOSE: This rule establishes procedures for secure electronic reporting of patient abstract data for inpatients and outpatients by hospitals to the Department of Health and Senior Services for the purpose of conducting epidemiologic monitoring and studies and publishing information to safeguard the health of the citizens of Missouri as authorized by sections 192.020, 192.067 and 192.667, RSMo.
As an alternative for hospitals that are not able to support HL7 messages, the following format will be used for transmission of data. The structure closely follows the fields defined in the HL7 message format.
All fields will be left justified with unknown values padded with spaces. Each record should end with a carriage return (ASC13) or carriage return/line feed (ASC13 ASCIO).
The required column in Table 1 indicates whether a field is Required (R), Optional (O) or Conditionally (C) required. See the description to determine the requirements for conditional fields.
Table 1 - Hospital Syndromic Surveillance ASCII file structure
| Field Name | Relative Position | Field Length | Required | Format | Description |
| Record Type | 1 | 1 | R | A | 4 = New Record 8 = Update of previously sent record |
| Sending Facility Identifier | 2-11 | 10 | R | A/N | This field shall contain the National Provider Identifier (NPI) for the hospital/facility sending data. If no NPI is available, use the Medicare provider number of state assigned number. |
| Sending Facility Name | 12-41 | 30 | R | A/N | Name of the originating hospital |
| Date/Time of Message | 42-53 | 12 | R | N | YYYYMMDDHHMM format for date and time record or message set is generated, |
| Processing ID | 54 | 1 | R | A | Unless directed by DHSS, all records should be Production records "P" P = Production D = Debugging/Testing. |
| Patient Medical Record Number | 55-74 | 20 | R | A/N | Medical Record Number of the patient. |
| Patient Last Name | 75-104 | 30 | R | A/N | Last name of patient. No space should be embedded within a last name as in MacBeth. Titles (for example, Sir, Msgr., Dr.) should not be recorded. Record hyphenated names with the hyphen, as in Smith-Jones. |
| Patient First Name | 105-124 | 20 | R | A/N | First name of patient. |
| Patient Middle Name | 125-144 | 20 | O | A/N | Middle name or initial of patient, if known. |
| Patient Name Suffix | 145-150 | 6 | O | A/N | Record suffixes such as JR, SR, III, if known |
| Date of Birth | 151-158 | 8 | R | N | YYYYMMDD date of birth. If only age is known, record YYYY as year of birth. |
| Sex | 159 | 1 | R | A | Patient sex at time of encounter M = Male F = Female U = Unknown |
| Race | 160 | 1 | R | A | W = White B = Black or African American A = Asian or Pacific Islander I = American Indian or Alaska Native M = Multiracial (two or more races) O = Other U = Unknown |
| Ethnicity | 161 | 1 | R | A | H = Hispanic or Latino N = Not Hispanic or Latino U = Unknown |
| Residence Address Line 1 | 162-191 | 30 | R | A/N | Free form address line |
| Residence Address Line 2 | 192-221 | 30 | C | A/N | Free form address line, if needed. |
| City | 222-246 | 25 | R | A/N | Patient city of residence. |
| State | 247-248 | 2 | R | A/N | Postal abbreviation for state of residence. Use 97 for homeless, 98 for non-US. |
| Zip Code | 249-253 | 5 | R | N | First five digits (homeless = 99997, non-US = 99998) |
| County Code | 254-256 | 3 | R | N | Use FIPS codes (homeless = 997, non-US = 998) |
| Country Code | 257-260 | 4 | R | N | Use FIPS codes (homeless = 9997) |
| Phone Number Area Code | 261-263 | 3 | O | N | Format 999 if known, blank if not known |
| Phone Number | 264-271 | 8 | O | A/N | Format 999-9999 including hyphen if known, blank if not known. |
| Extension | 272-276 | 5 | O | A/N | Telephone extension, if necessary or known. |
| Social Security Number | 277-285 | 9 | R | N | Contains the 9-digit SSN without hyphens or spaces |
| Patient Death Indicator | 286 | 1 | O | A | If available. Y = Yes N = No |
| Patient Death Date Time | 287-298 | 12 | C | N | YYYYMMDDHHMM representation of Date and Time (if known) of death if indicator is "Y". |
| Patient Class | 299 | 1 | R | A | Used to categorize patients by site. E = Emergency I = Inpatient O = Outpatient P = Preadmit R = Recurring patient B = Obstetrics |
| Admission Type | 300 | 1 | R | A | Indicates the circumstances under which the patient was or will be admitted A = Accident E = Emergency L = Labor and delivery R = Routine |
| Unique Encounter Identifier | 301-320 | 20 | R | A/N | Unique identifier within facility for each patient encounter or visit. |
| Admit Date/Time | 321-342 | 12 | R | N | YYYYMMDDHHMM This field contains the admit date and time. This field is also used to reflect the date/time of an emergency patient or outpatient registration |
| Admit Reason Text | 343-462 | 120 | R | A/N | Textual literal chief complaint. The text must be sent even if a code is available. |
| Admit Reason Code | 463-472 | 10 | O | A/N | Diagnostic code for the reason for visit or chief complaint, if available. Not all hospitals will have this code available at the time of the initial report to DHSS. |
| Admit Reason Coding Scheme | 473-480 | 8 | C | A/N | Standardized Coding scheme used for the Admit Reason Code, if used. I9C = ICD-9-CM I10 = ICD-10 SNOMED = SNOMED |
| Filler | 481-500 | 20 | R | Spaces |
19 CSR 10-33.040
*Original authority: 192.020, RSMo 1939, amended 1945, 1951; 192.067, RSMo 1988; and 192.667, RSMo 1992, amended 1993, 1995.