N.J. Admin. Code § 8:31B-2.1

Current through Register Vol. 56, No. 11, June 3, 2024

Section 8:31B-2.1 - Purpose

(a) The purpose of this subchapter is to provide the basis for a single patient data reporting system to satisfy the health planning requirements of the Health Care Reform Act of 1992 (P. L. 1992, c. 160). The subchapter incorporates herein by reference the National Uniform Bill (UB-04, CMS 1450), as amended and supplemented, as the common hospital billing format for all payers. The data elements and design of the form have been determined by the National Uniform Billing Committee (NUBC). The NUBC includes representatives of the Federal Government, major payers, and hospital associations. The NUBC is a Designated Standards Maintenance Organization (DSMO) in accordance with the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 (HIPAA), as adopted by the United States Congress. The Uniform Bill shall be transmitted electronically according to the HIPAA-compatible Health Care Service: Data Reporting 837 Version 5010 format, incorporated herein by reference, as amended and supplemented. The HIPAA-compatible Health Care Service: Data Reporting 837 Version 5010 format is developed and maintained by the DSMO, Accredited Standards Committee X12 (ASC X12) of the American National Standards Institute (ANSI). The UB-04, as amended and supplemented, can be obtained from the National Uniform Billing Committee in care of the American Hospital Association, 155 North Wacker Drive, Suite 400, Chicago, IL 60606, telephone (312) 422-3397, telefacsimile (312) 422-4526, website: http://www.nubc.org. The HIPAA-compatible Health Care Service: Data Reporting 837 Version 5010 electronic format can be obtained from the Washington Publishing Company, 2107 Elliott Avenue, Suite 305, Seattle, WA 98121, telephone (425) 562-2245, telefacsimile (775) 239-2061, website http://www.wpc-edi.com.

(b) This subchapter will continue to allow hospitals to:

1. Satisfy Department reporting requirements for patient-level clinical and financial information;

2. Allow common and consistent reporting of revenues for services related to patient care; and

3. Promote uniformity and accuracy of patient data reporting. Confidentiality of individual patients and physicians shall be maintained in fulfilling the above purposes.

N.J. Admin. Code § 8:31B-2.1

Amended by 50 N.J.R. 1494(a), effective 7/2/2018