Current through Bulletin 2024-20, October 15, 2024
Section R428-10-5 - Data Element Reporting(1) Tables 2 and 3 list the required data elements. Each hospital shall collect and report all data elements shown in Table 2. Each hospital shall report data elements shown in Table 3 whenever the information is a part of the hospital's patient record. Hospitals shall base data submissions on the specifications in the Submittal Manual for Inpatient Data.(2) Each hospital shall collect patient social security number as a required data element on the hospital discharge record and report the patient social security number with the complete discharge record according to the submittal schedule.(3) The Office shall adopt an encryption method for the patient social security number by creating a record linkage number as the control number.(4) Each hospital shall submit the reported data elements on encrypted electronic media acceptable to the Office or send electronically through the Utah Health Information Network or another compatible electronic data interchange network or other secure upload or secure email method.(5) The Office shall accept data that complies with data standards established in Rule R590-164, Uniform Health Billing Rule. TABLE (2) LEVEL 1 DATA ELEMENTS CATEGORY NAME
Provider
1. Provider identifier (hospital name) Patient2. Patient control number3. Patient's medical record number4. Patient Social Security Number6. Patient's address, city, state, zip7. Patient's date of birth8. Patient's gender Service10. Type of admission/visit11. Point of origin for admission or visit12. Patient's discharge status13. Statement covers period14. Condition codes (do not resuscitate, homeless, others) Charge17. HCPCS Procedure codes including modifiers18. Unit or basis for measurement code20. Total charges by revenue code Payer21. Payer's identification22. Patient's relationship to insured Diagnosis and Treatment23. Diagnosis version qualifier24. Principal diagnosis with present on admission25. Other diagnosis codes with present on admission26. Admitting diagnosis code27. Patient's reason for visit codes28. External cause of injury codes (E-code) with present on admission29. Principal ICD procedure code30. Other ICD procedure codes31. Date of principal procedure Physician32. Attending provider primary ID33. Operating physician primary ID34. Other operating physician primary ID35. Rendering physician primary ID36. Referring provider primary ID OtherTABLE (3) LEVEL 2 DATA ELEMENTS CATEGORY NAME
Patient
1. Patient marital status2. Patient race and ethnicity Employer5. Estimated amount due Payer7. Certificate/Social Security Number/Health Insurance Claim/Identification Number8. Insured group names Physician9. Attending provider secondary ID10. Attending provider specialty information11. Operating physician secondary ID12. Operating physician specialty information13. Other operating physician secondary ID14. Other operating physic. specialty information15. Rendering physician secondary ID16. Rendering physician specialty information17. Referring provider secondary ID18. Referring provider specialty informationUtah Admin. Code R428-10-5