Statutes, codes, and regulations
Utah Administrative Code
HealthTitle R428 - Center for Health Data, Health Care Statistics
Rule R428-10 - Health Data Authority Healthcare Facility Data Reporting Rule
Section R428-10-5 - Data Element Reporting

Utah Admin. Code 428-10-5

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Current through Bulletin No. 2024-21, November 1, 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) Patient
2. Patient control number
3. Patient's medical record number
4. Patient Social Security Number
5. Patient name
6. Patient's address, city, state, zip
7. Patient's date of birth
8. Patient's gender Service
9. Admission date
10. Type of admission/visit
11. Point of origin for admission or visit
12. Patient's discharge status
13. Statement covers period
14. Condition codes (do not resuscitate, homeless, others) Charge
15. Service line
16. Revenue codes
17. HCPCS Procedure codes including modifiers
18. Unit or basis for measurement code
19. Service units/days
20. Total charges by revenue code Payer
21. Payer's identification
22. Patient's relationship to insured Diagnosis and Treatment
23. Diagnosis version qualifier
24. Principal diagnosis with present on admission
25. Other diagnosis codes with present on admission
26. Admitting diagnosis code
27. Patient's reason for visit codes
28. External cause of injury codes (E-code) with present on admission
29. Principal ICD procedure code
30. Other ICD procedure codes
31. Date of principal procedure Physician
32. Attending provider primary ID
33. Operating physician primary ID
34. Other operating physician primary ID
35. Rendering physician primary ID
36. Referring provider primary ID Other
37. Type of bill

TABLE (3) LEVEL 2 DATA ELEMENTS CATEGORY NAME

Patient

1. Patient marital status
2. Patient race and ethnicity Employer
3. Employer name Charge
4. Prior payments
5. Estimated amount due Payer
6. Insured names
7. Certificate/Social Security Number/Health Insurance Claim/Identification Number
8. Insured group names Physician
9. Attending provider secondary ID
10. Attending provider specialty information
11. Operating physician secondary ID
12. Operating physician specialty information
13. Other operating physician secondary ID
14. Other operating physic. specialty information
15. Rendering physician secondary ID
16. Rendering physician specialty information
17. Referring provider secondary ID
18. Referring provider specialty information
19. Resident ID
20. Resident ID Type

Utah Admin. Code R428-10-5