Wash. Admin. Code § 246-455-020

Current through Register Vol. 24-23, December 1, 2024

Section 246-455-020 - Reporting data set information

(1) Hospitals shall collect and report the following data set elements to the department:

(a) Patient control number: Patient's unique alpha-numeric number assigned by the hospital to facilitate retrieval of individual patient records;

(b) Patient medical record number;

(c) Type of bill;

(d) National Provider Identifier (UB-04), or department assigned identifier, as applicable;

(e) Patient last name;

(f) Patient first name;

(g) Patient middle initial;

(h) Patient Social Security number (at least the last four digits);

(i) Patient address;

(j) Patient zip code (U.S.A.);

(k) Patient country code (outside U.S.A.) International Organization for Standardization (ISO) 3166-1;

(l) Patient's date of birth;

(m) Sex assigned at birth;

(n) Admission date;

(o) Type of admission;

(p) Admitting diagnosis code;

(q) Patient's ICD code (1-3) reason for visit;

(r) Point of origin for admission;

(s) Patient discharge status;

(t) Statement covers period (from - through);

(u) Revenue code;

(v) Units of service;

(w) Total charges;

(x) Payer identification (up to three): Payer identification number per the CHARS procedure manual identifying each payer group from which the hospital may expect some payment of the bill;

(y) Principal diagnosis code;

(z) Other diagnosis codes;

(aa) External cause of injury (ECI) code;

(bb) Principal procedure code;

(cc) Other procedure code;

(dd) Referring provider's National Provider Identifier (NPI), as applicable;

(ee) Attending provider's National Provider Identifier (NPI) according to Centers for Medicare and Medicaid Services (CMS) schedule;

(ff) Operating physician's National Provider Identifier (NPI) according to CMS schedule, as applicable;

(gg) Other provider's National Provider Identifier (NPI) according to CMS schedule, as applicable;

(hh) Admission hour;

(ii) Race - Until hospitals are required to report race consistent with WAC 246-455-025, race shall be reported per minimum office of management and budget (OMB) standards;

(jj) Ethnicity - Until hospitals are required to report ethnicity consistent with WAC 246-455-025, ethnicity shall be reported per minimum OMB standards;

(kk) Discharge hour;

(ll) Procedure date;

(mm) Present on admission status;

(nn) Health care provider taxonomy code;

(oo) Health care common procedure coding system (HCPCS);

(pp) Service date;

(qq) Facility federal tax number;

(rr) Insured last name, first name, middle name, suffix;

(ss) Patient's relationship to insured code;

(tt) Insured ID.

(2) The hospital shall report all patient discharge data required in this section according to UB-04 specifications unless noted otherwise.

(3) If the department has a designee, the hospital shall report all patient discharge data required in this section to the designee. The designee will report the patient discharge data required in this section submitted by the hospital to the department in the format prescribed by the department.

Wash. Admin. Code § 246-455-020

Amended by WSR 15-19-152, Filed 9/22/2015, effective 10/23/2015

Amended by WSR 22-13-187, Filed 6/22/2022, effective 10/1/2022

Statutory Authority: RCW 43.70.040 and 43.70.052. 07-09-091, § 246-455-020, filed 4/18/07, effective 5/23/07. Statutory Authority: RCW 43.70.040 and [43.]70.170. 03-13-029, § 246-455-020, filed 6/10/03, effective 7/11/03. Statutory Authority: RCW 43.70.040 and chapter 70.170 RCW. 94-12-090, § 246-455-020, filed 6/1/94, effective 7/2/94. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-455-020, filed 12/27/90, effective 1/31/91. Statutory Authority: Chapter 70.39 RCW. 87-08-037 (Order 87-02, Resolution No. 87-02), § 261-50-030, filed 3/30/87; 87-04-008 (Order 87-01, Resolution No. 87-01), § 261-50-030, filed 1/23/87. Statutory Authority: RCW 70.39.180. 86-14-081 (Order 86-03, Resolution No. 86-03), § 261-50-030, filed 7/1/86; 85-17-020 (Order 85-05, Resolution No. 85-05), § 261-50-030, filed 8/13/85. Statutory Authority: Chapter 70.39 RCW. 84-20-067 (Order 84-06, Resolution No. 84-06), § 261-50-030, filed 10/1/84.