reglab/statecodes huggingface dataset:
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97213 - Required Reporting

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
(1) Hospital Discharge Abstract Data: Each
				  hospital shall submit a hospital discharge abstract data record, as specified
				  in Subdivision (g) of Section
				  128735
				  of the Health and Safety Code, for each inpatient discharged during the
				  semiannual reporting period, according to the format specified in Subsection
				  (a) of Section
				  97215 and by the dates specified
				  in Subsection (c)(1) of Section
				  97211.
(2) Emergency Care Data: Each hospital shall
				  submit an emergency care data record, as specified in Subsection (a) of Section
				  128736
				  of the Health and Safety Code, for each encounter during the quarterly
				  reporting period, according to the format specified in Subsection (b) of
				  Section 97215 and by the dates specified
				  in Subsection (c)(2) of Section
				  97211. A hospital shall not report
				  an Emergency Care Data Record if the encounter resulted in a same-hospital
				  admission.
(3) Ambulatory Surgery
				  Data: Each hospital and freestanding ambulatory surgery clinic shall submit an
				  ambulatory surgery data record, as specified in Subsection (a) of Section
				  128737
				  of the Health and Safety Code, for each encounter during which at least one
				  ambulatory surgery procedure is performed, during the quarterly reporting
				  period, according to the format specified in Subsection (c) of Section
				  97215 and by the dates specified
				  in Subsection (c)(3) of Section
				  97211. An ambulatory surgery
				  procedure is defined by Subsection (a) of Section
				  128700
				  of the Health and Safety Code as those procedures performed on an outpatient
				  basis in the general operating rooms, ambulatory surgery rooms, endoscopy
				  units, or cardiac catheterization laboratories of a hospital or a freestanding
				  ambulatory surgery clinic. A hospital shall not report an Ambulatory Surgery
				  Data Record if the encounter resulted in a same-hospital
				  admission.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97214 - Form of Authentication. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New
					 section applicable to all discharges after December 31, 1996 filed 7-15-96;
					 operative 8-14-96 (Register 96, No. 29).
2. Amendment filed 7-23-97
					 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 97, No. 30).
3. Repealer of version of section
					 97214 applicable through 12-31-96
					 and amendment of version of section
					 97214 applicable beginning 1-1-97
					 filed 9-21-98; operative 10-21-98 (Register 98, No. 39). For prior history see
					 Register 97, No. 30.
4. Repealer filed 9-23-2003; operative
					 9-23-2003 pursuant to Government Code section
					 11343.4
					 (Register 2003, No. 39).
Note: Authority cited: Section
						128810,
						Health and Safety Code. Reference: Section
						128735,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97215 - Format

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Hospital Discharge Abstract Data reports for discharges occurring on or after
				  January 1, 2023, shall comply with the Department's Format and File
				  Specifications for Online Transmission: Inpatient Data Version 5.1 as revised
				  October 2022 and hereby incorporated by reference.
(b) Emergency Care Data reports for
				  encounters occurring on or after January 1, 2023, shall comply with the
				  Department's Format and File Specifications for Online Transmission: Emergency
				  Care and Ambulatory Surgery Data Version 3.1 as revised October 2022 and hereby
				  incorporated by reference.
(c)
				  Ambulatory Surgery Data reports for encounters occurring on or after January 1,
				  2023, shall comply with the Department's Format and File Specifications for
				  Online Transmission: Emergency Care and Ambulatory Surgery Data Version 3.1 as
				  revised October 2022 and hereby incorporated by reference.
(d) The Department's Format and File
				  Specifications for Online Transmission as named in (a), (b), and (c) are
				  available for download from the HCAI website. The Department will make a
				  hardcopy of either set of Format and File Specifications for Online
				  Transmission available upon request.
Note: Authority cited: Section
						128810, Health and Safety Code.
						Reference: Sections
						128735,
						128736 and
						128737, Health and Safety
						Code.
Note: Authority cited: Section
						128810,
						Health and Safety Code. Reference: Sections
						128735,
						128736
						and
						128737,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97216 - Definition of Data Element for Inpatients-Date of Birth

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) For discharges occurring on or after
				  January 1, 2017:
(1) For online transmission
				  of data reports as electronic data files, the patient's date of birth shall be
				  reported in numeric form as follows: the 4-digit year, the 2-digit month, and
				  the 2-digit day. The numeric form for days and months from 1 to 9 must have a
				  zero as the first digit.
(2) For
				  online entry of individual records, the patient's date of birth shall be
				  reported in numeric form as follows: the 2-digit month, the 2-digit day, and
				  the 4-digit year. The numeric form for days and months from 1 to 9 must have a
				  zero as the first digit.
(3) When
				  the complete date of birth is unknown, as much of the date as is known shall be
				  reported. At a minimum, an approximate year of birth shall be reported. If only
				  the age is known, the estimated year of birth shall be reported and the month
				  and day can be reported as 01 for month and 01 for day.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97217 - Definition of Data Element for Inpatients-Sex

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
For discharges occurring on or after January 1, 2017, the
					 patient's sex shall be reported as recorded at admission as male, female or
					 unknown. Unknown indicates that the patient's sex was
					 undetermined.
1. New
					 section filed 10-14-93; operative 11-15-93 (Register 93, No. 42).
2.
					 Amendment of section and NOTE filed 7-23-97 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 97, No. 30).
3. Amendment of section heading
					 filed 5-5-2005; operative 5-5-2005 pursuant to Government Code section
					 11343.4
					 (Register 2005, No. 18).
4. Amendment of subsection (a) and new
					 subsection (b) filed 10-16-2015; operative 1-1-2016 (Register 2015, No.
					 42).
5. Change without regulatory effect repealing subsection (a)
					 and subsection (b) designator filed 10-31-2018 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2018, No. 44).
Note: Authority cited: Section
						128810,
						Health and Safety Code. Reference: Section
						128735,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97218 - Definition of Data Element for Inpatients-Race

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Effective with discharges on or after
				  January 1, 2019, the patient's ethnic and racial background shall be reported
				  as one choice from the following list of alternatives under ethnicity and up to
				  five choices from the following list of alternatives under race:
(1) Ethnicity:
(A) Hispanic or Latino Ethnicity
(B) Non Hispanic or Latino
				  Ethnicity
(C)
				  Unknown
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97219 - Definition of Data Element for Inpatients - Patient Address

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Effective with discharges on or after January 1, 2023, the patient's address
				  shall be reported. The address shall include the address number and street
				  name, city, state, and ZIP Code. Do not report the address of the hospital. If
				  more than one address is available for the patient, report the address of the
				  patient's usual residence. If exact address is unknown or the patient is
				  experiencing homelessness, provide as much information as possible.
(1) The address number and street name shall
				  be reported.
(A) If the address number and/or
				  street name are unknown, leave blank.
(B) If the address is not part of the United
				  States, leave blank.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97220 - Definition of Data Element for Inpatients-Patient Social Security Number

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The patient's social security number is to be reported as a
					 9-digit number. If the patient's social security number is not recorded in the
					 patient's medical record, the social security number shall be reported as "not
					 in medical record," by reporting the social security number as "000000001." The
					 number to be reported is to be the patient's social security number, not the
					 social security number of some other person, such as the mother of a newborn or
					 the insurance beneficiary under whose account the hospital's bill is to be
					 submitted.
1. New
					 section filed 10-14-93; operative 11-15-93 (Register 93, No. 42).
2.
					 Amendment of section and NOTE filed 7-23-97 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 97, No. 30).
3. Amendment filed 9-21-98;
					 operative 10-21-98 (Register 98, No. 39).
4. Amendment of section
					 heading filed 5-5-2005; operative 5-5-2005 pursuant to Government Code section
					 11343.4
					 (Register 2005, No. 18).
Note: Authority cited: Section
						128810,
						Health and Safety Code. Reference: Section
						128735,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97221 - Definition of Data Element for Inpatients-Admission Date

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) For discharges occurring on or after
				  January 1, 2017:
(1) For online transmission
				  of data reports as electronic data files, the patient's admission date shall be
				  reported in numeric form as follows: the 4-digit year, the 2-digit month, and
				  the 2-digit day. The numeric form for days and months from 1 to 9 must have a
				  zero as the first digit.
(2) For
				  online entry of individual records, the patient's admission date shall be
				  reported in numeric form as follows: the 2-digit month, the 2-digit day, and
				  the 4-digit year. The numeric form for days and months from 1 to 9 must have a
				  zero as the first digit.
(3) For
				  discharges representing a transfer of a patient from one level of care within
				  the hospital to another level of care within the hospital, as defined by
				  Subsection (w) of Section
				  97212 and reported pursuant to
				  Section 97212, the admission date reported
				  shall be the date the patient was transferred to the level of care being
				  reported on this record.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97222 - Definition of Data Element for Inpatients - Source of Admission

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Effective with discharges occurring on or after January 1, 2023, in order to
				  describe the patient's source of admission, it is necessary to address two
				  aspects of the source: first, the point of patient origin for this admission;
				  and second, the route by which the patient was admitted. One alternative shall
				  be selected from the list following each aspect:
(1) The point of patient origin. Use the
				  appropriate code from the list below:
Code
Point of Origin for patients with Type
							 of Admission other than "Newborn"
1
Non-Health Care Facility Point of Origin
2
Clinic or Physician's Office
4
Transfer from a Hospital (Different Facility)
5
Transfer from a SNF, ICF, or Assisted Living Facility
							 (ALF)
6
Transfer from another Health Care Facility
8
Court/Law Enforcement
9
Information not Available
D
Transfer from One Distinct Unit of the Hospital to
							 another Distinct Unit of the Same Hospital Resulting in a Separate Claim to the
							 Payer
E
Transfer from Ambulatory Surgery Center
F
Transfer from a Hospice Facility
G
Transfer from a Designated Disaster Alternate Care
							 Site
Code
Point of Origin for patients with Type of
							 Admission "Newborn"
5
Born Inside this Hospital
6
Born Outside of this Hospital
(2) Route of admission.
(A) Your Emergency Department. Any patient
				  admitted as an inpatient after being treated or examined in this hospital's
				  emergency department.
(B) Another
				  Emergency Department. Any patient directly admitted as an inpatient after being
				  transferred from another hospital's emergency department.
(C) Not admitted from an Emergency
				  Department.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97223 - Definition of Data Element for Inpatients-Type of Admission

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Effective with discharges on and after January 1, 2017, the
					 patient's type of admission shall be reported using the appropriate code from
					 the list below:
Code
Type of Admission
1
Emergency
2
Urgent
3
Elective
4
Newborn
5
Trauma
9
Information not available
1. New
					 section filed 10-14-93; operative 11-15-93 (Register 93, No. 42).
2.
					 Editorial correction of printing errors in subsections (a)(1) and (b) (Register
					 94, No. 17).
3. Amendment of section and NOTE filed 7-23-97 pursuant
					 to section
					 100, title 1, California Code of
					 Regulations (Register 97, No. 30).
4. Amendment of section heading
					 filed 5-5-2005; operative 5-5-2005 pursuant to Government Code section
					 11343.4
					 (Register 2005, No. 18).
5. Amendment filed 10-16-2015; operative
					 1-1-2016 (Register 2015, No. 42).
6. Change without regulatory
					 effect repealing subsections (a)-(a)(4) and subsection (b) designator filed
					 10-31-2018 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2018, No. 44).
Note: Authority cited: Section
						128810,
						Health and Safety Code. Reference: Section
						128735,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97224 - Definition of Data Element for Inpatients-Discharge Date

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) For discharges occurring on or after
				  January 1, 2017:
(1) For online transmission
				  of data reports as electronic data files, the patient's discharge date shall be
				  reported in numeric form as follows: the 4-digit year, the 2-digit month, and
				  the 2-digit day. The numeric form for days and months from 1 to 9 must have a
				  zero as the first digit.
(2) For
				  online entry of individual records, the patient's discharge date shall be
				  reported in numeric form as follows: the 2-digit month, the 2-digit day, and
				  the 4-digit year. The numeric form for days and months from 1 to 9 must have a
				  zero as the first digit.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97225 - Definition of Data Element for Inpatients-Principal Diagnosis and Present on Admission Indicator

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  For discharges occurring on and after October 1, 2015: The patient's principal
				  diagnosis, defined as the condition established, after study, to be the chief
				  cause of the admission of the patient to the facility for care, shall be coded
				  according to the ICD-10-CM.
(b)
				  Effective with discharges on or after July 1, 2008, whether the patient's
				  principal diagnosis was present on admission shall be reported as one of the
				  following:
(1) Y. Yes. Condition was present
				  at the time of inpatient admission.
(2) N. No. Condition was not present at the
				  time of inpatient admission.
(3) U.
				  Unknown. Documentation is insufficient to determine if the condition was
				  present at the time of inpatient admission.
(4) W. Clinically undetermined. Provider is
				  unable to clinically determine whether the condition was present at the time of
				  inpatient admission.
(5) (blank)
				  Exempt from present on admission reporting.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97226 - Definition of Data Element for Inpatients - Other Diagnoses and Present on Admission Indicator

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) For
				  discharges occurring on or after January 1, 2023: The patient's other diagnoses
				  are defined as all conditions that coexist at the time of admission, that
				  develop subsequently during the hospital stay, or that affect the treatment
				  received and/or the length of stay. Diagnoses that relate to an earlier episode
				  that have no bearing on the current hospital stay are to be excluded. Diagnoses
				  shall be coded according to the ICD-10-CM. ICD-10-CM codes from Social
				  Determinants of Health (Z55-Z65) shall be included if they are documented in
				  the medical record. ICD-10-CM codes from External Causes of Morbidity (V00-Y99)
				  shall not be reported as other diagnoses.
(b) Effective with discharges on or after
				  July 1, 2008, whether the patient's other diagnosis was present on admission
				  shall be reported as one of the following:
(1) Y. Yes. Condition was present at the time
				  of inpatient admission.
(2) N. No.
				  Condition was not present at the time of inpatient admission.
(3) U. Unknown. Documentation is insufficient
				  to determine if the condition was present at the time of inpatient admission.
(4) W. Clinically undetermined.
				  Provider is unable to clinically determine whether the condition was present at
				  the time of inpatient admission.
(5) (blank) Exempt from present on admission
				  reporting.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97227 - Definition of Data Element for Inpatients-External Causes of Morbidity and Present on Admission Indicator

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) For discharges occurring on and after
				  October 1, 2015: The external causes of morbidity shall be coded using the
				  ICD-10-CM External Causes of Morbidity (V00-Y99). The external cause of
				  morbidity that resulted in the injury or health condition shall be listed
				  first. Additional cause of morbidity codes shall be reported if necessary to
				  describe the mechanisms that contributed to, or the causal events surrounding,
				  the injury or health condition.
(b)
				  Effective with discharges on or after July 1, 2008, whether the patient's
				  External Cause of Morbidity was present on admission shall be reported as one
				  of the following:
(1) Y. Yes. Condition was
				  present at the time of inpatient admission.
(2) N. No. Condition was not present at the
				  time of inpatient admission.
(3) U.
				  Unknown. Documentation is insufficient to determine if the condition was
				  present at the time of inpatient admission.
(4) W. Clinically undetermined. Provider is
				  unable to clinically determine whether the condition was present at the time of
				  inpatient admission.
(5) (blank)
				  Exempt from present on admission reporting.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97228 - Definition of Data Element for Inpatients-Principal Procedure and Date

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
For discharges occurring on or after January 1, 2017: The
					 patient's principal procedure is defined as one that was performed for
					 definitive treatment (rather than one performed for diagnostic or exploratory
					 purposes) or was necessary to take care of a complication. If there appear to
					 be two procedures that are principal, then the one most related to the
					 principal diagnosis should be selected as the principal procedure. Procedures
					 shall be coded according to the ICD-10-PCS. If only non-therapeutic procedures
					 were performed, then a non-therapeutic procedure should be reported as the
					 principal procedure, if it was a significant procedure. A significant procedure
					 is one that is surgical in nature, or carries a procedural risk, or carries an
					 anesthetic risk, or is needed for MS-DRG assignment. The date the principal
					 procedure was performed shall be reported in numeric form as follows: the
					 4-digit year, the 2-digit month, and the 2-digit day. The numeric form for days
					 and months from 1 to 9 must have a zero as the first digit.
1. New
					 section filed 10-14-93; operative 11-15-93 (Register 93, No. 42).
2.
					 Amendment of NOTE filed 7-23-97 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 97, No. 30).
3. Amendment filed 9-21-98;
					 operative 10-21-98 (Register 98, No. 39).
4. Amendment of section
					 heading filed 5-5-2005; operative 5-5-2005 pursuant to Government Code section
					 11343.4
					 (Register 2005, No. 18).
5. Change without regulatory effect
					 amending section filed 8-23-2011 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2011, No. 34).
6. Amendment filed 4-3-2014;
					 operative 7-1-2014 (Register 2014, No. 14).
7. Amendment filed
					 9-4-2014; operative 10-1-2014 pursuant to Government Code section
					 11343.4(b)(3)
					 (Register 2014, No. 36).
8. Amendment of subsection (b) and new
					 subsection (c) filed 10-16-2015; operative 1-1-2016 (Register 2015, No.
					 42).
9. Change without regulatory effect repealing subsection (a)
					 and relettering subsections filed 7-20-2016 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2016, No. 30).
10. Change without regulatory
					 effect repealing subsection (a) and subsection (b) designator filed 10-31-2018
					 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2018, No. 44).
Note: Authority cited: Section
						128810,
						Health and Safety Code. Reference: Section
						128735,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97229 - Definition of Data Element for Inpatients-Other Procedures and Dates

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
For discharges occurring on or after January 1, 2017: All
					 significant procedures are to be reported. A significant procedure is one that
					 is surgical in nature, or carries a procedural risk, or carries an anesthetic
					 risk, or is needed for MS-DRG assignment. Procedures shall be coded according
					 to the ICD-10-PCS. The dates shall be recorded with the corresponding other
					 procedures and be reported in numeric form as follows: the 4-digit year, the
					 2-digit month, and the 2-digit day. The numeric form for days and months from 1
					 to 9 must have a zero as the first digit.
1. New
					 section filed 10-14-93; operative 11-15-93 (Register 93, No. 42).
2.
					 Amendment of NOTE filed 7-23-97 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 97, No. 30).
3. Amendment filed 9-21-98;
					 operative 10-21-98 (Register 98, No. 39).
4. Amendment of section
					 heading filed 5-5-2005; operative 5-5-2005 pursuant to Government Code section
					 11343.4
					 (Register 2005, No. 18).
5. Change without regulatory effect
					 amending section filed 8-23-2011 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2011, No. 34).
6. Amendment filed 4-3-2014;
					 operative 7-1-2014 (Register 2014, No. 14).
7. Amendment filed
					 9-4-2014; operative 10-1-2014 pursuant to Government Code section
					 11343.4(b)(3)
					 (Register 2014, No. 36).
8. Amendment of subsection (b) and new
					 subsection (c) filed 10-16-2015; operative 1-1-2016 (Register 2015, No.
					 42).
9. Change without regulatory effect repealing subsection (a)
					 and relettering subsections filed 7-20-2016 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2016, No. 30).
10. Change without regulatory
					 effect repealing subsection (a) and subsection (b) designator filed 10-31-2018
					 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2018, No. 44).
Note: Authority cited: Section
						128810,
						Health and Safety Code. Reference: Section
						128735,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97230 - Definition of Data Element for Inpatients-Total Charges

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The total charges are defined as all charges for services
					 rendered during the length of stay for patient care at the facility, based on
					 the hospital's full established rates. Charges shall include, but not be
					 limited to, daily hospital services, ancillary services and any patient care
					 services. Hospital-based physician fees shall be excluded. Prepayment (e.g.
					 deposits and prepaid admissions) shall not be deducted from Total Charges. If a
					 patient's length of stay is more than 1 year (365 days), report Total Charges
					 for the last year (365 days) of stay only.
1. New
					 section filed 10-14-93; operative 11-15-93 (Register 93, No. 42).
2.
					 Amendment of NOTE filed 7-23-97 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 97, No. 30).
3. Amendment filed 9-21-98;
					 operative 10-21-98 (Register 98, No. 39).
4. Amendment of section
					 heading filed 5-5-2005; operative 5-5-2005 pursuant to Government Code section
					 11343.4
					 (Register 2005, No. 18).
Note: Authority cited: Section
						128810,
						Health and Safety Code. Reference: Section
						128735,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97232 - Definition of Data Element for Inpatients-Expected Source of Payment

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Effective with discharges on or after January 1, 1999, the
					 patient's expected source of payment -- the entity or organization which is
					 expected to pay or did pay the greatest share of the patient's bill -- shall be
					 reported using the following:
(1)
				  Payer Category. Select one of the following:
(A) Medicare. A federally administered third
				  party reimbursement program authorized by Title XVIII of the Social Security
				  Act. Includes crossovers to secondary payers.
(B) Medi-Cal. A state administered third
				  party reimbursement program authorized by Title XIX of the Social Security
				  Act.
(C) Private Coverage. Payment
				  covered by private, non-profit, or commercial health plans, whether insurance
				  or other coverage, or organizations. Included are payments by local or
				  organized charities, such as the Cerebral Palsy Foundation, Easter Seals, March
				  of Dimes, or Shriners.
(D) Workers'
				  Compensation. Payment from workers' compensation insurance, government or
				  privately sponsored.
(E) County
				  Indigent Programs. Patients covered under Welfare and Institutions Code Section
				  17000.
				  Includes programs funded in whole or in part by County Medical Services Program
				  (CMSP), California Healthcare for Indigents Program (CHIP), and/or Realignment
				  Funds whether or not a bill is rendered.
(F) Other Government. Any form of payment
				  from government agencies, whether local, state, federal, or foreign, except
				  those in Subsections (1)(A), (1)(B), (1)(D), or (1)(E) of this section.
				  Includes funds received through the California Children Services (CCS), the
				  Civilian Health and Medical Program of the Uniformed Services (TRICARE), and
				  the Veterans Administration.
(G)
				  Other Indigent. Patients receiving care pursuant to Hill-Burton obligations or
				  who meet the standards for charity care pursuant to the hospital's established
				  charity care policy. Includes indigent patients, except those described in
				  Subsection (1)(E) of this section.
(H) Self Pay. Payment directly by the
				  patient, personal guarantor, relatives, or friends. The greatest share of the
				  patient's bill is not expected to be paid by any form of insurance or other
				  health plan.
(I) Other Payer. Any
				  third party payment not included in Subsections (1)(A) through (1)(H) of this
				  section. Included are cases where no payment will be required by the facility,
				  such as special research or courtesy patients.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97233 - Definition of Data Element for Inpatients-Prehospital Care and Resuscitation

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Effective with discharges on or after January 1, 1999,
					 information about resuscitation orders in a patient's current medical record
					 shall be reported as follows:
(a) Yes,
				  a DNR order was written at the time of or within the first 24 hours of the
				  patient's admission to the hospital.
(b) No, a DNR order was not written at the
				  time of or within the first 24 hours of the patient's admission to the
				  hospital.
1. New
					 section filed 9-21-98; operative 10-21-98 (Register 98, No. 39).
2.
					 Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant to
					 Government Code section
					 11343.4
					 (Register 2005, No. 18).
Note: Authority cited: Section
						128810,
						Health and Safety Code. Reference: Section
						128735,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97234 - Definition of Data Element for Inpatients-Preferred Language Spoken

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Effective with discharges occurring on or after January 1,
					 2011, the patient's preferred language spoken shall be reported using one of
					 the following three alternatives:
(a)
				  If the patient's preferred language spoken is known and is included in the
				  following list of alternatives, report the three letter code from the list:
ENG -- English
AMH -- Amharic
ARA -- Arabic
ARM -- Armenian
YUE -- Cantonese (Yue Chinese)
CHI -- Chinese
HRV -- Croatian
PES -- Farsi
FRE -- French
CPF -- French Creole
GER -- German
GRE -- Greek
GUJ -- Gujarati
HEB -- Hebrew
HIN -- Hindi
HMN -- Hmong
HUN -- Hungarian
ILO -- Ilocano (Iloko)
IND -- Indonesian
ITA -- Italian
JPN -- Japanese
KOR -- Korean
LAO -- Lao
CMN -- Mandarin
IUM -- Mien (Iu Mien)
MKH -- Mon-Khmer
NAV -- Navajo
PAN -- Panjabi (Punjabi)
PER -- Persian
POL -- Polish
POR -- Portuguese
RUS -- Russian
SMO -- Samoan
SRP -- Serbian
SGN -- Sign Language
SPA -- Spanish
SWA -- Swahili
TGL -- Tagalog
TEL -- Telugu
THA -- Thai
TON -- Tonga
UKR -- Ukrainian
URD -- Urdu
VIE -- Vietnamese
YID -- Yiddish
YOR -- Yoruba
(b) If the preferred language spoken is
				  known, but is not listed in subsection (a), report the full name of the
				  language.
(c) If the preferred
				  language spoken is unknown, report the three digit code 999.
1. New
					 section filed 11-13-2008; operative 11-13-2008 pursuant to Government Code
					 section
					 11343.4
					 (Register 2008, No. 46).
2. Amendment of subsection (a) and repealer
					 of subsection (a)(1)-(30) filed 12-31-2009; operative 12-31-2009 pursuant to
					 Government Code section
					 11343.4
					 (Register 2010, No. 1).
3. Amendment of first paragraph and
					 subsection (a) filed 10-26-2010; operative 1-1-2011 pursuant to Government Code
					 section
					 11343.4(b)
					 (Register 2010, No. 44).
4. Change without regulatory effect
					 amending section heading and section filed 8-5-2014 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2014, No. 32).
Note: Authority cited: Section
						128810,
						Health and Safety Code. Reference: Section
						128735,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97239 - Hospital Identification Number. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New
					 section filed 10-14-93; operative 11-15-93 (Register 93, No. 42).
2.
					 Amendment filed 7-23-97 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 97, No. 30).
3. Amendment filed 9-21-98;
					 operative 10-21-98 (Register 98, No. 39).
4. Repealer filed
					 9-23-2003; operative 9-23-2003 pursuant to Government Code section
					 11343.4
					 (Register 2003, No. 39).
Note: Authority cited: Section
						128765,
						Health and Safety Code. Reference: Section
						128735,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97240 - Request for Modifications to Patient Data Reporting

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Reporting facilities may file a request with the Department for modifications
				  to Hospital Discharge Abstract Data, Emergency Care Data, or Ambulatory Surgery
				  Data reporting requirements. The modification request shall be supported by a
				  detailed justification of the hardship that full reporting of data would have
				  on the reporting facility; an explanation of attempts to meet data reporting
				  requirements; and a description of any other factors that might justify a
				  modification. Modifications may be approved for no more than one year.
				  Modifications to the data reporting requirements must be approved before data
				  to which they apply will be accepted. Any modifications to reporting
				  requirements are subject to disclosure to data users.
(b) In determining whether a modification to
				  data reporting requirements will be approved, the Department shall consider the
				  information provided pursuant to subsection (a) and evaluate whether the
				  requested modifications would impair the Department's ability to process the
				  data or interfere with the purposes of the data reporting programs under the
				  Act.
(c) Reporting facilities that
				  did not have any discharges or encounters that are required to be reported
				  pursuant to Section
				  97213(a) for a
				  specific report period must inform the Department by using the No Data to
				  Report screen available in the Department's online submission system or by
				  submitting a completed No Data to Report form (HCAI-OIS-772 Rev. August 2023).
				  The information must be submitted on or before the required due date of the
				  report period.
(d) Any facility
				  that is not licensed to provide inpatient care, or does not provide Emergency
				  Care encounters, or does not provide outpatient procedures, or is not licensed
				  as a surgical clinic, and from whom such reporting is not therefore expected,
				  is not required to file a No Data to Report form.
Note: Authority cited: Sections
						128760 and
						128810, Health and Safety Code.
						Reference: Sections
						128735,
						128736,
						128737 and
						128760, Health and Safety
						Code.
Note: Authority cited: Sections
						128760
						and
						128810,
						Health and Safety Code. Reference: Sections
						128735,
						128736,
						128737
						and
						128760,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97241 - Extensions of Time to File Reports

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Extensions are available to reporting facilities that are unable to complete
				  the submission of reports by the due date prescribed in Section
				  97211.
(1) Requests for extension shall be filed on
				  or before the required due date of the report by using the extension request
				  screen available through the Department's online submission system or by using
				  the Patient Data Reporting Extension Request form (HCAI-OIS-770 Rev. August
				  2023). Notices regarding the use of extension days, and new due dates, as well
				  as notices of approval and rejection, will be e-mailed to the primary contact
				  and Facility Administrator e-mail addresses provided by the facility, and other
				  users as requested by the facility.
(2) The Department shall respond within 5
				  days of receipt of the request by either granting what is determined to be a
				  reasonable extension or disapproving the request. The Department shall not
				  grant extensions that exceed the maximum number of days available for the
				  report period for all extensions. If a reporting facility submits the report
				  prior to the due date of an extension, those days not used will be applied to
				  the number of remaining extension days. A reporting facility that wishes to
				  contest any decision of the Department shall have the right to appeal, pursuant
				  to Section
				  97052.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97242 - Error Tolerance Levels. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
					 Renumbering and amendment of former section
					 97215 to new section
					 97242 filed 10-14-93; operative
					 11-15-93 (Register 93, No. 42).
2. Editorial correction of printing
					 errors in tables 1 and 2 (Register 94, No. 17).
3. Amendment of
					 Tables 1 and 2, newly designated subsection (d)(5)(A) and new subsection
					 (d)(5)(B) filed 11-27-95; operative 1-1-96 (Register 95, No. 48).
4.
					 Amendment of section and NOTE filed 7-23-97 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 97, No. 30).
5. Amendment of section,
					 including repealer of table 2, filed 9-21-98; operative 10-21-98 (Register 98,
					 No. 39).
6. Repealer filed 9-23-2003; operative 9-23-2003 pursuant
					 to Government Code section
					 11343.4
					 (Register 2003, No. 39).
Note: Authority cited: Section
						128810,
						Health and Safety Code. Reference: Section
						128735,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97243 - Acceptance Criteria. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
					 Renumbering and amendment of former section
					 97216 to new section
					 97243 filed 10-14-93; operative
					 11-15-93 (Register 93, No. 42).
2. Editorial correction of printing
					 errors in subsection (b) (Register 94, No. 17).
3. Amendment of
					 section and NOTE filed 7-23-97 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 97, No. 30).
4. Amendment filed 9-21-98;
					 operative 10-21-98 (Register 98, No. 39).
5. Repealer filed
					 9-23-2003; operative 9-23-2003 pursuant to Government Code section
					 11343.4
					 (Register 2003, No. 39).
Note: Authority cited: Section
						128810,
						Health and Safety Code. Reference: Section
						128735,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97244 - Method of Submission

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  For discharges and encounters occurring on or after January 1, 2021, reporting
				  facilities shall use the Department's online submission system known as SIERA
				  for submitting reports through either:
(1)
				  Online transmission of data reports as electronic data files, or
(2) Online entry of individual
				  records.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97245 - Online Test Option

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Reports may be tested before formal submission to the
					 Department using the online test option. Online testing of the format and
					 reports through the online test option, before formal transmission, is the
					 recommended means of ensuring compliant data that meets the standards
					 established by the Department before the due date. Reports tested through the
					 online test option will be subject to the same processing and will generate the
					 same reports as data that is formally submitted. The format and reports may be
					 tested through the test option as many times as needed to assure that the
					 reports meet the standards established by the Department in Section
					 97247.
1. New
					 section filed 9-23-2003; operative 9-23-2003 pursuant to Government Code
					 section
					 11343.4
					 (Register 2003, No. 39).
2. Amendment of NOTE filed 5-5-2005;
					 operative 5-5-2005 pursuant to Government Code section
					 11343.4
					 (Register 2005, No. 18).
3. Amendment filed 12-31-2009; operative
					 12-31-2009 pursuant to Government Code section
					 11343.4
					 (Register 2010, No. 1).
4. Change without regulatory effect amending
					 section filed 12-13-2019 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2019, No. 50).
5. Change without regulatory
					 effect amending section filed 1-24-2023 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2023, No. 4).
Note: Authority cited: Section
						128755,
						Health and Safety Code. Reference: Sections
						128735,
						128736
						and
						128737,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 10 - Health Facility Data › Article 8 - Patient Data Reporting Requirements › Section 97246 - Data Transmittal Requirements

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Data shall be submitted using the Department's online submission system to file
				  or submit each report. The following information must be included: the facility
				  name, the unique identification number specified in Section
				  97210, the beginning and ending
				  dates of the report period, the number of records in the report and the
				  following statement of certification:
I certify under penalty of perjury that I am an official of
					 this facility and am duly authorized to submit these data; and that, to the
					 extent of my knowledge and information, the accompanying records are true and
					 correct, and that the applicable definitions of the data elements as set forth
					 in Article 8 (Patient Data Reporting Requirements) of Chapter 10 (Health
					 Facility Data) of Division 7 of Title 22 of the California Code of Regulations,
					 have been followed by this facility.
(b) Reporting facilities with an approved
				  exemption to submit records using a method other than the Department's online
				  submission system must submit the following information: facility name, the
				  unique identification number specified in Section
				  97210, the data type of the
				  report, the report period of the records submitted, the number of records in
				  the report, the medium of accompanying records, the certification language as
				  provided in (a) above, with a signature of the authorized representative of the
				  facility and contact information. The information shall accompany the
				  report.
(c) A facility's
				  administrator may designate User Account Administrators. For each User Account
				  Administrator there must be a signed facility User Account Administrator
				  Agreement form (HCAI-OIS-773 Rev. August 2023), hereby incorporated by
				  reference, submitted to the Department.
(d) Forms may be obtained from the Department
				  of Health Care Access and Information web site at
www.hcai.ca.gov
or by contacting
				  the Department's Patient Data Program at (916) 326-3935.
Note: Authority cited: Section
						128810, Health and Safety Code.
						Reference: Sections
						128735,
						128736 and
						128737, Health and Safety
						Code.
Note: Authority cited: Section
						128810,
						Health and Safety Code. Reference: Sections
						128735,
						128736
						and
						128737,
						Health and Safety Code.