Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 10 - Office of the Director › Chapter 33 - Hospital and Ambulatory Surgical Center Data Disclosure › Section 19 CSR 10-33.010 - Reporting Patient Abstract Data by Hospitals, Ambulatory Surgical Centers, and Abortion Facilities

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment adds abortion facilities to
				  the types of facilities required to report patient abstract data to the
				  department.
PURPOSE: This rule establishes procedures for
				  reporting patient abstract data for inpatients and outpatients by hospitals,
				  ambulatory surgical centers, and abortion facilities to the Department of
				  Health and Senior Services and for the management and dissemination of this
				  data.
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. This material as incorporated by reference in this rule shall be
				  maintained by the agency at its headquarters and shall be made available to the
				  public for inspection and copying at no more than the actual cost of
				  reproduction. This note applies only to the reference material. The entire text
				  of the rule is printed here.
(1) The following definitions shall be used
				in the interpretation of this rule:
(A)
				Coinvestigator means any person or organization that applies to the Department
				of Health and Senior Services to be a coinvestigator of an epidemiological
				study;
(B) Department means the
				Missouri Department of Health and Senior Services;
(C) Epidemiological study means research
				using patient abstract data to understand, promote, or safeguard the health of
				a defined population. No marketing study or study designed to use data on a
				specific provider shall be considered an epidemiological study;
(D) Inpatient encounter means an encounter
				which begins with the formal acceptance by a hospital or a distinct part of a
				hospital of a patient who is to receive physician, dentist, or allied services
				while receiving room, board, and continuous nursing care. It ends with the
				termination of the room, board, and continuous nursing services, and the formal
				release of an inpatient from the hospital or the transfer of the patient to a
				different distinct hospital unit. All significant procedures are to be
				reported. A significant procedure is one that is surgical in nature; carries a
				procedural risk; requires specialized training; carries an anesthetic risk such
				as open procedures, endoscopy procedures, catherization procedures, pain
				management procedures, injection procedures such as myelograms, arthrograms,
				etc.; or is needed for Medicare Severity Diagnosis Related Group (MS-DRG)
				assignment. Inpatient procedures should be coded according to the International
				Classification of Diseases, Tenth Revision, Procedure Coding System
				(ICD-10-PCS);
(E) Observation
				services are those services furnished on a hospital's premises, including use
				of a bed and periodic monitoring by a hospital's nursing or other staff, which
				are reasonable and necessary to evaluate an outpatient's condition or determine
				the need for a possible admission to the hospital as an inpatient. Charges for
				observation services usually are made on an hourly basis. Observation services
				usually do not exceed twenty-four (24) hours. However, there is no hourly limit
				on the extent to which they may be used;
(F) Outpatient encounter refers to patients
				seen in the emergency room and patients receiving invasive procedures on an
				outpatient basis. All significant procedures are to be reported. A significant
				procedure is one that is surgical in nature; carries a procedural risk;
				requires specialized training; or carries an anesthetic risk such as open
				procedures, endoscopy procedures, catherization procedures, pain management
				procedures, injection procedures such as myelograms, arthrograms, etc.
				Outpatient procedures should be coded according to the Healthcare Common
				Procedure Coding System (HCPCS). HCPCS is divided into two (2) principal
				subsystems, referred to as level I and level II. Level I is comprised of
				Current Procedural Terminology (CPT-4), and level II is a standardized coding
				system used to report services not identified by CPT-4 codes;
(G) Public health authority means an agency
				or authority that is responsible for public health matters as part of its
				official mandate. Examples of public health authorities include agencies of a
				state, territory, political subdivision of a state or territory, or an Indian
				tribe, or persons or entities acting under a grant of authority or contract
				with a public health authority.