Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 421 - HEALTH CARE INFORMATION › Subchapter A - COLLECTION AND RELEASE OF HOSPITAL DISCHARGE DATA › Section 421.9 - Discharge Reports-Records, Data Fields and Codes

Current through Reg. 49, No. 28; July 12, 2024
(a) Hospitals that have not obtained an exemption
											  letter authorized by § 421.81 of this title (relating to Health Care Facilities Exemptions from Filing
											  Requirements) shall submit discharge reports, electronically in the file format for inpatient hospital bills
											  defined by the American National Standards Institute (ANSI), commonly known as the ANSI ASC X12N form 837
											  Health Care Claims (ANSI 837 Institutional Guide) transaction for institutional claims and/or encounters.
											  ANSI updates this format from time to time by issuing new versions.
(b) DSHS will make detailed specifications for these data elements
											  available to submitters and to the public.
(c) In addition to the
											  data elements contained in the ANSI 837 Institutional Guide, DSHS has defined the following data elements
											  shown in this subsection and as defined the location in the ANSI 837 Institutional Guide where each element
											  is to be reported. Data element content, format and locations may change as federal and state legislative
											  requirements change in regards to Public Law
											  104-191, Health Insurance Portability and Accountability Act of 1996 (HIPAA), as
											  amended, is implemented.
(1) Patient race - This data element shall be
											  reported at Loop 2300 in the K3 segment as the second numeric value in this data segment. Acceptable codes
											  are 1 = American Indian/Eskimo/Aleut, 2 = Asian or, Pacific Islander, 3 = Black, 4 = White and 5 = Other
											  Race. In order to obtain this data, the hospital staff retrieves the patient's response from a written form
											  or asks the patient, or the person speaking for the patient to classify the patient. If the patient, or
											  person speaking for the patient, declines to answer, the hospital staff is to use its best judgment to make
											  the correct classification based on available data.
(2) Patient
											  ethnicity - This data element shall be reported at Loop 2300 in the K3 segment as the first numeric value.
											  Acceptable codes are 1 = Hispanic or Latino Origin and 2 = Not of Hispanic or Latino Origin. In order to
											  obtain this data, the hospital staff retrieves the patient's response from a written form or asks the
											  patient, or the person speaking for the patient to classify the patient. If the patient, or person speaking
											  for the patient, declines to answer, the hospital staff is to use its best judgment to make the correct
											  classification based on available data.
(3) Other E-codes - These
											  additional E-codes (maximum of nine (9)) shall be reported in the following ANSI X12N Form 837 locations:
											  Loop 2300, segments, HI05-2, HI06-2, HI07-2, HI08-2, HI09-2, HI10-2, HI11-2 and HI12-2. (The first E-code is
											  reported in Loop 2300 segment HI04-2).
(4) THCIC Identification
											  Number - This data element shall be submitted in data segment REF02 of Loop 2010AA or Loop 2010AB (in the
											  Pay-to provider reported provided the services), or Loop 2310E (if the Service Facility Provider is
											  submitted).