Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 217 - REPORTING REQUIREMENTS FOR PATIENT LEVEL DATA ELEMENTS › Section 12VAC5-217-20 - Reporting requirements for patient level data elements

Current through Register Vol. 40, No. 24, July 15, 2024
Every inpatient hospital shall submit a complete filing of
				  each patient level data element listed in the table in this section for each
				  hospital inpatient, including a separate record for each infant, if applicable.
				  Most of these data elements are currently collected from a Uniform Billing Form
				  located in the latest publication of the Uniform Billing Manual prepared by the
				  National Uniform Billing Committee. The Uniform Billing Form and the Uniform
				  Billing Manual are located on the National Uniform Billing Committee's website
				  at
www.nubc.org
. The Uniform Billing
				  Manual provides a detailed field description and any special instruction
				  pertaining to that element. An asterisk (*) indicates when the required data
				  element is either not on the billing form or in the Uniform Billing Manual. The
				  instructions provided under that particular data element should then be
				  followed. Inpatient hospitals that submit patient level data directly to the
				  board or the nonprofit organization shall submit it in an electronic data
				  format.
Data Element
1. Hospital identifier.*
Enter the six-digit Medicare provider number or a
							 number assigned by the board or its designee.
*
*
2. Attending physician identifier.
Enter the nationally assigned physician
							 identification number, either the Uniform Physician Identification Number
							 (UPIN) or National Provider Identifier (NPI) as approved by the board for the
							 physician assigned as the attending physician for an inpatient.
3. Other physician identifier.
Enter the nationally assigned physician
							 identification number, either the Uniform Physician Identification Number
							 (UPIN) or National Provider Identifier (NPI) as approved by the board for the
							 physician identified as the operating physician for the principal procedure
							 reported.
4. Payor identifier.
5. Employer identifier.
6. Patient identifier.*
Enter the nine-digit social security number of the
							 patient. If a social security number has not been assigned, leave blank. The
							 nine-digit social security number is not required for patients under four years
							 of age.
*
*
7a. Patient sex.
7b. Race code.*
If an inpatient hospital collects information
							 regarding the choices listed below, the appropriate one-digit code reflecting
							 the race of the patient should be entered. If a hospital only collects
							 information for categories 0, 1, or 2, then the appropriate code should be
							 entered from those three selections.
0 = White
1 = Black
2 = Other
3 = Asian
4 = American Indian
5 = White Hispanic
6 = Black Hispanic
*
*
7c. Date of birth.
7d. Street address, city or county, and zip
							 code.
7e. Employment status code.
7f. Patient status (i.e., discharge).
Inpatient codes only.
7g. Birth weight (for infants)*
Enter the birth weight of newborns in grams.
*
*
8a. Admission type.
8b. Admission source.
8c. Admission date.
8d. Admission hour.
8e. Admission diagnosis code.
9a. Discharge date.
Only enter date of discharge.
*
*
10. Principal diagnosis code.
Enter secondary diagnoses (up to eight).
In addition, include diagnoses recorded in the
							 comments section for DX6-DX9.
11. External cause of injury code (E-code).
Record all external cause of injury codes in
							 secondary diagnoses position after recording all treated secondary
							 diagnoses.
12. Co-morbid conditions existing but not
							 treated.
13. Principal procedure code and date.
Enter other procedures and dates (up to five). In
							 addition, include procedures recorded in the comments section for
							 PX4-PX6.
14. Revenue code (up to 23).
Units of service (up to 23).
Units of service charges (up to 23).
15. Total charges (by revenue code category or by
							 HCPCS code).
(R.C. Code 001 is for total charges. See page
							 47-1.)
Statutory Authority: §§ 32.1-12 and 32.1-276.6 of
					 the Code of Virginia.