Haw. Code R. § 17-1739-59 - Service category designations

(a) Services provided by acute inpatient facilities shall be classified into one of four mutually exclusive service categories:

(1) Maternity - an inpatient stay which results in a delivery with a maternity principal or secondary diagnosis code;

(2) Surgical - an inpatient stay with the following characteristics:

(A) The claim has not been classified as a maternity claim;

(B) The claim includes a surgical code that is considered to be an operating room procedure; and

(C) The claim includes both:

(i) A surgical date; and

(ii) An operating room charge;

(3) Psychiatric - an inpatient stay with a psychiatric primary diagnosis code and with no operating room charge; or

(4) Medical - an inpatient stay not classified into one of the above three service categories.

(b) The standard medical data codes for claiming inpatient hospital services as described in subsection (a) are identified at 45 C.F.R. § 162.1002 valid at the time the service is furnished, pursuant to:

(1) International Classification of Diseases, 9^th Edition, Clinical Modification (ICD-9-CM);

(2) Internal Classification of Diseases, 10^th Revision, Clinical Modification (ICD-10-CM); and

(3) Internal Classification of Diseases, 10^th Revision, Procedure Coding System (ICD-10-PCS).

Notes

Haw. Code R. § 17-1739-59

[Eff 11/13/95] (Auth: HRS § 346-59) (Imp: 42 C.F.R. §447.252) Am 9/25/2015