Utah Admin. Code R426-7-3 - ED Data Set

(1) All hospitals licensed in Utah shall provide patient data as identified by the Department.

(2) This data shall be submitted at least quarterly to the Department. Corporate submittal is preferred.

(3) The data must be submitted in an electronic format determined and approved by the Department.

(4) If the Department determines that there are errors in the data, it may return the data to the data supplier for corrections. The data supplier shall correct the data and resubmit it to the Department within 30 days of receipt from the Department. If data is returned to the hospital for corrections, the hospital is not in compliance with this rule until corrected data is returned, accepted and approved by the Department.

(5) The minimum required data elements include:

Unique Patient Control Number

Record Type

Provider Identifier (hospital)

Patient Social Security Number

Patient Control Number

Type of Bill

Patient Name

Patient's Address (postal zip code)

Patient Date of Birth

Patient's Gender

Admission Date

Admission Hour

Discharge Hour

Discharge Status

Disposition from Hospital

Patient's Medical Record Number

Revenue Code 1 ("001" sum of all charges)

Total Charges by Revenue Code 1 ("001" last total Charge Field, is sum)

Revenue Code 2 ("450" used for record selection)

Total Charges by Revenue Code 2 (Charges associated with code 450)

Primary Payer Identification

Estimated Amount Due

Secondary Payer Identification

Estimated Amount Due

Tertiary Payer Identification

Estimated Amount Due

Patient Estimated Amount Due

Principal Diagnosis Code

Secondary Diagnosis Code 1

Secondary Diagnosis Code 2

Secondary Diagnosis Code 3

Secondary Diagnosis Code 4

Secondary Diagnosis Code 5

Secondary Diagnosis Code 6

Secondary Diagnosis Code 7

Secondary Diagnosis Code 8

External Cause of Injury Code (E-Code)

Procedure Coding Method Used

Principal Procedure

Secondary Procedure 1

Secondary Procedure 2

Secondary Procedure 3

Secondary Procedure 4, and

Secondary Procedure 5

Notes

Utah Admin. Code R426-7-3

Amended by Utah State Bulletin Number 2016-8, effective 4/1/2016