902 KAR 19:010.
Kentucky Birth Surveillance Registry.
RELATES TO: KRS
211.655, 211.660, 211.670
STATUTORY AUTHORITY:
KRS 211.660(6)
NECESSITY, FUNCTION,
AND CONFORMITY: KRS 211.660(1) requires the department to establish the
Kentucky Birth Surveillance Registry based on the need to provide information
on the incidence, prevalence, and trends of congenital anomalies, stillbirths
and high risk conditions; provide information as to possible causes; and
develop preventive strategies to reduce their incidence and the secondary
complications associated with them. This administrative regulation establishes
uniform procedures for collection of data for the registry.
Section 1.
Definitions. (1) "Agent" means an entity with which the department
may:
(a) Contract
pursuant to carrying out the duties of the registry; and
(b) Designate to act
on the behalf of the registry to edit or analyze data from hospitals.
(2)
"Cabinet" means the Cabinet for Health Services.
(3) "Coding and
transmission specifications" or "UB-92 Submission Manual" means
the technical directives the cabinet issues concerning technical matters
subject to frequent change, including codes and data for uniform provider entry
into particular character positions and fields of the UB-92 and uniform provider
formatting of fields and character positions for purposes of electronic data
transmissions pursuant to 902 KAR 17:040 or, where not specified, as are
delineated in the UB-92 Training Manual.
(4)
"Department" means the Department for Public Health.
(5)
"Division" means the Division of Adult and Child Health, which is the
administrator of the Kentucky Birth Surveillance Registry, and is located
within the Department for Public Health.
(6)
"Hospital" means an acute care hospital licensed under the provisions
of KRS Chapter 216B.
(7)
"Hospitalization" means the inpatient medical episode identified by a
patient's birth, admission date, length of stay and discharge date, and further
identified by a provider-assigned patient control number unique to that
inpatient episode.
(8)
"Laboratory" means a medical laboratory licensed under KRS Chapter
333.
(9) "ICD-9
Code" means the diagnosis code specifications under the International
Classification of Diseases, in current usage, required for reporting diagnoses
and diseases to all U.S. Public Health Service and Health Care Financing
Administration programs.
(10) "Medical
record" means the patient's actual medical record maintained by the
hospital's medical record department or by a laboratory.
(11)
"Record" means documentation
in UB-92 format, in paper or electronic form, of:
(a) A hospitalization;
(b) An outpatient visit; or
(c) A laboratory result.
(12)
"Registry" means the Kentucky Birth Surveillance Registry.
(13)
"UB-92" means the billing form identified by the Federal Health Care
Financing Administration as HCFA Form 1450, as recommended by the National
Uniform Billing Committee and adopted by the Kentucky Uniform Billing Committee
for use by hospitals and other providers in billing for hospitalizations.
Section 2. Data
Collection. (1) Hospitalization records. A hospital shall document, on a UB-92 record,
each hospitalization it provides for an inpatient of age five (5) years or
under who is diagnosed with a congenital birth anomaly or high-risk condition,
as defined by the department in accordance with KRS 211.660(2), and included in Section 7 of this administration
regulation. Each hospital shall provide to the registry the data specified in
Section 8 of this administrative regulation.
(2) Outpatient and
laboratory records.
(a) In accordance with KRS 211.660(3)(b),
a laboratory shall maintain medical records for each person tested who is five
(5) years of age or younger and who has a primary diagnosis or laboratory test
result indicating a congenital anomaly or high-risk condition, as defined by
the department and included in Section 7 of this administrative regulation.
(b) A laboratory, and a hospital
voluntarily maintaining an outpatient list as described at KRS 211.660(3)(a),
shall provide the data specified in Section 8 of this administrative
regulation.
(3)
Access to records. A reporting entity shall provide a requesting agent
of the registry with access to the medical record of any patient meeting the
criteria in subsections (1) or (2) of this section, as authorized by KRS
211.660(4).
Section 3. Data
Finalization and Submission. (1) Submission of final data. Data shall be deemed
final for purposes of submission to the registry as soon as a record is
sufficiently final that the provider could submit it to a payor for billing
purposes, whether or not the record has actually been submitted to a payor.
(a) Finalized data
shall not be withheld from submission to the registry on grounds that it
remains subject to adjudication by a payor; and
(b) Data on a
hospitalization shall not be submitted to the registry before:
1. The patient is
discharged; or
2. The record is
sufficiently final that it could be submitted to a payor for billing.
(2) Transmission of
records.
(a) Data submitted
to the registry shall be uniformly completed and formatted according to coding
and transmission specifications;
(b) Hospitals and
laboratories that have the capacity shall submit data on computer-readable
electronic media;
(c) Hospitals and
laboratories shall provide backup security against accidental erasure or loss
of the data until any incomplete or inaccurate records identified by the
registry have been corrected and resubmitted;
(d) Data submitted
by mail shall be by certified mail or other traceable carrier, such as United
Parcel Service; and
(e) A hospital or
laboratory that submits records in the form of paper copies shall either
deliver the copies to the registry’s reporting agent, or send them in secure
packaging by mail postmarked on or before the due date.
Section 4. Data
Submission Timetable. Quarterly submission. A hospital shall submit data at
least once for each calendar quarter. A quarterly submission shall contain data
from records of patients which became final during that quarter, as specified
in Section 3(1) of this administrative regulation. The data shall be submitted
to the registry not later than forty-five (45) days after the last day of that
quarter.
(1) If the 45th day
falls on a weekend or holiday, the submission due date shall become the next
following working day.
(2) Outpatient data and
laboratory reports shall be submitted directly to KBSR within thirty (30) days
of the written request.
(3) A hospital shall, within thirty (30)
days of receipt of a written request from the registry, submit a medical
records report for specified ICD-9 codes for a designated quarter.
Section 5. Data
Corrections. (1) Editing. The following UB-92 data fields from Section 9 of
this administrative regulation shall be edited by the registry upon receipt, in
order to ensure completeness and validity of the data for further processing:
patient name, insured’s name.
(2) If the registry
identifies a record as incomplete or invalid, the submitting hospital shall
submit a corrected copy within thirty (30) days of notification. Date of
notification shall be considered to be the date postmarked on the registry's
mailed notice of required correction. Submission shall be by either electronic
transmission or mailing.
Section 6. Working
Contacts. (1) Beginning January 1, 1996 and annually thereafter, each hospital
required to submit data shall report, by letter to the registry, the names and
telephone numbers of a chief executive officer shall not be designated as a
contact or backup, unless no other employee has the required technical
expertise.
(2) If the chief
executive officer, designated contact person or back-up person changes during
the year, the name of the replacing person shall be reported immediately to the
registry.
Section 7. Required
Reporting Conditions. The data which are submitted from the hospital to the
registry shall be at least for those patients, from birth to five (5) years of
age, for whom any reported diagnoses includes the following ICD-9 codes:
(1) All congenital
anomalies codes - 740-759. (Examples: microcephaly 742.1; macrocephaly 742.4;
upper GI anomalies 750; lower GI anomalies 751; gastroschisis/omphalocele
756.7; chromosome anomalies 758.)
(2) Dwarfism not
elsewhere classified - 259.4.
(3)
Metabolic/storage disorders - 270-279, Excluding codes 274, 276 and 278.
(4) Hereditary
hemolytic anemia - 282.
(5) Neurologic
disorders of brain and spinal cord - 334-335.
(6) Cerebral palsy -
343.
(7) Teratogens
(noxious influences) - 760.7 and all subcategories, from 760.70 to 760.79.
(8) Infant of
diabetic mother - 775.0.
(9) Failure to
thrive - 783.4.
(10) Small for
gestational age - 764.0.
Section 8. Required
Data Elements. (1) UB-92 data. Hospitals shall ensure that each copy of UB-92
data submitted to the registry contains at least the following data elements as
provided on the UB-92 form. Asterisks identify elements that shall not be blank
and shall conform to coding and transmission specifications.
UB-92 FIELD #
ELEMENT NAME
*5
Federal Tax Number
*12
Patient Name
13
Patient Address
*14
Birth Date
*15
Sex
*17
Admission/Start of Care
Date
*23
Medical Record #
*58
Insured’s Name
59
Patient Relationship
60
Certificate/SSN/Health
Insurance Claim/ID Number
*67
Principal Diagnosis Code
68-75
Other Diagnosis Codes
(Up to 8)
*82
Attending Physician
Unique Identification Number or Alternate Number
(2) Outpatient and laboratory data. A
laboratory and a hospital voluntarily maintaining a list of outpatients, in
accordance with KRS 211.660(3)(a), shall ensure that the data submitted to the
registry includes the following data elements: patient name, patient address,
birth date, sex, principal diagnosis, other diagnoses (up to eight (8)), and
reporting source.
Section 9.
Incorporation by Reference. (1) "UB-92 Training Manual (August 4,
1993)" is incorporated by reference.
(2) This material
may be inspected, copied, or obtained, subject to applicable copyright law, at
the Kentucky Birth Surveillance Registry, Division of Adult and Child Health,
Department for Public Health, 275 East Main Street, Frankfort, Kentucky 40621,
Monday through Friday, 8 a.m. to 4:30 p.m. (22 Ky.R. 1185; Am. 1480; 1604; eff.
3-7-96; 29 Ky.R. 574; 966; eff. 10-16-2002.)
