902 KAR 19:010. Kentucky Birth Surveillance Registry

Link to law: http://www.lrc.ky.gov/kar/902/019/010.htm
Published: 2015

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      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.)