Maine Health Data Organization

Chapter 241: Uniform Reporting System for Hospital Inpatient Data Sets and Hospital Outpatient Data

(routine technical)

Adopted Rule Summary of Changes (9/26/2017)

It is the responsibility of the hospital to review the adopted rule in its entirety. This summary is being provided to highlight only the major changes to the rule.

  1. General submission requirements
  2. Terminology in “Establishment of Requirements” statement is updated. (page 1)
  3. Section 1(G) – Clarifies the definition of Hospital Outpatient Data. (page 2)
  4. Section 1(J) – Deleted. (page 2)
  5. Old Section 2(A)(1)(b) – Removed. (page 3)
  6. New Section 2(A)(1)(b) – Removes payer identification codes and adds location of service codes to the allowed list of specific and unique coding. (page 3)
  7. Section 2(A)(3) – Hospital outpatient encounters will be submitted under the MHDO-assigned provider code of the hospital and all records will contain location of service information. (page 3)
  8. Section 2(A)(3)(a) and 2(A)(3)(b) – Removed. (page 3)
  9. Section 2(A)(4) – Clarified that inpatient is treated the same way as outpatient. Only reconciled lines are reported. (page 3)
  10. Section 2(B)(3) – Removed because no longer relevant. (page 3)
  11. Section 3(B) – Renames medium to filing method and aligns submission requirements with new MHDO submission portal. (page 4)
  12. Section 3(E) –Filing Period requirement is unchanged, but wording is condensed for clarity. (page 4).
  13. Section 7(A) – General reference to changes in the validation process and thresholds in the new hospital data portal. (page 6)
  14. Section 8 – Removed because no longer relevant. (page 6)
  1. Appendices
  1. Appendix A– NAIC source removed (pages 11), international country codes source added (page 13)and other code sources updated (pages 8-13).
  2. New data elements
  3. Statement Covers Period – From (IP2020; pages 17, 34)
  4. Patient Country Code (IP2021, pages 17, 34; OP2018, pages 53, 72)
  5. Patient Name fields (IP2022-IP2025, pages 17, 34; OP2019-OP2022, pages 53, 72)
  6. Patient Address lines (IP2026-IP2027, pages 17, 34; OP2023-OP2024, pages 53, 72)
  7. Payer Name (IP3009, pages 18, 35; OP3009, pages 54, 73).
  8. Place of Service (OP4006; pages55, 74)
  9. Deleted data elements
  10. Payer Identification Number (IP3004, pages 18, 35; OP3004, pages 54, 73) deleted and combined with Filler (IP3095, page 18; OP3095, page 54).
  11. Payer Name (IP3006, pages 18, 35; OP3006, pages 54, 73) deleted and combined with Filler (IP3097, page 18; OP3097, page 54)
  12. Data element/filler format changes
  13. Patient Discharge Status, numeric to text (IP2014, page 16; OP2014, page 52)
  14. Filler IP3095 has been expanded to include the record positions of deleted data element IP3004 and filler IP3096 (page 18); filler IP3097 has been expanded to include the record positions of deleted data element IP3006 and filler IP3098 (page 18); filler OP3095 has been expanded to include the record positions of deleted data element OP3004 and filler OP3096 (page 54); filler OP3097 has been expanded to include the record positions of deleted data element OP3006 and filler OP3098 (page 54).
  15. New Payer Name fields expanded to 100 characters (IP3009, page 18; OP3009, page 54).
  16. Filler, numeric to text (IP9098, page 30)
  17. Data element name changes
  18. MHDO-Assigned Hospital ID (IP0102, pages 15, 32; OP0102, pages 51, 70)
  19. Hospital Name (IP0103, pages 15, 32; OP0103, pages 51, 70)
  20. Record Type/Data element description changes
  21. Type of Bill (IP4004, page 19; OP4004, page 55)
  22. Sequence Numbers (IP/OP Record Type 30, Sequence 02-99, pages 18, 54; IP5002, page 20)
  23. POA value lists removed (pages 23-24)
  24. Submitter Name, obsolete description removed (OP0103, page 51)
  25. Attending and Operating Provider NPI (OP8004 and OP8005, page 67)
  26. Attending Provider Last (OP8006) and First (OP8007) Names (page 67)
  27. Typographical errors
  28. Reference to Revenue Code 0001(IP9004 and IP9005, page 48; OP9004, page 86)

Justification: This rule change containsclarifications, additions and deletions that will improve the content and value of the MHDO hospital encounter data for authorized data users. MHDO is aware of the challenges created for the hospitals when changes are made to the MHDO file layout. Therefore, we have minimized the disruption of the changes in the layout by ensuring that most of the changes occur at the end of a record type. Lastly, several of the changes align with updates to the national standards and the MHDO’s new data submission process.