FY 2025 Case Mix Updates Webinar Highlights
FY 2025 CASE MIX UPDATES WEBINAR
May 16, 2024
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SUBMISSION GUIDE HIGHLIGHTS
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CHANGES & REVISIONS
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HOSPITAL INPATIENT DISCHARGE DATA
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CHANGES & REVISIONS
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EMERGENCY DEPARTMENT DATA
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CHANGES & REVISIONS
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OUTPATIENT OBSERVATION DATA
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TABLE CHANGES & REVISIONS
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ALL CASE MIX DATA SUBMISSIONS
(HIDD/EDD/OOD)
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CHANGES & REVISIONS
FOR
ELECTRONIC HEALTH RECORD DATA
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QUESTIONS & COMMENTS
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Cathy Houston, Associate Director of Hospital Data Intake & Compliance
Catherine.Houston@CHIAMass.gov
Linda Stiller, Manager, Data Intake and Compliance
Linda.Stiller@CHIAMass.gov
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Hadish Gebremedhin, Senior Health Care Data Liaison
Hadish.Gebremedhin@CHIAMass.gov
Jillian Petrie, Health Care Data Liaison
Jillian.Petrie@CHIAMass.gov
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This content provides key highlights from the FY 2025 case mix updates webinar, including submission guide changes, revisions for hospital inpatient discharge data, and agenda details. It covers important topics like data quality, transition to CHIA submissions, and timeline for next steps. Stay informed about the upcoming changes and key updates in the healthcare industry.
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Presentation Transcript
FY 2025 CASE MIX UPDATES WEBINAR May 16, 2024
Agenda 2:00 Welcome 2:05 2:10 FY 2025 Submission Guide Highlights Review of Proposed Changes 2:30 Data Quality - EHRD 2:35 Transition to CHIA Submissions 2:40 Timeline / Next Steps 2:45 Questions & Comments
Submission Guide Changes - Highlights Key Changes: File Format File Type NEW! Asterisk Delimiter Format (All Filler fields removed) HIDD/EDD Remove Record Type 21 EDD Key Changes: New Fields File Type National Provider Identifier (NPI): Other Physician/Clinician and ED Physician/Clinician EDD Key Changes: Field Updates File Type Medical Record Number (MRN): Increase length to 25 Physician License Number (BORIM): Increase length to 25 Other assorted field/edit updates All All All Key Changes: Table Updates Type of Admission: Add Trauma as valid code Race, Ethnicity, Hispanic Indicator: Match EHRD code set Homeless Indicator: Add new code values File Type HIDD/EDD/OOD HIDD/EDD/OOD All
CHANGES & REVISIONS FOR HOSPITAL INPATIENT DISCHARGE DATA
Hospital Inpatient Discharge Data New / Update Record Type Field Medical Record Number (MRN) & Mother s Medical Record Number Description of requirement All U Change field size to 25 01, 99 Submitter EIN Submitter Name, Provider Name, Provider Address U Change field size to 9 01, 10 U Change field size to 100 Rename to Patient Sex at Birth, change field size to 8; add new code values 20 Patient Sex U 20 Billing Number U Change field size to 25 Disallow 99 as valid month & day when unknown; report 01 20 Patient Birthday U 20 Homeless Indicator Permanent and Temporary Patient Street Address Race 1, Race 2, Hispanic Indicator, Ethnicity 1, Ethnicity 2 U Change field size to 8; add new code values 25 U Change field size to 100 Change field size to 8; change code values to match EHRD code set 25 U 30 Accommodations 1-5 U Change field size to 20
Hospital Inpatient Discharge Data New / Update Record Type Field Description of requirement 30 Units of Service (Accom. Days) U Change field size to 6 30 Total Charges (Accom.) U Change field size to 10 40 Ancillaries 1-5 U Change field size to 20 40 Units of Service (Ancillary) U Change field size to 6 40 Total Charges (Service) U Change field size to 10 45 Number of hours in ED U Change field size to 10 80 BORIM license number U Change field size to 25; Remove BORIM7 95 Number of Discharges U Change field size to 6 95 Total Days No. of Providers on File, Count of Batches, Batch Type Counts U Change field size to 10 99 U Change field size to 1
CHANGES & REVISIONS FOR EMERGENCY DEPARTMENT DATA
Hospital Emergency Department Data New - Update Record Type Fields Description of requirement All Medical Record Number (MRN) U Change field size to 25 10 Provider Name, Provider Address U Change field size to 100 10 Provider City U Change field size to 15 20 Billing Number Medicaid Claim Certificate Number (New MMIS ID/Medicaid ID) U Change field size to 25 20 U Change field size to 12 Disallow 99 as valid month & day when unknown, report 01 ; change field size to 8 Rename to Patient Sex at Birth, change field size to 8; add new code values 20 Date of Birth U 20 Sex U 20 Registration Date U Change field size to 8 20 Discharge Date U Change field size to 8
Hospital Emergency Department Data New / Update Record Type Field Other Physician Number and ED Physician Number (BORIM) Description of requirement 20 U Change field size to 25; remove BORIM7 Rename to EMS Patient Care Report Number; Change field size to 50 20 Ambulance Run Sheet U 20 Homeless Indicator Other Physician or Clinician National Provider Identifier (NPI) ED Physician or Clinician National Provider Identifier (NPI) Permanent and Temporary Patient Street Address Race 1, Race 2, Hispanic Indicator, Ethnicity 1, Ethnicity 2 U Change field size to 8; add new code values 20 N New field 20 N New field 25 U Change field size to 100 Change field size to 8; change code values to match EHRD code set 25 U 25 Other Ethnicity Group Element: Service Line Items 2 30 Group Element: Site Summaries 2 - 4 U Change field size to 20 60 U Change field size to 16 94 U Change field size to 48
CHANGES & REVISIONS FOR OUTPATIENT OBSERVATION DATA
Hospital Outpatient Observation Data New / Update Field No. Field Description of requirement All MR_N (Medical Record Number) U Change field size to 25 5 Acct_N U Change field size to 25 7 MMIS_ID U Change field size to 12 Disallow 99 as valid month & day when unknown; report 01 Rename to Patient Sex at Birth, change field size to 8; add new code values Change field size to 8; change code values to match EHRD code set 8 DOB U 9 Sex Race 1, Race 2, Hispanic Indicator, Ethnicity1, Ethnicity2 10, 56, 55, 58, 59 U 24 Surgeon U Change field size to 25; remove BORIM7 25 Att_MD Permanent and Temporary Patient Street Address U Change field size to 25; remove BORIM7 47, 51 U Change field size to 100 67 Homeless Indicator Surgeon for Associated Procedure 1-3 (BORIM) U Change field size to 8; add new code values 69-71 U Change field size to 25; remove BORIM7 Change field size to 10; allow decimal and round to 2 places for partial hours 87 Number of hours in ED U
TABLE CHANGES & REVISIONS FOR ALL CASE MIX DATA SUBMISSIONS (HIDD/EDD/OOD)
Patient Sex at Birth Patient Sex at Birth Code Patient Sex at Birth Definition M Male F Female DONTKNOW Don t know ASKU Choose not to answer UNK Unknown UTC Unable to collect this information on patient due to lack of clinical capacity of patient to respond
Type of Admission * TYPEADM CODE * TYPE OF ADMISSION DEFINITION 6 Trauma
Race Race Code Patient Race Definition 1002-5 American Indian/Alaska Native 2028-9 Asian 2054-5 Black/African American 2076-8 Native Hawaiian or other Pacific Islander 2106-3 White OTH Other DONTKNOW Don t know ASKU Choose not to answer UNK Unknown UTC Unable to collect this information on patient due to lack of clinical capacity of patient to respond
Hispanic Indicator Hispanic Indicator Code Hispanic Indicator Definition 2135-2 Patient is Hispanic 2186-5 Patient is not Hispanic DONTKNOW Don t know ASKU Choose not to answer UNK Unknown UTC Unable to collect this information on patient due to lack of clinical capacity of patient to respond
Ethnicity Utilize Full list per CDC http://www.cdc.gov/nchs/data/dvs/Race_Ethnicity_CodeSet.pdf] and those below: Ethnicity Code AMER Ethnicity Definition American BRAZ Brazilian CANADA Canadian CAPE-V Cape Verdean CARIB Caribbean Islander E-EUR Eastern European PORT Portuguese RUSSN Russian OTH Other UNK Unknown DONTKNOW Don t know ASKU Choose not to answer UTC Unable to collect this information on patient due to lack of clinical capacity of patient to respond
Homeless Indicator Homeless Indicator Code Homeless Indicator Definition Y Patient is known to be homeless N Patient is not known to be homeless DONTKNOW Don t know ASKU Choose not to answer UNK Unknown UTC Unable to collect this information on patient due to lack of clinical capacity of patient to respond
CHANGES & REVISIONS FOR ELECTRONIC HEALTH RECORD DATA
Electronic Health Record Data New / Update Record Type Field Description of requirement 1 Hospital Name U Change field size to 100 2 Medical Record Number (MRN) U Change field size to 25 2 Permanent Patient Street Address U Change field size to 100 2 Temporary Patient Street Address U Change field size to 100 2 Patient Homeless Indicator U Change field size to 8; add new code values
Homeless Indicator Homeless Indicator Code Homeless Indicator Definition Y Patient is known to be homeless N Patient is not known to be homeless DONTKNOW Don t know ASKU Choose not to answer UNK Unknown UTC Unable to collect this information on patient due to lack of clinical capacity of patient to respond
Data Quality - EHRD Field Description Reported measurement = Kilograms Field size =10 Decimal allowed with 2 decimal places [ex., 90.95] Body Weight Reported measurement = Centimeters Field size =8 Decimal allowed with 2 decimal places [ex., 167.42] Body Height Reported data should be consistent with HIDD/EDD/OOD Race
Case Mix Data Submissions (HIDD/EDD/OOD) Transition from INET to CHIA Submissions FY 2024 Q3 Preliminary files (Apr-Jun) due 7/31/24 to be submitted in CHIA Submissions FileSecure must be downloaded and installed to encrypt file and decrypt edit error detail report If FileSecure is already installed, a new version must be downloaded Installation instructions will be posted to CHIA website INET application will be decommissioned
Timeline / Next Steps: FY25 Case Mix Intake Process Draft Timeline May 29, 2024 Provider Comment Period Ends June 2024 Administrative Bulletin and Guides Adopted June December 2024 CHIA and Hospitals Update Systems January 2025 Hospital Testing Period Quarter 1 Submission (Oct Dec) - Preliminary HIDD/EDD/OOD - EHRD - Final HIDD/EDD/OOD January 31, 2025 January 31, 2025 March 16, 2025
Submission Guides Published to CHIA Website http://www.chiamass.gov/hospital-data-specification-manuals/
Follow-up Contacts Cathy Houston, Associate Director of Hospital Data Intake & Compliance Catherine.Houston@CHIAMass.gov Linda Stiller, Manager, Data Intake and Compliance Linda.Stiller@CHIAMass.gov Hospital Liaisons: Hadish Gebremedhin, Senior Health Care Data Liaison Hadish.Gebremedhin@CHIAMass.gov Jillian Petrie, Health Care Data Liaison Jillian.Petrie@CHIAMass.gov Hospital Email: HospitalData@CHIAMass.gov
