(1) Critical Access Hospitals (certified by the Secretary
of the United States Department of Health and Human Services as a
critical access hospital under Title 42 United States Code, §1395i-4).
(2) Inpatient Rehabilitation Hospitals (a majority
of the patients are inpatients being rehabilitated).
(3) Inpatient Psychiatric Hospitals (a majority of
the patients are inpatients being treated for psychiatric diseases
or associated conditions).
(4) Cancer Hospitals (a majority of the patients are
inpatients being treated for cancer or associated cancerous conditions).
(5) Children's or Pediatric Hospitals (a majority of
the patients are under the age of 18 and admitted as inpatients).
(6) Long Term Care Hospitals (a majority of the patients
are inpatients being treated for chronic conditions or associated
diseases that require extended stays in a hospital).
(f) For patients which are covered by 42 USC §290dd-2
and 42 CFR Part 2, the hospital shall submit the following patient
identifying information or default values in the specified Record
and Field locations as required by subsection (a) of this section:
(1) Patient Account Number - This alphanumeric patient
control number shall be reported. This number is unique to the institution
and episode of care and will be used by the hospital to review and
certify data.
(2) Last Name - The patient's last name shall be removed
and replaced with "Doe."
(3) First Name - The patient's first name shall be
removed and replaced with "Jane" if female, or "John" if male, and
can include a sequential number (e.g., John1, John2, John3... etc.).
(4) Middle Initial - The patient's middle initial shall
be removed and left blank (space filled).
(5) Date of Birth - "January 1" and the patient's year
of birth shall be reported.
(6) Address - The patient's residence address shall
be removed and replaced with the hospital's street address.
(7) City - The patient's city of residence shall be
removed and replaced with the name of the city where the hospital
is located.
(8) State - The patient's state of residence shall
be reported.
(9) ZIP Code - The patient's ZIP code of residence
shall be removed and replaced with the hospital's ZIP code.
(10) Medical Record Number - The patient's medical
record number shall be reported. This number is unique to the institution
and episode of care and will be used by DSHS to process the claim
data and for the hospital to review and certify the patient's data.
(11) Social Security Number - The patient's Social
Security Number shall be removed and replaced with "999999999."
(12) Statement Dates - The month, day, and year of
the statement from and statement through dates shall be reported as
required. Only the year of service will be retained with the record
after transfer to the DSHS program administering and completing the
processing of the data for the health care data collection system
under Health and Safety Code, Chapter 108.
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Source Note: The provisions of this §421.9 adopted to be effective August 19, 1997, 22 TexReg 7490; amended to be effective December 29, 1997, 22 TexReg 12494; amended to be effective July 26, 1998, 23 TexReg 7365; amended to be effective February 21, 1999, 24 TexReg 948; amended to be effective July 29, 2001, 26 TexReg 5408; amended to be effective July 6, 2003, 28 TexReg 4915; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8842; amended to be effective December 27, 2007, 32 TexReg 9683; amended to be effective January 9, 2011, 35 TexReg 9743; amendedto be effective July 5, 2017, 42 TexReg 3373; amended to be effective January 30, 2019, 44 TexReg 429 |