Utah Department of Administrative Services Division of Administrative Rules

Utah Administrative Code

The Utah Administrative Code is the body of all effective administrative rules as compiled and organized by the Division of Administrative Rules (see Subsection 63G-3-102(5); see also Sections 63G-3-701 and 702).

NOTE: For a list of rules that have been made effective since May 1, 2016, please see the codification segue page.

NOTE TO RULEFILING AGENCIES: Use the RTF version for submitting rule changes.


R426. Health, Family Health and Preparedness, Emergency Medical Services.

Rule R426-7. Emergency Medical Services Prehospital Data System Rules.

As in effect on May 1, 2016

Table of Contents

R426-7-3. ED Data Set.

(1) All hospitals licensed in Utah shall provide patient data as identified by the Department.

(2) This data shall be submitted at least quarterly to the Department. Corporate submittal is preferred.

(3) The data must be submitted in an electronic format determined and approved by the Department.

(4) If the Department determines that there are errors in the data, it may return the data to the data supplier for corrections. The data supplier shall correct the data and resubmit it to the Department within 30 days of receipt from the Department. If data is returned to the hospital for corrections, the hospital is not in compliance with this rule until corrected data is returned, accepted and approved by the Department.

(5) The minimum required data elements include:

Unique Patient Control Number

Record Type

Provider Identifier (hospital)

Patient Social Security Number

Patient Control Number

Type of Bill

Patient Name

Patient's Address (postal zip code)

Patient Date of Birth

Patient's Gender

Admission Date

Admission Hour

Discharge Hour

Discharge Status

Disposition from Hospital

Patient's Medical Record Number

Revenue Code 1 ("001" sum of all charges)

Total Charges by Revenue Code 1 ("001" last total Charge Field, is sum)

Revenue Code 2 ("450" used for record selection)

Total Charges by Revenue Code 2 (Charges associated with code 450)

Primary Payer Identification

Estimated Amount Due

Secondary Payer Identification

Estimated Amount Due

Tertiary Payer Identification

Estimated Amount Due

Patient Estimated Amount Due

Principal Diagnosis Code

Secondary Diagnosis Code 1

Secondary Diagnosis Code 2

Secondary Diagnosis Code 3

Secondary Diagnosis Code 4

Secondary Diagnosis Code 5

Secondary Diagnosis Code 6

Secondary Diagnosis Code 7

Secondary Diagnosis Code 8

External Cause of Injury Code (E-Code)

Procedure Coding Method Used

Principal Procedure

Secondary Procedure 1

Secondary Procedure 2

Secondary Procedure 3

Secondary Procedure 4, and

Secondary Procedure 5

R426-7-4. Penalty for Violation of Rule.

As required by Section 63G-3-201(5): Any person or agency who violates any provision of this rule, per incident, may be assessed a penalty as provided in Section 26-23-6.

R426-7-100. Authority and Purpose.

(1) This rule is established under Title 26 Chapter 8a.

(2) The purpose of this rule is to establish minimum mandatory EMS data reporting requirements.

R426-7-200. Prehospital Data Set.

(1) Emergency medical service providers shall collect data as identified by the Department in this rule.

(2) Emergency Medical Services Providers shall submit the data to the Department electronically in the National Emergency Medical Services Information System (NEMSIS) format for every dispatch instance, regardless of patient disposition. In cases of mass casualty, data is required for every individual with whom EMS had contact, whether care was given or refused.

(3) The Department adopts by reference the National Highway Traffic Safety Administration (NHTSA) Uniform Pre-Hospital Emergency Medical Services (EMS) Dataset version 3.4 published in 2015 and the Utah NEMSIS 3.4 Elements and Values List published in 2016.

(4) Emergency Medical Services Providers shall submit NEMSIS Demographic data elements within 30 days after the end of each calendar quarter in the format defined in the NEMSIS EMSDemographicDataSet. Some data may change less frequently than quarterly, but Emergency Medical Services Providers shall submit all required data elements quarterly regardless of whether the data have changed. For Emergency Medical Services Providers directly using a reporting system provided by the Department, the data is considered submitted to the Department as soon as it has been entered or updated in the Department-provided system.

(5) Emergency Medical Services Providers shall submit NEMSIS EMS incident data elements for each Patient Care Report in the format defined in the NEMSIS EMSDataSet, as follows: incidents occurring between the 1st and 15th of a calendar month shall be submitted no later than the last day of the same calendar month; incidents occurring between the 16th and last day of a calendar month shall be submitted no later than the 15th of the following calendar month.

(a) For Emergency Medical Services Providers directly using a reporting system provided by the Department, the data is considered submitted to the Department as soon as it has been entered or updated in the Department-provided system.

(b) Emergency Medical Services Providers shall provide the Department 90 days notice when changing reporting systems.

(6) If the Department determines that there are errors in the data, it may ask the data supplier for corrections. The data supplier shall correct the data and resubmit it to the Department within 30 days of receipt from the Department. If data is returned to the supplier for corrections, the Emergency Medical Services Provider is not in compliance with this rule until corrected data is returned, accepted and approved by the Department.

(7) Emergency Medical Services Providers are not required to submit other NEMSIS data elements but may optionally do so.

(8) For each patient transported to a licensed acute care facility or a specialty hospital with an emergency department, each responding emergency medical services provider unit that cared for the patient during the incident shall provide a report of patient status, containing information critical to the ongoing care of the patient, to the receiving facility within one hour after the patient arrives at the receiving facility in at least one of the following formats:

(a) NEMSIS XML; or

(b) Paper form.

(9) For each patient transported to a licensed acute care facility or a specialty hospital with an emergency department, the receiving facility shall provide at least the following information to each Emergency Medical Services Provider that cared for the patient, within 24 hours of request by the Emergency Medical Services Provider:

(a) The patient's emergency department disposition;

(b) the patient's hospital disposition; and

(c) the patient's demographic information, including payment source.

KEY

emergency medical services

Date of Enactment or Last Substantive Amendment

March 25, 2016

Notice of Continuation

November 10, 2015

Authorizing, Implemented, or Interpreted Law

28-8a


Additional Information

Contact

For questions regarding the content or application of rules under Title R426, please contact the promulgating agency (Health, Family Health and Preparedness, Emergency Medical Services). A list of agencies with links to their homepages is available at http://www.utah.gov/government/agencylist.html or from http://www.rules.utah.gov/contact/agencycontacts.htm.