DOH has released more details about actions hospitals must take under its Statewide Planning and Research Cooperative System injury, cause and place remediation project.
The project was necessitated by a grant-funded study underway at DOH. SPARCS updated its edit rules to ensure injury, cause and place diagnosis codes between 2016 and 2023 are aligned to support the data integrity of the grant-funded study. As a result, New York state hospitals must resubmit inpatient and emergency department claims that fail these updated edit rules.
Since the April 27 announcement of this project, HANYS has advocated on behalf of the state’s hospitals, bringing attention to the project’s workforce and financial implications. In addition, the DOH six-year data retention requirement and electronic health record changes have left some facilities lacking the data requested by the state. HANYS strongly encouraged SPARCS to enforce the new edit requirements only moving forward, to mitigate the challenges of retrofitting the data. The state heard these considerations and released new guidelines to SPARCS coordinators at impacted facilities starting July 31. Delays in transferring the remediation file have extended the expected completion date as noted in the SPARCS submitter’s forum on Aug. 16. As of the forum, 105 of 211 facilities have received their files with priority focused on sites with higher remediation counts.
Detailed instructions and particulars regarding the required record remediation can be accessed through the Health Commerce System by state-designated SPARCS coordinators. Users of DataGen’s UDS SPARCS submission tool are seeing small volumes of remediation cases. From the clients we’ve heard from, less than 1% of their claims need remediation.
The full page of state instructions can be condensed into the following actions:
- Retrieve remediation files from the Health Commerce System.
- Look up record information in the source system regarding the N002 injury DX requiring a cause and N003 cause DX requiring a place errors found in the remediation files.
- Update the source system with information for re-extraction and import into UDS or update the records directly in UDS to minimize the effort required to meet the remediation requirements.
Reach out to DataGen today to learn more about how UDS can get your hospital compliant for the injury, cause and place remediation project and beyond.
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