Ariz. Admin. Code § 9-4-405

Current through Register Vol. 30, No. 50, December 13, 2024

Section R9-4-405 - Data Quality Assurance

A. To ensure completeness and accuracy of cancer reporting:

1. Upon notice from the Department of at least five business days, a hospital, clinic, physician, doctor of naturopathic medicine, dentist, or registered nurse practitioner required to report under R9-4-404 shall allow the Department to review any of the following records, as are applicable to the facility:

a. A report meeting the requirements of R9-4-404(B)(1);

b. Patient medical records;

c. Medical records of individuals not diagnosed with cancer;

d. Pathology reports;

e. Cytology reports;

f. Logs containing information about surgical procedures, as specified in A.A.C. R9-10-215(6) or A.A.C. R9-10-911(A); and

g. Records other than those specified in subsections (A)(1)(a) through (f) that contain information about diagnostic evaluation, cancer-directed treatment, or other treatment provided to an individual by the hospital, clinic, physician, doctor of naturopathic medicine, dentist, or registered nurse practitioner;

2. Within 14 calendar days after the Department's request, a hospital, clinic, physician, doctor of naturopathic medicine, dentist, or registered nurse practitioner required to report under R9-4-404 shall submit the following information about patients who were diagnosed with cancer or received treatment for cancer within the time period specified in the Department's request whose medical records include ICD Codes specified in a list provided by the Department:

a. The individual's name and date of birth,

b. The individual's medical record number,

c. The individual's admission and discharge dates,

d. All applicable codes for the individual that are in the list provided by the Department, and

e. Whether the code reflects the individual's principal or secondary diagnosis; and

3. Within 14 calendar days after the Department's request, a hospital shall resubmit all of the information required in R9-4-403(B)(2) for patients first released from the hospital within the time period specified in the Department's request.

B. The Department shall consider a hospital, clinic, physician, doctor of naturopathic medicine, dentist, or registered nurse practitioner required to report under R9-4-404 as meeting the criteria in R9-4-404 if the hospital, clinic, physician, doctor of naturopathic medicine, dentist, or registered nurse practitioner submits a case report to the Department for at least 97% of the patients for whom a case report is required under R9-4-404 during a calendar year.

C. The Department shall consider a hospital required to report under R9-4-404(A)(3) as meeting the criteria in R9-4-404(A)(3) if the hospital submits a follow-up report specified in R9-4-404(A)(3) to the Department once each calendar year for at least:

1. Eighty percent of all analytic patients from the hospital's reference date; and

2. Ninety percent of all analytic patients diagnosed within the last five years or from the hospital's reference date, whichever is shorter.

D. The Department shall return a case report not prepared according to R9-4-403 to the hospital, clinic, physician, doctor of naturopathic medicine, dentist, or registered nurse practitioner that submitted the case report, identifying the revisions that are needed in the case report.

E. Upon receiving a case report returned under subsection (D), a hospital, clinic, physician, doctor of naturopathic medicine, dentist, or registered nurse practitioner shall submit the revised case report to the Department within 15 business days after the date the Department requests the revision.

F. Upon written request by the Department, a hospital shall:

1. Prepare a case report based on a simulated medical record provided by the Department for the purpose of demonstrating the variability with which data is reported , and

2. Submit the case report to the Department within 15 business days after the date of the request.

Ariz. Admin. Code § R9-4-405

New Section made by final rulemaking at 12 A.A.R. 179, effective March 11, 2006 (Supp. 06-1). Amended by final rulemaking at 12 A.A.R. 3708, effective November 11, 2006 (Supp. 06-3). Amended by final rulemaking at 25 A.A.R. 3429, effective 1/1/2020.