90-590-241 Me. Code R. § 4

Current through 2024-51, December 18, 2024
Section 590-241-4 - Standards for Data; Notification; Response
A.Standards. The MHDO shall evaluate each inpatient file and each outpatient file submission in accordance with the following standards:
(1) The code for each data element identified in Appendices B-1 and C-1 shall be included within eligible values for the field;
(2) Coding values indicating "data not available" "data unknown" or the equivalent shall not be used for individual data elements unless specified as an eligible value for the field;
(3) Outpatient data sets shall have Current Procedural Terminology (CPT) Codes and Health Care Common Procedural Coding System (HCPCS) codes reported for specific revenue centers. The list of revenue centers requiring CPT and HCPCS codes shall be provided via the MHDO's designee; and
(4) CPT and HCPCS codes shall be assigned to the correct revenue centers.
B.Notification. Upon completion of the evaluation, the MHDO or its designee shall promptly notify each hospital whose data sets do not satisfy the standards for any filing period. This notification shall identify the specific file and the data fields and elements that do not satisfy the standards.
C.Response. Each hospital notified under Subsection B shall respond within 32 days of the notification by making the required changes and resubmitting, if necessary, to satisfy the standards.

90-590 C.M.R. ch. 241, § 4