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Question: Effect of NUBC's retirement of Point of Origin for Admission or Visit on Core Measures

It has recently been brought to our attention that effective 07/01/2010, NUBC will retire code "7 - Emergency Room" for the Point of Origin for Admission or Visit code set and the code "P7" will be implemented.

We are aware that the Point of Origin for Admission or Visit data element is retired effective with 10/01/2010 discharges according to version 3.2 of the Specifications Manual for National Hospital Inpatient Quality Measures.

However, the Point of Origin for Admission or Visit data element is still valid until 09/30/2010 discharges according to version 3.1 of the Specifications Manual for National Hospital Inpatient Quality Measures. We saw the note in this version of the manual that said "CMS and The Joint Commission are aware that there are additional UB-04 allowable values for this data element; however, they are not used for the national quality measure sets at this time". Therefore, we understand that the changes mandated by NUBC are not implemented at this point in time.

From 07/01/2010 to 09/30/2010, how should Code 7 - Emergency Room for the Point of Origin for Admission or Visit data element be used in relation to Core Measures since it is being retired by NUBC and will no longer be included on claims? Shouldn't the use of code 7 be discontinued effective with 07/01/2010 discharges to be consistent with NUBC? Many records that were previously coded with "7 - Emergency" room will be coded with the new code of "P7". This could cause records to be excluded according to the algorithms.

Answer:

Hospitals should continue to use the allowable value of 7 to denote an Emergency Room Point of Origin for discharges through 9/30/2010. As you point out, we are aware of the discrepancy, however, we continue to use value 7 for the applicable discharges.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical, Related Manual - Data Quality Manual
Related documents: AMI-1, AMI-7, AMI-7a, AMI-8, AMI-8a, AMI-9, PN-3a, PN-5, PN-5c, PN-6a, PN-6b, Point of Origin for Admission or Visit,
File: NUBC_Memo.pdf

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