Transcript Services Reporting

RSR
Ryan White HIV/AIDS Program
Services Reporting System
“First Steps for Data Flow”
RSR Part Three
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Three-Part Orientation Series:
Ryan White Services Report (RSR)
• Part 1: A Brief History of Data Reporting and
Moving to Client-level Data - December 8, 2008
http://www.careacttarget.org/datacollection.asp
• Part 2: Who, What, When, Why and What’s New –
December 15, 2008
http://www.careacttarget.org/datacollection.asp
• Part 3: “First Steps for Data Flow” - TODAY
January 12, 2009
• Essential Steps in Data Flow:
http://careacttarget.org/library/rsr/EssentialStepsinD
ataFlow1111.pdf
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Reminder: RSR Reference Sources
• Website: http://careacttarget.org/rsr.asp:
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Data Steps for data collection and reporting
Instruction Manual for the RSR Instruction (V1.2)
Required Data Elements for the Client Report
Sample forms, timeline, and archived web casts
Email address for RSR questions:
[email protected]
– Coming soon: FAQs
• Project Officers
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Seven Essential Steps in Data Flow
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Identify and Define Data Elements
Identify Data Sources
Collect Data
Validate and Assess Data Quality
Report Data
Communicate About Data
Use Data to Inform Your Program’s
Operations
http://careacttarget.org/rsr.asp
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Step 1: What do you need to report?
Identify RSR data elements and use
HAB definitions from these sources
• Required Data Elements for the Client Report
and Instruction Manual for RDR
•Remember that you have been collecting and
reporting most of the required RSR data in RDR
– Data for the Grantee Report – the same
– Data for the Provider Report – nearly identical
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Step 1: What do you need to report?
Once you identify data elements and
review the HAB definitions, you can
simplify data collection if you
• Use the data sources and documents we are
going to suggest for ease of collection
• Focus on collecting data and remember that
XML can reformat the data for the RSR
submission
Data Inventory Training is coming…
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Step 2: Where can you find it?
Client Level Report Data/Clinical Information
• Data Sources for RSR Questions 46 to 66 
electronic health record, medical record, third
party billing systems or lab reports
• Enrollment, case management or medical record
progress notes
• Clinical information for each RW HIV-positive or
indeterminate client, regardless of who paid
• In the slides that follow, we will present examples
of data needed and places to find the information
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Recap:Clinical Information Easier
• Where can you get the data you need?
• The Chart
• There are data sources for much of the
clinical information you need for the RSR
– Look to your billing system…it’s usually
electronic, and this may decrease cost and
improve data collection.
– Some examples follow
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But First, a Brief Look at Code Sets
• Standard Code Sets for Health Care Data
– CPT: Common Procedure Terminology (AMA)
– ADA: American Dental Association procedures
– HCPCS: Healthcare Common Procedure
Coding System (CMS)
– ICD-9: International Classification of Diseases,
9th Edition
– NDC: National Drug Codes (HHS)
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Clinical Information – First Visit
• Q 47. First outpatient/ambulatory care visit
– Look in your billing system for new visit data for
clients with ICD9-CM code 042 – HIV, symptomatic
– Remember, this is the first visit and it may not fall
within the current reporting dates
– Scan for visit codes such as:
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99201 – New, Brief
99202 – New, Limited
99203 – New, Intermediate
99204 – New, Extensive
99205 – New, Comprehensive
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Clinical Information - Visit
• Q 48 Outpatient/ambulatory care visit dates
(examples):
– Look in your billing system for patients with visits that have
the ICD9-CM code of 042. (HIV, symptomatic) This will
provide a great starting list.
– Look in your billing system for the dates of these visits, and
the kind of visit.
• 99211
• 99212
• 99213
• 99214
• 99215
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Clinical Information- CD4 tests
• Q 49. CD4 Cell Counts
– Look in your billing system for these codes:
• 86360 – Absolute CD4, CD8 and Ratio
• 86361 – Absolute CD4 count
• 3500F – CD4+ cell count or percentage*
– Also take the values and dates for these tests
Take Note: Electronic CD4 counts can also help
you to identify counts below 200, so you can
more easily find the patients who needs PCP
Prophylaxis
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Clinical Information- PCP Prophylaxis
• Q 51. PCP Prophylaxis
– Look first for patients with the ICD code of 042
who had visits during the reporting period
– Then look for a viral load count < 200
– Then look in your billing system for prophylactic
prescriptions for:
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Atovaquone
Bactrim
Dapsone
Pentamdine
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Clinical Information- Syphilis Screening
• Q 55. Has the client been screened for
Syphilis
– Look in your billing system for these codes:
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36415 – Venipuncture
86592 – Syphilis Test, qualitative
86781 – Antibody, treponimal pallidum, confirmatory
87164 – Dark Field Examination, with specimen
87166 – Dark Field Examination, without specimen
– Also take the dates for the screening tests
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Clinical Information- Substance Abuse
• Q 61. Was the client screened for substance
abuse (alcohol or drugs)
– Look in your billing system for these codes:
• 99210 to 99215 - Evaluation & Management
• 99408 to 99409 - Assessment and Brief
Intervention for Alcohol and/or Drug Abuse
- GO396 & GO397 (Medicare); HO049 &
HO050 (Medicaid)
– Also take the dates for these screens
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Clinical Information- Mental Health
• Q 62. Was a mental health screening
conducted for the client
– Look in your billing system for these codes:
• 99210 to 99215 - Evaluation & Management
• 95150 to 96155 - Health Behavioral
Assessment and Intervention
– Also take the values and dates for these tests
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Clinical Information- ART in Pregnancy
• Q 66. For HIV+ women only: was the
client prescribed Antiretroviral Therapy
(ART) during Pregnancy
– Look in your billing system for this code:
• 4271F – Patient receiving potent ART for less than
6 months or not receiving potent ART
– Also take the dates for the ART visits
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Clinical InformationNational Drug Codes -Bactrim
• Bactrim, the brand name, or Septra, is an
antibacterial drug covered by the AIDS Drug
Assistance Program (ADAP)
• There are a number of discrete NDC codes,
reflecting different delivery and dosage
strengths
– Look in your billing system for Bactrim’s therapeutic
class code: 00472128516, or, for specific prescriptions
– Bactrim Oral Suspension 200-40MG: 00472128516
– Bactrim Tablet 400MG-80MG: 00093008801
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RSR TA and Data Resources
• Reminder:
http://careacttarget.org/rsr.asp
Email address for RSR questions:
[email protected]
Today’s Q & A
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RSR TA and data Resources
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