VA Code Ann. § 32.1-276.6 - Patient-level data system continued; reporting requirements

The Virginia Patient-Level Data System (“System”) must establish and administer an integrated system for collection and analysis of information to be used by patients, employers, providers and purchasers of health care to improve the quality and accessibility of health care in the state.  All inpatient hospitals must submit patient level data as specified under this law.  General hospitals, outpatient surgical hospitals, other facilities, and physicians, and providers providing surgical services must report outpatient surgical data as set forth by this law.  The outpatient data may be reported directly to the non-profit organization.  Patient level data elements must include:

1. Hospital identifier;

2. Attending physician identifier (inpatient only);

3. Operating physician or other surgeon identifier;

4. Payor identifier;

5. Employer identifier as required on standard claims forms;

6. Patient identifier (all submissions);

7. Patient sex, race (inpatient only), date of birth, street address, city or county, zip code, employment status code, status at discharge, and birth weight for infants (inpatient only);

8. Admission type, source (inpatient only), date and hour, and diagnosis;

9. Discharge date (inpatient only) and status;

10. Principal and secondary diagnoses;

11. External cause of injury;

12. Co-morbid conditions existing but not treated;

13. Procedures and procedure dates;

14. Revenue center codes, units, and charges as required on standard claims forms; and

15. Total charges.

State agencies that provide coverage for outpatient services must submit the following patient level data on paid claims:

1. Provider identifier;

2. Patient identifier;

3. Physician or oral and maxillofacial surgeon identifier;

4. Dates of service and diagnostic, procedural, demographic, pharmaceutical, and financial information; and

5. Other related information.