Section R9-4-502. Reporting Sources; Information Submitted to the Department

A.      The designee of a hospital shall:

1.        Prepare a written report each month in a format specified by the Department identifying all individuals:

a.         Who are patients or the mothers of patients; and

b.        Whose:

i.         Discharge date is within the month for which the report is being prepared, as specified in sub- section (A)(2)(d); and

ii.        Medical record includes for the principal diag- nosis, a secondary diagnosis, or a procedure performed on the individual, an ICD-9-CM diagnosis or procedure code specified in a list provided to the hospital by the Department;

2.        Include the following information in the report specified in subsection (A)(1):

a.         The name, address, and telephone number of the hospital, or the identification number assigned by the Department to the hospital;

b.        The name and telephone number of the designee of the hospital;

c.         The date the report was completed;

d.        The month for which the report is being prepared; and

e.         For each patient or the mother of the patient:

i.         The patient’s or mother’s medical record num- ber;

ii.        The name of the patient or patient’s mother, if available, and, if applicable, any other name by which the patient or patient’s mother is known;

iii.      The race and ethnicity of the patient or patient’s mother;

iv.       The patient’s gender and date of birth, if appli- cable;

v.        The admission and discharge dates;

vi.       The principal and secondary diagnoses or the ICD-9-CM diagnosis  codes for the  principal and secondary diagnoses for the patient or patient’s mother; and

vii.     The procedure codes for the patient or patient’s mother; and

3.        Submit the report specified in subsection (A)(1) to the Department, in a format specified by the Department, within 30 calendar days after the end of the month for which the report is being prepared.

B.       The designee of a high-risk perinatal practice shall:

1.        Prepare a written report each month in a format specified by the Department for all individuals:

a.         Who are patients or the mothers of patients; and

b.        Whose:

i.         Date of last contact is within the month for which the report is being prepared, as specified in subsection (B)(2)(d); and

ii.        Medical record includes a principal or second- ary diagnosis specified in a list provided to the high-risk perinatal practice by the Department;

2.        Include the following information in the report specified in subsection (B)(1):

a.         The name, address, and telephone number of the high-risk perinatal practice, or the identification number assigned by the Department to the high-risk perinatal practice;

b.        The name and telephone number of the designee of the high-risk perinatal practice;

c.         The date the report was completed;

d.        The month for which the report is being prepared; and

e.         For each patient or the mother of the patient:

i.         The patient’s or mother’s medical record num- ber, if assigned;

ii.        The mother’s name;

iii.      The mother’s date of birth;

iv.      The mother’s estimated date of confinement;

v.        The patient’s gender, if known;

vi.       Whether the patient is from a singleton or mul- tiple gestation;

vii.     The location and date of the patient’s birth, if known;

viii.    Whether the patient was born alive or dead, if known;

ix.      The date of last contact with the mother;

x.        The principal and secondary diagnoses for the patient or the patient’s mother; and

xi.       If the principal and secondary diagnoses for the patient were made before the patient’s birth, whether the principal and secondary diagnoses were confirmed at birth; and

3.        Submit the report specified in subsection (B)(1) to the Department, in a format specified by the Department,

within 30 calendar days after the end of the month for which the report is being prepared.

C.      The designee of a genetic testing facility shall:

1.        Prepare a written report each month, in a format specified by the Department, for all individuals:

a.         Who are patients or the mothers of patients, and

b.        For whom the genetic testing facility performed a test:

i.         Completed within the month for which the report is being prepared, as specified in subsec- tion (C)(2)(d); and

ii.        Specified in a list provided by the Department to the genetic testing facility;

2.        Include the following information in the report specified in subsection (C)(1):

a.         The name, address, and telephone number of the genetic testing facility, or the identification number assigned by the Department to the genetic testing facility;

b.        The name and telephone number of the designee of the genetic testing facility;

c.         The date the report was completed;

d.        The month for which the report is being prepared; and

e.         For each patient or mother of a patient:

i.         If the test was performed on the patient:

(1)      The patient’s name, date of birth, and gender; and

(2)      The name of the patient’s parent or guardian;

ii.        If the test was performed on the mother of the patient:

(1)      The mother’s name and date of birth;

(2)      The estimated gestational age of the patient when the test was performed, if available; and

(3)      The mother’s estimated date of confinement when the test was performed, if available;

iii.      The name of the physician, registered nurse practitioner, or physician assistant who ordered the test for the patient or the patient’s mother; and

iv.       Information about the test, including:

(1)      The type of test performed on the patient or the patient’s mother,

(2)     The date the test was completed, and

(3)     The results of the test; and

3.        Submit the report specified in subsection (C)(1) to the Department, in a format specified by the Department, within 30 calendar days after the end of the month for which the report is being prepared.

D.      The designee of a prenatal diagnostic facility shall:

1.        Submit an electronic or paper report to the Department:

a.         For each mother:

i.         On whom the prenatal diagnostic facility con- ducts a test specified in a list provided by the Department to the prenatal diagnostic facility, and

ii.        Whose test result indicates a diagnosis speci- fied in a list provided by the Department to the prenatal diagnostic facility; and

b.        Within 30 calendar days from the date of the test;

2.        Include the following information in the report specified in subsection (D)(1):

a.         The name, address, and telephone number of the prenatal diagnostic facility, or the identification number assigned by the Department to the prenatal diagnostic facility;

b.        The name and telephone number of the designee of the prenatal diagnostic facility;

c.         The date the report was completed;

d.        The mother’s name and date of birth;

e.         The estimated gestational age of the patient at the time of the test;

f.         The mother’s estimated date of confinement;

g.        The outcome of the pregnancy, if known;

h.        The name of the physician, registered nurse practi- tioner, or physician assistant who ordered the test for the mother; and

i.         Information about the test, including:

i.         The type of test performed on the mother,

ii.       The date the test was completed, and

iii.      The results of the test.

Historical Note

Adopted effective September 25, 1991 (Supp. 91-3). New Section R9-4-502 renumbered from R9-4-501 and amended by final rulemaking at 7 A.A.R. 712, effective January 17, 2001 (Supp. 01-1). Section repealed; new Section made by final rulemaking at 13 A.A.R. 1702, effective June 30, 2007 (Supp. 07-2).