Uniform Data System Changes for Calendar Year 2010

(HRSA) is providing information on the changes to the Uniform Data System (UDS) for calendar year (CY) 2010. These include modifications to:

  • Provide a revised definition of agriculture in the UDS Manual;
  • Report full time equivalents (FTEs) for ophthalmologists, optometrists, and optometric assistants;
  • Combine reporting of Symptomatic and Asymptomatic HIV;
  • Report Hepatitis B and Hepatitis C patients, visits and tests; and
  • Report comprehensive and intermediate eye exam patients and visits.

HRSA collects data annually from section 330-funded health centers through the UDS. The data are reviewed to ensure compliance with legislative and regulatory requirements; improve health center performance and operations; and report overall program accomplishments. The data help to identify trends over time, enabling HRSA to establish or expand targeted programs and identify effective services and interventions to improve the health of underserved communities and vulnerable populations. UDS data are compared with national data to compare differences between the U.S. population at large and those individuals and families who rely on the health care safety net for primary care. UDS data also inform Health Center Program grantees, partners, and communities about health centers and their patients.

II. Changes for CY 2010 UDS Reporting

The following changes have been made to UDS Tables for CY 2010.

A. Table 4: Characteristics of Special Populations, Migrant and Seasonal Farmworkers – Revised Agriculture Definition

The definition of agricultural workers is being changed to align with the Health Center Program statute (section 330(g) of the Public Health Service Act). The following definition will be included in the CY 2010 UDS Manual:

  • Agriculture. The term "agriculture" means farming in all its branches, including--
    (i)   cultivation and tillage of the soil;
    (ii)   the production, cultivation, growing, and harvesting of any commodity grown on, in, or as an adjunct to or part of a commodity grown in or on, the land; and
    (iii)   any practice (including preparation and processing for market and delivery to storage or to market or to carriers for transportation to market) performed by a farmer or on a farm incident to or in conjunction with an activity described in clause (ii).

The impact of this change is likely to increase the number of agriculture workers that are reported because the definition of farming is broader than in previous UDS Manuals.

B. Table 5: Staffing and Utilization – Addition of Types of Vision Services Providers
Vision care is a primary care service that has been selected for reporting in the UDS because this care reduces disabilities, costs, and deaths associated with a number of eye diseases and disorders that disproportionately burden target populations served by health centers. The following data elements for vision services providers have been added to UDS Table 5: Staffing and Utilization:

  • Line 22a, Ophthalmologist – number of FTEs   
  • Line 22b, Optometrist – number of FTEs
  • Line 22c, Optometric Assistant – number of FTEs
  • Line 22d, Total Vision Services – clinic visits and patients

As identified below, eye exams provided by vision service providers are also reported in the UDS because they provide links to early detection, care, treatment and prevention of those who suffer from eye disease and chronic diseases such as diabetes, hypertension, thyroid disease and arthritis. These exams also provide opportunities to promote behavioral changes linked to eye health (e.g., cigarette smoking, excessive use of alcohol).

C. Table 6A: Selected Diagnoses and Services Rendered

1) Combine Symptomatic and Asymptomatic HIV
People with HIV are reported to go back and forth between symptomatic and asymptomatic during the course of the disease. This creates the likelihood of duplicate reporting of the same patient during the reporting year. Therefore, lines 1 and 2 of Table 6A are combined into a single line on the UDS.

2) Addition of Data Elements for Hepatitis B and Hepatitis C
Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation. In the United States, an estimated 1.2 million Americans are living with chronic Hepatitis B and 3.2 million Americans are living with chronic Hepatitis C. Hepatitis B and Hepatitis C have been reported to have a disproportionate impact on minority populations. Lab tests for these two conditions will assist providers in identifying health center patients that will benefit from treatment.

The following data elements for Hepatitis B and Hepatitis C have been added to Table 6A: Selected Diagnoses and Services Rendered:

  • Line 4a: Hepatitis B, along with the applicable ICD-9-CM codes. This line provides the number of patients and visits with a primary diagnosis of Hepatitis B.
  • Line 4b: Hepatitis C, along with the applicable ICD-9-CM codes. This line provides the number of patients and visits with a primary diagnosis of Hepatitis C.
  • Line 21a: Hepatitis B test, along with the applicable CPT codes. The number of visits and patients receiving Hepatitis B tests are reported on this line.
  • Line 21b: Hepatitis C test, along with the applicable CPT codes. The number of visits and patients receiving Hepatitis C tests are reported on this line.

3) Addition of Data Elements for Vision
The following data element for comprehensive and intermediate eye exams has been added to Table 6A: Selected Diagnoses and Services Rendered:

  • Line 26d: Comprehensive and Intermediate Eye Exams, along with the applicable ICD-9-CM codes (CPT 92002, 92004, 92012, 92014). This line provides the number of visits and patients receiving comprehensive eye exams. 

These changes will be included in the 2010 UDS manual trainings, technical assistance, and frequently asked questions.

Please note that final rules for reporting with ICD-10 (International Statistical Classification of Diseases and Related Health Problems, 10th Revision) codes were published on January 16, 2009. These rules provide that implementation of ICD-10 codes will be on or after October 1, 2013. While ICD-10 codes will apply to the 2013 Uniform Data System, providers are expected to meet Version 5010 electronic claims transactions standards effective January 2012, thereby setting the stage for ICD-10 reporting in 2013. We strongly encourage you to plan for the implementation of these changes in January 2012. HRSA will work with the Center for Medicare and Medicaid Services in developing technical assistance resources for health centers on Version 5010 and ICD-10.

If you have any questions regarding changes to the 2010 UDS, please contact the Office of Quality and Data at OQDComments@hrsa.gov or 301-594-0818.

Sincerely,

/S/

James Macrae
Associate Administrator for Primary Care

Attachment

TABLE 5 – STAFFING AND UTILIZATION

Personnel by Major Service Category

FTEs
( a )

Clinic Visits
( b )

Patients
( c )

1 Family Physicians      
2 General Practitioners      
3 Internists      
4 Obstetrician/Gynecologists      
5 Pediatricians      
6        
7 Other Specialty Physicians      
8

Total Physicians (Lines 1 – 7)

     
9a Nurse Practitioners      
9b Physician Assistants      
10 Certified Nurse Midwives      
10a

Total “Mid-Levels” (Lines 9a - 10)

     
11 Nurses      
12 Other Medical personnel      
13 Laboratory personnel      
14 X-ray personnel      
15

Total Medical (Lines 8 + 10a through 14)

     
16 Dentists      
17 Dental Hygienists      
18 Dental Assistants, Aides, Techs      
19

Total Dental Services (Lines 16 – 18)

     
20a Psychiatrists      
20a1 Licensed Clinical Psychologists      
20a2 Licensed Clinical Social Workers      
20b Other Licensed Mental Health Providers      
20c Other Mental Health Staff      
20

Mental Health (Lines 20a-c)

     
21

Substance Abuse Services

     
22a Ophthalmologists      
22b Optometrists      
22c Optometric Assistant s      
22d

Total Vision Services (Lines 22a-c)

     
22

Other Professional Services (specify___)

     
23

Pharmacy Personnel

     
24 Case Managers      
25 Patient / Community Education Specialists      
26 Outreach Workers      
27 Transportation Staff      
27a Eligibility Assistance Workers      
27b Interpretation Staff      
28 Other Enabling Services (specify___)      
29

Total Enabling Services (Lines 24-28)

     
29a

Other Programs / Services (specify___)

     
30a Management and Support Staff      
30b Fiscal and Billing Staff      
30c IT Staff      
30

Total Administrative Staff  (Lines 30a-30c)

     
31 Facility Staff      
32 Patient Support Staff      
33

Total Admin & Facility (Lines 30 – 32)

     
34

Total

(Lines 15+19+20+21+22+23+29+29a+33)

     

TABLE 6A – SELECTED DIAGNOSES AND SERVICES RENDERED

Diagnostic Category

Applicable
ICD-9-CM
Code

Number of Visits  by Primary Diagnosis
(A)

Number of
Patients with
Primary
Diagnosis
(B)

Selected Infectious and Parasitic Diseases

1, 2.

Symptomatic  and  Asymptomatic HIV

042.xx , 079.53, V08

   

3.

Tuberculosis

010.xx – 018.xx

   

4.

Syphilis and other sexually transmitted diseases

090.xx – 099.xx

   

4a.

Hepatitis B

070.20,070.22, 070.30, 070.32

   

4b.

Hepatitis C

070.41, 070.44, 070.51, 070.54, 070.70, 070.71

   
Selected Diseases of the Respiratory System

5.

Asthma

493.xx

   

6.

Chronic bronchitis and emphysema

490.xx – 492.xx

   
Selected Other Medical Conditions    

7.

Abnormal breast findings, female

174.xx; 198.81; 233.0x; 793.8x

   

8.

Abnormal cervical findings

180.xx; 198.82;

233.1x; 795.0x

   

9.

Diabetes mellitus

250.xx; 775.1x

   

10.

Heart disease (selected)

391.xx – 392.0x

410.xx – 429.xx

   

11.

Hypertension

401.xx – 405.xx

   

12.

Contact dermatitis and other eczema

692.xx

   

13.

Dehydration

276.5x

   

14.

Exposure to heat or cold

991.xx – 992.xx

   

14a.

Overweight and obesity 

ICD9CM Code: 278.0 – 278.02 or V85.xx excluding V85.51 and V85.52

   
15. Otitis media and eustachian tube disorders 381.xx – 382.xx    
16. Selected perinatal medical conditions 770.xx; 771.xx; 773.xx; 774.xx – 779.xx (excluding 779.3x)    
17. Lack of expected normal physiological development (such as delayed milestone; failure to gain weight; failure to thrive)--does not include sexual or mental development; Nutritional deficiencies

260.xx – 269.xx;

779.3x;

783.3x – 783.4x

   
Selected Mental Health and Substance Abuse Conditions
18. Alcohol related disorders

291.xx, 303.xx; 305.0x

357.5x

   
19. Other substance related disorders (excluding tobacco use disorders) 292.1x – 292.8x 304.xx, 305.2x – 305.9x 357.6x, 648.3x    
19a. Tobacco use disorder 305.1    
20a. Depression and other mood disorders

296.xx, 300.4

301.13, 311.xx

   
20b. Anxiety disorders including PTSD 300.0x, 300.21, 300.22, 300.23, 300.29, 300.3, 308.3, 309.81    
20c. Attention deficit and disruptive behavior disorders 312.8x, 312.9x, 313.81, 314.xx    
20d. Other mental disorders, excluding drug or alcohol dependence (includes mental retardation)

290.xx

293.xx – 302.xx (excluding 296.xx, 300.0x, 300.21, 300.22, 300.23, 300.29, 300.3, 300.4, 301.13);

 306.xx - 319.xx

(excluding 308.3, 309.81, 311.xx, 312.8x, 312.9x,313.81,314.xx) 

   
Selected Diagnostic Tests/Screening/Preventive Services

21.

HIV test

CPT-4: 86689;

86701-86703;

87390-87391

   

21a.

Hepatitis B test

CPT-4: 86704,86706, 87515-87517

   

21b.

Hepatitis C test

CPT-4: 86803-86804, 87520-87522

   

22.

Mammogram

CPT-4: 77055-77057

OR

ICD-9: V76.11; V76.12

   

23.

Pap test

CPT-4: 88141-88155; 88164-88167 OR

ICD-9: V72.3; V72.31; V76.2

   

24.

Selected Immunizations: Hepatitis A, Hemophilus Influenza B (HiB), Influenza virus, Pneumococcal, Diptheria, Tetanus, Pertussis (DTaP) (DTP) (DT), Mumps, Measles, Rubella, Poliovirus, Varicella, Hepatitis B Child)

CPT-4: 90633-90634, 90645 – 90648;

90657 – 90660; 90669; 90700 – 90702;

90704 – 90716; 90718; 90720-90721, 90723;

90743 – 90744; 90748

   

24a.

Seasonal flu vaccine

CPT-4: 90655-90662

   

24b.

H1N1 Flu vaccine

CPT-4: 90663; 90470

   

25.

Contraceptive management

ICD-9: V25.xx

   

26.

Health supervision of infant or child (ages 0 through 11)

CPT-4: 99391-99393;

99381-99383;

99431-99433

OR

ICD-9: V20.xx; V29.xx

   

26a.

Childhood lead test screening (9 to 72 months)

CPT-4: 83655

   

26b.

Screening, Brief Intervention, and Referral (SBIRT)

CPT-4: 99408-99409

   

26c.

Smoke/tobacco counseling; Smoking cessation treatment

CPT-4:  99406 and 99407;

S9075

   

26d.

Comprehensive and intermediate eye exams

CPT-4:  92002, 92004, 92012, 92014

   
Selected Dental Services

27.

I. Emergency Services

ADA:  D9110

   

28.

II. Oral Exams

ADA:  D0120, D0140, DO145, D0150, D0160, D0170, D0180

   

29.

Prophylaxis – adult or

child

ADA:  D1110, D1120,

   

30.

Sealants

ADA:  D1351

   

31.

Fluoride treatment – adult or child

ADA:  D1203, D1204, D1206

   

32.

III. Restorative Services

ADA:  D21xx, D23xx, D27xx

   

33.

IV. Oral Surgery

(extractions and other

surgical procedures)

ADA:  D7111, D7140, D7210, D7220, D7230, D7240, D7241, D7250, D7260, D7261, D7270, D7272, D7280

   

34.

V. Rehabilitative services

(Endo, Perio, Prostho,

Ortho)

ADA:  D3xxx, D4xxx, D5xxx, D6xxx, D8xxx

   

Note:  Encounters and patients are reported by Primary Diagnosis for lines 1-20d.
Note:  x denotes any number including the absence of a number in that place.

  • I International Classification of Diseases, 9th Revision, Clinical Modification, Volumes 1 and 2, 2008. American Medical Association.
  • II Current Procedural Terminology, CPT 2008. American Medical Association.
  • III Current Dental Terminology, CDT 2007 / 2008. American Dental Association.
Date Last Reviewed:  August 2018


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