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RSRRyan 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” - TODAYJanuary 12, 2009

• Essential Steps in Data Flow: http://careacttarget.org/library/rsr/EssentialStepsinDataFlow1111.pdf

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Reminder: RSR Reference Sources

• Website: http://careacttarget.org/rsr.asp:– 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:

RSR.TA@sphereinstitute.org

– Coming soon: FAQs

• Project Officers

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Seven Essential Steps in Data Flow

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:• 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:• 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:

• 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 Information- National 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: Data.TA@cicatelli.org

Today’s Q & A

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RSR TA and data Resources