1. (a) Council records are public records under Government Code, Chapter 552, except as specifically exempted by Health and Safety Code, §108.010 and §108.013. Copies of such records may be obtained upon request and upon payment of user fees established by the Council. The public use data file shall be available for public inspection during normal business hours. Discharge claims in the original format as submitted to the Council are not available to the public, are not stored at the Council's office and are exempt from disclosure pursuant to Health and Safety Code, §108.010 and §108.013, and shall not be released. Likewise, patient and physician identifying data collected by the Council through editing of hospital data shall not be released.

2. (b) Creation of codes and identifiers. The executive director shall develop the following codes and identifiers, as listed in paragraphs (1)-(2) of this subsection, required for creation of the public use data file and for other purposes.

   1. (1) The executive director shall create a process for assigning uniform patient identifiers, uniform physician identifiers and uniform other health professional identifiers using data elements collected. This process is confidential and not subject to public disclosure. Any documents or records produced describing the process or disclosing the person associated with an identifier are confidential and not subject to public disclosure.
   2. (2) The executive director shall create a process for assigning geographic identifiers to each discharge record.

3. (c) Creation of public use data file. The executive director will create a public use data file by creating a single record for each inpatient discharge and adding, modifying or deleting data elements in the following manner as listed in paragraphs (1)-(11) of this subsection:

   1. (1) delete patient, and insured name, Social Security Number, address and certificate data elements and any patient identifying information, if submitted; delete patient control and medical record numbers.
   2. (2) convert patient birth date to age;
   3. (3) convert admission and discharge dates to a length of stay measured in days and a code for the day of the week of the admission;
   4. (4) convert procedure and occurrence dates to day of stay values;
   5. (5) delete physician and other health professional names and numbers and assign a alphanumeric uniform physician identifier for the physicians and other health professionals who were reported as "attending" or "operating or other" on discharged patients;
   6. (6) assign codes indicating the primary and secondary sources of payment;
   7. (7) the minimum cell size required by §108.011(i)(2) of the Health and Safety Code shall be five, unless the executive director determines that a higher cell size is required to protect the confidentiality of an individual patient or physician. When determining a higher cell size, the executive director shall consider comments submitted by a hospital and recommendations submitted by the technical advisory committee as identified in the Texas Health and Safety Code §108.003(g)(5);
   8. (8) convert all procedure codes to ICD codes (in the version that is current for the date the data was due to be submitted or the version in effect at the date of service);
   9. (9) add risk and severity adjustment scores utilizing an algorithm approved by the Council;
   10. (10) suppress admission source data at patient level when the admission type code represents "Newborn";

   11. (11) data elements to be included in the public use data file:

       1. (A) Discharge Year and Quarter
       2. (B) Provider Name (Facility Name)
       3. (C) THCIC Identification Number
       4. (D) Facility Type Indicators
       5. (E) Patient Sex/Gender
       6. (F) Type of Admission
       7. (G) Source of Admission
       8. (H) Patient ZIP Code
       9. (I) County Code
       10. (J) Public Health Region Code
       11. (K) Patient State
       12. (L) Patient Status
       13. (M) Patient Race
       14. (N) Patient Ethnicity
       15. (O) Claim Type Indicator Code
       16. (P) Type of Bill
       17. (Q) Encounter Indicator: This indicates whether more than one claim was used to create the encounter
       18. (R) Principal Diagnosis Code (Current version of ICD codes at the time data is submitted)
       19. (S) Other Diagnosis Codes (Up to 24 diagnosis codes can be submitted and reported. Current version of ICD codes at the time data is submitted)
       20. (T) Principal Procedure code (if applicable)(Current version of ICD codes at the time data is submitted)
       21. (U) Other Procedure codes (Up to 24 procedure codes can be submitted and report Current version of ICD codes at the time data is submitted)
       22. (V) Admitting Diagnosis (Current version of ICD codes at the time data is submitted)
       23. (W) External Cause of Injury (E-codes), (if applicable) (Current version of ICD codes at the time data is submitted) up to 9 E-codes can be submitted and reported
       24. (X) Day of Week Patient is admitted code (Sun. = 1, Mon. = 2, Tues. = 3, Wed. = 4, Thur. = 5, Fri. = 6, Sat. = 7)
       25. (Y) Length of Stay
       26. (Z) Age of patient
       27. (AA) Day number of Principal Procedure (Calculated: Principal Procedure Date minus Admission/Start of Care Date)
       28. (BB) Day number of Procedure (1) (Calculated: Procedure Date (1) minus Admission/Start of Care Date)
       29. (CC) Day number of Procedure (2) (Calculated: Procedure Date (2) minus Admission/Start of Care Date)
       30. (DD) Day number of Procedure (3) (Calculated: Procedure Date (3) minus Admission/Start of Care Date)
       31. (EE) Day number of Procedure (4) (Calculated: Procedure Date (4) minus Admission/Start of Care Date)
       32. (FF) Day number of Procedure (5) (Calculated: Procedure Date (5) minus Admission/Start of Care Date)
       33. (GG) Major Diagnostic Category (MDC)
       34. (HH) HCFA-DRG Code (Obtained from the 3M HCFA-DRG Grouper)
       35. (II) APR-DRG Code (Obtained from 3M APR-DRG Grouper)
       36. (JJ) Risk of Mortality Score (Obtained from 3M APR-DRG Grouper)
       37. (KK) Severity of Illness Score (Obtained from 3M APR-DRG Grouper)
       38. (LL) Uniform Physician Identifier assigned to Attending Physician
       39. (MM) Uniform Physician Identifier assigned to Operating or Other Physician
       40. (NN) Service unit indicator from which the patient received services
       41. (OO) Accommodations Private Room Charges
       42. (PP) Accommodations Semi-Private Charges
       43. (QQ) Accommodations Ward Charges
       44. (RR) Accommodations Intensive Care Charges
       45. (SS) Accommodations Coronary Care Charges
       46. (TT) Ancillary Service - Other Charges
       47. (UU) Ancillary Service - Pharmacy Charges
       48. (VV) Ancillary Service - Medical/Surgical Supply Charges
       49. (WW) Ancillary Service - Durable Medical Equipment Charges
       50. (XX) Ancillary Service - Used Durable Medical Equipment Charges
       51. (YY) Ancillary Service - Physical Therapy Charges
       52. (ZZ) Ancillary Service - Occupational Therapy Charges
       53. (AAA) Ancillary Service - Speech Pathology Charges
       54. (BBB) Ancillary Service - Inhalation Therapy Charges
       55. (CCC) Ancillary Service - Blood Charges
       56. (DDD) Ancillary Service - Blood Administration Charges
       57. (EEE) Ancillary Service - Operating Room Charges
       58. (FFF) Ancillary Service - Lithotripsy Charges
       59. (GGG) Ancillary Service - Cardiology Charges
       60. (HHH) Ancillary Service - Anesthesia Charges
       61. (III) Ancillary Service - Laboratory Charges
       62. (JJJ) Ancillary Service - Radiology Charges
       63. (KKK) Ancillary Service - MRI Charges
       64. (LLL) Ancillary Service - Outpatient Services Charges
       65. (MMM) Ancillary Service - Emergency Service Charges
       66. (NNN) Ancillary Service - Ambulance Charges
       67. (OOO) Ancillary Service - Professional Fees Charges
       68. (PPP) Ancillary Service - Organ Acquisition Charges
       69. (QQQ) Ancillary Service - ESRD Revenue Setting Charges
       70. (RRR) Ancillary Service - Clinic Visit Charges
       71. (SSS) Total Charges - Accommodations
       72. (TTT) Total Charges - Ancillary
       73. (UUU) Total Non-Covered Accommodation Charges
       74. (VVV) Total Non-Covered Ancillary Charges
       75. (WWW) Total Charges
       76. (XXX) Total Non-Covered Charges
       77. (YYY) Encounter Identifier - a unique number for each encounter for the quarter
       78. (ZZZ) Service Line Revenue Code
       79. (AAAA) Service Line Procedure Code
       80. (BBBB) HCPCS/HIPPS Procedure Code
       81. (CCCC) HCPCS/HIPPS Procedure Modifiers (Up to 4 may be submitted and reported)
       82. (DDDD) Service Line Charge Amount
       83. (EEEE) Service Line Unit Code
       84. (FFFF) Service Line Unit Count
       85. (GGGG) Service Line Non-Covered Charge Amount
       86. (HHHH) Patient Country (when address is not in United States of America and confidentiality can be maintained)
4. (d) Release of public use data files. The Council shall release in an aggregate form, without uniform patient, physician or other health professional identifiers, public use data relating to hospitals described by the Health and Safety Code, §108.0025(1) that are not rural providers because they do not meet the requirements of §108.0025(2).

5. (e) The executive director will make available a public use data file on electronic, magnetic or optical media for each quarter:

   1. (1) The executive director shall release public use data from hospitals that have certified the data as required by §1301.17 of this title (relating to Certification of Discharge Reports). A hospital's failure to execute the certification form by the dates specified in §1301.17(d) of this title, or elects to not certify the discharge encounter data shall not prevent the executive director from releasing the hospital's data if the director believes the data submitted is reasonably accurate and complete. The executive director, with the recommendation of the Hospital Discharge Data Committee, may suppress for any quarter's data one or more data elements if deemed necessary to comply with provisions of the statutes. If an element is ordered suppressed by a judicial authority, the executive director may suppress the element without the recommendation of the Hospital Discharge Data Committee.
   2. (2) If additional discharge claims (not previously submitted as specified in §1301.16(c)(4) of this title (relating to Acceptance of Discharge Reports and Correction of Errors), excluding replacement, adjustments and void/cancel discharge claims become available after the initial release of the public use data file for any quarter, the executive director will add the discharge claims, that are received on or prior to the date specified in §1301.13(a)(1) of this title (relating to Schedule for Filing Discharge Reports) of the following quarter, to the public use data file and make the additional records available to the public.
   3. (3) The other sections of these rules notwithstanding, the executive director shall not create a public use data file from the discharge reports covering discharges occurring in 1998. It is the intent of the Council to utilize this data only for testing and calibration of its data processing systems and to allow hospitals the opportunity to test and calibrate their own data reporting systems.
   4. (4) The first public use data file available for release will cover discharges for the first and second quarter of 1999. The Council will initially release six months of data in order to provide a more reliable body of data for analysis and decision-making and to make available public use data files on a quarterly schedule thereafter.
6. (f) Texas State agencies that request data solely for internal use in accordance with Health and Safety Code, §108.012(b) shall abide by the data users agreement.
7. (g) The executive director shall establish procedures for screening all requests to assure that filling the request will not violate the provisions of Health and Safety Code, §108.013(c).
8. (h) The data elements specified for discharge reports in §1301.19 of this title (relating to Discharge Reports--Records, Data Fields and Codes) do not constitute "Provider Quality Data" as discussed in Health and Safety Code, §108.010.
9. (i) A public use data file which is specified by the requestor shall not be considered a "report issued by the Council" as referenced in Health and Safety Code, §108.011(f).
10. (j) Requests for data files including data on one or more providers are matters of public record and copies of all requests shall be maintained by the Council for two years from the date of receipt. The executive director shall make available on the Council's Internet site and publish in the Council's numbered letter for hospitals a summary of all requests received for public use data.
11. (k) With any public use data file prepared by the Council, the executive director shall attach all comments submitted by providers, which relate to any data included in the file. The Council shall also make these comments available at the Council's offices and on the Council's Internet site.

12. (l) A research data file may be released provided the following criteria are met:

    1. (1) the Texas Health Care Information Council Research Data Request Form is completed and submitted to the Council's executive director; and
    2. (2) the requestor has made payment according to the Council's fee schedule. The Council's fee includes a non-refundable "Review of Request Fee"; and
    3. (3) the Scientific Review Panel reviews the research request and has determined the proposed research outcome can be achieved with the requested data; and
    4. (4) the Council's Scientific Review Panel grants authorization to the request or restricts access to specified data elements determined to be inappropriate for the research proposal in accordance with this subsection of this title (relating to Scientific Review Panel); and
    5. (5) the requestor agrees to dispose of the research data using authorized methods by the established end date stated on the written data release agreement, and
    6. (6) the requestor has signed a written data release agreement.

Source Note:The provisions of this §421.8 adopted to be effective August 19, 1997, 22 TexReg 7490; amended to be effective December 29, 1997, 22 TexReg 12494; amended to be effective July 26, 1998, 23 TexReg 7365; amended to be effective December 24, 2000, 25 TexReg 12430; amended to be effective July 29, 2001, 26 TexReg 5408; amended to be effective April 21, 2002, 27 TexReg 3183; amended to be effective July 6, 2003, 28 TexReg 4915; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8842.