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Description
The Mothers' Medical Record Number Work Group is
an ad hoc work group formed after this data element was identified
as a priority by a survey done by the National Association of Health
Data Organizations. The work group is composed of a core group of
approximately three Consortium members. The work group was developed
to promote and facilitate the use of the data element, mothers'
medical record number, within the ASC X12N 837 Claims and Encounter
Transaction Implementation Guide. The proposed change was intended
to provide a vehicle to collect Mother's Medical Record Number on a
newborn claim submission consistent with the reporting of other
clinical and billing data using ANSI ASC X12 standards.
Business Case
Hospital discharge records have become a major
source for both program and research activities in the area of
maternal and child health. The Mother's Medical Record Number
collected for each inpatient newborn discharge facilitates linkage
between the mother's and baby's hospital records. The health of a
baby's mother is a documented risk factor in determining current and
future treatment needs for newborns. The data is used to facilitate
research and augment the treatment decisionmaking process for
newborn patients. Providing a reliable linkage variable reduces the
human and fiscal resources necessary to enable appropriate short-
and long-term decisions related to the care and treatment of
newborns in this country. Some State laws require the collection of
the Mother's Medical Record Number in their discharge data systems.
Another use of this data element would accommodate Medicaid rules.
If a mother is a Medicaid recipient, then her newborn child would
also qualify for Medicaid benefits. The collection of the Mother's
Medical Record number would facilitate the linking of Medicaid
eligible mothers to their newborn's records for enrolling these
qualified recipients. Current New York State law requires babies
born from Medicaid eligible mothers to be issued a Medicaid
insurance card within 15 days of birth. The mother's medical record
number facilitates the necessary linkage of the newborn and mother's
birth records. Finally, some payers also retroactively request the
Mother's Medical Record Number on newborn claims to justify payment
for services provided. The assignment of a mother's medical record
number code in the X12 standard anticipates the multiple potential
uses of this data element.
Collection Issues
Differing State statutes related to the
collection of the mother and newborn records have a significant
impact on the need for the Mother's Medical Record Number variable.
For instance, States requiring mother and newborn records to be
reported as one record would be less apt to require the reporting of
the Mother's Medical Record number than States requiring the
separation of mother and newborn records. In States where this
variable is required by statute, vendors under current contracts
would be obligated to support the necessary system changes to comply
with regulatory mandates. State systems collecting this data element
would also be obligated to protect the privacy of the mother and the
newborn.
Statement of Accommodation by Current ANSI X12
Standards
On the ANSI ASC X12 Health Claim Transaction Set
(837) the mother's medical record would already be included as a REF
number with an EA REF Identification Qualifier in the Subscriber
loop when the mother's insurance is used in payment of the newborn
claim. When the mother is not the subscriber for the newborn claim
the mother's medical record number would not be reported on a
routine 837 claim. Currently, no other ANSI transaction would
contain this information.
Proposed Change - Summary
Institutional 837 Implementation Guide 4030 or
higher: Add code to Data Element 128 for a Mother's Medical Record
Number Qualifier to be used in a REF segment. Add appropriate
language in the Institutional 837 Implementation Guide to
accommodate situational use of an additional REF segment titled
Mother's Medical Record Number in Loop 2300 - Claim Information.
This segment should have one repeat and be situational, with the
data condition as shown on the attached request document.
Inception
March 2000
Members
Robert Davis, M.S. Consultant
National Center for Health Statistics (NCHS)
Suzie Burke-Bebee, M.S.
Senior Informatician
Office Assistant Secretary for Planning and Evaluation
Department of Health and Human Services
Dorothy Webman, DSW
President, Workgroup for the Computerization of Behavioral Health
and Human Services Records
Accomplishments
The proposed change was approved and is now part
of the 4041 changes to the standard.
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