§ 97212. Definitions, as Used in This Article.
22 CA ADC § 97212Barclays Official California Code of Regulations
22 CCR § 97212
§ 97212. Definitions, as Used in This Article.
(a) Ambulatory Surgery (AS) Data Record. The Ambulatory Surgery Data Record consists of the set of data elements related to an encounter, as specified in Subsection (a) of Section 128737 of the Health and Safety Code and as defined in Sections 97251-97265 and 97267-97268 of the California Code of Regulations.
(e) Do Not Resuscitate (DNR) Order. A DNR order is a directive from a physician in a patient's current inpatient medical record instructing that the patient is not to be resuscitated in the event of a cardiac or pulmonary arrest. In the event of a cardiac or pulmonary arrest, resuscitative measures include, but are not limited to, the following: cardiopulmonary resuscitation (CPR), intubation, defibrillation, cardioactive drugs, or assisted ventilation.
(g) Emergency Department (ED). Emergency Department means, in a hospital licensed to provide emergency medical services, the location in which those services are provided, as specified in Subsection (b) of Section 128700 of the Health and Safety Code. For the purposes of this chapter, this includes emergency departments providing standby, basic, or comprehensive services.
(k) Freestanding Ambulatory Surgery Clinic. Freestanding ambulatory surgery clinic means a surgical clinic that is licensed by the state under paragraph (1) of subdivision (b) of Section 1204 of the Health and Safety Code. This type of facility is commonly known as a freestanding ambulatory surgery center.
(m)(1) ICD-10-CM. The International Classification of Diseases, Tenth Revision, Clinical Modification, published by the U.S. Department of Health and Human Services. Coding guidelines and annual revisions to ICD-10-CM are made nationally by the “Cooperating Parties” (the American Hospital Association, the Centers for Medicare and Medicaid Services, the National Center for Health Statistics, and the American Health Information Management Association).
(2) ICD-10-PCS. The International Classification of Diseases, Tenth Revision, Procedure Coding System, published by the U.S. Department of Health and Human Services. Coding guidelines and annual revisions to ICD-10-PCS are made nationally by the “Cooperating Parties” (the American Hospital Association, the Centers for Medicare and Medicaid Services, the National Center for Health Statistics, and the American Health Information Management Association).
(p) MS-DRG. Medicare Severity Diagnosis Related Groups is a classification scheme with which to categorize inpatients according to clinical coherence and expected resource intensity, as indicated by their diagnoses, procedures, sex, and disposition. It was established and is revised annually by the U.S. Department of Health and Human Services (DHHS) Centers for Medicare and Medicaid Services (CMS).
(r) Provider. A provider is the person who has primary responsibility for assessing and treating the condition of the patient at a given contact and exercises independent judgment in the care of the patient. This would include, but is not limited to, a practitioner licensed as a Medical Doctor (M.D.), a Doctor of Osteopathy, (D.O.), a Doctor of Dental Surgery (D.D.S.), or a Doctor of Podiatric Medicine (D.P.M.).
(v) SIERA. SIERA means the Department's System for Integrated Electronic Reporting and Auditing that is a secure online transmission system through which reports are submitted and corrected, and report extension requests are submitted using an internet web browser. SIERA is available on the Department's internet web site at: https://siera.hcai.ca.gov.
(1) Skilled nursing/intermediate care. Skilled nursing/intermediate care means inpatient care that is provided to inpatients occupying beds appearing on a hospital's license in the classifications of skilled nursing or intermediate care, as defined by paragraphs (2), (3), or (4) of Subdivision (a) of Section 1250.1 of the Health and Safety Code. Skilled nursing/intermediate care also means inpatient care that is provided to inpatients occupying general acute care beds that are being used to provide skilled nursing/intermediate care to those inpatients in an approved swing bed program.
(2) Physical rehabilitation care. Physical rehabilitation care means inpatient care that is provided to inpatients occupying beds included on a hospital's license within the general acute care classification, as defined by paragraph (1) of Subdivision (a) of Section 1250.1 of the Health and Safety Code, and designated as rehabilitation center beds, as defined by Subsection (a) of Section 70034 and by Section 70595 of Title 22 of the California Code of Regulations.
(3) Psychiatric care. Psychiatric care means inpatient care that is provided to inpatients occupying beds appearing on a hospital's license in the classification of acute psychiatric beds, as defined by paragraph (5) of Subdivision (a) Section 1250.1 of the Health and Safety Code, and psychiatric health facility, as defined by Subdivision (a) of Section 1250.2 of the Health and Safety Code.
(4) Chemical dependency recovery care. Chemical dependency recovery care means inpatient care that is provided to inpatients occupying beds appearing on a hospital's license as chemical dependency recovery beds, as defined by paragraph (7) of Subdivision (a) of Section 1250.1 of the Health and Safety Code and Subdivisions (a), (c), or (d) of Section 1250.3 of the Health and Safety Code.
(5) Acute care. Acute care, as defined by paragraph (1) of Subdivision (a) of Section 1250.1 of the Health and Safety Code, means all other types of inpatient care provided to inpatients occupying all other types of licensed beds in a hospital, other than those defined by paragraphs (1), (2), (3) and (4) of Subsection (w) of this section.
Credits
Note: Authority cited: Section 128810, Health and Safety Code. Reference: Sections 1250, 1250.1, 128700, 128735, 128736 and 128737, Health and Safety Code.
History
1. New section applicable to all discharges after December 31, 1996 filed 7-15-96; operative 8-14-96 (Register 96, No. 29).
2. Editorial correction of subsections (c)(2) and (g)(2) (Register 97, No. 19).
3. Amendment of section and Note filed 7-23-97 pursuant to section 100, title 1, California Code of Regulations (Register 97, No. 30).
4. Repealer of version of section 97212 applicable through 12-31-96 and amendment of version of section applicable beginning 1-1-97 filed 9-21-98; operative 10-21-98 (Register 98, No. 39). For prior history see Register 97, No. 30.
5. Amendment filed 9-23-2003; operative 9-23-2003 pursuant to Government Code section 11343.4 (Register 2003, No. 39).
6. Repealer and new section and amendment of Note filed 5-5-2005; operative 5-5-2005 pursuant to Government Code section 11343.4 (Register 2005, No. 18).
7. Change without regulatory effect amending subsection (p) filed 8-11-2005 pursuant to section 100, title 1, California Code of Regulations (Register 2005, No. 32).
8. Change without regulatory effect amending subsection (a), repealing subsection (f), relettering subsections, amending newly designated subsections (g) and (m) and adding subsection (r) filed 8-23-2011 pursuant to section 100, title 1, California Code of Regulations (Register 2011, No. 34).
9. Change without regulatory effect amending subsections (o) and (t) filed 10-2-2013 pursuant to section 100, title 1, California Code of Regulations (Register 2013, No. 40).
10. Redesignation of subsection (n) as subsection (n)(1) and new subsections (n)(2)-(3) filed 4-3-2014; operative 7-1-2014 (Register 2014, No. 14).
11. Change without regulatory effect amending subsection (h), repealing subsection (n)(1), renumbering subsections and amending subsection (p) filed 7-20-2016 pursuant to section 100, title 1, California Code of Regulations (Register 2016, No. 30).
12. Change without regulatory effect amending subsections (a) and (g) filed 5-9-2018 pursuant to section 100, title 1, California Code of Regulations (Register 2018, No. 19).
13. Editorial correction of subsection (m) (Register 2018, No. 25).
14. Change without regulatory effect adding subsection (x), relettering subsections and amending newly designated subsection (z) filed 12-13-2019 pursuant to section 100, title 1, California Code of Regulations (Register 2019, No. 50).
15. Change without regulatory effect amending subsections (e)(2) and (y)(5) filed 6-22-2020 pursuant to section 100, title 1, California Code of Regulations (Register 2020, No. 26).
16. Change without regulatory effect repealing subsections (d) and (q), relettering subsections and amending newly designated subsections (d)(2), (w)(5) and (x) filed 11-5-2021 pursuant to section 100, title 1, California Code of Regulations (Register 2021, No. 45).
17. Change without regulatory effect amending subsection (v) filed 1-24-2023 pursuant to section 100, title 1, California Code of Regulations (Register 2023, No. 4).
This database is current through 5/10/24 Register 2024, No. 19.
Cal. Admin. Code tit. 22, § 97212, 22 CA ADC § 97212
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