M1023_OTH_DIAG4_ICD


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Property Specification
Data System OASIS
Data Specs V3.00.1
Description Other diagnosis 4: ICD code
Group Asmt
Type ICD
Length 8
Fixed Start-End 1399-1406
Version Notes [V3.00.0] - Removed item from RFAs 04 and 05. Removed '=' as a valid item value.

Item Subsets
Active 01,03
Inactive 04,05,06,07,08,09,XX

Item Values
Value LOINC Text
ICD-10 ICD-10 diagnosis code
^ Blank (no diagnosis code)

Item Edits
Edit ID Type Severity Edit Text
-4885 Format Fatal FORMATTING OF ICD-10 DIAGNOSIS CODES
ICD-10 diagnosis codes must conform with the following formatting rules:
a) Character 1 must be alphabetic [A-Z,a-z].
b) Character 2 must be numeric [0-9].
c) Character 3 must be numeric [0-9] or alphabetic [A-Z,a-z].
d) Character 4 must be a decimal point.
e) Characters 5 through 8 must be numeric [0-9], alphabetic [A-Z,a-z], or caret [^].
f) If any character 5 through 8 is equal to [^], all subsequent characters must equal [^].

Note that additional formatting rules for particular items may further restrict the range of allowable values in character 1. Also note that an entirely blank ICD code must be submitted as a single caret: [^].
-5690 Format Fatal ***THIS EDIT DELETED IN V3.00.0***
-5001 Consistency Fatal If M0100_ASSMT_REASON=[01,03] and if a value submitted in items M1021_PRIMARY_DIAG_ICD, M1023_OTH_DIAG1_ICD, M1023_OTH_DIAG2_ICD, M1023_OTH_DIAG3_ICD, M1023_OTH_DIAG4_ICD, or M1023_OTH_DIAG5_ICD is not equal to [^], it must not equal (must not duplicate) any value submitted in the remaining items in this list.
-5201 Consistency Fatal If M0100_ASSMT_REASON=[01,03] and if character 1 of the Primary/Other ICD code in Column 2 is equal to [V,W,X,Y,Z,v,w,x,y,z], then the corresponding severity code must equal [^].
-5211 Consistency Fatal If M0100_ASSMT_REASON=[01,03] and if the Primary/Other ICD code in Column 2 is NOT equal to [^] AND character 1 of the ICD code is NOT equal to [V,W,X,Y,Z,v,w,x,y,z], then the corresponding severity code must not equal [^].
-5221 Consistency Fatal If M0100_ASSMT_REASON =[01,03], and if the Primary/Other ICD code in Column 2 is equal to [^], then the corresponding severity code must equal [^].

Supplemental Information
Edit ID Type Severity Edit Text
-9110 Information None If state law prohibits transmission of certain ICD codes (e.g., HIV or STD diagnoses), these codes will be removed by iQIES if found on records submitted by HHAs within that state. If any item within an ICD list contains such a code on a submitted record, it will be removed from the list. If any of these items is removed, but a valid code remains in a subsequent item on the list, the subsequent codes will be "moved up" so that no missing codes remain.

Therefore, if a non-blank value is required in an ICD code list and all of the submitted items in that list contain blank and/or prohibited codes, a fatal error will result and the record will be rejected. As long as at least one item in such a list contains a non-blank, correctly-formatted, allowable code, a fatal error will not occur.
-9150 Information None If an ICD list contains multiple codes, there should be no intervening items in the list which are equal to [^]. For example, if a 5-item list is populated with 3 ICD codes, those codes should occupy items 1, 2, and 3; items 4 and 5 should be equal to [^].

If the system finds a list which contains intervening items which are equal to [^], the values that are later in the list will be moved up to eliminate the intervening blank [^] item values. Diagnoses are only moved up within the same type of diagnosis, so a secondary diagnosis code will never be moved into an item which is for a primary diagnosis code.
-9170 Information None SUBMITTING ICD-10 DIAGNOSIS CODES
If the ICD-10 item is active, it must be submitted as an 8 character, fixed-format string with all blanks replaced with [^], and with a decimal point as the 4th character. The only exception to this rule is that an entirely blank ICD-10 item must be submitted as a single [^].

For example:
-The ICD-10 code "A12." would be submitted as [A12.^^^^].
-The ICD-10 code "A12.3" would be submitted as [A12.3^^^].
-The ICD-10 code "A12.34" would be submitted as [A12.34^^].
-The ICD-10 code "A12.345" would be submitted as [A12.345^]
-The ICD-10 code "A12.3456" would be submitted as [A12.3456]
-An entirely blank ICD-10 code would be submitted as [^].

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Generated: 06/30/2022 04:52:57 PM