Beginning with 2012, data reported on Table 6A include all visits with the designated diagnoses and all patients who received these diagnoses, regardless of whether it was a primary
diagnosis, a secondary diagnosis, a tertiary diagnosis, or any other level. A new data element, “First time diagnosis of HIV,” was added to this table beginning with CY 2014 reporting. This measure is described below.
This table reports on two separate sets of data: selected diagnoses and selected services rendered. It is designed to provide this information using data maintained for billing purposes and/or in electronic health records. As a subset of diagnoses and services, Table 6A is not expected to reflect the full range of diagnoses and services rendered by a health center. The diagnoses and services selected represent those that are prevalent among Health Center Program patients orwhich are generally regarded as sentinel indicators of access to primary care or are of special interest to HRSA. Diagnoses reported on this table are those made by a medical, dental, mental health, substance abuse, or vision provider only. Thus, if a case manager sees a diabetic patient, the visit is not to be reported on Table 6A. But if a physician shows the primary diagnosis as hypertension and the secondary diagnosis as diabetes, the visit and the patient are both recorded on both the line for hypertension and the line for diabetes. The table is included in both the Universal report and Grant reports. As of the 2014 UDS report, look-alikes are also required to complete this table.
• The Universal report: Column A provides data on all visits where each of the specified diagnostic or service codes was reported. Column B reports all individuals who had at least one visit where the specified diagnostic or service category was reported. The report includes all applicable diagnoses coded and services provided within the scope of any and all health center program-supported projects included in the UDS.
• The Grant report: The Grant report provides the same data for those visits provided to individuals served within the scope of the specific grant program, regardless of the source of the funding which paid for the visit or service.
Because Grant reports are sub-sets of the Universal report, no cell on a grant report may exceed the comparable cell of the Universal report.
Selected Diagnoses: Lines 1 through 20d present the name and applicable ICD-9-CM codes for the diagnosis or diagnostic range/group. Wherever possible, diagnoses have been grouped into code ranges. Where a range of ICD-9-CM codes is shown, health centers should report on all visits where the provider assigned diagnostic code is included in the range/group. In prior years, data were provided for only the primary diagnosis. Beginning with the report on 2012 activities, health centers have provided data on all diagnoses regardless of their order in the list of diagnoses reported for a specific visit.
• Beginning with CY 2014 UDS, an additional data element was added to this table: First- time diagnosis of HIV. The number of patients first diagnosed with HIV between October 1, 2013 through September 30, 2014, are to be reported on line 1-2a, Column B.
Patients who received a reactive initial HIV test confirmed by a positive supplemental HIV test are included in this reporting. Exclude patients whose HIV was diagnosed previously either by the health center staff or by any other provider in any other location. Note that the identification of patients for this measure crosses years and may include
prior year patients.
(NOTE: Many health centers are anticipating the transition to ICD-10 codes. These codes are notably different from the ICD-9 codes and they may not be used. Only ICD-9 codes should be used for 2014 UDS reporting. Additional information is available on the conversion process at
https://www.cms.gov/ICD10/11b1_2011_ICD10CM_and_GEMs.asp.)
Selected Tests/Screenings/Preventive Services: Lines 21 through 26d present the name and applicable ICD-9-CM diagnostic and/or CPT procedure codes for selected tests, screenings, and preventive services which are particularly important to the populations served or of particular interest to HRSA. On several lines both CPT codes and ICD-9 codes are provided. Health centers may use either the CPT codes or the ICD-9 codes for any specific visit, not both. As in the past, all visits meeting the selection criteria and definitions are reported. A reported service may be in addition to another service, and may be in addition to a reported diagnosis or may stem from a visit where there was no UDS-reportable diagnosis code.
NOTE: “V-Codes” for mammography and Pap test are listed to ensure capture of procedures which are done by the health center, but coded with a different CPT code for State
reimbursement under Title X or BCCCP. In some instances payors (especially governmental payors) ask health centers to use different codes for services which are included in the UDS. In these instances, health centers should add these codes to the published list for reporting purposes.
Health centers must actually perform the test in their labs or collect the sample and transfer it to a reference lab for the test to be counted. (Lab tests ordered by a health center, but paid for by a third party payor including Medicare and Medicaid are included, as are mammograms
performed by a health center, but read by an outside radiologist who then bills a third party.) Do not report referral for tests or procedures which are not performed by or paid for by the health center. (For example, referral of a woman to the County Health Department for a mammogram would not be counted.)
Selected Dental Services: Lines 27 through 34 present the name and applicable American Dental Association (ADA) procedure codes for selected dental services. These services may be performed only by a dental provider who is reported on Lines 16–17 on Table 5. Wherever appropriate, services have been grouped into code ranges. For these lines, the concept of a “primary” code is neither relevant nor used. All services are reported. Note that sealants or varnishes which are applied outside of a comprehensive treatment plan, especially when provided as part of a community service at schools, are not to be counted nor does this activity generate a visit reported on Table 5. Dental services reported on Table 6A must be provided directly by a licensed dental provider.
PLEASE NOTE: Only services which are provided at a “countable” visit are reported on Table 6A; included in these would be services “attendant to” a countable visit. Thus, if a provider asks that a patient come back in 30 days for a flu shot, when that patient presents, the shot is
counted because it is legally considered to be a part of the initial visit. Another person, who is not a clinic patient and who comes in just for the same flu shot and without a specific referral from a prior visit, would not have the interaction reported on Table 6A.