We have questions how to present activities that occur during the clock transition that occurs each fall (i.e. when the clock transitions from daylight savings time to standard time).
Suppose a patient is admitted to a hospital at 1:45 daylight savings time and s/he dies at 1:30 standard time on the night of the clock transition. How do we value the admit and discharge times on the claim? Is there a way to communicate that the admit is a daylight savings time while the discharge is a standard time? If not, how will the receiving system know that an admit that occurs at 1:45 AM and a discharge the occurs at 1:30 AM on the same day is not a mistake? Suppose a patient is involved in an auto accident at 1:45 daylight savings time on the night of the clock change. How should the accident hr. be presented on the accident date DTP segment in the 2300 loop? Suppose an electronic claim is generated at 1:45 am daylight savings time on the night of the clock change. How should ISA10 be valued?
We asked the Submitter for some additional clarification because the RFI primary reference was only the Professional 837 TR3. They added this:
I was attempting to ask the same questions for 837I and 837P. The question is more in general about the Time Zone changes in the fall when we repeat an hour, and the examples were to call out the potential problem of having times appear to go backwards."
There is not a way in the 5010 837 TR3’s to designate whether the time is represented as Standard Time or Daylight Savings Time in the segments and elements that contain a time component. In your scenario, the DTP – Admission Date/Hour and the DTP – Discharge Hour, you would report the time in the format HHMM. If this results in a Discharge time before the Admission time, you could include a 2300 NTE – Billing Note that explains the Admission Hour was Daylight Savings Time and the Discharge Hour was Standard Time.
The 837 Professional TR3 2300 Loop DTP – Accident Date does not contain an hour and minute component. It only reports the date of the accident. The ISA10, Interchange Time would be reported in the HHMM format as the current time regardless of whether it’s Standard Time or Daylight Savings Time.
If you have a business need not supported in a published TR3, you may submit an ASC X12 change request for consideration in a future version of the TR3. Change requests are submitted at http://changerequest.x12.org/