Questions Submitted by the Public, by Date Posted to the Website. Maximum dataset and direct data entry


What are the data content requirements that apply to direct data entry (DDE) systems?


Section 162.923(b) of the regulation requires that the data content and data condition requirements of the standard must be met by DDE systems. This means that these systems must:

  1. Collect all data elements that are required in the implementation guide, as well as those data elements that are situational and the situation is met (unless the data are already available on the health plan's system);
  2. Use only the internal and external code sets designated in the implementation guide with no additions or substitutions;
  3. Provide for at least the field size minimums noted in the implementation guides, but no more than the maximum sizes; and
  4. Permit at least the minimum number of field repeats noted in the implementation guide, but not more than the maximum number.