ARC 1950C
PUBLIC HEALTH DEPARTMENT[641]
Notice of Intended Action
Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)“b.”
Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.
Pursuant to the authority of Iowa Code section 135.22, the Department of Public Health hereby gives Notice of Intended Action to amend Chapter 21, “Central Registry for Brain and Spinal Cord Injuries,” Iowa Administrative Code.
The proposed amendments revise the reportable conditions of brain injury to be the same as those specified by rule for eligibility for the home- and community-based services waiver for persons with brain injury under the medical assistance program; the word “traumatic” in reference to brain injury has been removed throughout the rules to reflect this change. Item 8 outlines the information required in each report.
Additional amendments reflect the reportable conditions for brain and spinal cord injury to transition to the International Classification of Diseases, 10th Revision, Clinical Modification.
Any interested person may make written suggestions or comments on the proposed amendments on or before April 21, 2015. Such written comments should be directed to Maggie Ferguson, Brain Injury and Disability Program Manager, Department of Public Health, 321 East 12th Street, Des Moines, Iowa 50319. E-mail may be sent to maggie.ferguson@idph.iowa.gov.
Also, a public hearing will be held on Wednesday, April 22, 2015, from 1 to 2 p.m., at which time persons may present their views either orally or in writing. At the hearing, persons will be asked to give their names and addresses for the record and to confine their remarks to the subject of the amendments.
The public hearing will originate from Room 517 on the fifth floor of the Lucas State Office Building, 321 East 12th Street, Des Moines, Iowa, and will be accessible over the Iowa Communications Network (ICN) teleconference system by calling 1-866-685-1580 and entering the conference code 0009990482 when prompted.
Any persons who intend to attend the public hearing and have special requirements, such as those relating to hearing impairments, should contact the Department of Public Health and advise of specific needs.
After analysis and review of this rule making, no impact on jobs has been found.
These amendments are intended to implement Iowa Code section 135.22.
The following amendments are proposed.
	Item 1. Amend rule 641—21.1(135) as follows:
641—21.1(135) Purpose. This chapter describes the central registry for brain and spinal cord injuries. Data from the registry shall be utilized to facilitate prevention strategies and the provision of appropriate rehabilitative services by the department and other state agencies.
	Item 2. Strike “agency” and “agency’s” wherever they appear in rules 641—21.2(135), 641—21.4(135) and 641—21.5(135), subrule 21.6(1), the introductory paragraph of subrule 21.6(2), and paragraphs 21.6(2)“a” to “d” and “g” and insert “department” or “department’s” in lieu thereof, as the context requires.
	Item 3. Amend rule 641—21.2(135), definitions of “Brain injury” and “Reportable case,” as follows:
“Brain injury” means any clinically evident brain damage resulting from trauma or anoxia which temporarily or permanently impairs a person’s physical or cognitive functions clinically evident damage to the brain resulting directly or indirectly from trauma, infection, anoxia, vascular lesions, or tumor of the brain, not primarily related to a degenerative disease or aging process, which temporarily or permanently impairs a person’s physical, cognitive, or behavioral functions and is diagnosed by a physician.
“Reportable case” means a person who is admitted or transferred to a hospital with a diagnosis of acute traumatic brain or spinal cord injury or a person who is pronounced dead in the emergency department of a hospital with an acute traumatic brain or spinal cord injury.
	Item 4. Strike “traumatic” wherever it appears in rules 641—21.4(135) and 641—21.5(135), subrule 21.6(1), and paragraph 21.6(2)“g.”
	Item 5. Amend rule 641—21.3(135), introductory paragraph, as follows:
641—21.3(135) Reportable brain and spinal cord injuries. The brain and spinal cord injuries listed below are required to be reported to the Iowa Department of Public Health, Division of Health Protection, Lucas State Office Building, Des Moines, Iowa 50319-0075, as part of a statewide population-based registry.
	Item 6. Rescind subrule 21.3(1) and adopt the following new subrule in lieu thereof:
	21.3(1) Reportable cases of brain injuries are those that are identified by the following codes from the International Classification of Diseases, 9th Revision, Clinical Modification, or the International Classification of Diseases, 10th Revision, Clinical Modification:

International Classification of Diseases,
9th Revision, Clinical Modification	 	International Classification of Diseases,
10th Revision, Clinical Modification	
191.00	Malignant neoplasms of brain, cerebrum	 	C71.0	Malignant neoplasm of cerebrum, except lobes and ventricles	
191.10	Malignant neoplasms of brain, frontal lobe	 	C71.1	Malignant neoplasm of frontal lobe	
191.02	Malignant neoplasms of brain, temporal lobe	 	C71.2	Malignant neoplasm of temporal lobe	
191.30	Malignant neoplasms of brain, parietal lobe	 	C71.3	Malignant neoplasm of parietal lobe	
191.40	Malignant neoplasms of brain, occipital lobe	 	C71.4	Malignant neoplasm of occipital lobe	
191.50	Malignant neoplasms of brain, ventricles	 	C71.5	Malignant neoplasm of cerebral ventricle	
191.60	Malignant neoplasms of brain, cerebellum	 	C71.6	Malignant neoplasm of cerebellum	
191.70	Malignant neoplasms of brain, brain stem	 	C71.7	Malignant neoplasm of brain stem	
191.80	Malignant neoplasms of brain, other part of brain, includes midbrain, peduncle, and medulla oblongata	 	C71.8	Malignant neoplasm of overlapping sites of brain	
192.00	Malignant neoplasms of brain, cranial nerves	 	C72.50	Malignant neoplasm of unspecified cranial nerve	
		 	C72.59	Malignant neoplasm of other cranial nerves	
192.10	Malignant neoplasms of brain, cerebral meninges	 	C70.0	Malignant neoplasm of cerebral meninges	
198.30	Secondary malignant neoplasm of brain	 	C79.31	Secondary malignant neoplasm of brain	
198.40	Secondary malignant neoplasm of other parts of the nervous system, includes cerebral meninges	 	C79.32	Secondary malignant neoplasm of cerebral meninges	
		 	C79.49	Secondary malignant neoplasm of other parts of nervous system	
225.00	Benign neoplasm of brain and other parts of the nervous system, brain	 	D33.2	Benign neoplasm of brain, unspecified	
225.10	Benign neoplasm of brain and other parts of the nervous system, cranial nerves	 	D33.3	Benign neoplasm of cranial nerves	
225.20	Benign neoplasm of brain and other parts of the nervous system, cerebral meninges	 	D32.0	Benign neoplasm of cerebral meninges	
		 	D32.9	Benign neoplasm of meninges, unspecified	
323.01-
323.9	Encephalitis, myelitis and encephalomyelitis	 	G04.00-
G05.4	Encephalitis, myelitis and encephalomyelitis	
324.00	Intracranial and intraspinal abscess	 	G06.0	Intracranial abscess and granuloma	
 	 	 	G06.1	Intraspinal abscess and granuloma	
348.10	Anoxic brain damage	 	G93.1	Anoxic brain damage, not elsewhere classified	
430.00	Subarachnoid hemorrhage	 	I60.00-
I60.8	Nontraumatic subarachnoid hemorrhage	
431.00	Intracerebral hemorrhage	 	I61.0-
I61.9	Nontraumatic intracerebral hemorrhage	
432.00	Other and unspecified intracranial hemorrhage	 	I62.1	Nontraumatic extradural hemorrhage	
433.00	Occlusion and stenosis of precerebral arteries	 	I65.01-
I65.9	Occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction	
434.00	Occlusion of cerebral arteries	 	I66.01-
I66.9	Occlusion and stenosis of cerebral arteries, not resulting in cerebral infarction	
435.00	Transient cerebral ischemia	 	G45.0-
G45.9	Transient cerebral ischemic attacks and related syndromes	
436.00	Acute, but ill-defined, cerebrovascular disease	 	I67.89	Other cerebrovascular disease	
		 	I67.9	Cerebrovascular disease, unspecified	
437.00	Other and ill-defined cerebrovascular disease	 	I67.89	Other cerebrovascular disease	
		 	I67.9	Cerebrovascular disease, unspecified	
800.00-
800.99	Fracture of vault of skull	 	S02.0XXA;
S02.0XXB	Fracture of vault of skull	
801.00-
801.99	Fracture of base of skull	 	S02.1-
S02.19	Fracture of base of skull	
803.00-
803.99	Other and unqualified skull fractures	 	S02.91XA	Unspecified fracture of skull	
804.00-
804.99	Multiple fractures involving skull or face with other bones	 	S02.91XA	Unspecified fracture of skull	
850.00-
850.99	Concussion	 	S06.0X0A-
S06.0X9A	Concussion	
851.00-
851.99	Cerebral laceration and contusion	 	S06.31-
S06.33	Contusion and laceration of cerebrum	
852.00-
852.59	Subarachnoid, subdural, and extradural hemorrhage following injury	 	S06.4;
S06.5;
S06.6	Traumatic epidural, subdural, and subarachnoid hemorrhage	
853.00-
853.19	Other and unspecified intracranial hemorrhage following injury	 	S06.36	Traumatic hemorrhage of cerebrum, unspecified	
854.00-
854.19	Intracranial injury of other and unspecified nature	 	S06.8-
S06.9	Other specified intracranial injuries and unspecified intracranial injuries	
960-979	Poisoning by drugs, medicinal and biological substances	 	T36-T50	Poisoning by, adverse effect of and underdosing of systemic antibiotics; other systemic anti-infectives and antiparasitics; hormones and their synthetic substitutes and antagonists, not elsewhere classified; nonopioid analgesics, antipyretics and antirheumatics; narcotics and psychodysleptics (hallucinogens); anesthetics and therapeutic gases; antiepileptic, sedative-hypnotic and antiparkinsonism drugs; psychotropic drugs, not elsewhere classified; drugs primarily affecting the autonomic nervous system; primarily systemic and hematological agents, not elsewhere classified; agents primarily affecting the cardiovascular system; agents primarily affecting the gastrointestinal system; agents primarily acting on smooth and skeletal muscles and the respiratory system; topical agents primarily affecting skin and mucous membrane and by ophthalmological, otorhinolaryngological and dental drugs; diuretics and other unspecified drugs, medicaments and biological substances	
980-989	Toxic effects of substances	 	T51-T65	Toxic effect of substances chiefly nonmedicinal as to source alcohol; organic solvents; halogen derivatives; corrosive substances; soaps and detergents; metals; other inorganic substances; carbon monoxide; other gases, fumes and vapors; pesticides; noxious substances eaten as seafood; other noxious substances eaten as food; venomous animals and plants; aflatoxin and other mycotoxin food contaminants; other and unspecified substances	
990-995	Effects of external causes	 	T33;
T66-T71;
T73-T75;
T78; T80	Other and unspecified effects of other external causes; frostbite; radiation sickness; heat and light; hypothermia; other effects of reduced temperature; air pressure and water pressure; asphyxiation; other deprivation; adult and child abuse, neglect and other mistreatment, confirmed; other and unspecified effects of other external causes; adverse effects not elsewhere classified	
994.1	Drowning and nonfatal submersion	 	T75.1XXA	Unspecified effects of drowning and nonfatal submersion	
994.7	Asphyxiation and strangulation	 	T71.11A-
T71.9XXA	Asphyxiation by smothering under pillow; plastic bag; trapped in bed linens; smothering under another person’s body; smothering in furniture; hanging; other causes; systemic oxygen deficiency due to low oxygen content in ambient air due to unspecified cause; cave-in or falling earth; trapped in trunk of car; trapped in discarded refrigerator	
995.50-
995.59	Child maltreatment syndrome	 	T74.01XA-
T74.92XA	Adult and child abuse, neglect and other maltreatment, confirmed	
 	 	 	T76.01XA-
T76.92XA	Adult and child abuse, neglect and other maltreatment, suspected	
995.80-
995.89	Adult maltreatment syndrome	 	T74.01XA-
T74.92XA	Adult and child abuse, neglect and other maltreatment, confirmed	
 	 	 	T76.01XA-
T76.92XA	Adult and child abuse, neglect and other maltreatment, suspected	
	Item 7. Rescind subrule 21.3(2) and adopt the following new subrule in lieu thereof:
	21.3(2) Reportable cases of spinal cord injuries are those that are identified by the following codes from the International Classification of Diseases, 9th Revision, Clinical Modification, or the International Classification of Diseases, 10th Revision, Clinical Modification:
	a. 	Fracture.
	(1)	International Classification of Diseases, 9th Revision, Clinical Modification:

806.00-
806.9	Fracture of vertebral column with spinal cord injury	
	(2)	International Classification of Diseases, 10th Revision, Clinical Modification:

S12.000A	Unspecified displaced fracture of the first cervical vertebra, initial encounter for closed fracture	
S12.000B	Unspecified displaced fracture of first cervical vertebra, initial encounter for open fracture	
S12.001A	Unspecified nondisplaced fracture of first cervical vertebra, initial encounter for closed fracture	
S12.001B	Unspecified nondisplaced fracture of first cervical vertebra, initial encounter for open fracture	
S12.100A	Unspecified displaced fracture of second cervical vertebra, initial encounter for closed fracture	
S12.100B	Unspecified displaced fracture of second cervical vertebra, initial encounter for open fracture	
S12.101A	Unspecified nondisplaced fracture of second cervical vertebra, initial encounter for closed fracture	
S12.101B	Unspecified nondisplaced fracture of second cervical vertebra, initial encounter for open fracture	
S12.200A	Unspecified displaced fracture of third cervical vertebra, initial encounter for closed fracture	
S12.200B	Unspecified displaced fracture of third cervical vertebra, initial encounter for open fracture	
S12.201A	Unspecified nondisplaced fracture of third cervical vertebra, initial encounter for closed fracture	
S12.201B	Unspecified nondisplaced fracture of third cervical vertebra, initial encounter for open fracture	
S12.300A	Unspecified displaced fracture of fourth cervical vertebra, initial encounter for closed fracture	
S12.300B	Unspecified displaced fracture of fourth cervical vertebra, initial encounter for open fracture	
S12.301A	Unspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for closed fracture	
S12.301B	Unspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for open fracture	
S12.400A	Unspecified displaced fracture of fifth cervical vertebra, initial encounter for closed fracture	
S12.400B	Unspecified displaced fracture of fifth cervical vertebra, initial encounter for open fracture	
S12.401A	Unspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for closed fracture	
S12.401B	Unspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for open fracture	
S12.500A	Unspecified displaced fracture of sixth cervical vertebra, initial encounter for closed fracture	
S12.500B	Unspecified displaced fracture of sixth cervical vertebra, initial encounter for open fracture	
S12.501A	Unspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for closed fracture	
S12.501B	Unspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for open fracture	
S12.600A	Unspecified displaced fracture of seventh cervical vertebra, initial encounter for closed fracture	
S12.600B	Unspecified displaced fracture of seventh cervical vertebra, initial encounter for open fracture	
S12.601A	Unspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for closed fracture	
S12.601B	Unspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for open fracture	
S12.9XXA	Fracture of neck, unspecified, initial encounter	
S14.101A	Unspecified injury at C1 level of cervical spinal cord, initial encounter	
S14.102A	Unspecified injury at C2 level of cervical spinal cord, initial encounter	
S14.103A	Unspecified injury at C3 level of cervical spinal cord, initial encounter	
S14.104A	Unspecified injury at C4 level of cervical spinal cord, initial encounter	
S14.105A	Unspecified injury at C5 level of cervical spinal cord, initial encounter	
S14.106A	Unspecified injury at C6 level of cervical spinal cord, initial encounter	
S14.107A	Unspecified injury at C7 level of cervical spinal cord, initial encounter	
S14.109A	Unspecified injury at unspecified level of cervical spinal cord, initial encounter	
S14.111A	Complete lesion at C1 level of cervical spinal cord, initial encounter	
S14.112A	Complete lesion at C2 level of cervical spinal cord, initial encounter	
S14.113A	Complete lesion at C3 level of cervical spinal cord, initial encounter	
S14.114A	Complete lesion at C4 level of cervical spinal cord, initial encounter	
S14.115A	Complete lesion at C5 level of cervical spinal cord, initial encounter	
S14.116A	Complete lesion at C6 level of cervical spinal cord, initial encounter	
S14.117A	Complete lesion at C7 level of cervical spinal cord, initial encounter	
S14.121A	Central cord syndrome at C1 level of cervical spinal cord, initial encounter	
S14.122A	Central cord syndrome at C2 level of cervical spinal cord, initial encounter	
S14.123A	Central cord syndrome at C3 level of cervical spinal cord, initial encounter	
S14.124A	Central cord syndrome at C4 level of cervical spinal cord, initial encounter	
S14.125A	Central cord syndrome at C5 level of cervical spinal cord, initial encounter	
S14.126A	Central cord syndrome at C6 level of cervical spinal cord, initial encounter	
S14.127A	Central cord syndrome at C7 level of cervical spinal cord, initial encounter	
S14.131A	Anterior cord syndrome at C1 level of cervical spinal cord, initial encounter	
S14.132A	Anterior cord syndrome at C2 level of cervical spinal cord, initial encounter	
S14.133A	Anterior cord syndrome at C3 level of cervical spinal cord, initial encounter	
S14.134A	Anterior cord syndrome at C4 level of cervical spinal cord, initial encounter	
S14.135A	Anterior cord syndrome at C5 level of cervical spinal cord, initial encounter	
S14.136A	Anterior cord syndrome at C6 level of cervical spinal cord, initial encounter	
S14.137A	Anterior cord syndrome at C7 level of cervical spinal cord, initial encounter	
S14.151A	Other incomplete lesion at C1 level of cervical spinal cord, initial encounter	
S14.152A	Other incomplete lesion at C2 level of cervical spinal cord, initial encounter	
S14.153A	Other incomplete lesion at C3 level of cervical spinal cord, initial encounter	
S14.154A	Other incomplete lesion at C4 level of cervical spinal cord, initial encounter	
S14.155A	Other incomplete lesion at C5 level of cervical spinal cord, initial encounter	
S14.156A	Other incomplete lesion at C6 level of cervical spinal cord, initial encounter	
S14.157A	Other incomplete lesion at C7 level of cervical spinal cord, initial encounter	
S22.009A	Unspecified fracture of unspecified thoracic vertebra, initial encounter for closed fracture	
S22.009B	Unspecified fracture of unspecified thoracic vertebra, initial encounter for open fracture	
S22.019A	Unspecified fracture of first thoracic vertebra, initial encounter for closed fracture	
S22.019B	Unspecified fracture of first thoracic vertebra, initial encounter for open fracture	
S22.029A	Unspecified fracture of second thoracic vertebra, initial encounter for closed fracture	
S22.029B	Unspecified fracture of second thoracic vertebra, initial encounter for open fracture	
S22.039A	Unspecified fracture of third thoracic vertebra, initial encounter for closed fracture	
S22.039B	Unspecified fracture of third thoracic vertebra, initial encounter for open fracture	
S22.049A	Unspecified fracture of fourth thoracic vertebra, initial encounter for closed fracture	
S22.049B	Unspecified fracture of fourth thoracic vertebra, initial encounter for open fracture	
S22.059A	Unspecified fracture of T5-T6 vertebra, initial encounter for closed fracture	
S22.059B	Unspecified fracture of T5-T6 vertebra, initial encounter for open fracture	
S22.069A	Unspecified fracture of T7-T8 vertebra, initial encounter for closed fracture	
S22.069B	Unspecified fracture of T7-T8 vertebra, initial encounter for open fracture	
S22.079A	Unspecified fracture of T9-T10 vertebra, initial encounter for closed fracture	
S22.079B	Unspecified fracture of T9-T10 vertebra, initial encounter for open fracture	
S22.089A	Unspecified fracture of T11-T12 vertebra, initial encounter for closed fracture	
S22.089B	Unspecified fracture of T11-T12 vertebra, initial encounter for open fracture	
S24.101A	Unspecified injury at T1 level of thoracic spinal cord, initial encounter	
S24.102A	Unspecified injury at T2-T6 level of thoracic spinal cord, initial encounter	
S24.103A	Unspecified injury at T7-T10 level of thoracic spinal cord, initial encounter	
S24.104A	Unspecified injury at T11-T12 level of thoracic spinal cord, initial encounter	
S24.109A	Unspecified injury at unspecified level of thoracic spinal cord, initial encounter	
S24.111A	Complete lesion at T1 level of thoracic spinal cord, initial encounter	
S24.112A	Complete lesion at T2-T6 level of thoracic spinal cord, initial encounter	
S24.113A	Complete lesion at T7-T10 level of thoracic spinal cord, initial encounter	
S24.114A	Complete lesion at T11-T12 level of thoracic spinal cord, initial encounter	
S24.131A	Anterior cord syndrome at T1 level of thoracic spinal cord, initial encounter	
S24.132A	Anterior cord syndrome at T2-T6 level of thoracic spinal cord, initial encounter	
S24.133A	Anterior cord syndrome at T7-T10 level of thoracic spinal cord, initial encounter	
S24.134A	Anterior cord syndrome at T11-T12 level of thoracic spinal cord, initial encounter	
S24.151A	Other incomplete lesion at T1 level of thoracic spinal cord, initial encounter	
S24.152A	Other incomplete lesion at T2-T6 level of thoracic spinal cord, initial encounter	
S24.153A	Other incomplete lesion at T7-T10 level of thoracic spinal cord, initial encounter	
S24.154A	Other incomplete lesion at T11-T12 level of thoracic spinal cord, initial encounter	
S32.009A	Unspecified fracture of unspecified lumbar vertebra, initial encounter for closed fracture	
S32.009B	Unspecified fracture of unspecified lumbar vertebra, initial encounter for open fracture	
S32.10XA	Unspecified fracture of sacrum, initial encounter for closed fracture	
S32.10XB	Unspecified fracture of sacrum, initial encounter for open fracture	
S32.019A	Unspecified fracture of first lumbar vertebra, initial encounter for closed fracture	
S32.019B	Unspecified fracture of first lumbar vertebra, initial encounter for open fracture	
S32.029A	Unspecified fracture of second lumbar vertebra, initial encounter for closed fracture	
S32.029B	Unspecified fracture of second lumbar vertebra, initial encounter for open fracture	
S32.039A	Unspecified fracture of third lumbar vertebra, initial encounter for closed fracture	
S32.039B	Unspecified fracture of third lumbar vertebra, initial encounter for open fracture	
S32.049A	Unspecified fracture of fourth lumbar vertebra, initial encounter for closed fracture	
S32.049B	Unspecified fracture of fourth lumbar vertebra, initial encounter for open fracture	
S32.059A	Unspecified fracture of fifth lumbar vertebra, initial encounter for closed fracture	
S32.059B	Unspecified fracture of fifth lumbar vertebra, initial encounter for open fracture	
S32.2XXA	Fracture of coccyx, initial encounter for closed fracture	
S32.2XXB	Fracture of coccyx, initial encounter for open fracture	
S34.101A	Unspecified injury to L1 level of lumbar spinal cord, initial encounter	
S34.102A	Unspecified injury to L2 level of lumbar spinal cord, initial encounter	
S34.103A	Unspecified injury to L3 level of lumbar spinal cord, initial encounter	
S34.104A	Unspecified injury to L4 level of lumbar spinal cord, initial encounter	
S34.105A	Unspecified injury to L5 level of lumbar spinal cord, initial encounter	
S34.109A	Unspecified injury to unspecified level of lumbar spinal cord, initial encounter	
S34.111A	Complete lesion of L1 level of lumbar spinal cord, initial encounter	
S34.112A	Complete lesion of L2 level of lumbar spinal cord, initial encounter	
S34.113A	Complete lesion of L3 level of lumbar spinal cord, initial encounter	
S34.114A	Complete lesion of L4 level of lumbar spinal cord, initial encounter	
S34.115A	Complete lesion of L5 level of lumbar spinal cord, initial encounter	
S34.119A	Complete lesion of unspecified level of lumbar spinal cord, initial encounter	
S34.121A	Incomplete lesion of L1 level of lumbar spinal cord, initial encounter	
S34.122A	Incomplete lesion of L2 level of lumbar spinal cord, initial encounter	
S34.123A	Incomplete lesion of L3 level of lumbar spinal cord, initial encounter	
S34.124A	Incomplete lesion of L4 level of lumbar spinal cord, initial encounter	
S34.125A	Incomplete lesion of L5 level of lumbar spinal cord, initial encounter	
S34.129A	Incomplete lesion of unspecified level of lumbar spinal cord, initial encounter	
S34.131A	Complete lesion of sacral spinal cord, initial encounter	
S34.132A	Incomplete lesion of sacral spinal cord, initial encounter	
S34.139A	Unspecified injury to sacral spinal cord, initial encounter	
S34.3XXA	Injury of cauda equina, initial encounter	
	b. 	Spinal cord injury.
	(1)	International Classification of Diseases, 9th Revision, Clinical Modification:

952.00-
952.9	Spinal cord injury without evidence of spinal bone injury	
	(2)	International Classification of Diseases, 10th Revision, Clinical Modification:

S14.101A	Unspecified injury at C1 level of cervical spinal cord, initial encounter	
S14.102A	Unspecified injury at C2 level of cervical spinal cord, initial encounter	
S14.103A	Unspecified injury at C3 level of cervical spinal cord, initial encounter	
S14.104A	Unspecified injury at C4 level of cervical spinal cord, initial encounter	
S14.105A	Unspecified injury at C5 level of cervical spinal cord, initial encounter	
S14.106A	Unspecified injury at C6 level of cervical spinal cord, initial encounter	
S14.107A	Unspecified injury at C7 level of cervical spinal cord, initial encounter	
S14.108A	Unspecified injury at C8 level of cervical spinal cord, initial encounter	
S14.109A	Unspecified injury at unspecified level of cervical spinal cord, initial encounter	
S14.111A	Complete lesion at C1 level of cervical spinal cord, initial encounter	
S14.112A	Complete lesion at C2 level of cervical spinal cord, initial encounter	
S14.113A	Complete lesion at C3 level of cervical spinal cord, initial encounter	
S14.114A	Complete lesion at C4 level of cervical spinal cord, initial encounter	
S14.115A	Complete lesion at C5 level of cervical spinal cord, initial encounter	
S14.116A	Complete lesion at C6 level of cervical spinal cord, initial encounter	
S14.117A	Complete lesion at C7 level of cervical spinal cord, initial encounter	
S14.118A	Complete lesion at C8 level of cervical spinal cord, initial encounter	
S14.121A	Central cord syndrome at C1 level of cervical spinal cord, initial encounter	
S14.122A	Central cord syndrome at C2 level of cervical spinal cord, initial encounter	
S14.123A	Central cord syndrome at C3 level of cervical spinal cord, initial encounter	
S14.124A	Central cord syndrome at C4 level of cervical spinal cord, initial encounter	
S14.125A	Central cord syndrome at C5 level of cervical spinal cord, initial encounter	
S14.126A	Central cord syndrome at C6 level of cervical spinal cord, initial encounter	
S14.127A	Central cord syndrome at C7 level of cervical spinal cord, initial encounter	
S14.128A	Central cord syndrome at C8 level of cervical spinal cord, initial encounter	
S14.131A	Anterior cord syndrome at C1 level of cervical spinal cord, initial encounter	
S14.132A	Anterior cord syndrome at C2 level of cervical spinal cord, initial encounter	
S14.133A	Anterior cord syndrome at C3 level of cervical spinal cord, initial encounter	
S14.134A	Anterior cord syndrome at C4 level of cervical spinal cord, initial encounter	
S14.135A	Anterior cord syndrome at C5 level of cervical spinal cord, initial encounter	
S14.136A	Anterior cord syndrome at C6 level of cervical spinal cord, initial encounter	
S14.137A	Anterior cord syndrome at C7 level of cervical spinal cord, initial encounter	
S14.138A	Anterior cord syndrome at C8 level of cervical spinal cord, initial encounter	
S14.151A	Other incomplete lesion at C1 level of cervical spinal cord, initial encounter	
S14.152A	Other incomplete lesion at C2 level of cervical spinal cord, initial encounter	
S14.153A	Other incomplete lesion at C3 level of cervical spinal cord, initial encounter	
S14.154A	Other incomplete lesion at C4 level of cervical spinal cord, initial encounter	
S14.155A	Other incomplete lesion at C5 level of cervical spinal cord, initial encounter	
S14.156A	Other incomplete lesion at C6 level of cervical spinal cord, initial encounter	
S14.157A	Other incomplete lesion at C7 level of cervical spinal cord, initial encounter	
S14.158A	Other incomplete lesion at C8 level of cervical spinal cord, initial encounter	
S24.101A	Unspecified injury at T1 level of thoracic spinal cord, initial encounter	
S24.102A	Unspecified injury at T2-T6 level of thoracic spinal cord, initial encounter	
S24.103A	Unspecified injury at T7-T10 level of thoracic spinal cord, initial encounter	
S24.104A	Unspecified injury at T11-T12 level of thoracic spinal cord, initial encounter	
S24.109A	Unspecified injury at unspecified level of thoracic spinal cord, initial encounter	
S24.111A	Complete lesion at T1 level of thoracic spinal cord, initial encounter	
S24.112A	Complete lesion at T2-T6 level of thoracic spinal cord, initial encounter	
S24.113A	Complete lesion at T7-T10 level of thoracic spinal cord, initial encounter	
S24.114A	Complete lesion at T11-T12 level of thoracic spinal cord, initial encounter	
S24.131A	Anterior cord syndrome at T1 level of thoracic spinal cord, initial encounter	
S24.132A	Anterior cord syndrome at T2-T6 level of thoracic spinal cord, initial encounter	
S24.133A	Anterior cord syndrome at T7-T10 level of thoracic spinal cord, initial encounter	
S24.134A	Anterior cord syndrome at T11-T12 level of thoracic spinal cord, initial encounter	
S24.151A	Other incomplete lesion at T1 level of thoracic spinal cord, initial encounter	
S24.152A	Other incomplete lesion at T2-T6 level of thoracic spinal cord, initial encounter	
S24.153A	Other incomplete lesion at T7-T10 level of thoracic spinal cord, initial encounter	
S24.154A	Other incomplete lesion at T11-T12 level of thoracic spinal cord, initial encounter	
S34.109A	Unspecified injury to unspecified level of lumbar spinal cord, initial encounter	
S34.139A	Unspecified injury to sacral spinal cord, initial encounter	
S34.3XXA	Injury of cauda equina, initial encounter	
	Item 8. Adopt the following new subrule 21.5(3):
	21.5(3) Each report shall contain, at a minimum, all of the following information:
	a. 	The patient’s name;
	b. 	The patient’s address;
	c. 	The patient’s date of birth;
	d. 	The sex of the patient;
	e. 	The date, type, and cause of the brain or spinal cord injury;
	f. 	The patient’s score on the Glasgow coma scale, if available; and
	g. 	Other information required by the department.
	Item 9. Amend subrule 21.6(2), introductory paragraph, as follows:
	21.6(2) A registry report of a traumatic brain or spinal cord injury that which is submitted to the agency that department and which can be associated with a particular individual shall be released as follows solely by the department and only under the following conditions:
	Item 10. Rescind paragraph 21.6(2)“e” and adopt the following new paragraph in lieu thereof:
	e. 	To an authorized representative of a study or research project that shall be reviewed and approved by the department’s research and ethics review committee and approved by the director of public health. If information identifies individuals with brain or spinal cord injuries, the release of such information for research purposes shall be subject to the terms and conditions set by the department. Such study or research project shall maintain the identifying information as confidential and privileged. A formal memorandum of agreement signed by an authorized representative of the department and the director of the research project shall include provisions that the data provided by the department shall not be copied for retention, resold, or otherwise provided to another person or organization and shall be returned to the department or otherwise destroyed upon completion of the study.
	Item 11. Rescind paragraph 21.6(2)“f.”
	Item 12. Reletter paragraph 21.6(2)“g”  as 21.6(2)“f.”
	Item 13. Amend 641—Chapter 21, implementation sentence, as follows:
These rules are intended to implement Iowa Code section 135.22 as amended by 1994 Iowa Acts, House File 2145.