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    CHAPTER 21CENTRAL REGISTRY FORBRAIN AND SPINAL CORD INJURIES641—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.Related ARC(s): 2655C641—21.2(135)  Definitions.  For the purpose of these rules, the following definitions shall apply:
    "Acute injury" means an injury for which a person has been continuously hospitalized since recognition of that injury.
    "Brain injury" means 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.
    "Department" means Iowa department of public health.
    "Hospital" means hospital as defined by the department of inspections and appeals in Iowa Code section 135B.1.
    "Physical agent" means mechanical energy transmitted from a living or nonliving vector to humans.
    "Reportable case" means a person who is discharged from an Iowa hospital for an inpatient acute care, medical rehabilitation, skilled nursing care, or outpatient care visit with a diagnosis of acute brain or spinal cord injury.
    "Spinal cord injury" means any acute, traumatic lesion of the neural elements in the spinal canal, resulting in any degree of sensory deficit, motor deficit, or bladder/bowel dysfunction.
    Related ARC(s): 2655C641—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, Lucas State Office Building, Des Moines, Iowa 50319-0075, or its designee, as part of a statewide population-based registry.  21.3(1)    Brain injuries.    a.  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 ModificationInternational Classification of Diseases, 10th Revision, Clinical Modification191.00Malignant neoplasms of brain, cerebrumC71.0Malignant neoplasm of cerebrum, except lobes and ventricles191.10Malignant neoplasms of brain, frontal lobeC71.1Malignant neoplasm of frontal lobe191.02Malignant neoplasms of brain, temporal C71.2Malignant neoplasm of temporal 191.30Malignant neoplasms of brain, parietal lobeC71.3Malignant neoplasm of parietal lobe191.40Malignant neoplasms of brain, occipital lobeC71.4Malignant neoplasm of occipital lobe191.50Malignant neoplasms of brain, ventriclesC71.5Malignant neoplasm of cerebral ventricle191.60Malignant neoplasms of brain, cerebellumC71.6Malignant neoplasm of cerebellum191.70Malignant neoplasms of brain, brain stemC71.7Malignant neoplasm of brain stem191.80Malignant neoplasms of brain, other part of brain, includes midbrain, peduncle, and medulla oblongataC71.8Malignant neoplasm of overlapping sites of brain192.00Malignant neoplasms of brain, cranial nervesC72.50Malignant neoplasm of unspecified cranial nerveC72.59Malignant neoplasm of other cranial nerves192.10Malignant neoplasms of brain, cerebral meningesC70.0Malignant neoplasm of cerebral meninges198.30Secondary malignant neoplasm of brainC79.31Secondary malignant neoplasm of brain198.40Secondary malignant neoplasm of other parts of the nervous system, includes cerebral meningesC79.32Secondary malignant neoplasm of cerebral meningesC79.49Secondary malignant neoplasm of other parts of nervous system225.00Benign neoplasm of brain and other parts of the nervous system, brainD33.2Benign neoplasm of brain, unspecified225.10Benign neoplasm of brain and other parts of the nervous system, cranial nervesD33.3Benign neoplasm of cranial nerves225.20Benign neoplasm of brain and other parts of nervous system, cerebral meningesD32.0Benign neoplasm of cerebral meningesD32.9Benign neoplasm of meninges, unspecified323.01-323.9Encephalitis, myelitis and encephalomyelitisG04.00-G05.4Encephalitis, myelitis and encephalomyelitis324.00Intracranial and intraspinal abscessG06.0Intracranial abscess and granulomaG06.1Intraspinal abscess and granuloma348.10Anoxic brain damageG93.1Anoxic brain damage, not elsewhere classified430.00Subarachnoid hemorrhageI60.00-I60.8Nontraumatic subarachnoid hemorrhage431.00Intracerebral hemorrhageI61.0-I61.9Nontraumatic intracerebral hemorrhage432.00Other and unspecified intracranial hemorrhageI62.1Nontraumatic extradural hemorrhage433.00Occlusion and stenosis of precerebral arteriesI65.01-I65.9Occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction434.00Occlusion of cerebral arteriesI66.01-I66.9Occlusion and stenosis of cerebral arteries, not resulting in cerebral infarction435.00Transient cerebral ischemiaG45.0-G45.9Transient cerebral ischemic attacks and related syndromes 436.00Acute, but ill-defined, cerebrovascular diseaseI67.89Other cerebrovascular diseaseI67.9Cerebrovascular disease, unspecified437.00Other and ill-defined cerebrovascular diseaseI67.89Other cerebrovascular diseaseI67.9Cerebrovascular disease, unspecified800.00-800.99Fracture of vault of skullS02.0X XA;S02.0X XBFracture of vault of skull 801.00-801.99Fracture of base of skullS02.1-S02.19Fracture of base of skull803.00-803.99Other and unqualified skull fracturesS02.91 XAUnspecified fracture of skull804.00-804.99Multiple fractures involving skull or face with other bonesS02.91 XAUnspecified fracture of skull850.00-850.99ConcussionS06.0X 0A-S06.0X 9AConcussion851.00-851.99Cerebral laceration and contusionS06.31-S06.33Contusion and laceration of cerebrum852.00-852.59Subarachnoid, subdural, and extradural hemorrhage following injuryS06.4; S06.5; S06.6Traumatic epidural, subdural, and subarachnoid hemorrhage853.00-853.19Other and unspecified intracranial hemorrhage following injuryS06.36Traumatic hemorrhage of cerebrum, unspecified854.00-854.19Intracranial injury of other and unspecified natureS06.8-S06.9Other specified intracranial injuries and unspecified intracranial injuries  b.  Reportable cases of brain injury 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, only to the extent the injury or condition resulted in a brain injury.International Classification of Diseases, 9th Revision, Clinical ModificationInternational Classification of Diseases, 10th Revision, Clinical Modification960-979Poisoning by drugs, medicinal and biological substancesT41-T44Poisoning by, adverse effect of and underdosing of drugs and gases980-989Toxic effects of substancesT51; T58Toxic effect of alcohol; toxic effect of carbon monoxide990-995Effects of external causesT71Asphyxiation994.7Asphyxiation and strangulation994.1Drowning and nonfatal submersionT75.1X XAUnspecified effects of drowning and nonfatal submersion995.50-995.59Child maltreatment syndromeT74.1; T74.4Physical abuse, confirmed; shaken infant syndrome995.80-995.89Adult maltreatment syndrome  21.3(2)    Spinal cord injuries.  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:806.00-806.9Fracture of vertebral column with spinal cord injury  (2)  International Classification of Diseases, 10th Revision, Clinical Modification:S12.000AUnspecified displaced fracture of the first cervical vertebra, initial encounter for closed fractureS12.000BUnspecified displaced fracture of first cervical vertebra, initial encounter for open fractureS12.001AUnspecified nondisplaced fracture of first cervical vertebra, initial encounter for closed fractureS12.001BUnspecified nondisplaced fracture of first cervical vertebra, initial encounter for open fractureS12.100AUnspecified displaced fracture of second cervical vertebra, initial encounter for closed fractureS12.100BUnspecified displaced fracture of second cervical vertebra, initial encounter for open fractureS12.101AUnspecified nondisplaced fracture of second cervical vertebra, initial encounter for closed fractureS12.101BUnspecified nondisplaced fracture of second cervical vertebra, initial encounter for open fractureS12.200AUnspecified displaced fracture of third cervical vertebra, initial encounter for closed fractureS12.200BUnspecified displaced fracture of third cervical vertebra, initial encounter for open fractureS12.201AUnspecified nondisplaced fracture of third cervical vertebra, initial encounter for closed fractureS12.201BUnspecified nondisplaced fracture of third cervical vertebra, initial encounter for open fractureS12.300AUnspecified displaced fracture of fourth cervical vertebra, initial encounter for closed fractureS12.300BUnspecified displaced fracture of fourth cervical vertebra, initial encounter for open fractureS12.301AUnspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for closed fractureS12.301BUnspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for open fractureS12.400AUnspecified displaced fracture of fifth cervical vertebra, initial encounter for closed fractureS12.400BUnspecified displaced fracture of fifth cervical vertebra, initial encounter for open fractureS12.401AUnspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for closed fractureS12.401BUnspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for open fractureS12.500AUnspecified displaced fracture of sixth cervical vertebra, initial encounter for closed fractureS12.500BUnspecified displaced fracture of sixth cervical vertebra, initial encounter for open fractureS12.501AUnspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for closed fractureS12.501BUnspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for open fractureS12.600AUnspecified displaced fracture of seventh cervical vertebra, initial encounter for closed fractureS12.600BUnspecified displaced fracture of seventh cervical vertebra, initial encounter for open fractureS12.601AUnspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for closed fractureS12.601BUnspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for open fractureS12.9XXAFracture of neck, unspecified, initial encounterS14.101AUnspecified injury at C1 level of cervical spinal cord, initial encounterS14.102AUnspecified injury at C2 level of cervical spinal cord, initial encounterS14.103AUnspecified injury at C3 level of cervical spinal cord, initial encounterS14.104AUnspecified injury at C4 level of cervical spinal cord, initial encounterS14.105AUnspecified injury at C5 level of cervical spinal cord, initial encounterS14.106AUnspecified injury at C6 level of cervical spinal cord, initial encounterS14.107AUnspecified injury at C7 level of cervical spinal cord, initial encounterS14.109AUnspecified injury at unspecified level of cervical spinal cord, initial encounterS14.111AComplete lesion at C1 level of cervical spinal cord, initial encounterS14.112AComplete lesion at C2 level of cervical spinal cord, initial encounterS14.113AComplete lesion at C3 level of cervical spinal cord, initial encounterS14.114AComplete lesion at C4 level of cervical spinal cord, initial encounterS14.115AComplete lesion at C5 level of cervical spinal cord, initial encounterS14.116AComplete lesion at C6 level of cervical spinal cord, initial encounterS14.117AComplete lesion at C7 level of cervical spinal cord, initial encounterS14.121ACentral cord syndrome at C1 level of cervical spinal cord, initial encounterS14.122ACentral cord syndrome at C2 level of cervical spinal cord, initial encounterS14.123ACentral cord syndrome at C3 level of cervical spinal cord, initial encounterS14.124ACentral cord syndrome at C4 level of cervical spinal cord, initial encounterS14.125ACentral cord syndrome at C5 level of cervical spinal cord, initial encounterS14.126ACentral cord syndrome at C6 level of cervical spinal cord, initial encounterS14.127ACentral cord syndrome at C7 level of cervical spinal cord, initial encounterS14.131AAnterior cord syndrome at C1 level of cervical spinal cord, initial encounterS14.132AAnterior cord syndrome at C2 level of cervical spinal cord, initial encounterS14.133AAnterior cord syndrome at C3 level of cervical spinal cord, initial encounterS14.134AAnterior cord syndrome at C4 level of cervical spinal cord, initial encounterS14.135AAnterior cord syndrome at C5 level of cervical spinal cord, initial encounterS14.136AAnterior cord syndrome at C6 level of cervical spinal cord, initial encounterS14.137AAnterior cord syndrome at C7 level of cervical spinal cord, initial encounterS14.151AOther incomplete lesion at C1 level of cervical spinal cord, initial encounterS14.152AOther incomplete lesion at C2 level of cervical spinal cord, initial encounterS14.153AOther incomplete lesion at C3 level of cervical spinal cord, initial encounterS14.154AOther incomplete lesion at C4 level of cervical spinal cord, initial encounterS14.155AOther incomplete lesion at C5 level of cervical spinal cord, initial encounterS14.156AOther incomplete lesion at C6 level of cervical spinal cord, initial encounterS14.157AOther incomplete lesion at C7 level of cervical spinal cord, initial encounterS22.009AUnspecified fracture of unspecified thoracic vertebra, initial encounter for closed fractureS22.009BUnspecified fracture of unspecified thoracic vertebra, initial encounter for open fractureS22.019AUnspecified fracture of first thoracic vertebra, initial encounter for closed fractureS22.019BUnspecified fracture of first thoracic vertebra, initial encounter for open fractureS22.029AUnspecified fracture of second thoracic vertebra, initial encounter for closed fractureS22.029BUnspecified fracture of second thoracic vertebra, initial encounter for open fractureS22.039AUnspecified fracture of third thoracic vertebra, initial encounter for closed fractureS22.039BUnspecified fracture of third thoracic vertebra, initial encounter for open fractureS22.049AUnspecified fracture of fourth thoracic vertebra, initial encounter for closed fractureS22.049BUnspecified fracture of fourth thoracic vertebra, initial encounter for open fractureS22.059AUnspecified fracture of T5-T6 vertebra, initial encounter for closed fractureS22.059BUnspecified fracture of T5-T6 vertebra, initial encounter for open fractureS22.069AUnspecified fracture of T7-T8 vertebra, initial encounter for closed fractureS22.069BUnspecified fracture of T7-T8 vertebra, initial encounter for open fractureS22.079AUnspecified fracture of T9-T10 vertebra, initial encounter for closed fractureS22.079BUnspecified fracture of T9-T10 vertebra, initial encounter for open fractureS22.089AUnspecified fracture of T11-T12 vertebra, initial encounter for closed fractureS22.089BUnspecified fracture of T11-T12 vertebra, initial encounter for open fractureS24.101AUnspecified injury at T1 level of thoracic spinal cord, initial encounterS24.102AUnspecified injury at T2-T6 level of thoracic spinal cord, initial encounterS24.103AUnspecified injury at T7-T10 level of thoracic spinal cord, initial encounterS24.104AUnspecified injury at T11-T12 level of thoracic spinal cord, initial encounterS24.109AUnspecified injury at unspecified level of thoracic spinal cord, initial encounterS24.111AComplete lesion at T1 level of thoracic spinal cord, initial encounterS24.112AComplete lesion at T2-T6 level of thoracic spinal cord, initial encounterS24.113AComplete lesion at T7-T10 level of thoracic spinal cord, initial encounterS24.114AComplete lesion at T11-T12 level of thoracic spinal cord, initial encounterS24.131AAnterior cord syndrome at T1 level of thoracic spinal cord, initial encounterS24.132AAnterior cord syndrome at T2-T6 level of thoracic spinal cord, initial encounterS24.133AAnterior cord syndrome at T7-T10 level of thoracic spinal cord, initial encounterS24.134AAnterior cord syndrome at T11-T12 level of thoracic spinal cord, initial encounterS24.151AOther incomplete lesion at T1 level of thoracic spinal cord, initial encounterS24.152AOther incomplete lesion at T2-T6 level of thoracic spinal cord, initial encounterS24.153AOther incomplete lesion at T7-T10 level of thoracic spinal cord, initial encounterS24.154AOther incomplete lesion at T11-T12 level of thoracic spinal cord, initial encounterS32.009AUnspecified fracture of unspecified lumbar vertebra, initial encounter for closed fractureS32.009BUnspecified fracture of unspecified lumbar vertebra, initial encounter for open fractureS32.10XAUnspecified fracture of sacrum, initial encounter for closed fractureS32.10XBUnspecified fracture of sacrum, initial encounter for open fractureS32.019AUnspecified fracture of first lumbar vertebra, initial encounter for closed fractureS32.019BUnspecified fracture of first lumbar vertebra, initial encounter for open fractureS32.029AUnspecified fracture of second lumbar vertebra, initial encounter for closed fractureS32.029BUnspecified fracture of second lumbar vertebra, initial encounter for open fractureS32.039AUnspecified fracture of third lumbar vertebra, initial encounter for closed fractureS32.039BUnspecified fracture of third lumbar vertebra, initial encounter for open fractureS32.049AUnspecified fracture of fourth lumbar vertebra, initial encounter for closed fractureS32.049BUnspecified fracture of fourth lumbar vertebra, initial encounter for open fractureS32.059AUnspecified fracture of fifth lumbar vertebra, initial encounter for closed fractureS32.059BUnspecified fracture of fifth lumbar vertebra, initial encounter for open fractureS32.2XXAFracture of coccyx, initial encounter for closed fractureS32.2XXBFracture of coccyx, initial encounter for open fractureS34.101AUnspecified injury to L1 level of lumbar spinal cord, initial encounterS34.102AUnspecified injury to L2 level of lumbar spinal cord, initial encounterS34.103AUnspecified injury to L3 level of lumbar spinal cord, initial encounterS34.104AUnspecified injury to L4 level of lumbar spinal cord, initial encounterS34.105AUnspecified injury to L5 level of lumbar spinal cord, initial encounterS34.109AUnspecified injury to unspecified level of lumbar spinal cord, initial encounterS34.111AComplete lesion of L1 level of lumbar spinal cord, initial encounterS34.112AComplete lesion of L2 level of lumbar spinal cord, initial encounterS34.113AComplete lesion of L3 level of lumbar spinal cord, initial encounterS34.114AComplete lesion of L4 level of lumbar spinal cord, initial encounterS34.115AComplete lesion of L5 level of lumbar spinal cord, initial encounterS34.119AComplete lesion of unspecified level of lumbar spinal cord, initial encounterS34.121AIncomplete lesion of L1 level of lumbar spinal cord, initial encounterS34.122AIncomplete lesion of L2 level of lumbar spinal cord, initial encounterS34.123AIncomplete lesion of L3 level of lumbar spinal cord, initial encounterS34.124AIncomplete lesion of L4 level of lumbar spinal cord, initial encounterS34.125AIncomplete lesion of L5 level of lumbar spinal cord, initial encounterS34.129AIncomplete lesion of unspecified level of lumbar spinal cord, initial encounterS34.131AComplete lesion of sacral spinal cord, initial encounterS34.132AIncomplete lesion of sacral spinal cord, initial encounterS34.139AUnspecified injury to sacral spinal cord, initial encounterS34.3XXAInjury of cauda equina, initial encounter  b.  Spinal cord injury.  (1)  International Classification of Diseases, 9th Revision, Clinical Modification:952.00-952.9Spinal cord injury without evidence of spinal bone injury  (2)  International Classification of Diseases, 10th Revision, Clinical Modification:S14.101AUnspecified injury at C1 level of cervical spinal cord, initial encounterS14.102AUnspecified injury at C2 level of cervical spinal cord, initial encounterS14.103AUnspecified injury at C3 level of cervical spinal cord, initial encounterS14.104AUnspecified injury at C4 level of cervical spinal cord, initial encounterS14.105AUnspecified injury at C5 level of cervical spinal cord, initial encounterS14.106AUnspecified injury at C6 level of cervical spinal cord, initial encounterS14.107AUnspecified injury at C7 level of cervical spinal cord, initial encounterS14.108AUnspecified injury at C8 level of cervical spinal cord, initial encounterS14.109AUnspecified injury at unspecified level of cervical spinal cord, initial encounterS14.111AComplete lesion at C1 level of cervical spinal cord, initial encounterS14.112AComplete lesion at C2 level of cervical spinal cord, initial encounterS14.113AComplete lesion at C3 level of cervical spinal cord, initial encounterS14.114AComplete lesion at C4 level of cervical spinal cord, initial encounterS14.115AComplete lesion at C5 level of cervical spinal cord, initial encounterS14.116AComplete lesion at C6 level of cervical spinal cord, initial encounterS14.117AComplete lesion at C7 level of cervical spinal cord, initial encounterS14.118AComplete lesion at C8 level of cervical spinal cord, initial encounterS14.121ACentral cord syndrome at C1 level of cervical spinal cord, initial encounterS14.122ACentral cord syndrome at C2 level of cervical spinal cord, initial encounterS14.123ACentral cord syndrome at C3 level of cervical spinal cord, initial encounterS14.124ACentral cord syndrome at C4 level of cervical spinal cord, initial encounterS14.125ACentral cord syndrome at C5 level of cervical spinal cord, initial encounterS14.126ACentral cord syndrome at C6 level of cervical spinal cord, initial encounterS14.127ACentral cord syndrome at C7 level of cervical spinal cord, initial encounterS14.128ACentral cord syndrome at C8 level of cervical spinal cord, initial encounterS14.131AAnterior cord syndrome at C1 level of cervical spinal cord, initial encounterS14.132AAnterior cord syndrome at C2 level of cervical spinal cord, initial encounterS14.133AAnterior cord syndrome at C3 level of cervical spinal cord, initial encounterS14.134AAnterior cord syndrome at C4 level of cervical spinal cord, initial encounterS14.135AAnterior cord syndrome at C5 level of cervical spinal cord, initial encounterS14.136AAnterior cord syndrome at C6 level of cervical spinal cord, initial encounterS14.137AAnterior cord syndrome at C7 level of cervical spinal cord, initial encounterS14.138AAnterior cord syndrome at C8 level of cervical spinal cord, initial encounterS14.151AOther incomplete lesion at C1 level of cervical spinal cord, initial encounterS14.152AOther incomplete lesion at C2 level of cervical spinal cord, initial encounterS14.153AOther incomplete lesion at C3 level of cervical spinal cord, initial encounterS14.154AOther incomplete lesion at C4 level of cervical spinal cord, initial encounterS14.155AOther incomplete lesion at C5 level of cervical spinal cord, initial encounterS14.156AOther incomplete lesion at C6 level of cervical spinal cord, initial encounterS14.157AOther incomplete lesion at C7 level of cervical spinal cord, initial encounterS14.158AOther incomplete lesion at C8 level of cervical spinal cord, initial encounterS24.101AUnspecified injury at T1 level of thoracic spinal cord, initial encounterS24.102AUnspecified injury at T2-T6 level of thoracic spinal cord, initial encounterS24.103AUnspecified injury at T7-T10 level of thoracic spinal cord, initial encounterS24.104AUnspecified injury at T11-T12 level of thoracic spinal cord, initial encounterS24.109AUnspecified injury at unspecified level of thoracic spinal cord, initial encounterS24.111AComplete lesion at T1 level of thoracic spinal cord, initial encounterS24.112AComplete lesion at T2-T6 level of thoracic spinal cord, initial encounterS24.113AComplete lesion at T7-T10 level of thoracic spinal cord, initial encounterS24.114AComplete lesion at T11-T12 level of thoracic spinal cord, initial encounterS24.131AAnterior cord syndrome at T1 level of thoracic spinal cord, initial encounterS24.132AAnterior cord syndrome at T2-T6 level of thoracic spinal cord, initial encounterS24.133AAnterior cord syndrome at T7-T10 level of thoracic spinal cord, initial encounterS24.134AAnterior cord syndrome at T11-T12 level of thoracic spinal cord, initial encounterS24.151AOther incomplete lesion at T1 level of thoracic spinal cord, initial encounterS24.152AOther incomplete lesion at T2-T6 level of thoracic spinal cord, initial encounterS24.153AOther incomplete lesion at T7-T10 level of thoracic spinal cord, initial encounterS24.154AOther incomplete lesion at T11-T12 level of thoracic spinal cord, initial encounterS34.109AUnspecified injury to unspecified level of lumbar spinal cord, initial encounterS34.139AUnspecified injury to sacral spinal cord, initial encounterS34.3XXAInjury of cauda equina, initial encounterRelated ARC(s): 2655C641—21.4(135)  Who reports and under what circumstances.  Hospitals treating, transferring, or having pronounced dead any person determined to have sustained a reportable case of brain or spinal cord injury are required to submit information as identified by the department.Related ARC(s): 2655C641—21.5(135)  Method and frequency of reporting.    21.5(1)  To the extent possible, activities conducted under this chapter shall be coordinated with other health data collection methods. The department shall obtain brain and spinal cord injury data from the Iowa Hospital Association pursuant to 641—Chapter 177, and the association shall serve as the department’s intermediary in the collection of brain and spinal cord injury data.  21.5(2)  Hospitals shall report to the Iowa Hospital Association the required information for any reportable case of brain injury or spinal cord injury no later than 45 days after the end of the quarter during which the patient was discharged, transferred to another acute care hospital, or pronounced dead in the emergency department.  21.5(3)  Reports shall meet the data quality, format, and timeliness standards prescribed by the department and the Iowa Hospital Association.Related ARC(s): 2655C641—21.6(135)  Confidentiality.    21.6(1)  The department shall maintain the confidentiality of all submitted registry reports of brain and spinal cord injuries and shall not release reports, or any information which can be associated with a particular individual, unless the release is in compliance with the provisions of subrule 21.6(2).  21.6(2)  A registry report of a brain or spinal cord injury which is submitted to the department and which can be associated with a particular individual shall be released solely by the department and only under the following conditions:  a.  To the particular individual upon receipt of a written request signed by the particular individual and suitable identification presented in person to an employee designated by the department.  b.  If the particular individual is a minor, to a parent or attorney of the particular individual upon receipt of a written request signed by a parent or attorney of the individual and of a certified copy of the birth certificate and suitable identification presented to an employee designated by the department.  c.  If the particular individual has a court-appointed guardian or if the particular individual is deceased, to the court-appointed guardian or to the executor or administrator of the particular individual’s estate upon receipt of a written request signed by the court-appointed guardian, executor, or administrator, and of a certified copy of the order or decree which appoints the guardian, executor, or administrator, and of suitable identification presented to an employee designated by the department.  d.  To an attorney or other person who is designated by the particular individual upon receipt of a written request signed by the particular individual and suitable identification presented to an employee designated by the department.  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 the division of behavioral 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.  f.  The department may transmit transcripts or copies of reported cases to state or national brain and spinal cord injury registries when the reports relate to residents of other states or countries. The agreement shall require that the transcripts or records be used for statistical purposes only and that the identity of reported cases shall not be released.Related ARC(s): 2655C641—21.7(135)  Quality assurance.  For the purpose of ensuring the completeness and quality of submitted data, each hospital may allow the department inspection of parts of patient’s medical reports as necessary to verify or clarify these data by signing an agreement. The department’s authorized representative may enter the facility, obtain the information, and report it in the appropriate form. Prior to inspecting the records, this department shall work with the hospital to determine a time and date agreeable to both parties.Related ARC(s): 2655CThese rules are intended to implement Iowa Code section 135.22.    Related ARC(s): 2655C