Author: Larissa Lee

The Tennessee Department of Health (TDH), in collaboration with the Tennessee Hospital Association Health Information Network (THA HIN), has released the 2026 Hospital Discharge Data System (HDDS) User Manual. The TDH sent you two memos regarding the changes:  

TDH Memo from June 30, 2026

TDH Memo from July 15, 2026  

You can access the complete 2026 manual by clicking here. 

You will find a summary of changes to this manual on pages 6-7. We encourage you to review all changes.

However, there are two notable changes for THA members who report their data directly to THA HIN via HIDInet. They are as follows:

1. Excessive use of unknowns in provider/physician fields

Field No.	Description	Positions	HDDS Manual Data Dictionary Page No.
242-244	Attending Provider Name and Identifiers	1946-1970	107
245-247	Operating Physician Name and Identifiers	1971-1995	109
248-250	Other Provider (Individual) Name and Identifiers 1	1996-2020	111
251-253	Other Provider (Individual) Name and Identifiers 2	2021-2045	113

The first component of this field has two parts and uses twelve positions, (1) the profession code and (2) the TN state license number.

• The first part is two positions and contains the provider’s profession code
• The second part is the next ten positions following the profession code and contains the TN state license number for the provider, using leading zeros to fill all ten spaces.

Beginning with the submission of the Q4-2026 data, due by March 1, 2027, the use of the unknown code, UK9999999999, for all provider fields listed in the table above, will be limited to less than 40% in the inpatient and outpatient datasets.

• Over the coming weeks you will be able to see how often you are using the unknown code, UK9999999999, in your hospital’s/hospital system discharge data for all four of the fields listed in the table above, separating inpatient and outpatient calculations. This will be posted to page 1 of your verification report(s), and the report(s) will be available to view in HIDInet after you submit your Q2-2026 data, as usual. This will allow you to see if you need to make improvements to your data prior to the effective date of this new rule.
• Once this new rule is implemented with the submission of your Q4-2026 data, if the usage is above the 40% allowable threshold in any of the four provider fields listed above, in either your inpatient or outpatient data files, your data will not be accepted by the TDH and you will be required to make corrections to the applicable fields to bring them below 40%.
  
  Please note: The ability to make online corrections will be implemented for the Q4-2026 data submission period to all four of these fields in HIDInet (if you use the unknown code, UK9999999999, and are above the 40% allowable threshold). However, as always, we encourage you to make the changes/corrections internally to your data file and resubmit the full data file.

2. Freestanding Emergency Department (FSED) Identifier

Field No.	Description	Positions	HDDS Manual Data Dictionary Page No.
254b	Freestanding Emergency Department Identifier	2051-2057	116

This is a new field to properly identify an off-campus FSED, if applicable to your hospital(s). If the reporting/parent hospital does not have an off-campus FSED, this field is left blank.

This field does not have the standard 180-day effective rule. Over the coming days, we will reach out to each hospital/system that has an off-campus FSED. We will provide you with the reporting format information as well as your FSED identification number that has been assigned. We encourage you to read through page 116 of the new 2026 HDDS manual prior to our outreach.

We will encourage each parent hospital that is reporting for an off-campus FSED to begin the new reporting process with the Q3-2026 data submission which is due by November 29, 2026.

Special Note: This new field is shared with field 254a which is your hospital’s JAR ID. There have been no changes to the way you report your JAR ID – the field length was shortened to accompany the new FSED identifier field. The JAR ID field is now 5 characters in length (previously 12 characters). Please review page 115 of the HDDS manual to see the full information on this field.

The Tennessee Hospital Association (THA) worked with the Data Policy Committee (DPC) to review and update the THA Data Release Policy. The main objectives of this effort were to update DataBank uses and enable participating hospitals access to comparative analytics, limited to internal use only. There were no changes to the other sections of the Data Release Policy.

After a thorough review, the DPC recommended the updated policy for approval to the THA Board of Directors, which they approved at their June 15, 2026, meeting.

Enabling the access for DataBank participating hospitals and hospital systems to comparative analytics provides them the capability to analyze their own submitted data to support data quality improvement and also gives them access to benchmark their hospital against national and state-based peer groups. (Access will be provided to participants at a later date.) Please review the updated THA Data Release Policy which is now active and replaces any previous copies you may have on file. You can find the document HERE. 

As you are aware, with each new year comes a new set of CPT/HCPCS codes. After extensive review of the new 2026 codes by the Tennessee Hospital Association (THA) and the Tennessee Health Information Management Association (THIMA) professionals, we have determined which codes should be included or excluded from the ambulatory surgery definition beginning with the Q1-2026 discharge data which are due May 30, 2026. 

Please find the updated definition document here. Below is a breakdown of changes for 2026 THA ambulatory surgery definition: 

• 77 codes were added to, and 24 codes were removed from the general range of 10021-69990
• Zero codes were added to or removed from the exclusion CPT code list that are in the general range of 10021-69990
• 2 codes were added to, and 8 codes were removed from the inclusion CPT code list that are fall outside of the general range 10021-69990
• 6 codes were added to, and 4 codes were removed from the select HCPCS Level II code list
• 29 codes were added to, and 2 codes were removed from the Category III code list 

This update will continue to be made each year with the release of new CPT/HCPCS codes. 

You do not have to make any changes to the way you currently submit your data. This is only an update to reflect the new 2026 CPT/HCPCS codes that are included or excluded in the ambulatory surgery definition.

As you are aware, with each new year comes a new set of CPT/HCPCS codes. After extensive review of the new 2025 codes by the Tennessee Hospital Association (THA) and the Tennessee Health Information Management Association (THIMA) professionals, we have determined which codes should be included or excluded from the ambulatory surgery definition beginning with the Q1-2025 discharge data which are due May 30, 2025. 

Please find the updated, change version, definition document here. As you review the document you will see changes to the special inclusion and exclusion lists: the codes removed are highlighted in yellow and codes added are highlighted in peach. You may also find the FINAL ambulatory surgery definition document here (this version does not include markups). Below is a breakdown of changes for 2025 THA ambulatory surgery definition: 

• 28 codes were added to, and 13 codes were removed from the general surgery range of 10021-69990
• 5 codes were added to the special exclusion CPT codes that are in the general surgery range of 10021-69990
• 7 codes were added to, and 2 codes were removed from the select HCPCS Level II code list
• 34 codes were added to, and 3 codes were removed from the Category III code list 

This update will continue to be made each year with the release of new CPT/HCPCS codes. 

The THA ambulatory surgery definition document is made available so you understand how HIDINet flags your outpatient records as an ambulatory surgery record. Please continue to submit all outpatient records as you currently do, and the system will continue to define and flag the ambulatory surgery records for you. 

You do not have to make any changes to the way you currently submit your data. This is only an update to reflect the new 2025 CPT/HCPCS codes that are included or excluded in the ambulatory surgery definition.  

Beginning with Q1-2025 discharge data submissions there will be changes in reporting Medicare Advantage payer classification codes. 

There is a need to analyze more granular Medicare Advantage plans that have been identified as the most utilized Medicare Advantage payers across the state. Currently, all Tennessee hospitals report all Medicare Advantage plans in patient discharge records using payer “K.” Additional Medicare Advantage payer codes, K1 – K7, have been added to the payer classification categories.  

Beginning with your Q1-2025 discharge data submissions, we ask that you make changes to the way you map your Medicare Advantage payer classification codes as described below. This change applies to primary, secondary and tertiary payer name codes (additional details about these data fields can be found in the 2020 HDDS manual on pages 65, 68 and 71). 

The Tennessee Department of Health (TDH) emailed this notice on November 22, 2024. The notice can be found here. Please report the data to THA/HIDINet using the payer classification codes listed above beginning with your Q1-2025 data submissions which are due by May 30, 2025.

THA worked with the Data Policy Committee (DPC) to review
and update the THA Data Release Policy. The main objectives of this effort were
to reflect changes in THA’s data programs by removing outdated uses, clarify
language to ensure consistent interpretation of intended uses and prohibitions,
and explore new external uses for UB discharge data in health planning and
financial disclosures. After a thorough review, the DPC recommended the updated
policy for approval to the THA Board of Directors, which approved it at its
September 2024 meeting.

Enabling these additional UB discharge data uses to support
health planning and financial disclosures requires that THA segregate member
and non-member data for data subscribers and Market Optics users. Going
forward, the non-HIN/non-member data will only be available to subscribers upon
request, and will only be added to Market Optics once the Tennessee Department
of Health (TDH) has made the data publicly available (typically 18 months after
the close of a calendar year). For example, the 2023 data will be accessible in
July 2025.

Please review the updated THA Data Release Policy which is active and replaces any previous copies you may have on file. You can find the document HERE.

As you are aware, with each new year comes a new set of CPT/HCPCS codes.  After extensive review of the new 2024 codes by the Tennessee Hospital Association (THA) and the Tennessee Health Information Management Association (THIMA) professionals, we have determined which codes should be included or excluded from the ambulatory surgery definition beginning with the Q1-2024 discharge data which are due May 30, 2024. 

Please find the updated, change version, definition document here.  As you review the document you will see changes to the special inclusion and exclusion lists:  codes removed are highlighted in yellow and codes added are highlighted in peach.  You may also find the FINAL ambulatory surgery definition document here (this version does not include markups).  Below is a breakdown of changes for 2024 THA ambulatory surgery definition: 

• 23 codes were added, and 9 codes were removed to the general surgery range of 10021-69990 
• 6 codes were added to the select included CPT code list that are not within the general surgery range
• 5 codes were added to the select HCPCS Level II code list
• 26 codes were added, and 12 codes were removed the Category III code list 

This update will continue to be made each year with the release of new CPT/HCPCS codes. 

The THA ambulatory surgery definition document is made available, so you understand how HIDINet flags your outpatient records as an ambulatory surgery record.  Please continue to submit all your outpatient records as you currently do, and the system will continue to define and flag the ambulatory surgery records for you. 

You do not have to make any changes to the way you currently submit your data.  This is only an update to reflect the new 2024 CPT/HCPCS codes that are included or excluded in the ambulatory surgery definition.  

As you are aware, with each new year comes a new set of CPT/HCPCS codes.  After extensive review of the new 2023 codes by the Tennessee Hospital Association (THA) and the Tennessee Health Information Management Association (THIMA) professionals, we have determined which codes should be included or excluded from the ambulatory surgery definition beginning with the Q1-2023 discharge data which are due May 30, 2023. 

Please find the updated, FINAL ambulatory surgery definition document here.  Below is a breakdown of changes for 2023 THA ambulatory surgery definition: 

• 29 codes were added, and 19 codes were removed to the general surgery range of 10021-69990  (excluding two codes as noted on page 2)
• 4 codes were added to the select included CPT code list that are not within the general surgery range
• 55 codes were added to the select HCPCS Level II code list
• 3 codes were removed, and 7 codes were added to the Category III code list 

This update will continue to be made each year with the release of new CPT/HCPCS codes. 

The THA ambulatory surgery definition document is made available so you understand how HIDINet flags your outpatient records as an ambulatory surgery record.  Please continue to submit all of your outpatient records as you currently do, and the system will continue to define and flag the ambulatory surgery records for you. 

You do not have to make any changes to the way you currently submit your data.  This is only an update to reflect the new 2023 CPT/HCPCS codes that are included or excluded in the ambulatory surgery definition.