ICD-10-CM/AIS Mapping Software, 33799-33802 [2014-13727]

Download as PDF Federal Register / Vol. 79, No. 113 / Thursday, June 12, 2014 / Notices The effective date of the FAA’s approval of the Seattle-Tacoma International Airport noise compatibility program is May 29, 2014. FOR FURTHER INFORMATION CONTACT: Cayla Morgan, Federal Aviation Administration, Seattle Airports District Office, 1601 Lind Ave. SW., Renton, WA 98057–3356, telephone 425 227 2653. Documents reflecting this FAA action may be reviewed at this same location. SUPPLEMENTARY INFORMATION: This notice announces that the FAA has given its overall approval to the noise compatibility program for SeattleTacoma International Airport, effective May 29, 2014. Under section 47504 of the Act, an airport operator who has previously submitted a noise exposure map may submit to the FAA a noise compatibility program which sets forth the measures taken or proposed by the airport operator for the reduction of existing non-compatible land uses and prevention of additional non-compatible land uses within the area covered by the noise exposure maps. The Act requires such programs to be developed in consultation with interested and affected parties including local communities, government agencies, airport users, and FAA personnel. Each airport noise compatibility program developed in accordance with Federal Aviation Regulations (FAR) Part 150 is a local program, not a Federal program. The FAA does not substitute its judgment for that of the airport proprietor with respect to which measures should be recommended for action. The FAA’s approval or disapproval of FAR Part 150 program recommendations is measured according to the standards expressed in Part 150 and the Act and is limited to the following determinations: a. The noise compatibility program was developed in accordance with the provisions and procedures of FAR Part 150; b. Program measures are reasonably consistent with achieving the goals of reducing existing non-compatible land uses around the airport and preventing the introduction of additional noncompatible land uses; c. Program measures would not create an undue burden on interstate or foreign commerce, unjustly discriminate against types or classes of aeronautical uses, violate the terms of airport grant agreements, or intrude into areas preempted by the Federal Government; and d. Program measures relating to the use of flight procedures can be rmajette on DSK7SPTVN1PROD with NOTICES DATES: VerDate Mar<15>2010 21:18 Jun 11, 2014 Jkt 232001 implemented within the period covered by the program without derogating safety, adversely affecting the efficient use and management of the navigable airspace and air traffic control systems, or adversely affecting other powers and responsibilities of the Administrator prescribed by law. Specific limitations with respect to FAA’s approval of an airport noise compatibility program are delineated in FAR Part 150, section 150.5. Approval is not a determination concerning the acceptability of land uses under Federal, state, or local law. Approval does not by itself constitute an FAA implementing action. A request for Federal action or approval to implement specific noise compatibility measures may be required, and an FAA decision on the request may require an environmental assessment of the proposed action. Approval does not constitute a commitment by the FAA to financially assist in the implementation of the program nor a determination that all measures covered by the program are eligible for grant-in-aid funding from the FAA. Where Federal funding is sought, requests for project grants must be submitted to the FAA Seattle Airports District Office in Seattle, Washington. Seattle-Tacoma International Airport submitted to the FAA on October 24, 2013, the noise exposure maps, descriptions, and other documentation produced during the noise compatibility planning study conducted from 2009 through 2013. The Seattle-Tacoma International Airport noise exposure maps were determined by FAA to be in compliance with applicable requirements on December 13, 2014. Notice of this determination was published in the Federal Register on December 23, 2013 (78 FR 77548– 77549). The Seattle-Tacoma International Airport study contains a proposed noise compatibility program comprised of actions designed for phased implementation by airport management and adjacent jurisdictions. It was requested that the FAA evaluate and approve this material as a noise compatibility program as described in section 47504 of the Act. The FAA began its review of the program on December 13, 2014, and was required by a provision of the Act to approve or disapprove the program within 180 days (other than the use of new or modified flight procedures for noise control). Failure to approve or disapprove such program within the 180-day period shall be deemed to be an approval of such program. The submitted program contained 9 noise abatement measures, 10 noise PO 00000 Frm 00087 Fmt 4703 Sfmt 4703 33799 mitigation/land use compatibility measures, and 3 administrative recommendations. The FAA completed its review and determined that the procedural and substantive requirements of the Act and FAR Part 150 have been satisfied. The overall program therefore, was approved by the FAA on May 29, 2014. Approval was granted for 19 measures. One measure was withdrawn so no action was required. Measure A–10 to address maintenance run-ups was previously disapproved in the 2002 NCP and continues to be disapproved. Measure M–2B for sound insulation of schools was approved as a continuation of a previously approved program but the sound insulation of the Highline Community College was disapproved for Airport Improvement Program funding as it is outside the newly revised noise remedy boundary. These determinations are set forth in detail in a Record of Approval signed by the Airports Division Manager, Northwest Mountain Region on May 29, 2014. The Record of Approval, as well as other evaluation materials and the documents comprising the submittal are available for review at the FAA office listed above and at the Airport Noise Office of the Seattle-Tacoma International Airport. The Record of Approval also will be available on-line at https://www.faa.gov/airports/ environmental/airport_noise/part_150/ states/. Issued in Renton, Washington, on June 3, 2014. Sarah P. Dalton, Manager, Airports Division, Northwest Mountain Region. [FR Doc. 2014–13684 Filed 6–11–14; 8:45 am] BILLING CODE 4910–13–P DEPARTMENT OF TRANSPORTATION National Highway Traffic Safety Administration [Docket No. NHTSA–2014–0062] ICD–10–CM/AIS Mapping Software National Highway Traffic Safety Administration (NHTSA), Department of Transportation (DOT). ACTION: Request for information. AGENCY: This notice announces NHTSA’s Request for Information (RFI) and comment on the potential development of a mapping software to translate the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Clinical Modification (ICD–10–CM) discharge diagnoses into Abbreviated Injury Scale SUMMARY: E:\FR\FM\12JNN1.SGM 12JNN1 rmajette on DSK7SPTVN1PROD with NOTICES 33800 Federal Register / Vol. 79, No. 113 / Thursday, June 12, 2014 / Notices (AIS) pre-dot codes, injury descriptors, and severity scores. NHTSA is issuing this RFI in collaboration with, and on behalf of, its member agencies within the DOT Traffic Records Coordinating Committee (DOT/TRCC), specifically the Federal Highway Administration (FHWA), the Federal Motor Carrier Safety Administration (FMCSA), and the Bureau of Transportation Statistics (BTS). Feedback and comments on any aspect of the RFI are welcome from all interested public, private, and academic entities. While all feedback is welcome, DOT is particularly interested in feedback on the questions provided in the last section of this RFI. DATES: Comments must be received no later than August 11, 2014. ADDRESSES: Comments: You may submit comments [identified by Docket Number NHTSA–2014–0062] by any of the following methods: • Internet: To submit comments electronically, go to the U.S. Government regulations Web site at https://www.regulations.gov. Follow the online instructions for submitting comments. • Fax: Written comments may be faxed to 202–493–2251. • Mail: Send comments to Docket Management Facility, U.S. Department of Transportation, 1200 New Jersey Avenue SE., West Building Ground Floor, Room W12–140, Washington, DC 20590. • Hand Delivery: If you plan to submit written comments by hand or courier, please do so at 1200 New Jersey Avenue SE., West Building Ground Floor, Room W12–140, Washington, DC between 9 a.m. and 5 p.m. Eastern Time, Monday through Friday, except federal holidays • You may call Docket Management at 1–800–647–5527. Instructions: For detailed instructions on submitting comments and additional information see the Comments heading of the Supplementary Information section of this document. Note that all comments received will be posted without change to https:// www.regulations.gov, including any personal information provided. Please see the Privacy Act heading in the SUPPLEMENTARY INFORMATION. FOR FURTHER INFORMATION CONTACT: For questions about the program discussed herein, contact John Kindelberger, Mathematical Statistician, Office of Data Acquisition, Room W53–446, 1200 New Jersey Avenue SE., Washington, DC 20590. Telephone: 202–366–4696. Email: john.kindelberger@dot.gov. VerDate Mar<15>2010 21:18 Jun 11, 2014 Jkt 232001 On January 16, 2009, the U.S. Department of Health and Human Services (HHS) published a final rule adopting ICD–10– CM to replace ICD–9–CM in transactions covered by the Health Insurance Portability Accountability Act (HIPAA). The deadline for adopting ICD–10–CM has been postponed several times but is currently scheduled to take place at some point after October 1, 2015 (https://www.cms.gov/Medicare/ Coding/ICD10/?redirect=/ icd10). The ‘‘Moving Ahead for Progress in the 21st Century’’ Act (MAP–21), signed into law on July 6, 2012, requires the FHWA to establish measures for State departments of transportation to assess and report numbers and rates per vehicle mile traveled of roadway fatalities and serious injuries. [§ 1203; 23 USC 150(c)]. In Notice of Proposed Rulemaking 79 FR 13845 (Mar. 11, 2014), which can be found at https:// www.regulation.gov, the FHWA recommends that States prepare themselves so that no later than January 1, 2020, all States use a medical record injury outcome reporting system that links injury outcomes from medical records to crash reports. The DOT seeks comments and information from the public sector, private sector, and academic communities concerning the potential development of ICD–10–CM/AIS mapping software that would address the issues described in this RFI. While comments are welcome on any area of the RFI, the DOT is particularly interested in responses to the questions listed below. Responders are reminded that feedback or comments on any aspect of this notice are welcome from all interested public, private, and academic entities. While all feedback is welcome, the DOT is particularly interested in feedback on the following questions. Respondents may respond, to some, all, or none of these specific questions: 1. Is there a need for a mapping tool that translates ICD–10–CM codes to the AIS standard? 2. Is there a need for an updated mapping tool that translates ICD–9–CM codes to the AIS standard? 3. Are any steps currently being taken to develop a mapping tool? 4. What capabilities should such a mapping tool possess? 5. What platforms should the mapping tool run on? 6. Should the mapping tool be nonproprietary? Injury data enables epidemiologists, researchers, and policymakers to better identify the severity of injuries in SUPPLEMENTARY INFORMATION: PO 00000 Frm 00088 Fmt 4703 Sfmt 4703 addition to where, when, and why they occur. This data is, however, frequently spread among discrete databases that are difficult to link to each other or to injury causation data. The ability to link these datasets together is thus critical to efforts to understand injury trends, set injury prevention priorities, identify high risk populations and geographic areas, and develop targeted injury prevention strategies. The DOT, however, is particularly interested in forging and maintaining links among vehicle crash and injury datasets as such links can provide more complete information and better understanding of crash outcomes. State trauma registry and hospital discharge databases are two of the more significant sources of injury data. Trauma registries are designed to collect large amounts of information about the most seriously injured patients and are not typically used for injury surveillance purposes on their own. Hospital discharge datasets are designed primarily to monitor hospital census, utilization, and financial information but record enough information—like diagnosis codes and external cause/Ecodes—to make them useful injury surveillance tools. In addition, the prehospital emergency medical services (EMS) patient care reports, compliant with the National EMS Information System (NEMSIS) Standard, may be helpful, as they can serve as good link between the crash data and hospital data. NEMSIS data is submitted to the state level by local EMS agencies, and the collective statewide data is submitted to the National EMS Database. The most effective linkage point at this time is at the State level. These datasets are generally coded using different methodologies. Trauma registries use the Abbreviated Injury Scale while hospitals and emergency departments use the International Statistical Classification of Diseases and Related Health Problems for diagnosis, reporting, and billing. The Abbreviated Injury Scale (AIS), developed by the Association for the Advancement of Automotive Medicine (AAAM), is an anatomically based, consensus derived, global severity scoring system that classifies each injury by body region according to its relative importance on a 6-point ordinal scale (1 = minor and 6 = maximal). The AIS is the basis for the Injury Severity Score (ISS) calculation of the multiply injured patient. The AIS is protected by copyright, and both individual use and site licenses can be purchased from AAAM (https://www.aaam.org/aboutais.html). E:\FR\FM\12JNN1.SGM 12JNN1 rmajette on DSK7SPTVN1PROD with NOTICES Federal Register / Vol. 79, No. 113 / Thursday, June 12, 2014 / Notices The maximum AIS (MAIS) severity level is a recognized person-level injury severity indicator. For example, the Organization for Economic CoOperation and Development’s International Traffic Safety Data and Analysis Group (IRTAD) has recommended that MAIS of level three or higher be used as the standard for a seriously injured person in a motor vehicle crash (https:// www.internationaltransportforum.org/ irtadpublic/pdf/Road-CasualtiesWeb.pdf). Maintained by the World Health Organization (WHO), the International Statistical Classification of Diseases and Related Health Problems (ICD) is the international standard diagnostic tool for epidemiology, health management, and clinical purposes. While a version of the ninth revision, ICD–9–CM, is currently still widely used in the US, a replacement based on the tenth revision, ICD–10–CM, has been developed by a National Center for Health Statistics (NCHS) Technical Advisory Panel following extensive consultation with physician groups, clinical coders, and others to assure clinical accuracy and utility (https://www.cdc.gov/nchs/icd/ icd10cm.htm). In the early 90’s researchers at Johns Hopkins University developed a software tool (ICDMAP) that allowed analysts to generate a Maximum AIS (MAIS) or an Injury Severity Score (ISS) for each injured patient in the hospital discharge database using the ICD–9–CM diagnosis codes of each patient’s record. The ICDMAP enabled statewide performance measurement by MAIS and allowed analysts to associate the severity outcomes to with crash, vehicle, and roadway circumstances for planning and/or evaluation of countermeasures. While the ICDMAP-generated results are not as precise as those derived by clinicians in trauma registries, this approach has been validated and yields good sensitivity in estimating severity for studying the larger universe of injury hospitalizations. Translating ICD codes to AIS allows all crash-involved injuries to be compiled and analyzed in terms of AIS and MAIS severity. When linked to causal information—State crash databases, for example—ICD codes can be used to improve measurement of crash-related injury severity. There is not, however, currently any known software or service capable of translating between ICD–10–CM and AIS. Once hospitals transition to the ICD–10–CM, combining these two sets of injury data will no longer be possible, and analyses will be less complete and less useful. Significant effort is needed VerDate Mar<15>2010 21:18 Jun 11, 2014 Jkt 232001 to develop a mapping tool that will enable mapping of ICD–10–CM diagnosis codes with the corresponding AIS severity codes. RFI Guidelines Responses to this notice are not offers and cannot be accepted by the Government to form a binding contract or issue a grant. Information obtained as a result of this RFI may be used by the Government for program planning on a non-attribution basis. This RFI notice is NOT a solicitation for proposals, applications, proposal abstracts, or quotations. This RFI notice is not to be construed as a commitment on the part of the Government to award a contract or grant, nor does the Government intend to directly pay for any information or responses submitted as a result of this RFI notice. Comments How do I prepare and submit comments? Your comments must be written and in English. To ensure that your comments are correctly filed in the Docket, please include the Docket number of this document (NHTSA– 2014–0062) in your comments. Your primary comments must not be more than 15 pages long (49 CFR 553.21). However, you may attach additional documents to your primary comments. There is no limit on the length of the attachments. Please submit one copy of your comments, including the attachments, to Docket Management at the address given above under ADDRESSES. Please note that pursuant to the Data Quality Act, in order for substantive data to be relied upon and used by the agency, it must meet the information quality standards set forth in the OMB and DOT Data Quality Act guidelines. Accordingly, we encourage you to consult the guidelines in preparing your comments. OMB’s guidelines may be accessed at https://www.whitehouse.gov/ omb/fedreg_reproducible. DOT’s guidelines may be accessed at https:// www.rita.dot.gov/bts/sites/ rita.dot.gov.bts/files/subject_areas/ statistical_policy_and_research/data_ quality_guidelines/. Privacy Act: Anyone is able to search the electronic form of all comments received into any of our dockets by the name of the individual submitting the comment (or signing the comment, if submitted on behalf of an association, business, labor union, etc.). You may review DOT’s complete Privacy Act Statement in the Federal Register published on April 11, 2000 (65 FR PO 00000 Frm 00089 Fmt 4703 Sfmt 4703 33801 19477–78) or you may visit https:// www.regulations.gov. How can I be sure that my comments were received? If you wish Docket Management to notify you upon its receipt of your comments, enclose a self-addressed, stamped postcard in the envelope containing your comments. Upon receiving your comments, Docket Management will return the postcard by mail. You may also periodically access https://www.regulations.gov and enter the number for this docket (NHTSA– 2014–0062) to see if your comments are on line. How do I submit confidential business information? If you wish to submit any information under a claim of confidentiality, you should submit three copies of your complete submission, including the information you claim to be confidential business information, to the Chief Counsel, NHTSA, U.S. Department of Transportation, 1200 New Jersey Avenue SE., Washington, DC 20590. In addition, you should submit a copy, from which you have deleted the claimed confidential business information, to Docket Management at the address given above under ADDRESSES. When you send a comment containing information claimed to be confidential business information, you should include a cover letter setting forth the information specified in our confidential business information regulation (49 CFR Part 512.) Will the agency consider late comments? In our response, we will consider all comments that Docket Management receives before the close of business on the comment closing date indicated above under DATES. To the extent possible, we will also consider comments that Docket Management receives after that date. How can I read the comments submitted by other people? You may read the comments received by Docket Management at the address given above under ADDRESSES. The hours of the Docket are indicated above in the same location. You may also see the comments on the Internet. To read the comments on the Internet, take the following steps: (1) Go to the Federal Docket Management System (FDMS) at https:// www.regulations.gov. (2) FDMS provides two basic methods of searching to retrieve dockets and docket materials that are available in the E:\FR\FM\12JNN1.SGM 12JNN1 33802 Federal Register / Vol. 79, No. 113 / Thursday, June 12, 2014 / Notices system: (a) ‘‘Quick Search’’ to search using a full-text search engine, or (b) ‘‘Advanced Search,’’ which displays various indexed fields such as the docket name, docket identification number, phase of the action, initiating office, date of issuance, document title, document identification number, type of document, Federal Register reference, CFR citation, etc. Each data field in the advanced search may be searched independently or in combination with other fields, as desired. Each search yields a simultaneous display of all available information found in FDMS that is relevant to the requested subject or topic. (3) You may download the comments. However, since the comments are imaged documents, instead of word processing documents, the ‘‘pdf’’ versions of the documents are word searchable. Please note that even after the comment closing date, we will continue to file relevant information in the Docket as it becomes available. Further, some people may submit late comments. Accordingly, we recommend that you periodically check the Docket for new material. Authority: 49 U.S.C. 30111, 30181–83 delegation of authority at 49 CFR 1.95 and 501.8. Terry Shelton, Associate Administrator for the National Center for Statistics and Analysis. [FR Doc. 2014–13727 Filed 6–11–14; 8:45 am] BILLING CODE 4910–59–P DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket No. PHMSA–2014–0085; Notice 14–9] Hazardous Materials: Notice of Availability of Draft Environmental Assessment and Request for Public Comment for a Special Permit Relating to the Transport of Precursor Chemicals From Syria in Port Arthur, Texas Pipeline and Hazardous Materials Safety Administration, DOT. ACTION: Notice of Availability and Request for Public Comment. rmajette on DSK7SPTVN1PROD with NOTICES AGENCY: This notice informs the public of the availability of a draft environmental assessment in support of a special permit application that would allow offloading and the transport by highway of hazardous materials in nonDOT Specification Packaging in Port SUMMARY: VerDate Mar<15>2010 21:18 Jun 11, 2014 Jkt 232001 Arthur, Texas. PHMSA requests public comment on the draft environmental assessment. DATES: PHMSA will accept comments on the draft environmental assessment until close of business June 23, 2014. ADDRESSES: Comments may be submitted in the following ways: Federal eRulemaking Portal: www.regulations.gov. Follow instructions for submitting comments. Mail: Docket Management System: U.S. Department of Transportation, Docket Operations, M–30, West Building Ground Floor, Room W12–140, 1200 New Jersey Avenue SE., Washington, DC 20590. If you submit your comments by mail, please submit two copies. To receive confirmation that PHMSA has received your comments, please include a self-addressed stamped postcard. Hand Delivery: Docket Management System: U.S. Department of Transportation, Docket Operations, M–30, West Building Ground Floor, Room W12–140, 1200 New Jersey Avenue SE., Washington, DC 20590 between 9 a.m. and 5 p.m., Monday through Friday, except Federal holidays. Fax: Docket Management System: U.S. Department of Transportation, Docket Operations, 202–493–2251. Instructions: Include the agency name and docket number PHMSA–2014–0085 (Notice 14–9) at the beginning of your comment. Please note that all comments received will be posted without change to www.regulations.gov, including any personal information provided. Privacy Act: Anyone is able to search the electronic form of any written communications and comments received into any of our dockets by the name of the individual submitting the document (or signing the document, if submitted on behalf of an association, business, labor union, etc.). You may review DOT’s complete Privacy Act Statement in the Federal Register, 65 FR 19477, April 11, 2000, or you may visit www.regulations.gov. Docket: For access to the docket to read the draft environmental assessment or comments received, go to www.regulations.gov or DOT’s Docket Operations Office (see hand delivery address above). FOR FURTHER INFORMATION CONTACT: Alice Koethe, Attorney, Pipeline and Hazardous Materials Safety Administration, Office of the Chief Counsel, 1200 New Jersey Avenue SE., Washington, DC 20590; 202–366–7207; alice.koethe@dot.gov. SUPPLEMENTARY INFORMATION: In accordance with the National Environmental Policy Act (NEPA), 42 PO 00000 Frm 00090 Fmt 4703 Sfmt 4703 U.S.C. 4321–4347, the Council on Environmental Quality (CEQ) NEPA implementing regulations, 40 CFR parts 1500–1508, and DOT Order 5610.1C, Procedures for Considering Environmental Impacts, the Pipeline and Hazardous Materials Safety Administration (PHMSA) has prepared a draft environmental assessment (Draft EA) for an application for a Special Permit/Requested Relief of Certain Packaging Requirements for Highway Motor Vehicles relating to the transport of precursor chemicals from Syria in Port Arthur, Texas. PHMSA serves as the lead agency for the Draft EA, and the U.S. Coast Guard, U.S. Department of Commerce, and the U.S. Department of the Treasury serve as cooperating agencies. The Organisation for the Prohibition of Chemical Weapons (OPCW) and the Department of State have informed PHMSA that an operation is underway to eliminate Syria’s chemical weapons program, including the removal of 19 different chemicals from Syria used as precursors to chemical weapons. Five of these chemicals are bound for Port Arthur, Texas, where they will be destroyed and disposed (the ‘‘operation’’). These five chemicals have been/are to be transferred to a Norwegian sovereign immune cargo vessel, which is ultimately bound for Port Arthur, Texas. There are no explosives or munitions associated with the chemicals, and these chemicals have not been assembled into weapons or mixed for weapons purposes. OPCW informed PHMSA that these five chemicals are being shipped in 16 20ft ISO maritime shipping containers in various packagings. However, due to incomplete information from international officials and questions about loading, PHMSA cannot confirm that the UN packagings containing the chemicals are compliant with the Hazardous Materials Regulations, 49 CFR Parts 171–180 (HMR). Veolia is the private company that the OPCW selected for the destruction and disposal of the chemicals. Upon arrival at the Port of Port Arthur, Veolia’s subcontractor, Bed Rock Inc, d/b/a/Tri State Motor Transit Company (Tri State), will transport the chemicals 15 miles overland from the Port of Port Arthur to Veolia’s approved disposal site in Port Arthur, Texas. Due to the lack of compliance assurance with the HMR, Veolia has requested a special permit (SP) from PHMSA. PHMSA has prepared the Draft EA analyzing the environmental impacts of four alternatives: (1) The no action alternative, where PHMSA does not issue a SP because the chemicals do not E:\FR\FM\12JNN1.SGM 12JNN1

Agencies

[Federal Register Volume 79, Number 113 (Thursday, June 12, 2014)]
[Notices]
[Pages 33799-33802]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-13727]


-----------------------------------------------------------------------

DEPARTMENT OF TRANSPORTATION

National Highway Traffic Safety Administration

[Docket No. NHTSA-2014-0062]


ICD-10-CM/AIS Mapping Software

AGENCY: National Highway Traffic Safety Administration (NHTSA), 
Department of Transportation (DOT).

ACTION: Request for information.

-----------------------------------------------------------------------

SUMMARY: This notice announces NHTSA's Request for Information (RFI) 
and comment on the potential development of a mapping software to 
translate the International Statistical Classification of Diseases and 
Related Health Problems, 10th Revision, Clinical Modification (ICD-10-
CM) discharge diagnoses into Abbreviated Injury Scale

[[Page 33800]]

(AIS) pre-dot codes, injury descriptors, and severity scores. NHTSA is 
issuing this RFI in collaboration with, and on behalf of, its member 
agencies within the DOT Traffic Records Coordinating Committee (DOT/
TRCC), specifically the Federal Highway Administration (FHWA), the 
Federal Motor Carrier Safety Administration (FMCSA), and the Bureau of 
Transportation Statistics (BTS). Feedback and comments on any aspect of 
the RFI are welcome from all interested public, private, and academic 
entities. While all feedback is welcome, DOT is particularly interested 
in feedback on the questions provided in the last section of this RFI.

DATES: Comments must be received no later than August 11, 2014.

ADDRESSES:
    Comments: You may submit comments [identified by Docket Number 
NHTSA-2014-0062] by any of the following methods:
     Internet: To submit comments electronically, go to the 
U.S. Government regulations Web site at https://www.regulations.gov. 
Follow the online instructions for submitting comments.
     Fax: Written comments may be faxed to 202-493-2251.
     Mail: Send comments to Docket Management Facility, U.S. 
Department of Transportation, 1200 New Jersey Avenue SE., West Building 
Ground Floor, Room W12-140, Washington, DC 20590.
     Hand Delivery: If you plan to submit written comments by 
hand or courier, please do so at 1200 New Jersey Avenue SE., West 
Building Ground Floor, Room W12-140, Washington, DC between 9 a.m. and 
5 p.m. Eastern Time, Monday through Friday, except federal holidays
     You may call Docket Management at 1-800-647-5527.
    Instructions: For detailed instructions on submitting comments and 
additional information see the Comments heading of the Supplementary 
Information section of this document. Note that all comments received 
will be posted without change to https://www.regulations.gov, including 
any personal information provided. Please see the Privacy Act heading 
in the SUPPLEMENTARY INFORMATION.

FOR FURTHER INFORMATION CONTACT: For questions about the program 
discussed herein, contact John Kindelberger, Mathematical Statistician, 
Office of Data Acquisition, Room W53-446, 1200 New Jersey Avenue SE., 
Washington, DC 20590. Telephone: 202-366-4696. Email: 
john.kindelberger@dot.gov.

SUPPLEMENTARY INFORMATION: On January 16, 2009, the U.S. Department of 
Health and Human Services (HHS) published a final rule adopting ICD-10-
CM to replace ICD-9-CM in transactions covered by the Health Insurance 
Portability Accountability Act (HIPAA). The deadline for adopting ICD-
10-CM has been postponed several times but is currently scheduled to 
take place at some point after October 1, 2015 (https://www.cms.gov/Medicare/Coding/ICD10/?redirect=/icd10).
    The ``Moving Ahead for Progress in the 21st Century'' Act (MAP-21), 
signed into law on July 6, 2012, requires the FHWA to establish 
measures for State departments of transportation to assess and report 
numbers and rates per vehicle mile traveled of roadway fatalities and 
serious injuries. [Sec.  1203; 23 USC 150(c)]. In Notice of Proposed 
Rulemaking 79 FR 13845 (Mar. 11, 2014), which can be found at https://www.regulation.gov, the FHWA recommends that States prepare themselves 
so that no later than January 1, 2020, all States use a medical record 
injury outcome reporting system that links injury outcomes from medical 
records to crash reports.
    The DOT seeks comments and information from the public sector, 
private sector, and academic communities concerning the potential 
development of ICD-10-CM/AIS mapping software that would address the 
issues described in this RFI. While comments are welcome on any area of 
the RFI, the DOT is particularly interested in responses to the 
questions listed below. Responders are reminded that feedback or 
comments on any aspect of this notice are welcome from all interested 
public, private, and academic entities. While all feedback is welcome, 
the DOT is particularly interested in feedback on the following 
questions. Respondents may respond, to some, all, or none of these 
specific questions:
    1. Is there a need for a mapping tool that translates ICD-10-CM 
codes to the AIS standard?
    2. Is there a need for an updated mapping tool that translates ICD-
9-CM codes to the AIS standard?
    3. Are any steps currently being taken to develop a mapping tool?
    4. What capabilities should such a mapping tool possess?
    5. What platforms should the mapping tool run on?
    6. Should the mapping tool be non-proprietary?
    Injury data enables epidemiologists, researchers, and policymakers 
to better identify the severity of injuries in addition to where, when, 
and why they occur. This data is, however, frequently spread among 
discrete databases that are difficult to link to each other or to 
injury causation data. The ability to link these datasets together is 
thus critical to efforts to understand injury trends, set injury 
prevention priorities, identify high risk populations and geographic 
areas, and develop targeted injury prevention strategies. The DOT, 
however, is particularly interested in forging and maintaining links 
among vehicle crash and injury datasets as such links can provide more 
complete information and better understanding of crash outcomes.
    State trauma registry and hospital discharge databases are two of 
the more significant sources of injury data. Trauma registries are 
designed to collect large amounts of information about the most 
seriously injured patients and are not typically used for injury 
surveillance purposes on their own. Hospital discharge datasets are 
designed primarily to monitor hospital census, utilization, and 
financial information but record enough information--like diagnosis 
codes and external cause/E-codes--to make them useful injury 
surveillance tools. In addition, the pre-hospital emergency medical 
services (EMS) patient care reports, compliant with the National EMS 
Information System (NEMSIS) Standard, may be helpful, as they can serve 
as good link between the crash data and hospital data. NEMSIS data is 
submitted to the state level by local EMS agencies, and the collective 
statewide data is submitted to the National EMS Database. The most 
effective linkage point at this time is at the State level.
    These datasets are generally coded using different methodologies. 
Trauma registries use the Abbreviated Injury Scale while hospitals and 
emergency departments use the International Statistical Classification 
of Diseases and Related Health Problems for diagnosis, reporting, and 
billing.
    The Abbreviated Injury Scale (AIS), developed by the Association 
for the Advancement of Automotive Medicine (AAAM), is an anatomically 
based, consensus derived, global severity scoring system that 
classifies each injury by body region according to its relative 
importance on a 6-point ordinal scale (1 = minor and 6 = maximal). The 
AIS is the basis for the Injury Severity Score (ISS) calculation of the 
multiply injured patient. The AIS is protected by copyright, and both 
individual use and site licenses can be purchased from AAAM (https://www.aaam.org/about-ais.html).

[[Page 33801]]

    The maximum AIS (MAIS) severity level is a recognized person-level 
injury severity indicator. For example, the Organization for Economic 
Co-Operation and Development's International Traffic Safety Data and 
Analysis Group (IRTAD) has recommended that MAIS of level three or 
higher be used as the standard for a seriously injured person in a 
motor vehicle crash (https://www.internationaltransportforum.org/irtadpublic/pdf/Road-Casualties-Web.pdf).
    Maintained by the World Health Organization (WHO), the 
International Statistical Classification of Diseases and Related Health 
Problems (ICD) is the international standard diagnostic tool for 
epidemiology, health management, and clinical purposes. While a version 
of the ninth revision, ICD-9-CM, is currently still widely used in the 
US, a replacement based on the tenth revision, ICD-10-CM, has been 
developed by a National Center for Health Statistics (NCHS) Technical 
Advisory Panel following extensive consultation with physician groups, 
clinical coders, and others to assure clinical accuracy and utility 
(https://www.cdc.gov/nchs/icd/icd10cm.htm).
    In the early 90's researchers at Johns Hopkins University developed 
a software tool (ICDMAP) that allowed analysts to generate a Maximum 
AIS (MAIS) or an Injury Severity Score (ISS) for each injured patient 
in the hospital discharge database using the ICD-9-CM diagnosis codes 
of each patient's record. The ICDMAP enabled statewide performance 
measurement by MAIS and allowed analysts to associate the severity 
outcomes to with crash, vehicle, and roadway circumstances for planning 
and/or evaluation of countermeasures.
    While the ICDMAP-generated results are not as precise as those 
derived by clinicians in trauma registries, this approach has been 
validated and yields good sensitivity in estimating severity for 
studying the larger universe of injury hospitalizations. Translating 
ICD codes to AIS allows all crash-involved injuries to be compiled and 
analyzed in terms of AIS and MAIS severity. When linked to causal 
information--State crash databases, for example--ICD codes can be used 
to improve measurement of crash-related injury severity.
    There is not, however, currently any known software or service 
capable of translating between ICD-10-CM and AIS. Once hospitals 
transition to the ICD-10-CM, combining these two sets of injury data 
will no longer be possible, and analyses will be less complete and less 
useful. Significant effort is needed to develop a mapping tool that 
will enable mapping of ICD-10-CM diagnosis codes with the corresponding 
AIS severity codes.

RFI Guidelines

    Responses to this notice are not offers and cannot be accepted by 
the Government to form a binding contract or issue a grant. Information 
obtained as a result of this RFI may be used by the Government for 
program planning on a non-attribution basis. This RFI notice is NOT a 
solicitation for proposals, applications, proposal abstracts, or 
quotations. This RFI notice is not to be construed as a commitment on 
the part of the Government to award a contract or grant, nor does the 
Government intend to directly pay for any information or responses 
submitted as a result of this RFI notice.

Comments

How do I prepare and submit comments?

    Your comments must be written and in English. To ensure that your 
comments are correctly filed in the Docket, please include the Docket 
number of this document (NHTSA-2014-0062) in your comments.
    Your primary comments must not be more than 15 pages long (49 CFR 
553.21). However, you may attach additional documents to your primary 
comments. There is no limit on the length of the attachments.
    Please submit one copy of your comments, including the attachments, 
to Docket Management at the address given above under ADDRESSES.
    Please note that pursuant to the Data Quality Act, in order for 
substantive data to be relied upon and used by the agency, it must meet 
the information quality standards set forth in the OMB and DOT Data 
Quality Act guidelines. Accordingly, we encourage you to consult the 
guidelines in preparing your comments. OMB's guidelines may be accessed 
at https://www.whitehouse.gov/omb/fedreg_reproducible. DOT's guidelines 
may be accessed at https://www.rita.dot.gov/bts/sites/rita.dot.gov.bts/files/subject_areas/statistical_policy_and_research/data_quality_guidelines/.
    Privacy Act: Anyone is able to search the electronic form of all 
comments received into any of our dockets by the name of the individual 
submitting the comment (or signing the comment, if submitted on behalf 
of an association, business, labor union, etc.). You may review DOT's 
complete Privacy Act Statement in the Federal Register published on 
April 11, 2000 (65 FR 19477-78) or you may visit https://www.regulations.gov.

How can I be sure that my comments were received?

    If you wish Docket Management to notify you upon its receipt of 
your comments, enclose a self-addressed, stamped postcard in the 
envelope containing your comments. Upon receiving your comments, Docket 
Management will return the postcard by mail. You may also periodically 
access https://www.regulations.gov and enter the number for this docket 
(NHTSA-2014-0062) to see if your comments are on line.

How do I submit confidential business information?

    If you wish to submit any information under a claim of 
confidentiality, you should submit three copies of your complete 
submission, including the information you claim to be confidential 
business information, to the Chief Counsel, NHTSA, U.S. Department of 
Transportation, 1200 New Jersey Avenue SE., Washington, DC 20590. In 
addition, you should submit a copy, from which you have deleted the 
claimed confidential business information, to Docket Management at the 
address given above under ADDRESSES. When you send a comment containing 
information claimed to be confidential business information, you should 
include a cover letter setting forth the information specified in our 
confidential business information regulation (49 CFR Part 512.)

Will the agency consider late comments?

    In our response, we will consider all comments that Docket 
Management receives before the close of business on the comment closing 
date indicated above under DATES. To the extent possible, we will also 
consider comments that Docket Management receives after that date.

How can I read the comments submitted by other people?

    You may read the comments received by Docket Management at the 
address given above under ADDRESSES. The hours of the Docket are 
indicated above in the same location.
    You may also see the comments on the Internet. To read the comments 
on the Internet, take the following steps:
    (1) Go to the Federal Docket Management System (FDMS) at https://www.regulations.gov.
    (2) FDMS provides two basic methods of searching to retrieve 
dockets and docket materials that are available in the

[[Page 33802]]

system: (a) ``Quick Search'' to search using a full-text search engine, 
or (b) ``Advanced Search,'' which displays various indexed fields such 
as the docket name, docket identification number, phase of the action, 
initiating office, date of issuance, document title, document 
identification number, type of document, Federal Register reference, 
CFR citation, etc. Each data field in the advanced search may be 
searched independently or in combination with other fields, as desired. 
Each search yields a simultaneous display of all available information 
found in FDMS that is relevant to the requested subject or topic.
    (3) You may download the comments. However, since the comments are 
imaged documents, instead of word processing documents, the ``pdf'' 
versions of the documents are word searchable.
    Please note that even after the comment closing date, we will 
continue to file relevant information in the Docket as it becomes 
available. Further, some people may submit late comments. Accordingly, 
we recommend that you periodically check the Docket for new material.

    Authority: 49 U.S.C. 30111, 30181-83 delegation of authority at 
49 CFR 1.95 and 501.8.

Terry Shelton,
Associate Administrator for the National Center for Statistics and 
Analysis.
[FR Doc. 2014-13727 Filed 6-11-14; 8:45 am]
BILLING CODE 4910-59-P
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