Crosswalk of Changes

Original Form	Updated Form	Current/Question item	Requested Change
Attachment E - tab for "Jurisdictions_Rpt_QuartED" AND Attachment E - tab for "Jurisdictions_Rpt_QuartHOSP"	Attachment E - tab for "Jurisdictions_Rpt_ED_dis" AND Attachment E - tab for "Jurisdictions_Rpt_HOSP_dis"	- rows for jurisdiction by year by month by manner by age by sex by race by ethnicity for eight drug overdose indicators (all drug, all opioid, heroin, all stimulant, fentanyl, cocaine, benzodiazepines, and methamphetamine) and total ED visits OR total hospitalization visits	- rows for jurisdiction by year by month by age by sex by race by ethnicity for total ED visits OR total hospitalization visits
Attachment E - tab for "County_Rpt_QuartED_unintent" AND Attachment E - tab for "County_Rpt_QuartHOSP_unintent"	Attachment E - tab for "County_Rpt_ED_dis" AND Attachment E - tab for "County_Rpt_HOSP_dis"	- rows for jurisdiction by county name by county FIPS code by year by month for eight drug overdose indicators (all drug, all opioid, heroin, all stimulant, fentanyl, cocaine, benzodiazepines, and methamphetamine) and total ED visits OR total hospitalization visits	- rows for jurisdiction by county name by county FIPS code by year by month for total ED visits OR total hospitalization visits
Attachment E - tab for "County_Rpt_QuartED_selfharm"	N/A (remove this tab)	- rows for jurisdiction by county name by county FIPS code by year by month for eight drug overdose indicators (all drug, all opioid, heroin, all stimulant, fentanyl, cocaine, benzodiazepines, and methamphetamine) and total ED visits	This tab will be removed since recipients will no longer be required to submit overdose data stratified by intention. Overdose intent will be available for analysis in the line-level data because the discharge diagnosis codes provided will include this level of detail.
Attachment E - tab for "County_Rpt_QuartHOSP_selfharm"	N/A (remove this tab)	- rows for jurisdiction by county name by county FIPS code by year by month for eight drug overdose indicators (all drug, all opioid, heroin, all stimulant, fentanyl, cocaine, benzodiazepines, and methamphetamine) and total hospitalization visits	This tab will be removed since recipients will no longer be required to submit overdose data stratified by intention. Overdose intent will be available for analysis in the line-level data because the discharge diagnosis codes provided will include this level of detail.
N/A	Attachment E - tab for "Line_Level_Data"	N/A	Rows for line-level, deidentified data on all ED/hospital visits with a drug overdose code (i.e., with an ICD-10-CM code T36 through T50) will go in this tab. This includes drug overdoses of all intents, diagnoses (i.e., not just principal) and encounters (i.e., initial, subsequent, and sequelae). An indicator variable will indicate whether the visit is an ED or hospitalization visit. The line-level data will include variables from the standard UB-04/CMS 1450 billing form, in addition to race/ethnicity, where available (see Att E, template for collecting discharge data). If race and ethnicity data are unavailable at the time of the application or if improvements are ongoing, respondents should describe efforts to add this variable to the data collection or improve data quality to meet NOFO requirements. An additional data dictionary tab for line-level data, called "Data_Dict_Line_Level," was added.