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Appendix V V-Edited Outpatient Output File Description

FILE NAME:  Edited Outpatient DATE:  07/2009
FILE SORT SEQUENCE:  See Note at end RECORD LENGTH:  2000
SOURCE OF DATA:  Outpatient Input
DATA ELEMENT POSITION FIELD
NO. NAME FROM TO SIZE TYPE
Record Length 1 2000 2000 REC
1# SPARCS Region 1 2 2 A/N
2# SPARCS Identification Number 3 7 5 A/N
3# Patient Control Number 8 27 20 A/N
4# Medical Record Number 28 44 17 A/N
5# Admission Date (CCYYMMDD) 45 52 8 NUM
6# Discharge Date (CCYYMMDD) 53 60 8 NUM
7# Record Sequence Number 61 62 2 NUM
8# Record Sequence Count 63 64 2 NUM
9 Patient Sex 65 65 1 A/N
10 Patient Birth Date (CCYYMMDD) 66 73 8 NUM
11 Filler 74 75 2 A/N
12 Admission Hour 76 77 2 NUM
13 Filler 78 93 16 A/N
14# Discharge Hour 94 95 2 NUM
15 Filler 96 112 17 A/N
16 New York State Patient Status or Disposition 113 114 2 A/N
17 Filler 115 139 25 A/N
18 Patient Race 140 141 2 A/N
19 Patient Ethnicity 142 142 1 A/N
20 Filler 143 143 1 A/N
21 Expected Principal Reimbursement 144 145 2 A/N
22 Filler 146 149 4 A/N
23 Patient Residence Address-Address Line 1 150 167 18 A/N
24 Patient Residence Address-Address Line 2 168 185 18 A/N
25 Patient City 186 200 15 A/N
26 Patient County Code 201 202 2 A/N
27 Patient State 203 204 2 A/N
28 Patient Postal Service Zip Code and Extension Code 205 213 9 A/N
Source of Payment Information Group Definition (Occurs 6) 214 609 396 A/N
29* Source of Payment Code 214 214 1 A/N
30* Filler 215 233 19 A/N
31* Payer Identification Number 234 238 5 A/N
X12 Source of Payment Code 239 240 2 A/N
32* Filler 241 258 18 A/N
33* Provider Identification Number 259 271 13 A/N
34* Filler 272 279 8 A/N
35  Filler 610 613 4 A/N
36  Type of Bill 614 616 3 A/N
37  Transaction Code 617 617 1 A/N
38  Accident Related Code 618 619 2 A/N
39  Accident Related Date (CCYYMMDD) 620 627 8 A/N
40  Filler 628 661 34 A/N
Outpatient Ancillary Services Information Group Definition (Occurs 20) 662 1321 660 A/N
41* Outpatient Ancillary Revenue Code 662 665 4 A/N
42* Procedure Code-CPT4/HCPCS 666 670 5 A/N
43* Procedure Code-CPT4/HCPCS-Modifier 1 671 672 2 A/N
44* Procedure Code-CPT4/HCPCS-Modifier 2 673 674 2 A/N
45* Outpatient Ancillary Total Charge 675 684 10 NUM
46* Outpatient Ancillary Total Non-Covered Charge 685 694 10 NUM
47  Procedure Time 1322 1324 3 A/N
48  Accident Hour 1325 1326 2 A/N
49  Principal/Primary Diagnosis Code 1327 1332 6 A/N
Other Diagnosis Information Group Definition (Occurs 14) 1333 1444 112 A/N
50* Other Diagnosis Code (1-14 1333 1338 6 A/N
51* Filler 1339 1340 2 A/N
52  Principal Procedure Code 1445 1451 7 A/N
53  Principal Procedure Date (CCYYMMDD) 1452 1459 8 A/N
Other Procedure Information Group Definition (Occurs 14) 1460 1669 210 A/N
54* Other Procedure Code (1-14) 1460 1466 7 A/N
55* Other Procedure Date (1-14) (CCYYMMDD) 1467 1474 8 A/N
56  Admitting/Patient Reason for Visit Diagnosis Code 1670 1675 6 A/N
57  External Cause-of-Injury Code 1676 1681 6 A/N
58  Place-of-Injury Code 1682 1687 6 A/N
59  Procedure Coding Method 1688 1688 1 A/N
60  Method of Anesthesia Used 1689 1690 2 A/N
61  Filler 1691 1700 10 A/N
62  Attending/Emergency Department Physician 1 State License Number 1701 1708 8 A/N
63  Operating/Emergency Department Physician 2 State License Number 1709 1716 8 A/N
64  Other/Emergency Department Physician 3 State License Number 1717 1724 8 A/N
65  Filler 1725 1744 20 A/N
66  Total Outpatient Ancillary Charges 1745 1754 10 NUM
67  Total Outpatient Ancillary Non-Covered Charges 1755 1764 10 NUM
68  Filler 1765 1792 28 A/N
69  Age 1793 1795 3 NUM
70  Filler 1796 1825 30 A/N
71  Date Processed (CCYYMMDD) 1826 1833 8 NUM
72  Log Number 1834 1839 6 A/N
73  SPARCS Collector Code 1840 1842 3 A/N
74  Filler 1843 1846 4 A/N
75  Unique Personal Identifier 1847 1856 10 A/N
76  Age Warning Flag 1857 1857 1 A/N
77  Filler 1858 1858 1 A/N
78  Residence Indicator 1859 1859 1 A/N
79  Filler 1860 1934 75 A/N
80  Emergency Department Indicator 1935 1935 1 A/N
Filler 1936 2000 65 A/N

Note:   The asterisk (*) in the Field Number column indicates that this data element is part of a group. The From and To Field Positions are the first iteration of the data elements in the Group. Please refer to the appropriate Information Group Definition for the field positions of the other iterations in the group.

Note:   The number sign (#) character in the Field Number column indicates that this data element is part of the sort key for the outpatient output master file. The sort key order is a combination of fields 1, 2, 3, 4, 5, 6, 7, 8, & 14.

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