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APPENDIX V V-SPARCS Outpatient Master File Description

NOTE:  Bolded and UPPER CASE are IDENTIFYING DATA ELEMENTS see SPARCS Data Access

FILE NAME:  SPARCS Outpatient Master File Description
FILE SORT SEQUENCE:  Record Key RECORD LENGTH:  3000
SOURCE OF DATA:  SPARCS Data Submissions
POSITION FIELD
DATA ELEMENT NAME FROM TO SIZE TYPE
RECORD LENGTH 1 3000 3000 REC
RECORD KEY (First 100 characters of both MAIN RECORD and SERVICE LINE DATA) 1 100 100 KEY
Facility Identifier 1 6 6 A/N
PATIENT CONTROL NUMBER 7 26 20 A/N
MEDICAL RECORD NUMBER 27 43 17 A/N
ADMISSION DATE 44 51 8 NUM
DISCHARGE DATE 52 59 8 NUM
Key Hour 60 61 2 A/N
Record Sequence Number 62 64 3 NUM
Record Sequence Count 65 67 3 NUM
Log Number 68 73 6 NUM
Transaction Code 74 74 1 A/N
Claim Type 75 75 1 A/N
Emergency Department Indicator 76 76 1 A/N
Date Processed 77 84 8 A/N
SPARCS Region 85 86 2 A/N
Claim ID 87 98 12 A/N
Key Area Filler 99 100 2 A/N
MAIN RECORD 101 300 2900
RECORD KEY (see definitions above) 1 100 100 KEY
Patient Sex 101 101 1 A/N
PATIENT BIRTH DATE 102 109 8 NUM
Patient Race 110 111 2 A/N
Patient Ethnicity 112 112 1 A/N
PATIENT RESIDENCE ADDRESS - ADDRESS LINE 1 113 130 18 A/N
PATIENT RESIDENCE ADDRESS - ADDRESS LINE 2 131 148 18 A/N
Patient City 149 163 15 A/N
Patient State 164 165 2 A/N
Patient Postal Service Zip Code and EXTENSION CODE 166 174 9 A/N
Patient County Code 175 176 2 NUM
Patient Age 177 179 3 NUM
Patient Age in Days 180 182 3 NUM
Patient Age Group 183 183 1 A/N
UNIQUE PERSONAL IDENTIFIER 184 193 10 A/N
STATEMENT COVERS PERIOD FROM DATE 194 201 8 NUM
STATEMENT COVERS PERIOD THRU DATE 202 209 8 NUM
Admission Hour 210 211 2 NUM
Discharge Hour 212 213 2 NUM
Patient Discharge Status 214 215 2 A/N
Type of Bill 216 218 3 A/N
Accident Related Code 219 220 2 A/N
ACCIDENT RELATED DATE 221 228 8 NUM
Method of Anesthesia Used 229 230 2 NUM
ATTENDING PHYSICIAN 1 STATE LICENSE NUMBER 231 238 8 A/N
OPERATING PHYSICIAN 2 STATE LICENSE NUMBER 239 246 8 A/N
OTHER PHYSICIAN 3 STATE LICENSE NUMBER 247 254 8 A/N
Age Warning Flag 255 255 1 A/N
Procedure Date Warning Flag 256 256 1 A/N
AMI Warning Flag 257 257 1 NUM
AMI Heart Rate 258 260 3 NUM
AMI BP Systolic 261 263 3 NUM
AMI BP Diastolic 264 266 3 NUM
Residence Indicator 267 267 1 A/N
Facility NPI 268 277 10 NUM
Same Day Discharge Indicator 278 278 1 A/N
Admit Weekday 279 281 3 A/N
Discharge Weekday 282 284 3 A/N
Newborn Flag 285 285 1 A/N
AIDS/HIV Flag 286 286 1 A/N
Abortion Flag 287 287 1 A/N
Diagnosis Data (8 Occurs 25X) 288 487 200 A/N
Diagnosis Code 7 A/N
Present on Admission Indicator 1 A/N
Admitting Diagnosis Code 488 494 7 A/N
External Cause-of-Injury Code 495 501 7 A/N
Place-of-Injury Code 502 508 7 A/N
Coding Method 509 509 1 A/N
CCS Diagnosis Category 510 512 3 A/N
CCS Procedure Category 513 515 3 A/N
Expected Principal Reimbursement 516 517 2 A/N
Source of Payment Typology 1 518 522 5 NUM
Source of Payment Typology 2 523 527 5 NUM
Source of Payment Typology 3 528 532 5 NUM
Source of Payment Information (43 Occurs 6X) 533 790 258 A/N
Source of Payment Code 1 A/N
Filler 19 A/N
Payor Identification Number 8 A/N
Claim Filing Indicator 2 A/N
Provider Identification Number 13 A/N
Total Charges 791 802 12 NUM
Total Non-Covered Charges 803 814 12 NUM
Filler 815 822 8 NUM
SPARCS Collector Code 823 825 3 NUM
Source File Type 826 826 1 NUM
Facility Name 827 896 70 A/N
Health Service Area Code 897 897 1 NUM
Hospital County Code 898 899 2 NUM
Operating Certificate Number 900 906 7 NUM
Filler 907 919 1 A/N
Race/Ethnicity Codes 920 1009 90 A/N
Race/Ethnicity Code 9 A/N
Patient ID 1010 1021 12 A/N
Common Area Filler 1022 1300 279 A/N
Operating Time 1301 1303 3 A/N
Accident Hour 1304 1305 2 A/N
Medicaid Rate Code 1306 1309 4 A/N
Service Class 1310 1310 1 A/N
Outpatient Area Filler 1311 1702 392 A/N
PFI Check Digit 1703 1703 1 A/N
ICD-9 Procedure Data (4 Occurs 15X) 1704 1763 60 NUM
Outpatient Archive Area Filler 1764 2100 337 A/N
Filler 2101 3000 900 A/N

SERVICE LINE DATA RECORDS
RECORD KEY (see definitions above) 1 100 100 KEY
Overflow Type = "OPREV" 101 105 5 A/N
Overflow Filler Area 106 120 15 A/N
Service Lines (64 occurs 45) 121 3000 2880 SERVICE LINE

SERVICE LINE - Overflow Type = "OPREV" (64)
Revenue Code 1 4 4 A/N
Revenue Type 5 5 1 A/N
HCPCS/CPT Procedure Code 6 10 5 A/N
Modifier 1 11 12 2 A/N
Modifier 2 13 14 2 A/N
Service Charge 15 24 10 NUM
Unit Type 25 25 2 A/N
Unit Quantity 27 34 8 NUM
Non-Covered Charge 35 44 10 NUM
Service Date 45 52 8 A/N
Pre-Admit Flag 53 53 1 A/N
Final APG Assignment 54 58 5 A/N
Final APG Type 59 60 2 A/N
Final APG Category 61 62 2 A/N
Service Line Filler 63 64 2 A/N