Outpatient Output Data Element Table of Contents

Select Data Element Number or Name for definitions, codes and values, and edit applications.

NOTE:  Bolded and UPPER CASE Data Elements are DENIABLE [see "Data Protection Review Board (DPRB)]

Number Name
1 SPARCS Region
2 SPARCS Identification Number
3 PATIENT CONTROL NUMBER
4 MEDICAL RECORD NUMBER
5 ADMISSION DATE/START OF CARE
6 AMBULATORY SURGERY SERVICE DATE (DISCHARGE DATE)
7 Record Sequence Number
8 Record Sequence Count
9 Patient Sex
10 PATIENT BIRTH DATE
11 Filler
12 Admission Hour/Emergency Visit Hour
13 Filler
14 Discharge Hour
15 Filler
16 New York State Patient Status or Disposition
17 Filler
18 Patient Race
19 Patient Ethnicity
20 Filler
21 Expected Principal Reimbursement
22 Filler
23 PATIENT RESIDENCE ADDRESS-ADDRESS LINE 1
24 PATIENT RESIDENCE ADDRESS-ADDRESS LINE 2
25 Patient City
26 Patient County Code
27 Patient State
28 Patient Postal Service Zip Code and EXTENSION
29-34 Source of Payment Information Group Definition
29 Source of Payment Code
30 Filler
31 Payer Identification Number
32 Filler
33 Provider Identification Number
34 Filler
35 Filler
36 Type of Bill
37 Transaction Code
38 ACCIDENT RELATED CODE
39 ACCIDENT RELATED DATE
40 Filler
41-46 Outpatient Ancillary Services Information Group Definition
41 Outpatient Ancillary Revenue Code
42 Procedure Code-CPT4/HCPCS
43 Procedure Code-CPT4/HCPCS-Modifier 1
44 Procedure Code-CPT4/HCPCS-Modifier 2
45 Outpatient Ancillary Total Charges
46 Outpatient Ancillary Total Non-Covered Charges
47 Operating Room Time
48 Accident Hour
49 Principal/Primary Diagnosis Code
50-51 Other Diagnosis Information Group Definition
50 Other Diagnosis Code 1-14
51 Filler
52 Principal Procedure Code
53 PRINCIPAL PROCEDURE DATE
54-55 Other Procedure Information Group Definition
54 Other Procedure Code 1-14
55 OTHER PROCEDURE DATE 1-14
56 Admitting/Patient Reason for Visit Diagnosis Code
57 External Cause-of-Injury Code
58 Place-of-Injury Code
59 Procedure Coding Method
60 Method of Anesthesia Used
61 Filler
62 ATTENDING/EMERGENCY DEPARTMENT PHYSICIAN 1 STATE LICENSE NUMBER
63 OPERATING/EMERGENCY DEPARTMENT PHYSICIAN 2 STATE LICENSE NUMBER
64 OTHER/EMERGENCY DEPARTMENT PHYSICIAN 3 STATE LICENSE NUMBER
65 Filler
66 Total Outpatient Ancillary Charges
67 Total Outpatient Ancillary Non-Covered Charges
68 Filler
69 Age
70 Filler
71 Date Processed
72 Log Number
73 SPARCS Collector Code
74 Filler
75 UNIQUE PERSONAL IDENTIFIER
76 Age Warning Flag
77 Filler
78 Residence Indicator
79 Filler
80 Emergency Department Indicator
81 Filler
Revised 09/2003