Emergency Text
Every inpatient hospital shall submit a complete filing of each patient level data element listed in the table in this section for each hospital inpatient, including a separate record for each infant, if applicable. Most of these data elements are currently collected from a Uniform Billing Form located in the latest publication of the Uniform Billing Manual prepared by the National Uniform Billing Committee. The Uniform Billing Form and the Uniform Billing Manual are located on the National Uniform Billing Committee's website at www.nubc.org. The Uniform Billing Manual provides a detailed field description and any special instruction pertaining to that element. An asterisk (*) indicates when the required data element is either not on the billing form or in the Uniform Billing Manual. The instructions provided under that particular data element should then be followed. Inpatient hospitals that submit patient level data directly to the board or the nonprofit organization shall submit it in an electronic data format.
Data Element |
1. Hospital identifier.* |
2. Attending physician identifier. |
3. Other physician identifier. |
4. Payor identifier. |
5. Employer identifier. |
6. Patient identifier.* |
7a. Patient sex. |
7b. Race code.* |
0 = White |
1 = Black |
2 = Other |
3 = Asian |
4 = American Indian |
5 = White Hispanic |
6 = Black Hispanic |
7c. Date of birth. |
7d. Street address, city or county, and zip code. |
7e. Employment status code. |
7f. Patient status (i.e., discharge). |
7g. Birth weight (for infants).* |
8a. Admission type. |
8b. Admission source. |
8c. Admission date. |
8d. Admission hour. |
8e. Admission diagnosis code. |
9a. Discharge date. |
10. Principal diagnosis code. |
11. External cause of injury code (E-code). |
12. Co-morbid conditions existing but not treated. |
13. Principal procedure code and date. |
14. Revenue code (up to 23). |
15. Total charges (by revenue code category or by HCPCS code). |
16. Legal Status. Enter the legal status of the admission. Legal status applies to voluntary or involuntary psychiatric admissions of minors and adults.. 1= §16.1-338 Parental admission of minors < 14 and nonobjecting minors 14 years of age or older 2=§16.1-339 Parental admission of objecting minor 14 years of age or older 3=§16.1-340.1 Involuntary TDO (minor) 4=§16.1-345 Involuntary commitment (minor) 5=§37.2-805 Voluntary admission (adult) 6=§37.2-809 Involuntary TDO (adult) 7=§37.2-904 Sexually violent predators (prisoners or defendants) |