Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 186 - HEALTH REGISTRIES AND RELEASE OF INFORMATION
Chapter 6 - OUTPATIENT SURGICAL PROCEDURES DATA
Attachment 186-6-1
Nebraska Hospitals and Ambulatory Surgery Centers Data Dictionary.
This precise format is necessary.
Please follow the instructions for preparing the data.
|
REQUIRED |
VARIABLE NAME |
VARIABLE LABEL OR CODE |
DATA TYPE |
LENGTH |
Row one of the text file may have the field names as column headings but should not have a case record. |
|
1 |
Facility |
Hospital or Ambulatory Surgery Center name. Full name of Hospital or Ambulatory Surgery Center |
Char |
35 |
Column A, repeat for each record |
|
2 |
State License |
License number issued by Nebraska DHHS alpha-numeric Example ASC099 |
NUM |
Column B, repeat for each record |
|
|
3 |
License |
The national provider identifier number. It is an alpha-numeric consisting of 10 characters |
NUM |
10 |
Column C, repeat for each record |
|
4 |
Charges |
Facility portion of billed charges associated with primary procedure performed. Facility portion of billed charges should not include professional fees. 18 digits numeric unsigned 15 positions for whole dollar, 1 position for decimal and 2 positions for cents. |
NUM |
18 |
Column C, no $sign, no comma separator, numeric only, use decimal point and "00" if whole dollar charge. No need for leading zeroes. |
|
5 |
County |
County Name (Residence) |
CHAR |
35 |
Column D, leave blank if unknown |
|
6 |
State |
Patient State Code (Residence). Two letters postal code of the state name |
CHAR |
2 |
Column E, two letter postal code only - ALL CAPS |
|
7 |
ZIP5 |
5-Digit patient zip code (Residence). 5-Digits numeric zip code |
NUM |
5 |
Column F, 5-Digit only |
|
8 |
PROC |
Primary outpatient surgical procedure performed for each patient encounter at the facility, reported by Current Procedural Terminology (CPT) codes or Health Care Financing Administration Common Procedure Coding System (HCPCS) codes Procedure codes. Refer to CPT or HCPCS coding manual. |
CHAR |
5 |
Column G, alpha-numeric |
|
9 |
DATE |
The date the procedure was performed MM/DD/YYY |
NUM |
10 |
Column I, exactly this format, use "/", not"-", use leading zeroes. Use four digit year. |
|
10 |
PAYERCD |
Payer Code 1 - Medicare 2- Medicaid 3- Commercial Insurance 4- Self Pay 5- Other Government 6- Workers Compensation |
CHAR |
2 |
Column H. One digit of number. No insurance name, please. |
|
11 |
GENDER |
Gender of the patient Male = M Female = F Unknown = U |
CHAR |
1 |
Column J, one letter only |
|
12 |
AGE |
Age of the patient in years at the time of procedure. If less than 1 year, age = 0 |
NUM |
3 |
Column K, numbers only |
|
OPTIONAL |
|||||
|
13 |
DOB |
Date of patient birth MM/DD/YY |
NUM |
10 |
Column L, exactly this format, use "/" not"-", use leading zeroes. Use four digit year. |
|
14 |
DIAG1 |
Primary ICD-10 Diagnosis Code Diagnosis Codes. Refer to ICD-10-CM coding manual |
CHAR/NUM |
7 |
Column M, ICD Code only 1st character is alpha (not U); 2nd & 3rd characters are numeric; 4th, 5th & 6th characters can be any combination of alpha & numeric; 7th character (extension character) can be alpha or numeric |
|
15 |
DIAG2 |
Secondary ICD-10 Diagnosis Code Diagnosis codes. Refer to ICD-10-CM coding manual |
CHAR/NUM |
7 |
Column N, ICD Code only 1st character is alpha (not U); 2nd & 3rd characters are numeric; 4th, 5th & 6th characters can be any combination of alpha & numeric; 7th character (extension character) can be alpha or numeric |
|
16 |
DIAG3 |
Tertiary ICD-10 Diagnosis Code Diagnosis codes. Refer to ICD-10-CM coding manual |
CHAR/NUM |
7 |
Column O, ICD Code only 1st character is alpha (not U); 2nd & 3rd characters are numeric; 4th, 5th & 6th characters can be any combination of alpha & numeric; 7th character (extension character) can be alpha or numeric |
|
17 |
DIAG4 |
Fourth ICD-10 Diagnosis Code Diagnosis codes. Refer to ICD-10-CM coding manual |
CHAR/NUM |
7 |
Column P, ICD Code only 1st character is alpha (not U); 2nd & 3rd characters are numeric; 4th, 5th & 6th characters can be any combination of alpha & numeric; 7th character (extension character) can be alpha or numeric |
|
18 |
DIAG5 |
Fifth ICD-10 Diagnosis Code Diagnosis codes. Refer to ICD-10-CM coding manual |
CHAR/NUM |
7 |
Column Q, ICD Code only 1st character is alpha (not U); 2nd & 3rd characters are numeric; 4th, 5th & 6th characters can be any combination of alpha & numeric; 7th character (extension character) can be alpha or numeric |
|
19 |
DIAG6 |
Sixth ICD-10 Diagnosis Code Diagnosis codes. Refer to ICD-10-CM coding manual |
CHAR/NUM |
7 |
Column R, ICD Code only 1st character is alpha (not U); 2nd & 3rd characters are numeric; 4th, 5th & 6th characters can be any combination of alpha & numeric; 7th character (extension character) can be alpha or numeric |
|
20 |
DIAG7 |
Seventh ICD-10 Diagnosis Code Diagnosis codes. Refer to ICD-10-CM coding manual |
CHAR/NUM |
7 |
Column S, ICD Code only 1st character is alpha (not U); 2nd & 3rd characters are numeric; 4th, 5th & 6th characters can be any combination of alpha & numeric; 7th character (extension character) can be alpha or numeric |
|
21 |
DIAG8 |
Eight ICD-10 Diagnosis Code Diagnosis codes. Refer to ICD-10-CM coding manual |
CHAR/NUM |
7 |
Column T, ICD Code only 1st character is alpha (not U); 2nd & 3rd characters are numeric; 4th, 5th & 6th characters can be any combination of alpha & numeric; 7th character (extension character) can be alpha or numeric |
|
22 |
DIAG9 |
Ninth ICD-10 Diagnosis Code Diagnosis codes. Refer to ICD-10-CM coding manual |
CHAR/NUM |
7 |
Column U, ICD Code only 1st character is alpha (not U); 2nd & 3rd characters are numeric; 4th, 5th & 6th characters can be any combination of alpha & numeric; 7th character (extension character) can be alpha or numeric |
|
23 |
DIAG10 |
Tenth ICD-10 Diagnosis Code Diagnosis codes. Refer to ICD-10-CM coding manual |
CHAR/NUM |
7 |
Column V, ICD Code only 1st character is alpha (not U); 2nd & 3rd characters are numeric; 4th, 5th & 6th characters can be any combination of alpha & numeric; 7th character (extension character) can be alpha or numeric |
|
24 |
E-CODE |
E-code External cause of Injury and poisoning (E-code) Refer to ICD-10-CM coding manual |
CHAR/NUM |
7 |
Column W, E-Code only 1st character is alpha (not U); 2nd & 3rd characters are numeric; 4th, 5th & 6th characters can be any combination of alpha & numeric; 7th character (extension character) can be alpha or numeric |
