275 Patient Information
Function Group PI
This Draft Standard for Trial Use contains the format and establishes the data contents of the Patient Information Transaction Set (275) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used to communicate individual patient information requests and patient information (either solicited or unsolicited) between separate health care entities in a variety of settings to be consistent with confidentiality and use requirements. Patient information consists of demographic, clinical, and other supporting data.
Position
Segment
Name
Max Use
0100
Transaction Set HeaderMandatory
Max 1
To indicate the start of a transaction set and to assign a control number
0200
Beginning SegmentOptional
Max 1
To indicate the beginning of a transaction set
0300
Date/Time ReferenceOptional
Max 3
To specify pertinent dates and times
0400
TraceOptional
Max 5
To uniquely identify a transaction to an application
NM1Loop
Optional
Repeat >1
0500
Individual or Organizational NameMandatory
Max 1
To supply the full name of an individual or organizational entity
0600
Individual IdentificationOptional
Max 1
To provide identification of an individual or entity
0700
Demographic InformationOptional
Max 3
To supply demographic information
0800
Provider InformationOptional
Max 1
To specify the identifying characteristics of a provider
0900
Administrative Communications ContactOptional
Max 2
To identify a person or office to whom administrative communications should be directed
1000
Reference IdentificationOptional
Max 5
To specify identifying information
1050
Date or Time or PeriodOptional
Max 1
To specify any or all of a date, a time, or a time period
NX1Loop
Optional
Repeat 5
1100
Property or Entity IdentificationMandatory
Max 1
To define the attributes of a property or an entity
1200
Address InformationOptional
Max 1
To specify the location of the named party
1300
Geographic LocationOptional
Max 1
To specify the geographic place of the named party
Position
Segment
Name
Max Use
LXLoop
Optional
Repeat >1
0100
Assigned NumberMandatory
Max 1
To reference a line number in a transaction set
0150
TraceOptional
Max 1
To uniquely identify a transaction to an application
0175
Status InformationOptional
Max 1
To report the status, required action, and paid information of a claim or service line
0200
Individual or Organizational NameOptional
Max 1
To supply the full name of an individual or organizational entity
0300
Provider InformationOptional
Max 1
To specify the identifying characteristics of a provider
0400
Administrative Communications ContactOptional
Max 1
To identify a person or office to whom administrative communications should be directed
0500
Reference IdentificationOptional
Max 5
To specify identifying information
DTPLoop
Optional
Repeat >1
0600
Date or Time or PeriodMandatory
Max 1
To specify any or all of a date, a time, or a time period
0700
Category of Patient Information ServiceOptional
Max 1
To specify categories of patient information service
0800
Product/Item DescriptionOptional
Max 1
To describe a product or process in coded or free-form format
EFILoop
Optional
Repeat 1
0900
Electronic Format IdentificationMandatory
Max 1
To provide basic information about the electronic format of the interchange data
1000
Binary DataMandatory
Max 1
To transfer binary data in a single data segment and allow identification of the end of the data segment through a count; there is no identification of the internal structure of the binary data in this segment
1100
Transaction Set TrailerMandatory
Max 1
To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)