EDI 275 Patient Information

This X12 Transaction Set 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.

Segments

Position

Segment

Name

Max use

100

Transaction Set Header

Mandatory

AtMax 1

To indicate the start of a transaction set and to assign a control number

200

BGN

Beginning Segment

Opt

AtMax 1

To indicate the beginning of a transaction set

300

DTM

Date/Time Reference

Opt

AtMax 3

To specify pertinent dates and times

400

TRN

Trace

Opt

AtMax 5

To uniquely identify a transaction to an application

1000

LOOP

Opt

GT 1

500

NM1

Individual or Organizational Name

Opt

AtMax 1

To supply the full name of an individual or organizational entity

600

IN1

Individual Identification

Opt

AtMax 1

To provide identification of an individual or entity

700

DMG

Demographic Information

Opt

AtMax 3

To supply demographic information

800

PRV

Provider Information

Opt

AtMax 1

To specify the identifying characteristics of a provider

900

PER

Administrative Communications Contact

Opt

AtMax 2

To identify a person or office to whom administrative communications should be directed

1000

REF

Reference Information

Opt

AtMax 15

To specify identifying information

1050

DTP

Date or Time or Period

Opt

AtMax 1

To specify any or all of a date, a time, or a time period

1100

LOOP

Opt

AtMax 5

1100

NX1

Property or Entity Identification

Opt

AtMax 1

To define the attributes of a property or an entity

1200

Party Location

Opt

AtMax 1

To specify the location of the named party

1300

Geographic Location

Opt

AtMax 1

To specify the geographic place of the named party

2000

LOOP

Opt

GT 1

100

Transaction Set Line Number

Opt

AtMax 1

To reference a line number in a transaction set

150

TRN

Trace

Opt

AtMax 1

To uniquely identify a transaction to an application

175

STC

Status Information

Opt

AtMax 1

To report the status, required action, and paid information of a claim or service line

200

NM1

Individual or Organizational Name

Opt

AtMax 1

To supply the full name of an individual or organizational entity

300

PRV

Provider Information

Opt

AtMax 1

To specify the identifying characteristics of a provider

400

PER

Administrative Communications Contact

Opt

AtMax 1

To identify a person or office to whom administrative communications should be directed

500

REF

Reference Information

Opt

AtMax 5

To specify identifying information

540

Health Care Information Codes

Opt

AtMax 2

To supply information related to the delivery of health care

560

SVC

Service Information

Opt

AtMax 1

To supply payment and control information to a provider for a particular service

2100

LOOP

Opt

GT 1

600

DTP

Date or Time or Period

Opt

AtMax 1

To specify any or all of a date, a time, or a time period

700

CAT

Category of Patient Information Service

Opt

AtMax 1

To specify categories of patient information service

800

PID

Product/Item Description

Opt

AtMax 1

To describe a product or process in coded or free-form format

2110

LOOP

Opt

AtMax 1

900

OOI

Associated Object Type Identification

Opt

AtMax 1

To identify attributes and status related to the object

1000

BDS

Binary Data Structure

Mandatory

AtMax 1

To transfer binary data in a single data segment, convey a critical filter for transmission 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 Trailer

Mandatory

AtMax 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)

Elements

Position	Element	Name	Requirement	Type	Min/Max	Repeat

1	143	Transaction Set Identifier Code	Mandatory	ID	3/3	1

2	329	Transaction Set Control Number	Mandatory	Alphanumeric	4/9	1

3	1705	Implementation Convention Reference	Opt	Alphanumeric	1/35	1

EDI Dictionary

EDI 275 Patient Information

Segments

Elements