| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | sequence number(+) | 0;1 | NUMERIC | The record number for this extract entry. | ||
| 1 | year month | 0;2 | FREE TEXT | A six character string representing the year and the month for which this extract was performed. | ||
| 2 | extract number | 0;3 | POINTER | 727 | AC | The DSS extract log entry for this Event Capture extract. |
| 3 | facility | 0;4 | FREE TEXT | This is the facility/division where the extract was performed. | ||
| 4 | patient no. - dfn | 0;5 | POINTER | 2 | An identifying number for the patient at the local site. | |
| 5 | ssn | 0;6 | FREE TEXT | The patient's social security number. | ||
| 6 | name | 0;7 | FREE TEXT | The first four characters of the patient's last name associated with this extract record. | ||
| 7 | in out patient indicator | 0;8 | FREE TEXT | Indicates whether the patient was an inpatient or an outpatient for this extract. | ||
| 8 | day | 0;9 | FREE TEXT | Date when procedure was performed. | ||
| 9 | dss unit | 0;10 | POINTER | 724 | The DSS UNIT assigned for the procedure performed during this encounter. | |
| 10 | category | 0;11 | FREE TEXT | This field contains the IEN in file #726 for the Category associated with this extract record. | ||
| 11 | procedure | 0;12 | FREE TEXT | This field contains the name of the procedure selected for this extract record. | ||
| 12 | volume | 0;13 | NUMERIC | The number of days, or number of timed-specific units, or number of times the procedure was performed. | ||
| 13 | cost center | 0;14 | FREE TEXT | This is the cost center associated with the DSS Unit for this extract record. | ||
| 14 | ordering section | 0;15 | FREE TEXT | This is the IEN of the Ordering Section. The Ordering Section represents the medical specialty (for example, ambulatory care) responsible for the encounter. | ||
| 15 | section | 0;16 | FREE TEXT | This is the IEN in file #723 of the Medical Specialty of the DSS Unit associated with this extract record. | ||
| 16 | provider | 0;17 | FREE TEXT | The primary provider who performed the procedure associated with the Event Capture Patient record. | ||
| 17 | provider person class | 0;18 | FREE TEXT | The VA code of the Person Class of the Provider as of the date of this record. | ||
| 18 | provider #2 | 0;19 | FREE TEXT | The second assisting provider who performed the procedure associated with the Event Capture Patient record. | ||
| 19 | provider #2 person class | 0;20 | FREE TEXT | This is the VA code of the Person Class of the second assisting provider as of the date of this record. | ||
| 20 | provider #3 | 0;21 | FREE TEXT | The third assisting provider who performed the procedure associated with the Event Capture Patient record. | ||
| 21 | provider #3 person class | 0;22 | FREE TEXT | The VA code of the Person Class of the third assisting provider as of the date of this record. | ||
| 22 | placeholder4 | 0;23 | FREE TEXT | |||
| 23 | movement file # | 0;24 | POINTER | 405 | Current patient movement record associated with this extract record. | |
| 24 | treating specialty | 0;25 | FREE TEXT | The PTF CODE of the treating specialty associated with this extract record. Only applicable if the patient was an inpatient on the date of the procedure. | ||
| 25 | time | 0;26 | FREE TEXT | The time when the Event Capture procedure was performed. | ||
| 26 | primary care team | 0;27 | FREE TEXT | The IEN of the primary care team assigned to this patient. | ||
| 27 | primary care provider | 0;28 | FREE TEXT | The primary care provider assigned to this patient. | ||
| 28 | pce cpt code & modifiers | 0;29 | FREE TEXT | Five character Current Procedural Terminology (CPT) Code, the quantity (or how many times the unique code appears in the record), and up to five two-character CPT modifiers. | ||
| 29 | icd-9 code | 0;30 | FREE TEXT | The Primary ICD-9 code for the procedure performed. | ||
| 30 | secondary icd9 code #1 | 0;31 | FREE TEXT | The first of the secondary ICD-9 codes for the procedure performed. | ||
| 31 | secondary icd9 code #2 | 0;32 | FREE TEXT | The second of the secondary ICD-9 codes for the procedure performed. | ||
| 32 | secondary icd9 code #3 | 0;33 | FREE TEXT | The third of the secondary ICD-9 codes for the procedure performed. | ||
| 33 | secondary icd9 code #4 | 0;34 | FREE TEXT | The fourth of the secondary ICD-9 codes for the procedure performed. | ||
| 34 | agent orange | 0;35 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates whether patient was exposed to Agent Orange. | |
| 35 | radiation exposure | 0;36 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates if patient claims exposure to ionizing radiation. | |
| 36 | sw asia conditions | 0;37 | SET OF CODES | Y:YES N:NO U:UNKNOWN | This field is used to indicate if this visit represents treatment of a VA patient claiming exposure to Southwest Asia Conditions. | |
| 37 | service connected | 0;38 | BOOLEAN | Y:YES N:NO | Indicates if patient is service connected. | |
| 38 | sent to pce | 0;39 | BOOLEAN | Y:YES N:NO | This field flags data that has been sent from Event Capture to PCE. | |
| 39 | placeholder5 | 0;40 | FREE TEXT | |||
| 40 | dss identifier | 0;41 | FREE TEXT | The DSS Identifier represents the primary and secondary stop codes of the Associated Clinic. | ||
| 41 | placeholder1 | 0;42 | FREE TEXT | Placeholder; null. | ||
| 42 | master patient index | 1;1 | FREE TEXT | Unique national VA patient identifier. | ||
| 43 | dss product department | 1;2 | FREE TEXT | The nationally defined DSS Department Code designated for the patient care product. | ||
| 44 | placeholder | 1;3 | FREE TEXT | Currently NULL. | ||
| 45 | placeholder | 1;4 | FREE TEXT | Currently NULL. | ||
| 46 | placeholder | 1;5 | FREE TEXT | Currently NULL. | ||
| 47 | pc provider person class | 1;6 | FREE TEXT | The VA Code of the Person Class of the Primary Care Provider as of the date of this extract record. | ||
| 48 | placeholder | 1;7 | FREE TEXT | Currently NULL. | ||
| 49 | associate pc provider | 1;8 | FREE TEXT | The Associate Primary Care Provider assigned with the PCMM application. | ||
| 50 | assoc. pc prov. person class | 1;9 | FREE TEXT | VA Code of the Person Class of the patient's Associate Primary Care Provider. | ||
| 51 | placeholder | 1;10 | FREE TEXT | Currently NULL. | ||
| 52 | division | 1;11 | FREE TEXT | The Division field will not be used in the Event Capture extract. | ||
| 53 | mst status | 1;12 | SET OF CODES | Y:Yes, Screened reports MST N:No, Screened does not report MST D:Screened Declines to answer U:Unknown, not screened | Indicates the Military Sexual Trauma (MST) status of a patient on the day of the encounter. | |
| 54 | dom,prrtp and saartp indicator | 1;13 | SET OF CODES | P:GEN. PRRTP T:PTSD PRRTP S:DOM. PRRTP H:HOMELESS CWT/TR A:SA CWT/TR D:DOMICILIARY B:PTSD CWT/TR C:GEN. CET/TR | Indicates if the patient is admitted to either a RRTP, PRRTP, or SARRTP at the time care is provided. | |
| 55 | date of birth | 1;14 | FREE TEXT | Patient's date of birth. | ||
| 56 | enrollment category | 1;15 | FREE TEXT | Patient's enrollment category. | ||
| 57 | enrollment status | 1;16 | FREE TEXT | The IEN of the patient's enrollment status. | ||
| 58 | placeholder | 1;17 | FREE TEXT | |||
| 59 | period of service | 1;18 | FREE TEXT | The period of service that best classifies the patient based on eligibility code. | ||
| 60 | purple heart indicator | 1;19 | BOOLEAN | Y:YES N:NO | Indicates whether or not a patient is a Purple Heart recipient. | |
| 61 | observation patient indicator | 1;20 | SET OF CODES | NO:NO YES:YES | Indicates if patient is considered to be an observation patient. | |
| 62 | encounter number | 1;21 | FREE TEXT | The unique number assigned for DSS. | ||
| 63 | agent orange location | 1;22 | FREE TEXT | Indicates the location where the patient was exposed to Agent Orange. | ||
| 64 | ordering division | 1;23 | FREE TEXT | For future development; currently set to null. | ||
| 65 | contract start date | 1;24 | FREE TEXT | For future development; currently set to null. | ||
| 66 | contract end date | 1;25 | FREE TEXT | For future development; currently set to null. | ||
| 67 | contract type | 1;26 | FREE TEXT | For future development; currently set to null. | ||
| 68 | cnh status | 1;27 | SET OF CODES | YES:YES NO:NO | This field is used to indicate whether a patient is currently in a contract nursing home. | |
| 69 | production division code | 1;28 | FREE TEXT | Identifies the division/facility where the work was performed. | ||
| 70 | eligibility | 1;29 | FREE TEXT | Appropriate eligibility code based on veteran or non-veteran status. | ||
| 71 | head & neck cancer indicator | 1;30 | BOOLEAN | Y:YES N:NO | Identifies whether patient has head and/or neck cancer. | |
| 72 | ethnicity | 1;31 | FREE TEXT | The patient's PTF Ethnicity code. | ||
| 73 | race 1 | 1;32 | FREE TEXT | Self-reported by patient as recorded in VistA patient file. | ||
| 74 | enrollment location | 1;33 | FREE TEXT | The facility that the patient chooses to designate as his preferred location for care. | ||
| 75 | dss ip # | 1;34 | NUMERIC | The nationally defined DSS Intermediate Product Number designated to the Event Capture care product | ||
| 76 | enrollment priority | 1;35 | FREE TEXT | This field contains the enrollment priority group and the enrollment priority subgroup. | ||
| 77 | user enrollee | 1;36 | SET OF CODES | U:USER ENROLLED | Indicates whether a Veteran has User Enrollee status for the current or future fiscal year. | |
| 78 | patient type | 1;37 | SET OF CODES | AC:ACTIVE DUTY AL:ALLIED VETERAN CO:COLLATERAL EM:EMPLOYEE IN:INELIGIBLE MI:MILITARY RETIREE NO:NON-VETERAN (OTHER) NS:NSC VETERAN SC:SC VETERAN TR:TRICARE | Refers to the various types of patients which may be seen at a VA facility. Every patient in the system must have a TYPE specified. | |
| 79 | cv status eligibility | 1;38 | SET OF CODES | Y:YES E:ELIGIBILITY EXPIRED | Records if Veteran service on active duty in a theater of combat operations during a period of war after the Persian Gulf War or in combat against a hostile force during a period of hostilities after November 11, 1998. | |
| 80 | cv eligibility end date | 2;1 | FREE TEXT | Records the Combat Veteran eligibility expiration date of the veteran who served on active duty in a theater of combat operations during a period of war after the Persian Gulf War or in combat against a hostile force during a period of hostilities after November 11, 1998. | ||
| 81 | encounter cv | 2;2 | BOOLEAN | Y:YES | Records if a Veteran served on active duty in a theater of combat operations during a period of war after the Persian Gulf War or in combat against a hostile force during a period of hostilities after November 11, 1998. | |
| 82 | national patient record flag | 2;3 | BOOLEAN | Y:YES | This field records whether the patient's record contains 1 or more active category 1 (National) Patient Record Flags. | |
| 83 | eri | 2;4 | FREE TEXT | This field identifies patients from impacted zip code areas designated by the Federal Emergency Management Agency (FEMA). | ||
| 84 | agent orange enc indicator | 2;5 | BOOLEAN | Y:YES N:NO | Indicates whether service provided during this patient encounter is related to exposure to Agent Orange. | |
| 85 | encounter swac | 2;6 | BOOLEAN | Y:YES N:NO | Indicates the appropriate response for Southwest Asia conditions as related to this patient's episode of care. | |
| 86 | enc head/neck ca | 2;7 | BOOLEAN | Y:YES N:NO | Indicates whether service provided during this patient encounter is related to head/neck Cancer. | |
| 87 | encounter mst | 2;8 | BOOLEAN | Y:YES N:NO | Indicates the appropriate response for military sexual trauma as related to this patient's episode of care. | |
| 88 | radiation encounter indicator | 2;9 | BOOLEAN | Y:YES N:NO | Indicates whether service provided during this patient encounter is related to exposure to ionizing radiation. | |
| 89 | placeholder | 2;10 | FREE TEXT | Currently Null. | ||
| 90 | oef/oif | 2;11 | FREE TEXT | The Military Operation in which the patient was in combat during the specified time period. This field is a length of nine characters and reflects the OEF or OIF where this patient was in combat. | ||
| 91 | oef/oif return date | 2;12 | FREE TEXT | The date the patient left the OEF/OIF area, if known. Otherwise, it is the end date of military pay for this OEF/OIF deployment. This date field has a format equal to YYYYMMDD. | ||
| 92 | associate pc provider npi | 2;13 | FREE TEXT | A standard unique life-long identifier of the associate primary care provider. This field has a length of fifteen characters. | ||
| 93 | primary care provider npi | 2;14 | FREE TEXT | A standard unique life-long identifier of the primary care provider. This field has a length of fifteen characters. | ||
| 94 | provider npi | 2;15 | FREE TEXT | A standard unique life-long identifier of the individuals providing health care services. This field has a length of fifteen characters. | ||
| 95 | provider #2 npi | 2;16 | FREE TEXT | A standard unique life-long identifier of the second assisting provider of health care services. This field has a length of fifteen characters. | ||
| 96 | provider #3 npi | 2;17 | FREE TEXT | A standard unique life-long identifier of the third assisting provider of health care services. This field has a length of fifteen characters. | ||
| 97 | shad status | 2;18 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates whether patient meets requirements for Shipboard Hazard and Defense (SHAD). | |
| 98 | encounter shad | 2;19 | BOOLEAN | Y:YES N:NO | Indicates if treatment provided during this patient encounter is related to exposure PROJ 112/SHAD condition. Values: Y=YES, N=NO | |
| 99 | patcat | 2;20 | SET OF CODES | AD:Active Duty ADD:Active Duty Dependent FNRS:Former Non-Remarried Spouse RET:Retired RETD:Retiree Dependent RES:Reservist REC:Recruit TDRL:Temporary Disability TFL:TRICARE for Life | This is the Patient's category which will be used for FHCC (Federal Health Care Center) Reconciliation. DSS must capture and report DoD patients so that the FHCC reconciliation process can function as designed. "Reconciliation" is the process used within the new FHCC to determine which patients DoD pays for and which VA pays for. | |
| 100 | provider #4 | 2;21 | FREE TEXT | The fourth provider associated with the patient encounter. It represents an assisting Provider who performed the procedure associated with the Event Capture patient record. | ||
| 101 | provider #4 person class | 2;22 | FREE TEXT | This is the VA code of the Person Class of the fourth assisting Provider as of the date of this record. | ||
| 102 | provider #4 npi | 2;23 | FREE TEXT | A standard unique life-long identifier of the fourth assisting provider of health care services. | ||
| 103 | provider #5 | 2;24 | FREE TEXT | The fifth provider associated with the patient encounter. It represents an assisting Provider who performed the procedure associated with the Event Capture patient record. | ||
| 104 | provider #5 person class | 2;25 | FREE TEXT | This is the VA code of the Person Class of the fifth assisting Provider as of the date of this record. | ||
| 105 | provider #5 npi | 2;26 | FREE TEXT | A standard unique life-long identifier of the fifth assisting provider of health care services. | ||
| 106 | primary icd-10 code | 2;27 | FREE TEXT | The primary ICD10 code for this encounter. | ||
| 107 | secondary icd-10 code #1 | 2;28 | FREE TEXT | The first secondary ICD10 code for this encounter. | ||
| 108 | secondary icd-10 code #2 | 2;29 | FREE TEXT | The second secondary ICD-10 code for this encounter. | ||
| 109 | secondary icd-10 code #3 | 2;30 | FREE TEXT | The third secondary ICD-10 code for this encounter. | ||
| 110 | secondary icd-10 code #4 | 2;31 | FREE TEXT | The fourth secondary ICD-10 code for this encounter. | ||
| 111 | encounter sc | 3;1 | BOOLEAN | Y:YES N:NO | Indicates if treatment provided during this patient encounter is Service Connected. | |
| 112 | vietnam | 3;2 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates if patient is a Vietnam era veteran. | |
| 113 | provider #6 | 3;3 | FREE TEXT | The sixth provider associated with the patient encounter. It represents an assisting Provider who performed the procedure associated with the Event Capture patient record. | ||
| 114 | provider #6 person class | 3;4 | FREE TEXT | This is the VA code of the Person Class of the sixth assisting provider as of the date of this record. | ||
| 115 | provider #6 npi | 3;5 | FREE TEXT | A standard unique life-long identifier of the sixth assisting provider of health care services. | ||
| 116 | provider #7 | 3;6 | FREE TEXT | The seventh provider associated with the patient encounter. It represents an assisting Provider who performed the procedure associated with the Event Capture patient record. | ||
| 117 | provider #7 person class | 3;7 | FREE TEXT | This is the VA code of the Person Class of the seventh assisting provider as of the date of this record. | ||
| 118 | provider #7 npi | 3;8 | FREE TEXT | A standard unique life-long identifier of the seventh assisting provider of health care services. | ||
| 119 | 4char | 3;9 | FREE TEXT | A 4-character code value of the associated clinic as specified from the DSS Clinics and Stop Code Worksheet File if the record is sent to PCE. If the record does not get sent to PCE then the code comes from the DSS UNIT associated with this record. | ||
| 120 | placeholder | 3;10 | POINTER | 44 | Currently NULL. | |
| 121 | camp lejeune status | 3;11 | BOOLEAN | Y:YES N:NO | Indicates if patient was exposed to contaminated water while stationed at Camp Lejeune, NC between January 1, 1957 and December 31, 1987. | |
| 122 | encounter camp lejeune | 3;12 | BOOLEAN | Y:YES N:NO | Indicates if episode of care is related to exposure to contaminated water while stationed at Camp Lejeune, NC between January 1, 1957 and December 31, 1987. | |
| 123 | reason 1 | 3;13 | FREE TEXT | Identifies the first reason why the procedure was performed. | ||
| 124 | reason 2 | 3;14 | FREE TEXT | Identifies the second reason why the procedure was performed. | ||
| 125 | reason 3 | 3;15 | FREE TEXT | Identifies the third reason why the procedure was performed. | ||
| 126 | combat veteran indicator | 3;16 | BOOLEAN | Y:YES N:NO | Identifies if the patient served in a combat zone. | |
| 127 | combat veteran location | 3;17 | FREE TEXT | Identifies the war in which the combat service was incurred. | ||
| 128 | clinic ien | 3;18 | POINTER | 44 | The Associated Clinic of the Event Capture (EC) Procedure. |
Not Referenced