| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | sequence number | 0;1 | NUMERIC | B | The record number for this extract entry. | |
| 1 | year month | 0;2 | FREE TEXT | A six character numeric string representing the year and the month for which this extract was performed. | ||
| 2 | extract number | 0;3 | POINTER | 727 | AC | The corresponding entry in the DSS EXTRACT LOG file (#727) for this 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. | ||
| 7 | in/out patient indicator | 0;8 | SET OF CODES | I:INPATIENT O:OUTPATIENT | Indicates whether the patient was an inpatient or an outpatient for this extract. | |
| 8 | encounter number | 0;9 | FREE TEXT | The unique number assigned for DSS. | ||
| 9 | date of transfusion | 0;10 | FREE TEXT | This field contains the date of the blood component transfusion. | ||
| 10 | time of transfusion | 0;11 | FREE TEXT | A 6-character numeric string that represents the time of day the blood component transfusion was performed. | ||
| 11 | component | 0;12 | FREE TEXT | This is the name of the blood bank product transfused. | ||
| 12 | component abbreviation | 0;13 | FREE TEXT | Abbreviation of the blood component. | ||
| 13 | number of units | 0;14 | NUMERIC | Number of pooled units transfused. | ||
| 14 | volume | 0;15 | NUMERIC | This is the volume, in milliliters, of the component or unit transfused. | ||
| 15 | reaction | 0;16 | BOOLEAN | Y:YES N:NO | Indicates a transfusion reaction. | |
| 16 | reaction type | 0;17 | FREE TEXT | Type of reaction from transfusion | ||
| 17 | feeder location | 0;18 | FREE TEXT | The Location of the Blood Bank, where the blood is stored and where the Blood Bank technologist performed the (Blood Bank) tests. | ||
| 18 | dss product department | 0;19 | FREE TEXT | The nationally defined DSS Intermediate Department Number designated to the patient care product being provided. | ||
| 19 | dss ip # | 0;20 | FREE TEXT | The nationally defined DSS Intermediate Department Number designated to the patient care product being provided. | ||
| 20 | ordering provider | 0;21 | FREE TEXT | Provider for the patient transfused. | ||
| 21 | ordering provider person class | 0;22 | FREE TEXT | The VA Code of the Person Class of the Ordering Provider as of the date of this extract record. | ||
| 22 | eri | 0;23 | FREE TEXT | This field identifies patients from impacted zip code areas designated by the Federal Emergency Management Agency (FEMA). | ||
| 23 | unit modified | 0;24 | BOOLEAN | Y:YES N:NO | Indicates if unit of blood was modified. | |
| 24 | unit modification | 0;25 | FREE TEXT | Type of unit modification performed. | ||
| 25 | requesting provider | 0;26 | FREE TEXT | This is the provider who requested the transfusion. | ||
| 26 | requesting provider pc | 0;27 | FREE TEXT | The field holds the VA Code associated with the active Person Class of the Requesting Provider. | ||
| 27 | production division code | 0;28 | FREE TEXT | Identifies the division/facility where the work was performed. | ||
| 28 | ordering provider npi | 0;29 | FREE TEXT | A standard unique life-long identifier of the provider who ordered the type and cross match. This field has a length of fifteen characters. | ||
| 29 | requesting provider npi | 1;1 | FREE TEXT | A standard unique life-long identifier of the provider who requested the transfusion. This field has a length of fifteen characters. | ||
| 30 | patcat | 1;2 | 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. | |
| 31 | encounter sc | 1;3 | BOOLEAN | Y:YES N:NO | Indicates if treatment provided during this patient encounter is Service Connected. |
Not Referenced