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Transaction Set
in
X12 Release 004020

275 Patient Information

Functional 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.

Heading

Sequence
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 Segment
Max 1
To indicate the beginning of a transaction set
0300
Date/Time Reference
Max 3
To specify pertinent dates and times
0400
Trace
Max 5
To uniquely identify a transaction to an application
NM1 Loop
Repeat >1
0500
Individual or Organizational Name
Max 1
To supply the full name of an individual or organizational entity
Loop NM1 identifies a single patient; it also identifies other entities or individuals which include the requester, responder or other organizations.
0600
Individual Identification
Max 1
To provide identification of an individual or entity
0700
Demographic Information
Max 3
To supply demographic information
0800
Provider Information
Max 1
To specify the identifying characteristics of a provider
The PRV segment is only used in Loop NM1 when identifying a requestor or responder who is also a provider.
0900
Administrative Communications Contact
Max 2
To identify a person or office to whom administrative communications should be directed
1000
Reference Identification
Max 5
To specify identifying information
1050
Date or Time or Period
Max 1
To specify any or all of a date, a time, or a time period
NX1 Loop
Repeat 5
1100
Property or Entity Identification
Max 1
To define the attributes of a property or an entity
1200
Address Information
Max 1
To specify the location of the named party
1300
Geographic Location
Max 1
To specify the geographic place of the named party

Detail

Sequence
Segment
Name
Max use
LX Loop
Repeat >1
0100
Assigned Number
Max 1
To reference a line number in a transaction set
0150
Trace
Max 1
To uniquely identify a transaction to an application
The TRN segment in Loop LX identifies a previously sent transaction set. The LX loop provides supporting or additional information for that item when TRN is used.
0175
Status Information
Max 1
To report the status, required action, and paid information of a claim or service line
The STC segment in LX loop identifies the status and action requested in a prior transaction when the response is provided in this transaction.
0200
Individual or Organizational Name
Max 1
To supply the full name of an individual or organizational entity
The NM1 segment in loop LX identifies an individual provider within a responder group.
0300
Provider Information
Max 1
To specify the identifying characteristics of a provider
0400
Administrative Communications Contact
Max 1
To identify a person or office to whom administrative communications should be directed
0500
Reference Identification
Max 5
To specify identifying information
DTP Loop
Repeat >1
0600
Date or Time or Period
Max 1
To specify any or all of a date, a time, or a time period
0700
Category of Patient Information Service
Max 1
To specify categories of patient information service
0800
Product/Item Description
Max 1
To describe a product or process in coded or free-form format
EFI Loop
Repeat 1
0900
Electronic Format Identification
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)
Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference and Mapping Guides are provided for marketing purposes and are free of charge. All names, logos, and brands of third parties listed on our site are trademarks of their respective owners (including “X12”, which is a trademark of X12 Incorporated). Stedi, Inc. and its products and services are not endorsed by, sponsored by, or affiliated with these third parties. Our use of these names, logos, and brands is for identification purposes only, and does not imply any such endorsement, sponsorship, or affiliation.
Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference and Mapping Guides are provided for marketing purposes and are free of charge. All names, logos, and brands of third parties listed on our site are trademarks of their respective owners (including “X12”, which is a trademark of X12 Incorporated). Stedi, Inc. and its products and services are not endorsed by, sponsored by, or affiliated with these third parties. Our use of these names, logos, and brands is for identification purposes only, and does not imply any such endorsement, sponsorship, or affiliation.