Field Number | Data Element Name | |
FRM | PRM | |
1 | 3 | Uniform Patient I. D. |
2 | 4 | Patient Birthdate (MDY of MY) |
4 | - | Patient Zip Code (6 through 9 digits) |
5 | 6 | Date of Admission (MDY) |
6 | 7 | Date of Discharge (MDY) |
8a, b | 8 | Principle Procedure Date |
9a1-9c2 | - | Secondary Procedure Date |
23 | 17 | Patient Control Number |
29a-c | 20 | Certificate/Social Security Number/Health Insurance Claim/I. D. Number |
FRM-Facility Reporting Manual
PRM-Payor Reporting Manual
Pa. Code tit. 28, pt. VI, ch. 915, MISCELLANEOUS PROVISIONS, app A
This appendix cited in 28 Pa. Code § 915.3 (relating to definitions); 28 Pa. Code § 915.21 (relating to classes of data collected by the Council); and 28 Pa. Code § 915.22 (relating to release of nondisclosable data).