5.4 Data Elements in the Message Payload

Data Element Number	Data Element Name	Element Type	CMS Final Rule	Context/Metadata	Content	Human Readable
	X-Direct-Context	Message Header		R
	Content-Type	Mime-part		R
	Content-Transfer-Encoding	Mime-part		O
	Content-ID	Mime-part		R
	Content-Disposition	Mime-part		R
	version	Context		R
	Id	Context		R
	patient-id	Context		R
	Type	Context		R
	purpose	Context		R
	patient	Context		R
11a.	givenName	Context		R
11b.	surname	Context		R
11c.	middleName	Context		RE
11d.	dateOfBirth	Context		R
11e.	gender	Context		R
11f.	socialSecurityNumber	Context		RE
11g.	telephoneNumber	Context		RE
11h.	streetAddress	Context		RE
11i.	stateOrProvinceName	Context		RE
11j.	localityName	Context		RE
11k.	postalCode	Context		RE
11l.	country	Context
11m.	directAddress	Context		RE
	creation-time	Context		R
	profile	Context		R
	type-code	Context		R
	activity-code	Context		R		R
	author	Submission Set		R
	contentTypeCode	Submission Set		R
	entryUUID	Submission Set		R
	intendedRecipient	Submission Set		R
	patientId	Submission Set		RE
	sourceId	Submission Set		R
	submissionTime	Submission Set		R
	title	Submission Set		O
	uniqueId	Submission Set		R
	author	Document entry		RE
	classCode	Document entry		RE
	confidentialityCode	Document entry		RE
	creationTime	Document entry		RE
	entryUUID	Document entry		R
	formatCode	Document entry		R
	healthcareFacilityTypeCode	Document entry		RE
	languageCode	Document entry		RE
	mimeType	Document entry		R
	patientId	Document entry		RE
	practiceSettingCode	Document entry		RE
	sourcePatientId	Document entry		RE
	sourcePatientInfo	Document entry		R
37a.	Source patient identifier list
37b.	Source patient name			R
37c.	(Intentionally Blank)
37d.	(Intentionally Blank)
37e.	Source patient date of birth			R
37f.	Source patient administrative gender			R
37g.	Source patient address			RE
	typeCode	Document entry		R		R
	uniqueId	Document entry		R
	(Intentionally Blank)
40A.	Message Code	MSH-9.1 – Message Type.Message Code			R
40B.	Message Event	MSH-9.2 – Message Type.Trigger Event			R
	Transaction ID	MSH-10 – Message Control ID			R
	Event Date	EVN-2.1 - Recorded Date/Time.Time	R		R	R
	Version ID	MSH-12 – Version ID			R
	Patient ID	PID-3.1– Patient Identifier List.Id Number			R
	Patient ID Type	PID-3.5– Patient Identifier List.Identifier Type Code			RE
	Patient SSN Last 4 digits	PID-3.1 – Patient Identifier List.Id Number			O
	Patient First Name	PID-5.2 – Patient Name.Given Name	R		R	R
	Patient Last Name	PID-5.1 – Patient Name.Family Name	R		R	R
	Patient Middle Name	PID-5.3 – Patient Name.Second And Further Given Names Or Initials Thereof			RE	R
	Patient Suffix	PID-5.4 – Patient Name.Suffix (e.g., Jr Or Iii)			RE	R
	Patient Alias	PID-5.7 – - Patient Name.Name Type Code			O
	Patient Date of Birth	PID-7 – Date/Time of Birth			R	R
	Patient Gender	PID-8 – Administrative Sex			R	R
	Patient Street Address	PID-11.1 – Patient Address.Street Address			RE
	Patient Street Address 2	PID-11.2 – Patient Address.Other Designation			RE
	Patient City	PID-11.3 – Patient Address.City			RE
	Patient State	PID-11.4 – Patient Address.State Or Province			RE
	Patient ZIP	PID-11.5 –Patient Address.Zip Or Postal Code			RE
	Patient Countr– - if not US	PID-11.6 – Patient Address.Country			RE
	Patient Telephone Number	PID-13.6 – Phone Number – Home.Area/City Code PID-13.7 – Phone Number – Home.Local Number			RE
	Patient Telecommunication Use Type	PID-13.2 - Phone Number – Home.Telecommunication Use Code			RE
	Patient email	PID-13. 4– Phone Number – Home.Email Address			RE
	Patient Account Number	PID-18 – Patient Account Number			R
	Patient Date of Death	PID-29 – Patient Death Date and Time			RE
	Role	ROL-3.1 – Role-ROL. Identifier			RE
	Person Identifier (NPI)	ROL-4.1 - Role Person.Id Number			RE
	Person Last Name	ROL-4.2 - Role Person.Family Name			RE
	Person First Name	ROL-4.3 - Role Person.Given Name			RE
	Organization Identifier (NPI)	ROL-4.1 - Role Person.Id Number			RE
	Organization Name	ROL-4.2 - Role Person.Family Name			RE
	Person or Organization Direct address	ROL-12.4-Phone.Email Address			RE
	Treating Facility Identifier (Type 2 NPI)	EVN-7.2 – Event Facility.Universal Id			R
	Patient Class	PV1-2 - Patient Class			R	R
	Assigned Patient Location – Point of Care	PV1-3.1 - Assigned Patient Location.Point Of Care			RE
	Treating Facility Name	PV1-3.9 - Assigned Patient Location.Location Description			R
	Treating Facility Address	ROL-11 - Office/Home Address/Birthplace (ROL-3.1 = TF)			RE	RE
	Admission Type 	PV1-4 - Admission Type			R
	Prior Patient Location	PV1-6 - Prior Patient Location			RE
79a.	Treating Provider (Attending) NPI	PV1-7.1 – Attending Doctor.Id Number			RE	RE
	Treating Provider (Attending) Last Name	PV1-7.2 - Attending Doctor.Family Name			RE	RE
	Treating Provider (Attending) First Name	PV1-7.3 - Attending Doctor.Given Name			RE	RE
	Intentionally Blank
	Treating Provider (Attending) Direct address	ROL-12.4-Phone.Email Address			RE	RE
	Treating Provider (Consulting) NPI	PV1-9.1 - Consulting Doctor.Id Number			RE	RE
	Treating Provider (Consulting) Last Name	PV1-9.2 - Consulting Doctor.Family Name			RE	RE
	Treating Provider (Consulting) First Name	PV1-9.3 - Consulting Doctor.Given Name			RE	RE
	Intentionally Blank
	Treating Provider (Consulting) Direct address	ROL-12.4-Phone.Email Address			RE	RE
	Treating Provider (Admitting) NPI	PV1-17.1 - Admitting Doctor.Id Number			RE	RE
	Treating Provider (Admitting) Last Name	PV1-17.2 - Admitting Doctor.Family Name			RE	RE
	Treating Provider (Admitting) First Name	PV1-17.3 - Admitting Doctor.Given Name			RE	RE
	Intentionally Blank
	Treating Provider (Admitting) Direct address	ROL-12.4-Phone.Email Address			RE	RE
	Visit Number	PV1-19 - Visit Number			R
	Discharge Disposition	PV1-36 - Discharge Disposition			R	RE
	Discharged to Location	PV1-37 - Discharged to Location			RE
	Admit Date	PV1-44 - Admit Date/Time			R
	Admission Reason	PV2-3 - Admit Reason			RE	RE
	Diagnosis Code	DG1-3.1 - Diagnosis Code - DG1.Identifier			RE
	Diagnosis Description	DG1-3.2 - Diagnosis Code - DG1.Text			RE	RE
	Diagnosis Coding System	DG1-3.3 - Diagnosis Code - DG1.Name Of Coding System			RE
	Diagnosis Type	DG1-6 - Diagnosis Type			RE
	Insurance Company Name	IN1-4 - Insurance Company Name			RE
	Insurance Group Number	IN1-8 - Group Number			RE
	Insurance Type	IN1-15 - Plan Type			RE
	Patient Insurance Member ID	IN1-36 - Policy Number			RE
	Insured’s ID Number	IN1-49 – Insured’s ID Number			RE
	Primary Care Provider Identifier (NPI) NOTE: Type 1 NPI if the entity is an Individual	ROL-4.1 – Role Person.Id Number (with ROL-3.1 = PP)			RE RE
	Primary Care Provider Last Name	ROL-4.2 - Role Person.Family Name			RE
	Primary Care Provider First Name	ROL-4.3 - Role Person.Given Name			RE
	Time	EVN-2.1 – Recorded Date/Time.Time			R
	Universal Id Type	EVN-7.3 – Event Facility.Universal Id Type			R
	Mother’s Name 	NK1-2 - Name			RE
	Relationship 	NK1-3 - Relationship			RE
	Mother’s Address 	NK1-4 – Address			RE
	Mother’s Phone Number 	NK1-5.1 – Phone Number.Telephone Number			RE
	Newborn Baby Indicator 	PV2-36 – Newborn Baby Indicator			O
	Discharge Date/time	PV1-45 – Discharge Date/Time			O

- See Appendix