275 - Patient Information

FUNCTIONAL GROUP=PI

This X12 Transaction Set 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.

SCHEMA

ST

Segment	Name	Position
ST	Transaction Set Header	0100
BGN	Beginning Segment	0200
DTM	Date/Time Reference	0300
TRN	Trace	0400

NM1

Segment	Name	Position
NM1	Individual or Organizational Name	0500
IN1	Individual Identification	0600
DMG	Demographic Information	0700
PRV	Provider Information	0800
PER	Administrative Communications Contact	0900
REF	Reference Information	1000
DTP	Date or Time or Period	1050

NX1

Segment	Name	Position
NX1	Property or Entity Identification	1100
N3	Party Location	1200
N4	Geographic Location	1300

LX

Segment	Name	Position
LX	Transaction Set Line Number	0100
TRN	Trace	0150
STC	Status Information	0175
NM1	Individual or Organizational Name	0200
PRV	Provider Information	0300
PER	Administrative Communications Contact	0400
REF	Reference Information	0500
HI	Health Care Information Codes	0540
SVC	Service Information	0560

DTP

Segment	Name	Position
DTP	Date or Time or Period	0600
CAT	Category of Patient Information Service	0700
PID	Product/Item Description	0800

OOI

Segment	Name	Position
OOI	Associated Object Type Identification	0900
BDS	Binary Data Structure	1000
SE	Transaction Set Trailer	1100

COMMENTS

Notes
1/0500	Loop NM1 identifies a single patient; it also identifies other entities or individuals which include the requester, responder or other organizations.
1/0800	The PRV segment is only used in Loop NM1 when identifying a requestor or responder who is also a provider.
2/0150	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.
2/0175	The STC segment in LX loop identifies the status and action requested in a prior transaction when the response is provided in this transaction.
2/0200	The NM1 segment in loop LX identifies an individual provider within a responder group.

rev 02/12/2024