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Classification Level Data Class Data Class Description Data Element Data Element Description Applicable Standards Submitter Name Submitter Organization Submission Date
Level 0 Special Alerts for Care Handoffs External devices LOINC

Lines Tubes Drains Catheters Date/time prior urinary catheter removed

ICD 10, SNOMED, LOINC, RxNorm

 Holly Miller, MD MedAllies
Level 0 Special Alerts for Care Handoffs Internal devices LOINC

Stents
Monitors
Pumps
Defibrillators

ICD 10, SNOMED, LOINC, RxNorm

 Holly Miller, MD MedAllies
Level 0 Special Alerts for Care Handoffs Special equipment needed LOINC

Oxygen
Hoyer
Special fit wheelchair
Bariatric
Extended length
Wound care
VAC
Prosthetics, orthoses

ICD 10, SNOMED, LOINC, RxNorm

 Holly Miller, MD MedAllies
Level 0 Special Alerts for Care Handoffs Medications RxNorm, SNOMED

Important drug-drug interactions
High risk medications e.g.:
anticoagulants
opiates
sedatives
electrolyte altering
hypoglycemics
antipsychotics
Immunosuppressants
Tricyclic antidepressants
Complicated regimens e.g.:
loading
tapering
sliding scale
precise schedule
Instructions for missed or late medications

ICD 10, SNOMED, LOINC, RxNorm

 Holly Miller, MD MedAllies
Level 0 Special Alerts for Care Handoffs Risk Scores LACE - https://www.mdcalc.com/calc/3805/lace-index-readmission

ICD 10, SNOMED, LOINC, RxNorm

 Holly Miller, MD MedAllies
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Place of Service Code

Code indicating the location, such as inpatient, outpatient facility, office, or home health agency, where this service was performed.

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Member Liability

The amount of the member's liability.

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Claim Other Payer Paid Amount

The reduction in the payment amount to reflect the current carrier as a secondary, teritary, etc, payer. May be multiple occurrences if the current carrier is a teritary, etc. carrier.

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Claim Discount Amount

The amount of the discount.

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Total Amount

Total amount for each category (i.e., submitted, eligible, etc.)

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Service (from) Date

Date on which services began. UB04 (Form Locator 45).
Date on which services began. Located on CMS 1500 (Form Locator 24A)

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Line Number

Line identification number that represents the number assigned in a source system for identification and processing.

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Service to Date

Date on which services ended. Located on CMS 1500 (Form Locator 24A)

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Type of Service

High level classification of services into logical grouping.

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Compound Code

The code indicating whether or not the prescription is a compound. NCPDP field # 406-D6

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Line Payment Denial Code

Reason codes used to interpret the Non-Covered Amount that are provided to the Provider

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Benefit Payment Status

Indicates the in network or out of network payment status of the claim.

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Quantity Qualifier Code

The unit of measurement for the drug. (gram, ml, etc.).

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Quantity Dispensed

Quantity dispensed for the drug.

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners
Level 0 Explanation of Benefit

Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

 Allowed Number of Units

The quantity of units, times, days, visits, services, or treatments allowed for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider.

NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.

 Mark Roberts Leavitt Partners