USHIK: Links between ASC X12, the APCD Council, and States' Data Dictionaries

APCD To ASC X12 Relationship Mapping

The APCD to ASC X12 Relationship Mapping provides an alignment of APCD Council Exit Disclaimer [www.apcdcouncil.org] data elements to ASC X12 5010 data elements and to state APCD data elements for medical claims. A checkmark in a state column indicates that the state collects the data element corresponding to the APCD data element on a particular row. Note that one APCD data element may map to multiple ASC X12 data elements.

Grouping / APCD Element	ASC X12 Element	APCD Data Element ID	ME	MN	TN
Claim
Claim Status	Claim Status Code	MC038		-
Insurance Type/Product Code	Claim Filing Indicator Code	MC003
Line Counter	Assigned Number	MC005
National Plan ID	Other Payer Primary Identifier Payer Identifier	MC002		-
Patient Account/Control Number	Patient Control Number	MC068		-	-
Payer	Other Payer Primary Identifier Submitter Identifier	MC001
Payer Claim Control Number	Description Payer Claim Control Number Reference Identification Qualifier	MC004
Record Type		MC899	-
Type of Bill - Institutional	Claim Frequency Code Facility Code Qualifier Facility Type Code	MC036
Subscriber
Encrypted Subscriber First Name	Subscriber First Name	MC102			-
Encrypted Subscriber Last Name	Subscriber Last Name	MC101			-
Encrypted Subscriber Middle Initial	Subscriber Middle Name or Initial	MC103			-
Insured Group or Policy Number	Insured Group or Policy Number Subscriber Group or Policy Number	MC006		-
Plan Specific Contract Number	Subscriber Primary Identifier	MC008
Subscriber Social Security Number	Reference Identification Qualifier Subscriber Social Security Number	MC007		-	-
Patient
Encrypted Member First Name	Patient First Name	MC105		-	-
Encrypted Member Last Name	Patient Last Name	MC104		-	-
Encrypted Member Middle Initial	Patient Middle Name or Initial	MC106		-	-
Individual Relationship Code	Individual Relationship Code	MC011
Member City Name (Patient)	Patient City Name Subscriber City Name	MC014
Member Date of Birth (Patient)	Date Time Period Format Qualifier Patient Birth Date Subscriber Birth Date	MC013		-	-
Member Gender (Patient)	Patient Gender Code Subscriber Gender Code	MC012
Member Identification Code (Patient)	Identification Code Identification Code Qualifier Subscriber Primary Identifier	MC010		-	-
Member State or Province (Patient)	Patient State Code Subscriber State Code	MC015
Member Suffix or Sequence Number		MC009		-
Member ZIP Code (Patient)	Patient Postal Zone or ZIP Code Subscriber Postal Zone or ZIP Code	MC016
Subscriber Social Security Number	Reference Identification Qualifier Subscriber Social Security Number	MC007		-	-
Service
Dates
Date of Service - From	Date Time Period Format Qualifier Date Time Qualifier Statement From and To Date	MC059
Date of Service - Thru	Date Time Period Format Qualifier Date Time Qualifier Statement From and To Date	MC060
Date Service Approved/Accounts Payable Date/Actual	Adjudication or Payment Date Date Time Period Format Qualifier Date Time Qualifier	MC017
Admission
Admission Date	Admission Date/Hour or Start of Care Date Date Time Period Format Qualifier Date Time Qualifier	MC018
Admission Hour	Admission Date/Hour or Start of Care Date Date Time Period Format Qualifier Date Time Qualifier	MC019		-
Admission Type	Admission Type Code	MC020
National Billing Provider ID - "Biller"	Billing Provider Identifier Identification Code Qualifier	MC077
Point of Origin	Admission Type Code Date Time Period Format Qualifier Date Time Qualifier Discharge Time	MC021
Discharge
Discharge Date		MC069		-	-
Discharge Hour		MC022		-
Discharge Status	Patient Status Code	MC023
Diagnosis
Admitting Diagnosis	Admitting Diagnosis Code Code List Qualifier Code Date Time Period Format Qualifier	MC039
E-Code	Code List Qualifier Code External Cause of Injury Code	MC040
Other Diagnosis - 1	Code List Qualifier Code Other Diagnosis	MC042
Other Diagnosis - 10	Code List Qualifier Code Other Diagnosis	MC051
Other Diagnosis - 11	Code List Qualifier Code Other Diagnosis	MC052
Other Diagnosis - 12	Code List Qualifier Code Other Diagnosis	MC053
Other Diagnosis - 2	Code List Qualifier Code Date Time Period Format Qualifier Other Diagnosis	MC043
Other Diagnosis - 3	Code List Qualifier Code Date Time Period Format Qualifier Other Diagnosis	MC044
Other Diagnosis - 4	Code List Qualifier Code Other Diagnosis	MC045
Other Diagnosis - 5	Code List Qualifier Code Other Diagnosis	MC046
Other Diagnosis - 6	Code List Qualifier Code Other Diagnosis	MC047
Other Diagnosis - 7	Code List Qualifier Code Other Diagnosis	MC048
Other Diagnosis - 8	Code List Qualifier Code Other Diagnosis	MC049
Other Diagnosis - 9	Code List Qualifier Code Other Diagnosis	MC050
Principal Diagnosis	Code List Qualifier Code Principal Diagnosis Code	MC041
Billing Provider
Billing Provider Last Name or Organization Name	Billing Provider Organizational Name	MC078
Billing Provider Number		MC076
National Billing Provider ID - "Biller"	Billing Provider Identifier Identification Code Qualifier	MC077
Service Provider
National Service Provider ID	Attending Provider Primary Identifier Rendering Provider Identifier	MC026	-
Service Provider City Name	Laboratory or Facility City Name	MC033	-
Service Provider Entity Type Qualifier	Entity Type Qualifier	MC027	-
Service Provider First Name	Attending Provider First Name Rendering Provider First Name	MC028	-
Service Provider Last Name or Organization Name	Attending Provider Last Name Rendering Provider Last Name	MC030	-
Service Provider Middle Name	Attending Provider Middle Name or Initial Rendering Provider Middle Name or Initial	MC029	-
Service Provider Number	Reference Identification Qualifier Rendering Provider Secondary Identifier	MC024	-
Service Provider Specialty	Provider Taxonomy Code	MC032	-	-
Service Provider State or Province	Laboratory or Facility State or Province Code	MC034	-
Service Provider Suffix	Attending Provider Name Suffix Rendering Provider Name Suffix	MC031	-
Service Provider Tax ID Number		MC025	-
Service Provider ZIP Code	Laboratory or Facility Postal Zone or ZIP Code	MC035	-
Lines
APC		MC073		-
APC Version		MC074		-
Charge Amount	Line Item Charge Amount	MC062
Co-pay Amount	Code List Qualifier Code Value Code	MC065
Coinsurance Amount	Code List Qualifier Code Value Code	MC066		-
Deductible Amount	Code List Qualifier Code Value Code	MC067
DRG	Code List Qualifier Code Diagnosis Related Group (DRG) Code	MC071		-
DRG Version		MC072		-
Drug Code	National Drug Code Product or Service ID Qualifier	MC075		-
ICD-9-CM Procedure Code	Code List Qualifier Code Principal Procedure Code	MC058
Paid Amount	Service Line Paid Amount	MC063
Prepaid Amount		MC064
Procedure Code	Procedure Code Product or Service ID Qualifier	MC055
Procedure Modifier - 1	Procedure Modifier	MC056
Procedure Modifier - 2	Procedure Modifier	MC057		-
Quantity		MC061
Revenue Code	Service Line Revenue Code	MC054

United States Health Information Knowledgebase

APCD To ASC X12 Relationship Mapping