500 Medical Event Reporting

Functional Group MM

X12N Insurance Subcommittee

This X12 Transaction Set contains the format and establishes the data contents of the Medical Event Reporting Transaction Set (500) for use within the context of an Electronic Data Interchange (EDI) environment. This standard can be used to make voluntary, mandatory, baseline, annual and semi-annual reports on medication and medical device adverse effects and product problems.

Heading

Position
Segment
Name
Max use
0100
Transaction Set HeaderMandatory
Max 1
To indicate the start of a transaction set and to assign a control number
0200
Beginning SegmentMandatory
Max 1
To indicate the beginning of a transaction set
NM1 Loop
Repeat >1
0300
Individual or Organizational NameMandatory
Max 1
To supply the full name of an individual or organizational entity
The NM1 loop carries information about the party transmitting the report.
0500
Party LocationOptional
Max 2
To specify the location of the named party
0600
Geographic LocationOptional
Max 1
To specify the geographic place of the named party
0700
Reference InformationOptional
Max >1
To specify identifying information
0800
Administrative Communications ContactOptional
Max >1
To identify a person or office to whom administrative communications should be directed
0900
Date/Time ReferenceOptional
Max >1
To specify pertinent dates and times
1000
Quantity InformationOptional
Max >1
To specify quantity information
1100
TraceOptional
Max >1
To uniquely identify a transaction to an application
LM Loop
Repeat >1
1200
Code Source InformationMandatory
Max 1
To transmit standard code list identification information
1300
Industry Code IdentificationMandatory
Max >1
To identify standard industry codes

Detail

Position
Segment
Name
Max use
HL Loop
Repeat >1
0100
Hierarchical LevelMandatory
Max 1
To identify dependencies among and the content of hierarchically related groups of data segments
The HL loop divides a report into sections such as event, patient, device, medication, reporter, user facility, distributor and manufacturer.
LM Loop
Repeat >1
0200
Code Source InformationMandatory
Max 1
To transmit standard code list identification information
The LM loop provides report data in coded form.
LQ Loop
Repeat >1
0300
Industry Code IdentificationMandatory
Max 1
To identify standard industry codes
0400
Date/Time ReferenceOptional
Max >1
To specify pertinent dates and times
0500
Reference InformationOptional
Max >1
To specify identifying information
0600
Quantity InformationOptional
Max >1
To specify quantity information
0700
TextOptional
Max >1
To specify textual data
LIN Loop
Repeat >1
0800
Item IdentificationMandatory
Max 1
To specify basic item identification data
The LIN loop provides product device or medication specific information.
0900
Product/Item DescriptionOptional
Max >1
To describe a product or process in coded or free-form format
1000
Quantity InformationOptional
Max >1
To specify quantity information
1100
Date/Time ReferenceOptional
Max >1
To specify pertinent dates and times
1200
Reference InformationOptional
Max >1
To specify identifying information
1300
MeasurementsOptional
Max >1
To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See Figures Appendix for example of use of C001)
1400
TraceOptional
Max >1
To uniquely identify a transaction to an application
1500
TextOptional
Max >1
To specify textual data
NM1 Loop
Repeat >1
1600
Individual or Organizational NameMandatory
Max 1
To supply the full name of an individual or organizational entity
The NM1 loop carries party or organization reporting information.
1800
Party LocationOptional
Max 2
To specify the location of the named party
1900
Geographic LocationOptional
Max 1
To specify the geographic place of the named party
2000
Reference InformationOptional
Max >1
To specify identifying information
2100
Administrative Communications ContactOptional
Max >1
To identify a person or office to whom administrative communications should be directed
2200
Date/Time ReferenceOptional
Max >1
To specify pertinent dates and times
2300
Demographic InformationOptional
Max >1
To supply demographic information
2400
MeasurementsOptional
Max >1
To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See Figures Appendix for example of use of C001)
2500
PaperworkOptional
Max >1
To identify the type or transmission or both of paperwork or supporting information
2600
TraceOptional
Max >1
To uniquely identify a transaction to an application
QTY Loop
Repeat >1
2700
Quantity InformationMandatory
Max 1
To specify quantity information
LM Loop
Repeat >1
2800
Code Source InformationMandatory
Max 1
To transmit standard code list identification information
2900
Industry Code IdentificationMandatory
Max >1
To identify standard industry codes
PID Loop
Repeat >1
3000
Product/Item DescriptionMandatory
Max 1
To describe a product or process in coded or free-form format
3100
Date/Time ReferenceOptional
Max >1
To specify pertinent dates and times
3200
Quantity InformationOptional
Max >1
To specify quantity information
MTX Loop
Repeat >1
3300
TextMandatory
Max 1
To specify textual data
3400
Date/Time ReferenceOptional
Max >1
To specify pertinent dates and times
3500
Transaction TotalsOptional
Max 1
To transmit a hash total for a specific element in the transaction set
CTT01 is the number of occurrences of the HL segment.
3600
Transaction Set TrailerMandatory
Max 1
To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)

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