18.8.38 DG1 - Diagnosis Segment (6.5.2)

The DG1 segment contains patient diagnosis information of various types, for example, admitting, primary, etc. The DG1 segment is used to send multiple diagnoses (for example, for medical records encoding). It is also used when the FT1-19 - Diagnosis Code - FT1 does not provide sufficient information for a billing system. This diagnosis coding should be distinguished from the clinical problem segment used by caregivers to manage the patient (see Chapter 12, Patient Care). Coding methodologies are also defined.

HL7 Attribute Table - DG1 - Diagnosis

18.8.38.1 DG1 field definitions (6.5.2.0)

18.8.38.2 DG1-1 Set ID - DG1 (SI) 00375 (6.5.2.1)

Definition: This field contains the number that identifies this transaction. For the first occurrence of the segment the sequence number shall be 1, for the second occurrence it shall be 2, etc.

18.8.38.3 DG1-2 Diagnosis Coding Method 00376 (6.5.2.2)

Attention: DG1-2 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6 .

18.8.38.4 DG1-3 Diagnosis Code - DG1 (CWE) 00377 (6.5.2.3)

Definition: DG1-3 - Diagnosis Code - DG1 contains the diagnosis code assigned to this diagnosis. Refer to User-defined Table 0051 - Diagnosis Code in Chapter 2C, Code Tables, for suggested values. This field is a CWE data type for compatibility with clinical and ancillary systems. Either DG1-3.1-Identifier or DG1-3.2-Text is required. When a code is used in DG1-3.1-Identifier, a coding system is required in DG1-3.3-Name of Coding System.

Names of various diagnosis coding systems are listed in Chapter 2, Section 2.16.4, "Coding system table."

18.8.38.5 DG1-4 Diagnosis Description 00378 (6.5.2.4)

Attention: DG1-4 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

18.8.38.6 DG1-5 Diagnosis Date/Time (DTM) 00379 (6.5.2.5)

Definition: This field contains the date/time that the diagnosis was determined.

18.8.38.7 DG1-6 Diagnosis Type (CWE) 00380 (6.5.2.6)

Definition: This field contains a code that identifies the type of diagnosis being sent. Refer to User-defined Table 0052 - Diagnosis Type in Chapter 2C, Code Tables, for suggested values. This field should no longer be used to indicate "DRG" because the DRG fields have moved to the new DRG segment.

18.8.38.8 DG1-7 Major Diagnostic Category 00381 (6.5.2.7)

Attention: DG1-7 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6 .

18.8.38.9 DG1-8 Diagnostic Related Group 00382 (6.5.2.8)

Attention: DG1-8 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

18.8.38.10 DG1-9 DRG Approval Indicator 00383 (6.5.2.9)

Attention: DG1-9 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6

18.8.38.11 DG1-10 DRG Grouper Review Code 00384 (6.5.2.10)

Attention: DG1-10 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6

18.8.38.12 DG1-11 Outlier Type 00385 (6.5.2.11)

Attention: DG1-11 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6

18.8.38.13 DG1-12 Outlier Days 00386 (6.5.2.12)

Attention: DG1-12 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6

18.8.38.14 DG1-13 Outlier Cost 00387 (6.5.2.13)

Attention: DG1-13 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6

18.8.38.15 DG1-14 Grouper Version and Type 00388 (6.5.2.14)

Attention: DG1-14 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6

18.8.38.16 DG1-15 Diagnosis Priority (NM) 00389 (6.5.2.15)

Definition: This field contains the number that identifies the significance or priority of the diagnosis code. Refer to HL7 Table 0359 - Diagnosis Priority in Chapter 2C, Code Tables, for suggested values.

Note: As of v 2.7, the data type has been changed to numeric. The meaning of the values remains the same as those in HL7 Table 0418 - Procedure Priority, The value 0 conveys that this procedure is not included in the ranking. The value 1 means that this is the primary procedure. Values 2-99 convey ranked secondary procedures.

18.8.38.17 DG1-16 Diagnosing Clinician (XCN) 00390 (6.5.2.16)

Definition: This field contains the individual responsible for generating the diagnosis information. As of v 2.7, if XCN.1 - ID Number is populated, then the XCN.13 - Identifier Type Code and the XCN.9 - Assigning Authority or XCN.22 - Assigning Jurisdiction or XCN.23 - Assigning Agency or Department are required. If XCN.2 - Family Name is populated, then the XCN.10 - Name Type Code is required. No assumptions can be safely made based on position or sequence. Specification of meaning based on sequence is deprecated.

18.8.38.18 DG1-17 Diagnosis Classification (CWE) 00766 (6.5.2.17)

Definition: This field indicates if the patient information is for a diagnosis or a non-diagnosis code. Refer to User-defined Table 0228 - Diagnosis Classification in Chapter 2C, Code Tables, for suggested values.

18.8.38.19 DG1-18 Confidential Indicator (ID) 00767 (6.5.2.18)

Definition: This field indicates whether the diagnosis is confidential. Refer to HL7 Table 0136 - Yes/no Indicator in Chapter 2C, "Code Tables", for valid values.

• Ythe diagnosis is a confidential diagnosis

• Nthe diagnosis does not contain a confidential diagnosis

18.8.38.20 DG1-19 Attestation Date/Time (DTM) 00768 (6.5.2.19)

Definition: This field contains the time stamp that indicates the date and time that the attestation was signed.

18.8.38.21 DG1-20 Diagnosis Identifier (EI) 01850 (6.5.2.20)

Definition: This field contains a value that uniquely identifies a single diagnosis for an encounter. It is unique across all segments and messages for an encounter. This field is required in all implementations employing Update Diagnosis/Procedures (P12) messages.

18.8.38.22 DG1-21 Diagnosis Action Code (ID) 01894 (6.5.2.21)

Definition: This field defines the action to be taken for this diagnosis. Refer to HL7 Table 0206 - Segment Action Code in Chapter 2C, "Code Tables", for valid values. This field is required for the update diagnosis/procedures (P12) message. In all other events it is optional.

18.8.38.23 DG1-22 Parent Diagnosis (EI) 02152 (6.5.2.22)

Definition: This field contains the entity identifier for the parent diagnosis. This field links the "current" manifestation diagnosis ("*") to the entity identifier of the "parent" etiological diagnosis ("+").

18.8.38.24 DG1-23 DRG CCL Value Code (CWE) 02153 (6.5.2.23)

Definition: This field indicates the CCL value for the determined DRG for this diagnosis. Refer to Externally-defined Table 0728 - CCL Value in Chapter 2C, Code Tables, for suggested values.

18.8.38.25 DG1-24 DRG Grouping Usage (ID) 02154 (6.5.2.24)

Definition: This field identifies whether this particular diagnosis has been used for the DRG determination. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for suggested values. The values have the following meaning for this field:

YYes - Indicates that the diagnosis has been used for the DRG determination

NNo - Indicates that the diagnosis has not been used for the DRG determination

18.8.38.26 DG1-25 DRG Diagnosis Determination Status (CWE) 02155 (6.5.2.25)

Definition: This field contains the status of this particular diagnosis for the DRG determination. Refer to User-defined Table 0731 - DRG Diagnosis Determination Status in Chapter 2C, Code Tables, for suggested values.

18.8.38.27 DG1-26 Present On Admission (POA) Indicator (CWE) 02288 (6.5.2.26)

Definition: This field contains the present on admission indicator for this particular diagnosis. US reimbursement formulas for some states and Medicare have mandated that each diagnosis code be flagged as to whether it was present on admission or not. Refer to User-defined Table 0895 - Present On Admission (POA) Indicator in Chapter 2C, Code Tables, for suggested values.