THCIC Minimum Data Set

Below is a list of the data required by Texas' revised mandatory reporting rules. This information has been required for all hospital discharges since January 1, 2004.

If your hospital submits data to THA's Patient Data System, you will need to ensure all of this information is included. Otherwise, when your records are sent to THCIC, you will not be in compliance.

1. Patient Name
   1. Patient Last Name
   2. Patient First Name
   3. Patient Middle Initial
2. Patient Address
   1. Patient Address Line 1
   2. Patient Address Line 2 (if applicable)
   3. Patient City
   4. Patient State
   5. Patient ZIP
   6. Patient Country (if address is not in United States of America, or one of its territories)
3. Patient Birth Date
4. Patient Sex
5. Patient Race
6. Patient Ethnicity
7. Patient Social Security Number
8. Patient Account Number
9. Patient Medical Record Number
10. Claim Filing Indicator Code (Payer Source - primary and secondary (if applicable for secondary payer source)
11. Payer Name - Primary and secondary (if applicable, for both)
12. National Plan Identifier - for primary and secondary (if applicable) payers (National Health Plan Identification number, if applicable and when assigned by the Federal Government)
13. Type of Bill
14. Statement Dates (replaces Statement From and Statement Thru dates)
15. Admission / Start of Care
    1. Admission / Start of Care Date
    2. Admission / Start of Care Hour
16. Admission Type
17. Admission Source
18. Patient (Discharge) Status
19. Patient Discharge Hour
20. Principal Diagnosis
21. Admitting Diagnosis
22. Principle External Cause of Injury (E-Code)
23. Other Diagnosis Codes - up to 24 occurrences (all applicable)
24. External Cause Of Injury (E-Code) - up to 9 occurrences (if applicable)
25. Principal Procedure Code (if applicable)
26. Principal Procedure Date (if applicable)
27. Other Procedure Codes - up to 24 occurrences (if applicable)
28. Other Procedure Dates - up to 24 occurrences (if applicable)
29. Occurrence Span Code - up to 24 occurrences (if applicable)
30. Occurrence Span Code Associated Date - up to 24 occurrences (if applicable)
31. Occurrence Code - up to 24 occurrences (if applicable)
32. Occurrence Code Associated Date - up to 24 occurrences (if applicable)
33. Value Code - up to 24 occurrences (if applicable)
34. Value Code Associated Amount - up to 24 occurrences (if applicable)
35. Condition Code - up to 24 occurrences (if applicable)
36. Attending Physician or Attending Practitioner Name
    1. Attending Practitioner Last Name
    2. Attending Practitioner First Name
    3. Attending Practitioner Middle Initial
37. Attending Practitioner Primary Identifier (National Provider Identifier, when HIPAA rule is implemented)
38. Attending Practitioner Secondary Identifier (Texas state license number or UPIN)
39. Operating Physician or Other Practitioner Name (if applicable)
    1. Operating Physician or Other Practitioner Last Name
    2. Operating Physician or Other Practitioner First Name
    3. Operating Physician or Other Practitioner Middle Initial
40. Operating Physician or Other Practitioner Primary Identifier (National Provider Identifier, when HIPAA rule is implemented)
41. Operating Physician or Other Practitioner Secondary Identifier (Texas state license number or UPIN)
42. Total Claim Charges
43. Revenue Service Line Details (up to 999 service lines) (all applicable)
    1. Revenue Code
    2. Procedure Code
    3. HCPCS/HIPPS Procedure Modifier 1
    4. HCPCS/HIPPS Procedure Modifier 2
    5. HCPCS/HIPPS Procedure Modifier 3
    6. HCPCS/HIPPS Procedure Modifier 4
    7. Charge Amount
    8. Unit Code
    9. Unit Quantity
    10. Unit Rate
    11. Non-covered Charge Amount
44. Service Provider Name
45. Service Provider Primary Identifier - Provider Federal Tax ID (EIN) or National Provider Identifier (when HIPAA rule is implemented)
46. Service Provider Address
    1. Service Provider Address Line 1
    2. Service Provider Address Line 2 (if applicable)
    3. Service Provider City
    4. Service Provider State
    5. Service Provider ZIP
47. Service Provider Secondary Identifier - THCIC 6-digit Hospital ID assigned to each facility

Source: Section 25 TAC § 1301.19(e)