Data Element/Field Name
Required or Recommended
Facility Code
Required
Facility Description
Required
Procedure location
Required
Procedure Date
Required
Patient Name
Required
Patient date of birth
Required
Patient gender
Required
Patient Zip Code
Required
Case Number
Required
MedRecNum
Required
PAT attendance Yes or No
Required
PAT date
Required
Date/Time Procedure
Cancelled
Required
Cancellation Reason
Required
Encounter number (CSN)
Required
Patient Type
Required
Patient status
Required
Case Class
Required
Add On Yes or No
Required
Add on Scheduled Date
Required
Add on Scheduled Time
Required
OR Room #
Required
Anesthesia Type
Required
ASA Classification
Required
Primary Surgeon
Required
Primary Service/ Specialty
Required
CPT #
Required
ICD-10 CM code
Required
ICD-10 CM Name
Required
ICD-10 PCS Code
Required
ICD-10 PCS Name
Required
Procedure Name
Required
Date Case Created
Required
Time Case Created
Required
Scheduled Start Date
Required
Scheduled Start Time
Required
Scheduled Stop Date
Required
Scheduled Stop Time
Required
Scheduled Turnover Time
Required
In Facility
Required
Scheduled Pre-op Care
Duration
Required
Pre-op Care In Time
Required
Pre-op Care Out Time
Required
In Pre-Proc to In Room
Required
IN PRE-PROC TO PRE-PROC Required
COMPLETE
Required
Delay reason 1
Patient In Room Date
Required
Patient In Room Time
Required
Anesthesia Start Date
Required
Anesthesia Start Time
Required
Prep and position start
date time
Required
Prep and position end
date time
Required
Procedure/Cut Start Date
Required
Procedure/Cut Start Time
Required
Closure start date time
Required
Procedure/Cut Stop Date
Required
Procedure/Cut Stop Time
Required
Anesthesia Stop Date
Required
Anesthesia Stop Time
Required
Patient Out of Room Date
Required
Patient Out of Room Time
Required
In PACU
Required
PACU Phase I Care Start
Required
PACU Phase I Care
Complete
Required
OUT PACU
Required
Direct to Phase II?
Required
Phase II Care Start
Required
Phase II Care Complete
Required
Procedural Care Complete
Required
Patient BMI
Required
Total Direct Costs
Required