HIV Individual Dosage Form Codebook
HIV INDIVIDUAL DOSAGE FORM CODEBOOK
Coding Manual for the Individual Dosage Forms
Important Coding Note: There were recent additions to the service codes that are included in this codebook but
may not appear on the version of the Individual Dosage Form used by the grantee at this time. These additions do
not have an impact on the numeric codes originally assigned to the service types and will not impact the coding of
data from older versions of the form.
Item
Variable
Adm
Mth
Month of Encounter
Adm
Day
Adm Yr
Day of Encounter
Grant ID
Grant ID (5 digits)
Grp
Type
Adm
Frmt
Part ID #
Year of Encounter
Response Choice/Numeric
Code
1=January 8=August
2=February 9=September
3=March
10=October
4=April
11=November
5=May
12=December
6=June
7=July
Two digit number 1 to 31
98=Left blank
Record the four-digit year
(e.g. 2014, 2015, etc.)
Five-digit number that
follows “SP” in the Grant
Award Number issued by
CSAP
98=Left blank
Study Design Group Type (1 digit) 1= Intervention
[Please make sure that this
variable is set to 1 for all dosage
data submitted to SAMHSA.
Dosage data should not be
submitted for comparison groups
(if any)]
Administration Format (1 digit)
1=Individual/One-on-One
[Please make sure that this
Format
variable is set to 1 for all
individual dosage data.]
Participant ID Number
Enter the Participant ID
number
98=Left blank
Last Updated – 5/2015
Variable Name
MONTH
DAY
YEAR
GRANT_ID
DESIGNGRP
ADMIN_FRMT
PARTID
HIV Individual Dosage Form Codebook
Item
Variable
Response Choice/Numeric
Code
Please count the number of
service types recorded for
this individual on this
encounter date and enter the
number.
Variable Name
How many service types were
NUM_INTERV
administered to this individual on
this date?
[Up to four service types may be
entered in a group dosage form. If
more than four service types were
administered during this
encounter, please record the rest
in a separate individual dosage
form. Make sure to complete all
the required information in the
additional form.]
Please enter the appropriate Individual Service Code and the Duration Code for the first
service type.
1= Risk/Resiliency Assessment
Please enter the Individual
INTERV_TYP1
(01)
Service Code for the first service
2= Risk Reduction
type delivered on this date.
Counseling/Education (02)
3= HIV Testing Counseling (03)
3a= HCV Testing Counseling (03a)
4= Psycho-Social Counseling (04)
4a= Substance Abuse Counseling
(04a)
5= Substance Abuse Education (05)
6= HIV Education (06)
6a= STD Education (06a)
7= Hepatitis Education (07)
8= Mentoring -Peer or other type
(08)
9= Case Management Services (09)
10= All Other Individual Services
(10)
11= HIV Testing (11)
11a= HCV Testing (11a)
11b= Other STD Testing (11b)
12= Primary Health Care Services
(12)
13= Other Health Care Services
(13)
Please enter the Duration Code
[Enter the number of minutes this
specific service type lasted,
rounded up to the next fiveminute interval.]
Please record the 3-digit
duration code
DURATION1
2
Last Updated – 5/2015
HIV Individual Dosage Form Codebook
Item
Variable
Response Choice/Numeric
Variable Name
Code
If there was a single service type administered to this individual on this encounter date, coding
of the data for this encounter date is complete. Otherwise, please enter the appropriate
Individual Service Code and the Duration Code for the next service type.
1= Risk/Resiliency Assessment
Please enter the Individual
INTERV_TYP2
(01)
Service Code for the second
2= Risk Reduction
service type delivered on this date Counseling/Education (02)
(if applicable).
3= HIV Testing Counseling (03)
3a= HCV Testing Counseling (03a)
4= Psycho-Social Counseling (04)
4a= Substance Abuse Counseling
(04a)
5= Substance Abuse Education (05)
6= HIV Education (06)
6a= STD Education (06a)
7= Hepatitis Education (07)
8= Mentoring -Peer or other type
(08)
9= Case Management Services (09)
10= All Other Individual Services
(10)
11= HIV Testing (11)
11a= HCV Testing (11a)
11b= Other STD Testing (11b)
12= Primary Health Care Services
(12)
13= Other Health Care Services
(13)
98= Left blank
Please enter the Duration Code
[Enter the number of minutes this
specific service type lasted,
rounded up to the next fiveminute interval.]
Please record the 3-digit
duration code
98=Left blank
DURATION2
3
Last Updated – 5/2015
HIV Individual Dosage Form Codebook
Item
Variable
Response Choice/Numeric
Variable Name
Code
If there were only two service types administered to this individual on this encounter date,
coding of the data for this encounter date is complete. Otherwise, please enter the appropriate
Individual Service Code and the Duration Code for the next service type.
1= Risk/Resiliency Assessment
Please enter the Individual
INTERV_TYP3
(01)
Service Code for the third service
2= Risk Reduction
type delivered on this date (if
Counseling/Education (02)
applicable).
3= HIV Testing Counseling (03)
3a= HCV Testing Counseling (03a)
4= Psycho-Social Counseling (04)
4a= Substance Abuse Counseling
(04a)
5= Substance Abuse Education (05)
6= HIV Education (06)
6a= STD Education (06a)
7= Hepatitis Education (07)
8= Mentoring -Peer or other type
(08)
9= Case Management Services (09)
10= All Other Individual Services
(10)
11= HIV Testing (11)
11a= HCV Testing (11a)
11b= Other STD Testing (11b)
12= Primary Health Care Services
(12)
13= Other Health Care Services
(13)
98= Left blank
Please enter the Duration Code
[Enter the number of minutes this
specific service type lasted,
rounded up to the next fiveminute interval.]
Please record the 3-digit
duration code.
98=Left blank
DURATION3
4
Last Updated – 5/2015
HIV Individual Dosage Form Codebook
Item
Variable
Response Choice/Numeric
Variable Name
Code
If there were only three service types administered to this individual on this encounter date,
coding of the data for this encounter date is complete. Otherwise, please enter the appropriate
Individual Service Code and the Duration Code for the next service type.
1= Risk/Resiliency Assessment
Please enter the Individual
INTERV_TYP4
(01)
Service Code for the fourth
2= Risk Reduction
service type delivered on this date Counseling/Education (02)
(if applicable).
3= HIV Testing Counseling (03)
3a= HCV Testing Counseling (03a)
4= Psycho-Social Counseling (04)
4a= Substance Abuse Counseling
(04a)
5= Substance Abuse Education (05)
6= HIV Education (06)
6a= STD Education (06a)
7= Hepatitis Education (07)
8= Mentoring -Peer or other type
(08)
9= Case Management Services (09)
10= All Other Individual Services
(10)
11= HIV Testing (11)
11a= HCV Testing (11a)
11b= Other STD Testing (11b)
12= Primary Health Care Services
(12)
13= Other Health Care Services
(13)
98= Left blank
Please enter the Duration Code
[Enter the number of minutes this
specific service type lasted,
rounded up to the next fiveminute interval.]
Please record the 3-digit
duration code.
98=Left blank
DURATION4
5
Last Updated – 5/2015