|
| |
Location of Loss
The information in this section
describes the location where the claim occurred. All fields in this
section are required.
| Field
No. |
Field
Name |
Entry |
Description |
| 20 |
Type
of Institution |
Required |
Optional
for corporate files. Enter the code from the following table for
the type of institution where the incident occurred (or where the
patient was located at the time of incident) |
| Code |
Type
of Institution |
Code |
Type
of Institution |
| 01 |
Hospital |
09 |
Lab
outside hospital |
| 02 |
Hospital outpatient facility |
10 |
Blood
bank |
| 03 |
Emergicenter |
11 |
HMO |
| 04 |
Surgicenter |
12 |
Birthing Center |
| 05 |
Nursing home |
13 |
Prison |
| 06 |
Practitioner's office |
97 |
Telephone treatment |
| 07 |
Patient's home |
98 |
Other |
| 08 |
Other
outpatient facility |
99 |
Not
in institution |
|
Table
5-A |
| Field
No. |
Field
Name |
Entry |
Description |
| 21 |
Incident
Location |
Optional |
Optional for
corporate files. Enter the code for the location where the
incident occurred from the following table.
EDIT - If the
type of institution is coded as "01" (hospital) or
"05" (nursing home), then the incident location cannot be
coded "99". The incident location must be coded
"99" when a claim occurs in the patient's home
("07")
|
| Code |
Incident
Location |
Code |
Incident
Location |
| 01 |
Patient's room |
12 |
Pharmacy |
| 02 |
Labor
and delivery room |
13 |
Laboratory |
| 03 |
Operating room |
14 |
Dispensary |
| 04 |
Recovery room |
15 |
Other
department in hospital |
| 05 |
Critical care unit |
16 |
Rehabilitation center |
| 06 |
Special procedure room |
17 |
Radiation therapy department |
| 07 |
Nursery |
18 |
Catheterization lab |
| 08 |
Radiology department |
19 |
Morgue |
| 09 |
Physical therapy department |
97 |
Unknown |
| 10 |
Emergency department |
98 |
Other |
| 11 |
Outpatient department |
99 |
Not
in inpatient facility |
|
Table
5-B |
| Field
No. |
Field
Name |
Entry |
Description |
| 22 |
Type
of Hospital |
Required |
This field
is required if location was a hospital ("01") or hospital
outpatient facility ("02").
EDIT - If the
type of institution is coded as "01" (hospital) or
"05" (nursing home), then the incident location cannot be
coded "99". The incident location must be coded
"99" when a claim occurs in the patient's home
("07").
|
| Code |
Type
of Hospital |
Description |
|
n |
Non-teaching hospital |
A hospital
that does not have resident physicians. |
|
t |
Teaching hospital |
A hospital
having resident physicians. |
|
blank |
- |
Not
occurring in a hospital setting. |
|
Table
5-C |
* A list of teaching hospitals
can be found at www.aamc.org/teachinghospitals.htm
| Field
No. |
Field
Name |
Entry |
Description |
| 23 |
State |
Required |
Enter the
code for the state in which the loss occurred from the following table. |
| |
State |
|
State |
|
State |
|
State |
| ak |
Alaska |
id |
Idaho |
mt |
Montana |
ri |
Rhode
Island |
| al |
Alabama |
il |
Illinois |
nc |
North
Carolina |
sc |
South
Carolina |
| ar |
Arkansas |
in |
Indiana |
nd |
North
Dakota |
sd |
South
Dakota |
| az |
Arizona |
ks |
Kansas |
ne |
Nebraska |
tn |
Tennessee |
| ca |
California |
ky |
Kentucky |
nh |
New
Hampshire |
tx |
Texas |
| co |
Colorado |
la |
Louisiana |
nj |
New
Jersey |
ut |
Utah |
| ct |
Connecticut |
ma |
Massachusetts |
nm |
New
Mexico |
va |
Virginia |
| dc |
D.C. |
md |
Maryland |
nv |
Nevada |
vt |
Vermont |
| de |
Delaware |
me |
Maine |
ny |
New
York |
wa |
Washington |
| fl |
Florida |
mi |
Michigan |
oh |
Ohio |
wi |
Wisconsin |
| ga |
Georgia |
mn |
Minnesota |
ok |
Oklahoma |
wv |
West
Virginia |
| hi |
Hawaii |
mo |
Missouri |
or |
Oregon |
wy |
Wyoming |
| ia |
Iowa |
ms |
Mississippi |
pa |
Pennsylvania |
zz |
Other |
|
Table
5-D |
|