DG1 - Diagnosis Segment

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 Segment

Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
DG1
1	Set ID - DG1	SI	R		[1..1]	00375	[1..4]
2	Diagnosis Coding Method		W		[0..1]	00376
3	Diagnosis Code - DG1	CWE	R	0051 Diagnosis Code	[1..1]	00377
4	Diagnosis Description		W		[0..1]	00378
5	Diagnosis Date/Time	DTM	O		[0..1]	00379
6	Diagnosis Type	CWE	R	0052(S) Diagnosis Type(Suggested)	[1..1]	00380
7	Major Diagnostic Category	CNE	W	0118 Major Diagnostic Category	[0..1]	00381
8	Diagnostic Related Group	CNE	W	0055 Diagnosis Related Group	[0..1]	00382
9	DRG Approval Indicator	ID	W	0136(R) Yes/no Indicator(Required)	[0..1]	00383
10	DRG Grouper Review Code	CWE	W	0056 DRG Grouper Review Code	[0..1]	00384
11	Outlier Type	CWE	W	0083(S) Outlier Type(Suggested)	[0..1]	00385
12	Outlier Days	NM	W		[0..1]	00386
13	Outlier Cost	CP	W		[0..1]	00387
14	Grouper Version And Type		W		[0..1]	00388
15	Diagnosis Priority	NM	O	0359 Diagnosis Priority	[0..1]	00389		2	#
16	Diagnosing Clinician	XCN	O		[0..*]	00390
17	Diagnosis Classification	CWE	O	0228 Diagnosis Classification	[0..1]	00766
18	Confidential Indicator	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00767	[1..1]
19	Attestation Date/Time	DTM	O		[0..1]	00768
20	Diagnosis Identifier	EI	C		[0..1]	01850
21	Diagnosis Action Code	ID	C	0206(R) Segment Action Code(Required)	[0..1]	01894	[1..1]
22	Parent Diagnosis	EI	C		[0..1]	02152
23	DRG CCL Value Code	CWE	O	0728(R) CCL Value(Required)	[0..1]	02153
24	DRG Grouping Usage	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	02154	[1..1]
25	DRG Diagnosis Determination Status	CWE	O	0731(R) DRG Diagnosis Determination Status(Required)	[0..1]	02155
26	Present On Admission	CWE	O	0895(S) Present On Admission (POA) Indicator(Suggested)	[0..1]	02288

DG1-1: Set ID - DG1 (SI) 00375

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.

DG1-2: Diagnosis Coding Method () 00376

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 .

DG1-3: Diagnosis Code - DG1 (CWE) 00377

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."

DG1-4: Diagnosis Description () 00378

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.

DG1-5: Diagnosis Date/Time (DTM) 00379

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

DG1-6: Diagnosis Type (CWE) 00380

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.

DG1-7: Major Diagnostic Category (CNE) 00381

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 .

DG1-8: Diagnostic Related Group (CNE) 00382

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.

DG1-9: DRG Approval Indicator (ID) 00383

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

DG1-10: DRG Grouper Review Code (CWE) 00384

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

DG1-11: Outlier Type (CWE) 00385

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

DG1-12: Outlier Days (NM) 00386

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

DG1-13: Outlier Cost (CP) 00387

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

DG1-14: Grouper Version And Type () 00388

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

DG1-15: Diagnosis Priority (NM) 00389

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.

DG1-16: Diagnosing Clinician (XCN) 00390

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.

DG1-17: Diagnosis Classification (CWE) 00766

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.

DG1-18: Confidential Indicator (ID) 00767

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.

• Y    the diagnosis is a confidential diagnosis

• N    the diagnosis does not contain a confidential diagnosis

DG1-19: Attestation Date/Time (DTM) 00768

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

DG1-20: Diagnosis Identifier (EI) 01850

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.

DG1-21: Diagnosis Action Code (ID) 01894

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.

DG1-22: Parent Diagnosis (EI) 02152

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 ("+").

DG1-23: DRG CCL Value Code (CWE) 02153

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.

DG1-24: DRG Grouping Usage (ID) 02154

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:

Y    Yes - Indicates that the diagnosis has been used for the DRG determination

N    No – Indicates that the diagnosis has not been used for the DRG determination

DG1-25: DRG Diagnosis Determination Status (CWE) 02155

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.

DG1-26: Present On Admission (CWE) 02288

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.