59E-7.027. Header Record.  


Effective on Monday, January 1, 2018
  • 1The first record in the data file shall be a header record containing the information described below.

    18(1) 19Transaction Code. Enter Q for a calendar quarter report. A required field.

    31(2) 32Report Year. Enter the year of the data in the format YYYY where YYYY represents the year in four (4) digits. A required field.

    56(3) 57Report Quarter. Enter the quarter of the data, 1, 2, 3 or 4, where 1 corresponds to the first quarter of the calendar year, 2 corresponds to the second quarter of the calendar year, 3 corresponds to the third quarter of the calendar year, and 4 corresponds to the fourth quarter of the calendar year. A required field.

    115(4) Data Type. Enter PD10-4 120for Inpatient Data. A required field.

    126(5) 127Submission Type. Enter I or R where I indicates an initial submission 139of a data file 143or resubmission of 146a data file prior to certification, R indicates a replacement submission of previously certified inpatient data where resubmission has been requested or authorized by the Agency. A required field.

    175(6) Processing Date. Enter the date that the data file was created in the format YYYY-MM-DD where MM represents numbered months of the year from 01 to 12, DD represents numbered days of the month from 01 to 31, and YYYY represents the year in four (4) digits. A required field.

    226(7) AHCA Facility Number. Enter the identification number of the facility as assigned by the Agency for reporting purposes. A valid identification number must contain at least eight (8) digits and no more than ten (10) digits. A required field.

    266(8) Medicare Number. Enter the Medicare number of the facility as assigned by Centers for Medicare & Medicaid Services (CMS). A valid identification number must contain seven (7) numeric digits. A required field.

    299(9) Organization Name. Enter the name of the hospital from which the patient was discharged, 314and which is responsible for reporting the data. All questions regarding data accuracy and integrity will be referred to this entity. Up to a forty-character field. A required field.

    343(10) Contact Person Name. Enter the name of the contact person for the hospital. Submit name in the Last, First format. Up to a twenty-five-character field. A required field.

    372(11) Contact Phone Number. The area code, business telephone number, and if applicable, extension for the contact person. Enter the contact person’s telephone number in the numeric format (AAA)XXXXXXXEEEE where AAA is the area code, XXXXXXX represents the seven (7) digit phone number and EEEE represents the extension. Zero fill if no extension. A required field.

    428(12) Contact Person Email Address. Enter the email address of the contact person.

    441(13) 442Contact Person Street or P.O. Box Address. Enter the street or post office box address of the contact person’s mailing address. Up to a forty-character field. A required field.

    471(14) 472Mailing Address City. Enter the city of the contact person’s address. Up to a twenty-five character field. A required field.

    492(15) 493Mailing Address State. Enter the state of the contact person’s address using the U.S. Postal Service state abbreviation in the format XX. Use the abbreviation FL for Florida. A required field.

    524(16) 525Mailing Address Zip Code. Enter the 531numeric 532zip code of the contact person’s address in the format XXXXX-XXXX.

    543Rulemaking Authority 545408.061(1)(e), 546408.15(8) FS. 548Law Implemented 550408.061, 551408.062, 552408.063 FS. 554History–555New 1-1-10, F558ormerly 55959E-7.014, 560Amended 10-1-15, 1-1-18.