TEDS MH-TEDS Data TEDS MH-TEDS Data Elements

Treatment Episode Data Set (TEDS)

Attachment A_TEDS MH-TEDS Data Elements 202412.xlsx

OMB: 0930-0335

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OMB No.0930-0335




Expiration Date: XX/XX/XXXX
Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  The OMB control number for this project is 0930-0335.  Public reporting burden for this collection of information is estimated to average XX hours per respondent, per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 5600 Fishers Lane, Room 15E57-A, Rockville, Maryland, 20857.










LEGEND
Key field = must not be blank. Key fields, taken together, are used to uniquely identify and link records.
Data set classifications, i.e., SDS, MDS, and SuDS, apply to MH-TEDS admission variables only.

TEDS/MH-TEDS
Variable Name Data Field Reference Number Categories
Admission Record Discharge/Update Record
Value taken from admission record Value taken at time of discharge or data update
SYSTEM DATA SET (SDS)
System Transaction Type SDS 1
DIS 1 A=Add



C=Change



D=Delete
State Code – Key field SDS 2
DIS 2 2 character state abbreviation
Reporting Date SDS 3
DIS 3 MMYYYY
MINIMUM DATA SET (MDS)
State Provider Identifier – Key field MDS 1 DIS 11 DIS 4 1-15 alphanumeric
Client Identifier – Key field MDS 2 DIS 12 DIS 5 1-15 alphanumeric
Codependent or Collateral – Key field MDS 3 DIS 13 DIS 6 1=Codependent/Collateral
2=Client
Client Transaction Type – Key field MDS 4 DIS 14
A=Initial Admission (SU)



T=Transfer (SU)



D=Discharge (SU)



M=Initial Admission (MH)



X=Transfer (MH)



E=Discharge (MH)



U=Update (MH)
Date of Admission – Key field MDS 5 DIS 15
MMDDYYYY
Previous SU Treatment Episodes MDS 6

Optional reporting MH clients



0=0 Previous episodes



1=1 Previous episode



2=2 Previous episodes



3=3 Previous episodes



4=4 Previous episodes



5=5 or more previous episodes



6=Not applicable



7=Unknown



8=Not collected
Referral Source MDS 7

Optional reporting for MH



01=Individual



02=Alcohol/Drug use care provider



03=Other health care provider



04=School (Educational)



05=Employer/Employee Assistance Program (EAP)



06=Other community referral



07=Court/Criminal justice referral/DUI/DWI



97=Unknown



98=Not collected
Date of Birth MDS 8 DIS 17
MMDDYYYY



01010007=Unknown



01010008=Not collected
Sex MDS 9 DIS 18
1=Male



2=Female



7=Unknown



8=Not collected
Race MDS 10 DIS 19
01=Alaska Native (Aleut, Eskimo)



02=American Indian or Alaska Native



03=Asian or Pacific Islander



13=Asian



23=Native Hawaiian or Other Pacific Islander



04= Black or African American



05=White



20=Other single race



21=Two or more races



97=Unknown



98=Not collected
Hispanic or Latino Origin (Ethnicity) MDS 11 DIS 20
01=Puerto Rican



02=Mexican



03=Cuban



04=Other Specific Hispanic or Latino



05=Not of Hispanic or Latino Origin



06=Hispanic or Latino - specific origin not specified



97=Unknown



98=Not collected
Education MDS 12
MHD 5 00= Less than one school grade or no schooling



01-11=Grades 1 - 11



12=Grade 12 or GED



13=1st year of College/University (Freshman)



14=2nd Year of College/Univserity (Sophomore) or Associate Degree



15=3rd Year of College/University (Junior)



16=4th Year of College/University (Senior) or Bachelor's Degree



17=Some Post-Graduate Study- Degree not completed



18= Master's Degree completed



19-25=Post-graduate study



70=Graduate or Professional School



71=Vocational School (MH only)



72=Nursery School or Pre-school (MH only)



73=Kindergarten (MH only)



74=Self-contained Special Education Class (MH only)



97=Unknown



98=Not collected
Employment Status MDS 13
DIS 24 01=Full time

02=Part time

03=Unemployed

04=Not in the labor force

05=Employed, full/part time not specified (Temporary code, should be used in MH reporting only)
97=Unknown

98=Not collected
Substance Use (Primary, Secondary, Tertiary) MDS 14A MDS 14B MDS 14C
DIS 21a
DIS 21b
DIS 21c
Optional reporting for MH clients
01=None
02=Alcohol
03=Cocaine
04=Marijuana/hashish
05=Heroin
06=Non-prescription methadone
07=Other opiates and synthetics
08=PCP-phencyclidine
09=Hallucinogens
10=Methamphetamine/speed
11=Other amphetamines
12=Other stimulants
13=Benzodiazepine
14=Other tranquilizers
15=Barbiturates
16=Other sedatives or hypnotics
17=Inhalants
18=Over-the-counter medications
20=Other drugs
96=Not applicable (MH only)
97=Unknown
98=Not collected
Route of Administration (of Primary, Secondary, Tertiary Substances) MDS 15A MDS 15B MDS 15C

Optional reporting for MH clients - see Manual for SU route of administration categories
01=Oral
02=Smoking
03=Inhalation
04=Injection (intravenous, intramuscular, intradermal, or subcutaneous)
20=Other
96=Not applicable
97=Unknown
98=Not collected
Frequency of Use (of Primary, Secondary, Tertiary Substances) MDS 16A MDS 16B MDS 16C
DIS 22a
DIS 22b
DIS 22c
Optional reporting for MH clients - see Manual for SU frequency of use categories
01=No Use in the Past Month
02=1-3 Days in the Past Month
03=1-2 Days in the Past Week
04=3-6 Days in the Past Week
05=Daily
96=Not applicable
97=Unknown
98=Not collected
Age at First Use (of Primary, Secondary, Tertiary, Substances) MDS 17A
MDS 17B
MDS 17C


Optional reporting for MH clients with co-occurring SU
00=Newborn
01-95=Age at first use
96=Not applicable
97=Unknown
98=Not collected
Type of Treatment/Service Setting – Key field MDS 18 DIS 16 DIS 7 01=Withdrawal management, 24-hour service, Hospital Inpatient (SU only)



02=Withdrawal management, 24-hour service, Free-Standing Residential (SU only)



03=Rehabilitation/Residential - Hospital (other than withdrawal management) (SU only)



04=Rehabilitation/Residential - Short term (30 days or fewer) (SU only)



05=Rehabilitation/Residential - Long term (more than 30 days) (SU only)



06=Ambulatory-Intensive outpatient (SU only)



07=Ambulatory-Non-intensive outpatient (SU only)



08=Ambulatory-withdrawal management (SU only)



72=State psychiatric hospital (MH only)



73=SMHA funded/operated community-based program (MH only)



74=Residential treatment center (MH only)



75=Other psychiatric inpatient (MH only)



76=Institutions under the justice system (MH only)



96=Not applicable (use only for codependents or collateral clients (SU only)
Medications for Opioid Use Disorder MDS 19

Optional reporting for MH clients



1=Yes



2=No



6=Not applicable



7=Unknown



8=Not collected
SUPPLEMENTAL DATA SET (SuDS)
Detailed Drug Code (Primary, Secondary, Tertiary) SuDS 1
SuDS 2
SuDS 3


Optional reporting for MH clients
0201=Alcohol
0301=Crack
0302=Other cocaine
0401=Marijuana/Hashish, THC, and any other cannabis sativa preparations
0501=Heroin
0601=Non-prescription methadone
0701=Codeine
0702=Propoxyphene (Darvon)
0703=Oxycodone (Oxycontin)
0704=Meperidine (Demerol)
0705=Hydromorphone (Dilaudid)
0706=Butorphanol (Stadol), morphine (MS Contin), opium, and other narcotic analgesics, opiates, or synthetics
0707=Pentazocine (Talwin)
0708=Hydrocodone (Vicodine)
0709=Tramadol (Ultram)
0710=Buprenorphin (subutex, suboxone)
0711=Fentanyl
0801=PCP
0901=LSD
0902=DMT, mescaline, peyote, psilocybin, STP, and other hallucinogens
1001=Methamphetamine/speed
1101=Amphetamine
1103= Methylenedioxymethamphetamine (MDMA, Ecstasy)
1109="Bath Salts", phenmetrazine, and other amines and related drugs
1201=Other stimulants
1202=Methylphenidate (Ritalin)
1301=Alprazolam (Xanax)
1302=Chlordiazepoxide (Librium)
1303=Clorazepate (Tranzene)
1304=Diazepam (Valium)
1305=Flurazepam (Dalmane)
1306=Lorazepam (Ativan)
1307=Triazolam (Halcion)
1308=Halazepam, oxazepam (Serax), prazepam, temazepam (Restoril), and other Benzodiazepines
1309=Flunitrazepam (Rohypnol)
1310=Clonazepam (Klonopin,Rivotril)
1401=Meprobamate (Miltown)
1403=Other non-benzodiazepine tranquilizers
1501=Phenobarbital
1502=Secobarbital/amobarbital (Tuinal)
1503=Secobarbital (Seconal)
1509=Amobarbital, pentobarbital (Nembutal) and other barbiturate sedatives
1601=Ethchlorvynol (Placidyl)
1602=Glutethimide (Doriden)
1603=Methaqualone (Quaalude)
1604=Chloral hydrate and other Non-Barbiturate Sedatives/hypnotics
1605=Xylazine
1701=Aerosols
1702=Nitrites
1703=Gasoline, glue, and other inappropriately inhaled products
1704=Solvents (paint thinner and other solvents)
1705=Anesthetics (chloroform, ether, nitrous oxide, and other anesthetics)
1801=Diphenhydramine
1809=Other antihistamines, aspirin, Dextromethorphan (DXM) and other cough syrups, Ephedrine, sleep aids, and any other legally obtained, non-prescription medication
2001=Diphenylhydantoin/Phenytoin (Dilantin)
2002=Synthetic Cannabinoid "Spice", Carisoprodol (Soma) and other drugs
2003=GHB/GBL (gamma-hydroxybutyrate, gammabutyrolactone)
2004=Ketamine (Special K)
9996=Not applicable - use when the value in "Substance Use" is 01 (None)
9997=Unknown
9998=Not collected
Diagnostic Code (DSM or ICD) SuDS 4

xxx.xx



999.96=No SU Diagnosis (MH only)



999.97=Unknown



999.98=Not collected
Co-occurring Mental and Substance Use Disorders SuDS 5

1=Yes - Client has co-occurring mental and substance use disorders



2=No - Client does not have co-occurring mental and substance use disorders



7=Unknown



8=Not collected
Pregnant at Admission SuDS 6

Optional reporting for both SU and MH



1=Yes, client was pregnant at admission



2=No, client was not pregnant at admission



6=Not applicable - Use this code for male clients or pre-pubescent females.



7=Unknown



8=Not collected
Veteran Status SuDS 7

Optional reporting for both SU and MH



1=Veteran



2=Not a veteran



7=Unknown



8=Not collected
Living Arrangements SuDS 8
DIS 23 01=Homeless



02=Dependent Living



22=Dependent living: residential care (MH-only)



32=Dependent living: foster home/foster care (MH only)



42=Dependent living: crisis residence (MH only)



52=Dependent living: institutional setting (MH only)



62=Dependent living: jail and other institutions under the justice system (MH only)



72=Dependent living: adults in private residence who needs assistance in daily living (MH only)



03=Independent Living



04=Private residence, living arrangement not specified, adults (temporary code MH-only)



97=Unknown



98=Not collected
Source of Income/Support SuDS 9

Optional reporting for both SU and MH



01=Wages/salary



02=Public assistance



03=Retirement/pension



04=Disability



20=Other



21=None



97=Unknown



98=Not collected
Health Insurance SuDS 10

Optional reporting for MH



01=Private insurance



02=Blue Cross/Blue Shield



03=Medicare



04=Medicaid



06=Health Maintenance Organization (HMO)



20=Other (e,g., Tricare)



21=None



97=Unknown



98=Not collected
Payment Source, Primary (Expected or Actual) SuDS 11

Optional reporting for both SU and MH



01=Self-pay



02=Blue Cross/Blue Shield



03=Medicare



04=Medicaid



05=Other government payments



06=Worker's compensation



07=Other health insurance companies



08=No Charge - For example, free, charity, special research, or teaching



09=Other



97=Unknown



98=Not collected
Detailed Not-in-Labor Force SuDS 12
DIS 25 01=Homemaker



02=Student



03=Retired



04=Disabled



05= Resident of institution



06=Other



07=Sheltered/non-competitive employment (MH only)



96=Not applicable



97=Unknown



98=Not collected
Detailed Criminal Justice Referral SuDS 13

Optional reporting for both SU and MH



01=State/federal Court



02=Other Court



03=Probation/parole



04=Other Recognized Legal Entity



05=Diversionary program



06=Prison



07=DUI/DWI



08=Other



96=Not applicable



97=Unknown



98=Not collected
Marital Status SuDS 14

Optional reporting for both SU and MH



01=Never Married



02=Now Married



03=Separated



04=Divorced



05=Widowed



97=Unknown



98=Not collected
Days Waiting to Enter SU Treatment SuDS 15

Optional reporting for MH clients with co-occurring SU



000-995=Number of days waiting



996=Not applicable (MH only)



997=Unknown



998=Not collected
Arrests in Past 30 Days SuDS 16
DIS 26 00-96=Number of arrests



97=Unknown



98=Not collected
Attendance at SU Self-Help Groups in Past 30 Days SuDS 17
DIS 27 Optional reporting for MH clients with co-occurring SU



01=No attendance



02=Less than once a week - 1 to 3 times in the past 30 days



03=About once a week - 4 to 7 times in the past 30 days



04=2 to 3 times per week - 8 to 15 times in the past 30 days



05=At least 4 times a week - 16 to 30 times in the past 30 days



06=Some attendance - Number of times and frequency is unknown



96=Not applicable



97=Unknown



98=Not collected
Diagnostic Code Set Identifier SuDS 18
MHD 1 1=DSM-IV



2=ICD-9



3=ICD-10



4=DSM-5



5=DSM-III-R



7=Unknown



8=Not collected
Substance Use Diagnosis SuDS 19

xxx.xxxx



999.9996=No Substance use diagnosis (MH only)



999.9997=Unknown



999.9998=Not collected
Gender Identity SuDS 20

01=Male



02=Female



03=Transgender (Male to Female)



13=Transgender (Female to Male)



23=Transgender [Temporary code]



04=Two-Spirit [American Indian or Alaska Native only]



06=Other



16=I don't know



26=Prefer not to answer



97=Unknown



98=Not Collected
Sexual Orientation SuDS 21

01=Straight or Heterosexual



02=Lesbian or Gay



03=Bisexual



04=Two-Spirit [American Indian or Alaska Native only]



06=Other



16=I don't know



26=Prefer not to answer



97=Unknown



98=Not Collected
Other Variables
Date of Last Contact or Data Update - Key Field

DIS 8 MMDDYYYY




01010007=Unknown




01010008=Not collected
Date of Discharge - Key field

DIS 9 MMDDYYYY




1010006=Not Applicable (use for MH update record only)
Reason for Discharge, Transfer, or Discontinuance of Treatment

DIS 10 01=Treatment completed



02=Dropped out of treatment



03=Terminated by facility



04=Transferred to another treatment program or facility



14=Transferred to another treatment program but client is no show



24=Transferred to another treatment program or facility that is not in the SSA or SMHA reporting system.



34 =Discharged temporarily to an acute medical facility for medical services (MH-only)



05=Incarcerated or released by or to courts



06=Death



07=Other



08= Unknown - This code will continue to be accepted. However, states are encouraged to use the code 97 Unknown instead



96 = Not appliciable



97=Unknown


98=Not collected
Client Discharge Transaction Type - Key field
DIS 14 DIS 28 A=Initial Admission (SU)




T=Transfer (SU)




D=Discharge (SU)




M=Initial Admission (MH)




X=Transfer (MH)




E=Discharge (MH)




U=Update (MH)
MH Diagnostic Code - One (ICD-9 or ICD-10) MHA 1a
MHD 2a XXX.XXXX




999.9996=No MH Diagnosis-One (SU only)




999.9997=Unknown




999.9998=Not collected
MH Diagnostic Code - Two (ICD-9 or ICD-10) MHA 1b
MHD 2b XXX.XXXX



999.9996=No MH diagnosis - two



999.9997=Unknown



999.9998=Not collected
MH Diagnostic Code - Three (ICD-9 or ICD-10) MHA 1c
MHD 2c XXX.XXXX



999.9996=No MH diagnosis - three



999.9997=Unknown



999.9998=Not collected
SMI/SED Status MHA 2
MHD 3 Optional reporting for SU clients



1=SMI



2=SED



3=At risk for SED (optional)



4=Not SMI/SED



6=Not Applicable


7=Unknown



8=Not collected
School Attendance Status MHA 3
MHD 4 Optional reporting for SU clients



1=Yes, client has attended school at any time in the past 3 months



2=No, client has not attended school at any time in the past three months



6=Not applicable



7=Unknown


8=Not collected
Legal Status at Admission to State Hospital MHA 4

Not applicable for SU clients



01=Voluntary-self



02=Voluntary-others (parents, guardians, etc)



03=Involuntary-civil



04=Involuntary-criminal



05=Involuntary-juvenile justice



06=Involuntary-civil, sexual



96=Not applicable



97=Unknown



98=Not collected
GAF/CGAS Score MHA 5
MHD 6 Optional reporting for MH clients with co-occurring SU



0-100=GAF/CGAS Score



996=Not applicable (SU only)



997=Unknown



998=Not collected
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