Routine: ABMUB92

ABMUB92 ;IHS/ASDST/LSL - Update UB92 codes

 ;;2.6;IHS 3P BILLING SYSTEM;;NOV 12, 2009

 ; IHS/ASDS/LSL - 05/22/00 - V2.4 Patch 1 - NOIS XAA-0500-200043

 ;     Created routine to update 3P CODE file with new UB codes.

 ;     Cannot send a new global (3P CODES) because site may have

 ;     already added codes.  The IEN's will not match.

START ;

 ; A = ADMISSION SOURCE

 ; B = BILL TYPE

 ; C = CONDITION

 ; D = DENIAL REASON

 ; H = HCFA POS

 ; I = SPECIAL PROGRAM

 ; N = NEWBORN

 ; O = OCCURANCE

 ; P = PATIENT DISCHARGE STATUS

 ; R = RELATIONSHIP TO INSURED

 ; S = OCCURANCE SPAN

 ; T = ADMISSION TYPE

 ; V = VALUE

 ; X = PSRO APRROVAL

 F ABM="A","B","C","D","H","I","N","O","P","R","S","T","V","X" D DETAIL

 K ABMCODE,DA,DR,DIK,DIE,ABM,DIC,ABMC,ABMCNT,X,DD,DO,ABMDESC

DETAIL ;

 ; If code is one digit numeric, place 0 before code

 S ABMCODE=0

 F  S ABMCODE=$O(^ABMDCODE("AC",ABM,ABMCODE)) Q:$L(ABMCODE)>1!(ABMCODE="")  D

 . Q:+ABMCODE<1                     ; Not numeric

 . S ABMDA=0

 . F  S ABMDA=$O(^ABMDCODE("AC",ABM,ABMCODE,ABMDA)) Q:'+ABMDA  D

 . . S ABMC="0"_ABMCODE

 . . S DA=ABMDA

 . . S DIE="^ABMDCODE("

 . . S DR=".01///"_ABMC

 . . D ^DIE

 . . S DA=ABMDA

 . . S DIK="^ABMDCODE("

 . . S DIK(1)=".02^AC"

 . . D EN1^DIK                      ; Set additional AC X-ref

 ; Add new codes to file

 S DIC="^ABMDCODE("

 S DIC(0)="L"

 S ABMCNT=0

 F  D  Q:$P($T(@ABM+ABMCNT),";;",2)="END"

 . S ABMCNT=ABMCNT+1

 . Q:$P($T(@ABM+ABMCNT),";;",2)="END"

 . S X=$P($T(@ABM+ABMCNT),";;",2)

 . S ABMDESC=$P($T(@ABM+ABMCNT),";;",3)

 . Q:$D(^ABMDCODE("AC",ABM,X))=10

 . S DIC("DR")=".02////"_ABM_";.03////"_$E(ABMDESC,1,70)

 . K DD,DO

 . D FILE^DICN

 K DIC

FIX ;

 ; Get x-ref on single digit numeric back

 F ABM="A","B","C","D","H","I","N","O","P","R","S","T","V","X" D

 . S ABMCODE=0

 . F  S ABMCODE=$O(^ABMDCODE("AC",ABM,ABMCODE)) Q:ABMCODE=""  D

 . . Q:$E(ABMCODE)'=0

 . . S ABMDA=0

 . . F  S ABMDA=$O(^ABMDCODE("AC",ABM,ABMCODE,ABMDA)) Q:'+ABMDA  D

 . . . S ^ABMDCODE("AC",ABM,+ABMCODE,ABMDA)=""

A ; Admission Source Codes

 ;;A;;Transfer from a Critical Assess Hospital

 ;;B;;Transfer from Another Home Health Agency

 ;;END

B ; Bill Type

 ;;END

C ; Condition codes

 ;;09;;Neither Patient Nor Spouse Is Employed

 ;;10;;Patient/Spouse is Employed by NO Employee Group Health Plan Exists

 ;;11;;Disables Beneficiary but NO LGHP

 ;;17;;Patient is Homeless

 ;;19;;Child Retains Mother's Name

 ;;20;;Beneficiary Requested Billing

 ;;21;;Billing for Denial Notice

 ;;22;;Patient on Multiple Drug Regimen

 ;;23;;Home Caregiver Available

 ;;24;;Home IV Patient Also Receiving HHA Services

 ;;25;;Patient is Non-US Resident

 ;;26;;VA Eligible Patient Chooses to Rec Svcs in a Medicare Certified Fac

 ;;27;;Patient Ref to a Sole Community Hospital for a Diagnostic Lab Test

 ;;28;;Patient and/or Spouse's EGHP is Secondary to Medicare

 ;;29;;Disabled Beneficiary and/or Family Member's LGHP is 2nd to Medicare

 ;;37;;Ward Accomodation - Patient Request

 ;;38;;Semi-Private Room Not Available

 ;;39;;Private Room Medically Necessity

 ;;41;;Partial Hospitalization

 ;;42;;Continuing Care Not Related to Inpatient Admission

 ;;43;;Continuing Care Not Provided Within Prescribed Post-Discharge Window

 ;;46;;Non-Availability Statement on File

 ;;48;;Psychiatirc Residential Tx Centers for Children & Adolescents (RTC)

 ;;55;;SNF Bed Not Available

 ;;56;;Medical Appropriateness

 ;;57;;SNF Readmission

 ;;60;;Day Outlier

 ;;61;;Cost Outlier

 ;;66;;Provider Does not Wish Cost Outlier Payment

 ;;67;;Beneficiary Elects not to use Life Time Reserve (LTR) Days

 ;;68;;Beneficiary Elects to use Life Time Reserve (LTR) Days

 ;;69;;IME Payment Only Bill

 ;;70;;Self-Administered EPO

 ;;71;;Full Care in Unit

 ;;72;;Self-Care in Unit

 ;;73;;Self-Care Training

 ;;74;;Home

 ;;75;;Home - 100% Reimbursement

 ;;76;;Back-up in Facility Dialysis

 ;;77;;Provider Accepts Payment by a Primary Payer as Payment in Full

 ;;78;;New Coverage Not Implemented by HMO

 ;;79;;CORF Services Provided Offsite

 ;;END

D ; Denial Reasons

 ;;END

H ; HCFA POS

 ;;END

I ; Special Program

 ;;END

N ; Newborn

 ;;END

O ; Occurance Codes

 ;;09;;Start of Infertility Treatment Cycle

 ;;12;;Date of Onset Dependent Individual

 ;;17;;Date Outpatient Occupational Therapy Plan Established/Last Reviewed

 ;;27;;Date Home Health Plan Established or Last Reviewed

 ;;28;;Date Comprehensive Outpatient Rehab Plan Established/Last Reviewed

 ;;29;;Date Outpatient Physical Therapy Plan Established/Last Reviewed

 ;;30;;Date Outpatient Plan Established or Last Reviewed

 ;;31;;Date Beneficiary Notified of Intent to Bill Accomodations

 ;;32;;Date Beneficiary Notified of Intent to Bill Procedures or Treatments

 ;;33;;1st Date of Medicare Coordination period for ESRD Ben Covered by EGHP

 ;;34;;Date of Election of Extended Care Facilities

 ;;35;;Date Treatment started for PT

 ;;36;;Date of Inpatient Hospital Discharge for Covered Transplant Patients

 ;;37;;Date of Inpt Hospital Discharge for Non-Covered Transplant Patient

 ;;43;;Scheduled Date of Cancelled Surgery

 ;;44;;Date Treatment started for OT

 ;;45;;Date Treatment started for ST

 ;;46;;Date Treatment started for Cardiac Rehab

 ;;47;;Date Cost Outlier Status Begins

 ;;A1;;Birthdate - Insured A

 ;;A2;;Effective Date - Insured A Policy

 ;;A3;;Benefits Exhausted

 ;;B1;;Birthdate - Insured B

 ;;B2;;Effective Date - Insured B Policy

 ;;B3;;Benefits Exhausted

 ;;C1;;Birthdate - Insured C

 ;;C2;;Effective Date - Insured C Policy

 ;;C3;;Benefits Exhausted

 ;;E1;;Birthdate - Insured D

 ;;E2;;Effective Date - Insured D Policy

 ;;E3;;Benefits Exhausted

 ;;F1;;Birthdate - Insured E

 ;;F2;;Effective Date - Insured E Policy

 ;;F3;;Benefits Exhausted

 ;;G1;;Birthdate - Insured F

 ;;G2;;Effective Date - Insured F Policy

 ;;G3;;Benefits Exhausted

 ;;END

P ; Patient Discharge Status

 ;;08;;Discharged/Transferred to home under care of Home IV Provider

 ;;09;;Admitted as an inpatient to this hospital

 ;;40;;Expired at home

 ;;41;;Expired in a medical facility

 ;;42;;Expired - Place Unknown

 ;;50;;Hospice - Home

 ;;51;;Hospice - Medical Facility

 ;;61;;Discharged/Transferred to Swing Bed (In house)

 ;;71;;Discharged/Transferred to another facility for Outpatient Services

 ;;72;;Discharged/Transferred/Referred to this Facility for Outpatient Svcs

 ;;END

R ; Relationship to Insured

 ;;END

S ; Occurance Span codes

 ;;77;;Provider Liability Period

 ;;78;;SNF Prior Stay Dates

 ;;M0;;PRO/UR Approved Stay Dates

 ;;M1;;Provider Liability - No Utilization

 ;;M2;;Inpatient Respite Dates

 ;;END

T ; Admission Type

 ;;END

V ; Value codes

 ;;37;;Pints of Blood Furnished

 ;;38;;Blood Deductible

 ;;39;;Pints of Blood Replaced

 ;;41;;Black Lung

 ;;42;;VA

 ;;43;;Disabled Beneficiary Under Age 65 with LGHP

 ;;45;;Accident Hour

 ;;46;;Number of Grace Days

 ;;47;;Any Liability

 ;;48;;Hemoglobin Reading

 ;;49;;Hematocrit Reading

 ;;50;;Physical Therapy Visit

 ;;51;;Occupational Therapy Visit

 ;;52;;Speech Therapy Visit

 ;;53;;Cardiac Rehab Visits

 ;;56;;Skilled Nurse - Home Visit Hours (HHA only)

 ;;57;;Home Health Aide - Home Visit Hours (HHA only)

 ;;58;;Arterial Blood Gas (PO2/PA2)

 ;;59;;Oxygen Saturaton

 ;;60;;HHA Branch

 ;;61;;Location Where Service is Furnished (HHA and Hospice)

 ;;67;;Peritoneal Dialysis

 ;;68;;EPO-Drug

 ;;73;;Drug Deductible

 ;;74;;Drug Coinsurance

 ;;A1;;Deductible Payer A

 ;;A2;;Coinsurance Payer A

 ;;A3;;Estimated Responsibility Payer A

 ;;A4;;Covered Self-Administrable Drugs - Emergency

 ;;A5;;Covered Self-Administrable Drugs - Not Self-Administrable

 ;;A6;;Covered Self-Administrable Drugs - Diagnostic Study and Other

 ;;B1;;Deductible Payer B

 ;;B2;;Coinsurance Payer B

 ;;B3;;Estimated Responsibility Payer B

 ;;C1;;Deductible Payer C

 ;;C2;;Coinsurance Payer C

 ;;C3;;Estimated Responsibility Payer C

 ;;D3;;Patient Estimated Responsibility

 ;;E1;;Deductible Payer D

 ;;E2;;Coinsurance Payer D

 ;;E3;;Estimated Responsibility Payer D

 ;;F1;;Deductible Payer E

 ;;F2;;Coinsurance Payer E

 ;;F3;;Estimated Responsibility Payer E

 ;;G1;;Deductible Payer F

 ;;G2;;Coinsurance Payer F

 ;;G3;;Estimated Responsibility Payer F

 ;;END

X ; PSRO Approval

 ;;C1;;Approved as Billed

 ;;C2;;Automatic Approval as Billed Based on Focused Review

 ;;C3;;Partial Approval

 ;;C4;;Admission/Services Denied

 ;;C5;;Post Payment Review Applicable

 ;;C6;;Admission Preauthorization

 ;;C7;;Extended Authorization

 ;;END

ABMUB92   ;IHS/ASDST/LSL - Update UB92 codes

 +1       ;;2.6;IHS 3P BILLING SYSTEM;;NOV 12, 2009

 +2       ;

 +3       ; IHS/ASDS/LSL - 05/22/00 - V2.4 Patch 1 - NOIS XAA-0500-200043

 +4       ;     Created routine to update 3P CODE file with new UB codes.

 +5       ;     Cannot send a new global (3P CODES) because site may have

 +6       ;     already added codes.  The IEN's will not match.

 +7       ;

 +8        QUIT

START     ;

 +1       ; A = ADMISSION SOURCE

 +2       ; B = BILL TYPE

 +3       ; C = CONDITION

 +4       ; D = DENIAL REASON

 +5       ; H = HCFA POS

 +6       ; I = SPECIAL PROGRAM

 +7       ; N = NEWBORN

 +8       ; O = OCCURANCE

 +9       ; P = PATIENT DISCHARGE STATUS

 +10      ; R = RELATIONSHIP TO INSURED

 +11      ; S = OCCURANCE SPAN

 +12      ; T = ADMISSION TYPE

 +13      ; V = VALUE

 +14      ; X = PSRO APRROVAL

 +15      ;

 +16       FOR ABM="A","B","C","D","H","I","N","O","P","R","S","T","V","X"

               DO DETAIL

 +17       KILL ABMCODE,DA,DR,DIK,DIE,ABM,DIC,ABMC,ABMCNT,X,DD,DO,ABMDESC

 +18       QUIT

 +19      ;

DETAIL    ;

 +1       ; If code is one digit numeric, place 0 before code

 +2        SET ABMCODE=0

 +3        FOR

               SET ABMCODE=$ORDER(^ABMDCODE("AC",ABM,ABMCODE))

               IF $LENGTH(ABMCODE)>1!(ABMCODE="")

                   QUIT

               Begin DoDot:1

 +4       ; Not numeric

                   IF +ABMCODE<1

                       QUIT

 +5                SET ABMDA=0

 +6                FOR

                       SET ABMDA=$ORDER(^ABMDCODE("AC",ABM,ABMCODE,ABMDA))

                       IF '+ABMDA

                           QUIT

                       Begin DoDot:2

 +7                        SET ABMC="0"_ABMCODE

 +8                        SET DA=ABMDA

 +9                        SET DIE="^ABMDCODE("

 +10                       SET DR=".01///"_ABMC

 +11                       DO ^DIE

 +12                       SET DA=ABMDA

 +13                       SET DIK="^ABMDCODE("

 +14                       SET DIK(1)=".02^AC"

 +15      ; Set additional AC X-ref

                           DO EN1^DIK

                       End DoDot:2

               End DoDot:1

 +16      ;

 +17      ; Add new codes to file

 +18       SET DIC="^ABMDCODE("

 +19       SET DIC(0)="L"

 +20       SET ABMCNT=0

 +21       FOR

               Begin DoDot:1

 +22               SET ABMCNT=ABMCNT+1

 +23               IF $PIECE($TEXT(@ABM+ABMCNT),";;",2)="END"

                       QUIT

 +24               SET X=$PIECE($TEXT(@ABM+ABMCNT),";;",2)

 +25               SET ABMDESC=$PIECE($TEXT(@ABM+ABMCNT),";;",3)

 +26               IF $DATA(^ABMDCODE("AC",ABM,X))=10

                       QUIT

 +27               SET DIC("DR")=".02////"_ABM_";.03////"_$EXTRACT(ABMDESC,1,70)

 +28               KILL DD,DO

 +29               DO FILE^DICN

               End DoDot:1

               IF $PIECE($TEXT(@ABM+ABMCNT),";;",2)="END"

                   QUIT

 +30       KILL DIC

 +31       QUIT

 +32      ;

FIX       ;

 +1       ; Get x-ref on single digit numeric back

 +2        FOR ABM="A","B","C","D","H","I","N","O","P","R","S","T","V","X"

               Begin DoDot:1

 +3                SET ABMCODE=0

 +4                FOR

                       SET ABMCODE=$ORDER(^ABMDCODE("AC",ABM,ABMCODE))

                       IF ABMCODE=""

                           QUIT

                       Begin DoDot:2

 +5                        IF $EXTRACT(ABMCODE)'=0

                               QUIT

 +6                        SET ABMDA=0

 +7                        FOR

                               SET ABMDA=$ORDER(^ABMDCODE("AC",ABM,ABMCODE,ABMDA))

                               IF '+ABMDA

                                   QUIT

                               Begin DoDot:3

 +8                                SET ^ABMDCODE("AC",ABM,+ABMCODE,ABMDA)=""

                               End DoDot:3

                       End DoDot:2

               End DoDot:1

 +9        QUIT

 +10      ;

A         ; Admission Source Codes

 +1       ;;A;;Transfer from a Critical Assess Hospital

 +2       ;;B;;Transfer from Another Home Health Agency

 +3       ;;END

 +4       ;

B         ; Bill Type

 +1       ;;END

 +2       ;

C         ; Condition codes

 +1       ;;09;;Neither Patient Nor Spouse Is Employed

 +2       ;;10;;Patient/Spouse is Employed by NO Employee Group Health Plan Exists

 +3       ;;11;;Disables Beneficiary but NO LGHP

 +4       ;;17;;Patient is Homeless

 +5       ;;19;;Child Retains Mother's Name

 +6       ;;20;;Beneficiary Requested Billing

 +7       ;;21;;Billing for Denial Notice

 +8       ;;22;;Patient on Multiple Drug Regimen

 +9       ;;23;;Home Caregiver Available

 +10      ;;24;;Home IV Patient Also Receiving HHA Services

 +11      ;;25;;Patient is Non-US Resident

 +12      ;;26;;VA Eligible Patient Chooses to Rec Svcs in a Medicare Certified Fac

 +13      ;;27;;Patient Ref to a Sole Community Hospital for a Diagnostic Lab Test

 +14      ;;28;;Patient and/or Spouse's EGHP is Secondary to Medicare

 +15      ;;29;;Disabled Beneficiary and/or Family Member's LGHP is 2nd to Medicare

 +16      ;;37;;Ward Accomodation - Patient Request

 +17      ;;38;;Semi-Private Room Not Available

 +18      ;;39;;Private Room Medically Necessity

 +19      ;;41;;Partial Hospitalization

 +20      ;;42;;Continuing Care Not Related to Inpatient Admission

 +21      ;;43;;Continuing Care Not Provided Within Prescribed Post-Discharge Window

 +22      ;;46;;Non-Availability Statement on File

 +23      ;;48;;Psychiatirc Residential Tx Centers for Children & Adolescents (RTC)

 +24      ;;55;;SNF Bed Not Available

 +25      ;;56;;Medical Appropriateness

 +26      ;;57;;SNF Readmission

 +27      ;;60;;Day Outlier

 +28      ;;61;;Cost Outlier

 +29      ;;66;;Provider Does not Wish Cost Outlier Payment

 +30      ;;67;;Beneficiary Elects not to use Life Time Reserve (LTR) Days

 +31      ;;68;;Beneficiary Elects to use Life Time Reserve (LTR) Days

 +32      ;;69;;IME Payment Only Bill

 +33      ;;70;;Self-Administered EPO

 +34      ;;71;;Full Care in Unit

 +35      ;;72;;Self-Care in Unit

 +36      ;;73;;Self-Care Training

 +37      ;;74;;Home

 +38      ;;75;;Home - 100% Reimbursement

 +39      ;;76;;Back-up in Facility Dialysis

 +40      ;;77;;Provider Accepts Payment by a Primary Payer as Payment in Full

 +41      ;;78;;New Coverage Not Implemented by HMO

 +42      ;;79;;CORF Services Provided Offsite

 +43      ;;END

 +44      ;

D         ; Denial Reasons

 +1       ;;END

 +2       ;

H         ; HCFA POS

 +1       ;;END

 +2       ;

I         ; Special Program

 +1       ;;END

 +2       ;

N         ; Newborn

 +1       ;;END

 +2       ;

O         ; Occurance Codes

 +1       ;;09;;Start of Infertility Treatment Cycle

 +2       ;;12;;Date of Onset Dependent Individual

 +3       ;;17;;Date Outpatient Occupational Therapy Plan Established/Last Reviewed

 +4       ;;27;;Date Home Health Plan Established or Last Reviewed

 +5       ;;28;;Date Comprehensive Outpatient Rehab Plan Established/Last Reviewed

 +6       ;;29;;Date Outpatient Physical Therapy Plan Established/Last Reviewed

 +7       ;;30;;Date Outpatient Plan Established or Last Reviewed

 +8       ;;31;;Date Beneficiary Notified of Intent to Bill Accomodations

 +9       ;;32;;Date Beneficiary Notified of Intent to Bill Procedures or Treatments

 +10      ;;33;;1st Date of Medicare Coordination period for ESRD Ben Covered by EGHP

 +11      ;;34;;Date of Election of Extended Care Facilities

 +12      ;;35;;Date Treatment started for PT

 +13      ;;36;;Date of Inpatient Hospital Discharge for Covered Transplant Patients

 +14      ;;37;;Date of Inpt Hospital Discharge for Non-Covered Transplant Patient

 +15      ;;43;;Scheduled Date of Cancelled Surgery

 +16      ;;44;;Date Treatment started for OT

 +17      ;;45;;Date Treatment started for ST

 +18      ;;46;;Date Treatment started for Cardiac Rehab

 +19      ;;47;;Date Cost Outlier Status Begins

 +20      ;;A1;;Birthdate - Insured A

 +21      ;;A2;;Effective Date - Insured A Policy

 +22      ;;A3;;Benefits Exhausted

 +23      ;;B1;;Birthdate - Insured B

 +24      ;;B2;;Effective Date - Insured B Policy

 +25      ;;B3;;Benefits Exhausted

 +26      ;;C1;;Birthdate - Insured C

 +27      ;;C2;;Effective Date - Insured C Policy

 +28      ;;C3;;Benefits Exhausted

 +29      ;;E1;;Birthdate - Insured D

 +30      ;;E2;;Effective Date - Insured D Policy

 +31      ;;E3;;Benefits Exhausted

 +32      ;;F1;;Birthdate - Insured E

 +33      ;;F2;;Effective Date - Insured E Policy

 +34      ;;F3;;Benefits Exhausted

 +35      ;;G1;;Birthdate - Insured F

 +36      ;;G2;;Effective Date - Insured F Policy

 +37      ;;G3;;Benefits Exhausted

 +38      ;;END

 +39      ;

P         ; Patient Discharge Status

 +1       ;;08;;Discharged/Transferred to home under care of Home IV Provider

 +2       ;;09;;Admitted as an inpatient to this hospital

 +3       ;;40;;Expired at home

 +4       ;;41;;Expired in a medical facility

 +5       ;;42;;Expired - Place Unknown

 +6       ;;50;;Hospice - Home

 +7       ;;51;;Hospice - Medical Facility

 +8       ;;61;;Discharged/Transferred to Swing Bed (In house)

 +9       ;;71;;Discharged/Transferred to another facility for Outpatient Services

 +10      ;;72;;Discharged/Transferred/Referred to this Facility for Outpatient Svcs

 +11      ;;END

 +12      ;

R         ; Relationship to Insured

 +1       ;;END

 +2       ;

S         ; Occurance Span codes

 +1       ;;77;;Provider Liability Period

 +2       ;;78;;SNF Prior Stay Dates

 +3       ;;M0;;PRO/UR Approved Stay Dates

 +4       ;;M1;;Provider Liability - No Utilization

 +5       ;;M2;;Inpatient Respite Dates

 +6       ;;END

 +7       ;

T         ; Admission Type

 +1       ;;END

 +2       ;

V         ; Value codes

 +1       ;;37;;Pints of Blood Furnished

 +2       ;;38;;Blood Deductible

 +3       ;;39;;Pints of Blood Replaced

 +4       ;;41;;Black Lung

 +5       ;;42;;VA

 +6       ;;43;;Disabled Beneficiary Under Age 65 with LGHP

 +7       ;;45;;Accident Hour

 +8       ;;46;;Number of Grace Days

 +9       ;;47;;Any Liability

 +10      ;;48;;Hemoglobin Reading

 +11      ;;49;;Hematocrit Reading

 +12      ;;50;;Physical Therapy Visit

 +13      ;;51;;Occupational Therapy Visit

 +14      ;;52;;Speech Therapy Visit

 +15      ;;53;;Cardiac Rehab Visits

 +16      ;;56;;Skilled Nurse - Home Visit Hours (HHA only)

 +17      ;;57;;Home Health Aide - Home Visit Hours (HHA only)

 +18      ;;58;;Arterial Blood Gas (PO2/PA2)

 +19      ;;59;;Oxygen Saturaton

 +20      ;;60;;HHA Branch

 +21      ;;61;;Location Where Service is Furnished (HHA and Hospice)

 +22      ;;67;;Peritoneal Dialysis

 +23      ;;68;;EPO-Drug

 +24      ;;73;;Drug Deductible

 +25      ;;74;;Drug Coinsurance

 +26      ;;A1;;Deductible Payer A

 +27      ;;A2;;Coinsurance Payer A

 +28      ;;A3;;Estimated Responsibility Payer A

 +29      ;;A4;;Covered Self-Administrable Drugs - Emergency

 +30      ;;A5;;Covered Self-Administrable Drugs - Not Self-Administrable

 +31      ;;A6;;Covered Self-Administrable Drugs - Diagnostic Study and Other

 +32      ;;B1;;Deductible Payer B

 +33      ;;B2;;Coinsurance Payer B

 +34      ;;B3;;Estimated Responsibility Payer B

 +35      ;;C1;;Deductible Payer C

 +36      ;;C2;;Coinsurance Payer C

 +37      ;;C3;;Estimated Responsibility Payer C

 +38      ;;D3;;Patient Estimated Responsibility

 +39      ;;E1;;Deductible Payer D

 +40      ;;E2;;Coinsurance Payer D

 +41      ;;E3;;Estimated Responsibility Payer D

 +42      ;;F1;;Deductible Payer E

 +43      ;;F2;;Coinsurance Payer E

 +44      ;;F3;;Estimated Responsibility Payer E

 +45      ;;G1;;Deductible Payer F

 +46      ;;G2;;Coinsurance Payer F

 +47      ;;G3;;Estimated Responsibility Payer F

 +48      ;;END

 +49      ;

X         ; PSRO Approval

 +1       ;;C1;;Approved as Billed

 +2       ;;C2;;Automatic Approval as Billed Based on Focused Review

 +3       ;;C3;;Partial Approval

 +4       ;;C4;;Admission/Services Denied

 +5       ;;C5;;Post Payment Review Applicable

 +6       ;;C6;;Admission Preauthorization

 +7       ;;C7;;Extended Authorization

 +8       ;;END

ABMUB92.m