- IBDEI00W ; ; 18-MAR-1994
- ;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94
- Q:'DIFQR(358.5) F I=1:2 S X=$T(Q+I) Q:X="" S Y=$E($T(Q+I+1),4,999),X=$E(X,4,999) S:$A(Y)=126 I=I+1,Y=$E(Y,2,999)_$E($T(Q+I+1),5,99) S:$A(Y)=61 Y=$E(Y,2,999) X NO E S @X=Y
- Q Q
- ;;^UTILITY(U,$J,358.5)
- ;;=^IBE(358.5,
- ;;^UTILITY(U,$J,358.5,0)
- ;;=IMP/EXP DATA FIELD^358.5I^338^293
- ;;^UTILITY(U,$J,358.5,1,0)
- ;;=Subjective:^1^2^^^Subjective:^^^^0^0^10^2^132
- ;;^UTILITY(U,$J,358.5,2,0)
- ;;=OBJECTIVE^1^2^^^Objective:^^^^0^8^10^2^132
- ;;^UTILITY(U,$J,358.5,3,0)
- ;;=ASSESSMENT/DIAGNOSIS^1^2^^^Assessment/Diagnosis:^^^^0^18^8^2^132
- ;;^UTILITY(U,$J,358.5,4,0)
- ;;=PLAN^1^2^^^Plan:^^^^0^26^4^2^132
- ;;^UTILITY(U,$J,358.5,5,0)
- ;;=HEADER^2^3
- ;;^UTILITY(U,$J,358.5,5,2,0)
- ;;=^357.52I^2^2
- ;;^UTILITY(U,$J,358.5,5,2,1,0)
- ;;=**DOCTORS ORDERS**^^^50^0
- ;;^UTILITY(U,$J,358.5,5,2,2,0)
- ;;=Nurs. Sig^^^118^0
- ;;^UTILITY(U,$J,358.5,6,0)
- ;;=DOCTORS ORDERS^2^2^^^^^^^0^2^18^2^110
- ;;^UTILITY(U,$J,358.5,7,0)
- ;;=NURSE'S SIGNATURE^2^2^^^^^^^118^2^18^2^13
- ;;^UTILITY(U,$J,358.5,8,0)
- ;;=APPT DATE^3^4
- ;;^UTILITY(U,$J,358.5,8,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,8,2,1,0)
- ;;=Appt Date:^^^60^0^0^71^12^2
- ;;^UTILITY(U,$J,358.5,9,0)
- ;;=PAGE NUMBER^3^3
- ;;^UTILITY(U,$J,358.5,9,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,9,2,1,0)
- ;;=PAGE: 1^^^110^0
- ;;^UTILITY(U,$J,358.5,10,0)
- ;;=CLINIC^3^5
- ;;^UTILITY(U,$J,358.5,10,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,10,2,1,0)
- ;;=Clinic:^^^0^0^0^8^30^1
- ;;^UTILITY(U,$J,358.5,11,0)
- ;;=SIGNATURE^4^3
- ;;^UTILITY(U,$J,358.5,11,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,11,2,1,0)
- ;;=Signature of Provider^^^60^4^3^60^40^1
- ;;^UTILITY(U,$J,358.5,12,0)
- ;;=CLINIC^4^5
- ;;^UTILITY(U,$J,358.5,12,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,12,2,1,0)
- ;;=Clinic:^^^0^4^4^8^30^1
- ;;^UTILITY(U,$J,358.5,13,0)
- ;;=VITALS^5^2^^^BP ________ Wt ________ Pulse ________^^^^0^0^4^2^132
- ;;^UTILITY(U,$J,358.5,14,0)
- ;;=PATEINT NAME^6^6
- ;;^UTILITY(U,$J,358.5,14,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,14,2,1,0)
- ;;=NAME^^I^^^0^0^30^1
- ;;^UTILITY(U,$J,358.5,15,0)
- ;;=PID^6^7
- ;;^UTILITY(U,$J,358.5,15,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,15,2,1,0)
- ;;=PID^^I^^^1^0^15^1
- ;;^UTILITY(U,$J,358.5,16,0)
- ;;=ELIGIBILITY^6^8
- ;;^UTILITY(U,$J,358.5,16,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,16,2,1,0)
- ;;=Elig:^^^0^2^2^6^30^1
- ;;^UTILITY(U,$J,358.5,17,0)
- ;;=ADDRESS LINE 1^6^9^0^1
- ;;^UTILITY(U,$J,358.5,17,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,17,2,1,0)
- ;;=LINE1^^I^^^0^39^45^1
- ;;^UTILITY(U,$J,358.5,18,0)
- ;;=ADDRESS LINE 2^6^9^0^2
- ;;^UTILITY(U,$J,358.5,18,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,18,2,1,0)
- ;;=LINE2^^I^^^1^39^45^1
- ;;^UTILITY(U,$J,358.5,19,0)
- ;;=DATE^6^10
- ;;^UTILITY(U,$J,358.5,19,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,19,2,1,0)
- ;;=Date Printed:^^^90^1^1^104^12^1
- ;;^UTILITY(U,$J,358.5,20,0)
- ;;=CHECK IF SC^6^3
- ;;^UTILITY(U,$J,358.5,20,2,0)
- ;;=^357.52I^2^2
- ;;^UTILITY(U,$J,358.5,20,2,1,0)
- ;;=*** NOTE: IF THE PATIENT'S TREATMENT WAS FOR ANY CONDITION RELATED TO THE FOLLOWING SERVICE-CONNECTED^^^7^4
- ;;^UTILITY(U,$J,358.5,20,2,2,0)
- ;;=DISABILITIES, CHECK BELOW TO THE LEFT OF THE LISTED CONDITON(S). ***^^^11^5
- ;;^UTILITY(U,$J,358.5,21,0)
- ;;=SC DISABILITY 1^6^11^0^1
- ;;^UTILITY(U,$J,358.5,21,2,0)
- ;;=^357.52I^3^3
- ;;^UTILITY(U,$J,358.5,21,2,1,0)
- ;;=Disabilities:^^^8^7
- ;;^UTILITY(U,$J,358.5,21,2,2,0)
- ;;=(__)^^^0^8^8^5^45^1
- ;;^UTILITY(U,$J,358.5,21,2,3,0)
- ;;=% - SERVICE CONNECTED^^I^^^8^51^24^5
- ;;^UTILITY(U,$J,358.5,22,0)
- ;;=SC DISABILITY 2^6^11^0^2
- ;;^UTILITY(U,$J,358.5,22,2,0)
- ;;=^357.52I^2^2
- ;;^UTILITY(U,$J,358.5,22,2,1,0)
- ;;=(__)^^^0^9^9^5^45^1
- ;;^UTILITY(U,$J,358.5,22,2,2,0)
- ;;=% - SERVICE CONNECTED^^I^^^9^51^24^5
- ;;^UTILITY(U,$J,358.5,23,0)
- ;;=SC DISABILITY 3^6^11^1^3
- ;;^UTILITY(U,$J,358.5,23,2,0)
- ;;=^357.52I^2^2
- IBDEI00W ; ; 18-MAR-1994
- +1 ;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94
- +2 IF 'DIFQR(358.5)
- QUIT
- FOR I=1:2
- SET X=$TEXT(Q+I)
- IF X=""
- QUIT
- SET Y=$EXTRACT($TEXT(Q+I+1),4,999)
- SET X=$EXTRACT(X,4,999)
- IF $ASCII(Y)=126
- SET I=I+1
- SET Y=$EXTRACT(Y,2,999)_$EXTRACT($TEXT(Q+I+1),5,99)
- IF $ASCII(Y)=61
- SET Y=$EXTRACT(Y,2,999)
- XECUTE NO
- IF '$TEST
- SET @X=Y
- Q QUIT
- +1 ;;^UTILITY(U,$J,358.5)
- +2 ;;=^IBE(358.5,
- +3 ;;^UTILITY(U,$J,358.5,0)
- +4 ;;=IMP/EXP DATA FIELD^358.5I^338^293
- +5 ;;^UTILITY(U,$J,358.5,1,0)
- +6 ;;=Subjective:^1^2^^^Subjective:^^^^0^0^10^2^132
- +7 ;;^UTILITY(U,$J,358.5,2,0)
- +8 ;;=OBJECTIVE^1^2^^^Objective:^^^^0^8^10^2^132
- +9 ;;^UTILITY(U,$J,358.5,3,0)
- +10 ;;=ASSESSMENT/DIAGNOSIS^1^2^^^Assessment/Diagnosis:^^^^0^18^8^2^132
- +11 ;;^UTILITY(U,$J,358.5,4,0)
- +12 ;;=PLAN^1^2^^^Plan:^^^^0^26^4^2^132
- +13 ;;^UTILITY(U,$J,358.5,5,0)
- +14 ;;=HEADER^2^3
- +15 ;;^UTILITY(U,$J,358.5,5,2,0)
- +16 ;;=^357.52I^2^2
- +17 ;;^UTILITY(U,$J,358.5,5,2,1,0)
- +18 ;;=**DOCTORS ORDERS**^^^50^0
- +19 ;;^UTILITY(U,$J,358.5,5,2,2,0)
- +20 ;;=Nurs. Sig^^^118^0
- +21 ;;^UTILITY(U,$J,358.5,6,0)
- +22 ;;=DOCTORS ORDERS^2^2^^^^^^^0^2^18^2^110
- +23 ;;^UTILITY(U,$J,358.5,7,0)
- +24 ;;=NURSE'S SIGNATURE^2^2^^^^^^^118^2^18^2^13
- +25 ;;^UTILITY(U,$J,358.5,8,0)
- +26 ;;=APPT DATE^3^4
- +27 ;;^UTILITY(U,$J,358.5,8,2,0)
- +28 ;;=^357.52I^1^1
- +29 ;;^UTILITY(U,$J,358.5,8,2,1,0)
- +30 ;;=Appt Date:^^^60^0^0^71^12^2
- +31 ;;^UTILITY(U,$J,358.5,9,0)
- +32 ;;=PAGE NUMBER^3^3
- +33 ;;^UTILITY(U,$J,358.5,9,2,0)
- +34 ;;=^357.52I^1^1
- +35 ;;^UTILITY(U,$J,358.5,9,2,1,0)
- +36 ;;=PAGE: 1^^^110^0
- +37 ;;^UTILITY(U,$J,358.5,10,0)
- +38 ;;=CLINIC^3^5
- +39 ;;^UTILITY(U,$J,358.5,10,2,0)
- +40 ;;=^357.52I^1^1
- +41 ;;^UTILITY(U,$J,358.5,10,2,1,0)
- +42 ;;=Clinic:^^^0^0^0^8^30^1
- +43 ;;^UTILITY(U,$J,358.5,11,0)
- +44 ;;=SIGNATURE^4^3
- +45 ;;^UTILITY(U,$J,358.5,11,2,0)
- +46 ;;=^357.52I^1^1
- +47 ;;^UTILITY(U,$J,358.5,11,2,1,0)
- +48 ;;=Signature of Provider^^^60^4^3^60^40^1
- +49 ;;^UTILITY(U,$J,358.5,12,0)
- +50 ;;=CLINIC^4^5
- +51 ;;^UTILITY(U,$J,358.5,12,2,0)
- +52 ;;=^357.52I^1^1
- +53 ;;^UTILITY(U,$J,358.5,12,2,1,0)
- +54 ;;=Clinic:^^^0^4^4^8^30^1
- +55 ;;^UTILITY(U,$J,358.5,13,0)
- +56 ;;=VITALS^5^2^^^BP ________ Wt ________ Pulse ________^^^^0^0^4^2^132
- +57 ;;^UTILITY(U,$J,358.5,14,0)
- +58 ;;=PATEINT NAME^6^6
- +59 ;;^UTILITY(U,$J,358.5,14,2,0)
- +60 ;;=^357.52I^1^1
- +61 ;;^UTILITY(U,$J,358.5,14,2,1,0)
- +62 ;;=NAME^^I^^^0^0^30^1
- +63 ;;^UTILITY(U,$J,358.5,15,0)
- +64 ;;=PID^6^7
- +65 ;;^UTILITY(U,$J,358.5,15,2,0)
- +66 ;;=^357.52I^1^1
- +67 ;;^UTILITY(U,$J,358.5,15,2,1,0)
- +68 ;;=PID^^I^^^1^0^15^1
- +69 ;;^UTILITY(U,$J,358.5,16,0)
- +70 ;;=ELIGIBILITY^6^8
- +71 ;;^UTILITY(U,$J,358.5,16,2,0)
- +72 ;;=^357.52I^1^1
- +73 ;;^UTILITY(U,$J,358.5,16,2,1,0)
- +74 ;;=Elig:^^^0^2^2^6^30^1
- +75 ;;^UTILITY(U,$J,358.5,17,0)
- +76 ;;=ADDRESS LINE 1^6^9^0^1
- +77 ;;^UTILITY(U,$J,358.5,17,2,0)
- +78 ;;=^357.52I^1^1
- +79 ;;^UTILITY(U,$J,358.5,17,2,1,0)
- +80 ;;=LINE1^^I^^^0^39^45^1
- +81 ;;^UTILITY(U,$J,358.5,18,0)
- +82 ;;=ADDRESS LINE 2^6^9^0^2
- +83 ;;^UTILITY(U,$J,358.5,18,2,0)
- +84 ;;=^357.52I^1^1
- +85 ;;^UTILITY(U,$J,358.5,18,2,1,0)
- +86 ;;=LINE2^^I^^^1^39^45^1
- +87 ;;^UTILITY(U,$J,358.5,19,0)
- +88 ;;=DATE^6^10
- +89 ;;^UTILITY(U,$J,358.5,19,2,0)
- +90 ;;=^357.52I^1^1
- +91 ;;^UTILITY(U,$J,358.5,19,2,1,0)
- +92 ;;=Date Printed:^^^90^1^1^104^12^1
- +93 ;;^UTILITY(U,$J,358.5,20,0)
- +94 ;;=CHECK IF SC^6^3
- +95 ;;^UTILITY(U,$J,358.5,20,2,0)
- +96 ;;=^357.52I^2^2
- +97 ;;^UTILITY(U,$J,358.5,20,2,1,0)
- +98 ;;=*** NOTE: IF THE PATIENT'S TREATMENT WAS FOR ANY CONDITION RELATED TO THE FOLLOWING SERVICE-CONNECTED^^^7^4
- +99 ;;^UTILITY(U,$J,358.5,20,2,2,0)
- +100 ;;=DISABILITIES, CHECK BELOW TO THE LEFT OF THE LISTED CONDITON(S). ***^^^11^5
- +101 ;;^UTILITY(U,$J,358.5,21,0)
- +102 ;;=SC DISABILITY 1^6^11^0^1
- +103 ;;^UTILITY(U,$J,358.5,21,2,0)
- +104 ;;=^357.52I^3^3
- +105 ;;^UTILITY(U,$J,358.5,21,2,1,0)
- +106 ;;=Disabilities:^^^8^7
- +107 ;;^UTILITY(U,$J,358.5,21,2,2,0)
- +108 ;;=(__)^^^0^8^8^5^45^1
- +109 ;;^UTILITY(U,$J,358.5,21,2,3,0)
- +110 ;;=% - SERVICE CONNECTED^^I^^^8^51^24^5
- +111 ;;^UTILITY(U,$J,358.5,22,0)
- +112 ;;=SC DISABILITY 2^6^11^0^2
- +113 ;;^UTILITY(U,$J,358.5,22,2,0)
- +114 ;;=^357.52I^2^2
- +115 ;;^UTILITY(U,$J,358.5,22,2,1,0)
- +116 ;;=(__)^^^0^9^9^5^45^1
- +117 ;;^UTILITY(U,$J,358.5,22,2,2,0)
- +118 ;;=% - SERVICE CONNECTED^^I^^^9^51^24^5
- +119 ;;^UTILITY(U,$J,358.5,23,0)
- +120 ;;=SC DISABILITY 3^6^11^1^3
- +121 ;;^UTILITY(U,$J,358.5,23,2,0)
- +122 ;;=^357.52I^2^2
