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Sub-Field: 9002274.4043

Package: Third Party Billing

3P BILL(#9002274.4)-->9002274.4043

Sub-Field: 9002274.4043


Information

Parent File Name Number Package
3P BILL(#9002274.4) Misc. Services 9002274.4043 Third Party Billing

Details

Field # Name Loc Type Details
.01 MISC. SERVICE (CPT) 0;1 POINTER TO CPT FILE (#81) CPT(#81)

  • LAST EDITED:  JUN 08, 1990
  • CROSS-REFERENCE:  9002274.4043^B
    1)= S ^ABMDBILL(DUZ(2),DA(1),43,"B",$E(X,1,30),DA)=""
    2)= K ^ABMDBILL(DUZ(2),DA(1),43,"B",$E(X,1,30),DA)
.02 REVENUE CODE 0;2 POINTER TO REVENUE CODES FILE (#9999999.72) REVENUE CODES(#9999999.72)

  • LAST EDITED:  JUN 08, 1990
.03 UNITS 0;3 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JUN 08, 1990
  • HELP-PROMPT:  Type a Number between 1 and 999, 0 Decimal Digits
.04 UNIT CHARGE 0;4 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>99999.99)!(X<0)!(X?.E1"."3.N) X
  • LAST EDITED:  JUL 09, 2009
  • HELP-PROMPT:  Type a Dollar amount between 0 and 99999.99, 2 Decimal Digits
.05 MODIFIER 0;5 FREE TEXT

  • INPUT TRANSFORM:  D EN^ABMMODIT
  • LAST EDITED:  JUL 15, 2008
  • HELP-PROMPT:  Select entry from CPT Modifiers File.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.06 CORRESPONDING DIAGNOSIS 0;6 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>7!($L(X)<1) X
  • LAST EDITED:  APR 06, 1995
  • HELP-PROMPT:  Answer must be 1-7 characters in length.
.07 SERVICE FROM DATE/TIME 0;7 DATE

  • INPUT TRANSFORM:  S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 19, 2006
.11 *PROVIDER 0;11 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  JAN 10, 2006
.12 SERVICE TO DATE/TIME 0;12 DATE

  • INPUT TRANSFORM:  S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 19, 2006
.13 IN-HOUSE CLIA# 0;13 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<10)!'(X?2N1U7N) X
  • LAST EDITED:  JUN 28, 2005
  • HELP-PROMPT:  Answer must be 10 characters in length.
.14 REFERENCE LAB CLIA# 0;14 POINTER TO 3P REFERENCE LAB LOCATIONS FILE (#9002274.35) 3P REFERENCE LAB LOCATIONS(#9002274.35)

  • LAST EDITED:  JUN 28, 2005
.15 HCFA POS 0;15 POINTER TO 3P CODES FILE (#9002274.03) 3P CODES(#9002274.03)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),U,4)'=1,$P(^(0),U,2)=""H""" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  MAY 18, 2004
  • SCREEN:  S DIC("S")="I $P(^(0),U,4)'=1,$P(^(0),U,2)=""H"""
  • EXPLANATION:  HCFA POS entries only
.16 HCFA TOS 0;16 POINTER TO 3P CODES FILE (#9002274.03) 3P CODES(#9002274.03)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),U,4)'=1,$P(^(0),U2)=""K""" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  MAY 18, 2004
  • SCREEN:  S DIC("S")="I $P(^(0),U,4)'=1,$P(^(0),U2)=""K"""
  • EXPLANATION:  HCFA TOS entries only
.17 DATA SOURCE 0;17 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>12!($L(X)<1) X
  • LAST EDITED:  DEC 13, 2005
  • HELP-PROMPT:  Answer must be 1-12 characters in length.
.18 SERVICE LINE PROVIDER P;0 POINTER Multiple #9002274.404318 9002274.404318
.19 NDC 0;19 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<1) X
  • LAST EDITED:  SEP 05, 2017
  • HELP-PROMPT:  To be used when billing pharmacy using a J-code. Answer must be 1-15 characters in length.
.23 PRINT ORDER 0;23 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99999)!(X<1)!(X?.E1"."1.N) X
  • LAST EDITED:  SEP 05, 2017
  • HELP-PROMPT:  Type a number between 1 and 99999, 0 decimal digits.
11 QTY/LENGTH MEDICAL NECESSITY 1;1 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999999999)!(X<0)!(X?.E1"."1.N) X
  • LAST EDITED:  JUL 28, 2010
  • HELP-PROMPT:  NUMERIC VALUE OF QUANTITY 1-15 CHARACTERS
12 MONETARY AMT/DME RENTAL PRICE 1;2 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999999999999)!(X<0)!(X?.E1"."3.N) X
  • LAST EDITED:  JUL 28, 2010
  • HELP-PROMPT:  Type a Dollar amount between 0 and 999999999999999, 2 Decimal Digits
13 MONETARY AMT/DME PURCH. PRICE 1;3 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999999999999)!(X<0)!(X?.E1"."3.N) X
  • LAST EDITED:  JUL 28, 2010
  • HELP-PROMPT:  Type a Dollar amount between 0 and 999999999999999, 2 Decimal Digits
14 FRQ CODE/RENTAL UNIT PRICE IND 1;4 SET

  • LAST EDITED:  JUL 28, 2010
15 IMMUNIZATION LOT/BATCH NUMBER 1;5 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>50!($L(X)<1) X
  • LAST EDITED:  OCT 19, 2010
  • HELP-PROMPT:  Answer must be 1-50 characters in length
21 LINE ITEM CONTROL NUMBER 2;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>18!($L(X)<18) X
  • LAST EDITED:  FEB 01, 2011
  • HELP-PROMPT:  Answer must be 18 characters in length
  • TECHNICAL DESCR:  This field will be unique for each line item on every bill. The format being used is:
    Characters 1-12  = Bill IEN
    Characters 13-14 = Multiple #
    Characters 15-18 = Line item counter
22 CPT NARRATIVE 2;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>80!($L(X)<3) X
  • LAST EDITED:  FEB 22, 2012
  • HELP-PROMPT:  Answer must be 3-80 characters in length
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