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Global: ^ABMDBILL(2906

Package: Third Party Billing

Global: ^ABMDBILL(2906


Information

FileMan FileNo FileMan Filename Package
9002274.4 3P BILL Third Party Billing

Description

Accessed By FileMan Db Calls, Total: 15

Package Total Routines
IHS Accounts Receivable 8 BAR3PINQ    BARDYSUT    BARDYSV3    BARDYSV5    BARDYSVZ    BARPMUP1    BARPMUP2    BARUFFN
Third Party Billing 5 ABME5NM1    ABMEXLIP    ABMMUFC1    ABMMUFC5    ABMP2511    
IHS Patient Merge 2 BPMX3PB    BPMXFX1    

Pointed To By FileMan Files, Total: 4

Package Total FileMan Files
Third Party Billing 3 3P BILL(#9002274.4)[#9002274.4065(.01)]    3P CLAIM DATA(#9002274.3)[#9002274.3065(.01)]    3P TX STATUS(#9002274.6)[#9002274.61(.01)]    
IHS Patient 1 IHS HL7 SUPPLY INTERFACE(#9000021)[.07]    

Pointer To FileMan Files, Total: 40

Package Total FileMan Files
Third Party Billing 14 3P CANCEL BILL REASONS(#9002274.47)[.113]    3P CHARGE MASTER(#9002274.75)[#9002274.4045(.01)]    3P CONDITION INDICATORS(#9002274.34)[#9002274.414(.01)]    3P AREA OFFICE EXPORT(#9002274.9)[.18]    3P BILL(#9002274.4)[#9002274.4065(.01)]    3P CODES(#9002274.03)[.51.52.53.54.916#9002274.4021(.15)#9002274.4021(.16)#9002274.4027(.15)#9002274.4027(.16)#9002274.4035(.15)#9002274.4035(.16)#9002274.4037(.15)#9002274.4037(.16)#9002274.4039(.15)#9002274.4039(.16)#9002274.4043(.15)#9002274.4043(.16)#9002274.4047(.15)#9002274.4047(.16)#9002274.4051(.01)#9002274.4053(.01)#9002274.4055(.01)#9002274.4057(.01)#9002274.4059(.01)#9002274.4071(.01)]    3P DENIAL REASONS(#9002274.7)[#9002274.403(.05)]    3P EXPORT MODE(#9002274.08)[.06]    3P MODIFIERS(#9002274.07)[#9002274.4027(.05)]    3P TX STATUS(#9002274.6)[.17#9002274.4074(.01)]    3P VISIT TYPE(#9002274.8)[.07]    3P PROVIDER TAXONOMY(#9002274.95)[.888]    3P REFERENCE LAB LOCATIONS(#9002274.35)[.923#9002274.4037(.14)#9002274.4043(.14)#9002274.4047(.14)]    3P UFMS EXPORTS(#9002274.46)[#9002274.469(.01)]    
Utility Tables 7 INSURER(#9999999.18)[.08#9002274.4013(.01)#9002274.4013(.011)]
PROVIDER NARRATIVE(#9999999.27)[#9002274.4017(.03)#9002274.4019(.04)#9002274.4021(.06)]
ADA CODE(#9999999.31)[#9002274.4033(.01)]    LOCATION(#9999999.06)[.03.127.19]
COVERAGE TYPE(#9999999.65)[#9002274.401311(.01)]    REVENUE CODES(#9999999.72)[.97#9002274.4021(.03)#9002274.4023(.02)#9002274.4025(.01)#9002274.4027(.02)#9002274.4033(.02)#9002274.4035(.02)#9002274.4037(.02)#9002274.4039(.02)#9002274.4043(.02)#9002274.4045(.05)#9002274.4047(.02)]    VENDOR(#9999999.11)[.127]    
Kernel 4 STATE(#5)[.125.816]    PROVIDER CLASS(#7)[.887]    PERSON CLASS(#8932.1)[.886]    NEW PERSON(#200)[.111.12.14#9002274.4021(.14)#9002274.402118(.01)#9002274.4023(.1)#9002274.4023(.21)#9002274.402318(.01)#9002274.4027(.1)#9002274.402718(.01)#9002274.403318(.01)#9002274.4035(.1)#9002274.403518(.01)#9002274.4037(.11)#9002274.403718(.01)#9002274.4039(.11)#9002274.403918(.01)#9002274.4041(.01)#9002274.4043(.11)#9002274.404318(.01)#9002274.4047(.11)#9002274.4067(.02)]    
IHS Accounts Receivable 3 A/R TABLE TYPE/IHS(#90052.01)[#9002274.403(.15)]    A/R EDI STND CLAIM ADJ REASONS(#90056.06)[#9002274.403(.17)]    A/R TABLE ENTRY/IHS(#90052.02)[#9002274.403(.16)]    
IHS Patient 3 MEDICAID ELIGIBLE(#9000004)[#9002274.4013(.06)]    PATIENT(#9000001)[.05.127]    VISIT(#9000010)[#9002274.4011(.01)]    
Pharmacy Data Management 3 IV ADDITIVES(#52.6)[#9002274.4023(.07)]    IV SOLUTIONS(#52.7)[#9002274.4023(.08)]    DRUG(#50)[#9002274.4023(.01)]    
DRG Grouper 2 ICD OPERATION/PROCEDURE(#80.1)[#9002274.4019(.01)#9002274.4019(21)]    ICD DIAGNOSIS(#80)[.59.857.858.859#9002274.4017(.01)#9002274.4017(.04)#9002274.4017(.07)#9002274.4017(.08)#9002274.4017(.09)#9002274.4017(21)#9002274.4017(23)#9002274.4017(24)#9002274.4017(25)#9002274.4017(26)#9002274.4019(22)]
CPT Files 1 CPT(#81)[#9002274.4021(.01)#9002274.4023(.29)#9002274.4025(.07)#9002274.4027(.01)#9002274.4033(.03)#9002274.4035(.01)#9002274.4037(.01)#9002274.4039(.01)#9002274.4043(.01)#9002274.4045(.07)#9002274.4047(.01)]
IHS Dental System 1 DENTAL OPERATIVE SITE(#9002010.03)[#9002274.4033(.05)]    
Outpatient Pharmacy 1 PRESCRIPTION(#52)[#9002274.4023(.22)]    
Scheduling 1 CLINIC STOP(#40.7)[.1]    

Fields, Total: 187

Field # Name Loc Type Details
.01 BILL NUMBER 0;1 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<1) X
  • LAST EDITED:  SEP 04, 2003
  • HELP-PROMPT:  Answer must be 1-10 characters in length.
  • DELETE TEST:  .01,0)= I 1
    UNEDITABLE
  • CROSS-REFERENCE:  9002274.4^B
    1)= S ^ABMDBILL(DUZ(2),"B",$E(X,1,30),DA)=""
    2)= K ^ABMDBILL(DUZ(2),"B",$E(X,1,30),DA)
.02 BILL TYPE 0;2 FREE TEXT

  • INPUT TRANSFORM:  K:X[""""!($A(X)=45)!($L(X)>3)!($L(X)<3) X
  • LAST EDITED:  JUN 23, 1992
  • HELP-PROMPT:  Answer must be 3 characters in length.
  • AUDIT:  YES, ALWAYS
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.022 MANUAL,SPLIT CLAIM 0;22 SET
  • 'O' FOR ORIGINAL;
  • 'S' FOR SPLIT (MANUAL);
  • 'A' FOR AUTO-SPLIT;

  • LAST EDITED:  MAY 22, 2017
.03 VISIT LOCATION 0;3 POINTER TO LOCATION FILE (#9999999.06) LOCATION(#9999999.06)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),""^"",1)=DUZ(2)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  MAY 23, 1995
  • SCREEN:  S DIC("S")="I $P(^(0),""^"",1)=DUZ(2)"
  • EXPLANATION:  Locations Designated in 3P Parameters File Only
.04 BILL STATUS 0;4 SET
  • 'R' FOR REVIEWED;
  • 'A' FOR APPROVED;
  • 'B' FOR BILLED;
  • 'T' FOR TRANSFERRED TO FINANCE;
  • 'C' FOR COMPLETED;
  • 'P' FOR PARTIAL PAYMENT;
  • 'X' FOR CANCELLED;

  • LAST EDITED:  AUG 21, 1995
    WRITE AUTHORITY:  ^
  • CROSS-REFERENCE:  9002274.4^AC
    1)= S ^ABMDBILL(DUZ(2),"AC",$E(X,1,30),DA)=""
    2)= K ^ABMDBILL(DUZ(2),"AC",$E(X,1,30),DA)
  • CROSS-REFERENCE:  9002274.4^AS^MUMPS
    1)= S ^ABMDBILL(DUZ(2),"AS",+$P(^ABMDBILL(DUZ(2),DA,0),U),X,DA)=""
    2)= K ^ABMDBILL(DUZ(2),"AS",+$P(^ABMDBILL(DUZ(2),DA,0),U),X,DA)
    Cross reference that includes both the bill number and the bill status.
  • CROSS-REFERENCE:  9002274.4^AF^MUMPS
    1)= S ^ABMDBILL(DUZ(2),DA,"AF",$H,X)=DUZ
    2)= Q
    Creates a node that is an audit trail of all changes in status of the bill.  Stores the date/time in $H format, the user, and the new status.  Stored with the bill number instead of with other cross references.
  • CROSS-REFERENCE:  9002274.4^AG^MUMPS
    1)= D:$G(ABMAPOK) ^ABMAPASS
    2)= Q
    X-REFERENCE FOR A/R
.05 PATIENT 0;5 POINTER TO PATIENT FILE (#9000001) PATIENT(#9000001)

  • LAST EDITED:  MAY 10, 1992
  • CROSS-REFERENCE:  9002274.4^D
    1)= S ^ABMDBILL(DUZ(2),"D",$E(X,1,30),DA)=""
    2)= K ^ABMDBILL(DUZ(2),"D",$E(X,1,30),DA)
.06 EXPORT MODE 0;6 POINTER TO 3P EXPORT MODE FILE (#9002274.08) 3P EXPORT MODE(#9002274.08)

  • LAST EDITED:  MAR 05, 1991
.07 VISIT TYPE 0;7 POINTER TO 3P VISIT TYPE FILE (#9002274.8) 3P VISIT TYPE(#9002274.8)

  • LAST EDITED:  NOV 05, 1990
.08 ACTIVE INSURER 0;8 POINTER TO INSURER FILE (#9999999.18) INSURER(#9999999.18)

  • LAST EDITED:  MAY 03, 1992
  • CROSS-REFERENCE:  9002274.4^AJ
    1)= S ^ABMDBILL(DUZ(2),"AJ",$E(X,1,30),DA)=""
    2)= K ^ABMDBILL(DUZ(2),"AJ",$E(X,1,30),DA)
.09 PROCEDURE CODING METHOD 0;9 SET
  • 'C' FOR CPT;
  • 'I' FOR ICD;
.1 CLINIC 0;10 POINTER TO CLINIC STOP FILE (#40.7) CLINIC STOP(#40.7)

  • LAST EDITED:  MAR 03, 1991
.11 CHART REVIEWED (Y/N) 1;1 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  MAY 13, 1991
  • CROSS-REFERENCE:  ^^TRIGGER^9002274.4^.12
    1)= X ^DD(9002274.4,.11,1,1,1.3) I X S X=DIV S Y(1)=$S($D(^ABMDBILL(DUZ(2),D0,1)):^(1),1:"") S X=$P(Y(1),U,2),X=X S DIU=X K Y S X=DIV S X=$S($D(DUZ):DUZ,1:"") X ^DD(9002274.4,.11,1,1,1.4)
    1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$S($D(^ABMDBILL(DUZ(2),D0,1)):^(1),1:"") S X=$S('$D(^VA(200,+$P(Y(1),U,2),0)):"",1:$P(^(0),U,1))=""
    1.4)= S DIH=$S($D(^ABMDBILL(DUZ(2),DIV(0),1)):^(1),1:""),DIV=X S $P(^(1),U,2)=DIV,DIH=9002274.4,DIG=.12 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
    2)= Q
    CREATE CONDITION)= #.12=""
    CREATE VALUE)= S X=$S($D(DUZ):DUZ,1:"")
    DELETE VALUE)= NO EFFECT
    FIELD)= #.12
  • CROSS-REFERENCE:  ^^TRIGGER^9002274.4^.13
    1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$S($D(^ABMDBILL(DUZ(2),D0,1)):^(1),1:"") S X=$P(Y(1),U,3)="" I X S X=DIV S Y(1)=$S($D(^ABMDBILL(DUZ(2),D0,1)):^(1),1:"") S X=$P(Y(1),U,3),X=X S DIU=X K Y S X=DIV S X=DT X ^
    DD(9002274.4,.11,1,2,1.4)
    1.4)= S DIH=$S($D(^ABMDBILL(DUZ(2),DIV(0),1)):^(1),1:""),DIV=X S $P(^(1),U,3)=DIV,DIH=9002274.4,DIG=.13 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
    2)= Q
    CREATE CONDITION)= #.13=""
    CREATE VALUE)= S X=DT
    DELETE VALUE)= NO EFFECT
    FIELD)= #.13
.111 BILL CANCELLED BY 1;11 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  JUN 26, 2007
.112 BILL CANCELLATION DATE 1;12 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  JUN 26, 2007
  • HELP-PROMPT:  (No range limit on date)
.113 REASON FOR CANCELLATION 1;13 POINTER TO 3P CANCEL BILL REASONS FILE (#9002274.47) 3P CANCEL BILL REASONS(#9002274.47)

  • LAST EDITED:  NOV 13, 2007
.114 MASTER TAX ID# 1;14 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<9) X
  • LAST EDITED:  NOV 27, 2007
  • HELP-PROMPT:  Answer must be 9-10 characters in length
.115 OTHER BILL IDENTIFIER 1;15 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<1) X
  • LAST EDITED:  FEB 25, 2011
  • HELP-PROMPT:  Answer must be 1-20 characters in length
  • DESCRIPTION:  
    This field will either be a partial bill number (if a 1500 was used for billing and the number was cut off), or an RX number (for POS bills so lookup can be done using the RX number).
  • CROSS-REFERENCE:  9002274.4^G
    1)= S ^ABMDBILL(DUZ(2),"G",$E(X,1,30),DA)=""
    2)= K ^ABMDBILL(DUZ(2),"G",$E(X,1,30),DA)
.12 REVIEWING OFFICIAL 1;2 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  MAR 16, 1995
    WRITE AUTHORITY:  ^
  • NOTES:  TRIGGERED by the CHART REVIEWED (Y/N) field of the 3P BILL File
.1211 PATIENT WEIGHT (LBS) 12;11 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 08, 2005
  • HELP-PROMPT:  Type a Number between 1 and 999, 0 Decimal Digits
.1212 TYPE OF TRANSPORT 12;12 SET
  • 'I' FOR INITIAL TRIP;
  • 'R' FOR RETURN TRIP;
  • 'T' FOR TRANSFER TRIP;
  • 'X' FOR ROUND TRIP;

  • LAST EDITED:  AUG 08, 2005
.1213 TRANSPORTED TO/FOR 12;13 SET
  • 'A' FOR NEAREST FACILITY FOR CARE OF SYMPTOMS,COMPLAINTS, OR BOTH;
  • 'B' FOR BENEFIT OF PREFERRED PHYSICIAN;
  • 'C' FOR NEARNESS OF FAMILY MEMBERS;
  • 'D' FOR CARE OF SPECIALIST OR AVAILABILITY OF SPECIALIZED EQUIPMENT;
  • 'E' FOR TRANS. TO REHAB FACILITY;

  • LAST EDITED:  AUG 08, 2005
.1214 POINT OF PICKUP MODIFIER 12;14 SET
  • 'D' FOR DIAG/THERA/FREE FAC;
  • 'E' FOR RES/DOM/CUST. FAC;
  • 'G' FOR HOSP-BASED DIAL FAC;
  • 'H' FOR HOSPITAL;
  • 'I' FOR TRANS SITE (AIRPORT, ETC);
  • 'J' FOR NON-HOSP-BASED DIAL FAC;
  • 'N' FOR SNF;
  • 'P' FOR PHYS OFFICE;
  • 'R' FOR RESIDENCE;
  • 'S' FOR SCENE OF ACCIDENT;
  • 'X' FOR INTER. STOP AT PHYS OFFICE;

  • LAST EDITED:  AUG 08, 2005
.1215 MEDICAL NECESSITY IND 12;15 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  AUG 08, 2005
.1216 DEST MODIFIER 12;16 SET
  • 'E' FOR RES/DOM/CUST. FAC;
  • 'G' FOR HOSP-BASED DIAL FAC;
  • 'H' FOR HOSPITAL;
  • 'I' FOR TRANS SITE (AIRPORT, ETC);
  • 'J' FOR NON-HOSP-BASED DIAL FAC;
  • 'N' FOR SNF;
  • 'P' FOR PHYS OFFICE;
  • 'R' FOR RESIDENCE;
  • 'S' FOR SCENE OF ACCIDENT;
  • 'X' FOR INTER. STOP AT PHYS OFFICE;

  • LAST EDITED:  AUG 08, 2005
.122 POINT OF PICKUP ORIGIN 12;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<3) X
  • LAST EDITED:  AUG 08, 2005
  • HELP-PROMPT:  Answer must be 3-20 characters in length.
.123 POINT OF PICKUP ADDRESS 12;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>50!($L(X)<3) X
  • LAST EDITED:  AUG 08, 2005
  • HELP-PROMPT:  Answer must be 3-50 characters in length.
.124 POINT OF PICKUP CITY 12;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<3) X
  • LAST EDITED:  AUG 08, 2005
  • HELP-PROMPT:  Answer must be 3-30 characters in length.
.125 POINT OF PICKUP STATE 12;5 POINTER TO STATE FILE (#5) STATE(#5)

  • LAST EDITED:  AUG 08, 2005
.126 POINT OF PICKUP ZIP 12;6 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<5) X I $D(X)'=0 S:$L(X)=9 X=$E(X,1,5)_"-"_$E(X,6,9)
  • LAST EDITED:  AUG 08, 2005
  • HELP-PROMPT:  Answer must be 5-10 characters in length.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.127 DESTINATION 12;7 VARIABLE POINTER PATIENT(#9000001)  LOCATION(#9999999.06)  VENDOR(#9999999.11)  

  • LAST EDITED:  AUG 08, 2005
.128 COVERED MILEAGE 12;8 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 08, 2005
  • HELP-PROMPT:  Type a Number between 0 and 999, 0 Decimal Digits
.129 NON-COVERED MILEAGE 12;9 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 08, 2005
  • HELP-PROMPT:  Type a Number between 0 and 999, 0 Decimal Digits
.13 DATE REVIEWED 1;3 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
    WRITE AUTHORITY:  ^
  • NOTES:  TRIGGERED by the CHART REVIEWED (Y/N) field of the 3P BILL File
.14 APPROVING OFFICIAL 1;4 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  JUN 30, 1995
.15 DATE/TIME APPROVED 1;5 DATE

  • INPUT TRANSFORM:  S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 30, 1995
    WRITE AUTHORITY:  ^
  • CROSS-REFERENCE:  9002274.4^AP
    1)= S ^ABMDBILL(DUZ(2),"AP",$E(X,1,30),DA)=""
    2)= K ^ABMDBILL(DUZ(2),"AP",$E(X,1,30),DA)
.16 EXPORT STATUS 1;6 SET
  • 'A' FOR AWAITING TRANSFER TO AR;

  • LAST EDITED:  OCT 16, 1991
  • CROSS-REFERENCE:  9002274.4^AA
    1)= S ^ABMDBILL(DUZ(2),"AA",$E(X,1,30),DA)=""
    2)= K ^ABMDBILL(DUZ(2),"AA",$E(X,1,30),DA)
.17 EXPORT NUMBER 1;7 POINTER TO 3P TX STATUS FILE (#9002274.6) 3P TX STATUS(#9002274.6)

  • LAST EDITED:  MAY 02, 1992
  • CROSS-REFERENCE:  9002274.4^AX
    1)= S ^ABMDBILL(DUZ(2),"AX",$E(X,1,30),DA)=""
    2)= K ^ABMDBILL(DUZ(2),"AX",$E(X,1,30),DA)
.175 EXPORT NUMBER RE-EXPORT 74;0 POINTER Multiple #9002274.4074 9002274.4074
.18 DATE TX'ED TO AR 1;8 POINTER TO 3P AREA OFFICE EXPORT FILE (#9002274.9) 3P AREA OFFICE EXPORT(#9002274.9)

  • LAST EDITED:  APR 12, 1991
  • CROSS-REFERENCE:  9002274.4^AZ
    1)= S ^ABMDBILL(DUZ(2),"AZ",$E(X,1,30),DA)=""
    2)= K ^ABMDBILL(DUZ(2),"AZ",$E(X,1,30),DA)
.19 BILLING LOCATION 1;9 POINTER TO LOCATION FILE (#9999999.06) LOCATION(#9999999.06)

  • LAST EDITED:  SEP 17, 1996
.21 BILL AMOUNT 2;1 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999.99)!(X<0) X
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 999999.99, 2 Decimal Digits
.22 INSURER TYPE 2;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>3!($L(X)<1) X
  • OUTPUT TRANSFORM:  S X=Y S DIC="^AUTTINTY(",DIC(0)="MQX" D ^DIC S Y=$P(Y,U,2)
  • LAST EDITED:  APR 15, 2013
  • HELP-PROMPT:  Answer must be 1-3 characters in length.
.23 GROSS AMOUNT 2;3 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999.99)!(X<0) X
  • LAST EDITED:  MAR 04, 1991
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 999999.99, 2 Decimal Digits
.24 REBILL WRITE-OFF 2;4 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  JAN 17, 1992
.25 *UNCOLLECTED BALANCE 2;5 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>99999.99)!(X<0) X
  • LAST EDITED:  AUG 21, 1996
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 99999.99, 2 Decimal Digits
.26 A/R BILL LOCATION 2;6 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<1) X
  • LAST EDITED:  JUN 22, 2000
  • HELP-PROMPT:  Answer must be 1-15 characters in length.
.27 ORIGINAL BILL AMOUNT 2;7 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999.99)!(X<0)!(X?.E1"."3.N) X
  • LAST EDITED:  FEB 26, 2007
  • HELP-PROMPT:  Type a Dollar amount between 0 and 999999.99, 2 Decimal Digits
  • TECHNICAL DESCR:  
    This field will be used when billing secondary claims.  It will contain the original bill amount from the first (completed) bill.
.28 FLAT RATE AMOUNT 2;8 NUMBER

  • 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:  NOV 21, 2008
  • HELP-PROMPT:  Type a Dollar amount between 0 and 99999.99, 2 Decimal Digits
  • TECHNICAL DESCR:  
    This field was created to store the actual flat rate at the time the claim was approved.
.29 LINE ITEM CONTROL# - FLAT RATE 2;9 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>18!($L(X)<18) X
  • LAST EDITED:  FEB 02, 2011
  • HELP-PROMPT:  Answer must be 18 characters in length
  • TECHNICAL DESCR:  This field will be populated will a line item control number to be used when the bill is flat rate. The format of the number is:
    Characters 1-12 = Bill IEN
    Characters 13-18 = All zeros
.43 NUMBER X-RAYS INCLUDED 4;3 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 28, 1992
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
.44 ORTHODONTIC RELATED 4;4 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  JAN 28, 1992
.45 ORTHODONTIC PLACEMENT DATE 4;5 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JAN 28, 1992
.46 PROTHESIS INCLUDED 4;6 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  JAN 28, 1992
.47 PRIOR PLACEMENT DATE 4;7 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JAN 28, 1992
.48 CASE NUMBER 4;8 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<3) X
  • LAST EDITED:  JAN 28, 1992
  • HELP-PROMPT:  Answer must be 3-20 characters in length.
.49 RESUBMISSION (CONTROL) NUMBER 4;9 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>29!($L(X)<1) X
  • LAST EDITED:  MAR 20, 2007
  • HELP-PROMPT:  Answer must be 1-29 characters in length.
  • AUDIT:  YES, ALWAYS
.51 ADMISSION TYPE 5;1 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)=""T""" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  APR 17, 1990
  • SCREEN:  S DIC("S")="I $P(^(0),U,4)'=1,$P(^(0),U,2)=""T"""
  • EXPLANATION:  ADMISSION TYPE ONLY
.511 REFERRAL NUMBER 5;11 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>12!($L(X)<1) X
  • LAST EDITED:  AUG 22, 2002
  • HELP-PROMPT:  Answer must be 1-12 characters in length.
.512 PRIOR AUTHORIZATION NUMBER 5;12 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>22!($L(X)<1) X
  • LAST EDITED:  DEC 23, 2005
  • HELP-PROMPT:  Answer must be 1-22 characters in length.
.52 ADMISSION SOURCE/NEWBORN CODE 5;2 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)=$S($P(^ABMDBILL(DUZ(2),DA,5),U)=4:""N"",1:""A"")" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  MAR 20, 1990
  • SCREEN:  S DIC("S")="I $P(^(0),U,4)'=1,$P(^(0),U,2)=$S($P(^ABMDBILL(DUZ(2),DA,5),U)=4:""N"",1:""A"")"
  • EXPLANATION:  IF ADMIT TYPE=4 THEN NEWBORN CODE ELSE ADMISSION SOURCE
.525 NEWBORN DAYS 5;10 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>30)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  APR 06, 1991
  • HELP-PROMPT:  Type a Number between 1 and 30, 0 Decimal Digits
.53 DISCHARGE STATUS 5;3 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)=""P""" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  MAR 20, 1990
  • SCREEN:  S DIC("S")="I $P(^(0),U,4)'=1,$P(^(0),U,2)=""P"""
  • EXPLANATION:  CODE FOR PATIENT DISCHARGE STATUS
.54 PSRO APPROVAL CODE 5;4 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)=""X""" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  APR 17, 1990
  • SCREEN:  S DIC("S")="I $P(^(0),U,4)'=1,$P(^(0),U,2)=""X"""
  • EXPLANATION:  PSRO CODE
.55 PSRO APPROVED STAY FROM 5;5 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAR 21, 1990
.56 PSRO APPROVED STAY THRU 5;6 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAR 21, 1990
.57 PROF COMP DAYS 5;7 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  OCT 25, 1991
  • HELP-PROMPT:  Type a Number between 0 and 999, 0 Decimal Digits
.58 PRO AUTHORIZATION NUMBER 5;8 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>29!($L(X)<4) X
  • LAST EDITED:  JUN 04, 2001
  • HELP-PROMPT:  Answer must be 4-29 characters in length.
.59 ADMITTING DIAGNOSIS 5;9 POINTER TO ICD DIAGNOSIS FILE (#80) ICD DIAGNOSIS(#80)

  • LAST EDITED:  AUG 14, 1990
.61 ADMISSION DATE 6;1 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X K:$P($G(^DPT($P($G(^ABMDBILL(DUZ(2),DA,0)),U,5),0)),U,3)>Y X
  • LAST EDITED:  DEC 21, 2005
  • HELP-PROMPT:  ADMISSION DATE must be after Date of Birth
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.62 ADMISSION HOUR 6;2 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>23)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAR 21, 1990
  • HELP-PROMPT:  Type a Number between 0 and 23, 0 Decimal Digits
.63 DISCHARGE DATE 6;3 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X K:X<$P(^ABMDBILL(DUZ(2),DA,6),U) X
  • LAST EDITED:  MAR 20, 1991
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.64 DISCHARGE HOUR 6;4 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>23)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  APR 11, 1990
  • HELP-PROMPT:  Type a Number between 0 and 23, 0 Decimal Digits
.66 NON-COVERED DAYS 6;6 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAR 21, 1990
  • HELP-PROMPT:  Type a Number between 0 and 999, 0 Decimal Digits
.67 CO-INSURANCE DAYS 6;7 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  APR 11, 1990
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
.68 LIFETIME RESERVE DAYS 6;8 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  APR 11, 1990
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
.69 NUMBER OF OUTPATIENT VISITS 6;9 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 03, 1991
  • HELP-PROMPT:  Type a Number between 1 and 99, 0 Decimal Digits
.71 SERVICE DATE FROM 7;1 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X K:$P($G(^DPT($P($G(^ABMDBILL(DUZ(2),DA,0)),U,5),0)),U,3)>Y X
  • LAST EDITED:  DEC 21, 2005
  • HELP-PROMPT:  SERVICE FROM DATE must be after Date of Birth
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  9002274.4^AD
    1)= S ^ABMDBILL(DUZ(2),"AD",$E(X,1,30),DA)=""
    2)= K ^ABMDBILL(DUZ(2),"AD",$E(X,1,30),DA)
  • CROSS-REFERENCE:  9002274.4^ADR^MUMPS
    1)= S ^ABMDBILL(DUZ(2),"ADR",9999999-X,DA)=$P(^ABMDBILL(DUZ(2),DA,0),"^",5)
    2)= K ^ABMDBILL(DUZ(2),"ADR",9999999-X,DA)
    Inverse date cross reference which is set equal to patient.
.711 RELEASE OF INFORMATION DATE 7;11 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  APR 26, 2006
.712 ASSIGNMENT OF BENEFITS DATE 7;12 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  APR 26, 2006
.713 PROPERTY/CASUALTY CLAIM NUMBER 7;13 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>50!($L(X)<3) X
  • LAST EDITED:  JUL 22, 2010
  • HELP-PROMPT:  3-50 characters in length. Populates REF*Y4 of 837P.
.714 HEARING/VISION RX DATE 7;14 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  JUL 26, 2010
  • HELP-PROMPT:  (No range limit on date)
.715 START DISABILITY DATE 7;15 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  JUL 26, 2010
  • HELP-PROMPT:  Leave blank if unknown
.716 END DISABILITY DATE 7;16 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  JUL 26, 2010
  • HELP-PROMPT:  Leave blank if unknown
.717 DATE LAST WORKED 7;17 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  JUL 26, 2010
  • HELP-PROMPT:  (No range limit on date)
.718 DATE AUTH TO RETURN TO WORK 7;18 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  JUL 26, 2010
  • HELP-PROMPT:  (No range limit on date)
.719 ASSUMED CARE DATE 7;19 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  JUL 26, 2010
  • HELP-PROMPT:  (No range limit on date)
.72 SERVICE DATE TO 7;2 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  APR 19, 1990
.721 RELINQUISHED CARE DATE 7;21 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  JUL 26, 2010
  • HELP-PROMPT:  (No range limit on date)
.722 PROP/CASUALTY DT 1ST CONTACT 7;22 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  JUL 26, 2010
  • HELP-PROMPT:  (No range limit on date)
.723 PATIENT PAID AMOUNT 7;23 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999)!(X<0)!(X?.E1"."3.N) X
  • LAST EDITED:  JUL 27, 2010
  • HELP-PROMPT:  Type a Dollar amount between 0 and 999999, 2 Decimal Digits
.724 SPINAL MANIPULATION COND CODE 7;24 SET
  • 'A' FOR ACUTE CONDITION;
  • 'C' FOR CHRONIC CONDITION;
  • 'D' FOR NON-ACUTE;
  • 'E' FOR NON-LIFE THREATENING;
  • 'F' FOR ROUTINE;
  • 'G' FOR SYMPTOMATIC;
  • 'M' FOR ACUTE MANIFESTATION OF A CHRONIC CONDITION;

  • LAST EDITED:  JUL 27, 2010
.725 PROP/CASUAL PATIENT ID 7;25 SET
  • 'SY' FOR SOCIAL SECURITY NUMBER;
  • '1W' FOR MEMBER IDENTIFICATION NUMBER;

  • LAST EDITED:  OCT 04, 2010
.726 PROP/CASUAL PATIENT NUMBER 7;26 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>50!($L(X)<1) X
  • LAST EDITED:  OCT 04, 2010
  • HELP-PROMPT:  Answer must be 1-50 characters in length
.727 ACUTE MANIFESTATION DATE 7;27 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  FEB 25, 2014
  • HELP-PROMPT:  (No range limit on date)
.73 COVERED DAYS 7;3 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  APR 12, 1990
  • HELP-PROMPT:  Type a Number between 0 and 999, 0 Decimal Digits
.74 RELEASE OF INFORMATION 7;4 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;
  • 'R' FOR RESTRICTED;

  • LAST EDITED:  MAY 15, 1990
.75 ASSIGNMENT OF BENEFITS 7;5 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;
  • 'W' FOR NOT APPLICABLE;

  • LAST EDITED:  JUL 29, 2010
  • HELP-PROMPT:  Use code "W" when the patient refuses to assign benefits.
.76 PINTS OF BLOOD FURNISHED 7;6 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAR 27, 1990
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
.77 PINTS OF BLOOD REPLACED 7;7 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAR 27, 1990
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
.78 PINTS OF BLOOD NOT REPLACED 7;8 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAR 27, 1990
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
.79 BLOOD DEDUCTIBLE PINTS 7;9 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAR 27, 1990
  • HELP-PROMPT:  Type a Number between 0 and 9, 0 Decimal Digits
.81 OUTSIDE LAB CHARGES 8;1 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>99999.99)!(X<0) X
  • LAST EDITED:  MAR 27, 1990
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 99999.99, 2 Decimal Digits
.816 ACCIDENT STATE 8;16 POINTER TO STATE FILE (#5) STATE(#5)

  • LAST EDITED:  AUG 18, 2004
.82 INJURY DATE 8;2 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  DEC 20, 1990
.821 VISION CONDITION INFO 8;21 SET
  • 'E1' FOR SPECTACLE LENSES;
  • 'E2' FOR CONTACT LENSES;
  • 'E3' FOR SPECTACLE FRAMES;

  • LAST EDITED:  JUL 30, 2010
.822 VISION CERT. CONDITION IND 8;22 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUL 30, 2010
.823 INITIAL TREATMENT DATE 8;23 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  FEB 25, 2014
  • HELP-PROMPT:  (No range limit on date)
.824 EXP35 FL 17 PROVIDER NAME 8;24 FREE TEXT

  • INPUT TRANSFORM:  D NAME^AUPNPED
  • LAST EDITED:  MAR 07, 2014
  • HELP-PROMPT:  Answer must be 3-30 characters in length. Must be in the format LASTNAME,FIRSTNAME.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.825 EXP35 FL17 PROVIDER TYPE 8;25 SET
  • 'DN' FOR REFERRING PROVIDER;
  • 'DK' FOR ORDERING PROVIDER;
  • 'DQ' FOR SUPERVISING PROVIDER;

  • LAST EDITED:  MAR 07, 2014
.826 EXP35 FL17 PROVIDER NPI 8;26 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<10)!'(($$CHKDGT^XUSNPI(X))) X
  • LAST EDITED:  MAR 07, 2014
  • HELP-PROMPT:  Answer must be 10 characters in length.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.83 ACCIDENT TYPE 8;3 SET
  • '1' FOR AUTO;
  • '2' FOR AUTO-NO FAULT INSURANCE;
  • '3' FOR COURT ACTION POSSIBLE;
  • '4' FOR EMPLOYMENT RELATED;
  • '5' FOR OTHER ACCIDENT;
  • '6' FOR CRIME VICTIM;

  • LAST EDITED:  MAY 15, 1990
.84 ACCIDENT HOUR 8;4 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>23)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  APR 26, 1990
  • HELP-PROMPT:  Type a Number between 0 and 23, 0 Decimal Digits
.85 EMERGENCY (Y/N) 8;5 SET
  • 'Y' FOR YES;

  • LAST EDITED:  MAY 15, 1990
.855 EMERGENCY ROOM SUR-CHARGE 8;10 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999.99)!(X<0) X
  • LAST EDITED:  MAY 22, 1990
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 999.99, 2 Decimal Digits
.857 E-CODE 8;12 POINTER TO ICD DIAGNOSIS FILE (#80) ICD DIAGNOSIS(#80)

  • INPUT TRANSFORM:  K:$E($P(Y,"^",2))'="E" X
  • LAST EDITED:  MAR 11, 1994
  • HELP-PROMPT:  E-CODES ONLY
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.858 E-CODE (2) 8;19 POINTER TO ICD DIAGNOSIS FILE (#80) ICD DIAGNOSIS(#80)

  • INPUT TRANSFORM:  K:$E($P(Y,"^",2))'="E" X
  • LAST EDITED:  MAR 28, 2007
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.859 E-CODE (3) 8;20 POINTER TO ICD DIAGNOSIS FILE (#80) ICD DIAGNOSIS(#80)

  • INPUT TRANSFORM:  K:$E($P(Y,"^",2))'="E" X
  • LAST EDITED:  MAR 28, 2007
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.86 DATE OF FIRST SYMPTOM 8;6 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAY 19, 1990
.87 DATE OF FIRST CONSULTATION 8;7 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAY 20, 1990
.88 REFERRING PHYSICIAN 8;8 FREE TEXT

  • INPUT TRANSFORM:  D NAME^AUPNPED
  • LAST EDITED:  MAY 17, 2004
  • HELP-PROMPT:  Answer must be 3-30 characters in length. Must be in the format LASTNAME,FIRSTNAME
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.884 REFERRING PHYS ID QUALIFIER 8;18 SET
  • '0B' FOR STATE LIC NO;
  • '1B' FOR BLUE SHIELD PRV NO;
  • '1C' FOR MEDICARE PRV NO;
  • '1D' FOR MEDICAID PRV NO;
  • '1G' FOR PRV UPIN NO;
  • '1H' FOR CHAMPUS ID NO;
  • 'EI' FOR EMPLOYER'S ID NO;
  • 'G2' FOR PRV COMMERCIAL NO;
  • 'N5' FOR PRV PLAN NETWORK ID;
  • 'SY' FOR SSN;

  • LAST EDITED:  MAR 27, 2007
.885 REFER PHYSICIAN ID NO. 8;11 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<3) X
  • LAST EDITED:  JAN 28, 1992
  • HELP-PROMPT:  Answer must be 3-20 characters in length.
.886 REFER PHYSICIAN PERSON CLASS 8;13 POINTER TO PERSON CLASS FILE (#8932.1) PERSON CLASS(#8932.1)

  • LAST EDITED:  MAY 17, 2004
.887 REF PHYSICIAN PROVIDER CLASS 8;14 POINTER TO PROVIDER CLASS FILE (#7) PROVIDER CLASS(#7)

  • LAST EDITED:  JUL 14, 2004
.888 REFER PHYSICIAN TAXONOMY CODE 8;15 POINTER TO 3P PROVIDER TAXONOMY FILE (#9002274.95) 3P PROVIDER TAXONOMY(#9002274.95)

  • LAST EDITED:  JUL 14, 2004
.889 REFER PROV NPI 8;17 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<10)!'(($$CHKDGT^XUSNPI(X))) X
  • LAST EDITED:  MAR 05, 2007
  • HELP-PROMPT:  Answer must be 10 characters in length
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.89 DATE OF SIMILIAR SYMPTOM 8;9 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAY 20, 1990
.91 EMPLOYMENT RELATED (Y/N) 9;1 SET
  • 'Y' FOR YES;

  • LAST EDITED:  MAY 19, 1990
.911 DATE LAST SEEN 9;11 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUL 25, 2002
.912 SUPERVISING PROV(FL19) 9;12 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<1) X
  • LAST EDITED:  FEB 26, 2003
  • HELP-PROMPT:  Required by Medicare Part B when an independent physician, occupational therapist, or podiatrist providing routine foot care claims. Enter the UPIN and DATE LAST SEEN.
.913 DATE OF LAST X-RAY 9;13 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  FEB 26, 2003
  • HELP-PROMPT:  Required for Medicare Part B when the date of x-ray was taken at a time reasonably proximate to the initiation of treatment
.914 HOMEBOUND INDICATOR 9;14 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  FEB 26, 2003
  • HELP-PROMPT:  Required for Medicare Part B when an independent lab renders an EKG or obtains a specimen from a homebound or institutionalized patient
.915 HOSPICE EMPLOYED PROVIDER 9;15 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  FEB 26, 2003
  • HELP-PROMPT:  Required for Medicare Part B if treatment in the hospice was rendered by a hospice employed physician
.916 DELAYED REASON CODE 9;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),U,2)=""U""" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  OCT 24, 2005
  • SCREEN:  S DIC("S")="I $P(^(0),U,4)'=1,$P(^(0),U,2)=""U"""
  • EXPLANATION:  DELAYED REASON CODE entries only
.918 ORAL IMAGES 9;18 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 18, 2004
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
.919 MODEL(S) 9;19 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 18, 2004
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
.92 DATE ABLE TO WORK 9;2 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAY 19, 1990
.921 OTHER DENTAL CHARGES 9;21 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>99999)!(X<0) X
  • LAST EDITED:  AUG 18, 2004
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 99999, 2 Decimal Digits
.922 IN-HOUSE CLIA# 9;22 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<10)!'(X?2N1U7N) X
  • LAST EDITED:  NOV 28, 2005
  • HELP-PROMPT:  Answer must be 10 characters in length.
.923 REFERENCE LAB CLIA# 9;23 POINTER TO 3P REFERENCE LAB LOCATIONS FILE (#9002274.35) 3P REFERENCE LAB LOCATIONS(#9002274.35)

  • LAST EDITED:  NOV 28, 2005
.93 TOTAL DISABILITY FROM DATE 9;3 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAY 19, 1990
.94 TOTAL DISABILITY TO DATE 9;4 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAY 19, 1990
.95 PARTIAL DISABILITY FROM DATE 9;5 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAY 19, 1990
.96 PARTIAL DISABILITY TO DATE 9;6 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAY 19, 1990
.97 *REVENUE CODE 9;7 POINTER TO REVENUE CODES FILE (#9999999.72) REVENUE CODES(#9999999.72)

  • LAST EDITED:  MAR 01, 1996
.98 *REVENUE CHARGE 9;8 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999.99)!(X<0) X
  • LAST EDITED:  MAR 01, 1996
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 9999.99, 2 Decimal Digits
.99 PRE-PAYMENT AMOUNT 9;9 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999.99)!(X<0) X
  • LAST EDITED:  JUN 05, 1992
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 9999.99, 2 Decimal Digits
3 PAYMENT 3;0 DATE Multiple #9002274.403 9002274.403
8.5 VISION CONDITION INDICATORS 8.5;0 SET Multiple #9002274.4085 9002274.4085
10 HCFA 1500-B LINE 19 10;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>250!($L(X)<1) X
  • LAST EDITED:  JUL 19, 2002
  • HELP-PROMPT:  Information entered here will be placed in block 19 on the hard copy (only the first 48 characters) and in the appropriate field on the electronic format. Enter from 1 to 245 characters.
11 PCC Visit 11;0 POINTER Multiple #9002274.4011 9002274.4011

  • SCREEN:  S DIC("S")="I $P(^(0),U,5)=$P(^ABMDBILL(DUZ(2),DA,0),U,1)"
  • EXPLANATION:  VISIT MUST BE FOR PATIENT IN CONCERN
13 Insurer 13;0 POINTER Multiple #9002274.4013 9002274.4013
14 MED NECESSITY COND 14;0 POINTER Multiple #9002274.414 9002274.414
15 APC Visit 15;0 POINTER Multiple #9002274.4015 9002274.4015
17 Diagnosis 17;0 POINTER Multiple #9002274.4017 9002274.4017
19 ICD Procedure 19;0 POINTER Multiple #9002274.4019 9002274.4019

  • SCREEN:  S DIC("S")="I $P(^(0),U,3)=$P(^ABMDBILL(DUZ(2),DA,0),U,3)"
  • EXPLANATION:  ICD PROCEDURE MUST BE ASSOCIATED WITH THE VISIT
21 Med/Surg Procedure 21;0 POINTER Multiple #9002274.4021 9002274.4021
23 Pharmacy 23;0 POINTER Multiple #9002274.4023 9002274.4023
25 Revenue Code 25;0 POINTER Multiple #9002274.4025 9002274.4025

  • LAST EDITED:  SEP 13, 1996
27 Medical Procedures 27;0 POINTER Multiple #9002274.4027 9002274.4027

  • LAST EDITED:  APR 08, 1992
33 Dental 33;0 POINTER Multiple #9002274.4033 9002274.4033
35 Radiology 35;0 POINTER Multiple #9002274.4035 9002274.4035
37 Laboratory 37;0 POINTER Multiple #9002274.4037 9002274.4037
39 Anesthesia 39;0 POINTER Multiple #9002274.4039 9002274.4039
41 Providers 41;0 POINTER Multiple #9002274.4041 9002274.4041
43 Misc. Services 43;0 POINTER Multiple #9002274.4043 9002274.4043
45 Charge Master 45;0 POINTER Multiple #9002274.4045 9002274.4045

  • LAST EDITED:  JAN 13, 1998
47 AMBULANCE SERVICE 47;0 POINTER Multiple #9002274.4047 9002274.4047
51 Occurrence Code 51;0 POINTER Multiple #9002274.4051 9002274.4051

  • LAST EDITED:  FEB 25, 2014
53 Condition Code 53;0 POINTER Multiple #9002274.4053 9002274.4053
55 Value Codes 55;0 POINTER Multiple #9002274.4055 9002274.4055
57 Occurance Span Code 57;0 POINTER Multiple #9002274.4057 9002274.4057

  • SCREEN:  S DIC("S")="I $P(^(0),U,4)'=1,$P(^(0),U,2)=""S"""
  • EXPLANATION:  OCCURANCE SPAN CODES ONLY
59 Special Program Code 59;0 POINTER Multiple #9002274.4059 9002274.4059

  • SCREEN:  S DIC("S")="I $P(^(0),U,4)'=1,$P(^(0),U,2)=""I"""
  • EXPLANATION:  SPECIAL PROGRAM CODE
61 REMARKS 61;0 Multiple #9002274.4061 9002274.4061
65 ACTIVE BILLS 65;0 POINTER Multiple #9002274.4065 9002274.4065
67 DATE STMT WAS PRINTED 67;0 DATE Multiple #9002274.4067 9002274.4067
69 UFMS TRANSMISSION DATE 69;0 POINTER Multiple #9002274.469 9002274.469
73 POS REJECTIONS 73;0 Multiple #9002274.4073 9002274.4073
121 MSP REASON 12;1 SET
  • '12' FOR WORK AGE BEN OR SPOUSE W/EGHP;
  • '13' FOR END-STAGE RENAL DISEASE BEN 12-MTH PER W/EGHP;
  • '14' FOR NO-FLT INSUR INCLD. AUTO PRIMARY;
  • '15' FOR WORKER'S COMP;
  • '16' FOR PHS/OTHER FED;
  • '41' FOR BLACK LUNG;
  • '42' FOR VA;
  • '43' FOR DISABLED BEN <65 W/LGHP;
  • '47' FOR OTH. LIAB INS PRIMARY;

  • LAST EDITED:  AUG 04, 2010
411 RESUBMISSION (CONTROL) NOTE 4;11 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>80!($L(X)<3) X
  • LAST EDITED:  MAR 19, 2007
  • HELP-PROMPT:  Answer must be 3-80 characters in length
  • AUDIT:  YES, ALWAYS
412 PT STMT MESSAGE 4;12 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>70!($L(X)<1) X
  • LAST EDITED:  MAR 28, 2007
  • HELP-PROMPT:  Answer must be 1-70 characters in length
413 ORTHO TRTMT MTHS REMAINING 4;13 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1.N) X
  • LAST EDITED:  MAY 02, 2007
  • HELP-PROMPT:  Type a number between 0 and 99, 0 Decimal Digits
710 CLAIM ATTACHMENTS 71;0 POINTER Multiple #9002274.4071 9002274.4071
924 SUPERVISING PROVIDER 9;24 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<3) X
  • LAST EDITED:  DEC 11, 2012
  • HELP-PROMPT:  Answer must be 3-30 characters in length.
925 SUPERVISING PRV NPI 9;25 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<10)!'(($$CHKDGT^XUSNPI(X))) X
  • LAST EDITED:  MAR 05, 2007
  • HELP-PROMPT:  Answer must be 10 characters in length
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
1217 ORIGINAL MSP REASON 12;17 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<2) X
  • LAST EDITED:  JUL 09, 2009
  • HELP-PROMPT:  Answer must be 2-15 characters in length
1218 AMBULANCE PATIENT COUNT 12;18 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<0)!(X?.E1"."1.N) X
  • LAST EDITED:  JUL 29, 2010
  • HELP-PROMPT:  Type a number between 0 and 999, 0 Decimal Digits
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