ABMP2611.m

ABMP2611 ; IHS/SD/SDR - 3P BILLING 2.6 Patch 11 POST INIT ;  

 ;;2.6;IHS Third Party Billing;**11**;NOV 12, 2009;Build 133

 ;

 Q

POST ;

 D ICDEFFDT  ;re-populate ICD10 effective date with 10/1/14

 D ERRORCD  ;create new claim editor error codes

 D EXP34  ;add new export mode 34 ADA-2012

 D ECODES  ;add new 3P Codes entries

 D QUES28  ;add question 28 to export mode 27

 ;

 Q:(+$O(^ABMDCODE("AC","H","08",0))'=0)

 K DIC,X

 S DIC="^ABMDCODE("

 S DIC(0)="ML"

 S X="08"

 S DIC("DR")=".02///H"

 S DIC("DR")=DIC("DR")_";.03///TRIBAL 638 PROVIDER-BASED FACILITY"

 K DD,DO

 D FILE^DICN

 Q

ICDEFFDT ;

 D BMES^XPDUTL("Auto-populating ICD-10 EFFECTIVE DATE with 10/1/2014 for all insurers...")

 S ABMHOLD=DUZ(2)

 S DUZ(2)=0

 F  S DUZ(2)=$O(^ABMNINS(DUZ(2))) Q:'DUZ(2)  D

 .S ABMDA=0

 .F  S ABMDA=$O(^ABMNINS(DUZ(2),ABMDA)) Q:'ABMDA  D

 ..S DIE="^ABMNINS("_DUZ(2)_","

 ..S DA=ABMDA

 ..S DR=".12////3141001"

 ..D ^DIE

 Q

ERRORCD ;

 ;HEAT81017

 ;244 - No providers on claim

 K DIC,X

 S DIC="^ABMDERR("

 S DIC(0)="LM"

 S DINUM=244

 S X="No Providers on claim"

 S DIC("DR")=".02///Add some type of provider"

 S DIC("DR")=DIC("DR")_";.03///E"

 K DD,DO

 D FILE^DICN

 D SITE(244)

 Q

 ;

SITE(ABMX) ;

 S DUZHOLD=DUZ(2)

 S DUZ(2)=0

 F  S DUZ(2)=$O(^ABMDCLM(DUZ(2))) Q:'+DUZ(2)  D

 .S DIC(0)="LX"

 .S DA(1)=ABMX

 .S DIC="^ABMDERR("_DA(1)_",31,"

 .S DIC("P")=$P(^DD(9002274.04,31,0),U,2)

 .S DINUM=DUZ(2)

 .S X=$P($G(^DIC(4,DUZ(2),0)),U)

 .S DIC("DR")=".03////"_$S(ABMX=243:"W",1:"E")

 .D ^DIC

 .K DA,DIC,DINUM

 S DUZ(2)=DUZHOLD

 K DUZHOLD,DLAYGO,ABMX

 Q

EXP34 ;

 K DIC,DR,DINUM,DLAYGO,DIE

 S DIC="^ABMDEXP("

 S DIC(0)="LM"

 S DLAYGO=9002274

 S X="ADA-2012",DINUM=34

 K DD,DO

 D ^DIC

 Q:Y<0

 S DA=+Y

 S DIE="^ABMDEXP("

 S DR=".04////ABMDF34;.05////ABMDF34X;.06///C;.07///ADA Claim Form dated 2012;.08///1,2,3,4,9,32,33;.11////ABMDES4;.15///H"

 D ^DIE

 Q

QUES28 ;EP

 S ABMQUES=$P($G(^ABMDEXP(27,0)),U,8)

 S DIE="^ABMDEXP("

 S DA=27

 S DR=".08////"_ABMQUES_",28"

 D ^DIE

 Q

ECODES ;

 K DIC,X

 F ABMI=1:1 S ABMLN=$P($T(ECODETXT+ABMI),";;",2) Q:ABMLN="END"  D

 .S ABMCODE=$P(ABMLN,U)

 .I $D(^ABMDCODE("AC",$P(ABMLN,U,2),ABMCODE)) D  Q

 ..S DA=$O(^ABMDCODE("AC",$P(ABMLN,U,2),ABMCODE,0))

 ..S $P(^ABMDCODE(DA,0),U,2)=$P(ABMLN,U,2),$P(^(0),U,3)=$P(ABMLN,U,3),$P(^(0),U,4)=$P(ABMLN,U,4)

 .S ABMDESC=$P(ABMLN,U,3)

 .S ABMINAC=$P(ABMLN,U,4)

 .S DIC="^ABMDCODE("

 .S DIC(0)="ML"

 .S X=ABMCODE

 .S DIC("DR")=".02///"_$P(ABMLN,U,2)

 .S DIC("DR")=DIC("DR")_";.03///"_ABMDESC

 .S DIC("DR")=DIC("DR")_";.04///"_ABMINAC

 .K DD,DO

 .D FILE^DICN

VALUE23 ;

 ;now check for duplicate entries for value code 23

 S ABM=0

 F ABMI=0:1 S ABM=$O(^ABMDCODE("AC","V",23,ABM))  Q:'ABM

 I ABMI<2 Q

 S DA=9999

 S ABMI=ABMI-1

 F ABM=1:1:ABMI D

 .S DIE="^ABMDCODE("

 .S DA=$O(^ABMDCODE("AC","V",23,DA),-1)

 .S DR=".04////1"

 .D ^DIE

 ;

 Q

ECODETXT ;

 ;;03^H^SCHOOL

 ;;05^N^BORN INSIDE THIS HOSPITAL

 ;;06^N^BORN OUTSIDE THIS HOSPITAL

 ;;5^T^TRAUMA

 ;;01^N^NORMAL BIRTH^1

 ;;02^N^PREMARTURE BIRTH^1

 ;;03^N^SICK BABY^1

 ;;04^N^EXTRAMURAL BIRTH^1

 ;;1^A^NON-HEALTH CARE FACILITY POINT OF ORIGIN

 ;;2^A^CLINIC OR PHYSICIAN'S OFFICE

 ;;3^A^HMO REFERRAL^1	

 ;;5^A^TRANSFER FROM SKILLED NURSING/INTERMEDIATE CARE/ASSISTING LIVING FAC

 ;;7^A^EMERGENCY ROOM^1

 ;;9^A^INFORMATION NOT AVAILABLE

 ;;A^A^Transfer from a Critical Access Hospital

 ;;B^A^Transfer from Another Home Health Agency

 ;;D^A^TRANSFER FROM ONE UNIT TO ANOTHER, SAME HOSP, SEPARATE CLAIM TO PAYER

 ;;E^A^TRANSFER FROM AMBULATORY SURGERY CENTER

 ;;F^A^TRANSFER FROM HOSPICE FACILITY

 ;;10^P^DISCHARGED TO MENTAL HEALTH FACILITY

 ;;30^P^Still Patient

 ;;43^P^Discharged/transferred to a Federal Health Care Facility

 ;;51^P^Hospice - Medical Facility (Certified) Providing Hospice Level of Care

 ;;61^P^Discharged/transferred to a Hospital-Based Medicare Approved Swing Bed

 ;;62^P^Discharged/transf to IRF incl Rehab Distinct Part Units of a Hospital

 ;;63^P^Discharged/transf to a Medicare Certified Long Term Care Hosp (LTCH)

 ;;64^P^Discharged/transf to a Nursing Fac Cert under Medicaid, not Medicare

 ;;65^P^Discharged/transf to a Psych Hosp or Psych Distinct Part Unit of Hosp

 ;;66^P^Discharged/transf to a Critical Access Hospital (CAH)

 ;;70^P^Discharged/transf to another Type of Health Care Inst not Defined

 ;;72^P^Discharged/Transferred/Referred to this Facility for Outpatient Svcs^1

 ;;01^P^Discharged to Home or Self Care (Routine Discharge)

 ;;02^P^Discharged/transferred to a Short-Term General Hospital for Inpt Care

 ;;03^P^Dischrgd/trans to SNF with Medicare Cert, Anticipation of Skilled Care

 ;;04^P^Discharged/transf to Facility that Provides Custodial/Supportive Care

 ;;05^P^Discharged/transf to a Designated Cancer Center or Children's Hospital

 ;;06^P^Discharged/transf to Home Under Care of an Org Home Hlth Svc Org

 ;;07^P^Left Against medical Advice or Discontinued Care

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

 ;;04^C^Information Only Bill

 ;;06^C^ESRD Patient in 1st 30 Months of Entitlement Cov by Employer Grp Ins

 ;;08^C^Beneficiary wouldn't Provide Information Concerning Other Ins Coverage

 ;;10^C^Patient/Spouse is Employed but NO Employee Group Health Plan Exists

 ;;11^C^Disabled Beneficiary but NO LGHP

 ;;30^C^Qualifying Clinical Trials

 ;;37^C^Ward Accommodation - Patient Request

 ;;44^C^Inpatient Admission Changed to Outpatient

 ;;45^C^Ambiguous Gender Category

 ;;48^C^Psychiatric Residential Tx Centers for Children & Adolescents (RTC)

 ;;47^C^Transfer from another Home Health Agency

 ;;49^C^Product Replacement within Product Lifecycle

 ;;50^C^Product Replacement for Known Recall of Product

 ;;51^C^Attestation of Unrelated Outpatient Nondiagnostic services

 ;;52^C^Out of Hospice Service Area

 ;;55^C^SNF Bed Not Available^1

 ;;58^C^Terminated Medicare Advantage Enrollee

 ;;59^C^Non-primary ESRD Facility

 ;;78^C^New Coverage not Implemented by Managed Care Plan

 ;;80^C^Home Dialysis - Nursing Facility

 ;;A7^C^INDUCED ABORTION DANGER TO LIFE^1

 ;;A8^C^INDUCED ABORTION VICTIM RAPE/INCEST^1

 ;;AA^C^Abortion Performed due to Rape

 ;;AB^C^Abortion Performed due to Incest

 ;;AC^C^Abortion Performed-Serious Fetal Genetic Defect/Deformity/Abnormality

 ;;AD^C^Abortion Performed due to Life Endangering Physical Condition

 ;;AE^C^Abortion Performed-Physical Health of Mother not Life Endangering

 ;;AF^C^Abortion Performed-Emotional/psychological Health of the Mother

 ;;AG^C^Abortion Performed due to Social or Economic Reasons

 ;;AH^C^Elective Abortion

 ;;AI^C^Sterilization

 ;;AJ^C^Payer Responsible for Co-Payment

 ;;AK^C^Air Ambulance Required

 ;;AL^C^Specialized Treatment/bed Unavailable - Alternate Facility Transport

 ;;AM^C^Non-emergency Medically Necessary Stretcher Transport Required

 ;;AN^C^Preadmission Screening not Required

 ;;B0^C^Medicare Coordinated Care Demonstration Claim

 ;;B1^C^Beneficiary is Ineligible for Demonstration Program

 ;;B2^C^Critical Access Hospital Ambulance Attestation

 ;;B3^C^Pregnancy Indicator

 ;;B4^C^Admission Unrelated to Discharge on Same Day

 ;;BP^C^Gulf Oil Spill of 2010

 ;;D4^C^CHANGE IN CLINICAL CODES (ICD) FOR DIAGNOSIS AND/OR PROCEDURE

 ;;DR^C^Disaster Related

 ;;H0^C^Delayed Filing-Statement of Intent Submitted

 ;;H2^C^Discharge by a Hospice Provider for Cause

 ;;H3^C^Reoccurrence of GI Bleed Comorbid Category

 ;;H4^C^Reoccurrence of Pneumonia Comorbid Category

 ;;H5^C^Reoccurrence of Pericarditis Comorbid Category

 ;;P1^C^Do Not Resuscitate Order (DNR)

 ;;P7^C^Direct Inpatient Admission from Emergency Room

 ;;W0^C^United Mine Workers of America (UMWA) Demonstration Indicator

 ;;W2^C^Duplicate of Original Bill

 ;;W3^C^Level I Appeal

 ;;W4^C^Level II Appeal

 ;;W5^C^Level III Appeal

 ;;01^O^Accident/Medical Coverage

 ;;04^O^ACCIDENT/EMPLOYMENT RELATED

 ;;05^O^Accident/No Medical or Liability Coverage

 ;;16^O^Date of Last Therapy

 ;;31^O^Date Beneficiary Notified Of Intent To Bill Accommodations

 ;;38^O^Date Treatment Started for Home IV Therapy

 ;;39^O^Date Discharged on a Continuous Course of IV Therapy

 ;;50^O^Assessment Date

 ;;51^O^Date of Last Kt/V Reading

 ;;52^O^Medical Certification/recertification Date

 ;;54^O^Physician Follow-Up date

 ;;55^O^Date of Death

 ;;A4^O^Split Bill Date

 ;;E1^O^Birthdate-Insured D^1

 ;;E2^O^Effective Date-Insured D Policy^1

 ;;E3^O^Benefits Exhausted^1

 ;;F1^O^Birthdate - Insured E^1

 ;;F2^O^Effective Date - Insured E Policy^1

 ;;F3^O^Benefits Exhausted^1

 ;;G1^O^Birthdate - Insured F^1

 ;;G2^O^Effective Date - Insured F Policy^1

 ;;G3^O^Benefits Exhausted^1

 ;;79^S^Payer Code

 ;;80^S^Prior Same-SNF Stay Date for Payment Ban Purposes

 ;;81^S^Antepartum Days at Reduced Level of Care

 ;;M3^S^ICF Level of Care

 ;;M4^S^Residential Level of Care

 ;;04^V^Professional Component Charges which are Combined Billed

 ;;07^V^MEDICARE PART A CASH DEDUCTIBLE^1

 ;;21^V^CATASTROPHIC

 ;;25^V^Offset to the Patient-Payment Amount - Prescription Drugs

 ;;26^V^Offset to the Patient-Payment Amount - Hearing and Ear Services

 ;;27^V^Offset to the Patient-Payment Amount - Vision and Eye Services

 ;;28^V^Offset to the Patient-Payment Amount - Dental Services

 ;;29^V^Offset to the Patient-Payment Amount - Chiropractic Services

 ;;33^V^Offset to the Patient-Payment Amount - Podiatric Services

 ;;34^V^Offset to the Patient-Payment Amount - Other Medical Service

 ;;35^V^Offset to the Patient-Payment Amount - Health Insurance Premiums

 ;;37^V^Units of Blood Furnished

 ;;39^V^Units of Blood Replaced

 ;;44^V^Amt Prov Agreed to Accept fr 1st Payer, Amt < Chrgs Higher than Pymnt

 ;;54^V^Newborn Birth Weight in Grams

 ;;55^V^Eligibility Threshold for Charity Care

 ;;59^V^Oxygen Saturation 

 ;;66^V^Medicaid Spend Down Amount

 ;;69^V^State Charity Care Percent

 ;;73^V^Drug Deductible^1

 ;;74^V^Drug Coinsurance^1

 ;;81^V^NON-COVERED DAYS

 ;;510^V^OUTPATIENT FACILITY CHARGE^1

 ;;636^V^JCODES^1

 ;;A0^V^Special ZIP Code Reporting

 ;;A7^V^Co-payment Payer A

 ;;A8^V^Patient Weight

 ;;A9^V^Patient Height

 ;;AA^V^Regulatory Surcharges/Assessments/Allow/Hlth Cre Related Taxes Payer A

 ;;AB^V^Other Assessments or Allowance (e.g., Medical Education) Payer A

 ;;B7^V^Co-Payment Payer B

 ;;BA^V^Regulatory Surcharges/Assessments/Allow/Hlth Cre Related Taxes Payer B

 ;;BB^V^Other Assessments or Allowance (e.g., Medical Education) Payer B

 ;;C7^V^Co-Payment Payer C

 ;;CA^V^Regulatory Surcharges/Assessments/Allow/Hlth Cre Related Taxes Payer C

 ;;CB^V^Other Assessments or Allowance (e.g., Medical Education) Payer C

 ;;D4^V^Clinical Trial Number Assigned by NLM/NIH

 ;;D5^V^Last Kt/V Reading

 ;;E1^V^Deductible Payer D^1

 ;;E2^V^Coinsurance Payer D^1

 ;;E3^V^Estimated Responsibility Payer D^1

 ;;F1^V^Deductible Payer E^1

 ;;F2^V^Coinsurance Payer E^1

 ;;F3^V^Estimated Responsibility Payer E^1

 ;;FC^V^Patient Paid Amount

 ;;FD^V^Credit Received from the Manufacturer for a Replaced Medical Device

 ;;G1^V^Deductible Payer F^1

 ;;G2^V^Coinsurance Payer F^1

 ;;G3^V^Estimated Responsibility Payer F^1

 ;;G8^V^Facility where Inpatient Hospice Service is Delivered

 ;;Y1^V^Part A Demonstration Payment

 ;;Y2^V^Part B Demonstration Payment

 ;;Y3^V^Part B Coinsurance

 ;;Y4^V^Conventional Provider Payment Amount for Non-Demonstration Claims

 ;;END

ABMP2611  ; IHS/SD/SDR - 3P BILLING 2.6 Patch 11 POST INIT ;  

 +1       ;;2.6;IHS Third Party Billing;**11**;NOV 12, 2009;Build 133

 +2       ;

 +3        QUIT 

POST      ;

 +1       ;re-populate ICD10 effective date with 10/1/14

           DO ICDEFFDT

 +2       ;create new claim editor error codes

           DO ERRORCD

 +3       ;add new export mode 34 ADA-2012

           DO EXP34

 +4       ;add new 3P Codes entries

           DO ECODES

 +5       ;add question 28 to export mode 27

           DO QUES28

 +6       ;

 +7        IF (+$ORDER(^ABMDCODE("AC","H","08",0))'=0)

               QUIT 

 +8        KILL DIC,X

 +9        SET DIC="^ABMDCODE("

 +10       SET DIC(0)="ML"

 +11       SET X="08"

 +12       SET DIC("DR")=".02///H"

 +13       SET DIC("DR")=DIC("DR")_";.03///TRIBAL 638 PROVIDER-BASED FACILITY"

 +14       KILL DD,DO

 +15       DO FILE^DICN

 +16       QUIT 

ICDEFFDT  ;

 +1        DO BMES^XPDUTL("Auto-populating ICD-10 EFFECTIVE DATE with 10/1/2014 for all insurers...")

 +2        SET ABMHOLD=DUZ(2)

 +3        SET DUZ(2)=0

 +4        FOR 

               SET DUZ(2)=$ORDER(^ABMNINS(DUZ(2)))

               IF 'DUZ(2)

                   QUIT 

               Begin DoDot:1

 +5                SET ABMDA=0

 +6                FOR 

                       SET ABMDA=$ORDER(^ABMNINS(DUZ(2),ABMDA))

                       IF 'ABMDA

                           QUIT 

                       Begin DoDot:2

 +7                        SET DIE="^ABMNINS("_DUZ(2)_","

 +8                        SET DA=ABMDA

 +9                        SET DR=".12////3141001"

 +10                       DO ^DIE

                       End DoDot:2

               End DoDot:1

 +11       QUIT 

ERRORCD   ;

 +1       ;HEAT81017

 +2       ;244 - No providers on claim

 +3        KILL DIC,X

 +4        SET DIC="^ABMDERR("

 +5        SET DIC(0)="LM"

 +6        SET DINUM=244

 +7        SET X="No Providers on claim"

 +8        SET DIC("DR")=".02///Add some type of provider"

 +9        SET DIC("DR")=DIC("DR")_";.03///E"

 +10       KILL DD,DO

 +11       DO FILE^DICN

 +12       DO SITE(244)

 +13       QUIT 

 +14      ;

SITE(ABMX) ;

 +1        SET DUZHOLD=DUZ(2)

 +2        SET DUZ(2)=0

 +3        FOR 

               SET DUZ(2)=$ORDER(^ABMDCLM(DUZ(2)))

               IF '+DUZ(2)

                   QUIT 

               Begin DoDot:1

 +4                SET DIC(0)="LX"

 +5                SET DA(1)=ABMX

 +6                SET DIC="^ABMDERR("_DA(1)_",31,"

 +7                SET DIC("P")=$PIECE(^DD(9002274.04,31,0),U,2)

 +8                SET DINUM=DUZ(2)

 +9                SET X=$PIECE($GET(^DIC(4,DUZ(2),0)),U)

 +10               SET DIC("DR")=".03////"_$SELECT(ABMX=243:"W",1:"E")

 +11               DO ^DIC

 +12               KILL DA,DIC,DINUM

               End DoDot:1

 +13       SET DUZ(2)=DUZHOLD

 +14       KILL DUZHOLD,DLAYGO,ABMX

 +15       QUIT 

EXP34     ;

 +1        KILL DIC,DR,DINUM,DLAYGO,DIE

 +2        SET DIC="^ABMDEXP("

 +3        SET DIC(0)="LM"

 +4        SET DLAYGO=9002274

 +5        SET X="ADA-2012"

           SET DINUM=34

 +6        KILL DD,DO

 +7        DO ^DIC

 +8        IF Y<0

               QUIT 

 +9        SET DA=+Y

 +10       SET DIE="^ABMDEXP("

 +11       SET DR=".04////ABMDF34;.05////ABMDF34X;.06///C;.07///ADA Claim Form dated 2012;.08///1,2,3,4,9,32,33;.11////ABMDES4;.15///H"

 +12       DO ^DIE

 +13       QUIT 

QUES28    ;EP

 +1        SET ABMQUES=$PIECE($GET(^ABMDEXP(27,0)),U,8)

 +2        SET DIE="^ABMDEXP("

 +3        SET DA=27

 +4        SET DR=".08////"_ABMQUES_",28"

 +5        DO ^DIE

 +6        QUIT 

ECODES    ;

 +1        KILL DIC,X

 +2        FOR ABMI=1:1

               SET ABMLN=$PIECE($TEXT(ECODETXT+ABMI),";;",2)

               IF ABMLN="END"

                   QUIT 

               Begin DoDot:1

 +3                SET ABMCODE=$PIECE(ABMLN,U)

 +4                IF $DATA(^ABMDCODE("AC",$PIECE(ABMLN,U,2),ABMCODE))

                       Begin DoDot:2

 +5                        SET DA=$ORDER(^ABMDCODE("AC",$PIECE(ABMLN,U,2),ABMCODE,0))

 +6                        SET $PIECE(^ABMDCODE(DA,0),U,2)=$PIECE(ABMLN,U,2)

                           SET $PIECE(^(0),U,3)=$PIECE(ABMLN,U,3)

                           SET $PIECE(^(0),U,4)=$PIECE(ABMLN,U,4)

                       End DoDot:2

                       QUIT 

 +7                SET ABMDESC=$PIECE(ABMLN,U,3)

 +8                SET ABMINAC=$PIECE(ABMLN,U,4)

 +9                SET DIC="^ABMDCODE("

 +10               SET DIC(0)="ML"

 +11               SET X=ABMCODE

 +12               SET DIC("DR")=".02///"_$PIECE(ABMLN,U,2)

 +13               SET DIC("DR")=DIC("DR")_";.03///"_ABMDESC

 +14               SET DIC("DR")=DIC("DR")_";.04///"_ABMINAC

 +15               KILL DD,DO

 +16               DO FILE^DICN

               End DoDot:1

VALUE23   ;

 +1       ;now check for duplicate entries for value code 23

 +2        SET ABM=0

 +3        FOR ABMI=0:1

               SET ABM=$ORDER(^ABMDCODE("AC","V",23,ABM))

               IF 'ABM

                   QUIT 

 +4        IF ABMI<2

               QUIT 

 +5        SET DA=9999

 +6        SET ABMI=ABMI-1

 +7        FOR ABM=1:1:ABMI

               Begin DoDot:1

 +8                SET DIE="^ABMDCODE("

 +9                SET DA=$ORDER(^ABMDCODE("AC","V",23,DA),-1)

 +10               SET DR=".04////1"

 +11               DO ^DIE

               End DoDot:1

 +12      ;

 +13       QUIT 

ECODETXT  ;

 +1       ;;03^H^SCHOOL

 +2       ;;05^N^BORN INSIDE THIS HOSPITAL

 +3       ;;06^N^BORN OUTSIDE THIS HOSPITAL

 +4       ;;5^T^TRAUMA

 +5       ;;01^N^NORMAL BIRTH^1

 +6       ;;02^N^PREMARTURE BIRTH^1

 +7       ;;03^N^SICK BABY^1

 +8       ;;04^N^EXTRAMURAL BIRTH^1

 +9       ;;1^A^NON-HEALTH CARE FACILITY POINT OF ORIGIN

 +10      ;;2^A^CLINIC OR PHYSICIAN'S OFFICE

 +11      ;;3^A^HMO REFERRAL^1	

 +12      ;;5^A^TRANSFER FROM SKILLED NURSING/INTERMEDIATE CARE/ASSISTING LIVING FAC

 +13      ;;7^A^EMERGENCY ROOM^1

 +14      ;;9^A^INFORMATION NOT AVAILABLE

 +15      ;;A^A^Transfer from a Critical Access Hospital

 +16      ;;B^A^Transfer from Another Home Health Agency

 +17      ;;D^A^TRANSFER FROM ONE UNIT TO ANOTHER, SAME HOSP, SEPARATE CLAIM TO PAYER

 +18      ;;E^A^TRANSFER FROM AMBULATORY SURGERY CENTER

 +19      ;;F^A^TRANSFER FROM HOSPICE FACILITY

 +20      ;;10^P^DISCHARGED TO MENTAL HEALTH FACILITY

 +21      ;;30^P^Still Patient

 +22      ;;43^P^Discharged/transferred to a Federal Health Care Facility

 +23      ;;51^P^Hospice - Medical Facility (Certified) Providing Hospice Level of Care

 +24      ;;61^P^Discharged/transferred to a Hospital-Based Medicare Approved Swing Bed

 +25      ;;62^P^Discharged/transf to IRF incl Rehab Distinct Part Units of a Hospital

 +26      ;;63^P^Discharged/transf to a Medicare Certified Long Term Care Hosp (LTCH)

 +27      ;;64^P^Discharged/transf to a Nursing Fac Cert under Medicaid, not Medicare

 +28      ;;65^P^Discharged/transf to a Psych Hosp or Psych Distinct Part Unit of Hosp

 +29      ;;66^P^Discharged/transf to a Critical Access Hospital (CAH)

 +30      ;;70^P^Discharged/transf to another Type of Health Care Inst not Defined

 +31      ;;72^P^Discharged/Transferred/Referred to this Facility for Outpatient Svcs^1

 +32      ;;01^P^Discharged to Home or Self Care (Routine Discharge)

 +33      ;;02^P^Discharged/transferred to a Short-Term General Hospital for Inpt Care

 +34      ;;03^P^Dischrgd/trans to SNF with Medicare Cert, Anticipation of Skilled Care

 +35      ;;04^P^Discharged/transf to Facility that Provides Custodial/Supportive Care

 +36      ;;05^P^Discharged/transf to a Designated Cancer Center or Children's Hospital

 +37      ;;06^P^Discharged/transf to Home Under Care of an Org Home Hlth Svc Org

 +38      ;;07^P^Left Against medical Advice or Discontinued Care

 +39      ;;08^P^Discharged/Transferred to home under care of Home IV Provider^1

 +40      ;;04^C^Information Only Bill

 +41      ;;06^C^ESRD Patient in 1st 30 Months of Entitlement Cov by Employer Grp Ins

 +42      ;;08^C^Beneficiary wouldn't Provide Information Concerning Other Ins Coverage

 +43      ;;10^C^Patient/Spouse is Employed but NO Employee Group Health Plan Exists

 +44      ;;11^C^Disabled Beneficiary but NO LGHP

 +45      ;;30^C^Qualifying Clinical Trials

 +46      ;;37^C^Ward Accommodation - Patient Request

 +47      ;;44^C^Inpatient Admission Changed to Outpatient

 +48      ;;45^C^Ambiguous Gender Category

 +49      ;;48^C^Psychiatric Residential Tx Centers for Children & Adolescents (RTC)

 +50      ;;47^C^Transfer from another Home Health Agency

 +51      ;;49^C^Product Replacement within Product Lifecycle

 +52      ;;50^C^Product Replacement for Known Recall of Product

 +53      ;;51^C^Attestation of Unrelated Outpatient Nondiagnostic services

 +54      ;;52^C^Out of Hospice Service Area

 +55      ;;55^C^SNF Bed Not Available^1

 +56      ;;58^C^Terminated Medicare Advantage Enrollee

 +57      ;;59^C^Non-primary ESRD Facility

 +58      ;;78^C^New Coverage not Implemented by Managed Care Plan

 +59      ;;80^C^Home Dialysis - Nursing Facility

 +60      ;;A7^C^INDUCED ABORTION DANGER TO LIFE^1

 +61      ;;A8^C^INDUCED ABORTION VICTIM RAPE/INCEST^1

 +62      ;;AA^C^Abortion Performed due to Rape

 +63      ;;AB^C^Abortion Performed due to Incest

 +64      ;;AC^C^Abortion Performed-Serious Fetal Genetic Defect/Deformity/Abnormality

 +65      ;;AD^C^Abortion Performed due to Life Endangering Physical Condition

 +66      ;;AE^C^Abortion Performed-Physical Health of Mother not Life Endangering

 +67      ;;AF^C^Abortion Performed-Emotional/psychological Health of the Mother

 +68      ;;AG^C^Abortion Performed due to Social or Economic Reasons

 +69      ;;AH^C^Elective Abortion

 +70      ;;AI^C^Sterilization

 +71      ;;AJ^C^Payer Responsible for Co-Payment

 +72      ;;AK^C^Air Ambulance Required

 +73      ;;AL^C^Specialized Treatment/bed Unavailable - Alternate Facility Transport

 +74      ;;AM^C^Non-emergency Medically Necessary Stretcher Transport Required

 +75      ;;AN^C^Preadmission Screening not Required

 +76      ;;B0^C^Medicare Coordinated Care Demonstration Claim

 +77      ;;B1^C^Beneficiary is Ineligible for Demonstration Program

 +78      ;;B2^C^Critical Access Hospital Ambulance Attestation

 +79      ;;B3^C^Pregnancy Indicator

 +80      ;;B4^C^Admission Unrelated to Discharge on Same Day

 +81      ;;BP^C^Gulf Oil Spill of 2010

 +82      ;;D4^C^CHANGE IN CLINICAL CODES (ICD) FOR DIAGNOSIS AND/OR PROCEDURE

 +83      ;;DR^C^Disaster Related

 +84      ;;H0^C^Delayed Filing-Statement of Intent Submitted

 +85      ;;H2^C^Discharge by a Hospice Provider for Cause

 +86      ;;H3^C^Reoccurrence of GI Bleed Comorbid Category

 +87      ;;H4^C^Reoccurrence of Pneumonia Comorbid Category

 +88      ;;H5^C^Reoccurrence of Pericarditis Comorbid Category

 +89      ;;P1^C^Do Not Resuscitate Order (DNR)

 +90      ;;P7^C^Direct Inpatient Admission from Emergency Room

 +91      ;;W0^C^United Mine Workers of America (UMWA) Demonstration Indicator

 +92      ;;W2^C^Duplicate of Original Bill

 +93      ;;W3^C^Level I Appeal

 +94      ;;W4^C^Level II Appeal

 +95      ;;W5^C^Level III Appeal

 +96      ;;01^O^Accident/Medical Coverage

 +97      ;;04^O^ACCIDENT/EMPLOYMENT RELATED

 +98      ;;05^O^Accident/No Medical or Liability Coverage

 +99      ;;16^O^Date of Last Therapy

 +100     ;;31^O^Date Beneficiary Notified Of Intent To Bill Accommodations

 +101     ;;38^O^Date Treatment Started for Home IV Therapy

 +102     ;;39^O^Date Discharged on a Continuous Course of IV Therapy

 +103     ;;50^O^Assessment Date

 +104     ;;51^O^Date of Last Kt/V Reading

 +105     ;;52^O^Medical Certification/recertification Date

 +106     ;;54^O^Physician Follow-Up date

 +107     ;;55^O^Date of Death

 +108     ;;A4^O^Split Bill Date

 +109     ;;E1^O^Birthdate-Insured D^1

 +110     ;;E2^O^Effective Date-Insured D Policy^1

 +111     ;;E3^O^Benefits Exhausted^1

 +112     ;;F1^O^Birthdate - Insured E^1

 +113     ;;F2^O^Effective Date - Insured E Policy^1

 +114     ;;F3^O^Benefits Exhausted^1

 +115     ;;G1^O^Birthdate - Insured F^1

 +116     ;;G2^O^Effective Date - Insured F Policy^1

 +117     ;;G3^O^Benefits Exhausted^1

 +118     ;;79^S^Payer Code

 +119     ;;80^S^Prior Same-SNF Stay Date for Payment Ban Purposes

 +120     ;;81^S^Antepartum Days at Reduced Level of Care

 +121     ;;M3^S^ICF Level of Care

 +122     ;;M4^S^Residential Level of Care

 +123     ;;04^V^Professional Component Charges which are Combined Billed

 +124     ;;07^V^MEDICARE PART A CASH DEDUCTIBLE^1

 +125     ;;21^V^CATASTROPHIC

 +126     ;;25^V^Offset to the Patient-Payment Amount - Prescription Drugs

 +127     ;;26^V^Offset to the Patient-Payment Amount - Hearing and Ear Services

 +128     ;;27^V^Offset to the Patient-Payment Amount - Vision and Eye Services

 +129     ;;28^V^Offset to the Patient-Payment Amount - Dental Services

 +130     ;;29^V^Offset to the Patient-Payment Amount - Chiropractic Services

 +131     ;;33^V^Offset to the Patient-Payment Amount - Podiatric Services

 +132     ;;34^V^Offset to the Patient-Payment Amount - Other Medical Service

 +133     ;;35^V^Offset to the Patient-Payment Amount - Health Insurance Premiums

 +134     ;;37^V^Units of Blood Furnished

 +135     ;;39^V^Units of Blood Replaced

 +136     ;;44^V^Amt Prov Agreed to Accept fr 1st Payer, Amt < Chrgs Higher than Pymnt

 +137     ;;54^V^Newborn Birth Weight in Grams

 +138     ;;55^V^Eligibility Threshold for Charity Care

 +139     ;;59^V^Oxygen Saturation 

 +140     ;;66^V^Medicaid Spend Down Amount

 +141     ;;69^V^State Charity Care Percent

 +142     ;;73^V^Drug Deductible^1

 +143     ;;74^V^Drug Coinsurance^1

 +144     ;;81^V^NON-COVERED DAYS

 +145     ;;510^V^OUTPATIENT FACILITY CHARGE^1

 +146     ;;636^V^JCODES^1

 +147     ;;A0^V^Special ZIP Code Reporting

 +148     ;;A7^V^Co-payment Payer A

 +149     ;;A8^V^Patient Weight

 +150     ;;A9^V^Patient Height

 +151     ;;AA^V^Regulatory Surcharges/Assessments/Allow/Hlth Cre Related Taxes Payer A

 +152     ;;AB^V^Other Assessments or Allowance (e.g., Medical Education) Payer A

 +153     ;;B7^V^Co-Payment Payer B

 +154     ;;BA^V^Regulatory Surcharges/Assessments/Allow/Hlth Cre Related Taxes Payer B

 +155     ;;BB^V^Other Assessments or Allowance (e.g., Medical Education) Payer B

 +156     ;;C7^V^Co-Payment Payer C

 +157     ;;CA^V^Regulatory Surcharges/Assessments/Allow/Hlth Cre Related Taxes Payer C

 +158     ;;CB^V^Other Assessments or Allowance (e.g., Medical Education) Payer C

 +159     ;;D4^V^Clinical Trial Number Assigned by NLM/NIH

 +160     ;;D5^V^Last Kt/V Reading

 +161     ;;E1^V^Deductible Payer D^1

 +162     ;;E2^V^Coinsurance Payer D^1

 +163     ;;E3^V^Estimated Responsibility Payer D^1

 +164     ;;F1^V^Deductible Payer E^1

 +165     ;;F2^V^Coinsurance Payer E^1

 +166     ;;F3^V^Estimated Responsibility Payer E^1

 +167     ;;FC^V^Patient Paid Amount

 +168     ;;FD^V^Credit Received from the Manufacturer for a Replaced Medical Device

 +169     ;;G1^V^Deductible Payer F^1

 +170     ;;G2^V^Coinsurance Payer F^1

 +171     ;;G3^V^Estimated Responsibility Payer F^1

 +172     ;;G8^V^Facility where Inpatient Hospice Service is Delivered

 +173     ;;Y1^V^Part A Demonstration Payment

 +174     ;;Y2^V^Part B Demonstration Payment

 +175     ;;Y3^V^Part B Coinsurance

 +176     ;;Y4^V^Conventional Provider Payment Amount for Non-Demonstration Claims

 +177     ;;END