IBINI057 ; ; 21-MAR-1994
;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94
Q:'DIFQR(355.6) 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,$J,355.6)
;;=^IBE(355.6,
;;^UTILITY(U,$J,355.6,0)
;;=INSURANCE RIDERS^355.6^18^18
;;^UTILITY(U,$J,355.6,1,0)
;;=EXTEND COVERAGE TO 365 DAYS
;;^UTILITY(U,$J,355.6,1,11,0)
;;=^^1^1^2931130^^
;;^UTILITY(U,$J,355.6,1,11,1,0)
;;=Extends coverage to 365 dates of in-hospital visits.
;;^UTILITY(U,$J,355.6,2,0)
;;=COVERAGE FOR ACCIDENTAL INJURY
;;^UTILITY(U,$J,355.6,2,11,0)
;;=^^3^3^2931130^
;;^UTILITY(U,$J,355.6,2,11,1,0)
;;=Provides first-aid coverage for accidental injuries and coverage
;;^UTILITY(U,$J,355.6,2,11,2,0)
;;=for certain medical emergency examinations provided in the doctor's
;;^UTILITY(U,$J,355.6,2,11,3,0)
;;=office, outpatient or emergcy department.
;;^UTILITY(U,$J,355.6,3,0)
;;=EXTEND DEPENDENTS TO AGE 23
;;^UTILITY(U,$J,355.6,3,11,0)
;;=^^1^1^2931130^
;;^UTILITY(U,$J,355.6,3,11,1,0)
;;=Extends age limit for eligible dependents to 23.
;;^UTILITY(U,$J,355.6,4,0)
;;=AMBULANCE COVERAGE
;;^UTILITY(U,$J,355.6,4,11,0)
;;=^^2^2^2931130^
;;^UTILITY(U,$J,355.6,4,11,1,0)
;;=Provides benefits for necessary ambulance servcies to a hospital as ordered
;;^UTILITY(U,$J,355.6,4,11,2,0)
;;=by a physician or officer of the law.
;;^UTILITY(U,$J,355.6,5,0)
;;=NO LABORATORY MAXIMUM
;;^UTILITY(U,$J,355.6,5,11,0)
;;=^^3^3^2931130^
;;^UTILITY(U,$J,355.6,5,11,1,0)
;;=Removes Laboratory maximum and expands laboratory coverage to include
;;^UTILITY(U,$J,355.6,5,11,2,0)
;;=those in the doctor's office, outpatient department or independent lab
;;^UTILITY(U,$J,355.6,5,11,3,0)
;;=with no maximum benefit.
;;^UTILITY(U,$J,355.6,6,0)
;;=MENTAL HEALTH COVERAGE
;;^UTILITY(U,$J,355.6,6,11,0)
;;=^^5^5^2931130^
;;^UTILITY(U,$J,355.6,6,11,1,0)
;;=Provides coverage for specified mental health services provided by
;;^UTILITY(U,$J,355.6,6,11,2,0)
;;=psychiatrists, psychologists, and certified psychiatric social workers
;;^UTILITY(U,$J,355.6,6,11,3,0)
;;=when not otherwise covered by a plan.
;;^UTILITY(U,$J,355.6,6,11,4,0)
;;=
;;^UTILITY(U,$J,355.6,6,11,5,0)
;;=Inpatient and outpatient maximums may apply.
;;^UTILITY(U,$J,355.6,7,0)
;;=PRESCRIPTION COVERAGE
;;^UTILITY(U,$J,355.6,7,11,0)
;;=^^1^1^2931130^
;;^UTILITY(U,$J,355.6,7,11,1,0)
;;=Provides coverage for medications and nonexperimental therapy.
;;^UTILITY(U,$J,355.6,8,0)
;;=ELIMINATE PRESCRIPTION COVER
;;^UTILITY(U,$J,355.6,8,11,0)
;;=^^2^2^2931130^
;;^UTILITY(U,$J,355.6,8,11,1,0)
;;=Eliminates benefits for prescription drugs and insulin from
;;^UTILITY(U,$J,355.6,8,11,2,0)
;;=basic contract.
;;^UTILITY(U,$J,355.6,9,0)
;;=PRE-EXISTING COND. 11 MONTHS
;;^UTILITY(U,$J,355.6,9,11,0)
;;=^^1^1^2931130^
;;^UTILITY(U,$J,355.6,9,11,1,0)
;;=Imposes an 11 month waiting period for pre-existing conditions.
;;^UTILITY(U,$J,355.6,10,0)
;;=EXTEND DEPENDENTS TO AGE 25
;;^UTILITY(U,$J,355.6,10,11,0)
;;=^^1^1^2931130^
;;^UTILITY(U,$J,355.6,10,11,1,0)
;;=Extends coverage for student dependents to age 25.
;;^UTILITY(U,$J,355.6,11,0)
;;=ELIMINATE DEDUCTIBLE AND COPAY
;;^UTILITY(U,$J,355.6,11,11,0)
;;=^^1^1^2931130^
;;^UTILITY(U,$J,355.6,11,11,1,0)
;;=Eliminates deductibles and copayments for most hospital facility charges.
;;^UTILITY(U,$J,355.6,12,0)
;;=SUBSTANCE ABUSE 30 DAYS
;;^UTILITY(U,$J,355.6,12,11,0)
;;=^^2^2^2931130^
;;^UTILITY(U,$J,355.6,12,11,1,0)
;;=Provides benefits for up to 30 days of inpatient rehabilitation for
;;^UTILITY(U,$J,355.6,12,11,2,0)
;;=alcoholism or substance abuse during each calendar year.
;;^UTILITY(U,$J,355.6,13,0)
;;=NURSING HOME COVERAGE
IBINI057 ; ; 21-MAR-1994
+1 ;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94
+2 IF 'DIFQR(355.6)
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,355.6)
+2 ;;=^IBE(355.6,
+3 ;;^UTILITY(U,$J,355.6,0)
+4 ;;=INSURANCE RIDERS^355.6^18^18
+5 ;;^UTILITY(U,$J,355.6,1,0)
+6 ;;=EXTEND COVERAGE TO 365 DAYS
+7 ;;^UTILITY(U,$J,355.6,1,11,0)
+8 ;;=^^1^1^2931130^^
+9 ;;^UTILITY(U,$J,355.6,1,11,1,0)
+10 ;;=Extends coverage to 365 dates of in-hospital visits.
+11 ;;^UTILITY(U,$J,355.6,2,0)
+12 ;;=COVERAGE FOR ACCIDENTAL INJURY
+13 ;;^UTILITY(U,$J,355.6,2,11,0)
+14 ;;=^^3^3^2931130^
+15 ;;^UTILITY(U,$J,355.6,2,11,1,0)
+16 ;;=Provides first-aid coverage for accidental injuries and coverage
+17 ;;^UTILITY(U,$J,355.6,2,11,2,0)
+18 ;;=for certain medical emergency examinations provided in the doctor's
+19 ;;^UTILITY(U,$J,355.6,2,11,3,0)
+20 ;;=office, outpatient or emergcy department.
+21 ;;^UTILITY(U,$J,355.6,3,0)
+22 ;;=EXTEND DEPENDENTS TO AGE 23
+23 ;;^UTILITY(U,$J,355.6,3,11,0)
+24 ;;=^^1^1^2931130^
+25 ;;^UTILITY(U,$J,355.6,3,11,1,0)
+26 ;;=Extends age limit for eligible dependents to 23.
+27 ;;^UTILITY(U,$J,355.6,4,0)
+28 ;;=AMBULANCE COVERAGE
+29 ;;^UTILITY(U,$J,355.6,4,11,0)
+30 ;;=^^2^2^2931130^
+31 ;;^UTILITY(U,$J,355.6,4,11,1,0)
+32 ;;=Provides benefits for necessary ambulance servcies to a hospital as ordered
+33 ;;^UTILITY(U,$J,355.6,4,11,2,0)
+34 ;;=by a physician or officer of the law.
+35 ;;^UTILITY(U,$J,355.6,5,0)
+36 ;;=NO LABORATORY MAXIMUM
+37 ;;^UTILITY(U,$J,355.6,5,11,0)
+38 ;;=^^3^3^2931130^
+39 ;;^UTILITY(U,$J,355.6,5,11,1,0)
+40 ;;=Removes Laboratory maximum and expands laboratory coverage to include
+41 ;;^UTILITY(U,$J,355.6,5,11,2,0)
+42 ;;=those in the doctor's office, outpatient department or independent lab
+43 ;;^UTILITY(U,$J,355.6,5,11,3,0)
+44 ;;=with no maximum benefit.
+45 ;;^UTILITY(U,$J,355.6,6,0)
+46 ;;=MENTAL HEALTH COVERAGE
+47 ;;^UTILITY(U,$J,355.6,6,11,0)
+48 ;;=^^5^5^2931130^
+49 ;;^UTILITY(U,$J,355.6,6,11,1,0)
+50 ;;=Provides coverage for specified mental health services provided by
+51 ;;^UTILITY(U,$J,355.6,6,11,2,0)
+52 ;;=psychiatrists, psychologists, and certified psychiatric social workers
+53 ;;^UTILITY(U,$J,355.6,6,11,3,0)
+54 ;;=when not otherwise covered by a plan.
+55 ;;^UTILITY(U,$J,355.6,6,11,4,0)
+56 ;;=
+57 ;;^UTILITY(U,$J,355.6,6,11,5,0)
+58 ;;=Inpatient and outpatient maximums may apply.
+59 ;;^UTILITY(U,$J,355.6,7,0)
+60 ;;=PRESCRIPTION COVERAGE
+61 ;;^UTILITY(U,$J,355.6,7,11,0)
+62 ;;=^^1^1^2931130^
+63 ;;^UTILITY(U,$J,355.6,7,11,1,0)
+64 ;;=Provides coverage for medications and nonexperimental therapy.
+65 ;;^UTILITY(U,$J,355.6,8,0)
+66 ;;=ELIMINATE PRESCRIPTION COVER
+67 ;;^UTILITY(U,$J,355.6,8,11,0)
+68 ;;=^^2^2^2931130^
+69 ;;^UTILITY(U,$J,355.6,8,11,1,0)
+70 ;;=Eliminates benefits for prescription drugs and insulin from
+71 ;;^UTILITY(U,$J,355.6,8,11,2,0)
+72 ;;=basic contract.
+73 ;;^UTILITY(U,$J,355.6,9,0)
+74 ;;=PRE-EXISTING COND. 11 MONTHS
+75 ;;^UTILITY(U,$J,355.6,9,11,0)
+76 ;;=^^1^1^2931130^
+77 ;;^UTILITY(U,$J,355.6,9,11,1,0)
+78 ;;=Imposes an 11 month waiting period for pre-existing conditions.
+79 ;;^UTILITY(U,$J,355.6,10,0)
+80 ;;=EXTEND DEPENDENTS TO AGE 25
+81 ;;^UTILITY(U,$J,355.6,10,11,0)
+82 ;;=^^1^1^2931130^
+83 ;;^UTILITY(U,$J,355.6,10,11,1,0)
+84 ;;=Extends coverage for student dependents to age 25.
+85 ;;^UTILITY(U,$J,355.6,11,0)
+86 ;;=ELIMINATE DEDUCTIBLE AND COPAY
+87 ;;^UTILITY(U,$J,355.6,11,11,0)
+88 ;;=^^1^1^2931130^
+89 ;;^UTILITY(U,$J,355.6,11,11,1,0)
+90 ;;=Eliminates deductibles and copayments for most hospital facility charges.
+91 ;;^UTILITY(U,$J,355.6,12,0)
+92 ;;=SUBSTANCE ABUSE 30 DAYS
+93 ;;^UTILITY(U,$J,355.6,12,11,0)
+94 ;;=^^2^2^2931130^
+95 ;;^UTILITY(U,$J,355.6,12,11,1,0)
+96 ;;=Provides benefits for up to 30 days of inpatient rehabilitation for
+97 ;;^UTILITY(U,$J,355.6,12,11,2,0)
+98 ;;=alcoholism or substance abuse during each calendar year.
+99 ;;^UTILITY(U,$J,355.6,13,0)
+100 ;;=NURSING HOME COVERAGE
