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Sub-Field: 399.0304

Package: Integrated Billing

BILL/CLAIMS(#399)-->399.0304

Sub-Field: 399.0304


Information

Parent File Name Number Package
BILL/CLAIMS(#399) PROCEDURES 399.0304 Integrated Billing

Details

Field # Name Loc Type Details
.01 PROCEDURES 0;1 VARIABLE POINTER CPT(#81)  ICD OPERATION/PROCEDURE(#80.1)  

  • LAST EDITED:  SEP 03, 1993
  • HELP-PROMPT:  Procedure coding must match the PROCEDURE CODING METHOD entry for this bill.
  • DESCRIPTION:  
    These are ICD, CPT, of HCFA procedure codes associated with the episode of care on this bill.
  • TECHNICAL DESCR:  
  • EXECUTABLE HELP:  D 3^IBCSCH1
  • PRE-LOOKUP:  D ^IBCU7
  • CROSS-REFERENCE:  399.0304^B
    1)= S ^DGCR(399,DA(1),"CP","B",$E(X,1,30),DA)=""
    2)= K ^DGCR(399,DA(1),"CP","B",$E(X,1,30),DA)
    3)= Required Index for Variable Pointer
  • CROSS-REFERENCE:  399^ASD^MUMPS
    1)= I $P(X,";",2)="ICPT(",$D(^DGCR(399,DA(1),"CP",DA,0)),$P(^(0),"^",2) S ^DGCR(399,"ASD",-$P(^(0),"^",2),+X,DA(1),DA)=""
    2)= I $P(X,";",2)="ICPT(",$D(^DGCR(399,DA(1),"CP",DA,0)),$P(^(0),"^",2) K ^DGCR(399,"ASD",-$P(^(0),"^",2),+X,DA(1),DA)
    3)= DO NOT DELETE
    Index procedure date and all CPT procedures.
  • CROSS-REFERENCE:  ^^TRIGGER^399.0304^4
    1)= K DIV S DIV=X,D0=DA(1),DIV(0)=D0,D1=DA,DIV(1)=D1 S Y(1)=$S($D(^DGCR(399,D0,"CP",D1,0)):^(0),1:"") S X=$P(Y(1),U,5),X=X S DIU=X K Y X ^DD(399.0304,.01,1,3,1.1) X ^DD(399.0304,.01,1,3,1.4)
    1.1)= S X=DIV S X=$$CP^IBEFUNC1(DA(1),DA) I X'="" S X=1
    1.4)= S DIH=$S($D(^DGCR(399,DIV(0),"CP",DIV(1),0)):^(0),1:""),DIV=X S $P(^(0),U,5)=DIV,DIH=399.0304,DIG=4 D ^DICR:$N(^DD(DIH,DIG,1,0))>0
    2)= K DIV S DIV=X,D0=DA(1),DIV(0)=D0,D1=DA,DIV(1)=D1 S Y(1)=$S($D(^DGCR(399,D0,"CP",D1,0)):^(0),1:"") S X=$P(Y(1),U,5),X=X S DIU=X K Y S X="" X ^DD(399.0304,.01,1,3,2.4)
    2.4)= S DIH=$S($D(^DGCR(399,DIV(0),"CP",DIV(1),0)):^(0),1:""),DIV=X S $P(^(0),U,5)=DIV,DIH=399.0304,DIG=4 D ^DICR:$N(^DD(DIH,DIG,1,0))>0
    CREATE VALUE)= S X=$$CP^IBEFUNC1(DA(1),DA) I X'="" S X=1
    DELETE VALUE)= @
    FIELD)= BASC BILLABLE
    Calculate BASC Billable status.





1
PROCEDURE DATE
0;2
DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X I $D(X),$D(IBIFN),'$$OPV2^IBCU41(X,IBIFN,1) K X
  • LAST EDITED:  SEP 03, 1993
  • HELP-PROMPT:  Procedure date must be within the bill's STATEMENT FROM and STATEMENT TO dates.
  • DESCRIPTION:  
    This is the date the procedure was performed.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  399^ASD1^MUMPS
    1)= I $D(^DGCR(399,DA(1),"CP",DA,0)),+^(0),$P($P(^(0),"^",1),";",2)="ICPT(" S ^DGCR(399,"ASD",-X,+^(0),DA(1),DA)=""
    2)= I $D(^DGCR(399,DA(1),"CP",DA,0)),+^(0),$P($P(^(0),"^",1),";",2)="ICPT(" K ^DGCR(399,"ASD",-X,+^(0),DA(1),DA)
    3)= DO NOT DELETE
    Index procedure date and all CPT procedures.
  • CROSS-REFERENCE:  ^^TRIGGER^399.0304^4
    1)= K DIV S DIV=X,D0=DA(1),DIV(0)=D0,D1=DA,DIV(1)=D1 S Y(1)=$S($D(^DGCR(399,D0,"CP",D1,0)):^(0),1:"") S X=$P(Y(1),U,5),X=X S DIU=X K Y X ^DD(399.0304,1,1,2,1.1) X ^DD(399.0304,1,1,2,1.4)
    1.1)= S X=DIV S X=$$CP^IBEFUNC1(DA(1),DA) I X'="" S X=1
    1.4)= S DIH=$S($D(^DGCR(399,DIV(0),"CP",DIV(1),0)):^(0),1:""),DIV=X S $P(^(0),U,5)=DIV,DIH=399.0304,DIG=4 D ^DICR:$N(^DD(DIH,DIG,1,0))>0
    2)= K DIV S DIV=X,D0=DA(1),DIV(0)=D0,D1=DA,DIV(1)=D1 S Y(1)=$S($D(^DGCR(399,D0,"CP",D1,0)):^(0),1:"") S X=$P(Y(1),U,5),X=X S DIU=X K Y S X="" X ^DD(399.0304,1,1,2,2.4)
    2.4)= S DIH=$S($D(^DGCR(399,DIV(0),"CP",DIV(1),0)):^(0),1:""),DIV=X S $P(^(0),U,5)=DIV,DIH=399.0304,DIG=4 D ^DICR:$N(^DD(DIH,DIG,1,0))>0
    CREATE VALUE)= S X=$$CP^IBEFUNC1(DA(1),DA) I X'="" S X=1
    DELETE VALUE)= @
    FIELD)= BASC BILLABLE
    Calculate BASC Billable Status flag.





2
*ADDITIONAL PROCEDURE NAME
0;3
FREE TEXT

  • INPUT TRANSFORM:  K:X[""""!($A(X)=45) X I $D(X) K:$L(X)>28!($L(X)<3)!'(X?.ANP) X
  • LAST EDITED:  NOV 04, 1991
  • HELP-PROMPT:  Answer must be 3-28 characters in length.
  • DESCRIPTION:  This is the name of the procedure.
    This field has been marked for deletion 11/4/91.
    WRITE AUTHORITY:  ^
    UNEDITABLE





3
PRINT ORDER
0;4
NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X I $D(X),$D(^DGCR(399,DA(1),"CP","D",X)) W !!,*7,"This number already used!" K X
  • LAST EDITED:  OCT 30, 1991
  • HELP-PROMPT:  Type a Number between 1 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    This is the relative order that this procedure will appear on the bill.  The lowest numbers will appear on the UB forms in the blocks for procedure.  The highest numbers will appear as additional procedures.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  399.0304^D
    1)= S ^DGCR(399,DA(1),"CP","D",$E(X,1,30),DA)=""
    2)= K ^DGCR(399,DA(1),"CP","D",$E(X,1,30),DA)





4
BASC BILLABLE
0;5
SET

  • '1' FOR YES;
  • LAST EDITED:  FEB 28, 1992
  • DESCRIPTION:  
    This field will be completed by the system if this procedure is an Ambulatory Surgery that can be billed under the HCFA rate system.
  • NOTES:  TRIGGERED by the DIVISION field of the PROCEDURES sub-field of the BILL/CLAIMS File
    TRIGGERED by the PROCEDURES field of the PROCEDURES sub-field of the BILL/CLAIMS File
    TRIGGERED by the PROCEDURE DATE field of the PROCEDURES sub-field of the BILL/CLAIMS File
  • CROSS-REFERENCE:  399.0304^AREV7^MUMPS
    1)= S DGRVRCAL=1
    2)= S DGRVRCAL=2
    When this field is edited or changed, the revenue codes and charges for this bill will automatically be recalculated.
  • CROSS-REFERENCE:  399.0304^ASC
    1)= S ^DGCR(399,DA(1),"CP","ASC",$E(X,1,30),DA)=""
    2)= K ^DGCR(399,DA(1),"CP","ASC",$E(X,1,30),DA)
    This cross-reference is used to determine if any procedures entered are billable as Ambulatory Surgery Codes.





5
DIVISION
0;6
POINTER TO MEDICAL CENTER DIVISION FILE (#40.8) 

************************REQUIRED FIELD************************
MEDICAL CENTER DIVISION(#40.8)
  • LAST EDITED:  SEP 03, 1993
  • HELP-PROMPT:  Enter the division where this procedure was performed.
  • DESCRIPTION:  
    Enter the Division at which this procedure was performed.  If this field is not filled in for Billable Ambulatory Surgical Codes then a BASC revenue code and amount will not be calculated.
  • CROSS-REFERENCE:  ^^TRIGGER^399.0304^4
    1)= K DIV S DIV=X,D0=DA(1),DIV(0)=D0,D1=DA,DIV(1)=D1 S Y(1)=$S($D(^DGCR(399,D0,"CP",D1,0)):^(0),1:"") S X=$P(Y(1),U,5),X=X S DIU=X K Y X ^DD(399.0304,5,1,1,1.1) X ^DD(399.0304,5,1,1,1.4)
    1.1)= S X=DIV S X=$$CP^IBEFUNC1(DA(1),DA) I X'="" S X=1
    1.4)= S DIH=$S($D(^DGCR(399,DIV(0),"CP",DIV(1),0)):^(0),1:""),DIV=X S $P(^(0),U,5)=DIV,DIH=399.0304,DIG=4 D ^DICR:$N(^DD(DIH,DIG,1,0))>0
    2)= K DIV S DIV=X,D0=DA(1),DIV(0)=D0,D1=DA,DIV(1)=D1 S Y(1)=$S($D(^DGCR(399,D0,"CP",D1,0)):^(0),1:"") S X=$P(Y(1),U,5),X=X S DIU=X K Y S X="" X ^DD(399.0304,5,1,1,2.4)
    2.4)= S DIH=$S($D(^DGCR(399,DIV(0),"CP",DIV(1),0)):^(0),1:""),DIV=X S $P(^(0),U,5)=DIV,DIH=399.0304,DIG=4 D ^DICR:$N(^DD(DIH,DIG,1,0))>0
    CREATE VALUE)= S X=$$CP^IBEFUNC1(DA(1),DA) I X'="" S X=1
    DELETE VALUE)= @
    FIELD)= BASC BILLABLE
    Calculate and set BASC billable flag.





6
ASSOCIATED CLINIC
0;7
POINTER TO HOSPITAL LOCATION FILE (#44)
HOSPITAL LOCATION(#44)
  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),U,3)=""C"",$S('$D(^(""I"")):1,'^(""I""):1,'$D(DGPROCDT):0,^(""I"")>DGPROCDT:1,'$P(^(""I""),U,2):0,1:$P(^(""I""),U,2)'>DGPROCDT)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  DEC 31, 1991
  • DESCRIPTION:  
    Enter the clinic where this procedure was performed.  This field must be completed in order for this procedure to successfully be transfered to the Add/Edit Stop code logic for inclusion in OPC workload.
  • SCREEN:  S DIC("S")="I $P(^(0),U,3)=""C"",$S('$D(^(""I"")):1,'^(""I""):1,'$D(DGPROCDT):0,^(""I"")>DGPROCDT:1,'$P(^(""I""),U,2):0,1:$P(^(""I""),U,2)'>DGPROCDT)"
  • EXPLANATION:  Only active clinics!





7
*ASSOCIATED DIAGNOSIS
0;8
POINTER TO ICD DIAGNOSIS FILE (#80)
ICD DIAGNOSIS(#80)
  • LAST EDITED:  NOV 16, 1993
  • HELP-PROMPT:  Enter the diagnosis related to this procedure.
  • DESCRIPTION:  
    This is the diagnosis most closely related to this procedure.  Used on the HFCA 1500, block 24e.
  • TECHNICAL DESCR:  
    Replaced by (399,304,10-13) so that could point to the diagnosis file (362.3).  "*"ed for deletion 11/16/93.





8
PLACE OF SERVICE
0;9
POINTER TO PLACE OF SERVICE FILE (#353.1)
PLACE OF SERVICE(#353.1)
  • LAST EDITED:  JUN 04, 1993
  • HELP-PROMPT:  Enter the Place of Service appropriate for this procedure.
  • DESCRIPTION:  
    This is the Place of Service appropriate for this Procedure.  Used only for the HCFA 1500 claim form.





9
TYPE OF SERVICE
0;10
POINTER TO TYPE OF SERVICE FILE (#353.2)
TYPE OF SERVICE(#353.2)
  • LAST EDITED:  JUN 04, 1993
  • HELP-PROMPT:  Enter the Type of Service appropriate for this procedure.
  • DESCRIPTION:  
    This is the Type of Service to be associated with this procedure.  Applies only to the HCFA 1500 claim form.





10
ASSOCIATED DIAGNOSIS (1)
0;11
POINTER TO IB BILL/CLAIMS DIAGNOSIS FILE (#362.3)
IB BILL/CLAIMS DIAGNOSIS(#362.3)
  • INPUT TRANSFORM:  S DIC("S")="I +$P(^IBA(362.3,Y,0),U,2)=+$G(DA(1))" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  NOV 30, 1993
  • HELP-PROMPT:  Enter the diagnosis related to this procedure.
  • DESCRIPTION:  
    The diagnosis most closely related to this procedure.  Used only for the HCFA 1500, block 24e.
  • TECHNICAL DESCR:  
    Converted from (399,304,7) with IB 2.0.
  • SCREEN:  S DIC("S")="I +$P(^IBA(362.3,Y,0),U,2)=+$G(DA(1))"
  • EXPLANATION:  Only Diagnosis for this bill may be chosen.





11
ASSOCIATED DIAGNOSIS (2)
0;12
POINTER TO IB BILL/CLAIMS DIAGNOSIS FILE (#362.3)
IB BILL/CLAIMS DIAGNOSIS(#362.3)
  • INPUT TRANSFORM:  S DIC("S")="I +$P(^IBA(362.3,Y,0),U,2)=+$G(DA(1))" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  NOV 30, 1993
  • HELP-PROMPT:  Enter a diagnosis related to this procedure.
  • DESCRIPTION:  
    The diagnosis most closely related to this procedure.  Used only for the HCFA 1500, block 24e.
  • SCREEN:  S DIC("S")="I +$P(^IBA(362.3,Y,0),U,2)=+$G(DA(1))"
  • EXPLANATION:  Only Diagnosis for this bill may be chosen.





12
ASSOCIATED DIAGNOSIS (3)
0;13
POINTER TO IB BILL/CLAIMS DIAGNOSIS FILE (#362.3)
IB BILL/CLAIMS DIAGNOSIS(#362.3)
  • INPUT TRANSFORM:  S DIC("S")="I +$P(^IBA(362.3,Y,0),U,2)=+$G(DA(1))" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  NOV 30, 1993
  • HELP-PROMPT:  Enter a diagnosis related to this procedure.
  • DESCRIPTION:  
    The diagnosis most closely related to this procedure.  Used only for the HCFA 1500, block 24e.
  • SCREEN:  S DIC("S")="I +$P(^IBA(362.3,Y,0),U,2)=+$G(DA(1))"
  • EXPLANATION:  Only Diagnosis for this bill may be chosen.





13
ASSOCIATED DIAGNOSIS (4)
0;14
POINTER TO IB BILL/CLAIMS DIAGNOSIS FILE (#362.3)
IB BILL/CLAIMS DIAGNOSIS(#362.3)
  • INPUT TRANSFORM:  S DIC("S")="I +$P(^IBA(362.3,Y,0),U,2)=+$G(DA(1))" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  NOV 30, 1993
  • HELP-PROMPT:  Enter a diagnosis related to this procedure.
  • DESCRIPTION:  
    The diagnosis most closely related to this procedure.  Used only for the HCFA 1500, block 24e.
  • SCREEN:  S DIC("S")="I +$P(^IBA(362.3,Y,0),U,2)=+$G(DA(1))"
  • EXPLANATION:  Only Diagnosis for this bill may be chosen.







    



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