Sub-Field: 69.05

Parent File	Name	Number	Package
69.03	ICD CODES	69.05	Lab Service

Field #	Name	Loc	Type	Details
.01	ICD CODES	0;1	POINTER TO ICD DIAGNOSIS FILE (#80)	ICD DIAGNOSIS(#80) LAST EDITED: `APR 07, 2014` DESCRIPTION: `ICD ordering diagnosis code. For CPRS laboratory orders, the ordering provider enters this diagnosis via CPRS. For internal laboratory orders, the provider must indicate the diagnosis code on paper for entry by` the laboratory staff. When the lab test is resulted, the ordering diagnosis code will be sent to PCE/PTF for billing purposes. CROSS-REFERENCE: `69.05^B` 1)= S ^LRO(69,DA(3),1,DA(2),2,DA(1),2,"B",$E(X,1,30),DA)="" 2)= K ^LRO(69,DA(3),1,DA(2),2,DA(1),2,"B",$E(X,1,30),DA)
1	SERVICE CONNECTION INDICATOR	0;2	SET	LAST EDITED: `SEP 17, 2003` DESCRIPTION: `Indicates if the care provided is for a service connected or non-service connected condition. The ordering provider is responsible for providing Service Connection indicator to the laboratory via CPRS entry or,` for internal laboratory orders, on paper. The Service Connection indicator is sent to PCE/PTF at verification.
2	COMBAT VETERAN	0;3	SET	LAST EDITED: `JAN 23, 2004` DESCRIPTION: `Indicates if the care provided is to treat a condition related to Combat Veteran exposure. The ordering provider is responsible for providing the Combat Veteran indicator to the laboratory via CPRS entry or, for` internal laboratory orders, on paper. The Combat Veteran indicator is sent to PCE at verification.
3	AGENT ORANGE	0;4	SET	LAST EDITED: `JAN 23, 2004` DESCRIPTION: `Indicates if the care provided is to treat a condition related to Agent Orange exposure. The ordering provider is responsible for providing the Agent Orange indicator to the laboratory via CPRS entry or, for` internal laboratory orders, on paper. The Agent Orange indicator is sent to PCE at verification.
4	IONIZING RADIATION	0;5	SET	LAST EDITED: `JAN 23, 2004` DESCRIPTION: `Indicates if the care provided is to treat a condition related to Ionizing Radiation exposure. The ordering provider is responsible for ible for providing the Ionizing Radiation indicator to the laboratory via` CPRS entry or, for internal laboratory orders, on paper. The Ionizing Radiation indicator is sent to PCE at verification.
5	SOUTHWEST ASIA CONDITIONS	0;6	SET	LAST EDITED: `JUN 07, 2006` HELP-PROMPT: `Enter '1' or 'Y(es)' if care provided is to treat a condition related to Southwest Asia Conditions (SWAC); otherwise, enter '0' or 'N(o)'.` DESCRIPTION: `Indicates if the care provided is to treat a condition related to Southwest Asia Conditions (formerly referred to as Environmental Contaminants ) during the Persian Gulf War. The ordering provider is responsible` for providing the indicator to the laboratory via CPRS entry or, for internal laboratory orders, on paper. The Southwest Asia Conditions indicator is sent to PCE at verification.
6	MILITARY SEXUAL TRAUMA	0;7	SET	LAST EDITED: `DEC 23, 2005` DESCRIPTION: `Indicates if the care provided is to treat a condition related to MST. The ordering provider is responsible for providing the Environmental MST indicator to the laboratory via CPRS entry or, for internal` laboratory orders, on paper. The MST indicator is sent to PCE at verification.
7	HEAD AND NECK CANCER	0;8	SET	LAST EDITED: `DEC 23, 2005` DESCRIPTION: `Indicates if the care provided is to treat a condition related to Head and Neck Cancer. The ordering provider is responsible for providing the Head and Neck Cancer indicator to the laboratory via CPRS entry or, for` internal laboratory orders, on paper. The Head and Neck Cancer indicator is sent to PCE at verification.
8	PRIMARY DIAGNOSIS	0;9	SET	LAST EDITED: `MAR 22, 2004` DESCRIPTION: This diagnosis is the primary diagnosis.
9	SHIPBOARD HAZARD AND DEFENSE	0;10	SET	LAST EDITED: `JUN 06, 2006` HELP-PROMPT: `Enter '1' or 'Y(es)' if care provided is to treat a condition related to Shipboard Hazard and Defense (SHAD); otherwise, enter '0' or 'N(o)'.` DESCRIPTION: `Indicates if the care provided is to treat a condition related to Shipboard Hazard And Defense (SHAD). The ordering provider is responsible for providing the value for the SHAD indicator to the laboratory via CPRS` entry or, for internal laboratory orders, on paper. The indicator value is sent to PCE at verification.

Field #

Name

Loc

Type

Details

.01

ICD CODES

0;1

POINTER TO ICD DIAGNOSIS FILE (#80)

ICD DIAGNOSIS(#80)

LAST EDITED: APR 07, 2014
DESCRIPTION: ICD ordering diagnosis code. For CPRS laboratory orders, the ordering provider enters this diagnosis via CPRS. For internal laboratory orders, the provider must indicate the diagnosis code on paper for entry by
```
the laboratory staff.  When the lab test is resulted, the ordering diagnosis code will be sent to PCE/PTF for billing purposes.
```

CROSS-REFERENCE: 69.05^B

1)= S ^LRO(69,DA(3),1,DA(2),2,DA(1),2,"B",$E(X,1,30),DA)=""

2)= K ^LRO(69,DA(3),1,DA(2),2,DA(1),2,"B",$E(X,1,30),DA)

1

SERVICE CONNECTION INDICATOR

0;2

SET

LAST EDITED: SEP 17, 2003
DESCRIPTION: Indicates if the care provided is for a service connected or non-service connected condition. The ordering provider is responsible for providing Service Connection indicator to the laboratory via CPRS entry or,
```
for internal laboratory orders, on paper.  The Service Connection indicator is sent to PCE/PTF at verification.
```

2

COMBAT VETERAN

0;3

SET

LAST EDITED: JAN 23, 2004
DESCRIPTION: Indicates if the care provided is to treat a condition related to Combat Veteran exposure. The ordering provider is responsible for providing the Combat Veteran indicator to the laboratory via CPRS entry or, for
```
internal laboratory orders, on paper.  The Combat Veteran indicator is sent to PCE at verification.
```

3

AGENT ORANGE

0;4

SET

LAST EDITED: JAN 23, 2004
DESCRIPTION: Indicates if the care provided is to treat a condition related to Agent Orange exposure. The ordering provider is responsible for providing the Agent Orange indicator to the laboratory via CPRS entry or, for
```
internal laboratory orders, on paper.  The Agent Orange indicator is sent to PCE at verification.
```

4

IONIZING RADIATION

0;5

SET

LAST EDITED: JAN 23, 2004
DESCRIPTION: Indicates if the care provided is to treat a condition related to Ionizing Radiation exposure. The ordering provider is responsible for ible for providing the Ionizing Radiation indicator to the laboratory via
```
CPRS entry or, for internal laboratory orders, on paper.  The Ionizing Radiation indicator is sent to PCE at verification.
```

5

SOUTHWEST ASIA CONDITIONS

0;6

SET

LAST EDITED: JUN 07, 2006
HELP-PROMPT: Enter '1' or 'Y(es)' if care provided is to treat a condition related to Southwest Asia Conditions (SWAC); otherwise, enter '0' or 'N(o)'.
DESCRIPTION: Indicates if the care provided is to treat a condition related to Southwest Asia Conditions (formerly referred to as Environmental Contaminants ) during the Persian Gulf War. The ordering provider is responsible
```
for providing the indicator to the laboratory via CPRS entry or, for internal laboratory orders, on paper.  The Southwest Asia Conditions indicator is sent to PCE at verification.
```

6

MILITARY SEXUAL TRAUMA

0;7

SET

LAST EDITED: DEC 23, 2005
DESCRIPTION: Indicates if the care provided is to treat a condition related to MST. The ordering provider is responsible for providing the Environmental MST indicator to the laboratory via CPRS entry or, for internal
```
laboratory orders, on paper.  The MST indicator is sent to PCE at verification.
```

7

HEAD AND NECK CANCER

0;8

SET

LAST EDITED: DEC 23, 2005
DESCRIPTION: Indicates if the care provided is to treat a condition related to Head and Neck Cancer. The ordering provider is responsible for providing the Head and Neck Cancer indicator to the laboratory via CPRS entry or, for
```
internal laboratory orders, on paper.  The Head and Neck Cancer indicator is sent to PCE at verification.
```

8

PRIMARY DIAGNOSIS

0;9

SET

LAST EDITED: MAR 22, 2004

DESCRIPTION:

This diagnosis is the primary diagnosis.

9

SHIPBOARD HAZARD AND DEFENSE

0;10

SET

LAST EDITED: JUN 06, 2006
HELP-PROMPT: Enter '1' or 'Y(es)' if care provided is to treat a condition related to Shipboard Hazard and Defense (SHAD); otherwise, enter '0' or 'N(o)'.
DESCRIPTION: Indicates if the care provided is to treat a condition related to Shipboard Hazard And Defense (SHAD). The ordering provider is responsible for providing the value for the SHAD indicator to the laboratory via CPRS
```
entry or, for internal laboratory orders, on paper.  The indicator value is sent to PCE at verification.
```

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Package: Lab Service

LAB ORDER ENTRY(#69)-->69.01-->69.03-->69.05

Sub-Field: 69.05

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