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InfoFileMan FileNo | FileMan Filename | Package |
---|---|---|
399 | BILL/CLAIMS | Integrated Billing |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | BILL NUMBER | 0;1 | FREE TEXT |
|
.02 | PATIENT NAME | 0;2 | POINTER TO PATIENT FILE (#2) | ************************REQUIRED FIELD************************ PATIENT(#2)
|
.03 | EVENT DATE | 0;3 | DATE | ************************REQUIRED FIELD************************
|
.04 | LOCATION OF CARE | 0;4 | SET | ************************REQUIRED FIELD************************
|
.05 | BILL CLASSIFICATION | 0;5 | SET | ************************REQUIRED FIELD************************
|
.06 | TIMEFRAME OF BILL | 0;6 | SET | ************************REQUIRED FIELD************************
|
.07 | RATE TYPE | 0;7 | POINTER TO RATE TYPE FILE (#399.3) | ************************REQUIRED FIELD************************ RATE TYPE(#399.3)
|
.08 | PTF ENTRY NUMBER | 0;8 | POINTER TO PTF FILE (#45) | ************************REQUIRED FIELD************************ PTF(#45)
|
.09 | PROCEDURE CODING METHOD | 0;9 | SET |
|
.11 | WHO'S RESPONSIBLE FOR BILL? | 0;11 | SET | ************************REQUIRED FIELD************************
|
.13 | STATUS | 0;13 | SET | ************************REQUIRED FIELD************************
|
.14 | STATUS DATE | 0;14 | DATE | ************************REQUIRED FIELD************************
|
.15 | BILL COPIED FROM | 0;15 | POINTER TO BILL/CLAIMS FILE (#399) | BILL/CLAIMS(#399)
|
.16 | NON-VA DISCHARGE DATE | 0;16 | DATE |
|
.17 | PRIMARY BILL | 0;17 | POINTER TO BILL/CLAIMS FILE (#399) | BILL/CLAIMS(#399)
|
.18 | SC AT TIME OF CARE | 0;18 | FREE TEXT |
|
.19 | FORM TYPE | 0;19 | POINTER TO BILL FORM TYPE FILE (#353) | ************************REQUIRED FIELD************************ BILL FORM TYPE(#353)
|
.2 | AUTO | 0;20 | SET |
|
.21 | CURRENT BILL PAYER SEQUENCE | 0;21 | SET |
|
.22 | DEFAULT DIVISION | 0;22 | POINTER TO MEDICAL CENTER DIVISION FILE (#40.8) | MEDICAL CENTER DIVISION(#40.8)
|
.24 | UB-04 LOCATION OF CARE | 0;24 | SET | ************************REQUIRED FIELD************************
|
.25 | UB-04 BILL CLASSIFICATION | 0;25 | POINTER TO MCCR UTILITY FILE (#399.1) | ************************REQUIRED FIELD************************ MCCR UTILITY(#399.1)
|
.26 | UB-04 TIMEFRAME OF BILL | 0;26 | SET | ************************REQUIRED FIELD************************
|
.27 | BILL CHARGE TYPE | 0;27 | SET |
|
.28 | INITIAL DATE OF SERVICE | 0;28 | DATE |
|
1 | DATE ENTERED | S;1 | DATE | ************************REQUIRED FIELD************************
|
2 | ENTERED/EDITED BY | S;2 | POINTER TO NEW PERSON FILE (#200) | ************************REQUIRED FIELD************************ NEW PERSON(#200)
|
3 | INITIAL REVIEW | S;3 | FREE TEXT |
|
4 | INITIAL REVIEW DATE | S;4 | DATE |
|
5 | INITIAL REVIEWER | S;5 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
6 | SECONDARY REVIEW | S;6 | FREE TEXT |
|
7 | MRA REQUESTED DATE | S;7 | DATE |
|
8 | MRA REQUESTOR | S;8 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
9 | AUTHORIZE BILL GENERATION? | S;9 | FREE TEXT |
|
10 | AUTHORIZATION DATE | S;10 | DATE |
|
11 | AUTHORIZER | S;11 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
12 | DATE FIRST PRINTED | S;12 | DATE | ************************REQUIRED FIELD************************
|
13 | FIRST PRINTED BY | S;13 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
14 | DATE LAST PRINTED | S;14 | DATE |
|
15 | LAST PRINTED BY | S;15 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
16 | CANCEL BILL? | S;16 | FREE TEXT |
|
17 | DATE BILL CANCELLED | S;17 | DATE |
|
18 | BILL CANCELLED BY | S;18 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
19 | REASON CANCELLED | S;19 | FREE TEXT | ************************REQUIRED FIELD************************
|
20 | LAST AUSTIN CONFIRM DATE | TX;1 | DATE |
|
21 | LAST ELECTRONIC EXTRACT DATE | TX;2 | DATE |
|
22 | MRA RECORDED DATE | TX;3 | DATE |
|
23 | IS DUPLICATE? | S;20 | SET |
|
24 | CLAIM MRA STATUS | TX;5 | SET |
|
25 | REQUEST AN MRA? | TX;6 | FREE TEXT |
|
26 | PRINTED VIA EDI? | TX;7 | SET |
|
27 | FORCE CLAIM TO PRINT | TX;8 | SET |
|
28 | FORCE PRINT MRA SECONDARY | TX;9 | SET |
|
28.1 | MRA REVIEW STATUS | TX;10 | SET |
|
29 | BILL CLONED TO | S1;1 | POINTER TO BILL/CLAIMS FILE (#399) | BILL/CLAIMS(#399)
|
30 | BILL CLONED FROM | S1;2 | POINTER TO BILL/CLAIMS FILE (#399) | BILL/CLAIMS(#399)
|
31 | DATE BILL CLONED | S1;3 | DATE |
|
32 | BILL CLONED BY | S1;4 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
33 | REASON CLONED | S1;5 | FREE TEXT |
|
34 | AUTO PROCESSED FROM CLAIM | S1;6 | POINTER TO BILL/CLAIMS FILE (#399) | BILL/CLAIMS(#399)
|
35 | AUTO PROCESS | S1;7 | SET |
|
36 | AUTO PROCESS REASON | S1;8 | POINTER TO IB ERROR FILE (#350.8) | IB ERROR(#350.8)
|
37 | REMOVED FROM WORKLIST BY | S1;9 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
37.1 | ON TAS PCR? | S1;10 | SET (BOOLEAN Data Type) |
|
38 | REMOVED FROM WORKLIST HOW | UF32;4 | SET |
|
39 | REMOVED FROM WORKLIST DATE | UF32;5 | DATE |
|
40 | CONDITION CODE | CC;0 | POINTER Multiple #399.04 | 399.04
|
41 | OCCURRENCE CODE | OC;0 | POINTER Multiple #399.041 | 399.041
|
42 | REVENUE CODE | RC;0 | POINTER Multiple #399.042 | 399.042
|
43 | OP VISITS DATE(S) | OP;0 | DATE Multiple #399.043 | 399.043
|
44 | REASON(S) DISAPPROVED-INITIAL | D1;0 | POINTER Multiple #399.044 | 399.044
|
45 | REASON(S) DISAPPROVED-SECOND | D2;0 | POINTER Multiple #399.045 | 399.045
|
46 | RETURNED LOG DATE/TIME | R;0 | DATE Multiple #399.046 | 399.046
|
47 | VALUE CODE | CV;0 | POINTER Multiple #399.047 | 399.047
|
48 | OTHER CARE | OT;0 | POINTER Multiple #399.048 | 399.048
|
51 | *CPT PROCEDURE CODE (1) | C;1 | POINTER TO CPT FILE (#81) | CPT(#81)
|
52 | *CPT PROCEDURE CODE (2) | C;2 | POINTER TO CPT FILE (#81) | CPT(#81)
|
53 | *CPT PROCEDURE CODE (3) | C;3 | POINTER TO CPT FILE (#81) | CPT(#81)
|
54 | *ICD PROCEDURE CODE (1) | C;4 | POINTER TO ICD OPERATION/PROCEDURE FILE (#80.1) | ICD OPERATION/PROCEDURE(#80.1)
|
55 | *ICD PROCEDURE CODE (2) | C;5 | POINTER TO ICD OPERATION/PROCEDURE FILE (#80.1) | ICD OPERATION/PROCEDURE(#80.1)
|
56 | *ICD PROCEDURE CODE (3) | C;6 | POINTER TO ICD OPERATION/PROCEDURE FILE (#80.1) | ICD OPERATION/PROCEDURE(#80.1)
|
57 | *HCFA PROCEDURE CODE (1) | C;7 | POINTER TO CPT FILE (#81) | CPT(#81)
|
58 | *HCFA PROCEDURE CODE (2) | C;8 | POINTER TO CPT FILE (#81) | CPT(#81)
|
59 | *HCFA PROCEDURE CODE (3) | C;9 | POINTER TO CPT FILE (#81) | CPT(#81)
|
60 | OUTPATIENT DIAGNOSIS | C;10 | FREE TEXT |
|
61 | *PROCDEDURE DATE (1) | C;11 | DATE | ************************REQUIRED FIELD************************
|
62 | *PROCEDURE DATE (2) | C;12 | DATE | ************************REQUIRED FIELD************************
|
63 | *PROCEDURE DATE (3) | C;13 | DATE | ************************REQUIRED FIELD************************
|
65 | *ICD DIAGNOSIS CODE (2) | C;15 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
|
66 | *ICD DIAGNOSIS CODE (3) | C;16 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
|
67 | *ICD DIAGNOSIS CODE (4) | C;17 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
|
68 | *ICD DIAGNOSIS CODE (5) | C;18 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
|
77 | MRA REQUEST CLAIM COMMENTS | TXC;0 | DATE Multiple #399.077 | 399.077
|
78 | EOB CLAIM COMMENTS | TXC2;0 | DATE Multiple #399.078 | 399.078
|
92 | BANDING DATE | DEN;1 | DATE |
|
93 | TREATMENT MONTHS COUNT | DEN;2 | NUMBER |
|
94 | TREATMENT MONTHS REMAINING | DEN;3 | NUMBER |
|
95 | TREATMENT INDICATOR | DEN;4 | SET |
|
96 | TOOTH NUMBER | DEN1;0 | Multiple #399.096 | 399.096
|
97 | DENTAL CLAIM NOTE | DEN2;1 | FREE TEXT |
|
101 | PRIMARY INSURANCE CARRIER | M;1 | POINTER TO INSURANCE COMPANY FILE (#36) | ************************REQUIRED FIELD************************ INSURANCE COMPANY(#36)
|
102 | SECONDARY INSURANCE CARRIER | M;2 | POINTER TO INSURANCE COMPANY FILE (#36) | INSURANCE COMPANY(#36)
|
103 | TERTIARY INSURANCE CARRIER | M;3 | POINTER TO INSURANCE COMPANY FILE (#36) | INSURANCE COMPANY(#36)
|
104 | MAILING ADDRESS NAME | M;4 | FREE TEXT |
|
105 | MAILING ADDRESS STREET | M;5 | FREE TEXT |
|
106 | MAILING ADDRESS STREET2 | M;6 | FREE TEXT |
|
107 | MAILING ADDRESS CITY | M;7 | FREE TEXT |
|
108 | MAILING ADDRESS STATE | M;8 | POINTER TO STATE FILE (#5) | STATE(#5)
|
109 | MAILING ADDRESS ZIP CODE | M;9 | FREE TEXT |
|
110 | *PATIENT SHORT MAILING ADDRESS | M;10 | FREE TEXT | ************************REQUIRED FIELD************************
|
111 | RESPONSIBLE INSTITUTION | M;11 | POINTER TO INSTITUTION FILE (#4) | ************************REQUIRED FIELD************************ INSTITUTION(#4)
|
112 | PRIMARY INSURANCE POLICY | M;12 | FREE TEXT |
|
113 | SECONDARY INSURANCE POLICY | M;13 | FREE TEXT |
|
114 | TERTIARY INSURANCE POLICY | M;14 | FREE TEXT |
|
121 | MAILING ADDRESS STREET3 | M1;1 | FREE TEXT |
|
122 | PRIMARY PROVIDER # | M1;2 | FREE TEXT |
|
123 | SECONDARY PROVIDER # | M1;3 | FREE TEXT |
|
124 | TERTIARY PROVIDER # | M1;4 | FREE TEXT |
|
125 | PRIMARY BILL # | M1;5 | POINTER TO BILL/CLAIMS FILE (#399) | BILL/CLAIMS(#399)
|
126 | SECONDARY BILL # | M1;6 | POINTER TO BILL/CLAIMS FILE (#399) | BILL/CLAIMS(#399)
|
127 | TERTIARY BILL # | M1;7 | POINTER TO BILL/CLAIMS FILE (#399) | BILL/CLAIMS(#399)
|
128 | PRIMARY ID QUALIFIER | M1;10 | POINTER TO IB PROVIDER ID # TYPE FILE (#355.97) | IB PROVIDER ID # TYPE(#355.97)
|
129 | SECONDARY ID QUALIFIER | M1;11 | POINTER TO IB PROVIDER ID # TYPE FILE (#355.97) | IB PROVIDER ID # TYPE(#355.97)
|
130 | TERTIARY ID QUALIFIER | M1;12 | POINTER TO IB PROVIDER ID # TYPE FILE (#355.97) | IB PROVIDER ID # TYPE(#355.97)
|
135 | BILL PAYER CARRIER | MP;1 | POINTER TO INSURANCE COMPANY FILE (#36) | INSURANCE COMPANY(#36)
|
136 | BILL PAYER POLICY | MP;2 | FREE TEXT |
|
140 | PRIMARY PAYER-ALT ID TYPE | M2;1 | POINTER TO IB ALTERNATE PRIMARY ID TYPE FILE (#355.98) | IB ALTERNATE PRIMARY ID TYPE(#355.98)
|
141 | PRIMARY PAYER-ALT ID | M2;2 | FREE TEXT |
|
142 | SECONDARY PAYER-ALT ID TYPE | M2;3 | POINTER TO IB ALTERNATE PRIMARY ID TYPE FILE (#355.98) | IB ALTERNATE PRIMARY ID TYPE(#355.98)
|
143 | SECONDARY PAYER-ALT ID | M2;4 | FREE TEXT |
|
144 | TERTIARY PAYER-ALT ID TYPE | M2;5 | POINTER TO IB ALTERNATE PRIMARY ID TYPE FILE (#355.98) | IB ALTERNATE PRIMARY ID TYPE(#355.98)
|
145 | TERTIARY PAYER-ALT ID | M2;6 | FREE TEXT |
|
151 | STATEMENT COVERS FROM | U;1 | DATE | ************************REQUIRED FIELD************************
|
152 | STATEMENT COVERS TO | U;2 | DATE | ************************REQUIRED FIELD************************
|
153 | POWER OF ATTORNEY COMPLETED? | U;3 | FREE TEXT | ************************REQUIRED FIELD************************
|
154 | WHOSE EMPLOYMENT INFO.? | U;4 | SET | ************************REQUIRED FIELD************************
|
155 | IS THIS A SENSITIVE RECORD? | U;5 | FREE TEXT | ************************REQUIRED FIELD************************
|
156 | ASSIGNMENT OF BENEFITS | U;6 | FREE TEXT | ************************REQUIRED FIELD************************
|
157 | R.O.I. FORM(S) COMPLETED? | U;7 | FREE TEXT |
|
158 | TYPE OF ADMISSION | U;8 | SET |
|
159 | SOURCE OF ADMISSION | U;9 | SET |
|
159.5 | NON-PTF ADMISSION HOUR | U;20 | FREE TEXT |
|
160 | ACCIDENT HOUR | U;10 | FREE TEXT |
|
161 | DISCHARGE BEDSECTION | U;11 | POINTER TO MCCR UTILITY FILE (#399.1) | MCCR UTILITY(#399.1)
|
162 | DISCHARGE STATUS | U;12 | POINTER TO MCCR UTILITY FILE (#399.1) | MCCR UTILITY(#399.1)
|
163 | TREATMENT AUTHORIZATION CODE | U;13 | FREE TEXT |
|
164 | BC/BS PROVIDER # | U;14 | FREE TEXT | ************************REQUIRED FIELD************************
|
165 | LENGTH OF STAY | U;15 | FREE TEXT |
|
166 | UNABLE TO WORK FROM | U;16 | DATE |
|
167 | UNABLE TO WORK TO | U;17 | DATE |
|
168 | *PLACE OF SERVICE | U;18 | POINTER TO PLACE OF SERVICE FILE (#353.1) | PLACE OF SERVICE(#353.1)
|
169 | *TYPE OF SERVICE | U;19 | POINTER TO TYPE OF SERVICE FILE (#353.2) | TYPE OF SERVICE(#353.2)
|
170 | PPS | U1;15 | POINTER TO DRG FILE (#80.2) | DRG(#80.2)
|
201 | TOTAL CHARGES | U1;1 | NUMBER |
|
202 | OFFSET AMOUNT | U1;2 | NUMBER |
|
203 | OFFSET DESCRIPTION | U1;3 | FREE TEXT |
|
204 | *UB82 FORM LOCATOR 2 | U1;4 | FREE TEXT |
|
205 | *FORM LOCATOR 9 | U1;5 | FREE TEXT |
|
206 | *FORM LOCATOR 27 | U1;6 | FREE TEXT |
|
207 | *FORM LOCATOR 45 | U1;7 | FREE TEXT |
|
208 | *BILL COMMENT | U1;8 | FREE TEXT |
|
209 | *FISCAL YEAR 1 | U1;9 | FREE TEXT | ************************REQUIRED FIELD************************
|
210 | *FY 1 CHARGES | U1;10 | NUMBER | ************************REQUIRED FIELD************************
|
211 | *FISCAL YEAR 2 | U1;11 | FREE TEXT |
|
212 | *FY 2 CHARGES | U1;12 | NUMBER |
|
213 | *FORM LOCATOR 92 | U1;13 | FREE TEXT |
|
214 | *FORM LOCATOR 93 | U1;14 | FREE TEXT |
|
215 | ADMITTING DIAGNOSIS | U2;1 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
|
216 | COVERED DAYS | U2;2 | NUMBER |
|
217 | NON-COVERED DAYS | U2;3 | NUMBER |
|
218 | PRIMARY PRIOR PAYMENT | U2;4 | NUMBER |
|
219 | SECONDARY PRIOR PAYMENT | U2;5 | NUMBER |
|
220 | TERTIARY PRIOR PAYMENT | U2;6 | NUMBER |
|
221 | CO-INSURANCE DAYS | U2;7 | NUMBER |
|
222 | PROVIDER | PRV;0 | SET Multiple #399.0222 | 399.0222
|
230 | SECONDARY AUTHORIZATION CODE | U2;8 | FREE TEXT |
|
231 | TERTIARY AUTHORIZATION CODE | U2;9 | FREE TEXT |
|
232 | NON-VA FACILITY | U2;10 | POINTER TO IB NON/OTHER VA BILLING PROVIDER FILE (#355.93) | IB NON/OTHER VA BILLING PROVIDER(#355.93)
|
233 | NON-VA CARE TYPE | U2;11 | SET |
|
234 | NON-VA CARE ID # | U2;12 | FREE TEXT |
|
235 | LAB CLIA NUMBER | U2;13 | FREE TEXT |
|
236 | HOMEBOUND | U2;14 | SET |
|
237 | DATE LAST SEEN | U2;15 | DATE |
|
238 | SPECIAL PROGRAM INDICATOR | U2;16 | SET |
|
239 | PRIMARY EMC ID CARE UNIT | U2;17 | FREE TEXT |
|
240 | SECONDARY EMC ID CARE UNIT | U2;18 | FREE TEXT |
|
241 | TERTIARY EMC ID CARE UNIT | U2;19 | FREE TEXT |
|
242 | MAMMOGRAPHY CERT NUMBER | U3;1 | FREE TEXT |
|
243 | SERVICE FACILITY TAXONOMY | U3;2 | POINTER TO PERSON CLASS FILE (#8932.1) | PERSON CLASS(#8932.1)
|
244 | NON-VA FACILITY TAXONOMY | U3;3 | POINTER TO PERSON CLASS FILE (#8932.1) | PERSON CLASS(#8932.1)
|
245 | LAST XRAY DATE | U3;4 | DATE |
|
246 | DATE OF INITIAL TREATMENT | U3;5 | DATE |
|
247 | DATE OF ACUTE MANIFESTATION | U3;6 | DATE |
|
248 | PATIENT CONDITION CODE | U3;7 | SET |
|
249 | PRV DIAGNOSIS (1) | U3;8 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
|
250 | PRV DIAGNOSIS (2) | U3;9 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
|
251 | PRV DIAGNOSIS (3) | U3;10 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
|
252 | BILLING PROVIDER TAXONOMY | U3;11 | POINTER TO PERSON CLASS FILE (#8932.1) | PERSON CLASS(#8932.1)
|
253 | PRIMARY REFERRAL NUMBER | UF32;1 | FREE TEXT |
|
254 | SECONDARY REFERRAL NUMBER | UF32;2 | FREE TEXT |
|
255 | TERTIARY REFERRAL NUMBER | UF32;3 | FREE TEXT |
|
260 | COB TOTAL NON-COVERED AMOUNT | U4;1 | NUMBER |
|
261 | PROPERTY/CASUALTY CLAIM NUMBER | U4;2 | FREE TEXT |
|
262 | PROP/CAS DATE OF 1ST CONTACT | U4;3 | DATE |
|
263 | DISABILITY START DATE | U4;4 | DATE |
|
264 | DISABILITY END DATE | U4;5 | DATE |
|
266 | PRIMARY SURGICAL PROC CODE | U4;7 | POINTER TO CPT FILE (#81) | CPT(#81)
|
267 | SECONDARY SURGICAL PROC CODE | U4;8 | POINTER TO CPT FILE (#81) | CPT(#81)
|
268 | PROPERTY/CASUALTY CONTACT NAME | U4;9 | FREE TEXT |
|
269 | PROP/CAS COMMUNICATION NUMBER | U4;10 | NUMBER |
|
269.1 | PROP/CAS EXTENSION NUMBER | U4;11 | NUMBER |
|
271 | AMBULANCE P/U ADDRESS 1 | U5;2 | FREE TEXT |
|
272 | AMBULANCE P/U ADDRESS 2 | U5;3 | FREE TEXT |
|
273 | AMBULANCE P/U CITY | U5;4 | FREE TEXT |
|
274 | AMBULANCE P/U STATE | U5;5 | POINTER TO STATE FILE (#5) | STATE(#5)
|
275 | AMBULANCE P/U ZIP | U5;6 | FREE TEXT |
|
276 | AMBULANCE D/O LOCATION | U6;1 | FREE TEXT |
|
277 | AMBULANCE D/O ADDRESS 1 | U6;2 | FREE TEXT |
|
278 | AMBULANCE D/O ADDRESS 2 | U6;3 | FREE TEXT |
|
279 | AMBULANCE D/O CITY | U6;4 | FREE TEXT |
|
280 | AMBULANCE D/O STATE | U6;5 | POINTER TO STATE FILE (#5) | STATE(#5)
|
281 | AMBULANCE D/O ZIP | U6;6 | FREE TEXT |
|
282 | ASSUMED CARE DATE | U4;13 | DATE |
|
283 | RELINQUISHED CARE DATE | U4;14 | DATE |
|
284 | ATTACHMENT CONTROL NUMBER | U8;1 | FREE TEXT |
|
285 | ATTACHMENT REPORT TYPE | U8;2 | POINTER TO IB ATTACHMENT REPORT TYPE FILE (#353.3) | IB ATTACHMENT REPORT TYPE(#353.3)
|
286 | ATTACHMENT REPORT TRANS CODE | U8;3 | SET |
|
287 | PATIENT WEIGHT (LB) | U7;1 | NUMBER |
|
288 | TRANSPORT REASON CODE | U7;2 | POINTER TO TRANSPORT REASON CODE FILE (#353.4) | TRANSPORT REASON CODE(#353.4)
|
289 | AMBULANCE TRANSPORT DISTANCE | U7;3 | NUMBER |
|
290 | ROUND TRIP PURPOSE DESCRIPTION | U7;4 | FREE TEXT |
|
291 | STRETCHER PURPOSE DESCRIPTION | U7;5 | FREE TEXT |
|
292 | AMBULANCE CONDITION INDICATOR | U9;0 | POINTER Multiple #399.0292 | 399.0292
|
301 | PRIMARY NODE | I1;E1,240 | FREE TEXT | ************************REQUIRED FIELD************************
|
302 | SECONDARY NODE | I2;E1,240 | FREE TEXT | ************************REQUIRED FIELD************************
|
303 | TERTIARY NODE | I3;E1,240 | FREE TEXT | ************************REQUIRED FIELD************************
|
304 | PROCEDURES | CP;0 | VARIABLE POINTER Multiple #399.0304 | 399.0304
|
371 | PRIMARY NODE 7 | I17;E1,240 | FREE TEXT | ************************REQUIRED FIELD************************
|
372 | SECONDARY NODE 7 | I27;E1,240 | FREE TEXT | ************************REQUIRED FIELD************************
|
373 | TERTIARY NODE 7 | I37;E1,240 | FREE TEXT | ************************REQUIRED FIELD************************
|
400 | BLOCK 31 | UF2;1 | FREE TEXT |
|
402 | BILL REMARKS | UF2;3 | FREE TEXT |
|
453 | FORM LOCATOR 64A | UF3;4 | FREE TEXT |
|
454 | FORM LOCATOR 64B | UF3;5 | FREE TEXT |
|
455 | FORM LOCATOR 64C | UF3;6 | FREE TEXT |
|
457 | *FORM LOCATOR 57 | UF31;1 | FREE TEXT |
|
458 | *FORM LOCATOR 78 | UF31;2 | FREE TEXT |
|
459 | FORM LOC 19-UNSPECIFIED DATA | UF31;3 | FREE TEXT |
|
460 | ECME NUMBER | M1;8 | FREE TEXT |
|
461 | ECME APPROVAL | M1;9 | FREE TEXT |
|
471 | PRIMARY INSURANCE HPID | M1;13 | NUMBER |
|
472 | SECONDARY INSURANCE HPID | M1;14 | NUMBER |
|
473 | TERTIARY INSURANCE HPID | M1;15 | NUMBER |
|
474 | PRIMARY HPID EDIT DATE/TIME | MP;3 | DATE |
|
475 | PRIMARY HPID CHANGES MADE BY | MP;4 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
476 | SECONDARY HPID EDIT DATE/TIME | MP;5 | DATE |
|
477 | SECONDARY HPID CHANGES MADE BY | MP;6 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
478 | TERTIARY HPID EDIT DATE/TIME | MP;7 | DATE |
|
479 | TERTIARY HPID CHANGES MADE BY | MP;8 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
ICR LINK | Subscribing Package(s) | Fields Referenced | Description |
---|---|---|---|
ICR #1992 | BILL NUMBER (.01). Access: Direct Global Read & w/Fileman DATE ENTERED (1). Access: Direct Global Read & w/Fileman DATE FIRST PRINTED (12). Access: Direct Global Read & w/Fileman DATE BILL CANCELLED (17). Access: Direct Global Read & w/Fileman OP VISITS DATE(S) (43). Access: Direct Global Read & w/Fileman TOTAL CHARGES (201). Access: Direct Global Read & w/Fileman |
||
ICR #2281 | STATEMENT COVERS FROM (151). Access: Direct Global Read & w/Fileman STATEMENT COVERS TO (152). Access: Direct Global Read & w/Fileman |
'C' xref. | |
ICR #3820 | BILL CHARGE TYPE (.27). Access: Direct Global Read & w/Fileman DEFAULT DIVISION (.22). Access: Direct Global Read & w/Fileman RATE TYPE (.07). Access: Direct Global Read & w/Fileman SC AT TIME OF CARESC (.18). Access: Direct Global Read & w/Fileman AUTO (.2). Access: Direct Global Read & w/Fileman CURRENT BILL PAYER SEQUENCE (.21). Access: Direct Global Read & w/Fileman EVENT DATE (.03). Access: Direct Global Read & w/Fileman LOCATION OF CARE (.04). Access: Direct Global Read & w/Fileman BILL CLASSIFICATION (.05). Access: Direct Global Read & w/Fileman TIMEFRAME OF BILL (.06). Access: Direct Global Read & w/Fileman PROCEDURE CODING METHOD (.09). Access: Direct Global Read & w/Fileman STATUS (.13). Access: Direct Global Read & w/Fileman STATUS DATE (.14). Access: Direct Global Read & w/Fileman UB92 LOCATION OF CARE (.24). Access: Direct Global Read & w/Fileman UB92 BILL CLASSIFICATION (.25). Access: Direct Global Read & w/Fileman UB92 TIMEFRAME OF BILL (.26). Access: Direct Global Read & w/Fileman BILL NUMBER (.01). Access: Direct Global Read & w/Fileman PATIENT NAME (.02). Access: Direct Global Read & w/Fileman STATEMENT COVERS FROM (151). Access: Direct Global Read & w/Fileman STATEMENT COVERS TO (152). Access: Direct Global Read & w/Fileman IS THIS A SENSITIVE RECORD (155). Access: Direct Global Read & w/Fileman ASSIGNMENT OF BENEFITS (156). Access: Direct Global Read & w/Fileman TREATMENT AUTHORIZATION (163). Access: Direct Global Read & w/Fileman OFFSET AMOUNT (202). Access: Direct Global Read & w/Fileman ADMITTING DIAGNOSIS (215). Access: Direct Global Read & w/Fileman COVERED DAYS (216). Access: Direct Global Read & w/Fileman NON-COVERED DAYS (217). Access: Direct Global Read & w/Fileman PRIMARY PRIOR PAYMENT (218). Access: Direct Global Read & w/Fileman SECONDARY PRIOR PAYMENT (219). Access: Direct Global Read & w/Fileman TERTIARY PRIOR PAYMENT (220). Access: Direct Global Read & w/Fileman AUTHORIZATION DATE (10). Access: Direct Global Read & w/Fileman DATE FIRST PRINTED (12). Access: Direct Global Read & w/Fileman BILL PAYER CARRIER (135). Access: Direct Global Read & w/Fileman PRIMARY PROVIDER (122). Access: Direct Global Read & w/Fileman SECONDARY PROVIDER (123). Access: Direct Global Read & w/Fileman TERTIARY PROVIDER (124). Access: Direct Global Read & w/Fileman WHO'S RESPONSIBLE FOR BILL? (.11). Access: Direct Global Read & w/Fileman VALUE CODE (.01). Access: Direct Global Read & w/Fileman VALUE (.02). Access: Direct Global Read & w/Fileman REVENUE CODE (.01). Access: Direct Global Read & w/Fileman CHARGES (.02). Access: Direct Global Read & w/Fileman UNITS OF SERVICE (.03). Access: Direct Global Read & w/Fileman TOTAL (.04). Access: Direct Global Read & w/Fileman BEDSECTION (.05). Access: Direct Global Read & w/Fileman NON-COVERED DAYS (.09). Access: Direct Global Read & w/Fileman TYPE (.1). Access: Direct Global Read & w/Fileman ITEM (.11). Access: Direct Global Read & w/Fileman OP VISIT DATE (.01). Access: Direct Global Read & w/Fileman OCCURENCE CODE (.01). Access: Direct Global Read & w/Fileman (DGCR(399,D0,CV). Access: |
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ICR #7217 | PTF ENTRY NUMBER (.08). Access: Read w/Fileman PRIMARY BILL (.17). Access: Read w/Fileman BILL CANCELLED BY (18). Access: Read w/Fileman REASON CANCELLED (19). Access: Read w/Fileman |