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Global: ^IBA(355.93

Package: Integrated Billing

Global: ^IBA(355.93


Information

FileMan FileNo FileMan Filename Package
355.93 IB NON/OTHER VA BILLING PROVIDER Integrated Billing

Description

Directly Accessed By Routines, Total: 64

Package Total Routines
Integrated Billing 56 DATE/TIME ALLOW FB UPDATE    DATE/TIME LAST FB UPDATE    DATE/TIME OF LAST NPI CHANGE    IB PROVIDERS FROM FB    IB SCREEN102    IB SCREEN10H    IB20P402    IB20P436
IBCBB1    IBCEF71    IBCEF73    IBCEF76    IBCEFG1    IBCEFP    IBCEFP1    IBCEP2
IBCEP2A    IBCEP5    IBCEP5A    IBCEP5D    IBCEP8    IBCEP81    IBCEP82    IBCEP8A
IBCEP8B    IBCEP8C    IBCEP8C1    IBCEU    IBCSCH2    IBFBWL3    IBRFN4    IBXSA21
IBXSA22    IBXSA26    IBXSA27    IBXSA28    IBXSAH1    IBXSAH10    IBXSAH2    IBXSAH6
IBXSAH9    IBXSC822    IBXSC823    IBXSC8H    IBXSC8H2    IBY137PO    IBY343PO    IBY343PR
IBY358PO    IBY374PO    IBYOPRE    ^DGCR(399    ^IBA(355.93    ^IBA(364.5    ^IBE(399.6    TAXONOMY CODE
Kernel 2 XUSNPIX3    XUSNPIX4    
Accounts Receivable 1 RCXVDC3    

Accessed By FileMan Db Calls, Total: 33

Package Total Routines
Integrated Billing 30 IB20A436    IB20P436    IBCEF79    IBCEP5    IBCEP5A    IBCEP5B    IBCEP5D    IBCEP8
IBCEP81    IBCEP82    IBCEP8B    IBCEP8C    IBCEP8C1    IBCSCH2    IBTRH5I    IBTRHLI2
IBXSA22    IBXSA26    IBXSA27    IBXSA28    IBXSAH10    IBXSAH2    IBXSAH6    IBXSAH9
IBXSC823    IBXSC8H2    IBY137PO    IBY320PO    IBY343PO    IBY343PR    
Accounts Receivable 2 RCDPEWLD    RCXVDC3    
Fee Basis 1 FBPAID3B    

Pointed To By FileMan Files, Total: 5

Package Total FileMan Files
Integrated Billing 4 BILL/CLAIMS(#399)[232#399.0222(.02)#399.0404(.02)]
IB BILLING PRACTITIONER ID(#355.9)[.01]    IB NON/OTHER VA BILLING PROVIDER(#355.93)[.18]    HCS REVIEW TRANSMISSION(#356.22)[#356.2213(.03)#356.22168(.03)]    
Fee Basis 1 FEE BASIS PAID TO IB(#161.9)[.07]    

Pointer To FileMan Files, Total: 5

Package Total FileMan Files
Kernel 3 STATE(#5)[.07.16]    PERSON CLASS(#8932.1)[#355.9342(.01)]    NEW PERSON(#200)[#355.9301(.04)#355.935(.02)#355.9351(.03)]
Integrated Billing 2 IB NON/OTHER VA BILLING PROVIDER(#355.93)[.18]    IB PROVIDER ID # TYPE(#355.97)[.13]    

Fields, Total: 25

Field # Name Loc Type Details
.01 NAME 0;1 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:($L(X)>60)!($L(X)<3) X I $D(X) D PRVFMT^IBCEP8
    MAXIMUM LENGTH: 60
  • LAST EDITED:  APR 27, 2017
  • HELP-PROMPT:  Enter the name of a NON-VA provider/facility or other VA. Name must start with a letter and can have letters,numbers,comma,space,dash only. Names aren't valid if they exist in the NEW PERSON file.
  • DESCRIPTION:  This is the name of either an individual NON-VA provider or a NON-VA or another VA facility that provides services to the V.A. for which the V.A. can in turn bill an insurance company for reimbursement.
    For individual type entries: The name should be entered in LAST,FIRST MIDDLE format. Enter only data that is actually part of the provider's name. Do not include extra titles, identification, flags, local information,
    etc. All individual provider names will be converted to the 'standardized' format. 'Standardized' for individuals means all punctuation except '-' and space are removed, the name is changed to all uppercase, 2 or more
    successive '-' or spaces are converted to a single '-' or space and any words for birth position (1ST-10TH) are changed to their Roman numeral equivalents.
    For facility type entries: The name MUST start with an Alpha character. The name may contain numerals, spaces, commas, periods, and a hyphen or dash. No other punctuation characters are allowed in the name.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  355.93^B
    1)= S ^IBA(355.93,"B",$E(X,1,30),DA)=""
    2)= K ^IBA(355.93,"B",$E(X,1,30),DA)
  • CROSS-REFERENCE:  ^^TRIGGER^355.93^.02
    1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S X=IBFLPFLP I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,2),X=X S DIU=X K Y S X=DIV S X=IBFLPFLP X ^DD(355.93,.01,1,2,1.4)
    1.4)= S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,2)=DIV,DIH=355.93,DIG=.02 D ^DICR
    2)= Q
    3)= Do not delete
    CREATE CONDITION)= S X=IBFLPFLP
    CREATE VALUE)= S X=IBFLPFLP
    DELETE VALUE)= NO EFFECT
    FIELD)= PROVIDER TYPE
    Trigger to change provider type based on user input during add/edit of the NAME field (#.01). Population of this field is based on the value of the IBFLPFLP variable returned by the NAME field input transform.
.02 PROVIDER TYPE 0;2 SET
************************REQUIRED FIELD************************
  • '1' FOR FACILITY/GROUP;
  • '2' FOR INDIVIDUAL;

  • INPUT TRANSFORM:  K:$L(X)>1!($L(X)<1) X Q:$G(IBIFN)="" I $$INDIVIDUAL^IBCU4(IBIFN,X,"")=0 K X
  • LAST EDITED:  MAR 22, 2022
  • HELP-PROMPT:  Enter 1 or 2 to designate this entry as a facility or an individual.
  • DESCRIPTION:  This field identifies the type of provider being defined. Facility providers can be used to fill in the name and address of the non-VA facility where services were rendered (box 32 on the CMS-1500). An individual
    provider can be selected as the rendering, attending, referring or operating provider on a bill.
  • EXECUTABLE HELP:  D INDIVHELP^IBCU4
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
    TRIGGERED by the NAME field of the IB NON/OTHER VA BILLING PROVIDER File
  • CROSS-REFERENCE:  ^^TRIGGER^355.93^.03
    1)= Q
    2)= X ^DD(355.93,.02,1,1,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,3),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,3)=DIV,DIH=355.93,DIG=.03 D ^DICR
    2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(Y(1),$C(59)_X_":",2),$C(59))="INDIVIDUAL"
    3)= Do not delete
    CREATE VALUE)= NO EFFECT
    DELETE CONDITION)= OLD PROVIDER TYPE="INDIVIDUAL"
    DELETE VALUE)= @
    FIELD)= CRE
    This trigger deletes the value of the CREDENTIALS field if the type is no longer an individual provider type.
  • CROSS-REFERENCE:  ^^TRIGGER^355.93^.04
    1)= Q
    2)= X ^DD(355.93,.02,1,2,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,4),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,4)=DIV,DIH=355.93,DIG=.04 D ^DICR
    2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(Y(1),$C(59)_X_":",2),$C(59))="INDIVIDUAL"
    3)= Do not delete
    CREATE VALUE)= NO EFFECT
    DELETE CONDITION)= OLD PROVIDER TYPE="INDIVIDUAL"
    DELETE VALUE)= @
    FIELD)= SPE
    This trigger deletes the value of the SPECIALTY field if the type is no longer an individual provider type.
  • CROSS-REFERENCE:  ^^TRIGGER^355.93^.05
    1)= Q
    2)= X ^DD(355.93,.02,1,3,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,5),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,5)=DIV,DIH=355.93,DIG=.05 D ^DICR
    2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(Y(1),$C(59)_X_":",2),$C(59))="FACILITY/GROUP"
    3)= Do not delete
    CREATE VALUE)= NO EFFECT
    DELETE CONDITION)= OLD PROVIDER TYPE="FACILITY/GROUP"
    DELETE VALUE)= @
    FIELD)= STREET ADDRESS
    This trigger deletes the value of the STREET ADDRESS field if the type is no longer a facility type provider.
  • CROSS-REFERENCE:  ^^TRIGGER^355.93^.06
    1)= Q
    2)= X ^DD(355.93,.02,1,4,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,6),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,6)=DIV,DIH=355.93,DIG=.06 D ^DICR
    2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(Y(1),$C(59)_X_":",2),$C(59))="FACILITY/GROUP"
    3)= Do not delete
    CREATE VALUE)= NO EFFECT
    DELETE CONDITION)= OLD PROVIDER TYPE="FACILITY/GROUP"
    DELETE VALUE)= @
    FIELD)= CITY
    This trigger deletes the value of the CITY field if the type is no longer a facility type provider.
  • CROSS-REFERENCE:  ^^TRIGGER^355.93^.07
    1)= Q
    2)= X ^DD(355.93,.02,1,5,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,7),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,7)=DIV,DIH=355.93,DIG=.07 D ^DICR
    2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(Y(1),$C(59)_X_":",2),$C(59))="FACILITY/GROUP"
    3)= Do not delete
    CREATE VALUE)= NO EFFECT
    DELETE CONDITION)= OLD PROVIDER TYPE="FACILITY/GROUP"
    DELETE VALUE)= @
    FIELD)= STATE
    This trigger deletes the value of the STATE field if the type is no longer a facility type provider.
  • CROSS-REFERENCE:  ^^TRIGGER^355.93^.08
    1)= Q
    2)= X ^DD(355.93,.02,1,6,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,8),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,8)=DIV,DIH=355.93,DIG=.08 D ^DICR
    2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(Y(1),$C(59)_X_":",2),$C(59))="FACILITY/GROUP"
    3)= Do not delete
    CREATE VALUE)= NO EFFECT
    DELETE CONDITION)= OLD PROVIDER TYPE="FACILITY/GROUP"
    DELETE VALUE)= @
    FIELD)= ZIP
    This trigger deletes the value of the ZIP CODE field if the type is no longer a facility type provider.
  • CROSS-REFERENCE:  ^^TRIGGER^355.93^.09
    1)= Q
    2)= X ^DD(355.93,.02,1,7,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,9),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,9)=DIV,DIH=355.93,DIG=.09 D ^DICR
    2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(Y(1),$C(59)_X_":",2),$C(59))="FACILITY/GROUP"
    3)= Do not delete
    CREATE VALUE)= NO EFFECT
    DELETE CONDITION)= OLD PROVIDER TYPE="FACILITY/GROUP"
    DELETE VALUE)= @
    FIELD)= FACILITY DEFAULT ID NUMBER
    This trigger deletes the value of the FACILITY DEFAULT ID NUMBER field if the type is no longer a facility type provider.
  • CROSS-REFERENCE:  ^^TRIGGER^355.93^.1
    1)= Q
    2)= X ^DD(355.93,.02,1,8,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,10),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,10)=DIV,DIH=355.93,DIG=.1 D ^DICR
    2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(Y(1),$C(59)_X_":",2),$C(59))="FACILITY/GROUP"
    3)= Do not delete
    CREATE VALUE)= NO EFFECT
    DELETE CONDITION)= OLD PROVIDER TYPE="FACILITY/GROUP"
    DELETE VALUE)= @
    FIELD)= STREET ADDRESS LINE 2
    This trigger deletes the value of the STREET ADDRESS LINE 2 field if the provider type is no longer a facility type provider.
  • CROSS-REFERENCE:  ^^TRIGGER^355.93^.13
    1)= X ^DD(355.93,.02,1,9,1.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,13),X=X S DIU=X K Y S X=DIV S X="16" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,13)=DIV,DIH=355.93,DIG=.13 D ^DICR
    1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(2)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=Y(0),X=X S X=X="1",Y(1)=$G(X) S X=$P(Y(2),U,9)]"",Y=X,X=Y(1),X=X&Y
    2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,13),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,13)=DIV,DIH=355.93,DIG=.13 D ^DICR
    CREATE CONDITION)= INTERNAL(PROVIDER TYPE)="1"&(FACILITY DEFAULT ID NUMBER]"")
    CREATE VALUE)= "16"
    DELETE VALUE)= @
    FIELD)= PRIMARY ID QUALIFIER
    This trigger sets the primary id qualifier to the default value of 16 if the provider type is a facility and the FACILITY DEFAULT ID NUMBER is not null.
.03 CREDENTIALS 0;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>3!($L(X)<1) X I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)'=2 K X
  • LAST EDITED:  OCT 05, 2000
  • HELP-PROMPT:  Answer must be 1-3 characters in length.
  • DESCRIPTION:  
    This is the 1 to 3 digits that represents the credentials for this provider. This field is only valid for INDIVIDUAL providers.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
    TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
.04 SPECIALTY 0;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>2!($L(X)<2) X I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)'=2 K X
  • LAST EDITED:  OCT 05, 2000
  • HELP-PROMPT:  Answer must be 2 characters in length.
  • DESCRIPTION:  
    This is the 2 digits that represent the specialty for this provider. This field is only valid for INDIVIDUAL providers.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
    TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
.05 STREET ADDRESS 0;5 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S X=$$UP^XLFSTR(X) K:$L(X)>55!($L(X)<1)!$$BADADD^IBCEP8B(X) X I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)'=1 K X
    MAXIMUM LENGTH: 55
  • LAST EDITED:  APR 27, 2017
  • HELP-PROMPT:  Answer must be 1-55 characters in length. Cannot be a post office box.
  • DESCRIPTION:  
    This is the street address of the non-VA facility that rendered the care that is being billed by the VA. It is only valid for FACILITY providers. It cannot be a post office box.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
    TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
.06 CITY 0;6 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<1) X I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)'=1 K X
  • LAST EDITED:  OCT 05, 2000
  • HELP-PROMPT:  Answer must be 1-20 characters in length.
  • DESCRIPTION:  
    This is the city of the non-VA facility that rendered the care that is being billed by the VA. It is only valid for FACILITY providers.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
    TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
.07 STATE 0;7 POINTER TO STATE FILE (#5) STATE(#5)

  • INPUT TRANSFORM:  I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)'=1 K X
  • LAST EDITED:  OCT 05, 2000
  • HELP-PROMPT:  Enter a valid state where the facility is located
  • DESCRIPTION:  
    This is the state of the non-VA facility that rendered the care that is being billed by the VA. It is only valid for FACILITY providers.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
    TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
.08 ZIP CODE 0;8 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<9)!'((X?9N)!(X?5N1"-"4N))!($E(X,$L(X)-3,$L(X))="0000") X I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)'=1 K X
  • LAST EDITED:  MAR 12, 2014
  • HELP-PROMPT:  Answer must be nine (999999999) or ten digits (99999-9999) in length. The last 4 digits cannot be "0000".
  • DESCRIPTION:  This is the zip code of the non-VA facility that rendered the care that is being billed by the VA. It is only valid for FACILITY providers. The ZIP code must be a nine digit ZIP code number and not ending in "0000" (four
    consecutive zeros).
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
    TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
.09 FACILITY DEFAULT ID NUMBER 0;9 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<1) X I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)'=1 K X
  • LAST EDITED:  MAR 28, 2006
  • HELP-PROMPT:  Enter the Federal Tax ID of the outside facility.
  • DESCRIPTION:  
    Enter the Federal Tax ID of the outside facility.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
    TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
  • CROSS-REFERENCE:  ^^TRIGGER^355.93^.13
    1)= X ^DD(355.93,.09,1,1,1.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,13),X=X S DIU=X K Y S X=DIV S X="16" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,13)=DIV,DIH=355.93,DIG=.13 D ^DICR
    1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,2),X=X S X=X="1",Y(2)=$G(X) S X=Y(0)]"",Y=X,X=Y(2),X=X&Y
    2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,13),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,13)=DIV,DIH=355.93,DIG=.13 D ^DICR
    CREATE CONDITION)= INTERNAL(PROVIDER TYPE)="1"&(FACILITY DEFAULT ID NUMBER]"")
    CREATE VALUE)= "16"
    DELETE VALUE)= @
    FIELD)= PRIMARY ID QUALIFIER
.1 STREET ADDRESS LINE 2 0;10 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)'=1 K X
  • LAST EDITED:  JUL 21, 2010
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • DESCRIPTION:  
    This is line 2 of the street address of the non-VA facility that rendered the care that is being billed by the VA. It is only valid for FACILITY providers.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
    TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
.11 X12 TYPE OF FACILITY 0;11 SET
  • '77' FOR SERVICE LOCATION;
  • 'FA' FOR FACILITY;
  • 'LI' FOR INDEPENDENT LAB;
  • 'TL' FOR TESTING LAB;

  • LAST EDITED:  JUN 19, 2007
  • HELP-PROMPT:  Enter a code to describe the type of facility for professional claims. Type Facility (FA) will automatically be sent on institutional claims.
  • DESCRIPTION:  
    This is the code for the type of facility as identified in the X12 documents. It is used to describe the type of facility for professional claims. Facility (FA) will automatically be sent on institutional claims.
.12 STATE LICENSE # 0;12 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  AUG 25, 2003
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • DESCRIPTION:  This is the State license # for the non-VA provider. Note, there can be only 1 state license # on file for non-VA/other VA providers. Enter multiple entries for the provider if multiple state license numbers are required
    (one for each state).
  • NOTES:  TRIGGERED by the STATE field of the IB NON/OTHER VA BILLING PROVIDER File
.13 PRIMARY ID QUALIFIER 0;13 POINTER TO IB PROVIDER ID # TYPE FILE (#355.97) IB PROVIDER ID # TYPE(#355.97)

  • INPUT TRANSFORM:  S DIC("S")="I $P($G(^(1)),U,4)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  MAR 09, 2006
  • HELP-PROMPT:  The only Qualifier allowed is the TAX ID.
  • DESCRIPTION:  
    This is the Qualifier associated with the FACILITY DEFAULT ID NUMBER.
  • SCREEN:  S DIC("S")="I $P($G(^(1)),U,4)"
  • EXPLANATION:  Only TAX ID allowed
  • NOTES:  TRIGGERED by the FACILITY DEFAULT ID NUMBER field of the IB NON/OTHER VA BILLING PROVIDER File
    TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
.15 MAMMOGRAPHY CERTIFICATION # 0;15 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<3) X
  • LAST EDITED:  MAR 09, 2006
  • HELP-PROMPT:  Enter the Mammography Certification Number for this facility. Must be 3-15 characters.
  • DESCRIPTION:  
    This is the mammography certification number for the non-VA facility which is used as a default on the claim when mammography services are performed. It is required by some insurance companies.
.16 LICENSE STATE 0;16 POINTER TO STATE FILE (#5) STATE(#5)

  • LAST EDITED:  NOV 08, 2011
  • HELP-PROMPT:  Enter the state which issued the license of the individual or facility.
  • DESCRIPTION:  
    This is the state which issued the STATE LICENSE #(#.12) field of the non-VA individual or facility that rendered the care that is being billed by the VA.
.17 SOLE PROPRIETORSHIP 0;17 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  SEP 15, 2014
  • HELP-PROMPT:  Enter Y if this is a sole proprietorship, N if it is not.
  • DESCRIPTION:  
    A sole proprietorship is a Non-VA facility that is owned by a single Non-VA provider.
  • TECHNICAL DESCR:  
    This field provides the ability to mark the organization as a sole proprietorship, which allows use of the single provider's NPI for the organization. Duplicate use of an NPI would otherwise not be permitted.
.18 NON-VA PROVIDER 0;18 POINTER TO IB NON/OTHER VA BILLING PROVIDER FILE (#355.93) IB NON/OTHER VA BILLING PROVIDER(#355.93)

  • INPUT TRANSFORM:  S DIC("S")="I $P($G(^(0)),U,2)=2" D ^DIC K DIC S DIC=$G(DIE),X=+Y K:Y<0 X
  • LAST EDITED:  SEP 08, 2014
  • HELP-PROMPT:  Enter the Non-VA Provider that functions as the sole-proprietor of this facility.
  • DESCRIPTION:  
    Non-VA provider associated with this facility.
  • SCREEN:  S DIC("S")="I $P($G(^(0)),U,2)=2"
  • EXPLANATION:  Only individuals can function as a Sole-proprietor.
1.01 P&C CONTACT NAME 1;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<3) X
  • LAST EDITED:  JAN 25, 2013
  • HELP-PROMPT:  Enter the Contact Person (3-30 characters) at this Lab/Facility (Last Name,First Name).
  • DESCRIPTION:  
    For use with property and casualty claims, this is the name of the contact person at this Lab/Facility (Last Name, First Name).
1.02 P&C CONTACT PHONE NUMBER 1;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<10) X
  • LAST EDITED:  JAN 25, 2013
  • HELP-PROMPT:  Answer must be 10-15 characters in length.
  • DESCRIPTION:  
    For use with property and casualty claims, this is the area code and phone number of the contact person at this facility.
  • CROSS-REFERENCE:  ^^TRIGGER^355.93^1.03
    1)= Q
    2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^IBA(355.93,D0,1)):^(1),1:"") S X=$P(Y(1),U,3),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),1)),DIV=X S $P(^(1),U,3)=DIV,DIH=355.93,DIG=1.03 D ^DICR
    CREATE VALUE)= NO EFFECT
    DELETE VALUE)= S X=""
    FIELD)= CONTACT PHONE EXTENSION
    If Contact Phone is deleted, extension will be deleted also.
1.03 P&C CONTACT PHONE EXTENSION 1;3 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999999999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 25, 2013
  • HELP-PROMPT:  Type a number between 0 and 9999999999, 0 decimal digits.
  • DESCRIPTION:  
    For use with property and casualty claims, this is the phone extension of the contact person at this facility, if known.
  • NOTES:  TRIGGERED by the P&C CONTACT PHONE NUMBER field of the IB NON/OTHER VA BILLING PROVIDER File
40 DATE/TIME OF LAST NPI CHANGE NPISTATUS;0 DATE Multiple #355.9301 355.9301
41.01 NPI 0;14 FREE TEXT

  • INPUT TRANSFORM:  N IBOLDNPI S IBOLDNPI=$P($G(^IBA(355.93,DA,0)),U,14) K:$L(X)>10!($L(X)<10)!'$$CHKDGT^XUSNPI(X)!$$NPIUSED^IBCEP81(X,IBOLDNPI,DA,$S(X=IBOLDNPI:2,1:0),"XUSNPIMTL") X
  • LAST EDITED:  MAY 12, 2008
  • HELP-PROMPT:  Answer must be 10 characters in length and a valid unique NPI number.
  • DESCRIPTION:  
    Unique National Provider Identifier. A unique integer assigned to a provider by CMS. This field contains the current NPI for this provider.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  355.93^NPI
    1)= S ^IBA(355.93,"NPI",$E(X,1,30),DA)=""
    2)= K ^IBA(355.93,"NPI",$E(X,1,30),DA)
    This cross reference holds a list of the active NPIs in this file.
  • CROSS-REFERENCE:  355.93^NPIHISTORY
    1)= S ^IBA(355.93,"NPIHISTORY",$E(X,1,30),DA)=""
    2)= K ^IBA(355.93,"NPIHISTORY",$E(X,1,30),DA)
    3)= An entry into the NPI History cross reference should not be deleted
    This cross reference holds the entire history of the NPIs used in the file.
42 TAXONOMY CODE TAXONOMY;0 POINTER Multiple #355.9342 355.9342

  • IDENTIFIED BY:  
50 DATE/TIME LAST FB UPDATE 4;0 DATE Multiple #355.935 355.935

  • DESCRIPTION:  
    This multiple tracks updates to this file that are made by the FEE BASIS PAID TO IB background job.
51 DATE/TIME ALLOW FB UPDATE 3;0 DATE Multiple #355.9351 355.9351

  • DESCRIPTION:  
    This multiple stores information that the Fee Basis interface uses to control whether updates to this record should be allowed. Historical information is saved, and the most recent entry is used by the interface.

ICR, Total: 3

ICR LINK Subscribing Package(s) Fields Referenced Description
ICR #4939
  • Kernel
  • STATUS (.02).
    Access: Direct Global Read & w/Fileman

    PROVIDER TYPE (.02).
    Access: Read w/Fileman

    Uses "NPI42" x-ref to get IEN (D0) for a given NPINUMBER.Uses "C" x-ref in NPISTATUS node to get IEN (D1) for agiven NPI NUMBER within the 'NPISTATUS' multiple for this IEN (D0).
    ICR #4957
  • Accounts Receivable
  • NPI (41.01).
    Access: Direct Global Read & w/Fileman

    The IBA(355.93 global holds the demographic data for anon-VA provider, both individual and organizational.
    ICR #4965
  • Kernel
  • NAME (.01).
    Access: Direct Global Read & w/Fileman

    PROVIDER TYPE (.02).
    Access: Direct Global Read & w/Fileman

    STREET ADDRESS (.05).
    Access: Direct Global Read & w/Fileman

    STREET ADDRESS LINE 2 (.1).
    Access: Direct Global Read & w/Fileman

    CITY (.06).
    Access: Direct Global Read & w/Fileman

    STATE (.07).
    Access: Direct Global Read & w/Fileman

    ZIP CODE (.08).
    Access: Direct Global Read & w/Fileman

    FACILITY DEFAULT ID NUMBER (.09).
    Access: Direct Global Read & w/Fileman

    STATE LICENSE # (.12).
    Access: Direct Global Read & w/Fileman

    The IBA(355.93 global holds the demographic data for anon-VA provider, both individual and organizational.Uses NPI x-ref to get IEN for a given NPI numberUses B x-ref in NPISTATUS node to check active date fora given NPI numberUses B x-ref in TAXONOMY node to loop through and getdata for all IENs pointing to file 8932.1

    External References

    Name Field # of Occurrence
    ^DIC .13+1, .18+1
    ^DICR .01(XREF 2n1.4), .02(XREF 1K), .02(XREF 2K), .02(XREF 3K), .02(XREF 4K), .02(XREF 5K), .02(XREF 6K), .02(XREF 7K), .02(XREF 8K), .02(XREF 9S)
    .02(XREF 9K), .09(XREF 1S), .09(XREF 1K), 1.02(XREF 1K)
    PRVFMT^IBCEP8 .01+1
    $$NPIUSED^IBCEP81 41.01+1
    $$BADADD^IBCEP8B .05+1
    INDIVHELP^IBCU4 .02(HELP )
    $$UP^XLFSTR .05+1
    $$CHKDGT^XUSNPI 41.01+1

    Global Variables Directly Accessed

    Name Line Occurrences  (* Changed,  ! Killed)
    ^DD(355.93 .01(XREF 2S), .02(XREF 1K), .02(XREF 1n2.3), .02(XREF 2K), .02(XREF 2n2.3), .02(XREF 3K), .02(XREF 3n2.3), .02(XREF 4K), .02(XREF 4n2.3), .02(XREF 5K)
    .02(XREF 5n2.3), .02(XREF 6K), .02(XREF 6n2.3), .02(XREF 7K), .02(XREF 7n2.3), .02(XREF 8K), .02(XREF 8n2.3), .02(XREF 9S), .09(XREF 1S)
    ^IBA(355.93 - [#355.93] IXNPI42SL+1*, IXNPI42KL+1!, IXNPI42KEIC+1!, .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2n1.4), .02(XREF 1K), .02(XREF 2K), .02(XREF 3K)
    .02(XREF 4K), .02(XREF 5K), .02(XREF 6K), .02(XREF 7K), .02(XREF 8K), .02(XREF 9S), .02(XREF 9n1.3), .02(XREF 9K), .03+1, .04+1
    , .05+1, .06+1, .07+1, .08+1, .09+1, .09(XREF 1S), .09(XREF 1n1.3), .09(XREF 1K), .1+1, 1.02(XREF 1K)
    , 41.01+1, 41.01(XREF 1S), 41.01(XREF 1K), 41.01(XREF 2S), 41.01(XREF 2K)

    Naked Globals

    Name Field # of Occurrence
    ^(0 .01(XREF 2S), .01(XREF 2n1.4), .02(XREF 1K), .02(XREF 2K), .02(XREF 3K), .02(XREF 4K), .02(XREF 5K), .02(XREF 6K), .02(XREF 7K), .02(XREF 8K)
    .02(XREF 9S), .02(XREF 9n1.3), .02(XREF 9K), .09(XREF 1S), .09(XREF 1n1.3), .09(XREF 1K)
    ^(1 1.02(XREF 1K)

    Local Variables

    Legend:

    >> Not killed explicitly
    * Changed
    ! Killed
    ~ Newed

    Name Field # of Occurrence
    >> D0 .01(XREF 2S), .02(XREF 1K), .02(XREF 1n2.3), .02(XREF 2K), .02(XREF 2n2.3), .02(XREF 3K), .02(XREF 3n2.3), .02(XREF 4K), .02(XREF 4n2.3), .02(XREF 5K)
    .02(XREF 5n2.3), .02(XREF 6K), .02(XREF 6n2.3), .02(XREF 7K), .02(XREF 7n2.3), .02(XREF 8K), .02(XREF 8n2.3), .02(XREF 9S), .02(XREF 9n1.3), .02(XREF 9K)
    .09(XREF 1S), .09(XREF 1n1.3), .09(XREF 1K), 1.02(XREF 1K)
    >> DA IXNPI42SL+1, IXNPI42KL+1, .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .02(XREF 1n2.3), .02(XREF 2n2.3), .02(XREF 3n2.3), .02(XREF 4n2.3), .02(XREF 5n2.3)
    .02(XREF 6n2.3), .02(XREF 7n2.3), .02(XREF 8n2.3), .02(XREF 9n1.3), .02(XREF 9K), .03+1, .04+1, .05+1, .06+1, .07+1
    , .08+1, .09+1, .09(XREF 1n1.3), .09(XREF 1K), .1+1, 1.02(XREF 1K), 41.01+1, 41.01(XREF 1S), 41.01(XREF 1K), 41.01(XREF 2S)
    41.01(XREF 2K)
    >> DA(1 IXNPI42SL+1, IXNPI42KL+1
    DIC ID.02+1, .13+1!*, .18+1!*
    DIC("S" .13+1*, .13SCR+1*, .18+1*, .18SCR+1*
    >> DIE .13+1, .18+1
    >> DIG .01(XREF 2n1.4), .02(XREF 1K), .02(XREF 2K), .02(XREF 3K), .02(XREF 4K), .02(XREF 5K), .02(XREF 6K), .02(XREF 7K), .02(XREF 8K), .02(XREF 9S)
    .02(XREF 9K), .09(XREF 1S), .09(XREF 1K), 1.02(XREF 1K)
    >> DIH .01(XREF 2n1.4), .02(XREF 1K), .02(XREF 2K), .02(XREF 3K), .02(XREF 4K), .02(XREF 5K), .02(XREF 6K), .02(XREF 7K), .02(XREF 8K), .02(XREF 9S)
    .02(XREF 9K), .09(XREF 1S), .09(XREF 1K), 1.02(XREF 1K)
    >> DIU .01(XREF 2S), .02(XREF 1K), .02(XREF 2K), .02(XREF 3K), .02(XREF 4K), .02(XREF 5K), .02(XREF 6K), .02(XREF 7K), .02(XREF 8K), .02(XREF 9S)
    .02(XREF 9K), .09(XREF 1S), .09(XREF 1K), 1.02(XREF 1K)
    DIV .01(XREF 2S), .01(XREF 2n1.4), .02(XREF 1K), .02(XREF 1n2.3), .02(XREF 2K), .02(XREF 2n2.3), .02(XREF 3K), .02(XREF 3n2.3), .02(XREF 4K), .02(XREF 4n2.3)
    .02(XREF 5K), .02(XREF 5n2.3), .02(XREF 6K), .02(XREF 6n2.3), .02(XREF 7K), .02(XREF 7n2.3), .02(XREF 8K), .02(XREF 8n2.3), .02(XREF 9S), .02(XREF 9n1.3)
    .02(XREF 9K), .09(XREF 1S), .09(XREF 1n1.3), .09(XREF 1K), 1.02(XREF 1K)
    DIV(0 .01(XREF 2S), .01(XREF 2n1.4), .02(XREF 1K), .02(XREF 1n2.3), .02(XREF 2K), .02(XREF 2n2.3), .02(XREF 3K), .02(XREF 3n2.3), .02(XREF 4K), .02(XREF 4n2.3)
    .02(XREF 5K), .02(XREF 5n2.3), .02(XREF 6K), .02(XREF 6n2.3), .02(XREF 7K), .02(XREF 7n2.3), .02(XREF 8K), .02(XREF 8n2.3), .02(XREF 9S), .02(XREF 9n1.3)
    .02(XREF 9K), .09(XREF 1S), .09(XREF 1n1.3), .09(XREF 1K), 1.02(XREF 1K)
    >> IBFLPFLP .01(XREF 2S)
    IBOLDNPI 41.01+1~*
    U .01(XREF 2S), .01(XREF 2n1.4), .02(XREF 1K), .02(XREF 1n2.3), .02(XREF 2K), .02(XREF 2n2.3), .02(XREF 3K), .02(XREF 3n2.3), .02(XREF 4K), .02(XREF 4n2.3)
    .02(XREF 5K), .02(XREF 5n2.3), .02(XREF 6K), .02(XREF 6n2.3), .02(XREF 7K), .02(XREF 7n2.3), .02(XREF 8K), .02(XREF 8n2.3), .02(XREF 9S), .02(XREF 9n1.3)
    .02(XREF 9K), .03+1, .04+1, .05+1, .06+1, .07+1, .08+1, .09+1, .09(XREF 1S), .09(XREF 1n1.3)
    .09(XREF 1K), .1+1, 1.02(XREF 1K), 41.01+1
    X IXNPI42SL+1, IXNPI42KL+1, .01+1!, .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2n1.4), .02(XREF 1K), .02(XREF 1n2.3), .02(XREF 2K)
    .02(XREF 2n2.3), .02(XREF 3K), .02(XREF 3n2.3), .02(XREF 4K), .02(XREF 4n2.3), .02(XREF 5K), .02(XREF 5n2.3), .02(XREF 6K), .02(XREF 6n2.3), .02(XREF 7K)
    .02(XREF 7n2.3), .02(XREF 8K), .02(XREF 8n2.3), .02(XREF 9S), .02(XREF 9n1.3), .02(XREF 9K), .03+1!, .04+1!, .05+1*!, .06+1!
    , .07+1!, .08+1!, .09+1!, .09(XREF 1S), .09(XREF 1n1.3), .09(XREF 1K), .1+1!, .12+1!, .13+1*!, .15+1!
    , .18+1*!, 1.01+1!, 1.02+1!, 1.02(XREF 1K), 1.03+1!, 41.01+1!, 41.01(XREF 1S), 41.01(XREF 1K), 41.01(XREF 2S), 41.01(XREF 2K)
    Y .01(XREF 2S), .02(XREF 1K), .02(XREF 2K), .02(XREF 3K), .02(XREF 4K), .02(XREF 5K), .02(XREF 6K), .02(XREF 7K), .02(XREF 8K), .02(XREF 9S)
    .02(XREF 9n1.3), .02(XREF 9K), .09(XREF 1S), .09(XREF 1n1.3), .09(XREF 1K), .13+1, .18+1, 1.02(XREF 1K)
    Y(0 .01(XREF 2S), .02(XREF 1n2.3), .02(XREF 2n2.3), .02(XREF 3n2.3), .02(XREF 4n2.3), .02(XREF 5n2.3), .02(XREF 6n2.3), .02(XREF 7n2.3), .02(XREF 8n2.3), .02(XREF 9n1.3)
    .09(XREF 1n1.3)
    Y(1 .01(XREF 2S), .02(XREF 1K), .02(XREF 1n2.3), .02(XREF 2K), .02(XREF 2n2.3), .02(XREF 3K), .02(XREF 3n2.3), .02(XREF 4K), .02(XREF 4n2.3), .02(XREF 5K)
    .02(XREF 5n2.3), .02(XREF 6K), .02(XREF 6n2.3), .02(XREF 7K), .02(XREF 7n2.3), .02(XREF 8K), .02(XREF 8n2.3), .02(XREF 9S), .02(XREF 9n1.3), .02(XREF 9K)
    .09(XREF 1S), .09(XREF 1n1.3), .09(XREF 1K), 1.02(XREF 1K)
    Y(2 .02(XREF 9n1.3), .09(XREF 1n1.3)
    Info |  Desc |  Directly Accessed By Routines |  Accessed By FileMan Db Calls |  Pointed To By FileMan Files |  Pointer To FileMan Files |  Fields |  ICR |  External References |  Global Variables Directly Accessed |  Naked Globals |  Local Variables  | All