- ECXAPRO3 ;ALB/JAP - PRO Extract Audit Report (cont) ; DEC 03,2008
- ;;3.0;DSS EXTRACTS;**21,31,76,94,116,149**;Dec 22, 1997;Build 27
- ;
- TEXT ;description of line numbers as in des^rmprn62 plus summary headers
- ;;100;WHEELCHAIRS AND ACCESSORIES
- ;;100 A;MOTORIZED
- ;;100 A1;SCOOTERS
- ;;100 B;MANUAL CUSTOM
- ;;100 C;MANUAL A/O
- ;;100 D;ACCESSORIES
- ;;100 E;CUSHION FOAM
- ;;100 F;CUSHION SPEC
- ;;100 G;CARRIERS
- ;;100 H;NSC VAN MODS
- ;;100 I;SCOOTER ACCESSORIES
- ;;200;ARTIFICIAL LEGS
- ;;200 A;LEG IPOP
- ;;200 B;LEG TEM
- ;;200 C;LEG PART FOOT
- ;;200 E;LEG SYMES
- ;;200 F;LEG B/K
- ;;200 G;LEG A/O
- ;;200 H;LEG A/K
- ;;200 I;LEG COMPONENT
- ;;300;ARTIFICIAL ARMS AND TERMINAL DEVICES
- ;;300 A;ARM B/E
- ;;300 B;ARM, A/E
- ;;300 C;COSMETIC GLOVES
- ;;300 D;ARM, A/O
- ;;300 E;TERMINAL DEVICES
- ;;300 F;EXT. POWERED,ARM
- ;;400;BRACES AND ORTHOTICS
- ;;400 A;BRACE ANKLE
- ;;400 B;BRACE LEG AK
- ;;400 C;BRACE, SPINAL
- ;;400 D;BRACE AL/OTH
- ;;400 E;ELAS HOSE, EA
- ;;400 F;BRACES, KNEE
- ;;400 G;CORSET/BELT
- ;;400 H;ORTHOSIS WHO
- ;;400 X;ORTHOTICS UNKNOWN
- ;;500;SHOES/ORTHOTICS
- ;;500 A;ARCH SUPT, EA
- ;;500 B;SHOE INLAY, EA
- ;;500 C;SHOE MOLDED, EA
- ;;500 D;SHOE ORTH OTH
- ;;500 E;INSERTS, SHOE
- ;;500 F;SHOES A/O, EA
- ;;600;NEUROSENSORY AIDS
- ;;600 1;EYEGLASSES PR
- ;;600 A;SP OVER 2,500
- ;;600 B;HEARING AIDS
- ;;600 C;AID FOR BLIND
- ;;600 D;CONT LENS, EA.
- ;;600 E;EAR INSERT
- ;;600 F;ASST LISTENING DEVICES
- ;;600 G;SPEECH DEVICES
- ;;700;RESTORATIONS
- ;;700 A;EYE
- ;;700 B;FACIAL
- ;;700 C;BODY, OTHER
- ;;700 D;BREAST PROSTHESIS
- ;;800;OXYGEN AND RESPIRATORY
- ;;800 A;OXYGEN EQP
- ;;800 B;OXYGEN CONCEN
- ;;800 C;OXYGEN GAS
- ;;800 D;OXYGEN, SUPPLIES
- ;;800 E;OXYGEN LIQUID
- ;;800 F;VENTILATOR, A/O
- ;;800 G;RESPIRATORY EQUIPMENT
- ;;800 H;RESPIRATORY SUPPLIES
- ;;900;MEDICAL EQUIPMENT
- ;;900 A;WALKING AIDS
- ;;900 B;INVALID LIFT
- ;;900 C;BED HOSP STD
- ;;900 D;BED HOSP SPEC
- ;;900 E;MATTRESS STAN
- ;;900 F;MATTRESS SPEC
- ;;900 G;BED, ACCESSORIES
- ;;900 H;ENVIRON CONTR
- ;;900 I;SPEC HOME EQP (SAFETY)
- ;;900 J;TENS UNIT
- ;;900 K;MED EQP AL/OTH
- ;;900 L;EQP RENTAL
- ;;900 M;COMPUTER EQUIPMENT
- ;;900 N;TELEHEALTH
- ;;900 O;EXERCISE EQUIPMENT
- ;;900 P;WOMENS HEALTH
- ;;910;ALL OTHER SUPPLIES AND EQUIPMENT
- ;;910 A;MED SUP AL/OTH
- ;;910 B;BATTERIES
- ;;920;HOME DIALYSIS PROGRAM
- ;;920 A;HOME DIAL EQP
- ;;920 B;HOME DIAL SUP
- ;;930;ADAPTIVE EQUIPMENT
- ;;930 A;MOD VANS
- ;;930 B;ADAPT EQP AL/OTH
- ;;940;HISA
- ;;940 A;HISA SC
- ;;940 B;HISA NSC
- ;;960;SURGICAL IMPLANTS
- ;;960 A;HEAD & NECK
- ;;960 A1;H&N INTRAOCULAR LENS
- ;;960 A2;H&N HEAD
- ;;960 A3;H&N NECK
- ;;960 A4;H&N EYES A/O
- ;;960 B;ABDOMEN
- ;;960 B1;ABDOMEN STENT
- ;;960 B2;ABDOMEN MESH
- ;;960 B3;ABDOMEN CATHETER
- ;;960 C;UPPER EXTREMITY
- ;;960 C1;UE ARM
- ;;960 C2;UE SHOULDER
- ;;960 C3;UE HAND
- ;;960 D;LOWER EXTREMITY
- ;;960 D1;LE HIP
- ;;960 D2;LE KNEE
- ;;960 D3;LE FOOT
- ;;960 E;THORACIC
- ;;960 E1;THOR PACEMAKER/LEADS
- ;;960 E2;THOR ICD/LEADS
- ;;960 E3;THOR STENTS
- ;;960 E4;THOR VALVE
- ;;960 F;DENTAL IMPLANT
- ;;960 G;ALL SCRWS,PLTS, ANCRS, ETC.
- ;;960 X;SI UNKNOWNS (ALL)
- ;;970;BIO IMPLANTS
- ;;970 A;BIOLOGICAL IMPLANTS
- ;;999;MISC
- ;;999 A;AL/OTH ITEMS
- ;;999 P1;PEDS DME
- ;;999 P2;ALL OTHER PEDS
- ;;999 X;HCPCS NOT GRP
- ;;999 Z;NO HCPCS
- ;;R07;HEARING AID, LOCAL REPAIRS
- ;;R10;WHEELCHAIRS AND ACCESSORIES
- ;;R10 A;WHEELCHAIR
- ;;R10 B;CARRIERS
- ;;R10 C;NSC VAN MODS
- ;;R10 ;WHEELCHAIR
- ;;R20;ARTIFICIAL LEGS
- ;;R20 A;LEG A/K
- ;;R20 B;LEG B/K, PTB
- ;;R20 C;LEG B/K, STD
- ;;R20 D;LEG ALL OTHER
- ;;R30;ARTIFICIAL ARMS AND TERMINAL DEVICES
- ;;R30 ;ART ARM,TOTAL
- ;;R40;BRACES AND ORTHOTICS
- ;;R40 ;BRACE TOTAL
- ;;R50;SHOES/ORTHOTICS
- ;;R50 A;ORTH SHOE ALL
- ;;R50 B;SHOE MOD
- ;;R50 C;A/O ITEM SERV
- ;;R60;NEUROSENSORY AIDS
- ;;R60 A;AID FOR BLIND
- ;;R60 B;EYEGLASS RPR
- ;;R60 C;HEARING AID
- ;;R60 D;ASST LISTENING DEVICE
- ;;R60 E;SPEECH DEVICES
- ;;R70;HOME DIALYSIS EQUIPMENT
- ;;R70 ;HOME DIAL EQU
- ;;R80;MEDICAL EQUIPMENT
- ;;R80 A;INVALID LIFTS
- ;;R80 B;REPAIR TO ECU
- ;;R80 C;MED EQUIP A/O
- ;;R80 D;HME DELIVERY/PICKUP
- ;;R80 E;TELEHEALTH
- ;;R80 F;COMPUTERS
- ;;R90;ALL OTHER
- ;;R90 ;ALL OTHER
- ;;R90 A;SHIPPING
- ;;R90 B;TRAINING
- ;;R91;O2 & RESPIRATORY
- ;;R91 A;CONCENTRATOR
- ;;R91 B;VENTILATOR
- ;;R91 C;EQUIPMENT A/O
- ;;R91 D;SERVICE VISIT
- ;;R91 E;COMPRESSED O2
- ;;R91 F;LIQUID O2
- ;;R91 G;LIQUID DEL SYS
- ;;R91 H;RESPIRATORY EQUIP
- ;;R99 A;SHIPPING
- ;;R99 B;NONRESPONSE
- ;;R99 P;MISC PEDS
- ;;R99 X;HCPCS NOT GRP
- ;;R99 Z;NO HCPCS
- ;;QUIT
- --- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HECXAPRO3 4569 printed Mar 13, 2025@20:56:52 Page 2
- ECXAPRO3 ;ALB/JAP - PRO Extract Audit Report (cont) ; DEC 03,2008
- +1 ;;3.0;DSS EXTRACTS;**21,31,76,94,116,149**;Dec 22, 1997;Build 27
- +2 ;
- TEXT ;description of line numbers as in des^rmprn62 plus summary headers
- +1 ;;100;WHEELCHAIRS AND ACCESSORIES
- +2 ;;100 A;MOTORIZED
- +3 ;;100 A1;SCOOTERS
- +4 ;;100 B;MANUAL CUSTOM
- +5 ;;100 C;MANUAL A/O
- +6 ;;100 D;ACCESSORIES
- +7 ;;100 E;CUSHION FOAM
- +8 ;;100 F;CUSHION SPEC
- +9 ;;100 G;CARRIERS
- +10 ;;100 H;NSC VAN MODS
- +11 ;;100 I;SCOOTER ACCESSORIES
- +12 ;;200;ARTIFICIAL LEGS
- +13 ;;200 A;LEG IPOP
- +14 ;;200 B;LEG TEM
- +15 ;;200 C;LEG PART FOOT
- +16 ;;200 E;LEG SYMES
- +17 ;;200 F;LEG B/K
- +18 ;;200 G;LEG A/O
- +19 ;;200 H;LEG A/K
- +20 ;;200 I;LEG COMPONENT
- +21 ;;300;ARTIFICIAL ARMS AND TERMINAL DEVICES
- +22 ;;300 A;ARM B/E
- +23 ;;300 B;ARM, A/E
- +24 ;;300 C;COSMETIC GLOVES
- +25 ;;300 D;ARM, A/O
- +26 ;;300 E;TERMINAL DEVICES
- +27 ;;300 F;EXT. POWERED,ARM
- +28 ;;400;BRACES AND ORTHOTICS
- +29 ;;400 A;BRACE ANKLE
- +30 ;;400 B;BRACE LEG AK
- +31 ;;400 C;BRACE, SPINAL
- +32 ;;400 D;BRACE AL/OTH
- +33 ;;400 E;ELAS HOSE, EA
- +34 ;;400 F;BRACES, KNEE
- +35 ;;400 G;CORSET/BELT
- +36 ;;400 H;ORTHOSIS WHO
- +37 ;;400 X;ORTHOTICS UNKNOWN
- +38 ;;500;SHOES/ORTHOTICS
- +39 ;;500 A;ARCH SUPT, EA
- +40 ;;500 B;SHOE INLAY, EA
- +41 ;;500 C;SHOE MOLDED, EA
- +42 ;;500 D;SHOE ORTH OTH
- +43 ;;500 E;INSERTS, SHOE
- +44 ;;500 F;SHOES A/O, EA
- +45 ;;600;NEUROSENSORY AIDS
- +46 ;;600 1;EYEGLASSES PR
- +47 ;;600 A;SP OVER 2,500
- +48 ;;600 B;HEARING AIDS
- +49 ;;600 C;AID FOR BLIND
- +50 ;;600 D;CONT LENS, EA.
- +51 ;;600 E;EAR INSERT
- +52 ;;600 F;ASST LISTENING DEVICES
- +53 ;;600 G;SPEECH DEVICES
- +54 ;;700;RESTORATIONS
- +55 ;;700 A;EYE
- +56 ;;700 B;FACIAL
- +57 ;;700 C;BODY, OTHER
- +58 ;;700 D;BREAST PROSTHESIS
- +59 ;;800;OXYGEN AND RESPIRATORY
- +60 ;;800 A;OXYGEN EQP
- +61 ;;800 B;OXYGEN CONCEN
- +62 ;;800 C;OXYGEN GAS
- +63 ;;800 D;OXYGEN, SUPPLIES
- +64 ;;800 E;OXYGEN LIQUID
- +65 ;;800 F;VENTILATOR, A/O
- +66 ;;800 G;RESPIRATORY EQUIPMENT
- +67 ;;800 H;RESPIRATORY SUPPLIES
- +68 ;;900;MEDICAL EQUIPMENT
- +69 ;;900 A;WALKING AIDS
- +70 ;;900 B;INVALID LIFT
- +71 ;;900 C;BED HOSP STD
- +72 ;;900 D;BED HOSP SPEC
- +73 ;;900 E;MATTRESS STAN
- +74 ;;900 F;MATTRESS SPEC
- +75 ;;900 G;BED, ACCESSORIES
- +76 ;;900 H;ENVIRON CONTR
- +77 ;;900 I;SPEC HOME EQP (SAFETY)
- +78 ;;900 J;TENS UNIT
- +79 ;;900 K;MED EQP AL/OTH
- +80 ;;900 L;EQP RENTAL
- +81 ;;900 M;COMPUTER EQUIPMENT
- +82 ;;900 N;TELEHEALTH
- +83 ;;900 O;EXERCISE EQUIPMENT
- +84 ;;900 P;WOMENS HEALTH
- +85 ;;910;ALL OTHER SUPPLIES AND EQUIPMENT
- +86 ;;910 A;MED SUP AL/OTH
- +87 ;;910 B;BATTERIES
- +88 ;;920;HOME DIALYSIS PROGRAM
- +89 ;;920 A;HOME DIAL EQP
- +90 ;;920 B;HOME DIAL SUP
- +91 ;;930;ADAPTIVE EQUIPMENT
- +92 ;;930 A;MOD VANS
- +93 ;;930 B;ADAPT EQP AL/OTH
- +94 ;;940;HISA
- +95 ;;940 A;HISA SC
- +96 ;;940 B;HISA NSC
- +97 ;;960;SURGICAL IMPLANTS
- +98 ;;960 A;HEAD & NECK
- +99 ;;960 A1;H&N INTRAOCULAR LENS
- +100 ;;960 A2;H&N HEAD
- +101 ;;960 A3;H&N NECK
- +102 ;;960 A4;H&N EYES A/O
- +103 ;;960 B;ABDOMEN
- +104 ;;960 B1;ABDOMEN STENT
- +105 ;;960 B2;ABDOMEN MESH
- +106 ;;960 B3;ABDOMEN CATHETER
- +107 ;;960 C;UPPER EXTREMITY
- +108 ;;960 C1;UE ARM
- +109 ;;960 C2;UE SHOULDER
- +110 ;;960 C3;UE HAND
- +111 ;;960 D;LOWER EXTREMITY
- +112 ;;960 D1;LE HIP
- +113 ;;960 D2;LE KNEE
- +114 ;;960 D3;LE FOOT
- +115 ;;960 E;THORACIC
- +116 ;;960 E1;THOR PACEMAKER/LEADS
- +117 ;;960 E2;THOR ICD/LEADS
- +118 ;;960 E3;THOR STENTS
- +119 ;;960 E4;THOR VALVE
- +120 ;;960 F;DENTAL IMPLANT
- +121 ;;960 G;ALL SCRWS,PLTS, ANCRS, ETC.
- +122 ;;960 X;SI UNKNOWNS (ALL)
- +123 ;;970;BIO IMPLANTS
- +124 ;;970 A;BIOLOGICAL IMPLANTS
- +125 ;;999;MISC
- +126 ;;999 A;AL/OTH ITEMS
- +127 ;;999 P1;PEDS DME
- +128 ;;999 P2;ALL OTHER PEDS
- +129 ;;999 X;HCPCS NOT GRP
- +130 ;;999 Z;NO HCPCS
- +131 ;;R07;HEARING AID, LOCAL REPAIRS
- +132 ;;R10;WHEELCHAIRS AND ACCESSORIES
- +133 ;;R10 A;WHEELCHAIR
- +134 ;;R10 B;CARRIERS
- +135 ;;R10 C;NSC VAN MODS
- +136 ;;R10 ;WHEELCHAIR
- +137 ;;R20;ARTIFICIAL LEGS
- +138 ;;R20 A;LEG A/K
- +139 ;;R20 B;LEG B/K, PTB
- +140 ;;R20 C;LEG B/K, STD
- +141 ;;R20 D;LEG ALL OTHER
- +142 ;;R30;ARTIFICIAL ARMS AND TERMINAL DEVICES
- +143 ;;R30 ;ART ARM,TOTAL
- +144 ;;R40;BRACES AND ORTHOTICS
- +145 ;;R40 ;BRACE TOTAL
- +146 ;;R50;SHOES/ORTHOTICS
- +147 ;;R50 A;ORTH SHOE ALL
- +148 ;;R50 B;SHOE MOD
- +149 ;;R50 C;A/O ITEM SERV
- +150 ;;R60;NEUROSENSORY AIDS
- +151 ;;R60 A;AID FOR BLIND
- +152 ;;R60 B;EYEGLASS RPR
- +153 ;;R60 C;HEARING AID
- +154 ;;R60 D;ASST LISTENING DEVICE
- +155 ;;R60 E;SPEECH DEVICES
- +156 ;;R70;HOME DIALYSIS EQUIPMENT
- +157 ;;R70 ;HOME DIAL EQU
- +158 ;;R80;MEDICAL EQUIPMENT
- +159 ;;R80 A;INVALID LIFTS
- +160 ;;R80 B;REPAIR TO ECU
- +161 ;;R80 C;MED EQUIP A/O
- +162 ;;R80 D;HME DELIVERY/PICKUP
- +163 ;;R80 E;TELEHEALTH
- +164 ;;R80 F;COMPUTERS
- +165 ;;R90;ALL OTHER
- +166 ;;R90 ;ALL OTHER
- +167 ;;R90 A;SHIPPING
- +168 ;;R90 B;TRAINING
- +169 ;;R91;O2 & RESPIRATORY
- +170 ;;R91 A;CONCENTRATOR
- +171 ;;R91 B;VENTILATOR
- +172 ;;R91 C;EQUIPMENT A/O
- +173 ;;R91 D;SERVICE VISIT
- +174 ;;R91 E;COMPRESSED O2
- +175 ;;R91 F;LIQUID O2
- +176 ;;R91 G;LIQUID DEL SYS
- +177 ;;R91 H;RESPIRATORY EQUIP
- +178 ;;R99 A;SHIPPING
- +179 ;;R99 B;NONRESPONSE
- +180 ;;R99 P;MISC PEDS
- +181 ;;R99 X;HCPCS NOT GRP
- +182 ;;R99 Z;NO HCPCS
- +183 ;;QUIT