IBDEI004 ; ; 01-AUG-2022
;;3.0;IB ENCOUNTER FORM IMP/EXP;;AUG 01, 2022
Q:'DIFQR(358.1) F I=1:2 S X=$T(Q+I) Q:X="" S Y=$E($T(Q+I+1),4,999),X=$E(X,4,999) S:$A(Y)=126 I=I+1,Y=$E(Y,2,999)_$E($T(Q+I+1),5,999) S:$A(Y)=61 Y=$E(Y,2,999) X NO E S @X=Y
Q Q
;;^UTILITY(U,$J,358.1)
;;=^IBE(358.1,
;;^UTILITY(U,$J,358.1,0)
;;=IMP/EXP ENCOUNTER FORM BLOCK^358.1I^171^167
;;^UTILITY(U,$J,358.1,1,0)
;;=HEADER^1^^1^57^50^1^^^2
;;^UTILITY(U,$J,358.1,2,0)
;;=PATIENT INFORMATION^1^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,3,0)
;;=CPT CODES^1^^7^0^132^9^^^1^FILL IN BUBBLE FOR TELEPHONE CALL PERFORMED^UBRC^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,4,0)
;;=ECOE ICD-10^1^^17^0^132^129^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
;;^UTILITY(U,$J,358.1,5,0)
;;=HEADER^2^^1^49^26^1^^^2
;;^UTILITY(U,$J,358.1,6,0)
;;=PATIENT INFORMATION^2^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,7,0)
;;=PREVENTIVE HEALTH ICD-10^2^^41^0^132^204^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,8,0)
;;=PROCEDURES (V2.1)^2^^7^0^133^33^^^1^MARK ALL PROCEDURES PERFORMED^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,9,0)
;;=CPT CODES^3^^17^0^132^23^^^1^PLEASE MARK PROCEDURES PERFORMED THIS VISIT^CR^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,10,0)
;;=HEADER^3^^1^49^23^1^^^2
;;^UTILITY(U,$J,358.1,11,0)
;;=PATIENT INFORMATION^3^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,12,0)
;;=1995 VISIT TYPE CODES (V2.1)^3^^7^0^132^9^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,13,0)
;;=SLEEP MEDICINE ICD-10^3^^41^0^132^124^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,14,0)
;;=CPT PROCEDURE^4^^21^0^133^159^^^1^MARK BUBBLE FOR ALL PROCEDURES PERFORMED TODAY^CRUB^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,15,0)
;;=1995 VISIT TYPE CODES (V2.1)^4^^6^0^132^14^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,16,0)
;;=HEADER^4^^1^44^39^1^^^2
;;^UTILITY(U,$J,358.1,17,0)
;;=PATIENT INFORMATION^4^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,18,0)
;;=ICD-10 DIAGNOSES (V1.0)^4^^181^0^132^494^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,19,0)
;;=1995 VISIT TYPE CODES (V2.1)^5^^7^0^132^8^^^1^^CRU^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,20,0)
;;=HEADER^5^^2^55^18^1^^^2
;;^UTILITY(U,$J,358.1,21,0)
;;=PATIENT INFORMATION^5^^4^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,22,0)
;;=CPT CODES^5^^16^0^132^69^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^BCU^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,23,0)
;;=NEUROLOGY ICD-10^5^^86^0^132^414^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,24,0)
;;=HEADER^6^^1^47^42^1^^^2
;;^UTILITY(U,$J,358.1,25,0)
;;=PATIENT INFORMATION^6^^4^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,26,0)
;;=1995 VISIT TYPE CODES (V2.1)^6^^7^0^132^5^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,27,0)
;;=PROCEDURES (V2.1)^6^^13^0^133^12^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,28,0)
;;=ADHC ICD-10^6^^26^0^132^284^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,29,0)
;;=HEADER^7^^1^56^20^1^^^2
;;^UTILITY(U,$J,358.1,30,0)
;;=PATIENT INFORMATION^7^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,31,0)
;;=CPT CODES^7^^7^0^132^23^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^BC^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,32,0)
;;=BLIND REHAB ICD-10^7^^31^0^132^174^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,33,0)
;;=HEADER^8^^1^49^19^1^^^2
;;^UTILITY(U,$J,358.1,34,0)
;;=PATIENT INFORMATION^8^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,35,0)
;;=1995 VISIT TYPE CODES (V2.1)^8^^7^0^132^9^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,36,0)
;;=CARDIOLOGY/CARDIAC CATH ICD-10^8^^511^0^132^509^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,37,0)
;;=CARDIOLOGY PROCEDURES^8^^17^0^132^493^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^CR^EPS PROCEDURES^0
;;^UTILITY(U,$J,358.1,38,0)
;;=1995 VISIT TYPE CODES (V2.1)^9^^6^0^132^9^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,39,0)
;;=HEADER^9^^1^56^21^1^^^2
;;^UTILITY(U,$J,358.1,40,0)
;;=PATIENT INFORMATION^9^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,41,0)
;;=PROCEDURES (V2.1)^9^^15^0^133^30^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,42,0)
;;=CHIROPRACTIC ICD-10^9^^46^0^132^259^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,43,0)
;;=HEADER^10^^1^57^28^1^^^2
;;^UTILITY(U,$J,358.1,44,0)
;;=PATIENT INFORMATION^10^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,45,0)
;;=PROCEDURES (V2.1)^10^^7^0^133^23^^^1^MANAGEMENT OF MEDICATION THERAPY^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,46,0)
;;=CLINICAL PHARMACIST ICD-10^10^^31^0^132^179^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,47,0)
;;=1995 VISIT TYPE CODES (V2.1)^11^^5^0^132^20^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,48,0)
;;=PATIENT INFORMATION^11^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,49,0)
;;=HEADER^11^^1^49^17^1^^^2
;;^UTILITY(U,$J,358.1,50,0)
;;=CPT CODES (3 COL)^11^^26^0^132^24^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^BCU^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,51,0)
;;=DIABETES ICD-10^11^^51^0^132^354^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,52,0)
;;=PROCEDURES (V2.1)^12^^21^0^133^124^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,53,0)
;;=1995 VISIT TYPE CODES (V2.1)^12^^6^0^132^14^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,54,0)
;;=HEADER^12^^1^56^29^1^^^2
;;^UTILITY(U,$J,358.1,55,0)
;;=PATIENT INFORMATION^12^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,56,0)
;;=EMERGENCY DEPT ICD-10^12^^146^0^132^829^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,57,0)
;;=1995 VISIT TYPE CODES (V2.1)^13^^6^0^132^9^^^1^^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,58,0)
;;=HEADER^13^^1^54^22^1^^^2
;;^UTILITY(U,$J,358.1,59,0)
;;=PATIENT INFORMATION^13^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,60,0)
;;=ENDOCRINE ICD-10^13^^47^0^132^263^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,61,0)
;;=CPT CODES^13^^16^0^132^30^^^1^MARK PROCEDURE(S) PERFORMED THIS VISIT^RC^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,62,0)
;;=HEADER^14^^1^54^23^1^^^2
;;^UTILITY(U,$J,358.1,63,0)
;;=PATIENT INFORMATION^14^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,64,0)
;;=PROCEDURES (V2.1)^14^^7^0^133^43^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,65,0)
;;=EYE/TELERETINAL ICD-10^14^^51^0^132^759^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,66,0)
;;=HEADER^15^^1^60^12^1^^^2
;;^UTILITY(U,$J,358.1,67,0)
;;=PATIENT INFORMATION^15^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,68,0)
;;=1995 VISIT TYPE CODES (V2.1)^15^^6^0^132^34^^^1^^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,69,0)
;;=PROCEDURES (V2.1)^15^^41^0^133^219^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,70,0)
;;=EYE/TELERETINAL ICD-10^15^^261^0^132^759^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
;;^UTILITY(U,$J,358.1,71,0)
;;=1995 VISIT TYPE CODES (V2.1)^16^^6^0^132^9^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,72,0)
;;=HEADER^16^^1^54^22^1^^^2
;;^UTILITY(U,$J,358.1,73,0)
;;=PATIENT INFORMATION^16^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,74,0)
;;=ICD-10 DIAGNOSES (V1.0)^16^^106^0^132^709^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,75,0)
;;=CPT CODES (3 COL)^16^^15^0^132^90^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^BCU^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,76,0)
;;=HEADER^17^^1^58^23^1^^^2
;;^UTILITY(U,$J,358.1,77,0)
;;=PATIENT INFORMATION^17^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,78,0)
;;=1995 VISIT TYPE CODES (V2.1)^17^^6^0^132^14^^^1^TYPE OF HOME VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,79,0)
;;=PRIMARY CARE ICD-10^17^^101^0^132^2754^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,80,0)
;;=PROCEDURES (V2.1)^17^^21^0^133^79^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,81,0)
;;=PATIENT INFORMATION^18^^4^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,82,0)
;;=PROCEDURE CODES^18^^7^0^132^48^^^1^PLEASE CHECK OFF PROCEDURE CODES PERFORMED AT THIS VISIT^CU^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,83,0)
;;=HEADER^18^^1^56^21^1^^^2
;;^UTILITY(U,$J,358.1,84,0)
;;=NURSING ICD-10^18^^56^0^132^644^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
;;^UTILITY(U,$J,358.1,85,0)
;;=PROCEDURES (V2.1)^19^^6^0^133^34^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,86,0)
;;=HEADER^19^^1^49^29^1^^^2
;;^UTILITY(U,$J,358.1,87,0)
;;=PATIENT INFORMATION^19^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,88,0)
;;=REHAB ICD-10 CODES^19^^41^0^132^1419^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,89,0)
;;=1995 VISIT TYPE CODES (V2.1)^20^^6^0^132^29^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,90,0)
;;=HEADER^20^^1^57^18^1^^^2
;;^UTILITY(U,$J,358.1,91,0)
;;=PATIENT INFORMATION^20^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,92,0)
;;=PROCEDURES (V2.1)^20^^36^0^133^24^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,93,0)
;;=INPATIENT ICD-10^20^^61^0^132^1189^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,94,0)
;;=1995 VISIT TYPE CODES (V2.1)^21^^6^0^132^19^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,95,0)
;;=HEADER^21^^1^56^17^1^^^2
;;^UTILITY(U,$J,358.1,96,0)
;;=PATIENT INFORMATION^21^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,97,0)
;;=PROCEDURES (V2.1)^21^^26^0^133^94^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,98,0)
;;=PRIMARY CARE ICD-10^21^^121^0^132^2754^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,99,0)
;;=HEADER^22^^1^46^24^1^^^2
;;^UTILITY(U,$J,358.1,100,0)
;;=PATIENT INFORMATION^22^^4^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,101,0)
;;=1995 VISIT TYPE CODES (V2.1)^22^^7^0^132^6^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,102,0)
;;=PROCEDURES (V2.1)^22^^14^0^133^126^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,103,0)
;;=NURSING ICD-10^22^^141^0^132^644^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,104,0)
;;=WOMEN'S CLINIC PROCEDURES^23^^19^0^132^76^^^1^PROCEDURES^CR^WOMEN'S CLINIC PROCEDURES^0
;;^UTILITY(U,$J,358.1,105,0)
;;=PATIENT INFORMATION^23^^3^1^132^3^^^2^^^Patient information-name/ssn/age^0
;;^UTILITY(U,$J,358.1,106,0)
;;=HEADER^23^^1^49^30^1^^^2
;;^UTILITY(U,$J,358.1,107,0)
;;=1995 VISIT TYPE CODES (V2.1)^23^^7^0^132^11^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,108,0)
;;=ICD-10 DIAGNOSES (V1.0)^23^^96^0^132^1149^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,109,0)
;;=1995 VISIT TYPE CODES (V2.1)^24^^6^0^132^14^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,110,0)
;;=PROCEDURES (V2.1)^24^^21^0^133^84^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,111,0)
;;=HEADER^24^^1^58^34^1^^^2
;;^UTILITY(U,$J,358.1,112,0)
;;=PATIENT INFORMATION^24^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,113,0)
;;=ICD-10 DIAGNOSES (V1.0)^24^^106^0^132^894^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,114,0)
;;=1995 VISIT TYPE CODES (V2.1)^25^^6^0^132^9^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,115,0)
;;=HEADER^25^^1^58^24^1^^^2
;;^UTILITY(U,$J,358.1,116,0)
;;=PATIENT INFORMATION^25^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,117,0)
;;=PROCEDURES (V2.1)^25^^16^0^133^59^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,118,0)
;;=ICD-10 DIAGNOSES (V1.0)^25^^81^0^132^894^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
;;^UTILITY(U,$J,358.1,119,0)
;;=HEADER^26^^1^56^21^1^^^2
;;^UTILITY(U,$J,358.1,120,0)
;;=PATIENT INFORMATION^26^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,121,0)
;;=PROCEDURES (V2.1)^26^^27^0^133^133^^^1^MARK ALL PROCEDURES PERFORMED^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,122,0)
;;=1995 VISIT TYPE CODES (V2.1)^26^^6^0^132^20^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,123,0)
;;=PRIMARY CARE ICD-10^26^^161^0^132^2754^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
;;^UTILITY(U,$J,358.1,124,0)
;;=CPT CODES^27^^16^0^132^63^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^BC^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,125,0)
;;=1995 VISIT TYPE CODES (V2.1)^27^^5^0^132^10^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,126,0)
;;=HEADER^27^^1^57^18^1^^^2
;;^UTILITY(U,$J,358.1,127,0)
;;=PATIENT INFORMATION^27^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,128,0)
;;=RESPIRATORY THERAPY ICD-10^27^^81^0^132^949^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,129,0)
;;=HEADER^28^^1^52^27^1^^^2
;;^UTILITY(U,$J,358.1,130,0)
;;=PATIENT INFORMATION^28^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,131,0)
;;=PROCEDURES (V2.1)^28^^26^0^133^74^^^1^MARK ALL PROCEDURES PERFORMED^CR^Common CPT-4 procedures^0
;;^UTILITY(U,$J,358.1,132,0)
;;=1995 VISIT TYPE CODES (V2.1)^28^^6^0^132^19^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,133,0)
;;=SCI ICD-10^28^^101^0^132^369^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,134,0)
;;=HEADER^29^^1^59^26^1^^^2
;;^UTILITY(U,$J,358.1,135,0)
;;=PATIENT INFORMATION^29^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,136,0)
;;=CPT CODES^29^^7^0^132^13^^^1^FILL IN BUBBLE FOR TELEPHONE CALL PERFORMED^UBRC^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,137,0)
;;=TELEPHONE ICD-10^29^^21^0^132^109^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,138,0)
;;=PATIENT INFORMATION^30^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,139,0)
;;=HEADER^30^^1^49^17^1^^^2
;;^UTILITY(U,$J,358.1,140,0)
;;=CPT CODES (3 COL)^30^^7^0^132^8^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^BCU^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,141,0)
;;=EYE/TELERETINAL ICD-10^30^^16^0^132^759^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
;;^UTILITY(U,$J,358.1,142,0)
;;=1995 VISIT TYPE CODES (V2.1)^31^^6^0^132^14^^^1^^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,143,0)
;;=HEADER^31^^1^54^19^1^^^2
;;^UTILITY(U,$J,358.1,144,0)
;;=PATIENT INFORMATION^31^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,145,0)
;;=ANESTHESIA ICD-10^31^^206^0^132^406^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,146,0)
;;=CPT CODES^31^^21^0^132^184^^^1^MARK PROCEDURE(S) PERFORMED THIS VISIT^RC^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,147,0)
;;=CPT CODES^32^^26^0^132^14^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^CU^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,148,0)
;;=PATIENT INFORMATION^32^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,149,0)
;;=HEADER^32^^1^48^42^1^^^2
;;^UTILITY(U,$J,358.1,150,0)
;;=HOSPICE/PALLIATIVE CARE ICD-10^32^^41^0^132^364^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,151,0)
;;=1995 VISIT TYPE CODES (V2.1)^32^^6^0^132^19^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,152,0)
;;=CPT CODES^33^^16^0^132^19^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^CU^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,153,0)
;;=PATIENT INFORMATION^33^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,154,0)
;;=1995 VISIT TYPE CODES (V2.1)^33^^6^0^132^9^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
;;^UTILITY(U,$J,358.1,155,0)
;;=HEADER^33^^1^48^43^1^^^2
;;^UTILITY(U,$J,358.1,156,0)
;;=HOSPICE/PALLIATIVE CARE ICD-10^33^^36^0^132^364^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
;;^UTILITY(U,$J,358.1,157,0)
;;=HEADER^34^^1^54^35^1^^^2
;;^UTILITY(U,$J,358.1,158,0)
;;=PATIENT INFORMATION^34^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,159,0)
;;=COVID-19 ICD CODES^34^^7^0^132^48^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
;;^UTILITY(U,$J,358.1,160,0)
;;=HEADER^35^^1^49^45^1^^^2
;;^UTILITY(U,$J,358.1,161,0)
;;=PATIENT INFORMATION^35^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,162,0)
;;=CPT CODES^35^^7^0^132^48^^^1^MARK PROCEDURE(S) PERFORMED THIS VISIT^RC^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,163,0)
;;=COVID-19 ICD CODES^35^^56^0^132^48^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
;;^UTILITY(U,$J,358.1,168,0)
;;=PATIENT INFORMATION^37^^3^0^132^3^^^2^^^Patient information-name/ssn/age
;;^UTILITY(U,$J,358.1,169,0)
;;=HEADER^37^^1^49^26^1^^^2
;;^UTILITY(U,$J,358.1,170,0)
;;=CPT CODES (3 COL)^37^^7^0^132^13^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^BCU^Selection list - CPT codes^0
;;^UTILITY(U,$J,358.1,171,0)
;;=DIABETES ICD-10^37^^21^0^132^19^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HIBDEI004 18462 printed Sep 23, 2025@19:14:58 Page 2
IBDEI004 ; ; 01-AUG-2022
+1 ;;3.0;IB ENCOUNTER FORM IMP/EXP;;AUG 01, 2022
+2 if 'DIFQR(358.1)
QUIT
FOR I=1:2
SET X=$TEXT(Q+I)
if X=""
QUIT
SET Y=$EXTRACT($TEXT(Q+I+1),4,999)
SET X=$EXTRACT(X,4,999)
if $ASCII(Y)=126
SET I=I+1
SET Y=$EXTRACT(Y,2,999)_$EXTRACT($TEXT(Q+I+1),5,999)
if $ASCII(Y)=61
SET Y=$EXTRACT(Y,2,999)
XECUTE NO
IF '$TEST
SET @X=Y
Q QUIT
+1 ;;^UTILITY(U,$J,358.1)
+2 ;;=^IBE(358.1,
+3 ;;^UTILITY(U,$J,358.1,0)
+4 ;;=IMP/EXP ENCOUNTER FORM BLOCK^358.1I^171^167
+5 ;;^UTILITY(U,$J,358.1,1,0)
+6 ;;=HEADER^1^^1^57^50^1^^^2
+7 ;;^UTILITY(U,$J,358.1,2,0)
+8 ;;=PATIENT INFORMATION^1^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+9 ;;^UTILITY(U,$J,358.1,3,0)
+10 ;;=CPT CODES^1^^7^0^132^9^^^1^FILL IN BUBBLE FOR TELEPHONE CALL PERFORMED^UBRC^Selection list - CPT codes^0
+11 ;;^UTILITY(U,$J,358.1,4,0)
+12 ;;=ECOE ICD-10^1^^17^0^132^129^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
+13 ;;^UTILITY(U,$J,358.1,5,0)
+14 ;;=HEADER^2^^1^49^26^1^^^2
+15 ;;^UTILITY(U,$J,358.1,6,0)
+16 ;;=PATIENT INFORMATION^2^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+17 ;;^UTILITY(U,$J,358.1,7,0)
+18 ;;=PREVENTIVE HEALTH ICD-10^2^^41^0^132^204^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+19 ;;^UTILITY(U,$J,358.1,8,0)
+20 ;;=PROCEDURES (V2.1)^2^^7^0^133^33^^^1^MARK ALL PROCEDURES PERFORMED^CR^Common CPT-4 procedures^0
+21 ;;^UTILITY(U,$J,358.1,9,0)
+22 ;;=CPT CODES^3^^17^0^132^23^^^1^PLEASE MARK PROCEDURES PERFORMED THIS VISIT^CR^Selection list - CPT codes^0
+23 ;;^UTILITY(U,$J,358.1,10,0)
+24 ;;=HEADER^3^^1^49^23^1^^^2
+25 ;;^UTILITY(U,$J,358.1,11,0)
+26 ;;=PATIENT INFORMATION^3^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+27 ;;^UTILITY(U,$J,358.1,12,0)
+28 ;;=1995 VISIT TYPE CODES (V2.1)^3^^7^0^132^9^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+29 ;;^UTILITY(U,$J,358.1,13,0)
+30 ;;=SLEEP MEDICINE ICD-10^3^^41^0^132^124^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+31 ;;^UTILITY(U,$J,358.1,14,0)
+32 ;;=CPT PROCEDURE^4^^21^0^133^159^^^1^MARK BUBBLE FOR ALL PROCEDURES PERFORMED TODAY^CRUB^Common CPT-4 procedures^0
+33 ;;^UTILITY(U,$J,358.1,15,0)
+34 ;;=1995 VISIT TYPE CODES (V2.1)^4^^6^0^132^14^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+35 ;;^UTILITY(U,$J,358.1,16,0)
+36 ;;=HEADER^4^^1^44^39^1^^^2
+37 ;;^UTILITY(U,$J,358.1,17,0)
+38 ;;=PATIENT INFORMATION^4^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+39 ;;^UTILITY(U,$J,358.1,18,0)
+40 ;;=ICD-10 DIAGNOSES (V1.0)^4^^181^0^132^494^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+41 ;;^UTILITY(U,$J,358.1,19,0)
+42 ;;=1995 VISIT TYPE CODES (V2.1)^5^^7^0^132^8^^^1^^CRU^1995 visit types WITH CODES SHOWN^0
+43 ;;^UTILITY(U,$J,358.1,20,0)
+44 ;;=HEADER^5^^2^55^18^1^^^2
+45 ;;^UTILITY(U,$J,358.1,21,0)
+46 ;;=PATIENT INFORMATION^5^^4^0^132^3^^^2^^^Patient information-name/ssn/age
+47 ;;^UTILITY(U,$J,358.1,22,0)
+48 ;;=CPT CODES^5^^16^0^132^69^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^BCU^Selection list - CPT codes^0
+49 ;;^UTILITY(U,$J,358.1,23,0)
+50 ;;=NEUROLOGY ICD-10^5^^86^0^132^414^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+51 ;;^UTILITY(U,$J,358.1,24,0)
+52 ;;=HEADER^6^^1^47^42^1^^^2
+53 ;;^UTILITY(U,$J,358.1,25,0)
+54 ;;=PATIENT INFORMATION^6^^4^0^132^3^^^2^^^Patient information-name/ssn/age
+55 ;;^UTILITY(U,$J,358.1,26,0)
+56 ;;=1995 VISIT TYPE CODES (V2.1)^6^^7^0^132^5^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+57 ;;^UTILITY(U,$J,358.1,27,0)
+58 ;;=PROCEDURES (V2.1)^6^^13^0^133^12^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
+59 ;;^UTILITY(U,$J,358.1,28,0)
+60 ;;=ADHC ICD-10^6^^26^0^132^284^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+61 ;;^UTILITY(U,$J,358.1,29,0)
+62 ;;=HEADER^7^^1^56^20^1^^^2
+63 ;;^UTILITY(U,$J,358.1,30,0)
+64 ;;=PATIENT INFORMATION^7^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+65 ;;^UTILITY(U,$J,358.1,31,0)
+66 ;;=CPT CODES^7^^7^0^132^23^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^BC^Selection list - CPT codes^0
+67 ;;^UTILITY(U,$J,358.1,32,0)
+68 ;;=BLIND REHAB ICD-10^7^^31^0^132^174^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+69 ;;^UTILITY(U,$J,358.1,33,0)
+70 ;;=HEADER^8^^1^49^19^1^^^2
+71 ;;^UTILITY(U,$J,358.1,34,0)
+72 ;;=PATIENT INFORMATION^8^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+73 ;;^UTILITY(U,$J,358.1,35,0)
+74 ;;=1995 VISIT TYPE CODES (V2.1)^8^^7^0^132^9^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+75 ;;^UTILITY(U,$J,358.1,36,0)
+76 ;;=CARDIOLOGY/CARDIAC CATH ICD-10^8^^511^0^132^509^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+77 ;;^UTILITY(U,$J,358.1,37,0)
+78 ;;=CARDIOLOGY PROCEDURES^8^^17^0^132^493^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^CR^EPS PROCEDURES^0
+79 ;;^UTILITY(U,$J,358.1,38,0)
+80 ;;=1995 VISIT TYPE CODES (V2.1)^9^^6^0^132^9^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+81 ;;^UTILITY(U,$J,358.1,39,0)
+82 ;;=HEADER^9^^1^56^21^1^^^2
+83 ;;^UTILITY(U,$J,358.1,40,0)
+84 ;;=PATIENT INFORMATION^9^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+85 ;;^UTILITY(U,$J,358.1,41,0)
+86 ;;=PROCEDURES (V2.1)^9^^15^0^133^30^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
+87 ;;^UTILITY(U,$J,358.1,42,0)
+88 ;;=CHIROPRACTIC ICD-10^9^^46^0^132^259^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+89 ;;^UTILITY(U,$J,358.1,43,0)
+90 ;;=HEADER^10^^1^57^28^1^^^2
+91 ;;^UTILITY(U,$J,358.1,44,0)
+92 ;;=PATIENT INFORMATION^10^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+93 ;;^UTILITY(U,$J,358.1,45,0)
+94 ;;=PROCEDURES (V2.1)^10^^7^0^133^23^^^1^MANAGEMENT OF MEDICATION THERAPY^CR^Common CPT-4 procedures^0
+95 ;;^UTILITY(U,$J,358.1,46,0)
+96 ;;=CLINICAL PHARMACIST ICD-10^10^^31^0^132^179^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+97 ;;^UTILITY(U,$J,358.1,47,0)
+98 ;;=1995 VISIT TYPE CODES (V2.1)^11^^5^0^132^20^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+99 ;;^UTILITY(U,$J,358.1,48,0)
+100 ;;=PATIENT INFORMATION^11^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+101 ;;^UTILITY(U,$J,358.1,49,0)
+102 ;;=HEADER^11^^1^49^17^1^^^2
+103 ;;^UTILITY(U,$J,358.1,50,0)
+104 ;;=CPT CODES (3 COL)^11^^26^0^132^24^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^BCU^Selection list - CPT codes^0
+105 ;;^UTILITY(U,$J,358.1,51,0)
+106 ;;=DIABETES ICD-10^11^^51^0^132^354^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+107 ;;^UTILITY(U,$J,358.1,52,0)
+108 ;;=PROCEDURES (V2.1)^12^^21^0^133^124^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
+109 ;;^UTILITY(U,$J,358.1,53,0)
+110 ;;=1995 VISIT TYPE CODES (V2.1)^12^^6^0^132^14^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+111 ;;^UTILITY(U,$J,358.1,54,0)
+112 ;;=HEADER^12^^1^56^29^1^^^2
+113 ;;^UTILITY(U,$J,358.1,55,0)
+114 ;;=PATIENT INFORMATION^12^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+115 ;;^UTILITY(U,$J,358.1,56,0)
+116 ;;=EMERGENCY DEPT ICD-10^12^^146^0^132^829^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+117 ;;^UTILITY(U,$J,358.1,57,0)
+118 ;;=1995 VISIT TYPE CODES (V2.1)^13^^6^0^132^9^^^1^^CR^1995 visit types WITH CODES SHOWN^0
+119 ;;^UTILITY(U,$J,358.1,58,0)
+120 ;;=HEADER^13^^1^54^22^1^^^2
+121 ;;^UTILITY(U,$J,358.1,59,0)
+122 ;;=PATIENT INFORMATION^13^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+123 ;;^UTILITY(U,$J,358.1,60,0)
+124 ;;=ENDOCRINE ICD-10^13^^47^0^132^263^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+125 ;;^UTILITY(U,$J,358.1,61,0)
+126 ;;=CPT CODES^13^^16^0^132^30^^^1^MARK PROCEDURE(S) PERFORMED THIS VISIT^RC^Selection list - CPT codes^0
+127 ;;^UTILITY(U,$J,358.1,62,0)
+128 ;;=HEADER^14^^1^54^23^1^^^2
+129 ;;^UTILITY(U,$J,358.1,63,0)
+130 ;;=PATIENT INFORMATION^14^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+131 ;;^UTILITY(U,$J,358.1,64,0)
+132 ;;=PROCEDURES (V2.1)^14^^7^0^133^43^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
+133 ;;^UTILITY(U,$J,358.1,65,0)
+134 ;;=EYE/TELERETINAL ICD-10^14^^51^0^132^759^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+135 ;;^UTILITY(U,$J,358.1,66,0)
+136 ;;=HEADER^15^^1^60^12^1^^^2
+137 ;;^UTILITY(U,$J,358.1,67,0)
+138 ;;=PATIENT INFORMATION^15^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+139 ;;^UTILITY(U,$J,358.1,68,0)
+140 ;;=1995 VISIT TYPE CODES (V2.1)^15^^6^0^132^34^^^1^^CR^1995 visit types WITH CODES SHOWN^0
+141 ;;^UTILITY(U,$J,358.1,69,0)
+142 ;;=PROCEDURES (V2.1)^15^^41^0^133^219^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
+143 ;;^UTILITY(U,$J,358.1,70,0)
+144 ;;=EYE/TELERETINAL ICD-10^15^^261^0^132^759^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
+145 ;;^UTILITY(U,$J,358.1,71,0)
+146 ;;=1995 VISIT TYPE CODES (V2.1)^16^^6^0^132^9^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+147 ;;^UTILITY(U,$J,358.1,72,0)
+148 ;;=HEADER^16^^1^54^22^1^^^2
+149 ;;^UTILITY(U,$J,358.1,73,0)
+150 ;;=PATIENT INFORMATION^16^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+151 ;;^UTILITY(U,$J,358.1,74,0)
+152 ;;=ICD-10 DIAGNOSES (V1.0)^16^^106^0^132^709^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+153 ;;^UTILITY(U,$J,358.1,75,0)
+154 ;;=CPT CODES (3 COL)^16^^15^0^132^90^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^BCU^Selection list - CPT codes^0
+155 ;;^UTILITY(U,$J,358.1,76,0)
+156 ;;=HEADER^17^^1^58^23^1^^^2
+157 ;;^UTILITY(U,$J,358.1,77,0)
+158 ;;=PATIENT INFORMATION^17^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+159 ;;^UTILITY(U,$J,358.1,78,0)
+160 ;;=1995 VISIT TYPE CODES (V2.1)^17^^6^0^132^14^^^1^TYPE OF HOME VISIT^CR^1995 visit types WITH CODES SHOWN^0
+161 ;;^UTILITY(U,$J,358.1,79,0)
+162 ;;=PRIMARY CARE ICD-10^17^^101^0^132^2754^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+163 ;;^UTILITY(U,$J,358.1,80,0)
+164 ;;=PROCEDURES (V2.1)^17^^21^0^133^79^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
+165 ;;^UTILITY(U,$J,358.1,81,0)
+166 ;;=PATIENT INFORMATION^18^^4^0^132^3^^^2^^^Patient information-name/ssn/age
+167 ;;^UTILITY(U,$J,358.1,82,0)
+168 ;;=PROCEDURE CODES^18^^7^0^132^48^^^1^PLEASE CHECK OFF PROCEDURE CODES PERFORMED AT THIS VISIT^CU^Selection list - CPT codes^0
+169 ;;^UTILITY(U,$J,358.1,83,0)
+170 ;;=HEADER^18^^1^56^21^1^^^2
+171 ;;^UTILITY(U,$J,358.1,84,0)
+172 ;;=NURSING ICD-10^18^^56^0^132^644^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
+173 ;;^UTILITY(U,$J,358.1,85,0)
+174 ;;=PROCEDURES (V2.1)^19^^6^0^133^34^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
+175 ;;^UTILITY(U,$J,358.1,86,0)
+176 ;;=HEADER^19^^1^49^29^1^^^2
+177 ;;^UTILITY(U,$J,358.1,87,0)
+178 ;;=PATIENT INFORMATION^19^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+179 ;;^UTILITY(U,$J,358.1,88,0)
+180 ;;=REHAB ICD-10 CODES^19^^41^0^132^1419^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+181 ;;^UTILITY(U,$J,358.1,89,0)
+182 ;;=1995 VISIT TYPE CODES (V2.1)^20^^6^0^132^29^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+183 ;;^UTILITY(U,$J,358.1,90,0)
+184 ;;=HEADER^20^^1^57^18^1^^^2
+185 ;;^UTILITY(U,$J,358.1,91,0)
+186 ;;=PATIENT INFORMATION^20^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+187 ;;^UTILITY(U,$J,358.1,92,0)
+188 ;;=PROCEDURES (V2.1)^20^^36^0^133^24^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
+189 ;;^UTILITY(U,$J,358.1,93,0)
+190 ;;=INPATIENT ICD-10^20^^61^0^132^1189^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+191 ;;^UTILITY(U,$J,358.1,94,0)
+192 ;;=1995 VISIT TYPE CODES (V2.1)^21^^6^0^132^19^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+193 ;;^UTILITY(U,$J,358.1,95,0)
+194 ;;=HEADER^21^^1^56^17^1^^^2
+195 ;;^UTILITY(U,$J,358.1,96,0)
+196 ;;=PATIENT INFORMATION^21^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+197 ;;^UTILITY(U,$J,358.1,97,0)
+198 ;;=PROCEDURES (V2.1)^21^^26^0^133^94^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
+199 ;;^UTILITY(U,$J,358.1,98,0)
+200 ;;=PRIMARY CARE ICD-10^21^^121^0^132^2754^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+201 ;;^UTILITY(U,$J,358.1,99,0)
+202 ;;=HEADER^22^^1^46^24^1^^^2
+203 ;;^UTILITY(U,$J,358.1,100,0)
+204 ;;=PATIENT INFORMATION^22^^4^0^132^3^^^2^^^Patient information-name/ssn/age
+205 ;;^UTILITY(U,$J,358.1,101,0)
+206 ;;=1995 VISIT TYPE CODES (V2.1)^22^^7^0^132^6^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+207 ;;^UTILITY(U,$J,358.1,102,0)
+208 ;;=PROCEDURES (V2.1)^22^^14^0^133^126^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
+209 ;;^UTILITY(U,$J,358.1,103,0)
+210 ;;=NURSING ICD-10^22^^141^0^132^644^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+211 ;;^UTILITY(U,$J,358.1,104,0)
+212 ;;=WOMEN'S CLINIC PROCEDURES^23^^19^0^132^76^^^1^PROCEDURES^CR^WOMEN'S CLINIC PROCEDURES^0
+213 ;;^UTILITY(U,$J,358.1,105,0)
+214 ;;=PATIENT INFORMATION^23^^3^1^132^3^^^2^^^Patient information-name/ssn/age^0
+215 ;;^UTILITY(U,$J,358.1,106,0)
+216 ;;=HEADER^23^^1^49^30^1^^^2
+217 ;;^UTILITY(U,$J,358.1,107,0)
+218 ;;=1995 VISIT TYPE CODES (V2.1)^23^^7^0^132^11^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+219 ;;^UTILITY(U,$J,358.1,108,0)
+220 ;;=ICD-10 DIAGNOSES (V1.0)^23^^96^0^132^1149^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+221 ;;^UTILITY(U,$J,358.1,109,0)
+222 ;;=1995 VISIT TYPE CODES (V2.1)^24^^6^0^132^14^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+223 ;;^UTILITY(U,$J,358.1,110,0)
+224 ;;=PROCEDURES (V2.1)^24^^21^0^133^84^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
+225 ;;^UTILITY(U,$J,358.1,111,0)
+226 ;;=HEADER^24^^1^58^34^1^^^2
+227 ;;^UTILITY(U,$J,358.1,112,0)
+228 ;;=PATIENT INFORMATION^24^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+229 ;;^UTILITY(U,$J,358.1,113,0)
+230 ;;=ICD-10 DIAGNOSES (V1.0)^24^^106^0^132^894^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+231 ;;^UTILITY(U,$J,358.1,114,0)
+232 ;;=1995 VISIT TYPE CODES (V2.1)^25^^6^0^132^9^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+233 ;;^UTILITY(U,$J,358.1,115,0)
+234 ;;=HEADER^25^^1^58^24^1^^^2
+235 ;;^UTILITY(U,$J,358.1,116,0)
+236 ;;=PATIENT INFORMATION^25^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+237 ;;^UTILITY(U,$J,358.1,117,0)
+238 ;;=PROCEDURES (V2.1)^25^^16^0^133^59^^^1^PROCEDURES^CR^Common CPT-4 procedures^0
+239 ;;^UTILITY(U,$J,358.1,118,0)
+240 ;;=ICD-10 DIAGNOSES (V1.0)^25^^81^0^132^894^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
+241 ;;^UTILITY(U,$J,358.1,119,0)
+242 ;;=HEADER^26^^1^56^21^1^^^2
+243 ;;^UTILITY(U,$J,358.1,120,0)
+244 ;;=PATIENT INFORMATION^26^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+245 ;;^UTILITY(U,$J,358.1,121,0)
+246 ;;=PROCEDURES (V2.1)^26^^27^0^133^133^^^1^MARK ALL PROCEDURES PERFORMED^CR^Common CPT-4 procedures^0
+247 ;;^UTILITY(U,$J,358.1,122,0)
+248 ;;=1995 VISIT TYPE CODES (V2.1)^26^^6^0^132^20^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+249 ;;^UTILITY(U,$J,358.1,123,0)
+250 ;;=PRIMARY CARE ICD-10^26^^161^0^132^2754^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
+251 ;;^UTILITY(U,$J,358.1,124,0)
+252 ;;=CPT CODES^27^^16^0^132^63^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^BC^Selection list - CPT codes^0
+253 ;;^UTILITY(U,$J,358.1,125,0)
+254 ;;=1995 VISIT TYPE CODES (V2.1)^27^^5^0^132^10^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+255 ;;^UTILITY(U,$J,358.1,126,0)
+256 ;;=HEADER^27^^1^57^18^1^^^2
+257 ;;^UTILITY(U,$J,358.1,127,0)
+258 ;;=PATIENT INFORMATION^27^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+259 ;;^UTILITY(U,$J,358.1,128,0)
+260 ;;=RESPIRATORY THERAPY ICD-10^27^^81^0^132^949^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+261 ;;^UTILITY(U,$J,358.1,129,0)
+262 ;;=HEADER^28^^1^52^27^1^^^2
+263 ;;^UTILITY(U,$J,358.1,130,0)
+264 ;;=PATIENT INFORMATION^28^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+265 ;;^UTILITY(U,$J,358.1,131,0)
+266 ;;=PROCEDURES (V2.1)^28^^26^0^133^74^^^1^MARK ALL PROCEDURES PERFORMED^CR^Common CPT-4 procedures^0
+267 ;;^UTILITY(U,$J,358.1,132,0)
+268 ;;=1995 VISIT TYPE CODES (V2.1)^28^^6^0^132^19^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+269 ;;^UTILITY(U,$J,358.1,133,0)
+270 ;;=SCI ICD-10^28^^101^0^132^369^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+271 ;;^UTILITY(U,$J,358.1,134,0)
+272 ;;=HEADER^29^^1^59^26^1^^^2
+273 ;;^UTILITY(U,$J,358.1,135,0)
+274 ;;=PATIENT INFORMATION^29^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+275 ;;^UTILITY(U,$J,358.1,136,0)
+276 ;;=CPT CODES^29^^7^0^132^13^^^1^FILL IN BUBBLE FOR TELEPHONE CALL PERFORMED^UBRC^Selection list - CPT codes^0
+277 ;;^UTILITY(U,$J,358.1,137,0)
+278 ;;=TELEPHONE ICD-10^29^^21^0^132^109^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+279 ;;^UTILITY(U,$J,358.1,138,0)
+280 ;;=PATIENT INFORMATION^30^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+281 ;;^UTILITY(U,$J,358.1,139,0)
+282 ;;=HEADER^30^^1^49^17^1^^^2
+283 ;;^UTILITY(U,$J,358.1,140,0)
+284 ;;=CPT CODES (3 COL)^30^^7^0^132^8^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^BCU^Selection list - CPT codes^0
+285 ;;^UTILITY(U,$J,358.1,141,0)
+286 ;;=EYE/TELERETINAL ICD-10^30^^16^0^132^759^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
+287 ;;^UTILITY(U,$J,358.1,142,0)
+288 ;;=1995 VISIT TYPE CODES (V2.1)^31^^6^0^132^14^^^1^^CR^1995 visit types WITH CODES SHOWN^0
+289 ;;^UTILITY(U,$J,358.1,143,0)
+290 ;;=HEADER^31^^1^54^19^1^^^2
+291 ;;^UTILITY(U,$J,358.1,144,0)
+292 ;;=PATIENT INFORMATION^31^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+293 ;;^UTILITY(U,$J,358.1,145,0)
+294 ;;=ANESTHESIA ICD-10^31^^206^0^132^406^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+295 ;;^UTILITY(U,$J,358.1,146,0)
+296 ;;=CPT CODES^31^^21^0^132^184^^^1^MARK PROCEDURE(S) PERFORMED THIS VISIT^RC^Selection list - CPT codes^0
+297 ;;^UTILITY(U,$J,358.1,147,0)
+298 ;;=CPT CODES^32^^26^0^132^14^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^CU^Selection list - CPT codes^0
+299 ;;^UTILITY(U,$J,358.1,148,0)
+300 ;;=PATIENT INFORMATION^32^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+301 ;;^UTILITY(U,$J,358.1,149,0)
+302 ;;=HEADER^32^^1^48^42^1^^^2
+303 ;;^UTILITY(U,$J,358.1,150,0)
+304 ;;=HOSPICE/PALLIATIVE CARE ICD-10^32^^41^0^132^364^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+305 ;;^UTILITY(U,$J,358.1,151,0)
+306 ;;=1995 VISIT TYPE CODES (V2.1)^32^^6^0^132^19^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+307 ;;^UTILITY(U,$J,358.1,152,0)
+308 ;;=CPT CODES^33^^16^0^132^19^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^CU^Selection list - CPT codes^0
+309 ;;^UTILITY(U,$J,358.1,153,0)
+310 ;;=PATIENT INFORMATION^33^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+311 ;;^UTILITY(U,$J,358.1,154,0)
+312 ;;=1995 VISIT TYPE CODES (V2.1)^33^^6^0^132^9^^^1^TYPE OF VISIT^CR^1995 visit types WITH CODES SHOWN^0
+313 ;;^UTILITY(U,$J,358.1,155,0)
+314 ;;=HEADER^33^^1^48^43^1^^^2
+315 ;;^UTILITY(U,$J,358.1,156,0)
+316 ;;=HOSPICE/PALLIATIVE CARE ICD-10^33^^36^0^132^364^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
+317 ;;^UTILITY(U,$J,358.1,157,0)
+318 ;;=HEADER^34^^1^54^35^1^^^2
+319 ;;^UTILITY(U,$J,358.1,158,0)
+320 ;;=PATIENT INFORMATION^34^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+321 ;;^UTILITY(U,$J,358.1,159,0)
+322 ;;=COVID-19 ICD CODES^34^^7^0^132^48^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
+323 ;;^UTILITY(U,$J,358.1,160,0)
+324 ;;=HEADER^35^^1^49^45^1^^^2
+325 ;;^UTILITY(U,$J,358.1,161,0)
+326 ;;=PATIENT INFORMATION^35^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+327 ;;^UTILITY(U,$J,358.1,162,0)
+328 ;;=CPT CODES^35^^7^0^132^48^^^1^MARK PROCEDURE(S) PERFORMED THIS VISIT^RC^Selection list - CPT codes^0
+329 ;;^UTILITY(U,$J,358.1,163,0)
+330 ;;=COVID-19 ICD CODES^35^^56^0^132^48^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^
+331 ;;^UTILITY(U,$J,358.1,168,0)
+332 ;;=PATIENT INFORMATION^37^^3^0^132^3^^^2^^^Patient information-name/ssn/age
+333 ;;^UTILITY(U,$J,358.1,169,0)
+334 ;;=HEADER^37^^1^49^26^1^^^2
+335 ;;^UTILITY(U,$J,358.1,170,0)
+336 ;;=CPT CODES (3 COL)^37^^7^0^132^13^^^1^PLEASE CHECK OFF PROCEDURES PERFORMED THIS VISIT^BCU^Selection list - CPT codes^0
+337 ;;^UTILITY(U,$J,358.1,171,0)
+338 ;;=DIABETES ICD-10^37^^21^0^132^19^^^1^DIAGNOSIS^CR^Common ICD-10 diagnoses^0
