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Sub-Field: 161.01

Package: Fee Basis

FEE BASIS PATIENT(#161)-->161.01

Sub-Field: 161.01


Information

Parent File Name Number Package
FEE BASIS PATIENT(#161) AUTHORIZATION 161.01 Fee Basis

Details

Field # Name Loc Type Details
.01 FROM DATE 0;1 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  FEB 17, 2015
  • DESCRIPTION:  The beginning date for which the patient is authorized to obtain services from private vendors. For every claim made by a vendor for this patient, this date will be checked to insure that the date the service was
    provided was on or after this date.
  • DELETE TEST:  .01,0)= I $$DELA^FBUCDD1(.DA,1)
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  161^AIC1^MUMPS
    1)= S:$P(^FBAAA(DA(1),1,DA,0),U,20)]"" ^FBAAA("AIC",DA(1),-X,$P(^FBAAA(DA(1),1,DA,0),U,20),DA)=""
    2)= K:$P(^FBAAA(DA(1),1,DA,0),U,20)]"" ^FBAAA("AIC",DA(1),-X,$P(^FBAAA(DA(1),1,DA,0),U,20),DA)
    Cross-reference used to identify potential billables using inverse date. Used to set "AIC" cross-reference on field .097, POTENTIAL COST RECOVERY CASE.
  • CROSS-REFERENCE:  161^ATST
    1)= S ^FBAAA("ATST",$E(X,1,30),DA(1),DA)=""
    2)= K ^FBAAA("ATST",$E(X,1,30),DA(1),DA)
  • CROSS-REFERENCE:  161.01^B
    1)= S ^FBAAA(DA(1),1,"B",$E(X,1,30),DA)=""
    2)= K ^FBAAA(DA(1),1,"B",$E(X,1,30),DA)
  • CROSS-REFERENCE:  161^AENR01^MUMPS
    1)= D:'$D(DIU(0)) EVENT^IVMPLOG(DA(1))
    2)= D:'$D(DIU(0)) EVENT^IVMPLOG(DA(1))
    Notify HEC of changes to FEE Authorization.
  • CROSS-REFERENCE:  161^AC^MUMPS
    1)= D:'$D(DIU(0)) EVENT^IBFBUTIL(DA(1))
    2)= D:'$D(DIU(0)) EVENT^IBFBUTIL(DA(1))
    Add new entry into file 360 on new Authorization
  • RECORD INDEXES:  AMRA (#427), AUD (#1151)
.02 TO DATE 0;2 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X I $D(X),$P(^FBAAA(DA(1),1,DA,0),U,1)>X K X W !!,"To Date cannot be earlier than From Date!",!
  • LAST EDITED:  OCT 31, 2014
  • DESCRIPTION:  The date through which the veteran may obtain services from private vendors, and which the VA will reimburse. For every claim submitted by a vendor, this date is compared with the date the service was provided, and
    service date must be on or before this date.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  161^AENR02^MUMPS
    1)= D:'$D(DIU(0)) EVENT^IVMPLOG(DA(1)),ENRLLMNT^FBGMT2(DA(1))
    2)= Q
    Notify HEC and Enrollment of changes to FEE Authorization.
  • RECORD INDEXES:  AUD (#1151)
.021 AUTHORIZATION REMARKS 2;0 WORD-PROCESSING #161.06

  • DESCRIPTION:  
    Used to identify limitations or detail specifics regarding the authorization. The information contained here is displayed during the enter payment option and also on patient inquiry option.
.03 FEE PROGRAM 0;3 POINTER TO FEE BASIS PROGRAM FILE (#161.8)
************************REQUIRED FIELD************************
FEE BASIS PROGRAM(#161.8)

  • LAST EDITED:  JUL 23, 1998
  • DESCRIPTION:  
    Links this authorization to one of the valid Fee programs (ie Medical, Contract Hospital, Community Nursing Home).
  • CROSS-REFERENCE:  161^AENR03^MUMPS
    1)= D:'$D(DIU(0)) EVENT^IVMPLOG(DA(1))
    2)= Q
    Notify HEC of changes to FEE Authorization.
.04 VENDOR 0;4 POINTER TO FEE BASIS VENDOR FILE (#161.2) FEE BASIS VENDOR(#161.2)

  • LAST EDITED:  DEC 23, 1993
  • DESCRIPTION:  
    The name of the vendor providing the veteran service if the authorization is limited to one specific vendor.
  • CROSS-REFERENCE:  161^ACV^MUMPS
    1)= S ^FBAAA("ACV",$E(X,1,30),DA(1),DA)=""
    2)= K ^FBAAA("ACV",$E(X,1,30),DA(1),DA)
.055 ASSOCIATED 7078/583 0;9 VARIABLE POINTER VA FORM 10-7078(#162.4)  FEE BASIS UNAUTHORIZED CLAIMS(#162.7)  

  • LAST EDITED:  SEP 19, 1990
  • DESCRIPTION:  
    This field contains the related 7078/583 for the authorization. It points to the 7078 file or the 583 file for an unauthorized claim.
  • CROSS-REFERENCE:  161.01^AG^MUMPS
    1)= S ^FBAAA("AG",$E(X,1,30),DA(1),DA)=""
    2)= K ^FBAAA("AG",$E(X,1,30),DA(1),DA)
.06 DISCHARGE TYPE 0;15 SET
  • '1' FOR TRANSFER TO VA;
  • '2' FOR DEATH WITH AUTOPSY;
  • '3' FOR DEATH WITHOUT AUTOPSY;
  • '4' FOR DISCHARGE;

  • LAST EDITED:  OCT 31, 2014
  • DESCRIPTION:  
    This field is filled in as part of the disposition process in contract hospital.
  • RECORD INDEXES:  AUD (#1151)
.065 PATIENT TYPE CODE 0;18 SET
  • '00' FOR SURGICAL;
  • '10' FOR MEDICAL;
  • '60' FOR HOME NURSING SERVICE;
  • '85' FOR PSYCHIATRIC-CONTRACT;
  • '86' FOR PSYCHIATRIC;
  • '95' FOR NEUROLOGICAL-CONTRACT;
  • '96' FOR NEUROLOGICAL;

  • LAST EDITED:  FEB 21, 1986
  • DESCRIPTION:  
    The code which indicates whether the patient is a medical, surgical, psychiatric or one of the other valid codes. See M-1, Part I, Chapter 18 for specific detail.
.07 PURPOSE OF VISIT CODE 0;7 POINTER TO FEE BASIS PURPOSE OF VISIT FILE (#161.82)
************************REQUIRED FIELD************************
FEE BASIS PURPOSE OF VISIT(#161.82)

  • INPUT TRANSFORM:  S DIC("S")="I $S('$G(^(""I"")):1,DT'>^(""I""):1,1:0),$S('$D(FBTYPE):1,$P(^(0),U,2)=FBTYPE:1,1:0)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  OCT 31, 2014
  • DESCRIPTION:  Used to indicate the purpose for the visit to the provider. Selection of these are screened based on the Fee program entered earlier. For example, if Outpatient Medical Fee Program is selected Purpose of visit of
    'Authorized Contract Hospitalization' could not be selected.
  • SCREEN:  S DIC("S")="I $S('$G(^(""I"")):1,DT'>^(""I""):1,1:0),$S('$D(FBTYPE):1,$P(^(0),U,2)=FBTYPE:1,1:0)"
  • EXPLANATION:  Allows selection of POV related to FEE Program being used...disallows selection of an inactive POV Code.
  • RECORD INDEXES:  AUD (#1151)
.08 DX LINE 1 0;8 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>60!($L(X)<3) X
  • LAST EDITED:  MAR 26, 2012
  • HELP-PROMPT:  Answer must be 3-60 characters in length.
  • DESCRIPTION:  
    Patient's diagnosis for which this authorization is being issued. This field is strictly for ICD-9. It may contain free text comments as well as ICD-9 codes.
.085 DX LINE 2 3;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>60!($L(X)<2) X
  • LAST EDITED:  MAR 26, 2012
  • HELP-PROMPT:  Answer must be 2-60 characters in length.
  • DESCRIPTION:  
    An additional 60 characters to continue the description of patient's diagnosis for which this authorization is being issued. This field is strictly for ICD-9. It may contain free text comments as well as ICD-9 codes.
.086 DX LINE 3 3;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>60!($L(X)<2) X
  • LAST EDITED:  MAR 26, 2012
  • HELP-PROMPT:  Answer must be 2-60 characters in length.
  • DESCRIPTION:  
    An additional 60 characters to continue describing patient's diagnosis. This is the diagnosis applicable to this authorization. This field is strictly for ICD-9. It may contain free text comments as well as ICD-9 codes.
.087 ICD DIAGNOSIS C;2 POINTER TO ICD DIAGNOSIS FILE (#80)
************************REQUIRED FIELD************************
ICD DIAGNOSIS(#80)

  • LAST EDITED:  MAR 26, 2012
  • HELP-PROMPT:  Select the Diagnosis.
  • DESCRIPTION:  
    Patient's diagnosis for which this authorization is being issued. This field is only for ICD-10 and later.
.095 TREATMENT TYPE CODE 0;13 SET
************************REQUIRED FIELD************************
  • '1' FOR SHORT TERM FEE STATUS;
  • '2' FOR HOME NURSING SERVICES;
  • '3' FOR I.D. CARD STATUS;
  • '4' FOR STATE HOME;

  • LAST EDITED:  OCT 31, 2014
  • DESCRIPTION:  
    Indicates what the type of treatment this authorization is related to. See M-1, Part 1, Chapter 18, for valid entries.
  • SCREEN:  S DIC("S")="I Y'=4"
  • EXPLANATION:  Select a value appropriate for the FEE program.
  • CROSS-REFERENCE:  161^AENR095^MUMPS
    1)= D:'$D(DIU(0)) EVENT^IVMPLOG(DA(1))
    2)= Q
    Notify HEC of changes to FEE Authorization.
  • RECORD INDEXES:  AUD (#1151)
.096 ACCIDENT RELATED (Y/N) 0;19 FREE TEXT

  • INPUT TRANSFORM:  I $D(X) D YN^FBAAUTL3
  • OUTPUT TRANSFORM:  D OUTYN^FBAAUTL3
  • LAST EDITED:  MAR 18, 1994
  • HELP-PROMPT:  Answer 'Yes' or '1' for YES and a 'No' or '0' for NO.
  • DESCRIPTION:  
    This field allows the fee system to track those authorizations that were issued for an accident related condition.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  161.01^AA^MUMPS
    1)= S ^FBAAA("AA",X,$P(^FBAAA(DA(1),1,DA,0),U,1),DA(1),DA)=""
    2)= K ^FBAAA("AA",X,$P(^FBAAA(DA(1),1,DA,0),U,1),DA(1),DA)
.097 POTENTIAL COST RECOVERY CASE 0;20 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  I $D(X) D YN^FBAAUTL3
  • OUTPUT TRANSFORM:  D OUTYN^FBAAUTL3
  • LAST EDITED:  MAR 18, 1994
  • HELP-PROMPT:  Answer a 'Yes' or '1' for YES and a 'No' or '0' for NO.
  • DESCRIPTION:  
    Determines if payment can be recovered from the veteran's insurance, or if payment can be recovered due to the veteran being a Cat. C patient.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  161.01^AC^MUMPS
    1)= S ^FBAAA("AC",X,$P(^FBAAA(DA(1),1,DA,0),U,1),DA(1),DA)=""
    2)= K ^FBAAA("AC",X,$P(^FBAAA(DA(1),1,DA,0),U,1),DA(1),DA)
  • CROSS-REFERENCE:  161^AIC^MUMPS
    1)= S:$P(^FBAAA(DA(1),1,DA,0),U) ^FBAAA("AIC",DA(1),-($P(^FBAAA(DA(1),1,DA,0),U)),X,DA)=""
    2)= K:$P(^FBAAA(DA(1),1,DA,0),U) ^FBAAA("AIC",DA(1),-($P(^FBAAA(DA(1),1,DA,0),U)),X,DA)
    Cross-reference used to identify potential billables using inverse date.
1 PRINT AUTHORIZATION (Y/N) C;1 FREE TEXT

  • INPUT TRANSFORM:  I $D(X) D YN^FBAAUTL3
  • LAST EDITED:  MAY 25, 1994
  • HELP-PROMPT:  Answer a 'Yes' or '1' for YES and a 'No' or '0' for NO.
  • DESCRIPTION:  
    Used to indicate whether a VA Form 7079, Request For Outpatient Services, should be printed at the completion of entering the authorization data.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  161.01^AF^MUMPS
    1)= D ADD^FBAAUTL2
    2)= D KILL^FBAAUTL2
  • CROSS-REFERENCE:  161^AF^MUMPS
    1)= S ^FBAAA("AF",$P(^FBAAA(DA(1),1,DA,0),U,3),DT,DA(1),DA)=""
    2)= K ^FBAAA("AF",$P(^FBAAA(DA(1),1,DA,0),U,3),DT,DA(1),DA)
2 TYPE OF CARE 0;14 SET
  • '1' FOR C&P;
  • '2' FOR OPT NSC;
  • '3' FOR OPT SC;

  • LAST EDITED:  MAR 24, 1988
  • DESCRIPTION:  
    Defines whether this authorization is related to OPT/NSC, OPT/SC, or C&P type of care.
3 DATE PRINTED 1;2 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • DESCRIPTION:  
    The date the last 7079 was printed for this authorization.
    DELETE AUTHORITY: ~
100 CLERK 100;1 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  APR 05, 1990
  • DESCRIPTION:  
    The last user to enter/edit data for this authorization.
    DELETE AUTHORITY: ~
101 PRIMARY SERVICE AREA 0;5 POINTER TO INSTITUTION FILE (#4)
************************REQUIRED FIELD************************
INSTITUTION(#4)

  • LAST EDITED:  APR 03, 1990
  • DESCRIPTION:  
    The VA Hospital responsible for the veterans care.
102 AUSTIN DELETE FLAG ADEL;1 FREE TEXT

  • INPUT TRANSFORM:  I $D(X) D YN^FBAAUTL3
  • OUTPUT TRANSFORM:  D OUTYN^FBAAUTL3
  • LAST EDITED:  JUL 23, 1998
  • HELP-PROMPT:  Answer 'Yes' or '1' for YES and 'No' or '0' for NO.
  • DESCRIPTION:  
    This field will be populated when a 'Delete MRA' is transmitted to Austin DPC. This field will also be used to screen out selection for payments made to Austin.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  161^AENR102^MUMPS
    1)= D:'$D(DIU(0)) EVENT^IVMPLOG(DA(1))
    2)= D:'$D(DIU(0)) EVENT^IVMPLOG(DA(1))
    Notify HEC of changes to FEE Authorization.
103 DATE DELETE MRA TRANSMITTED ADEL;2 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAY 26, 1992
  • DESCRIPTION:  
    This field will be set internally when a 'Delete Veteran MRA' is sent to Austin. It will be used to screen selection during the enter payment options.
104 REFERRING PROVIDER 0;21 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • INPUT TRANSFORM:  S DIC("S")="I $$PROVIDER^FBAAAUT(+Y)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  APR 16, 2008
  • HELP-PROMPT:  Enter the provider who referred this patient for service.
  • DESCRIPTION:  
    This field contains the name of the VA provider who referred this patient for service. This is not necessarily the same as the Authorizing Physician although they may be the same in some cases.
  • SCREEN:  S DIC("S")="I $$PROVIDER^FBAAAUT(+Y)"
  • EXPLANATION:  Types of users allowed should only be providers.
105 CONTRACT 0;22 POINTER TO FEE BASIS CONTRACT FILE (#161.43) FEE BASIS CONTRACT(#161.43)

  • INPUT TRANSFORM:  S DIC("S")="I $$CNTRSCR^FBUTL7($G(DA(1)),$G(DA),+Y)" D ^DIC K DIC S DIC=$G(DIE),X=+Y K:Y<0 X
  • LAST EDITED:  JUN 03, 2009
  • HELP-PROMPT:  If the authorization is under a contract then select it.
  • DESCRIPTION:  Contract (if any) applicable to all authorized services. If an authorization has a contract, the system will automatically assign that contract to any payments associated with the authorization if the vendor being paid
    matches the vendor specified on the authorization.
  • SCREEN:  S DIC("S")="I $$CNTRSCR^FBUTL7($G(DA(1)),$G(DA),+Y)"
  • EXPLANATION:  Contract must be active and applicable for the authorized vendor.
  • FIELD INDEX:  ACN (#879) REGULAR IR SORTING ONLY WHOLE FILE (#161)
    Short Descr: Index of contracts.
    Description: This is an index of contracts entered for fee authorizations. The index will be used to prevent deletion of entries from the FEE BASIS CONTRACT file that are referenced (pointed to) by an authorization.
    Set Logic: S ^FBAAA("ACN",X,DA(1),DA)=""
    Kill Logic: K ^FBAAA("ACN",X,DA(1),DA)
    Whole Kill: K ^FBAAA("ACN")
    X(1): CONTRACT (161.01,105) (Subscr 1) (forwards)
292 USER AUDIT LOG1;0 DATE Multiple #161.192 161.192

  • DESCRIPTION:  This multiple tracks users that entered or edited the authorization using selected menu options. Note that some types of authorizations are also associated with a record in other files such as #162.2, #162.4, and
    #162.7. In such cases the USER AUDIT in those other files must also be reviewed to obtain a complete list of users.
  • TECHNICAL DESCR:  The USER AUDIT multiple was added by patch FB*3.5*154 and does not reflect actions taken prior to patch installation with one exception. During the install the patch attempts to create one entry in the multiple for each
    pre-existing authorization using data from the CLERK (#7) field and the patch install date.
  • INDEXED BY:  EDITED BY (AU)
293 DATA AUDIT LOG2;0 DATE Multiple #161.193 161.193

  • DESCRIPTION:  
    The data audit multiple stores historical information for selected fields.
  • TECHNICAL DESCR:  
    The AUD index tracks changes to selected fields and populates the DATA AUDIT multiple. The multiple was added by patch FB*3.5*151 and does not reflect actions taken prior to patch installation.
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