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Sub-Field: 162.579

Package: Fee Basis

FEE BASIS INVOICE(#162.5)-->162.579

Sub-Field: 162.579


Information

Parent File Name Number Package
FEE BASIS INVOICE(#162.5) LINE ITEM RENDERING PROV 162.579 Fee Basis

Details

Field # Name Loc Type Details
.01 LINE ITEM NUMBER 0;1 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>25)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  FEB 15, 2012
  • HELP-PROMPT:  Type a number between 0 and 25, 0 decimal digits.
  • DESCRIPTION:  Enter the line item number for the associated Rendering Provider information. Example, Line item 3 has a Rendering Provider different than the claim level Rendering Provider. You would enter 3 to associate this different
    Rendering Provider to the line item 3 of the claim.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  162.579^B
    1)= S ^FBAAI(DA(1),"RPROV","B",$E(X,1,30),DA)=""
    2)= K ^FBAAI(DA(1),"RPROV","B",$E(X,1,30),DA)
.02 RENDERING PROV NAME 0;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  APR 22, 2011
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • DESCRIPTION:  
    Enter the associated line item Rendering Provider's name found in the line item level claim information.
.03 RENDERING PROV NPI 0;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<10) X
  • LAST EDITED:  APR 22, 2011
  • HELP-PROMPT:  Answer must be 10 characters in length.
  • DESCRIPTION:  
    Enter the associated line item Rendering Provider's National Provider Identifier (NPI) for the line level claim information.
.04 RENDERING PROV TAXONOMY CODE 0;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<10) X
  • LAST EDITED:  APR 22, 2011
  • HELP-PROMPT:  Answer must be 10 characters in length.
  • DESCRIPTION:  
    Enter the associated line item Rendering Provider's Taxonomy code found in the line item level of the claim information. This value must be 10 characters, including any leading zeros.
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