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Sub-Field: 361.1154

Package: Integrated Billing

EXPLANATION OF BENEFITS(#361.1)-->361.115-->361.1154

Sub-Field: 361.1154


Information

Parent File Name Number Package
361.115 LINE ITEM REMARK 361.1154 Integrated Billing

Details

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

  • INPUT TRANSFORM:  K:+X'=X!(X>99999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 17, 2004
  • HELP-PROMPT:  Type a Number between 1 and 99999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the sequential number used to enumerate the line item remarks in the ERA.
  • CROSS-REFERENCE:  361.1154^B
    1)= S ^IBM(361.1,DA(2),15,DA(1),4,"B",$E(X,1,30),DA)=""
    2)= K ^IBM(361.1,DA(2),15,DA(1),4,"B",$E(X,1,30),DA)
.02 LINE ITEM REMARK CODE 0;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<1) X
  • LAST EDITED:  AUG 17, 2004
  • HELP-PROMPT:  Answer must be 1-10 characters in length.
  • DESCRIPTION:  
    This is the remark code provided by MEDICARE for this line item.
.03 LINE ITEM REMARK CODE TEXT 0;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>190!($L(X)<1) X
  • LAST EDITED:  AUG 17, 2004
  • HELP-PROMPT:  Answer must be 1-190 characters in length.
  • DESCRIPTION:  
    This is the free text explanation of the remark code in this record.
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