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Sub-Field: 365.01

Package: Integrated Billing

IIV RESPONSE(#365)-->365.01

Sub-Field: 365.01


Information

Parent File Name Number Package
IIV RESPONSE(#365) HEALTH CARE CODE INFORMATION 365.01 Integrated Billing

Details

Field # Name Loc Type Details
.01 SEQUENCE 0;1 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:+X'=X!(X>99999)!(X<1)!(X?.E1"."1.N) X
  • LAST EDITED:  JUN 10, 2013
  • HELP-PROMPT:  Type a number between 1 and 99999, 0 decimal digits.
  • DESCRIPTION:  
    This field contains a sequential number generated at the time a record is stored in the subfile.
  • TECHNICAL DESCR:  
    Sequential number 1..N, assigned automatically.
  • CROSS-REFERENCE:  365.01^B
    1)= S ^IBCN(365,DA(1),11,"B",$E(X,1,30),DA)=""
    2)= K ^IBCN(365,DA(1),11,"B",$E(X,1,30),DA)
.02 DIAGNOSIS CODE 0;2 POINTER TO ICD DIAGNOSIS FILE (#80) ICD DIAGNOSIS(#80)

  • LAST EDITED:  MAY 22, 2013
  • HELP-PROMPT:  Select the diagnosis code.
  • DESCRIPTION:  
    Diagnosis Code sent by the payer in response to the insurance eligibility inquiry.
  • TECHNICAL DESCR:  
    Source: Health Care Diagnosis Code information in the X12 271 HI segment in these X12 loops: 2100C, 2100D. 271 HL7 message DG1.3.1
.03 DIAGNOSIS CODE QUALIFIER 0;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<1) X
  • LAST EDITED:  MAY 22, 2013
  • HELP-PROMPT:  Answer must be 1-10 characters in length.
  • DESCRIPTION:  
    Diagnosis Type Code identifying a specific industry code list ICD-9 or ICD-10.
  • TECHNICAL DESCR:  Source: 271 HL7 message DG1.3.3
    ABK or BK" - represent ICD-10-CM and ICD-9-CM principal diagnosis code qualifiers. These qualifiers also represent the code as a primary code.
    "ABF or BF" - also represent ICD-10-CM and ICD-9-CM diagnosis code qualifiers and these qualifiers represent the code as a secondary code.
    When the payer sends an ABK or an ABF, the Eligibility Communicator will map these to the HL7 code "I10C".
    When the payer sends an ABK or an ABF, the Eligibility Communicator will map these to the HL7 code "I9C".
    SOURCE OF DATA:
.04 PRIMARY OR SECONDARY? 0;4 SET
  • 'P' FOR PRIMARY;
  • 'S' FOR SECONDARY;

  • LAST EDITED:  MAY 22, 2013
  • HELP-PROMPT:  Does this code represent a primary or secondary diagnosis?
  • DESCRIPTION:  
    This field indicates whether the code in the DIAGNOSIS CODE (#.02) field is a primary or secondary diagnosis.
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