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Sub-Field: 9002313.1001

Package: E Claims Management Engine

BPS CLAIMS(#9002313.02)-->9002313.0201-->9002313.1001

Sub-Field: 9002313.1001


Information

Parent File Name Number Package
9002313.0201 DUR PPS REPEATING FIELDS 9002313.1001 E Claims Management Engine

Details

Field # Name Loc Type Details
.01 DUR PPS CODE COUNT 0;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>3!($L(X)<3) X
  • LAST EDITED:  JAN 04, 2008
  • HELP-PROMPT:  Answer must be 3 characters in length
  • DESCRIPTION:  
    The number of DUR messages that were returned in the response message. NCPDP standard field 473-7E.
  • TECHNICAL DESCR:  
    REQUEST DUR/PPS SEGMENT.
  • CROSS-REFERENCE:  9002313.1001^B
    1)= S ^BPSC(DA(2),400,DA(1),473.01,"B",$E(X,1,30),DA)=""
    2)= K ^BPSC(DA(2),400,DA(1),473.01,"B",$E(X,1,30),DA)
439 REASON FOR SERVICE CODE 0;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>4!($L(X)<4) X
  • LAST EDITED:  JAN 04, 2008
  • HELP-PROMPT:  Answer must be 4 characters in length
  • DESCRIPTION:  
    Code identifying the type of utilization conflict detected or the reason for the pharmacist's professional service. NCPDP standard field 439-E4.
  • TECHNICAL DESCR:  
    REQUEST DUR/PPS SEGMENT. RESPONSE DUR/PPS SEGMENT.
440 PROFESSIONAL SERVICE CODE 0;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>4!($L(X)<4) X
  • LAST EDITED:  JAN 04, 2008
  • HELP-PROMPT:  Answer must be 4 characters in length
  • DESCRIPTION:  
    Code identifying the type of utilization conflict detected or the reason for the pharmacist's professional service. NCPDP standard field 440-E5.
  • TECHNICAL DESCR:  
    If the pharmacist spoke with the patient as a result of a conflict code being transmitted on a prescription, the field would reflect P0. REQUEST DUR/PPS SEGMENT.
441 RESULT OF SERVICE CODE 0;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>4!($L(X)<4) X
  • LAST EDITED:  JAN 04, 2008
  • HELP-PROMPT:  Answer must be 4 characters in length
  • DESCRIPTION:  
    Action taken by a pharmacist in response to a conflict or the result of a pharmacist's professional service. NCPDP standard field 441-E6.
  • TECHNICAL DESCR:  
    REQUEST DUR/PPS SEGMENT.
474 DUR/PPS LEVEL OF EFFORT 0;5 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>4!($L(X)<4) X
  • LAST EDITED:  MAR 31, 2021
  • HELP-PROMPT:  Answer must be 4 characters in length
  • DESCRIPTION:  
    Code indicating the level of effort as determined by the complexity of decision making or resources utilized by a pharmacist to perform a professional service. NCPDP standard field 474-8E.
  • TECHNICAL DESCR:  
    REQUEST DUR/PPS SEGMENT.
475 DUR/DUE CO-AGENT ID QUALIFIER 0;6 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>4!($L(X)<4) X
  • LAST EDITED:  MAR 31, 2021
  • HELP-PROMPT:  Answer must be 4 characters in length
  • DESCRIPTION:  
    Code qualifying the value in DUR Co-Agent ID (476-H6). NCPDP standard field 475-J9.
  • TECHNICAL DESCR:  
    REQUEST DUR/PPS SEGMENT.
476 DUR/DUE CO-AGENT ID 0;7 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>21!($L(X)<21) X
  • LAST EDITED:  MAR 31, 2021
  • HELP-PROMPT:  Answer must be 21 characters in length
  • DESCRIPTION:  
    Identifies the co-existing agent contributing to the DUR event (drug or disease conflicting with the prescribed drug or prompting pharmacist professional service). NCPDP standard field 476-H6.
  • TECHNICAL DESCR:  
    Qualified by DUR Co-Agent ID Qualifier (475-J9). REQUEST DUR/PPS SEGMENT.
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