N-HCFA 1500 SERVICE LINE (EDI) (126)    IB DATA ELEMENT DEFINITION (364.5)

Name Value
NAME N-HCFA 1500 SERVICE LINE (EDI)
SECURITY LEVEL NATIONAL,NO EDIT
TYPE OF ELEMENT EXTRACTED VIA CODE
ELEMENT CATEGORY GROUP ELEMENT
BASE FILE BILL/CLAIMS
EXTRACT CODE S IBXDATA="" I $$FT^IBCEF(IBXIEN)=2 D OUTPT^IBCEF11(IBXIEN,0)
DESCRIPTION
The elements of the outpatient services line on the HCFA 1500 (BOX 24) for
For COB data at a line level, the array IBXDATA(n,"COB",COBSEQ,m)=cob line
level adjustment data (0-node) and IBXDATA(n,"COB",COBSEQ,m,z,p) = the
reasons for the adj m,p are sequence #'s, z = ' PR' for deductible and
co-insurance entries and = Reason Group Code for the rest.
bill entry IBXIEN.  Format is begin date^end date^place of service code
 type of service code^procedure or revenue code^type of code^ diagnosis
 pointers^unit charge^units^modifier pointer ien(s) separated by commas
 purchased charge amount ^ anesthesia minutes^emergency indicator^lab type
of service flag. Data is returned in an array IBXDATA(1-n).  Also returns
the arrays IBXDATA(n,"AUX")=the 'AUX' node for the procedure entry on the
claim IBXDATA("ITEM",item type,item pointer)=n^ctr if this data can be
gathered.