| Name | Value |
|---|---|
| NAME | N-HCFA 1500 SERVICES (PRINT) |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| TYPE OF ELEMENT | EXTRACTED VIA CODE |
| ELEMENT CATEGORY | GROUP ELEMENT |
| BASE FILE | BILL/CLAIMS |
| EXTRACT CODE | K IBXSAVE("BOX24") D OUTPT^IBCEF11(IBXIEN,1) |
| DESCRIPTION | The elements of the outpatient services line on the HCFA 1500 (BOX 24) for not hospice physician flag ^ chiro - level of subluxation ^ chiro - treatment series # ^ chiro - quantity ^ EPSDT indicator IBXDATA(n,"A") for revenue code description (abbreviated) if no procedure. IBXDATA(n,"TEXT") for lines of text that will span the entire block 24. IBXDATA(n,"RX")=rx#^drug name^NDC#^refill#^refil dt^qty^days^charg^ien 362.4 bill entry IBXIEN. Format is begin date (MMDDYYYY)^ end date (MMDDYYYY) or null if not different from start date^ place of service code^ type of service code^procedure or bedsection name^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(n) for the above data, and IBXDATA(n,"AUX")=box 24K data ^ last chiropractic xray date ^ attending, |