N-HCFA 1500 SERVICES (PRINT) (154)    IB DATA ELEMENT DEFINITION (364.5)

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,