UB-04 (1347) IB FORM FIELD CONTENT (364.7)
Name
Value
FORM FIELD REFERENCE
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
DATA ELEMENT
N-GET FROM PREVIOUS EXTRACT
PAD CHARACTER
NO PAD REQUIRED
FORMAT CODE
I $D(IBXSAVE("DX",3)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE("DX",3),$$BDATE^
IBACSV
(IBXIEN)),U),".")
FORMAT CODE DESCRIPTION
If there is a third diagnosis, print its name.