| Name | Value |
|---|---|
| FORM FIELD REFERENCE | UB-04 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| DATA ELEMENT | N-UB-04 PROCEDURES |
| PAD CHARACTER | NO PAD REQUIRED |
| FORMAT CODE | K:'$$INPAT^IBCEF(IBXIEN) IBXDATA N Z S Z="" F S Z=$O(IBXDATA(Z)) Q:'Z S $P(IBXDATA(Z),U,2)=$$DATE^IBCF3($P(IBXDATA(Z),U,2)),IBXSAVE("PROC",Z)=IBXDATA(Z) K IBXDATA(Z) |
| FORMAT CODE DESCRIPTION | This is a group data element so more than one occurrence of IBXDATA(n) is possible. Save off the procedures in the IBXSAVE array. Six procedures will fit on a single page of a bill. If more than 6 procedure codes are on the bill, multiple pages are used. The format of the IBXSAVE array is: the actual code for the ICD9 or ICD0 code^proc date formatted as MMDDYY |