LEGACY HCFA-1500 (311)    IB FORM FIELD CONTENT (364.7)

Name Value
FORM FIELD REFERENCE LEGACY HCFA-1500
SECURITY LEVEL NATIONAL,NO EDIT
DATA ELEMENT N-CURRENT AUTHORIZATION CODE
PAD CHARACTER NO PAD REQUIRED
FORMAT CODE I $$OLAB^IBCEU(IBXIEN) N IBZ S IBZ=IBXDATA D F^IBCEF("N-LAB CLIA #",,,IBXIEN) I IBXDATA="",IBZ'="" S IBXDATA=IBZ
FORMAT CODE DESCRIPTION
If the bill is for services rendered at an outside lab, get the CLIA number.
If this # is not available, use the prior authorization #.