LEGACY UB-92 (612)    IB FORM FIELD CONTENT (364.7)

Name Value
FORM FIELD REFERENCE LEGACY UB-92
SECURITY LEVEL NATIONAL,NO EDIT
DATA ELEMENT N-DIAGNOSIS E-CODE
PAD CHARACTER NO PAD REQUIRED
FORMAT CODE DESCRIPTION
This data element relies on the existence of the array containing the
diagnoses for the bill, previously extracted.  This data will be output if
it is the first 'E-code' dx found.