{"aaData": [["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-BILL DESIGNATION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nThis is CI2-2.\nFileMan Extract - CURRENT BILL PAYER SEQUENCE (Field .21, File 399)\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IDEM\")),U,3)\n", "\nRetrieves insured demographics from IBXSAVE array previously extracted. If\ndata element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-DISCHARGE DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"DISDT\")=$S($$INPAT^IBCEF(IBXIEN,1):IBXDATA,1:\"\") K IBXDATA\n", "\nSave off data element's value in IBXSAVE array. No output. IB*547 \nrequirement to use only Inpatient Discharge Date/Time\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURR INS FORM LOC 64\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURR INS FORM LOC 64\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(IBXDATA]\"\":\"F8\",1:\"\")\n", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-PURCHASED SERVICE TOTAL\n", "", "", "", "SPACE PAD ON RIGHT\n", "", "", "", "S IBXDATA=$S('IBXDATA:\"\",1:$TR($J(IBXDATA,10,2),\" \"))\n", "\nFormat data in 10 characters with 2 decimals.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-HCFA 1500 BOX 19\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=2,$$FT^IBCEF(IBXIEN)'=7 K IBXDATA\n", "\nClaim must be a CMS-1500 claim for this to be transmitted.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTHER INSURANCE CO TYPES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N A,Q,Z S Q=$G(IBXDATA) K IBXDATA I $$FT^IBCEF(IBXIEN)=2!($$FT^IBCEF(IBXIEN)=7) F Z=1,2 S A=$P(Q,U,Z) I $D(^DGCR(399,IBXIEN,\"I\"_(Z+1))) S IBXDATA(Z)=$S(A=1:\"HM\",A=2:\"C1\",A=3:\"MB\",A=4:\"MC\",A=5:\"GP\",1:\"OT\") D OIT^IBCEF12\n", "\nThis is a group data element so more than 1 occurrence of a value is\n 4:MEDICAID (MC)\n 5:GROUP POLICY (GP)\n 9:OTHER (OT)\npossible for the data element in the IBXDATA array. If any 'other'\ninsurance company data is found, the data is formatted as the insurance type\nof the insurance company in X12 format (see codes below or refer to the\n837 V4010 field 2320/SBR/05 - professional guide)\n \n Type codes: = 1:HMO (HM)\n 2:COMMERCIAL (C1)\n 3:MEDICARE (MB)\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,IBZ S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $P($G(IBXSAVE(\"OUTPT\",Z,\"AUX\")),U,8)'=\"\" S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z,\"AUX\"),U,8),IBZ=$P(IBXSAVE(\"OUTPT\",Z,\"AUX\"),U,9) S:IBZ=\"\" IBZ=\" \" S IBXDATA(Z)=IBZ_IBXDATA(Z)\n", "\nThis is a group data element so more than 1 occurrence of a value is\nLength was also reduced from 80 chars to 61 chars in the field since that \nis all the Box 24 shaded area allows for the comment per line item.\npossible for the data element in the previously extracted IBXSAVE array.\nOnly output the data for service lines that have data.\n \nesg - 8/18/06 - IB patch 348 - new CMS 1500 claim form\nIf the service line comment qualifier doesn't exist, then add 2 blank \nspaces in front of the service line comment. If it does exist, then add \nit to the front of the comment.\n \n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,\"NAME\")),U,4)\n", "\nCredentials should be in the 4th piece of the "NAME" node of the \nRendering Provider IBXSAVE array.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-LAB OR FACILITY PRIMARY ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D BOX324^IBCEP8A(IBXIEN,.IBXSAVE,.IBXDATA)\n", "\nHCFA-1500 form, Box 32, Line 4.\nDisplay mammography certification number if it exists.\nOtherwise, display the facility tax ID for remote VA site or non-VA site.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $P(IBXSAVE(\"DISDT\"),\".\",2)'=\"\" S IBXDATA=$E($P(IBXSAVE(\"DISDT\"),\".\",2)_\"0000\",1,4)\n", "\nExtract time from date/time retrieved from IBXSAVE array previously\nextracted. Format time in HHMM format. If data element's value is null,\ndo not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURRENT INSURANCE CO TYPE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXDATA) K IBXSAVE(\"DEFID\") S IBXDATA=$P(\"HM^C1^MB^MC^GP^^^^OT\",U,+IBXDATA) S:IBXDATA=\"C1\" IBXSAVE(\"DEFID\")=1 S IBXDATA=\"\" S IBXDATA=\"\"\n", "\nTranslate to X12 code, default to Group Policy (GP) if data is missing.\nRefer to Professional 837 V4010 2000B/SBR/05 for codes. REMOVED DEFAULT "GP"\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nThis element is blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=\"\" F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"RX\")),$P(IBXSAVE(\"OUTPT\",Z,\"RX\"),U,3)'=\"\" S IBXDATA(Z)=\"N4\"\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array.\nChanges the internal code into a valid X12 837 code (N1,N2,N3,N4).\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "", "", "", "", "N S K IBXDATA S S=19 D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,S)\n", "\nThis data element assumes the existence of the IBXSAVE array for each line\nitem (LCOB) that was previously extracted. If the line has COB data\nassociated with it, output the procedure type code for each COB sequence\nfound for the line.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"759.0\" I '$$PROD^XUPROD(1) S $E(IBXDATA,11)=\"D\"\n", "\nThis field contains the VistA IB patch# that pertains to the\napplicable changes in the claim map. Austin uses this field to determine\nwhich set of EDI claim maps to use when processing the EDI claims.\n\nIf the EDI claims are being transmitted from a non-production account,\nthen the "D" in the 11th position indicates to Austin that it is test\ndata.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"OSQ\") N Q,OK M Q=IBXSAVE(\"PROVINF\",IBXIEN,\"O\") S (C,Z)=0 F S Z=$O(Q(Z)) Q:'Z S OK=0 X \"N A F A=1:1 Q:'$D(Q(Z,5,A)) I $P(Q(Z,5,A),U,4)'=\"\"\"\" S OK=1 Q\" I OK S C=C+1,IBXDATA(C)=$G(Q(Z)),IBXSAVE(\"OSQ\",Z)=C D:C>1 ID^IBCEF2(C,\"OP8 \")\n", "\nOutput if an ID exists for the 'other insurance'. If more than 1 ins,\nmust output the record id. Must kill the IBXSAVE("OSQ") array as this is\nused to determine the current bill's sequence of other providers and which\nIBXDATA array entry needs to be set for each. IBXSAVE("OSQ") must be killed\nat the last field for this record.\nIBXSAVE("OSQ",n)=m where n = the sequence for the other insurance (if bill\nis primary, 1=secondary, 2=tertiary; if bill is secondary, 1=primary,\n2=tertiary; if bill is tertiary, 1=primary, 2=secondary). And where\nm = the IBXDATA(m) entry to set for the 'n' COB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D PROVSEQ^IBCEF72(IBXIEN,.IBXSAVE,.IBXDATA,3,\"OP1 \")\n", "\nOutput if an ID exists for the 'other insurance'. If more than 1\ninsurance, must output the record id. The IBXSAVE("OSQ") array is \nused to determine the current bill's sequence of other providers and\nwhich IBXDATA array entry needs to be set for each. This variable must\nbe killed at the last field for this record. IBXSAVE("OSQ",n)=m where\nn = the sequence for the other insurance (if bill is primary, 1=secondary,\n2=tertiary; if bill is secondary, 1=primary, 2=tertiary; if bill is\ntertiary, 1=primary, 2=secondary. And where m=the IBXDATA(m) entry to\nset for the 'n' COB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-SOURCE OF ADMISSION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I IBXDATA=\"\",'$$INPAT^IBCEF(IBXIEN,1) S IBXDATA=2\n", "\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D OTH^IBCEF76(IBXIEN,.IBXSAVE,.IBXDATA,($$FT^IBCEF(IBXIEN)=3),\"OP3 \")\n", "\nOP3-2\nCall the provider ID function only if the claim is a UB claim.\nOutput the other payer sequence.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D PROVSEQ^IBCEF72(IBXIEN,.IBXSAVE,.IBXDATA,1,\"OP4 \")\n", "\nOutput if an ID exists for the 'other insurance'. If more than 1 insurance\nmust output the record id. Must kill the IBXSAVE("OSQ") array as this\nis used to determine the current bill's sequence of other providers and\nwhich IBXDATA array entry needs to be set for each. This variable must\nbe killed at the last field for this record. IBXSAVE("OSQ",n)=m where\nn = the sequence for the other insurance (if bill is primary, 1=secondary,\n2=tertiary; if bill is secondary, 1=primary, 2=tertiary; if bill is\ntertiary, 1=primary, 2=secondary. And where m=the IBXDATA(m) entry to\nset for the 'n' COB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D OTH^IBCEF76(IBXIEN,.IBXSAVE,.IBXDATA,($$FT^IBCEF(IBXIEN)=2!($$FT^IBCEF(IBXIEN)=7)),\"OP7 \")\n", "\nOP7-2\nother payer sequence. Call provider ID function only when claim is a \n1500 claim.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"OSQ\") N C,Z,Q,OK M Q=IBXSAVE(\"PROVINF\",IBXIEN,\"O\") S (C,Z)=0 F S Z=$O(Q(Z)) Q:'Z S OK=0 X \"N A F A=1:1 Q:'$D(Q(Z,9,A)) I $P(Q(Z,9,A),U,4)'=\"\"\"\" S OK=1 Q\" I OK S C=C+1,IBXDATA(C)=$G(Q(Z)),IBXSAVE(\"OSQ\",Z)=C D:C>1 ID^IBCEF2(C,\"OP9 \")\n", "\nOutput if an ID exists for the 'other insurance'. If more than 1 insurance\nmust output the record id. Must kill the IBXSAVE("OSQ") array as this\nis used to determine the current bill's sequence of other providers and\nwhich IBXDATA array entry needs to be set for each. This variable must\nbe killed at the last field for this record. IBXSAVE("OSQ",n)=m where\nn = the sequence for the other insurance (if bill is primary, 1=secondary,\n2=tertiary; if bill is secondary, 1=primary, 2=tertiary; if bill is\ntertiary, 1=primary, 2=secondary. And where m=the IBXDATA(m) entry to\nset for the 'n' COB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ALL CUR/OTH PROVIDER INFO\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"OSQ\") N C,Z,Q,OK M Q=IBXSAVE(\"PROVINF\",IBXIEN,\"O\") S (C,Z)=0 F S Z=$O(Q(Z)) Q:'Z S OK=0 X \"N A F A=1:1 Q:'$D(Q(Z,2,A)) I $P(Q(Z,2,A),U,4)'=\"\"\"\" S OK=1 Q\" I OK S C=C+1,IBXDATA(C)=$G(Q(Z)),IBXSAVE(\"OSQ\",Z)=C D:C>1 ID^IBCEF2(C,\"OP2 \")\n", "\nOutput if an ID exists for the 'other insurance'. If more than 1 insurance\nmust output the record id. Must kill the IBXSAVE("OSQ") array as this\nis used to determine the current bill's sequence of other providers and\nwhich IBXDATA array entry needs to be set for each. This variable must\nbe killed at the last field for this record. IBXSAVE("OSQ",n)=m where\nn = the sequence for the other insurance (if bill is primary, 1=secondary,\n2=tertiary; if bill is secondary, 1=primary, 2=tertiary; if bill is\ntertiary, 1=primary, 2=secondary. And where m=the IBXDATA(m) entry to\nset for the 'n' COB sequence.\n\n\n"], ["File: 364.6, IEN: 1084", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z0 K IBXDATA S Z0=0 F S Z0=$O(IBXSAVE(Z0)) Q:'Z0 S IBXDATA(Z0)=$P(IBXSAVE(Z0),U,1)\n", "\nOI3-5\n2330C/NM108\nOther payer patient primary ID qualifier\n
\n\n"], ["File: 364.6, IEN: 1311", "NATIONAL,NO EDIT\n", "N-OTH INSURANCE SEQUENCE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ,Z,Z0 M IBZ=IBXDATA K IBXDATA I $O(IBXSAVE(1,0)) S (Z,Z0)=0 F S Z=$O(IBXSAVE(1,Z)) Q:'Z S Z0=Z0+1,IBXDATA(Z0)=IBXSAVE(1,Z) I Z0>1 D ID^IBCEF2(Z0,\"OI3 \")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. The IBXSAVE(1) variable\nholds the indicator of which insurance [(P)rimary/(S)econdary/(T)ertiary] is\ncurrently responsible for the bill. Using this data as a guide, the next\ninsurance for the primary is secondary, then tertiary. For secondary, it's\nprimary then tertiary, and for tertiary, it's primary, then secondary. For\nother than the first occurrence, the RECORD ID 'OI3 ' must be output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURANCE SEQUENCE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ,Z,Z0 M IBZ=IBXDATA K IBXDATA I $O(IBXSAVE(1,0)) S (Z,Z0)=0 F S Z=$O(IBXSAVE(1,Z)) Q:'Z S Z0=Z0+1,IBXDATA(Z0)=IBXSAVE(1,Z) I Z0>1 D ID^IBCEF2(Z0,\"OI4 \")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. The IBXSAVE(1) variable\nholds the indicator of which insurance [(P)rimary/(S)econdary/(T)ertiary] is\ncurrently responsible for the bill. Using this data as a guide, the next\ninsurance for the primary is secondary, then tertiary. For secondary, it's\nprimary then tertiary, and for tertiary, it's primary, then secondary. For\nother than the first occurrence, the RECORD ID 'OI4 ' must be output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURANCE SEQUENCE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ,Z,Z0 M IBZ=IBXDATA K IBXDATA I $O(IBXSAVE(1,0)) S (Z,Z0)=0 F S Z=$O(IBXSAVE(1,Z)) Q:'Z S Z0=Z0+1,IBXDATA(Z0)=IBXSAVE(1,Z) I Z0>1 D ID^IBCEF2(Z0,\"OI5 \")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. The IBXSAVE(1) variable\nholds the indicator of which insurance [(P)rimary/(S)econdary/(T)ertiary] is\ncurrently responsible for the bill. Using this data as a guide, the next\ninsurance for the primary is secondary, then tertiary. For secondary, it's\nprimary then tertiary, and for tertiary, it's primary, then secondary. For\nother than the first occurrence, the RECORD ID 'OI5 ' must be output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(^DGCR(399,IBXIEN,\"U\")),U,8) S:'IBXDATA IBXDATA=9\n", "\nIf data element's value is null, transmit 9.\n
\n\n"], ["File: 364.6, IEN: 1314", "NATIONAL,NO EDIT\n", "N-OTH INSURANCE SEQUENCE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ,Z,Z0,Z1 M IBZ=IBXDATA K IBXDATA I $O(IBXSAVE(1,0)) S Z1=0 F Z0=1:1:3 I $D(IBXSAVE(1,Z0)) S Z1=Z1+1,IBXDATA(Z1)=\"QC\"\n", "\nIf the previous extract returned a value for ibxdata then the\nQC modifier is needed here.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "", "", "", "", "K IBXDATA\n", "\nThis data is being moved to CI5[8] with eClaims Iteration III.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nThis data is being moved to CI5[9] with eClaims Iteration III.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "", "", "", "", "S IBXDATA=\"\"\n", "\nPrior to IB patch 320, this was the current insurance billing provider ID \nqualifier (one of them). All billing provider ID's and qualifiers are \nnow in the CI1A segment so this field has been removed.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,\"ENTITY TYPE\"))\n", "\nGet the attending provider id info. If facility provider,\noutput 2 for non-person or 1 for person.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "", "", "", "", "S IBXDATA=$G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,\"ENTITY TYPE\"))\n", "\nGet the referring provider id info. If facility provider, output 2 for\nnon-person or 1 for person.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "", "", "", "", "S IBXDATA=$G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,2,\"ENTITY TYPE\"))\n", "\nGet the operating provider id info. If facility provider, output 2 for\nnon-person or 1 for person.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,9,\"ENTITY TYPE\"))\n", "\nGet the other provider id info. If facility provider, output 2 for\nnon-person or 1 for person.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "", "", "", "", "K IBXSAVE N A,L,Z S L=0 F S L=$O(^TMP(\"IBXDATA\",$J,IBXREC,IBXPG,L)) Q:'L S A=0 X \"S Z=2 F S Z=$O(^TMP(\"\"IBXDATA\"\",$J,IBXREC,IBXPG,L,Z)) Q:'Z I $G(^(Z))'=\"\"\"\" S A=1 Q\" I 'A K ^TMP(\"IBXDATA\",$J,IBXREC,IBXPG,L)\n", "\nCheck all the data elements on the record. If all but the 1st and second\nare null, force a null into the second element so no output occurs.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURANCE SEQUENCE\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA\n", "\nGet the current payer sequence from the claim. \nOutput "P" if primary, "S" if secondary or tertiary. \n \nThis field is a duplicate of CI2.2. It was decided to blank this field \nout so as not to confuse the user. 8/24/10\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CONDITION CODES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA K:$O(IBFL(24,0))=\"\" IBFL(24) N Z,Z0,Z1,R S (Z,Z0,R)=0 F S Z=$O(IBFL(24,Z)) K:'Z&'Z0 IBFL(24) Q:'Z S Z1=IBFL(24,Z) K IBFL(24,Z) I Z1'=\"\" S Z0=Z0+1 S IBFL(24,Z0)=Z1 D ID^IBCEF2(Z0,\"CC\"_$$M^IBCEF2(.R))\n", "\nData element's array reference is IBFL(24), not default of IBXDATA. This is\na group data element so more than 1 occurrence of a value is possible for\nthe data element in the IBFL(24) array. Each entry found is output on its\nown CCn entry where n is a record count that will allow it to be mapped into\none of the 12 available pieces of the 837 condition code record correctly.\nThis is done to accommodate Austin's translator and one of its shortcomings.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$S($$COBN^IBCEF(IBXIEN)=1:\"\",+$$MRASEC^IBCEF4(IBXIEN):\"M\",1:\"N\")\n", "\nIf the bill payer is secondary to MEDICARE WNR with an MRA on file\noutput 'M'. For non-secondaries, output nothing. \nFor non-MRA secondaries, output 'N'. \n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA,VC80 N R,VZ,Z,Z0 S (Z,R)=0,VC80=$$VC80CK^IBCEF2(IBIFN) F S Z=$O(IBXSAVE(\"VALUE\",Z)) Q:'Z S VZ=IBXSAVE(\"VALUE\",Z) S:+VC80 IBXSV(\"VC80\",Z)=VZ S Z0=$P(VZ,U) I Z0'=\"\" S IBXDATA(Z)=Z0 D ID^IBCEF2(Z,\"VC\"_$$M^IBCEF2(.R))\n", "\nEach value code found in the IBXSAVE array previously extracted is\noutput on its own VCn entry where n is a record count that will allow it\nto be mapped into one of the 12 available pieces of the 837 value code\nrecord correctly. This is done to accommodate Austin's translator and one\nof its shortcomings.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-VALUE CODE GROUP\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z K:$D(IBFL(39))=1 IBFL(39) S Z=0 F S Z=$O(IBFL(39,Z)) K:'Z IBFL(39) Q:'Z S IBXSAVE(\"VALUE\",Z)=IBFL(39,Z)\n", "\nData element's array reference is IBFL(39), not default of IBXDATA. This is\na group data element so more than 1 occurrence of a value is possible for\nthe data element in the IBFL(39) array. Save off values in IBXSAVE array\nfor later use. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D VALCODEFMT^IBCVC(.IBXSAVE,.IBXDATA)\n", "\nEach value code amount found in the IBXSAVE array previously extracted is\nformatted according to its datatype.\n \nDollar amounts are denoted by the setting of field #.19 in file #399.1 as \n"YES"\n \nOther data types are defined by code in CHK^IBCVC and VALCODEFMT^IBCVC.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURR INSURED EMPLOYER INFO\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"EMP\")=IBXDATA K IBXDATA\n", "\nSaves off data element in IBXSAVE array. Do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=\"\"\n", "\nMRD;IB*2.0*516 - Changed to be blank.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-PRINT BILL SUBMIT STATUS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=$J(\"\",+$P($G(^IBE(350.9,1,1)),U,27)),IBXDATA=Z_IBXDATA K ^UTILITY(\"VADM\",$J),^UTILITY(\"VAPA\",$J),^TMP(\"IBXSAVE\",$J),IBXSAVE S ^TMP(\"IB 1500 PRINT\",$J,IBXIEN)=1\n", "\nMove the text over to the column specified in the 1500 ADDRESS COLUMN\nparameter (file 350.9, field 1.27). Also initialize utility globals\nand variables used in this form.\n \n3/30/09 - IB patch 400 - Set the claim into the scratch global which \nindicates this claim is currently being printed as a CMS-1500 claim form.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURANCE MAILING NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S:$$WNRBILL^IBEFUNC(IBXIEN) IBXDATA=\"MEDICARE\" S Z=\"\",$P(Z,\" \",+$P($G(^IBE(350.9,1,1)),U,27)+1)=\"\" S IBXSAVE(\"INDENT\")=Z S:IBXDATA'=\"\" IBXDATA=Z_IBXDATA\n", "\nIf the 1500 ADDRESS COLUMN parameter exists, move the text over to\nthis column by adding spaces at the start of it. Save the indent parameter\nin IBXSAVE("INDENT") for future use. If the current insurance is MEDICARE\nWNR, output 'MEDICARE'.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CURR INS CO FULL ADDRESS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Y,Z K IBXSAVE(\"CADR\") I $O(IBXDATA(0)) S Y=$G(IBXDATA(6)) D ZIPOUT^VAFADDR S:Y'=\"\" $P(IBXSAVE(\"CADR\"),U,6)=Y F Z=1:1:5,7 S:$D(IBXDATA(Z)) $P(IBXSAVE(\"CADR\"),U,Z)=IBXDATA(Z) I Z=7 D CIADDR^IBCEF1(.IBXDATA,.IBXSAVE,,1)\n", "\nIf the 1500 ADDRESS COLUMN parameter exists, move the text over to this\ncolumn by adding spaces at the start of it. Format the address so each\nstreet address occupies one line, then a line containing city followed by\na comma and space, the state abbreviation, a space and the zip code,\nformatted for zip plus 4 if appropriate.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CURRENT INS POLICY TYPE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=IBXDATA D F^IBCEF(\"N-CURRENT INSURANCE CO TYPE\") S IBXDATA=$J(\"\",$S(Z=16!(Z=\"MB\")!(Z=\"MA\"):0,Z=\"TV\"!(Z=\"MC\"):7,Z=\"CH\":14,$$CHAMPVA^IBCEU3(IBXIEN)&($P($G(^DIC(36,+$$CURR^IBCEF2(IBXIEN),0)),U,2)=\"Y\"):23,IBXDATA=5:30,1:44))_\"X\"\n", "\nCheck appropriate box for type of insurance. \nCMS-1500, Box 1. Possibility of checking one box. FECA BLK LUNG is not \nan available selection. Choices are mainly extracted from the ELECTRONIC \nPLAN TYPE field (#.15) in FILE# 355.3. Also used for the Group Health \nPlan box is the 3.09 field in file 36 (if the value is 5).\n \nCode is basically setting IBXDATA=$J("",[some offset amount])_"X".\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\n1500 form, Box 1a. Current insurance insured's ID number.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-PATIENT NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\n1500 form, Box 2. Patient Name\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-PATIENT BIRTHDATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(+IBXDATA,1)\n", "\nFormat the date as MM DD YYYY.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-PATIENT SEX\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"SEX\")=IBXDATA,IBXDATA=$S($G(IBXSAVE(\"SEX\"))=\"M\":\"X\",1:\"\")\n", "\nSave the value of patient sex in IBXSAVE variable for later use. If the\nvalue is 'M', this field's value is 'X'.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$G(IBXSAVE(\"SEX\"))'=\"M\" IBXDATA=\"X\" K IBXSAVE(\"SEX\")\n", "\nThis field relies on the existence of variable IBXSAVE("SEX") previously\nextracted. If its value is not 'M', assume the sex is female and this\nfield's value will be 'X'.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED DEMOGRAPHICS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"IDEM\")=IBXDATA\n", "\nSave the insured's demographic data in IBXSAVE("IDEM").\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PROVIDER SIGNATURE ON FILE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:IBXDATA=\"\" IBXDATA=\"N\"\n", "\nIf data element is null, output 'N'.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED FULL NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nIf the current insured is the patient, the word 'SAME' is printed instead\nof repeating the name.\n \nesg - 8/23/06 - IB*2*348 - Requirement 3.2.1.12 - No longer print the \nword "SAME" in Box 4 ever. We have to print the name of the insured in \nall cases.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-PATIENT STREET ADDRESS 1-3\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z F Z=1:1:3 S IBXDATA=IBXDATA_$S(Z>1:\" \",1:\"\")_$G(^UTILITY(\"VAPA\",$J,Z))\n", "\nConcatenate all 3 lines of the address together, separated by a space.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED PT RELATION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"PREL\")=+IBXDATA,IBXDATA=$S(IBXSAVE(\"PREL\")=1:\"X\",1:\"\")\n", "\nSave the value of patient sex in IBXSAVE variable for later use. If\nthe value is '1' (patient), this field's value is 'X'.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXSAVE(\"PREL\"))=2 S IBXDATA=\"X\"\n", "\nThis field relies on the existence of variable IBXSAVE("PREL")\npreviously extracted. If its value is '2' (spouse), this field's value\nwill be 'X'.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXSAVE(\"PREL\"))=3 S IBXDATA=\"X\"\n", "\nThis field relies on the existence of variable IBXSAVE("PREL") previously\nextracted. If its value is '3' (child), this field's value will be 'X'.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$G(IBXSAVE(\"PREL\"))=\"\"!(\"123\"'[$G(IBXSAVE(\"PREL\"))) IBXDATA=\"X\" K IBXSAVE(\"PREL\")\n", "\nThis field relies on the existence of variable IBXSAVE("PREL") previously\nextracted. If its value is not a '1', '2', or '3', assume it is other and\nthis field's value will be 'X'.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED FULL ADDRESS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"IADR\")=IBXDATA\n", "\nIf patient is different than the insured, then save the address \ninformation.\n \nesg - 8/23/06 - IB*2*348 - Requirement 3.2.1.8 - Save the address \ninformation in all cases. Remove printing of the word "SAME" in Box 7.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IADR\")),U)\n", "\n1500 form, Box 7 - Insured's address\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-PATIENT CITY\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-PATIENT STATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$STATE^IBCEFG1(IBXDATA)\n", "\nOutput the state abbreviation.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURANCE SEQUENCE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ,Z,Z0 M IBZ=IBXDATA K IBXDATA I $O(IBXSAVE(1,0)) S (Z,Z0)=0 F S Z=$O(IBXSAVE(1,Z)) Q:'Z S Z0=Z0+1,IBXDATA(Z0)=IBXSAVE(1,Z) I Z0>1 D ID^IBCEF2(Z0,\"OI1 \")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. The IBXSAVE(1) variable\nholds the indicator of which insurance [(P)rimary/(S)econdary/(T)ertiary] is\ncurrently responsible for the bill. Using this data as a guide, the next\ninsurance for the primary is secondary, then tertiary. For secondary, it's\nprimary then tertiary, and for tertiary, it's primary, then secondary. For\nother than the first occurrence, the RECORD ID 'OI1 ' must be output.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nThis is no longer used.\n \nSave the value of marital status in IBXSAVE variable for later use. If\nthe value is 'I' (NEVER MARRIED), this field's value is 'X'.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nThis field is no longer used.\n \nThis field relies on the existence of variable IBXSAVE("MSTAT")\npreviously extracted. If its value is 'M' (MARRIED), this field's value\nwill be 'X'.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nThis field is no longer used.\n \nThis field relies on the existence of variable IBXSAVE("MSTAT") previously\nextracted. If its value is not a 'M', or 'I', assume it must be other and\nthis field's value will be 'X'.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IADR\")),U,2)\n", "\nThis field relies on the existence of variable IBXSAVE("IADR") previously\nextracted.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IADR\")),U,3)\n", "\nThis field relies on the existence of variable IBXSAVE("IADR") previously\nextracted. Output the state abbreviation.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-PATIENT ZIP CODE\n", "", "", "", "", "", "", "", "N Y S Y=IBXDATA D ZIPOUT^VAFADDR S IBXDATA=Y\n", "\nFormat zip code as zip plus 4 if needed.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-PATIENT PHONE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ S IBZ=$$NOPUNCT^IBCEF(IBXDATA,1) S IBXDATA=$S(IBZ?10N:($E(IBZ,1,3)_\" \"_$E(IBZ,4,6)_\"-\"_$E(IBZ,7,10)),1:$J(IBXDATA,14))\n", "\nCMS-1500, Box 5 patient telephone with area code.\nStrip out all punctuation. If you have exactly 10 numbers left, then \nformat as nnn nnn-nnnn because the form already has the area code \nparenthesis pre-printed.\nIf you have something other than 10 numbers, then just display the raw \ndata right justified so as to not overwrite those pre-printed parenthesis.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nThis field is no longer used.\n \nIf the value of this field is '1' (EMPLOYED FULL TIME), '2' (EMPLOYED\nPART TIME), '4' (SELF EMPLOYED), or '6' (FULL TIME MILITARY), assume\nemployed and output this field as 'X'.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IADR\")),U,4)\n", "\nThis field relies on the existence of variable IBXSAVE("IADR") previously\nextracted. Output the insured's zip code.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IDEM\")),U,3) I IBXDATA'=\"\" N IBZ S IBZ=$$NOPUNCT^IBCEF(IBXDATA,1),IBXDATA=$S(IBZ?10N:($E(IBZ,1,3)_\" \"_$E(IBZ,4,6)_\"-\"_$E(IBZ,7,10)),1:$J(IBXDATA,14))\n", "\nThis field relies on the existence of the variable IBXSAVE("IDEM")\npreviously extracted.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURANCE CO. NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N C,Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S C=$$OTHINS1^IBCEF2(IBXIEN) F Z=1,2 I $G(IBZ(Z))'=\"\",$E(C,Z) S:$$WNRBILL^IBEFUNC(IBXIEN,$E(C,Z)) $P(IBZ(Z),U)=\"MEDICARE\" S IBXSAVE(\"OI#\",Z)=$P(IBZ(Z),U,2,3),IBXDATA(Z)=$P(IBZ(Z),U)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. If any other insurance\ninsurance company data is found, the data is formatted as the name of the\ninsurance company from the insurance company file.\nSaves the claim office id and payer id in IBXSAVE array.\nIf other insurance is MEDICARE WNR, output is MEDICARE.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-OTH INSURED FULL NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ M IBZ=IBXDATA K IBXDATA S IBXDATA=$G(IBZ(1))\n", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED GROUP NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=$$WNRBILL^IBEFUNC(IBXIEN,+$$COBN^IBCEF(IBXIEN)) S:Z IBXDATA=\"NONE\" Q:Z I $$POLICY^IBCEF(IBXIEN,2,$P($G(^DGCR(399,IBXIEN,0)),U,21))=\"\" S IBXDATA=\"\"\n", "\nOnly output the group number if the SUBSCRIBER ID field is non-null.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-OTH INSURED GRP NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ M IBZ=IBXDATA K IBXDATA,IBXSAVE(\"OINUM\") D:$G(IBZ(1))=\"\" F^IBCEF(\"N-OTH INSURED ID\",\"IBZ\") S:$E($$OTHINS1^IBCEF2(IBXIEN)) (IBXDATA,IBXSAVE(\"OINUM\"))=$G(IBZ(1))\n", "\nSave the value of other insured group number in IBXSAVE variable for later\nuse. Use the first occurrence of other insured group number for this\nfield's value. If the other insurance is a medigap (MEDICARE WNR is\nbefore this insurance on the bill), the group # is preceeded by 'MG'\non output. If no other insured group number is found, use the other\ninsured's policy id number instead.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CONDITION RELATED TO EMPLOY\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"CONDE\")=IBXDATA,IBXDATA=$S(IBXDATA:\"X\",1:\"\")\n", "\nSave the value of condition related to employment in IBXSAVE variable for\nlater use. If this value is 1 (yes), this field's value is 'X'.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:'$G(IBXSAVE(\"CONDE\")) IBXDATA=\"X\" K IBXSAVE(\"CONDE\")\n", "\nThis field relies on the existence of the IBXSAVE("CONDE") variable\npreviously extracted. If this variable's value is 0 or null, this assumes\ncondition is not related and this field's value is 'X'.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2($P($G(IBXSAVE(\"IDEM\")),U),1)\n", "\nThis field relies on the existence of the variable IBXSAVE("IDEM")\npreviously extracted. Format the birthdate as MM DD YYYY.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$P($G(IBXSAVE(\"IDEM\")),U,2)=\"M\" IBXDATA=\"X\"\n", "\nThis field relies on the existence of the IBXSAVE("IDEM") variable\npreviously extracted. The second '^' piece contains the sex and if this\nis an 'M', this field's value is 'X'.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:\"M\"'[$P($G(IBXSAVE(\"IDEM\")),U,2) IBXDATA=\"X\"\n", "\nThis field relies on the existence of the IBXSAVE("IDEM") variable\npreviously extracted. The second '^' piece contains the sex and if this\nis not an 'M', this field's value is 'X'.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nThis is no longer used.\n \nSave the other insured's demographic data in IBXSAVE for later use. Format\nthe birthdate as MM DD YYYY.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nThis is no longer used.\n \n \nThis field relies on the existence of the IBXSAVE("OIDEM") variable\npreviously extracted. The second '^' piece contains the sex and if this\nis an 'M', this field's value is 'X'.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURED PT RELATION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $G(IBZ(Z))'=\"\",$D(^DGCR(399,IBXIEN,\"I\"_(Z+1))) S Z0=$$PRELCNV^IBCNSP1(IBZ(Z),1) I Z0'=\"\" S IBXDATA(Z)=Z0\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. If any other insurance\nis found, the output is formatted as the X12 code for the DHCP value for\nrelationship.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nThis field is no longer used.\n \nThis field relies on the existence of the IBXSAVE("OIDEM") variable\npreviously extracted. The second '^' piece contains the sex and if this\nis not a null and is not an 'M', this field's value is 'X'.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CONDITION RELATED TO AUTO\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"CONDA\")=IBXDATA,IBXDATA=$S(IBXDATA:\"X\",1:\"\")\n", "\nSave the value of condition related to auto accident in IBXSAVE variable\nfor later use. If this value is 1 (yes), this field's value is 'X'.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:'$G(IBXSAVE(\"CONDA\")) IBXDATA=\"X\"\n", "\nThis field relies on the existence of the IBXSAVE("CONDA") variable\npreviously extracted. If this variable's value is 0 or null, this assumes\ncondition is not related and this field's value is 'X'.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-AUTO ACCIDENT STATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$STATE^IBCEFG1(IBXDATA) K IBXSAVE(\"CONDA\")\n", "\nOutput state abbreviation.\n
\n\n"], ["File: 364.6, IEN: 1444", "NATIONAL,NO EDIT\n", "N-OTHER CLAIM ID (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P(IBXDATA,U)\n", "\nThis is the Property/Casualty number.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\n9C is now a reserved empty box. \n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CONDITION RELATED TO OTH ACC\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"CONDOA\")=IBXDATA,IBXDATA=$S(IBXDATA:\"X\",1:\"\")\n", "\nSave the value of condition related to other accident in IBXSAVE variable\nfor later use. If this value is 1 (yes), this field's value is 'X'.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:'$G(IBXSAVE(\"CONDOA\")) IBXDATA=\"X\" K IBXSAVE(\"CONDOA\")\n", "\nThis field relies on the existence of the IBXSAVE("CONDOA") variable\npreviously extracted. If this variable's value is 0 or null, this assumes\ncondition is not related and this field's value is 'X'.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED GROUP NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-OTH INSURED GRP NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"OINUM\") S IBXDATA=\"\" I $O(IBXDATA(\"\")) N C,Z,Z0 S C=$$OTHINS1^IBCEF2(IBXIEN),Z=$G(IBXDATA(1)) K IBXDATA I $E(C) S IBXDATA=$S($$MCRWNR^IBEFUNC(+$G(^DGCR(399,IBXIEN,\"I\"_$E(C)))):\"MEDICARE\",$P(Z,U,2):$P($G(^DIC(36,+Z,0)),U),1:$P(Z,U))\n", "\nUse the first occurrence of other insured group name. The first '^' piece\nof this value has either the group name or the insurance company pointer.\nIf the second '^' piece is a 1, the insurance company name is extracted\nusing the insurance company pointer in the first '^' piece, otherwise, the\nname in the first '^' piece is output.\nMEDICARE WNR always outputs MEDICARE.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURED GRP NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N C,Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S C=$$OTHINS1^IBCEF2(IBXIEN) F Z=1,2 I $G(IBZ(Z))'=\"\",$E(C,Z) S IBXDATA(Z)=$$NOPUNCT^IBCEF(IBZ(Z),,\"/-\")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. If any other insurance\nis found, the other insured data is output.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CLAIM CODES (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-OTHER INSURANCE EXISTS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"OI\")=IBXDATA,IBXDATA=$S(IBXDATA:\"X\",1:\"\")\n", "\nSave the other insurance exists data in the IBXSAVE variable for later\nuse. If the value is 1, output an 'X'.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:'$G(IBXSAVE(\"OI\")) IBXDATA=\"X\" K IBXSAVE(\"OI\")\n", "\nThis field relies on the existence of the IBXSAVE("OI") variable\npreviously extracted. If the value of this data element is null or 0,\noutput an 'X' in this field\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 BOX 12\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ D F^IBCEF(\"N-ROI INDICATOR\",\"IBZ\") S:IBZ IBXDATA=\"MODIFIED/RESTRICTED RELEASE \"_IBXDATA S:$L(IBXDATA)<35 IBXDATA=$J(\"\",3)_IBXDATA\n", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 BOX 13\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$J(\"\",3)_IBXDATA\n", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-PATIENT NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=$$NAME^IBCEFG1(IBXDATA),IBXDATA=$P(Z,U,2)_\" \"_$S($P(Z,U,3)'=\"\":$E($P(Z,U,3))_\" \",1:\"\")_$P(Z,U)\n", "\nOutput the patient's name as the signature first middle last name.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-STATEMENT COVERS FROM DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$FMTE^XLFDT(IBXDATA,\"5D\")\n", "\nFormat data element in MM/DD/CCYY date format.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED FULL NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=$$NAME^IBCEFG1(IBXDATA),IBXDATA=$P(Z,U,2)_\" \"_$S($P(Z,U,3)'=\"\":$E($P(Z,U,3))_\" \",1:\"\")_$P(Z,U)\n", "\nOutput the current insured's name as the signature first name, middle name\nlast name\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CUR ILL DATE (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,1)\n", "\nFormat date as MM DD YYYY.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-OTHER DATE (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,1)\n", "\nFormat date as MM DD YYYY.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURED GRP NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"OINUM\") N C,Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S C=$$OTHINS1^IBCEF2(IBXIEN) F Z=1,2 I $E(C,Z),'$$WNRBILL^IBEFUNC(IBXIEN,$E(C,Z)) S IBXDATA(Z)=$$NOPUNCT^IBCEF($G(IBZ(Z)))\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. If the insurance for\nany COB sequence is MEDICARE WNR, output nothing for that insurance.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DATE UNABLE TO WORK FROM\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,1)\n", "\nFormat date as MM DD YYYY.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DATE UNABLE TO WORK TO\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,1)\n", "\nFormat date as MM DD YYYY.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$GETPRV^IBCEF83(IBXIEN,,1,\"B1\") I IBXDATA=\"\" S IBXDATA=$$GETPRV^IBCEF83(IBXIEN,,5,\"B1\")\n", "\ncms-1500, box 17a/1, 2 character qualifier for the Referring provider \nother ID (non-NPI ID).\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$GETPRV^IBCEF83(IBXIEN,,1,\"B2\") I IBXDATA=\"\" S IBXDATA=$$GETPRV^IBCEF83(IBXIEN,,5,\"B2\")\n", "\nCMS-1500, Box 17a/2, Referring Provider other ID number (non NPI ID \nnumber).\n
\n\n"], ["File: 364.6, IEN: 1464", "NATIONAL,NO EDIT\n", "N-REFERRING PROVIDER NAME BR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$GETPRV^IBCEF83(IBXIEN,,1,\"B3\") I IBXDATA=\"\" S IBXDATA=$$GETPRV^IBCEF83(IBXIEN,,5,\"B3\")\n", "\nNPI# of Referring Physician\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 BOX 18 (FR)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,1)\n", "\n'From' date is the first '^' piece of this data. Format date as MM DD YYYY.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 BOX 18 (TO)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D:'IBXDATA&'$$INPAT^IBCEF(IBXIEN,1) F^IBCEF(\"N-STATEMENT COVERS TO DATE\",,,IBXIEN) S IBXDATA=$$DATE^IBCF2(IBXDATA,1)\n", "\nIf there is no date in IBXDATA, set it to Statement Covers To Date then \nformat the resulted date.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 BOX 19\n", "", "", "", "", "", "", "", "S IBXSAVE(\"BOX19\")=$S($L(IBXDATA)<49:$J(\"\",48),$L(IBXDATA)<84:$J(\"\",25),1:\"\")_IBXDATA,IBXDATA=$E(IBXSAVE(\"BOX19\"),1,48)\n", "\nThis field holds the 1st through 48th characters of the box's data.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D:'$D(IBXSAVE(\"BOX19\")) F^IBCEF(\"N-HCFA 1500 BOX 19\",,,IBXIEN) S IBXDATA=$E($G(IBXSAVE(\"BOX19\")),49,96) K IBXSAVE(\"BOX19\")\n", "\nIf the array that holds the entire box 19 data is not defined, extract it.\nThis field will hold the 49th through 96th characters of the box's data.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURED ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,IBZ M IBZ=IBXDATA K IBXDATA,IBXSAVE(\"OIID\") F Z=1,2 I $D(^DGCR(399,IBXIEN,\"I\"_(Z+1))),$G(IBZ(Z))'=\"\" S IBZ(Z)=$$NOPUNCT^IBCEF(IBZ(Z)) I IBZ(Z)'=\"\" S IBXDATA(Z)=IBZ(Z),IBXSAVE(\"OIID\",Z)=1\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible other payers on the bill (F Z=1,2). If that other insurance \nexists on the claim and the subscriber ID is not nil after stripping out \nthe punctuation marks, then build IBXDATA(Z) array and also save the \nIBXSAVE("OIID",Z) array entry to indicate that a valid ID is being output \nfor this other payer Z. This is so the qualifier in OI2-11 can be output \nbecause we have the ID#.\npossible for the data element in the IBXDATA array. If any other insured\nID data is found, the data is output.\n \nOI2-3\n2330A/NM109\n \nMerge IBZ=IBXDATA which is the list of other payer subscriber ID's \nreturned from data element N-OTH INSURED ID. Loop thru each of the \n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $P($G(^DGCR(399,IBXIEN,\"U2\")),U,10) S IBXDATA=\"X\"\n", "\ncms-1500, box 20 Outside Lab=YES\nChanged with IB patch 371\nIf there is an outside facility on the claim, then an "X" should display \nin the YES box.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CMS-1500 PURCH SVC TOTAL\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S('IBXDATA:\"\",1:$$DOL^IBCEF77(IBXDATA,9)) I '$P($G(^DGCR(399,IBXIEN,\"U2\")),U,10) K IBXDATA\n", "\nFormat the amount in 9 characters with 2 decimals.\n \nIf there is not an Outside facility on the claim, then NO gets the "X" \nand the charges field will be blank.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nThe 1500 instruction manual says that this area should always be left \nblank.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IB M IB=IBXDATA K IBXDATA D DXSV^IBCEF31(.IB,.IBXSAVE) S IBXDATA=$P($$ICD9^IBACSV(+$G(IBXSAVE(\"DX\",1)),$$BDATE^IBACSV(IBXIEN)),U) D PGDX^IBCEF31(1,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", "\nSave the diagnoses in the IBXSAVE array for later use. Output the\ndiagnosis code for the first diagnosis. Check for any diagnosis codes\nthat should display in the first position on pages subsequent to page 1\nand output them.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE 3 (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$ICD9^IBACSV(+IBXDATA,$$BDATE^IBACSV(IBXIEN)),U) D PGDX^IBCEF31(3,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", "\nOutput the third diagnosis code. Check for any diagnosis codes that should\ndisplay in the third position on pages subsequent to page 1 and output\nthem.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-UB-04 TIMEFRAME OF BILL\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"FQCD\") S:(\"^7^8^\"[(U_IBXDATA_U)) IBXSAVE(\"FQCD\")=IBXDATA I '$D(IBXSAVE(\"FQCD\")) K IBXDATA\n", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CURR INS FORM LOC 64\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I '$D(IBXSAVE(\"FQCD\")) K IBXDATA\n", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE 2 (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$ICD9^IBACSV(+IBXDATA,$$BDATE^IBACSV(IBXIEN)),U) D PGDX^IBCEF31(2,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", "\nOutput the second diagnosis code. Check for any diagnosis codes that should\ndisplay in the second position on pages subsequent to page 1 and output\nthem.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE 4 (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$ICD9^IBACSV(+IBXDATA,$$BDATE^IBACSV(IBXIEN)),U) D PGDX^IBCEF31(4,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", "\nOutput the forth diagnosis code. Check for any diagnosis codes that should\ndisplay in the forth position on pages subsequent to page 1 and output\nthem.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CURRENT AUTH/REFERRAL CODE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$OLAB^IBCEU(IBXIEN) N IBZ S IBZ=IBXDATA D F^IBCEF(\"N-LAB CLIA #\",,,IBXIEN) I IBXDATA=\"\",IBZ'=\"\" S IBXDATA=IBZ\n", "\nIf the bill is for services rendered at an outside lab, get the CLIA number.\nIf this # is not available, use the prior authorization #.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURED FULL NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $D(^DGCR(399,IBXIEN,\"I\"_(Z+1))),$G(IBZ(Z))'=\"\" S IBXSAVE(\"OINM\",Z)=$$NAME^IBCEFG1(IBZ(Z))\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. If any other insurance,\nthe name data is saved in the IBXSAVE array for later use, formatted in\nLAST^FIRST^MIDDLE format. No output.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I '$O(IBXSAVE(\"BOX24\",0)) D B24^IBCEF3(.IBXSAVE,IBXIEN,1)\n", "\nIf array doesn't already exist, extract it\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DATE OF SERVICE FROM\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exist\nfor the bill, this outputs the rest on additional bill pages.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DATE OF SERVICE TO\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 PLACE OF SERVICE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-HCFA EMERGENCY INDICATOR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 PROCEDURES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE REFS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exist for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 CHARGES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exist for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 UNITS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exist for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-HCFA BOX 24H FREE TEXT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z F Z=1,2 S:$P($G(IBXSAVE(\"OINM\",Z)),U)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"OINM\",Z),U)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany other insurance name data is found, the last name is output.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CMS-1500 BOX 24I ID QUAL BR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CMS-1500 24J REND PROV ID BR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"DX\"),IBXSAVE(\"BOX24\"),IBXSAVE(\"OCC\"),IBXSAVE(\"OCCS\"),IBXSAVE(\"IDEM\"),IBXSAVE(\"IADR\")\n", "\nClean up IBXSAVE array.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-FEDERAL TAX ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 EIN FLAG (BOX 25)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-AR BILL NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-ASSIGN OF BENEFITS INDICATOR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=$S(IBXDATA=\"\"!(\"Nn0\"'[IBXDATA):1,1:6) S IBXDATA=$J(\"X\",Z)\n", "\nPrint indicator of ASSIGNMENT OF BENEFITS. Check Yes if data element value\nreturned is null or is not 0,'n', or 'N', otherwise check No.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-TOTAL CHARGES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"TOT\")=IBXDATA K IBXDATA I $O(^TMP(\"IBXDATA\",$J,IBXREC,\"\"),-1)'>1 S IBXDATA=$$DOL^IBCEF77(IBXSAVE(\"TOT\"),9)\n", "\nSave the total charges in IBXSAVE array for later use. If\ntotal is not null, output as numeric with 2 decimal places.\nOnly output totals on last page of form.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-PRIOR PAYMENTS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"PAID\")=0 K IBXDATA I $O(^TMP(\"IBXDATA\",$J,IBXREC,\"\"),-1)'>1 S IBXDATA=$$DOL^IBCEF77(IBXSAVE(\"PTOT\"),8) K IBXSAVE(\"PAID\")\n", "\nThe payment received from the patient or other payers.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nthis field is no longer used.\n \nIf not 0, output as numeric with 2 decimals.\nOnly output total on last page of form.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"BILLING PRV\",IBXIEN,\"C\",1,2)),U,1)\n", "\nEI=Employer ID;SY=Social Security Number;0B=State License Number;\n1A = Blue Cross Number;1B=Blue Shield Number;1C=Medicare Number;\n1D = Medicaid Number;1G=UPIN Number;1H=TRICARE ID Number;\nB3 = PPO Number;BQ=HMO Code Number;U3=USIN Number;G2=Commercial Number;\nFH = Clinic Number;X5=State Industrial Accident Provider Number;\nLU=Location Number\nThis is the X12 interpretation of the type of billing provider id for this insurance co. It is calculated from the electronic type of plan. Refer to the 837 V4010 (professional) fields 2010BB/REF(2)/01 and 2000B/SBR/09 for details.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z F Z=1,2 I $P($G(IBXSAVE(\"OINM\",Z)),U,2)'=\"\" S IBXDATA(Z)=$P(IBXSAVE(\"OINM\",Z),U,2)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany other insurance name data is found, the first name is output.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ S IBXDATA=$G(IBXSAVE(\"BOX33\",\"PHONE\")),IBZ=$$NOPUNCT^IBCEF(IBXDATA,1),IBXDATA=$S(IBZ?10N:($E(IBZ,1,3)_\" \"_$E(IBZ,4,6)_\"-\"_$E(IBZ,7,10)),1:$J(IBXDATA,13))\n", "\nBilling provider phone number, CMS-1500, Box 33, upper right hand corner.\n \nThis is actually the Pay-To Provider phone number.\n \nIB*2*400 changes.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "Q:'$G(IBXSAVE(\"SERVFACFLAG\")) N Z S Z=$G(IBXSAVE(\"BPSFDATA\")),IBXDATA=$$GETFAC^IBCEP8(+$P(Z,U,4),$P(Z,U,3),0)\n", "\nesg - 10/1/08 - IB*2*400 - Print the service facility name only if there \nis a service facility for the claim\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"BOX33\",\"NAME\"))\n", "\nBilling provider name - Box 33 on the CMS-1500.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-ATT/REND PHYSICIAN NAME BR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"BOX31\")=IBXDATA,IBXDATA=$$NAME31^IBCF2(IBXIEN,IBXDATA)\n", "\nFormats the name in 21 spaces for block 31 of the 1500.\nIBXSAVE("BOX31") is the name in format Last,first mi^ien in file 200\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-BILLING PROVIDER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=$P(IBXDATA,U,3),IBXSAVE(\"SERVFACFLAG\")=$S(Z=\"\":0,1:1),IBXSAVE(\"BPSFDATA\")=IBXDATA D GETBP^IBCEF79(IBXIEN,\"\",+IBXDATA,\"BOX33\",.IBXSAVE)\n", "\nCalculate only field to populate boxes 32 and 33 on the CMS-1500 claim \n \nThe IBXSAVE("BOX33") array elements will be built with information about \nthe billing provider name, address, and phone# to go into Box 33.\nform. The data element call to N-BILLING PROVIDER will save information \nabout the service facility and the billing provider for this claim.\n \nIBXSAVE("SERVFACFLAG") is a 0/1 flag indicating if there is a service \nfacility for this claim.\n \nIBXSAVE("BPSFDATA") is the string of information returned by the \n$$B^IBCEF79 function call.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "KILL IBXSAVE(\"SERVFACFLAG\"),IBXSAVE(\"BPSFDATA\"),IBXSAVE(\"BOX33\"),^TMP(\"IB 1500 PRINT\",$J,IBXIEN),IBXPROV\n", "\nRemove IBXSAVE array entries used in the construction of Boxes 32 and 33.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "Q:'$G(IBXSAVE(\"SERVFACFLAG\")) N Z S Z=$G(IBXSAVE(\"BPSFDATA\")),IBXDATA=$$GETFAC^IBCEP8(+$P(Z,U,4),$P(Z,U,3),12)\n", "\nBox 32 - service facility address lines 1&2\nOnly print data if there is a service facility for this claim.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"BOX33\",\"ADDR1\"))_\" \"_$G(IBXSAVE(\"BOX33\",\"ADDR2\"))\n", "\ncms-1500, Box 33 Billing provider address lines 1&2.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DATE FIRST PRINTED\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N A,Z S Z=$$DATE31^IBCF2(IBXDATA,IBXIEN) S A=$$GETPRV^IBCEF83(IBXIEN,,3,\"A6\"),IBXDATA=A_$J(\"\",11-$L(A))_Z\n", "\nPrint credentials left justified and date right justified. Format date as\nMM/DD/YYYY.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "Q:'$G(IBXSAVE(\"SERVFACFLAG\")) N Z S Z=$G(IBXSAVE(\"BPSFDATA\")),IBXDATA=$$GETFAC^IBCEP8(+$P(Z,U,4),$P(Z,U,3),3,26)\n", "\nCMS-1500, Box 32, service facility city,st,zip\nOnly print this information if there is a service facility for this claim.\n \nThe 4th parameter to the $$GETFAC function is 26 since there is only room \nfor 26 characters for city, st zip. This function will try to truncate \nthe city, st zip in the best possible way if necessary.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z F Z=1,2 I $P($G(IBXSAVE(\"OINM\",Z)),U,3)'=\"\" S IBXDATA(Z)=$P(IBXSAVE(\"OINM\",Z),U,3)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany other insurance name data is found, the middle name is output.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$CSZ^IBCEP8($G(IBXSAVE(\"BOX33\",\"CITY\")),$G(IBXSAVE(\"BOX33\",\"ST\")),$G(IBXSAVE(\"BOX33\",\"ZIP\")),29)\n", "\ncms-1500, Box 33, Billing Provider city,st,zip\n \nThere is only room for 29 characters for city, st zip. This $$CSZ\nfunction will try to truncate the city, st zip in the best possible way if\nnecessary.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I '$D(^DGCR(399,IBXIEN,\"PRV\",0)) S IBXDATA=$E($P($G(IBXSAVE(\"BOX31\")),U),43,63)\n", "\nThis line is no longer printed on the standard 1500.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "Q:'$G(IBXSAVE(\"SERVFACFLAG\")) S IBXDATA=$P($$ORGNPI^IBCEF73A(IBXIEN),U,1),IBXSAVE(\"NPISVC\")=IBXDATA\n", "\nCMS-1500 form, Box 32a.\nService Facility NPI#\n \nSave the service facility NPI# in IBXSAVE("NPISVC") for use in Box 32b.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "Q:'$G(IBXSAVE(\"SERVFACFLAG\")) N IBX,IBY,IBZ S IBY=$$PRTLID^IBCEF77(IBXIEN,$G(IBXSAVE(\"NPISVC\"))) K IBXSAVE(\"NPISVC\"),IBXDATA I IBY D ALLIDS^IBCEF75(IBXIEN,.IBZ,1) S IBX=$G(IBZ(\"LAB/FAC\",IBXIEN,\"C\",1,1)),IBXDATA=$P(IBX,U,1)_$P(IBX,U,2)\n", "\n1500, Box 32b. Accommodate the reporting of other ID numbers.\nEnter the 2 digit qualifier followed by the secondary ID number.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$ORGNPI^IBCEF73A(IBXIEN),U,3),IBXSAVE(\"NPIBILL\")=IBXDATA\n", "\ncms-1500 form, Box 33a. Billing provider NPI.\n \nSave the billing provider NPI in IBXSAVE("NPIBILL") for use in Box 33b.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBX,IBY,IBZ S IBY=$$PRTLID^IBCEF77(IBXIEN,$G(IBXSAVE(\"NPIBILL\"))) K IBXSAVE(\"NPIBILL\"),IBXDATA I IBY D ALLIDS^IBCEF75(IBXIEN,.IBZ,1) S IBX=$G(IBZ(\"BILLING PRV\",IBXIEN,\"C\",1,2)),IBXDATA=$P(IBX,U,1)_$P(IBX,U,2)\n", "\n1500 form. Box 33b. Billing provider Other ID number.\nEnter the 2 digit qualifier followed by the secondary ID#.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $O(^TMP(\"IBXDATA\",$J,IBXREC,1)) N Z,FLDS X \"F Z=1:1:+$O(^IBA(364.6,\"\"ASEQ\"\",2,1,\"\"\"\"),-1) S:(Z'>43!(Z'<57))&(Z'=6)&(Z'=39)&(Z'=41) FLDS(Z)=\"\"\"\"\" F Z=2:1:+$O(^TMP(\"IBXDATA\",$J,IBXREC,Z),-1) D MPG^IBCEF3(Z,.FLDS,2)\n", "\nIf there is more than 1 page of bill extracted, the variable\nFLDS(line,column) holds the lines and columns that should be duplicated on\npages after the first. This takes care of the population of these static\nfields on these subsequent pages.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I '$P($G(^DGCR(399,IBXIEN,\"U2\")),U,10) S IBXDATA=\"X\"\n", "\nCMS-1500, box 20 Outside Lab=NO.\nChanged with IB patch 371\nIf there is not an outside facility on the claim, then the NO box gets \nthe "X".\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURED DEMOGRAPHICS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $D(^DGCR(399,IBXIEN,\"I\"_(Z+1))),$G(IBZ(Z))'=\"\" S IBXSAVE(\"OIDEM\",Z)=IBZ(Z)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. If any other insurance,\nthe data is saved in the IBXSAVE array for later use. No output.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K ^UTILITY(\"VADM\",$J),^UTILITY(\"VAPA\",$J),^TMP(\"IBXSAVE\",$J),IBXSAVE\n", "\nKills off globals,other variables to be used, sets right margin variable.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-PRINT BILL SUBMIT STATUS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-BILLING PROVIDER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"BPDATA\")=IBXDATA,IBXDATA=$$BNIEN^XUAF4(+IBXSAVE(\"BPDATA\")) S:IBXDATA=\"\" IBXDATA=$$GETFAC^IBCEP8(+IBXSAVE(\"BPDATA\"),0,0)\n", "\nBilling Provider name. Use the data element to extract the billing \nprovider IEN for this claim. Save this string into scratch variable \nIBXSAVE("BPDATA") for use in other fields in FL-1. Extract the facility \nname from file 4.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$GETFAC^IBCEP8(+IBXSAVE(\"BPDATA\"),0,12)\n", "\nRetrieve the billing provider address from the Institution file \n(file#4). Grab both address line 1 and address line 2.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$GETFAC^IBCEP8(+IBXSAVE(\"BPDATA\"),0,\"3C\")\n", "\nGet the billing provider city from file 4.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$GETFAC^IBCEP8(+IBXSAVE(\"BPDATA\"),0,\"3S\")\n", "\nGet the billing provider state from file 4.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$TR($$GETFAC^IBCEP8(+IBXSAVE(\"BPDATA\"),0,\"3Z\"),\"-\")\n", "\nGet the billing provider zip code from file 4. Form Locator 1\naccommodates a 9-digit zip code so strip out the hyphen.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D GETBP^IBCEF79(IBXIEN,\"\",+IBXSAVE(\"BPDATA\"),\"FL1\",.IBXSAVE) S IBXDATA=$G(IBXSAVE(\"FL1\",\"PHONE\")),IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)\n", "\nThis is the Pay-To provider phone number being used in FL-1, line 4.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURED EMPLOYR INFO\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $D(^DGCR(399,IBXIEN,\"I\"_(Z+1))),$G(IBZ(Z))'=\"\" S IBXSAVE(\"OIEMP\",Z)=IBZ(Z)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. If any other insurance,\nthe employer data is saved in the IBXSAVE array for later use.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"UBFL2\")),U,1)\n", "\nPay-to provider name\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"UBFL2\")),U,5)_\" \"_$P($G(IBXSAVE(\"UBFL2\")),U,6)\n", "\nUB-04, FL-2\nPay-to provider street address\nConcatenate address line 1 and line 2 together and try to fit as much as \npossible within the given 25 characters.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"UBFL2\")),U,7)\n", "\nUB-04, FL-2\npay-to provider city name\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"UBFL2\")),U,8)\n", "\nUB-04, FL-2\npay-to provider state code\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"UBFL2\")),U,9)\n", "\nUB-04, FL-2\npay-to provider zip code\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",1)) S IBXDATA=$P(IBXSAVE(\"PROC\",1),U),IBXDATA=$S(IBXDATA[\"ICPT\"!(IBXDATA[\"ICD0\"):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the first occurrence exists, output the code\nreferenced by its first '^' piece.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA,IBXSAVE(\"UBFL2\"),IBXSAVE(\"BPDATA\"),IBXSAVE(\"FL1\")\n", "\nNOT USED. Reserved for Assignment by the NUBC.\n \nKill some scratch arrays here used for FL-1 and FL-2.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-AR BILL NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-MEDICAL RECORD NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)\n", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=0_$$TOB^IBCEF1(IBXIEN)\n", "\nType of bill is 4 characters long with the first digit being a leading \nzero.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)'=7 N Z F Z=1,2 I $D(^DGCR(399,IBXIEN,\"I\"_(Z+1))),$P($G(IBXSAVE(\"OIEMP\",Z)),U)'=\"\" S IBXDATA(Z)=$P(IBXSAVE(\"OIEMP\",Z),U)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany other insurance employer data is found, the data is output.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-BILLING SITE\n", "", "", "", "ZERO PAD ON LEFT\n", "", "", "", "S IBXDATA=$E($P(IBXDATA,U,3),4,7) I $TR(IBXDATA,0)=\"\" K IBXDATA\n", "\nAlways 0-fill data to the left. If primary site, don't output. If not\nprimary site, this is the site suffix (up to 4 digits)\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-FEDERAL TAX ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-STATEMENT COVERS FROM DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,,1)\n", "\nFormat date in MMDDYY format.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-STATEMENT COVERS TO DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,,1)\n", "\nFormat date in MMDDYY format.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nReserved for Assignment by the NUBC.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nReserved for Assignment by the NUBC.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-CURR INSURED PT RELATION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(IBXDATA'=\"01\":$P($$INSSECID^IBCEF21(IBXIEN,\"PAT\"),U,2),1:\"\")\n", "\nThis is the patient identification number as assigned by the current \npayer for this patient.\n \nThe patient ID in box 8a is situational. It should be used only when the \npatient is not the subscriber. Report if number is different from the \nsubscriber ID in FL-60. FL-60 holds the subscriber ID#.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-PATIENT NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-PATIENT STREET ADDRESS 1-3\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(^UTILITY(\"VAPA\",$J,1))_\" \"_$G(^UTILITY(\"VAPA\",$J,2))_\" \"_$G(^UTILITY(\"VAPA\",$J,3))\n", "\nPatient address - street address\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-PATIENT CITY\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nPatient address - city\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany other insurance employer data is found, the data is output.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-PATIENT STATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$GET1^DIQ(5,$S(+$$PTADDR^IBCEF(IBXIEN,25)>1:+$$PTADDR^IBCEF(IBXIEN,23),1:+IBXDATA),1)\n", "\nPatient address - state/province (2-char code)\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-PATIENT ZIP CODE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:+$$PTADDR^IBCEF(IBXIEN,25)>1 IBXDATA=$$PTADDR^IBCEF(IBXIEN,24)\n", "\nPatient address - zip code/postal code\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-OCCURRENCE CODES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z0=0 F Z=1,5 S Z0=Z0+1 S:$G(IBXSAVE(\"OCC\",Z))'=\"\" IBXDATA(Z0)=$P(IBXSAVE(\"OCC\",Z),U)\n", "\nThe data element extracts multiply-occurring data for the occurrence codes\nand occurrence span codes and outputs the first occurrence code here.\nOverflow codes are printed on a separate page.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=1:4 Q:$G(IBXSAVE(\"OCC\",Z))=\"\" S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(\"OCC\",Z),U,2),,1) S:Z'>5 IBXDATA(Z0)=Z1 D:Z>5 XOCC^IBCEF3($P(IBXSAVE(\"OCC\",Z),U)_U_Z1,Z0,31) K IBXSAVE(\"OCC\",Z)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCC") extracted previously. This field outputs the 1st and 5th\noccurrences of occurrence code 'from date' formatted as MMDDYY found in the\nsecond '^' piece of the IBXSAVE("OCC",n) array data element.\nOverflow codes (9,13,...) are printed on a separate page.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z0=0 F Z=2,6 S Z0=Z0+1 S:$G(IBXSAVE(\"OCC\",Z))'=\"\" IBXDATA(Z0)=$P(IBXSAVE(\"OCC\",Z),U)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCC") extracted previously. This field outputs the 2nd and 6th\noccurrences of occurrence codes found in the IBXSAVE("OCC",n) array data\nelement. Overflow codes are printed on a separate page.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=2:4 Q:$G(IBXSAVE(\"OCC\",Z))=\"\" S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(\"OCC\",Z),U,2),,1) S:Z'>6 IBXDATA(Z0)=Z1 D:Z>6 XOCC^IBCEF3($P(IBXSAVE(\"OCC\",Z),U)_U_Z1,Z0,32) K IBXSAVE(\"OCC\",Z)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCC") extracted previously. This field outputs the 2nd and 6th\noccurrences of occurrence code 'from date' formatted as MMDDYY found in the\nsecond '^' piece of the IBXSAVE("OCC",n) array data element.\nOverflow codes (10,14,...) are printed on a separate page.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z0=0 F Z=3,7 S Z0=Z0+1 S:$G(IBXSAVE(\"OCC\",Z))'=\"\" IBXDATA(Z0)=$P(IBXSAVE(\"OCC\",Z),U)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCC") extracted previously. This field outputs the 3rd and 7th\noccurrences of occurrence codes found in the IBXSAVE("OCC",n) array data\nelement. Overflow codes are printed on a separate page.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=3:4 Q:$G(IBXSAVE(\"OCC\",Z))=\"\" S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(\"OCC\",Z),U,2),,1) S:Z'>7 IBXDATA(Z0)=Z1 D:Z>7 XOCC^IBCEF3($P(IBXSAVE(\"OCC\",Z),U)_U_Z1,Z0,33) K IBXSAVE(\"OCC\",Z)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCC") extracted previously. This field outputs the 3rd and 7th\noccurrences of occurrence code 'from date' formatted as MMDDYY found in the\nsecond '^' piece of the IBXSAVE("OCC",n) array data element.\nAny overflow codes (11,15,...) are output on a separate page.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z0=0 F Z=4,8 S Z0=Z0+1 S:$G(IBXSAVE(\"OCC\",Z))'=\"\" IBXDATA(Z0)=$P(IBXSAVE(\"OCC\",Z),U)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCC") extracted previously. This field outputs the 4th and 8th\noccurrences of occurrence codes found in the IBXSAVE("OCC",n) array data\nelement. Overflow codes are printed on a separate page.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=4:4 Q:$G(IBXSAVE(\"OCC\",Z))=\"\" S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(\"OCC\",Z),U,2),,1) S:Z'>8 IBXDATA(Z0)=Z1 D:Z>8 XOCC^IBCEF3($P(IBXSAVE(\"OCC\",Z),U)_U_Z1,Z0,34) K IBXSAVE(\"OCC\",Z)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCC") extracted previously. This field outputs the 4th and 8th\noccurrences of occurrence code 'from date' formatted as MMDDYY found in the\nsecond '^' piece of the IBXSAVE("OCC",n) array data element.\nAny overflow codes (12,16,...) are output on a separate page.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany other insurance employer data is found, the data is formatted as the 2\ncharacter state abbreviation.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z0=0 F Z=1,3 S Z0=Z0+1 S:$G(IBXSAVE(\"OCCS\",Z))'=\"\" IBXDATA(Z0)=$P(IBXSAVE(\"OCCS\",Z),U)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCCS") extracted previously. This field outputs the 1st and 3rd\noccurrences of occurrence span codes found in the IBXSAVE("OCCS",n) array\ndata element. Overflow codes are printed on a separate page.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z0=0 F Z=1,3 S Z0=Z0+1 S:$G(IBXSAVE(\"OCCS\",Z))'=\"\" IBXDATA(Z0)=$$DATE^IBCF2($P(IBXSAVE(\"OCCS\",Z),U,2),,1)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCCS") extracted previously. This field outputs the 1st and 3rd\noccurrences of occurrence span code 'from date' formatted as MMDDYY found\nin the second '^' piece of the IBXSAVE("OCCS",n) array data element.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Q,Z0 K IBXDATA S Z0=0 F Z=1:2 Q:$G(IBXSAVE(\"OCCS\",Z))=\"\" S Z0=Z0+1,Q=$$DATE^IBCF2($P(IBXSAVE(\"OCCS\",Z),U,3),,1) S:Z'>3 IBXDATA(Z0)=Q D:Z>3 XOCCS^IBCEF3($P(IBXSAVE(\"OCCS\",Z),U)_U_$$DATE^IBCF2($P(IBXSAVE(\"OCCS\",Z),U,2),,1)_U_Q,Z0,35)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCCS") extracted previously. This field outputs the 1st and 3rd\noccurrences of occurrence span code 'to date' formatted as MMDDYY found\nin the third '^' piece of the IBXSAVE("OCCS",n) array data element.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N CIEN S CIEN=+$$PTADDR^IBCEF(IBXIEN,25),IBXDATA=$S(CIEN>1:$$GET1^DIQ(779.004,CIEN,1.2),1:\"\")\n", "\nPatient address - country code.\nPrinted if country is not USA, blank otherwise.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z0=0 F Z=2,4 S Z0=Z0+1 S:$G(IBXSAVE(\"OCCS\",Z))'=\"\" IBXDATA(Z0)=$P(IBXSAVE(\"OCCS\",Z),U)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCCS") extracted previously. This field outputs the 2nd and 4th\noccurrences of occurrence span codes found in the IBXSAVE("OCCS",n) array\ndata element. Overflow codes are printed on a separate page.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z0=0 F Z=2,4 S Z0=Z0+1 S:$G(IBXSAVE(\"OCCS\",Z))'=\"\" IBXDATA(Z0)=$$DATE^IBCF2($P(IBXSAVE(\"OCCS\",Z),U,2),,1)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCCS") extracted previously. This field outputs the 2nd and 4th\noccurrences of occurrence span code 'from date' formatted as MMDDYY found\nin the second '^' piece of the IBXSAVE("OCCS",n) array data element.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Q,Z0 K IBXDATA S Z0=0 F Z=2:2 Q:$G(IBXSAVE(\"OCCS\",Z))=\"\" S Z0=Z0+1,Q=$$DATE^IBCF2($P(IBXSAVE(\"OCCS\",Z),U,3),,1) S:Z'>4 IBXDATA(Z0)=Q D:Z>4 XOCCS^IBCEF3($P(IBXSAVE(\"OCCS\",Z),U)_U_$$DATE^IBCF2($P(IBXSAVE(\"OCCS\",Z),U,2),,1)_U_Q,Z0,36)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCCS") extracted previously. This field outputs the 2nd and 4th\noccurrences of occurrence span code 'to date' formatted as MMDDYY found\nin the third '^' piece of the IBXSAVE("OCCS",n) array data element.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "", "", "", "", "S IBXDATA=$$DXIND^IBCF2(IBXIEN)\n", "\nA 9 indicates ICD 9 codes. A 0 indicates ICD 10 Codes.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-DIAGNOSES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N C,Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S (C,Z)=0 F S Z=$O(IBZ(Z)) Q:'Z I '$$ECODE^IBCEU4(+IBZ(Z)) S C=C+1 S:C=1 IBXDATA=$TR($P($$ICD9^IBACSV(+IBZ(Z),$$BDATE^IBACSV(IBXIEN)),U),\".\") S IBXSAVE(\"DX\",C)=+IBZ(Z)_U_$$GETPOA^IBCEU4($P(IBZ(Z),U,2),1)\n", "\nThe principal dx is found in the first occurrence of the data element's\nvalues. The diagnoses are saved off in the IBXSAVE("DX") array for later\nuse. Only allow 3 E-codes in ICD-9.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CKPGUB^IBCEF3\n", "\nChecks for multi-page output, adds the static fields to subsequent pages.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"INM\")),U,5)\n", "\nINSURED NAME SUFFIX also known as SUBSCRIBER NAME SUFFIX. It is extracted \nusing a function call, $$SETSTR^VALM1 to get the full name then an IB\nfunction to format it, $$NAME^IBCEFG1.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nReserved for Assignment by the NUBC. Not used.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nReserved for Assignment by the NUBC. Box 37 line 2. Not used.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",11)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",11),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a eleventh diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-PATIENT BIRTHDATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,1,1) S:IBXDATA=\"\" IBXDATA=\"00000000\"\n", "\nIf BIRTHDATE exists, format it MMDDYYYY. If it doesn't exist, output\n00000000.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-PATIENT SEX\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:IBXDATA=\"\" IBXDATA=\"U\"\n", "\nIf the data element's value is null, set it equal to 'U'.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-ADMISSION DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:'$$HHLTH^IBCEF1(IBXIEN,1) IBXDATA=\"\" I $$HHLTH^IBCEF1(IBXIEN,1) S IBXSAVE(\"ADTM\")=$$TIME^IBCF3(IBXDATA),IBXDATA=$$DATE^IBCF2($P(IBXDATA,\".\"),,1)\n", "\nSave the admission time in IBXSAVE array for later use. Format date\nwithout the time as MMDDYY. IB*2.0*547 removed the STATEMENT FROM date on \ninpatient professional claims.\nIB*2.0*574 added STATEMENT FROM date for Outpatient Home Health and Hospice\nclaims.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S('$$INPAT^IBCEF(IBXIEN,1):\"\",$G(IBXSAVE(\"ADTM\"))'=\"\":$E(IBXSAVE(\"ADTM\"),1,2),1:\"00\")\n", "\nAdmission time\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-TYPE OF ADMISSION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:'IBXDATA IBXDATA=9\n", "\nAdmission type:\nesg - 8/15/07 - FL-14 is always required - even for outpatients - so if \nIBXDATA does not have a value, set it equal to "9" for local printing.\n1 - Emergency\n2 - Urgent\n3 - Elective\n4 - Newborn\n5 - Trauma\n6-8 - Reserved\n9 - Information not available\n \n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-SOURCE OF ADMISSION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nSource of admission:\n9 - Information not available\nA - Transfer from a critical access hospital\nB - Transfer from another home health agency\nC - Readmission to same home health agency\nD - Transfer from hospital inpatient in the same facility,\n resulting in a separate claim to the payer\nCodes for Newborn admission type:\n1 - Normal delivery\n2 - Premature delivery\n3 - Sick baby\n1 - Physician referral\n4 - Extramural birth\n5-9 - Reserved\n2 - Clinic referral\n3 - HMO referral\n4 - Transfer from a hospital\n5 - Transfer from a skilled nursing facility\n6 - Transfer from another health care facility\n7 - Emergency room\n8 - Court / Law enforcement\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-DISCHARGE DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:'$$INPAT^IBCEF(IBXIEN,1) IBXDATA I $D(IBXDATA) S IBXDATA=$S($P(IBXDATA,\".\",2)'=\"\":$$TIME^IBCF3(IBXDATA),1:\"\")\n", "\nIf this is an outpatient bill, no output. For inpatient bills, output the\ntime portion of the discharge date/time or 99 if no time found.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-HOMEBOUND\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(+IBXDATA:\"Y\",1:\"\")\n", "\nOnly report if Data is 1 set IBXDATA to Y\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-PATIENT STATUS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-CURR INSURANCE MAILING NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$$WNRBILL^IBEFUNC(IBXIEN) IBXDATA=\"MEDICARE\" S IBXSAVE(\"CADR_NAME\")=$G(IBXDATA)\n", "\nExtract the current payer name and save it in IBXSAVE.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-CURR INS CO FULL ADDRESS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Y,Z K IBXSAVE(\"CADR\") I $O(IBXDATA(0)) S Y=$G(IBXDATA(6)) D ZIPOUT^VAFADDR S:Y'=\"\" $P(IBXSAVE(\"CADR\"),U,6)=Y F Z=1:1:5,7 S:$D(IBXDATA(Z)) $P(IBXSAVE(\"CADR\"),U,Z)=IBXDATA(Z)\n", "\nExtract the current payer address and store the address components in the \n[7] claim office ID (not used)\nIBXSAVE("CADR") pieced string variable with the following pieces:\n \n[1] address line 1\n[2] address line 2\n[3] address line 3\n[4] city\n[5] pointer to the state file\n[6] external zip code with dashes\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CIADDR^IBCEF1(.IBXDATA,.IBXSAVE,,2)\n", "\nCalls CIADDR^IBCEF1 where the IBXDATA formatted array is returned. The \nIBXSAVE array elements for the current payer name and address are killed.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",12)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",12),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a twelth diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",13)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",13),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a thirteenth diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-VALUE CODES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 S Z=0 F S Z=$O(IBFL(39,Z)) K:'Z IBFL(39) Q:'Z S Z0=$P(IBFL(39,Z),U,2),Z1=$P(IBFL(39,Z),U,3),IBXSAVE(\"VC\",Z)=$P(IBFL(39,Z),U,1)_U_$S(Z1:$$DOL^IBCEF77(Z0,10),1:$J(Z0,8))\n", "\nSave all value codes extracted into IBXSAVE("VC") array for later use. \nNon-dollar amounts are formatted right-justified to the left of the \ndollars/cents delimiter on the pre-printed UB form (thus 8 characters).\nFormat the value as we loop through them.\n \nIBXSAVE("VC",z) = [1] VALUE CODE\n [2] FORMATTED VALUE AMOUNT\n \nDollar amounts are formatted using all 10 characters with the decimal \npoint implied by the dollars/cents delimiter on the pre-printed UB form.\n \n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,DATA,CODE I $D(IBXSAVE(\"VC\")) K IBXSAVE(\"VCS\") S Z=0 F S Z=$O(IBXSAVE(\"VC\",Z)) Q:'Z S DATA=$G(IBXSAVE(\"VC\",Z)),CODE=$P(DATA,U,1) I CODE'=\"\" S IBXSAVE(\"VCS\",\" \"_CODE,Z)=DATA\n", "\nIf the "VC" value code array exists, then sort it by value code in the \nIBXSAVE("VCS") array.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N CODE,CT,Z I $D(IBXSAVE(\"VCS\")) K IBXSAVE(\"VC\") S CODE=\"\",CT=0 F S CODE=$O(IBXSAVE(\"VCS\",CODE)) Q:CODE=\"\" S Z=0 F S Z=$O(IBXSAVE(\"VCS\",CODE,Z)) Q:'Z S CT=CT+1,IBXSAVE(\"VC\",CT)=IBXSAVE(\"VCS\",CODE,Z) K IBXSAVE(\"VCS\",CODE,Z)\n", "\nIf the value codes exist and have been sorted into the IBXSAVE("VCS") \narray, then loop thru that array and re-build the IBXSAVE("VC") array.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=0 F Z=1:3:10 Q:'$D(IBXSAVE(\"VC\",Z)) S Z0=Z0+1,IBXDATA(Z0)=$P(IBXSAVE(\"VC\",Z),U)\n", "\nThis data element relies on the array IBXSAVE("VC") previously extracted.\nThis is a group data element and can have multiple occurrences. Output is\nthe first piece of each occurrence found.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ,W,DEFPOS,POS,HOF D F^IBCEF(\"N-HCFA SERVICE LINE CALLABLE\",\"IBZ\",,IBXIEN) S DEFPOS=\"\",W=0 X \"F S W=$O(IBZ(W)) Q:'W S POS=$P($G(IBZ(W)),U,3),HOF=(POS=11!(POS=12)) S:DEFPOS=\"\"\"\"!HOF DEFPOS=POS Q:HOF\" S IBXDATA=DEFPOS\n", "\nFor professional claims only, this is the claim level place of service \n \nPrevious to IB patch 400, this field was the admitting DX. The admitting\nDX and qualifier is now sent in CL1A-15 (Qualifier) and CL1A-16 (Admitting\nDX code).\ncode. IB patch 400 changes.\n \nBuild the array with all professional line items (IBZ array).\nLoop through the line items looking for POS code of 11 or 12 (home or \noffice). If either 11 or 12 is found, then use that POS code as the \nclaim level POS code. If neither 11 nor 12 is found in the line level \nPOS codes, then use the first POS code found in the line items as the \nclaim level POS code.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=1:3 Q:$G(IBXSAVE(\"VC\",Z))=\"\" S Z0=Z0+1,Z1=$P(IBXSAVE(\"VC\",Z),U,2) S:Z'>10 IBXDATA(Z0)=Z1 D:Z>10 XVAL^IBCEF3(IBXSAVE(\"VC\",Z),Z) K IBXSAVE(\"VC\",Z)\n", "\nThis data element relies on the array IBXSAVE("VC") previously extracted.\nThis is a group data element and can have multiple occurrences. Output is\nthe second piece of each occurrence found.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=0 F Z=2:3:11 Q:'$D(IBXSAVE(\"VC\",Z)) S Z0=Z0+1,IBXDATA(Z0)=$P(IBXSAVE(\"VC\",Z),U)\n", "\nThis data element relies on the array IBXSAVE("VC") previously extracted.\nThis is a group data element and can have multiple occurrences. Output is\nthe first piece of each occurrence found.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=2:3 Q:$G(IBXSAVE(\"VC\",Z))=\"\" S Z0=Z0+1,Z1=$P(IBXSAVE(\"VC\",Z),U,2) S:Z'>11 IBXDATA(Z0)=Z1 D:Z>11 XVAL^IBCEF3(IBXSAVE(\"VC\",Z),Z) K IBXSAVE(\"VC\",Z)\n", "\nThis data element relies on the array IBXSAVE("VC") previously extracted.\nThis is a group data element and can have multiple occurrences. Output is\nthe second piece of each occurrence found.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=0 F Z=3:3:12 Q:'$D(IBXSAVE(\"VC\",Z)) S Z0=Z0+1,IBXDATA(Z0)=$P(IBXSAVE(\"VC\",Z),U)\n", "\nThis data element relies on the array IBXSAVE("VC") previously extracted.\nThis is a group data element and can have multiple occurrences. Output is\nthe first piece of each occurrence found. If there are more than 12\nvalue codes, they are stored in the overflow array.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=3:3 Q:$G(IBXSAVE(\"VC\",Z))=\"\" S Z0=Z0+1,Z1=$P(IBXSAVE(\"VC\",Z),U,2) S:Z'>12 IBXDATA(Z0)=Z1 D:Z>12 XVAL^IBCEF3(IBXSAVE(\"VC\",Z),Z) K IBXSAVE(\"VC\",Z)\n", "\nThis data element relies on the array IBXSAVE("VC") previously extracted.\nThis is a group data element and can have multiple occurrences. Output is\nthe second piece of each occurrence found.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",1))'=\"\" S IBXDATA=IBXSAVE(\"CC\",1) K IBXSAVE(\"CC\",1)\n", "\nData element's array reference is IBFL(24), not default of IBXDATA. This is\na group data element so more than 1 occurrence of a value is possible for\nthe data element in the IBFL(24) array. All occurrences of the data element\nare saved in the IBXSAVE("CC",n) array and only IBXSAVE("CC",1) is output\nin this field. Note: hard code is used to output the\ncodes that exceed the # that will fit on one page if multiple pages of bill\nare printed.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-CONDITION CODES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=0 F S Z=$O(IBFL(24,Z)) Q:Z=\"\" S IBXSAVE(\"CCU\",\" \"_$G(IBFL(24,Z)))=\"\"\n", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",2))'=\"\" S IBXDATA=IBXSAVE(\"CC\",2) K IBXSAVE(\"CC\",2)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the second occurrence of the array.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",3))'=\"\" S IBXDATA=IBXSAVE(\"CC\",3) K IBXSAVE(\"CC\",3)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the third occurrence of the array.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",4))'=\"\" S IBXDATA=IBXSAVE(\"CC\",4) K IBXSAVE(\"CC\",4)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the fourth occurrence of the array.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=0 F S Z=$O(IBXSAVE(\"PMOD\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"PMOD\",Z),\",\",3)\n", "\nThis data element relies on the existence of the variable IBXSAVE("PMOD") \npreviously extracted.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",5))'=\"\" S IBXDATA=IBXSAVE(\"CC\",5) K IBXSAVE(\"CC\",5)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the fifth occurrence of the array.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",6))'=\"\" S IBXDATA=IBXSAVE(\"CC\",6) K IBXSAVE(\"CC\",6)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the sixth occurrence of the array.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",7))'=\"\" S IBXDATA=IBXSAVE(\"CC\",7) K IBXSAVE(\"CC\",7)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the seventh occurrence of the array.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",8))'=\"\" S IBXDATA=IBXSAVE(\"CC\",8) K IBXSAVE(\"CC\",8)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the eighth occurrence of the array.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",9))'=\"\" S IBXDATA=IBXSAVE(\"CC\",9) K IBXSAVE(\"CC\",9)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the ninth occurance of the array.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",10))'=\"\" S IBXDATA=IBXSAVE(\"CC\",10) K IBXSAVE(\"CC\",10)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the tenth occurance of the array.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$G(IBXSAVE(\"CC\",11))'=\"\" IBXDATA=IBXSAVE(\"CC\",11) K IBXSAVE(\"CC\",11) S Z=0 F S Z=$O(IBXSAVE(\"CC\",Z)) Q:'Z D XCC^IBCEF3(IBXSAVE(\"CC\",Z),Z)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the eleventh occurrence of the array.\nIf there are more than 11 condition codes present, save them in the global\noverflow array.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-CONDITION RELATED TO AUTO\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$G(IBXDATA)'=\"\" IBXDATA=$$STATE^IBCEFG1($P(IBXDATA,U,2))\n", "\n2 char state abbreviation where the accident occured.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nFL-30\nReserved for assignment by the NUBC. Not used. 11 positions upper \nline. 13 positions lower line.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ S (IBZ,IBXDATA)=\"\" D F^IBCEF(\"N-ORGANIZATION NPI CODES\",\"IBZ\",,IBXIEN) S IBXDATA=$P(IBZ,U,3),IBXSAVE(\"NPIBILL\")=IBXDATA\n", "\nNPI - Billing Provider.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURR INSURANCE MAILING NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXDATA)'=\"\",$$WNRBILL^IBEFUNC(IBXIEN) S IBXDATA=\"MEDICARE\"\n", "\nIf header data has already been extracted, array ^TMP("IBHDR1",$J) will\nalready exist. Don't want to extract this field again, so kill data\nelement so there is no output. If MEDICARE WNR is current insurance,\nmailing name is MEDICARE.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-ALL INSURANCE COMPANIES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 M Z0=IBXDATA K IBXDATA S Z=\"\" F S Z=$O(Z0(Z)) Q:'Z I $D(^DGCR(399,IBXIEN,\"I\"_Z)) S IBXDATA(Z)=$S(Z<3&$$WNRBILL^IBEFUNC(IBXIEN,Z):\"MEDICARE\",1:$P(Z0(Z),U))\n", "\nThe first 15 characters of the name of the primary, secondary, and tertiary\ninsurance companies along with the claim office number and payer id, if\nknown. If the primary or secondary insurance is MEDICARE WNR, output\n'MEDICARE'.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nField reserved to contain National Plan ID. Currently blank.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-ROI INDICATOR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=$S(IBXDATA&'$P($G(^DGCR(399,IBXIEN,\"U\")),U,7):\"I\",1:\"Y\") F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,\"I\"_Z))) S IBXDATA(Z)=Z0\n", "\nFor each insurance on file in the bill, print the ROI indicator = 'I' if\nthe record is sensitive and there's no ROI on file, or 'Y' otherwise.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-ASSIGN OF BENEFITS INDICATOR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=$S(IBXDATA=\"\"!(\"Nn0\"'[IBXDATA):\"Y\",1:\"N\") F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,\"I\"_Z))) S IBXDATA(Z)=Z0\n", "\nFor each insurance on file in the bill, print the ASSIGNMENT OF BENEFITS\nindicator = 'Y' if the data element value returned is null or is not 0,'n'\nor 'N', otherwise print 'N'.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-PRIOR PAYMENTS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z F Z=1:1:3 K:'$D(^DGCR(399,IBXIEN,\"I\"_Z)) IBXDATA(Z) I $D(IBXDATA(Z)) S IBXDATA(Z)=$$DOL^IBCEF77(IBXDATA(Z),10)\n", "\nIf the insurance company for the prior payment does not exist for the bill,\ndon't output the prior payment information.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-TOTAL CHARGES LESS OFFSET\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ S IBZ=$G(IBXDATA) K IBXDATA S Z0=$$COBN^IBCEF(IBXIEN),IBXDATA(Z0)=$$DOL^IBCEF77(+IBZ,11) F Z=1:1:3 I Z'=Z0,$D(^DGCR(399,IBXIEN,\"I\"_Z)) S IBXDATA(Z)=$$DOL^IBCEF77(0,11)\n", "\nSet the estimated amt for the current insurance equal to the balance on the\nbill.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",2)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",2),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a second diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",3)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",3),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a third diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",4)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",4),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a fourth diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",5)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",5),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a fifth diagnosis, print its name.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IADR\")),U,6)\n", "\nRetrieves insured address line 2 data from IBXSAVE array previously\nextracted. If data element's value is null, do not output.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",6)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",6),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a sixth diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",7)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",7),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a seventh diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",8)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",8),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is an eighth diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",9)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",9),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a ninth diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",10)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",10),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a tenth diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",14)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",14),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a fourteenth diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",15)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",15),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a fifteenth diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",16)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",16),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a sixteenth diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",17)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",17),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a seventeenth diagnosis, print its name.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",18)) S IBXDATA=$TR($P($$ICD9^IBACSV(+IBXSAVE(\"DX\",18),$$BDATE^IBACSV(IBXIEN)),U),\".\")\n", "\nIf there is a eighteenth diagnosis, print its name. Check for more than \n17 other diagnoses on file. If there is, output on new pg.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURR INSURED GROUP NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S($G(IBXSAVE(\"CI3-2\"))'=\"\":\"\",'$$WNRBILL^IBEFUNC(IBXIEN):$$NOPUNCT^IBCEF(IBXDATA),1:\"\")\n", "\nThe GROUP NAME is not sent if the GROUP NUMBER is present. \nIf this is an MRA Request, then nothing is sent. \n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-ALL INSURANCE CO PROV NUM\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:'$$PRTLID^IBCEF77(IBXIEN,$G(IBXSAVE(\"NPIBILL\"))) IBXDATA K IBXSAVE(\"NPIBILL\")\n", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-ALL INSURED FULL NAMES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z F Z=1:1:3 I $G(IBXDATA(Z))'=\"\",IBXDATA(Z)'[\",\" S Q=$$NAME^IBCEFG1(IBXDATA(Z),1),IBXDATA(Z)=$P(Q,U)_$S($P(Q,U,2)'=\"\":\",\"_$P(Q,U,2),1:\"\")\n", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-ALL INSURED PT RELATION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,FLG S FLG=$S($$ISRX^IBCEF1(IBXIEN):2,1:1) F Z=1:1:3 I $D(IBXDATA(Z)) S IBXDATA(Z)=$$PRELCNV^IBCNSP1(IBXDATA(Z),FLG)\n", "\nIB patch 377\nConvert the VistA codes into HIPAA or NCPDP codes.\nHIPAA codes are the same as EDI codes.\nFLG variable controls conversion:\n 1 - convert to HIPAA, 2 - convert to NCPDP.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-ALL INSURANCE NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-ALL INSURANCE GROUP NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=$$COBN^IBCEF(IBXIEN) F Z=1:1:3 S IBXDATA(Z)=$G(IBXDATA(Z))_\" \" I $D(^DGCR(399,IBXIEN,\"I\"_Z)),$$WNRBILL^IBEFUNC(IBXIEN,Z) S IBXDATA(Z)=\"\"\n", "\nIf the insurance is MEDICARE WNR, do not output the group name.\nAdd a space to the end of the Group Name to separate it from\nthe next field , Group Number.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-ALL INSURANCE GROUP NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=$$COBN^IBCEF(IBXIEN) F Z=1:1:3 I $D(^DGCR(399,IBXIEN,\"I\"_Z)),Z0=Z,$$WNRBILL^IBEFUNC(IBXIEN,Z) S IBXDATA(Z)=\"\"\n", "\nIf the insurance is MEDICARE WNR, do not output the group number.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-ALL AUTH/REFERRAL CODES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=$P($G(^DGCR(399,IBXIEN,\"UF3\")),U,4,6) K IBXDATA F Z=1,2,3 S IBXDATA(Z)=$P(Z0,U,Z)\n", "\nDocument control numbers from file 399/fields 453-455.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,IBZ D:'$D(IBXSAVE(\"OIEMP\")) F^IBCEF(\"N-ALL INSURED EMPLOYER INFO\",\"IBZ\",,IBXIEN) K IBXDATA M:$O(IBZ(\"\")) IBXSAVE(\"OIEMP\")=IBZ F Z=1:1:3 I $D(IBXSAVE(\"OIEMP\",Z)) S IBXDATA(Z)=$P(IBXSAVE(\"OIEMP\",Z),U)\n", "\nIf the array IBXSAVE("OIEMP") doesn't already exist, extract it. For each\ninsured on the bill, extract the first piece of the data element for output\nin this field.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nFL-30\nReserved for assignment by the NUBC. Not used. 11 positions upper \nline. 13 positions lower line.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURR INSURED GROUP NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"CI3-2\")=IBXDATA S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,,\"/-:\") I $$WNRBILL^IBEFUNC(IBXIEN) S IBXDATA=\"\"\n", "\nIf the insurance is MEDICARE WNR, do not output the group number.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-ADMITTING DIAGNOSIS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$TR(IBXDATA,\".\")\n", "\nRemove decimal from Admitting diagnosis.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N IBZ,Z,Z0,C D F^IBCEF(\"N-DIAGNOSES\",\"IBZ\",,IBXIEN) S (C,Z)=0 F S Z=$O(IBZ(Z)) Q:'Z I $$ECODE^IBCEU4(+IBZ(Z),.Z0),$G(Z0)'=\"\" S C=C+1,IBXSAVE(\"DX-E\",C)=Z0_U_$$GETPOA^IBCEU4($P(IBZ(Z),U,2),1) S:C=1 IBXDATA=$TR(Z0,\".\") Q:C=3\n", "\nThis data element creates an array containing E-code diagnoses for\nthe bill and corresponding POA indicators. IBXDATA is set to the\nfirst 'E-code' dx found. ICD-9 only.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",1)) S IBXDATA=$P(IBXSAVE(\"PROC\",1),U,2) K IBXSAVE(\"PROC\",1)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the first occurrence exists, output the date\nfound in its second '^' piece.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",2)) S IBXDATA=$P(IBXSAVE(\"PROC\",2),U),IBXDATA=$S(IBXDATA[\"ICD0\"!(IBXDATA[\"ICPT\"):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the second occurrence exists, output the code\nreferenced by its first '^' piece.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",2)) S IBXDATA=$P(IBXSAVE(\"PROC\",2),U,2) K IBXSAVE(\"PROC\",2)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the second occurrence exists, output the date\nfound in its second '^' piece.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",3)) S IBXDATA=$P(IBXSAVE(\"PROC\",3),U),IBXDATA=$S(IBXDATA[\"ICD0\"!(IBXDATA[\"ICPT\"):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the third occurrence exists, output the code\nreferenced by its first '^' piece.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",3)) S IBXDATA=$P(IBXSAVE(\"PROC\",3),U,2) K IBXSAVE(\"PROC\",3)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the third occurrence exists, output the date\nfound in its second '^' piece.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",4)) S IBXDATA=$P(IBXSAVE(\"PROC\",4),U),IBXDATA=$S(IBXDATA[\"ICD0\"!(IBXDATA[\"ICPT\"):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the fourth occurrence exists, output the code\nreferenced by its first '^' piece.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",4)) S IBXDATA=$P(IBXSAVE(\"PROC\",4),U,2) K IBXSAVE(\"PROC\",4)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the fourth occurrence exists, output the date\nfound in its second '^' piece.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",5)) S IBXDATA=$P(IBXSAVE(\"PROC\",5),U),IBXDATA=$S(IBXDATA[\"ICD0\"!(IBXDATA[\"ICPT\"):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the fifth occurrence exists, output the code\nreferenced by its first '^' piece.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PRESCRIPTIONS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,CT K IBXDATA S (Z,CT)=0,Z0=$G(^TMP($J,\"IBLCT\")) F S Z=$O(IBXSAVE(\"OUTPT\",Z)) S:'Z ^TMP($J,\"IBLCT\")=Z0+$O(IBXDATA(\"\"),-1) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"RX\")) S IBXDATA(Z)=Z,CT=CT+1 D:CT>1 ID^IBCEF2(Z,\"RX1 \")\n", "\n^TMP($J,"IBLCT") keeps track of the last service line # output. Data \nelement is a group data element so multiple ocurrences of the data element\nare possible in the IBXDATA array. Save the data in the IBXSAVE array for\nlater use. For every service line > 1, output the RX1 record id.\nIf the prescription references a service line already output, use that\nservice line # to reference this prescription.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",5)) S IBXDATA=$P(IBXSAVE(\"PROC\",5),U,2) K IBXSAVE(\"PROC\",5)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the fifth occurrence exists, output the date\nfound in its second '^' piece.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",6)) S IBXDATA=$P(IBXSAVE(\"PROC\",6),U),IBXDATA=$S(IBXDATA[\"ICD0\"!(IBXDATA[\"ICPT\"):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the sixth occurrence exists, output the code\nreferenced by its first '^' piece.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Q,R S:$D(IBXSAVE(\"PROC\",6)) IBXDATA=$P(IBXSAVE(\"PROC\",6),U,2) S Z=6 F S Z=$O(IBXSAVE(\"PROC\",Z)) Q:'Z S R=IBXSAVE(\"PROC\",Z),Q=$P(R,U,2) D XPROC^IBCEF3($S(R[\"ICPT\"!(R[\"ICD0\"):$P($$PRCD^IBCEF1(R),U),1:$P(R,U))_U_Q,Z)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the sixth occurrence exists, output the date\nfound in its second '^' piece.\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",1)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",1),U,2),1:\" \") K IBXSAVE(\"DX\",1)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",2)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",2),U,2),1:\" \") K IBXSAVE(\"DX\",2)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",3)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",3),U,2),1:\" \") K IBXSAVE(\"DX\",3)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",4)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",4),U,2),1:\" \") K IBXSAVE(\"DX\",4)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",5)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",5),U,2),1:\" \") K IBXSAVE(\"DX\",5)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",6)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",6),U,2),1:\" \") K IBXSAVE(\"DX\",6)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",7)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",7),U,2),1:\" \") K IBXSAVE(\"DX\",7)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=\"\" F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"RX\")) S:$P(IBXSAVE(\"OUTPT\",Z,\"RX\"),U)'=\"\"&($P(IBXSAVE(\"OUTPT\",Z,\"RX\"),U,3)'=\"\") IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z,\"RX\"),U)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",8)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",8),U,2),1:\" \") K IBXSAVE(\"DX\",8)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",9)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",9),U,2),1:\" \") K IBXSAVE(\"DX\",9)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",10)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",10),U,2),1:\" \") K IBXSAVE(\"DX\",10)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",11)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",11),U,2),1:\" \") K IBXSAVE(\"DX\",11)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",12)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",12),U,2),1:\" \") K IBXSAVE(\"DX\",12)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",13)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",13),U,2),1:\" \") K IBXSAVE(\"DX\",13)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",14)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",14),U,2),1:\" \") K IBXSAVE(\"DX\",14)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",15)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",15),U,2),1:\" \") K IBXSAVE(\"DX\",15)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",16)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",16),U,2),1:\" \") K IBXSAVE(\"DX\",16)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",17)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",17),U,2),1:\" \") K IBXSAVE(\"DX\",17)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IADR\")),U,5)\n", "\nRetrieves insured address data from IBXSAVE array previously extracted. If\ndata element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=\"\" F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"RX\")) S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z,\"RX\"),U,2)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",18)) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):$P(IBXSAVE(\"DX\",18),U,2),1:\" \") K IBXSAVE(\"DX\",18)\n", "\nThis is the present on admissions indicator. The value "U" (No\nInformation in the Record) is sent for INPATIENT claims if no\nPOA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-UB-04 PROCEDURES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:'$$INPAT^IBCEF(IBXIEN) IBXDATA N Z S Z=\"\" F S Z=$O(IBXDATA(Z)) Q:'Z S $P(IBXDATA(Z),U,2)=$$DATE^IBCF3($P(IBXDATA(Z),U,2)),IBXSAVE(\"PROC\",Z)=IBXDATA(Z) K IBXDATA(Z)\n", "\nThis is a group data element so more than one occurrence of IBXDATA(n) is\npossible. Save off the procedures in the IBXSAVE array. Six procedures\nwill fit on a single page of a bill. If more than 6 procedure codes are\non the bill, multiple pages are used. The format of the IBXSAVE array is:\n the actual code for the ICD9 or ICD0 code^proc date formatted as MMDDYY\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-UB-04 SERVICE LINE (PRINT)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Q,R F Z=1:1 Q:'$D(^TMP($J,\"IBC-RC\",Z)) S R=^(Z),Q=$S(+R=1:$$FO^IBCNEUT1($P(R,U,2),4,\"R\",0),+R=2:$E($P(R,U,2),1,5),1:\"\") S:Z'>22 IBXDATA(Z)=Q D:Z>22 CKREV^IBCEF3(Z,Q)\n", "\nThis data element is a group data element where more than one occurrence\nlines of service line can appear on one form, if there are more than 22\nlines, subsequent pages are forced for the remaining data lines after 22.\nmight be expected. It relies on the presence of data in array\nIBXSAVE("REV",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, the data is found in the second '^'\npiece of the array. For text line where the first piece = 2, the text is\nassumed to start in column 1, so the data is extracted from positions 1-5.\nFor text line where the first piece = 3, the text is assumed to start in\ncolumn 6, so there is no data extracted for this field. Since only 22\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,A,B,C F Z=1:1 Q:'$D(^TMP($J,\"IBC-RC\",Z)) S B=^(Z),C=$$B43^IBCEF77(B),A=$S(+B=1:$S(C]\"\":C,1:$E($P(B,U,3),1,24)),+B=2:$S(C]\"\":C,1:$E($P(B,U,2),6,30)),1:$S(C]\"\":C,1:$E($P(B,U,2),1,25))) S:Z'>22 IBXDATA(Z)=A D:Z>22 CKREV^IBCEF3(Z,A)\n", "\nThis data element is a group data element where more than one occurrence\n1-25. Since only 22 lines of service line can appear on one form, if there\nare more than 22 lines, subsequent pages are forced for the remaining data\nlines after 22.\nmight be expected. It relies on the presence of data in array\nIBXSAVE("REV",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, the data is found in the third '^'\npiece of the array. For text line where the first piece = 2, the text is\nassumed TO start in column 1, so the data is extracted from positions \n6-30. For text line where the first piece = 3, the text is assumed to\nstart in column 6, so the data for this field is extracted from positions\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I '$$INPAT^IBCEF(IBXIEN) S IBXDATA=$TR($P($$ICD9^IBACSV($P($G(^DGCR(399,IBXIEN,\"U3\")),U,8)),U),\".\")\n", "\nThis is Patient Reason for Visit diagnosis code\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I '$$INPAT^IBCEF(IBXIEN) S IBXDATA=$TR($P($$ICD9^IBACSV($P($G(^DGCR(399,IBXIEN,\"U3\")),U,9)),U),\".\")\n", "\nThis is Patient Reason for Visit diagnosis code\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I '$$INPAT^IBCEF(IBXIEN) S IBXDATA=$TR($P($$ICD9^IBACSV($P($G(^DGCR(399,IBXIEN,\"U3\")),U,10)),U),\".\")\n", "\nThis is Patient Reason for Visit diagnosis code\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=\"\" F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"RX\")) D PADNDC^IBCEF72(Z) S IBXDATA(Z)=$S($P(IBXSAVE(\"OUTPT\",Z,\"RX\"),U,3)=\"\":\"\",1:$TR($P(IBXSAVE(\"OUTPT\",Z,\"RX\"),U,3),\"-\"))\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array.\nIf we don't know the NDC#, output all 9's.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z I $$INPAT^IBCEF(IBXIEN) S Z=+$P($G(^DGCR(399,IBXIEN,\"U1\")),U,15) I Z S IBXDATA=$$FO^IBCNEUT1(Z,4,\"R\",0)\n", "\nIB*2*400 - for Inpatient claims only.\nRetrieve the PPS code from field# 170 in the claim. If it exists, then \nformat it as a 4 character numeric field, right justified, zero filled.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S:$$INPAT^IBCEF(IBXIEN) IBXDATA=$P($G(IBXSAVE(\"DX-E\",1)),U,2) K IBXSAVE(\"DX-E\",1)\n", "\nThis is the Present on Admission indicator for the first 'E-code' \ndiagnosis. The value "U" (No Information in the Record) is sent \nfor INPATIENT claims if no POA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$TR($P($G(IBXSAVE(\"DX-E\",2)),U),\".\")\n", "\nThis is the second 'E-code' diagnosis found.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S:$$INPAT^IBCEF(IBXIEN) IBXDATA=$P($G(IBXSAVE(\"DX-E\",2)),U,2) K IBXSAVE(\"DX-E\",2)\n", "\nThis is the Present on Admission indicator for the second 'E-code'\ndiagnosis. The value "U" (No Information in the Record) is sent \nfor INPATIENT claims if no POA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$TR($P($G(IBXSAVE(\"DX-E\",3)),U),\".\")\n", "\nThis is the third 'E-code' diagnosis found.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S:$$INPAT^IBCEF(IBXIEN) IBXDATA=$P($G(IBXSAVE(\"DX-E\",3)),U,2) K IBXSAVE(\"DX-E\",3)\n", "\nThis is the Present on Admission indicator for the third 'E-code'\ndiagnosis. The value "U" (No Information in the Record) is sent \nfor INPATIENT claims if no POA indicator is available.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,D,T,T4,T5 F Z=1:1 Q:'$G(^TMP($J,\"IBC-RC\",Z)) S D=^(Z),T=$P(D,U,2),T5=$P(D,U,5),T4=$P(D,U,4),Z0=$S(+D=2:$E(T,31,45),+D=3:$E(T,26,40),T4'=\"\"&(T>219):T4,T5'=\"\"&(T<220)&(T>1):$J(T5,7,2),1:\"\") S:Z'>22 IBXDATA(Z)=Z0 D:Z>22 CKREV^IBCEF3(Z,Z0)\n", "\nThis data element is a group data element where more than one occurrence\nformatted with 2 decimal places. Since only 22 lines of service can appear\non one form, if there are more than 22 lines, subsequent pages are forced\nfor the remaining data lines after 22.\nmight be expected. It relies on the presence of data in global\n^TMP($J,"IBC-RC",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, the data is found in the fourth\n(procedure code and modifiers) or fifth (unit charge) '^' pieces of the\narray. If there is a procedure and a unit charge, only the procedure code\nand its modifiers will print. If there is a unit charge and this is an\ninpatient bill and the revenue code is 100-219, it is printed and\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D DATE45^IBCF33(IBXIEN,.IBXDATA,$G(IBXSAVE(\"DATE\")))\n", "\nThis data element is a group data element where more than one occurrence\nextracted from positions 41-47. Since only 22 lines of service line can\nappear on one form, if there are more than 22 lines, subsequent pages are\nforced for the remaining data lines after 22.\nmight be expected. It relies on the presence of data in array\nIBXSAVE("REV",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, output the OUTPATIENT from date \nthat was previously extracted into IBXSAVE("DATE"). For text line where\nthe first piece = 2, the text is assumed to start in column 1, so the data\nis extracted from positions 46-52. For text line where the first piece =\n3, the text is assumed to start in column 6, so the data for this field is\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D REMARK^IBCEF77(IBXIEN,.IBXDATA,1)\n", "\nRemarks in FL-80 on the UB-04. All data is retrieved and formatted by \nREMARK^IBCEF77. Line 1 of this box has a mandatory 5 leading spaces and \ntherefore only 19 printed characters can be in line 1. Lines 2-4 have a \nmax length of 24 characters.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N DIFF S IBXSAVE(\"UBFL2\")=$$PRVDATA^IBJPS3(IBXIEN),DIFF=$$DIFF^IBJPS3(IBXIEN,0) S:'DIFF IBXSAVE(\"UBFL2\")=\"\"\n", "\nUB-04 FL-2 pay-to provider data gathering\n \nRetrieve the pay-to provider string and save it into IBXSAVE. If there \nare NO differences between the pay-to provider and the billing provider, \nthen suppress the pay-to provider data here in FL-2 and don't output \nanything.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"DN1 \"\n", "\nOutput RECORD ID for DN1 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ORTHO BANDING QUALIFIER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7,$P($G(^DGCR(399,IBXIEN,\"DEN\")),U)'=\"\" S IBXDATA=452\n", "\nOrthodontic Banding Qualifier always will be 452.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA(1)=\"\",IBXDATA(2)=\"\",IBXDATA(3)=\"\",IBXDATA(4)=\"\"\n", "\nNot currently used. This field is for overflow codes or externally \nmaintained codes.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA(1)=\"\",IBXDATA(2)=\"\",IBXDATA(3)=\"\",IBXDATA(4)=\"\"\n", "\nNot currently used. This field is for overflow codes or externally\nmaintained codes.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA(1)=\"\",IBXDATA(2)=\"\",IBXDATA(3)=\"\",IBXDATA(4)=\"\"\n", "\nNot currently used. This field is for overflow codes or externally\nmaintained codes.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=\"\" F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"RX\")) S IBXDATA(Z)=$S($P(IBXSAVE(\"OUTPT\",Z,\"RX\"),U,5)'=\"\":$$DT^IBCEFG1($P(IBXSAVE(\"OUTPT\",Z,\"RX\"),U,5),\"\",\"D8\"),1:\"\")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is formatted as date in CCYYMMDD\nformat.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$GETPRV^IBCEF83(IBXIEN,,4,\"A1\"),\",\",1)\n", "\nAttending Providers last name\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$GETPRV^IBCEF83(IBXIEN,,4,\"A1\"),\",\",2)\n", "\nAttending Providers first name\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$GETPRV^IBCEF83(IBXIEN,,2,\"A1\"),\",\",1)\n", "\nOperating Provider last name\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$GETPRV^IBCEF83(IBXIEN,,2,\"A1\"),\",\",2)\n", "\nOperating Provider first name\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,\"IBC-RC\",Z)) S Z1=^(Z),Z0=$S(+Z1=1:$J($P(Z1,U,6),7),+Z1=2:$E($P(Z1,U,2),53,59),1:$E($P(Z1,U,2),48,54)) S:Z'>22 IBXDATA(Z)=Z0 D:Z>22 CKREV^IBCEF3(Z,Z0)\n", "\nThis data element is a group data element where more than one occurrence\nfield is extracted from positions 48-54.\nSince only 22 lines of service line can appear on one form, if there\nare more than 22 lines, subsequent pages are forced for the remaining data\nlines after 22.\nmight be expected. It relies on the presence of data in array\nIBXSAVE("REV",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, the data is found in the sixth '^'\npiece of the array. For text line\nwhere the first piece = 2, the text is assumed to start in column 1, so the\ndata is extracted from positions 53-59. For text line where the first\npiece = 3, the text is assumed to start in column 6, so the data for this\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,\"IBC-RC\",Z)) S Z1=^(Z),Z0=$S(+Z1=1:$$DOL^IBCEF77($P(Z1,U,7),10),+Z1=2:$E($P(Z1,U,2),60,69),1:$E($P(Z1,U,2),55,64)) S:Z'>22 IBXDATA(Z)=Z0 D:Z>22 CKREV^IBCEF3(Z,Z0)\n", "\nThis data element is a group data element where more than one occurrence\n55-64. Since only 22 lines of service line can appear on one form, if\nthere are more than 22 lines, subsequent pages are forced for the\nremaining data lines after 22.\nmight be expected. It relies on the presence of data in array\nIBXSAVE("REV",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, the data is found in the seventh \n'^' piece of the array. For text line where the first piece = 2, the text\nis assumed to start in column 1, so the data is extracted from positions\n60-69. For text line where the first piece = 3, the text is assumed to\nstart in column 6, so the data for this field is extracted from positions\n\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($P(IBXSAVE(\"BOX 78\"),U,1),\",\",1)\n", "\nOther Provider last name\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($P(IBXSAVE(\"BOX 78\"),U,1),\",\",2) K IBXSAVE(\"BOX 78\")\n", "\nOther Provider first name\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($P(IBXSAVE(\"BOX 79\"),U,1),\",\",1)\n", "\nOTHER PROVIDER LAST NAME\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($P(IBXSAVE(\"BOX 79\"),U,1),\",\",2) K IBXSAVE(\"BOX 79\"),IBXPROV\n", "\nOTHER PROVIDER FIRST NAME\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-INITIAL TREATMENT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$S($$FT^IBCEF(IBXIEN)=3:\"\",1:$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")) S:IBXDATA IBXSAVE(\"INIT-DATE\")=1\n", "\nINITIAL TREATMENT DATE ON CLAIMS INVOLVING\n SPINAL MANIPULATION FOR MEDICARE PART B\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$GETPRV^IBCEF83(IBXIEN,,4,\"B3\")\n", "\nAttending Provider NPI if available\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$GETPRV^IBCEF83(IBXIEN,,4,\"B1\")\n", "\nLegacy ID quailifer\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$GETPRV^IBCEF83(IBXIEN,,4,\"B2\")\n", "\nAttending legacy ID\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$GETPRV^IBCEF83(IBXIEN,,2,\"B3\")\n", "\nOperating Provider NPI if available\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$GETPRV^IBCEF83(IBXIEN,,2,\"B1\")\n", "\nOperating provider legacy ID if needed\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$GETPRV^IBCEF83(IBXIEN,,2,\"B2\")\n", "\nOperating legacy ID if needed\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D UB047879^IBCEF83(IBXIEN,.IBXDATA) S IBXSAVE(\"BOX 78\")=IBXDATA(1),IBXSAVE(\"BOX 79\")=IBXDATA(2) K IBXDATA S IBXDATA=$P(IBXSAVE(\"BOX 78\"),U,4)\n", "\nOther provider NPI if available\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P(IBXSAVE(\"BOX 78\"),U,2)\n", "\nOther provider legacy ID qualifier if needed\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P(IBXSAVE(\"BOX 78\"),U,3)\n", "\nOther provider legacy ID if needed\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,\"IBC-RC\",Z)) S Z1=^(Z),Z0=$S(+Z1=1:$$DOL^IBCEF77($P(Z1,U,8),10),+Z1=2:$E($P(Z1,U,2),70,79),1:$E($P(Z1,U,2),65,74)) S:Z'>22 IBXDATA(Z)=Z0 D:Z>22 CKREV^IBCEF3(Z,Z0)\n", "\nThis data element is a group data element where more than one occurrence\n65-74. Since only 22 lines of service line can appear on one form, if\nthere are more than 22 lines, subsequent pages are forced for the\nremaining data lines after 22.\nmight be expected. It relies on the presence of data in array\nIBXSAVE("REV",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, the data is found in the eighth \n'^' piece of the array. For text line where the first piece = 2, the text\nis assumed to start in column 1, so the data is extracted from positions\n70-79. For text line where the first piece = 3, the text is assumed to\nstart in column 6, so the data for this field is extracted from positions\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"PRV-BP\",\"ADDR1\"))\n", "\nPRV-4\nBilling provider address line 1\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nReserved by the NUBC. This field is always blank.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P(IBXSAVE(\"BOX 79\"),U,4)\n", "\nOTHER PROVIDER NPI\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P(IBXSAVE(\"BOX 79\"),U,2)\n", "\nOTHER PROVIDER ID QUALIFIER.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P(IBXSAVE(\"BOX 79\"),U,3)\n", "\nOTHER PROVIDER OTHER ID\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nNot currently used\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nNot currently used\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nThis field is always blank.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-DATE FIRST PRINTED\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S:'IBXDATA IBXDATA=DT S Z=$$DT^IBCEFG1(IBXDATA,\"\",\"D6\"),IBXDATA=$E(Z,3,6)_$E(Z,1,2)\n", "\nBill creation date in MMDDYY format.\nesg - 10/9/07 - change this from today's date to be the date first \nprinted. However, if the claim has never been printed, then the FileMan \nfield 12 - DATE FIRST PRINTED won't be populated yet so in this case, \ndefault in today's date.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"OCCS\")\n", "\nFormat code for FL-35/3 and FL-36/3 grew too big. So cleanup of the \narray used is being done here.\n
\n\n"], ["UB-04", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N CCU,IBI,Z S (IBI,Z)=0 M CCU=IBXSAVE(\"CCU\") K IBXDATA,IBXSAVE(\"CCU\") F S Z=$O(CCU(Z)) Q:Z=\"\" S IBI=IBI+1,IBXSAVE(\"CC\",IBI)=$E(Z,2,99)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"PRV-BP\",\"CITY\")) I IBXDATA'=\"\" S IBXDATA=$TR(IBXDATA,\"-/.,()'\",\" \")\n", "\nPRV-5\nBilling provider city name\nGet the city name from the IBXSAVE array, then strip out the\nstandard city punctuation marks - converting "-" and "/" to spaces.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ORTHO BANDING DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$$FT^IBCEF(IBXIEN)'=7 IBXDATA=\"\" I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")\n", "\nFormat date is CCYYMMDD\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ORTHO TX MTHS COUNT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 K IBXDATA\n", "\nOrtho Treatment Months count for Dental Claim\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ORTHO TX MTHS COUNT TRANSFER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 K IBXDATA\n", "\nOrtho Treatment months remaining for a transfer patient.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ORTHO TX INDICATOR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 D TRANS^IBCEF12\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"DN2 \"\n", "\nOutput the record id for 'DN2' record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-TOOTH NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(^TMP(\"IBXSAVE\",$J,\"TO\",IBXIEN,Z)) Q:'Z S Z1=^(Z),IBXSAVE(\"OUTPT\",Z)=Z1,IBXDATA(Z)=$P(Z1,U) I Z>1 D ID^IBCEF2(Z,\"DN2 \")\n", "\nTooth number of treatment\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z),U,2)\n", "\nTooth Status code, either E (to be extracted) or M (Missing)\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z),U,3)\n", "\nCode List Qualifier Code - will always be JP for Dental claim.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7,$G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,\"TAXONOMY\"))'=\"\" S IBXDATA=\"RF\"\n", "\nCode identifing the type of provider. For Dental, always RF for \nReferring.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7,$G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,\"TAXONOMY\"))'=\"\" S IBXDATA=\"PXC\"\n", "\nCode qualifing the Reference Identification. For Dental, it will always \nbe PXC for Taxonomy Code.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"PRV-BP\",\"ST\"))\n", "\nPRV-6\nGet 2 character state code.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,\"TAXONOMY\"))\n", "\nReference information as specified by the Reference Identification \nQualifier. For Dental, this will be the Taxonomy Code.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OPRB\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSetup IBXSAVE array for OPRB record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7,$D(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,\"NAME\")) S IBXDATA=\"DD\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7,$D(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,\"NAME\")) S IBXDATA=1\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,\"NAME\")),U)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,\"NAME\")),U,2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,\"NAME\")),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,\"NAME\")),U,5)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,0)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"PRV-BP\",\"ZIP\")),IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)\n", "\nPRV-7\nBilling provider zip code\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,0)),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7,$G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,\"TAXONOMY\"))'=\"\" S IBXDATA=\"AS\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,\"TAXONOMY\"))\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OPRC\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSet up IBXSAVE array for OPRC record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA ;I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,1)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA ;I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,1)),\"^\",4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA ;I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,2)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA ;I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,2)),U,4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"PRV-BP\",\"PHONE\")) I IBXDATA'=\"\" S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)\n", "\nPRV-8\nBilling provider phone#\nUse the pay-to provider phone# and strip all punctuation.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA ;I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,3)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA ;I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,3)),U,4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA ;I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,4)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA ;I $$FT^IBCEF(IBXIEN)=7 S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,6,4)),U,4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OP10\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSetup IBXSAVE array for the OP10 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"OSQ\") N C,Z,Q,OK M Q=IBXSAVE(\"PROVINF\",IBXIEN,\"O\") S (C,Z)=0 F S Z=$O(Q(Z)) Q:'Z S OK=0 X \"N A F A=1:1 Q:'$D(Q(Z,6,A)) I $P(Q(Z,6,A),U,4)'=\"\"\"\" S OK=1 Q\" I OK S C=C+1,IBXDATA(C)=$G(Q(Z)),IBXSAVE(\"OSQ\",Z)=C D:C>1 ID^IBCEF2(C,\"OP10\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,6,\"DD\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,6,\"1\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IDEM\")),U)\n", "\nRetrieves insured demographics data from IBXSAVE array previously extracted.\n \n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=0 F S Z=$O(IBXSAVE(\"PMOD\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"PMOD\",Z),\",\",4) I '$O(IBXSAVE(\"PMOD\",Z)) K IBXSAVE(\"PMOD\")\n", "\nThis data element relies on the existence of the variable IBXSAVE("PMOD") \npreviously extracted.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"CI6 \"\n", "\nPiece 1 of the CI6 segment. Hard code the segment name of "CI6 " taking \nup 4 characters as is the custom.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P(IBXSAVE,U,1)\n", "\nOnly one value for the subscriber primary ID qualifier. "MI" - member \nidentification number. Not stored in the VistA database....hardcoded.\nQualifier for subscriber primary ID\n2010BA/NM108\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P(IBXSAVE,U,2) I $$WNRBILL^IBEFUNC(IBXIEN) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA)\n", "\nSubscriber Primary ID#\n2010BA/NM109\nCarry over the old format code from the old CI2-6 field: If this is the \nHIC # for MEDICARE, strip the dashes, if any.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P(IBXSAVE,U,3)\n", "\nSubscriber secondary ID qualifier#1\n2010BA/REF(1)/01\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P(IBXSAVE,U,4)\n", "\nSubscriber secondary ID #1\n2010BA/REF(1)/02\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,6,\"Q\",1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,6,\"I\",1) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,6,\"Q\",2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,6,\"I\",2) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,6,\"Q\",3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $P($G(IBXSAVE(\"CADR\")),U,4)'=\"\" S IBXDATA=$TR($P(IBXSAVE(\"CADR\"),U,4),\"-/.,()'\",\" \")\n", "\nIf header data has already been extracted, array ^TMP("IBHDR1",$J) will\nalready exist. Don't want to extract this field again, so kill data\nelement so there is no output. Also don't output data element if its\nvalue is null.\nThis data relies on the presence of the IBXSAVE("CADR") array that should\nhave been set in a previous data field.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,6,\"I\",3) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", "\nClean up IBXSAVE arry after OP10 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"DEN \"\n", "\nOutput the record id for 'DEN' record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-HCFA J430D SERV LINE (EDI)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 D DEN^IBCEF12\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D SRVDTQ^IBCEF12\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D SRVDT^IBCEF12\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S IBXDATA(Z)=\"AD\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 S IBXNOREQ=$$NFT^IBCEF1(2,IBXIEN) K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S:$P(IBXSAVE(\"OUTPT\",Z),U,5)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z),U,5)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXDATA) S IBXDATA=\"CI5 \"\n", "\nRECORD ID 'CI5 '\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D CLEANUP^IBCEF78(.IBXSAVE),PAYERIDS^IBCEF78(IBXIEN,.IBXSAVE) I $P($G(IBXSAVE(\"CI_PID\",1)),U)'=\"\" S IBXDATA=$P($G(IBXSAVE(\"CI_PID\",1)),U)\n", "\nHard-coded Primary Payer ID Qualifier\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CHKADD^IBCEF7 I $P($G(IBXSAVE(\"CADR\")),U)'=\"\" S IBXDATA=$P(IBXSAVE(\"CADR\"),U)\n", "\nIf header data has already been extracted, array ^TMP("IBHDR1",$J) will\nalready exist. Don't want to extract this field again, so kill data\nelement so there is no output. Also don't output data element if its\nvalue is null.\nThis data relies on the presence of the IBXSAVE("CADR") array that should\nhave been set in a previous data field.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $P($G(IBXSAVE(\"CI_PID\",1)),U,2)'=\"\" S IBXDATA=$P($G(IBXSAVE(\"CI_PID\",1)),U,2)\n", "\nIf header data has already been extracted, array ^TMP("IBHDR1",$J) will\nalready exist. Don't want to extract this field again, so kill data\nelement so there is no output. Positions 1-5 are the id number as\nassigned by ENVOY, positions 6-9 are the claim office id (default if there\nis none is '0000'). Also don't output data element if its value is null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA F Z=1,2 S:$G(IBXSAVE(\"OIID\",Z)) IBXDATA(Z)=\"MI\" K IBXSAVE(\"OIID\",Z)\n", "\nOI2-11\n2330A/NM108\nQualifier for other payer subscriber primary ID number. This is \nhardcoded to be "MI" for all other payers on the claim that have a valid \nID# extracted in OI2-3. When IBXSAVE("OIID",Z) is true, this means that \nother payer has a valid subscriber ID.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $P($G(IBXSAVE(\"CI_PSIDS\",1)),U)'=\"\" S IBXDATA=$P($G(IBXSAVE(\"CI_PSIDS\",1)),U)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $P($G(IBXSAVE(\"CI_PSIDS\",1)),U,2)'=\"\" S IBXDATA=$P($G(IBXSAVE(\"CI_PSIDS\",1)),U,2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $P($G(IBXSAVE(\"CI_PSIDS\",1)),U,3)'=\"\" S IBXDATA=$P($G(IBXSAVE(\"CI_PSIDS\",1)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $P($G(IBXSAVE(\"CI_PSIDS\",1)),U,4)'=\"\" S IBXDATA=$P($G(IBXSAVE(\"CI_PSIDS\",1)),U,4)\n", ""], ["File: 364.6, IEN: 1826", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"CI_PSIDS\",1)),U,5)\n", ""], ["File: 364.6, IEN: 1827", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"CI_PSIDS\",1)),U,6) D CLEANUP^IBCEF78(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z,Z0 S Z=0 F S Z=$O(IBXDATA(Z)) Q:'Z D SETMODS^IBCVA1(IBXDATA(Z),Z,.IBXSAVE) S Z0=$P($G(IBXSAVE(\"PROCMODS\",Z)),\",\") I Z0'=\"\" S IBXDATA(Z)=Z0\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE=$$INSSECID^IBCEF21(IBXIEN)\n", "\nExtract the current insurance subscriber primary and secondary ID's and \nqualifiers into the IBXSAVE string. See the routine for comments.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $P($G(IBXSAVE(\"CADR\")),U,5)'=\"\" S IBXDATA=$$STATE^IBCEFG1($P(IBXSAVE(\"CADR\"),U,5))\n", "\nIf header data has already been extracted, array ^TMP("IBHDR1",$J) will\nalready exist. Don't want to extract this field again, so kill data\nelement so there is no output. If header not yet extracted, format data\nas state's 2-character abbreviation.\nThis data relies on the presence of the IBXSAVE("CADR") array that should\nhave been set in a previous data field.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OI6 \"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURANCE SEQUENCE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ,Z,Z0 M IBZ=IBXDATA K IBXDATA I $O(IBXSAVE(1,0)) S (Z,Z0)=0 F S Z=$O(IBXSAVE(1,Z)) Q:'Z S Z0=Z0+1,IBXDATA(Z0)=IBXSAVE(1,Z) I Z0>1 D ID^IBCEF2(Z0,\"OI6 \")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEF78(.IBXSAVE),PAYERIDS^IBCEF78(IBXIEN,.IBXSAVE) N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"OI_PID\",Z)),U)\n", ""], ["File: 364.6, IEN: 1833", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA,IBXSAVE S Z=$$COBN^IBCEF(IBXIEN),Z0=0 F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IBXIEN,\"I\"_Z1)) S Z0=Z0+1,IBXSAVE(Z0)=$$INSSECID^IBCEF21(IBXIEN,\"PAT\",Z1)\n", "\nExtract the string(s) of other payer patient ID information into the \nfunction.\nIBXSAVE(Z0) array. This will be used to populate the rest of this OI3 \nsegment.\nZ is the current payer sequence number (1,2, or 3)\nZ0 is a counter and subscript of IBXSAVE(1) thru IBXSAVE(2)\nZ1 is the loop variable through all possible insurances on the claim\n \nIf Z1'=Z and insurance is defined for insurance# Z1, then increment the \nZ0 counter variable and store the string returned from the $$INSSECID \n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"OI_PID\",Z)),U,2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"OI_PSIDS\",Z)),U)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"OI_PSIDS\",Z)),U,2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"OI_PSIDS\",Z)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"OI_PSIDS\",Z)),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"OI_HPID\",Z)),U)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $P($G(IBXSAVE(\"CADR\")),U,6)'=\"\" S IBXDATA=$$NOPUNCT^IBCEF($P(IBXSAVE(\"CADR\"),U,6),1)\n", "\nIf header data has already been extracted, array ^TMP("IBHDR1",$J) will\nalready exist. Don't want to extract this field again, so kill data\nelement so there is no output. Also don't output data element if its\nvalue is null.\nThis data relies on the presence of the IBXSAVE("CADR") array that should\nhave been set in a previous data field.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"OI_HPID\",Z)),U,2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA,IBXSAVE S Z=$$COBN^IBCEF(IBXIEN),Z0=0 F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IBXIEN,\"I\"_Z1)) S Z0=Z0+1,IBXSAVE(Z0)=$$INSSECID^IBCEF21(IBXIEN,\"SUB\",Z1)\n", "\nQualifier for date of initial treatment.\ncounter variable and store the string returned from the $$INSSECID\nfunction.\nIBXSAVE(Z0) array. This will be used to populate pieces 9 thru 14 of this\nOI5 segment.\n \nZ is the current payer sequence number (1,2, or 3)\nZ0 is a counter and subscript of IBXSAVE(1) thru IBXSAVE(2)\nZ1 is the loop variable through all possible insurances on the claim\n \nIf Z1'=Z and insurance is defined for insurance# Z1, then increment the Z0\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S($G(IBXSAVE(\"INIT-DATE\")):454,1:\"\") K IBXSAVE(\"INIT-DATE\")\n", "\nQualifier for date of initial treatment.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S($G(IBXSAVE(\"ACUT-DATE\")):453,1:\"\") K IBXSAVE(\"ACUT-DATE\")\n", "\nQualifier for date of acute manifestation.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S($G(IBXSAVE(\"XRAY-DATE\")):455,1:\"\") K IBXSAVE(\"XRAY-DATE\")\n", "\nQualifier for date of the last Xray.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PTNM\")),U,5)\n", "\nPatient name suffix.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"REM\") I $$FT^IBCEF(IBXIEN)=3 N Z S Z=$P($G(^DGCR(399,IBXIEN,\"UF2\")),U,3),IBXDATA=\"\" S:Z'=\"\" IBXDATA=\"ADD\",IBXSAVE(\"REM\")=Z\n", "\nGet bill remarks from field 399/402, if non-empty save value in \nIBXSAVE("REM"), and set IBXDATA to "ADD" (qualifier).\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"REM\")) K IBXSAVE(\"REM\")\n", "\nBill remarks.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P($G(IBXSAVE(\"PROCMODS\",Z)),\",\",2) I Z0'=\"\" S IBXDATA(Z)=Z0\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P($G(IBXSAVE(\"PROCMODS\",Z)),\",\",3) I Z0'=\"\" S IBXDATA(Z)=Z0\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-SET 837 HEADER NODE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nSet ^TMP("IBHDR",$J) global node so the header data is not extracted again.\nNo output needed.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEF78(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P($G(IBXSAVE(\"PROCMODS\",Z)),\",\",4) K IBXSAVE(\"PROCMODS\",Z) I Z0'=\"\" S IBXDATA(Z)=Z0\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"DEND\")) S IBXDATA(Z)=$G(IBXSAVE(\"OUTPT\",Z,\"DEND\"))\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S IBXDATA(Z)=$S($P(IBXSAVE(\"OUTPT\",Z),U,8)=\"\":$$DOLLAR^IBCEFG1(\"0.00\"),1:$$DOLLAR^IBCEFG1($P(IBXSAVE(\"OUTPT\",Z),U,8)*$P(IBXSAVE(\"OUTPT\",Z),U,9)))\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D POS^IBCEF12 Q\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"DEN\")) S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z,\"DEN\"),U)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"DEN\")) S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z,\"DEN\"),U,2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"DEN\")) S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z,\"DEN\"),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"DEN\")) S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z,\"DEN\"),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "Q:'$G(IBXSAVE(\"SERVFACFLAG\")) N Z S Z=$G(IBXSAVE(\"SERVFACDATA\")),IBXDATA=$$GETFAC^IBCEP8(+$P(Z,U,4),$P(Z,U,3),0)\n", "\nSUB-2 lab/facility name\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"DEN\")) S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z,\"DEN\"),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "Q:'$G(IBXSAVE(\"SERVFACFLAG\")) N Z S Z=$G(IBXSAVE(\"SERVFACDATA\")),IBXDATA=$$GETFAC^IBCEP8(+$P(Z,U,4),$P(Z,U,3),1)\n", "\nSUB-3 lab/facility address line 1\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,SEQ K IBXSAVE(\"OTH_PAY_ADDR\") I $O(IBXSAVE(1,0)) S (Z,Z0)=0 F S Z=$O(IBXSAVE(1,Z)) Q:'Z S Z0=Z0+1,SEQ=IBXSAVE(1,Z),IBXSAVE(\"OTH_PAY_ADDR\",Z0)=$$ADD^IBCNADD(IBXIEN,SEQ)\n", "\nThe IBXSAVE input array should still exist from the piece 2 call to\n \nOutput:\nIBXSAVE("OTH_PAY_ADDR",1)=address string for other payer#1\nIBXSAVE("OTH_PAY_ADDR",2)=address string for other payer#2\n \nAddress string format:\n [1] address line 1\n [2] address line 2\n [3] address line 3\n [4] city\ndata element N-OTH INSURANCE SEQUENCE.\n [5] state ien ptr to file 5\n [6] zipcode\n \nUtility call $$ADD^IBCNADD(IBXIEN,SEQ) to pull the payer address for the\npayer at the specified payer sequence.\n \nInput:\nIBXSAVE(1)=current payer sequence letter\nIBXSAVE(1,Z)=other payer sequence letters where Z is the payer sequence\nnumber of the other payers\n \nLoop through this to produce the output IBXSAVE array.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"OTH_PAY_ADDR\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z1 S Z=0 F S Z=$O(^TMP(\"DCX\",$J,1,Z)) Q:'Z S Z1=$P(^TMP(\"DCX\",$J,1,Z),U,3),IBXDATA(Z)=$S(Z1=1:\"\",1:$P(^TMP(\"DCX\",$J,1,Z),U,3))\n", "\nPOA indicator for this diagnosis. Defaults to "".\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-REFERRING PROVIDER ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(IBXDATA'=\"\":\"Ref:\"_IBXDATA,$O(^DGCR(399,IBXIEN,\"PRV\",\"B\",1,0)):\"Ref:VAD000\",1:\"\")\n", "\nID of Referring Physician\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"DEN\")) S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z,\"DEN\"),U,6)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"DEN1\"\n", "\nOutput the record id for 'DEN1' record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-HCFA J430D SERV LINE (EDI)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 D DEN1^IBCEF12\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 D PROC^IBCEF12\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P(IBXSAVE(\"OUTPT\",Z),U,7) S:$P(Z0,\",\")'=\"\" IBXDATA(Z)=$P(Z0,\",\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P(IBXSAVE(\"OUTPT\",Z),U,7) S:$P(Z0,\",\",2) IBXDATA(Z)=$P(Z0,\",\",2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P(IBXSAVE(\"OUTPT\",Z),U,7) S:$P(Z0,\",\",3) IBXDATA(Z)=$P(Z0,\",\",3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P(IBXSAVE(\"OUTPT\",Z),U,7) S:$P(Z0,\",\",4) IBXDATA(Z)=$P(Z0,\",\",4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"DEN\")) S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z,\"DEN\"),U,7)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z,DT S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"DEN\")) S DT=$P(IBXSAVE(\"OUTPT\",Z,\"DEN\"),U,8) I DT'=\"\" S IBXDATA(Z)=$$DT^IBCEFG1(DT,\"\",\"D8\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "Q:'$G(IBXSAVE(\"SERVFACFLAG\")) N Z S Z=$G(IBXSAVE(\"SERVFACDATA\")),IBXDATA=$$GETFAC^IBCEP8(+$P(Z,U,4),$P(Z,U,3),\"3S\")\n", "\nSUB-5 lab/facility state code\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $P($G(IBXSAVE(\"OUTPT\",Z,\"DEN\")),U,9)'=\"\" S IBXDATA(Z)=452\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z,DT S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"DEN\")) S DT=$P(IBXSAVE(\"OUTPT\",Z,\"DEN\"),U,9) I DT'=\"\" S IBXDATA(Z)=$$DT^IBCEFG1(DT,\"\",\"D8\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $P($G(IBXSAVE(\"OUTPT\",Z,\"DEN\")),U,10)'=\"\" S IBXDATA(Z)=446\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z,DT S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"DEN\")) S DT=$P(IBXSAVE(\"OUTPT\",Z,\"DEN\"),U,10) I DT'=\"\" S IBXDATA(Z)=$$DT^IBCEFG1(DT,\"\",\"D8\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $P($G(IBXSAVE(\"OUTPT\",Z,\"DEN\")),U,11)'=\"\" S IBXDATA(Z)=196\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z,DT S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"DEN\")) S DT=$P(IBXSAVE(\"OUTPT\",Z,\"DEN\"),U,11) I DT'=\"\" S IBXDATA(Z)=$$DT^IBCEFG1(DT,\"\",\"D8\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $P($G(IBXSAVE(\"OUTPT\",Z,\"DEN\")),U,12)'=\"\" S IBXDATA(Z)=198\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 N Z,DT S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"DEN\")) S DT=$P(IBXSAVE(\"OUTPT\",Z,\"DEN\"),U,12) I DT'=\"\" S IBXDATA(Z)=$$DT^IBCEFG1(DT,\"\",\"D8\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"DEN2\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-HCFA J430D SERV LINE (EDI)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 D DEN2^IBCEF12\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$P($G(IBXSAVE(\"EMP\")),U)\n", "\nRetrieves insured employment info from IBXSAVE array previously extracted.\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "Q:'$G(IBXSAVE(\"SERVFACFLAG\")) N Z S Z=$G(IBXSAVE(\"SERVFACDATA\")),IBXDATA=$$GETFAC^IBCEP8(+$P(Z,U,4),$P(Z,U,3),\"3Z\"),IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)\n", "\nSUB-6 lab/facility zip code\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D DEN23^IBCEF12\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D DEN24^IBCEF12\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D DEN25^IBCEF12\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D DEN26^IBCEF12\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D DEN27^IBCEF12\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D DEN28^IBCEF12\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 D DEN29^IBCEF12\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"LSUR\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$G(IBXSAVE(\"SLPRV\",Z,\"SLC\")) D:Z>1 ID^IBCEF2(Z,\"LSUR\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1,\"LSUR\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-BATCH NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:'$G(IBXDATA) IBXDATA=\"UNASSIGNED\" S IBXSAVE(\"BATCH\")=IBXDATA\n", "\nSet an error condition if no batch # and the header fields have not\nalready been extracted. No output if error condition or header fields\nhave already been extracted.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-BILLING PROVIDER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D GETBP^IBCEF79(IBXIEN,\"\",+IBXDATA,\"PRV-BP\",.IBXSAVE)\n", "\nPRV-2.5\n--------\ncalculate only field to build the IBXSAVE("PRV-BP") array which will hold \nthe billing provider name, address, and phone#.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"PRV-BP\"),IBXSAVE(\"ORGNPI\"),IBXSAVE(\"ORGTAX\")\n", "\nClean up the IBXSAVE usage at the end of the PRV segment.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$INPAT^IBCEF(IBXIEN),$$FT^IBCEF(IBXIEN)=3,+$P($G(^DGCR(399,IBXIEN,\"U1\")),U,15) S IBXDATA=\"DR\"\n", "\nCL1A-13 - Inpatient, UB claims only.\nIf field# 170 exists and is a valid pointer to file 80.2, then the value \nof this field is the qualifier "DR".\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z I $$INPAT^IBCEF(IBXIEN),$$FT^IBCEF(IBXIEN)=3 S Z=+$P($G(^DGCR(399,IBXIEN,\"U1\")),U,15) I Z S IBXDATA=$$FO^IBCNEUT1(Z,4,\"R\",0)\n", "\nCL1A-14 - Inpatient, UB claims only.\nIf the PPS field exists, then output the ien right justified with leading \n0's.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U)'=\"\" IBXDATA(Z)=\"DD\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-BILLING PROVIDER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"SERVFACFLAG\")=$S($P(IBXDATA,U,3)=\"\":0,1:1) I IBXSAVE(\"SERVFACFLAG\") S IBXSAVE(\"SERVFACDATA\")=IBXDATA\n", "\nSUB, piece 1.5\na 1 if the service facility is a non-VA facility in file 355.93.\nPiece [4] is the IEN to either file 4 or 355.93.\n \nVariable Z1 is the value of the $$SENDSF function call. This function \nwill only return 0 (don't send) if the pre-patch 400 switchback flag is \nset to ON, and care was provided at the main division in the database, \nand the insurance company parameter that says to send the service \nfacility data is set to NO (don't send).\nMRD;IB*2.0*516 - The function $$SENDSF^IBCEF79 now will always return\n'1'.\nUse the data element to extract the billing provider/service facility \ninformation.\nIBXSAVE("SERVFACFLAG")=0 to indicate there is no service facility info\nIBXSAVE("SERVFACFLAG")=1 to indicate there is service facility info\n \nIBXSAVE("SERVFACDATA") is the string of data from the $$B^IBCEF79 \nfunction. Therefore [3] is "" if there is no service facility data, or \n[3] is 0 if the service facility is a VA institution in file 4, or [3] is \n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"SERVFACFLAG\"),IBXSAVE(\"SERVFACDATA\")\n", "\nClean up IBXSAVE array used in the building of the SUB segment.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z I $$FT^IBCEF(IBXIEN)=3,'$$INPAT^IBCEF(IBXIEN) S Z=$P($G(^DGCR(399,IBXIEN,\"U3\")),U,8) I Z'=\"\" S IBXDATA=$S($$ICD9VER^IBACSV(Z)=1:\"PR\",1:\"APR\")\n", "\nThis is a qualifier for PRV diagnosis (1)\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=3,'$$INPAT^IBCEF(IBXIEN) S IBXDATA=$TR($P($$ICD9^IBACSV($P($G(^DGCR(399,IBXIEN,\"U3\")),U,8)),U,1),\".\")\n", "\nThis is PRV diagnosis (1)\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z I $$FT^IBCEF(IBXIEN)=3,'$$INPAT^IBCEF(IBXIEN) S Z=$P($G(^DGCR(399,IBXIEN,\"U3\")),U,9) I Z'=\"\" S IBXDATA=$S($$ICD9VER^IBACSV(Z)=1:\"PR\",1:\"APR\")\n", "\nThis is a qualifier for PRV diagnosis (2)\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-BATCH DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXDATA) S IBXDATA=$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")\n", "\nIf header data has already been extracted, array ^TMP("IBHDR",$J) will\nalready exist. Don't want to extract this field again, so kill data\nelement so there is no output. If header data not already extracted,\nformat date as CCYYMMDD.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=3,'$$INPAT^IBCEF(IBXIEN) S IBXDATA=$TR($P($$ICD9^IBACSV($P($G(^DGCR(399,IBXIEN,\"U3\")),U,9)),U,1),\".\")\n", "\nThis is PRV diagnosis (2)\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z I $$FT^IBCEF(IBXIEN)=3,'$$INPAT^IBCEF(IBXIEN) S Z=$P($G(^DGCR(399,IBXIEN,\"U3\")),U,10) I Z'=\"\" S IBXDATA=$S($$ICD9VER^IBACSV(Z)=1:\"PR\",1:\"APR\")\n", "\nThis is a qualifier for PRV diagnosis (3)\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=3,'$$INPAT^IBCEF(IBXIEN) S IBXDATA=$TR($P($$ICD9^IBACSV($P($G(^DGCR(399,IBXIEN,\"U3\")),U,10)),U,1),\".\")\n", "\nThis is PRV diagnosis (3)\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"PRV1\"\n", "\nPRV1 segment, piece 1. Literal value is "PRV1".\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N DIFF S IBXSAVE(\"PRV1\")=$$PRVDATA^IBJPS3(IBXIEN),DIFF=$$DIFF^IBJPS3(IBXIEN,1) S:'DIFF (IBXSAVE(\"PRV1\"),IBPTPNPI)=\"\" Q:'DIFF S $P(IBXSAVE(\"PRV1\"),U,12,14)=\"87^2^24\",IBPTPNPI=$P($G(IBXSAVE(\"PRV1\")),U,2)\n", "\nPRV1-1.5 calculate only piece\nPRV1-3 Entity type qualifier is "2"\nPRV1-5 ID Code qualifier is "24"\n \nVery special variable IBPTPNPI is also set here in this format code. \nThis is the pay-to provider NPI#. It is also blanked out if no \ndifferences exist. This is used in NPI-18.\n--------------------------------\nSave the pay-to provider data string in IBXSAVE. But if no differences \nexist between the pay-to provider data and the billing provider data, \nthen blank out the pay-to provider data.\nIf differences do exist, then manually hard-code the literal values for 3 \nfields into the pay-to provider string:\n \nPRV1-2 Entity ID code is "87"\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PRV1\")),U,12)\n", "\nPRV1-2 Entity ID code\nThis value is set by PRV1-1.5.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PRV1\")),U,13)\n", "\nPRV1-3 Entity type qualifer\nSet by PRV1-1.5\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INS FORM LOC 64\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", "\nPRV1-5 ID code qualifier\nThis is set by PRV1-1.5\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", "\nPRV1-6\npay-to provider primary ID (tax ID here). Strip out the punctuation.\n \n \nplease note: The pay-to provider NPI# which is really the primary ID is\nbeing sent with NPI-18.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"BATCH\"))\n", "\nIf header data has already been extracted, array ^TMP("IBHDR",$J) will\nalready exist. Don't want to extract this field again, so kill data\nelement so there is no output. If header data not already extracted,\nretrieve data element from IBXSAVE array previously extracted.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PRV1\")),U,5)\n", "\nPRV1-7\npay-to provider address line 1\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PRV1\")),U,6)\n", "\nPRV1-8\npay-to provider address line 2\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PRV1\")),U,7) I IBXDATA'=\"\" S IBXDATA=$TR(IBXDATA,\"-/.,()'\",\" \")\n", "\nPRV1-9\npay-to provider city name\nPerform the standard punctuation edits on the city name to convert "-" \nand "/" into spaces.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PRV1\")),U,8)\n", "\nPRV1-10\npay-to provider state abbreviation\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PRV1\")),U,9),IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)\n", "\nPRV1-11 - pay-to provider zip code\nRemove any punctuation including dashes or spaces.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBX,IBZ,Z S IBXSAVE(\"CL1A-16\")=\"\" I $$INPAT^IBCEF(IBXIEN),$$FT^IBCEF(IBXIEN)=3 S IBZ=+$G(^DGCR(399,IBXIEN,\"U2\")) I IBZ S Z=$$ICD9^IBACSV(IBZ),IBX=$TR($P(Z,U,1),\".\") I IBX'=\"\" S IBXDATA=$S($P(Z,U,19)=1:\"BJ\",1:\"ABJ\"),IBXSAVE(\"CL1A-16\")=IBX\n", "\nCL1A-15\nThis is the admitting diagnosis qualifier. This is for inpatient,\nUB's only. If the claim has an admitting diagnosis, then save it\nin temporary variable IBXSAVE("CL1A-16") and output "BJ" here in\nthis piece.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"CL1A-16\")) K IBXSAVE(\"CL1A-16\")\n", "\nCL1A-16\nThis is the admitting diagnosis. It is calculated from CL1A-15 - \nadmitting dx qualifier field.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"AMB \"\n", "\nOutput RECORD ID for AMB PICK UP record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N DATA,NODE,Z K IBXDATA S Z=0 F NODE=\"U5\",\"U6\" S DATA=$G(IBXSAVE(\"AMB\",NODE)) I $L(DATA) S Z=Z+1,IBXDATA(Z)=$S(NODE=\"U5\":\"PW\",1:45) D:Z>1 ID^IBCEF2(Z,\"AMB\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=\"AMB1\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURANCE PRIOR PAYMENT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $D(^DGCR(399,IBXIEN,\"I\"_(Z+1))),$D(IBZ(Z)) S IBXDATA(Z)=$$DOLLAR^IBCEFG1(IBZ(Z))\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. If any other insurance\nprior payment data is found, the data is formatted as a numeric including\ncents, without the decimals.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N DATA,NODE,Z K IBXDATA S Z=0 F NODE=\"U5\",\"U6\" S DATA=$G(IBXSAVE(\"AMB\",NODE)) I $L(DATA) S Z=Z+1,IBXDATA(Z)=$P(IBXSAVE(\"AMB\",NODE),U,2)\n", "\nGets the Ambulance Address 1 from the 2nd piece of the data string.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N DATA,NODE,Z K IBXDATA S Z=0 F NODE=\"U5\",\"U6\" S DATA=$G(IBXSAVE(\"AMB\",NODE)) I $L(DATA) S Z=Z+1,IBXDATA(Z)=$P(IBXSAVE(\"AMB\",NODE),U,3)\n", "\nGets the Ambulance Address 2 from the 3rd piece of the data string.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N DATA,NODE,Z K IBXDATA S Z=0 F NODE=\"U5\",\"U6\" S DATA=$G(IBXSAVE(\"AMB\",NODE)) I $L(DATA) S Z=Z+1,IBXDATA(Z)=$P(IBXSAVE(\"AMB\",NODE),U,4)\n", "\nGets the Ambulance City from the 4th piece of the data string\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N DATA,NODE,Z K IBXDATA S Z=0 F NODE=\"U5\",\"U6\" S DATA=$G(IBXSAVE(\"AMB\",NODE)) I $L(DATA) S Z=Z+1,IBXDATA(Z)=$$STATE^IBCEFG1($P(IBXSAVE(\"AMB\",NODE),U,5))\n", "\nGets the Ambulance State from the 5th piece of the data string.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N DATA,NODE,Z K IBXDATA S Z=0 F NODE=\"U5\",\"U6\" S DATA=$G(IBXSAVE(\"AMB\",NODE)) I $L(DATA) S Z=Z+1,IBXDATA(Z)=$P(IBXSAVE(\"AMB\",NODE),U,6)\n", "\nGets the Ambulance Zip code from the 6th piece of the data string.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA I $P($G(IBXSAVE(\"AMB\",\"U7\")),U,1) S IBXDATA=\"LB\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"AMB\",\"U7\")),U,1) I IBXDATA=\"\" K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"AMB\",\"U7\")),U,2) S:IBXDATA IBXDATA=$$GET1^DIQ(399,IBXIEN,288,IBXDATA) I IBXDATA=\"\" K IBXDATA\n", "\nAmbulance Transport Reason Code\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA I $P($G(IBXSAVE(\"AMB\",\"U7\")),U,3)'=\"\" S IBXDATA=\"DH\"\n", "\nAmbulance Distance Units. Only if Ambulance distance is not null.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"AMB\",\"U7\")),U,3) I IBXDATA=\"\" K IBXDATA\n", "\nAmbulance Transport Distance\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-HCFA 1500 SERVICE LINE (EDI)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N A,Z,Q,IBZ K IBXSAVE(\"OUTPT\") D SET1^IBCEF1(IBXIEN,.A,.IBZ,.IBXDATA,.IBXNOREQ) S Z=0,Q=$G(@A) F S Z=$O(IBZ(Z)) S:'Z @A=Q Q:'Z M IBXSAVE(\"OUTPT\",Z)=IBZ(Z) S Q=Q+1,IBXDATA(Z)=Q D:Z>1 ID^IBCEF2(Z,\"PRF \") D SVITM^IBCEF2(.IBXSAVE,Z)\n", "\n^TMP($J,"IBLCT") keeps track of the last service line # output. Data\nelement is a group data element so multiple ocuurences of the data element\nare possible in the IBXDATA array. Save the data in the IBXSAVE array for\nlater use. For every service line > 1, output the PRF record id.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"AMB\",\"U7\")),U,4) I IBXDATA=\"\" K IBXDATA\n", "\nAmbulance Round Trip Purpose\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N DATA,NODE,Z K IBXDATA S Z=0 F NODE=\"U5\",\"U6\" S DATA=$G(IBXSAVE(\"AMB\",NODE)) I $L(DATA) S Z=Z+1,IBXDATA(Z)=$P(IBXSAVE(\"AMB\",NODE),U,1)\n", "\nGet the Ambulance Drop Off Location from the 1st piece of the data string.\nThis is from the Drop Off record ("U6") only. Will always be blank on the\npick up record.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ORGANIZATION NPI CODES\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"ORGNPI\")),U,3)\n", "\nExtract NPI Code for Billing Provider\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ORGANIZATION NPI CODES\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$S($P($G(IBXSAVE(\"ORGNPI\")),U,3)]\"\":\"XX\",1:\"\")\n", "\nIf the NPI number exists this field will be set to XX; otherwise to null.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PROP/CAS DATE OF 1ST CONTACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$S($$FT^IBCEF(IBXIEN)=3:\"\",IBXDATA:444,1:\"\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PROP/CAS DATE OF 1ST CONTACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$S($$FT^IBCEF(IBXIEN)=3:\"\",1:$$DT^IBCEFG1(IBXDATA,\"\",\"D8\"))\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-DISABILITY DATE QUALIFIER\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-DISABILITY START DATE\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXSAVE(\"DIS ST DT\")=$S($$FT^IBCEF(IBXIEN)=3:\"\",1:$$DT^IBCEFG1(IBXDATA,\"\",\"D8\"))\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-DISABILITY END DATE\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXSAVE(\"DIS END DT\")=$S($$FT^IBCEF(IBXIEN)=3:\"\",1:$$DT^IBCEFG1(IBXDATA,\"\",\"D8\"))\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-DISABILITY DATE QUALIFIER\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$S($$FT^IBCEF(IBXIEN)=3:\"\",IBXDATA=360:IBXSAVE(\"DIS ST DT\"),IBXDATA=361:IBXSAVE(\"DIS END DT\"),IBXDATA=314:IBXSAVE(\"DIS ST DT\")_\"-\"_IBXSAVE(\"DIS END DT\"),1:\"\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $P(IBXSAVE(\"OUTPT\",Z),U,6)'=\"\" S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z),U,6) I IBXDATA(Z)=\"CJ\",'$$WNRBILL^IBEFUNC(IBXIEN) S IBXDATA(Z)=\"HC\"\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ASSUME CARE DATE\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$S($$FT^IBCEF(IBXIEN)=3:\"\",IBXDATA:\"090\",1:\"\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ASSUME CARE DATE\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$S($$FT^IBCEF(IBXIEN)=3:\"\",1:$$DT^IBCEFG1(IBXDATA,\"\",\"D8\"))\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RELINQUISH CARE DATE\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$S($$FT^IBCEF(IBXIEN)=3:\"\",IBXDATA:\"091\",1:\"\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RELINQUISH CARE DATE\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$S($$FT^IBCEF(IBXIEN)=3:\"\",1:$$DT^IBCEFG1(IBXDATA,\"\",\"D8\"))\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ORGANIZATION TAXONOMIES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S($P($G(IBXSAVE(\"ORGTAX\")),U,3)]\"\":\"BI\",1:\"\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ORGANIZATION TAXONOMIES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"ORGTAX\")),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURRENT AUTHORIZATION CODE\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$S(IBXDATA]\"\":\"G1\",1:\"\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURRENT REFERRAL NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(IBXDATA]\"\":\"9F\",1:\"\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURRENT REFERRAL NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"CL1B\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXNOREQ=$$NFT^IBCEF1(2,IBXIEN) N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S IBXDATA(Z)=$S($P(IBXSAVE(\"OUTPT\",Z),U,8)=\"\":$$DOLLAR^IBCEFG1(\"0.00\"),1:$$DOLLAR^IBCEFG1($P(IBXSAVE(\"OUTPT\",Z),U,8)*$P(IBXSAVE(\"OUTPT\",Z),U,9)))\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. The\ndata is calculated by unit charge * # of units. If any service line data is\nfound, the data is formatted as a numeric including cents, without the\ndecimal.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ATT RPT TYPE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ATT RPT TRX CODE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ATT CONTROL NUM\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(IBXDATA]\"\":\"AC\",1:\"\") I $$FT^IBCEF(IBXIEN)=7,$P($G(^DGCR(399,IBXIEN,\"U8\")),U,3)=\"AA\" S IBXDATA=\"\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ATT CONTROL NUM\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7,$P($G(^DGCR(399,IBXIEN,\"U8\")),\"^\",3)=\"AA\" S IBXDATA=\"\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PROP/CAS CLAIM NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S($TR(IBXDATA,\" \")]\"\":\"Y4\",1:\"\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PROP/CAS CLAIM NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$TR(IBXDATA,\" \"),IBXSAVE(\"PCCLAIM\")=0 I IBXDATA]\"\" S IBXSAVE(\"PCCLAIM\")=1\n", "\nSUbsequeNt fields Prop/Cas COntact Name, Prop/Cas Contact Phone and\nProp/Cas COntact Extension should ONLY be sent if this field has a value,\nindicating that this IS a Property & Casualty claim.\nSetting IBXSAVE("PCCLAIM") here to 0 (Not a P&C Claim) or 1 (IS a P&C \nClaim) for reference in these later fields.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PROP/CAS CONTACT NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(IBXDATA]\"\":\"IC\",1:\"\") I $G(IBXSAVE(\"PCCLAIM\"))=0 S IBXDATA=\"\"\n", "\nDon't populate this field if this is not a Property and Casualty Claim. \nSee Format Description for Prop/Cas Claim NUmber for more info.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PROP/CAS CONTACT NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXSAVE(\"PCCLAIM\"))=0 S IBXDATA=\"\"\n", "\nDon't populate this field if this is not a Property and Casualty Claim. \nSee Format Description for Prop/Cas Claim NUmber for more info.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PROP/CAS CONTACT TELEPHONE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(IBXDATA]\"\":\"TE\",1:\"\") I $G(IBXSAVE(\"PCCLAIM\"))=0 S IBXDATA=\"\"\n", "\nDon't populate this field if this is not a Property and Casualty Claim. \nSee Format Description for Prop/Cas Claim NUmber for more info.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PROP/CAS CONTACT TELEPHONE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXSAVE(\"PCCLAIM\"))=0 S IBXDATA=\"\"\n", "\nDon't populate this field if this is not a Property and Casualty Claim. \nSee Format Description for Prop/Cas Claim NUmber for more info.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0,Q S IBXNOREQ=$$NFT^IBCEF1(2,IBXIEN),Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P(IBXSAVE(\"OUTPT\",Z),U,4),Q=$S(Z0'=7:9,1:12) S:$P(IBXSAVE(\"OUTPT\",Z),U,Q)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z),U,Q) S:IBXDATA(Z)<1 IBXDATA(Z)=1\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extracted IBXSAVE array. If\nany service line data is found, the data is output.\nIf the type of service is not 7 (anesthesia), the units are output. If the\ntype of service is anesthesia, the anesthesia minutes are output. If the #\nof units is less than 1, 1 is the default.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PROP/CAS CONTACT EXTENSION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(IBXDATA]\"\":\"EX\",1:\"\") I $G(IBXSAVE(\"PCCLAIM\"))=0 S IBXDATA=\"\"\n", "\nDon't populate this field if this is not a Property and Casualty Claim. \nSee Format Description for Prop/Cas Claim NUmber for more info.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PROP/CAS CONTACT EXTENSION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$G(IBXSAVE(\"PCCLAIM\"))=0 IBXDATA=\"\" K IBXSAVE(\"PCCLAIM\")\n", "\nDon't populate this field if this is not a Property and Casualty Claim. \nSee Format Description for Prop/Cas Claim Number for more info.\nSaved value IBXSAVE("PCCLAIM") is not needed after this, so it's killed.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"SPC \"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PRI SURG PROC CODE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(IBXDATA]\"\":\"BP\",1:\"\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PRI SURG PROC CODE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-SEC SURG PROC CODE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(IBXDATA]\"\":\"BO\",1:\"\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-SEC SURG PROC CODE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"C\",1,0)),U,1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXNOREQ=$$NFT^IBCEF1(2,IBXIEN) N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S:$P(IBXSAVE(\"OUTPT\",Z),U,3)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z),U,3)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OPR9\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nExtract the Rendering Physician Name. Controls processing of the record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,\"NAME\")) S IBXDATA=82\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,\"NAME\")) S IBXDATA=1\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S Z=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,\"NAME\")),U,1) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S Z=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,\"NAME\")),U,2) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S Z=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,\"NAME\")),U,3) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S Z=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,\"NAME\")),U,5) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S Z=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,0)),U,3) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S Z=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,0)),U,4) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,\"TAXONOMY\"))]\"\" S IBXDATA=\"PE\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S Z=$G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,\"TAXONOMY\")) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OPRA\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)'=7 S Z=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,1)),\"^\",3) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)'=7 S Z=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,1)),\"^\",4),1) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)'=7 S Z=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,2)),\"^\",3) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)'=7 S Z=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,2)),\"^\",4),1) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)'=7 S Z=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,3)),\"^\",3) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)'=7 S Z=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,3)),\"^\",4),1) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)'=7 S Z=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,4)),\"^\",3) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXNOREQ=$$NFT^IBCEF1(2,IBXIEN) N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S:$P(IBXSAVE(\"OUTPT\",Z),U)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z),U)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)'=7 S Z=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,3,4)),\"^\",4),1) I Z]\"\" S IBXDATA=Z\n", ""], ["IB 837 TRANSMISSION", "", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OP1A\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBIFN)=3 D PROVSEQ^IBCEF72(IBXIEN,.IBXSAVE,.IBXDATA,4,\"OP1A\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,4,\"71\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,4,\"1\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,4,\"Q\",1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,4,\"I\",1) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,4,\"Q\",2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,4,\"I\",2) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,4,\"Q\",3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P(IBXSAVE(\"OUTPT\",Z),U,7) S:$P(Z0,\",\")'=\"\" IBXDATA(Z)=$P(Z0,\",\")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output. Data is taken from the\nfirst ',' delimited piece of the extracted data.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,4,\"I\",3) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=\"\" F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $P($G(IBXSAVE(\"OUTPT\",Z,\"RX\")),U,11) S IBXDATA(Z)=471\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=\"\" F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"RX\")) S IBXDATA(Z)=$S($P(IBXSAVE(\"OUTPT\",Z,\"RX\"),U,11)'=\"\":$$DT^IBCEFG1($P(IBXSAVE(\"OUTPT\",Z,\"RX\"),U,11),\"\",\"D8\"),1:\"\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTHER PAYER REF NUM\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $G(IBZ(Z))'=\"\" S IBXDATA(Z)=\"9F\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTHER PAYER REF NUM\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $G(IBZ(Z))'=\"\" S IBXDATA(Z)=IBZ(Z)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"CCOB\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"CCOB\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"CCOB\",IBZ,Z,0)),U,6) S IBXDATA(Z0)=573\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"CCOB\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"CCOB\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"CCOB\",IBZ,Z,0)),U,6) S IBXDATA(Z0)=$$DT^IBCEFG1($P(IBXSAVE(\"CCOB\",IBZ,Z,0),U,6),\"\",\"D8\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "", "", "", "", "N Z,Z0,IBZ K IBXDATA I $$FT^IBCEF(IBXIEN)'=7 S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"CCOB\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"CCOB\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"CCOB\",IBZ,Z,0)),U,21)'=\"\" S IBXDATA(Z0)=$P(IBXSAVE(\"CCOB\",IBZ,Z,0),U,21)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P(IBXSAVE(\"OUTPT\",Z),U,7) S:$P(Z0,\",\",2) IBXDATA(Z)=$P(Z0,\",\",2)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output. Data is taken from the\nsecond ',' delimited piece of the extracted data. \n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,6)'=\"\" IBXDATA(Z)=\"XX\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,6)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P(IBXSAVE(\"OUTPT\",Z),U,7) S:$P(Z0,\",\",3) IBXDATA(Z)=$P(Z0,\",\",3)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output. Data is taken from the\nthird ',' delimited piece of the extracted data. \n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P(IBXSAVE(\"OUTPT\",Z),U,7) S:$P(Z0,\",\",4) IBXDATA(Z)=$P(Z0,\",\",4)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output. Data is taken from the\nfourth ',' delimited piece of the extracted data. \n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"LDAT\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LDAT^IBCEF11\n", "\nService line counter for LDAT record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"LDAT\") D GETLDAT^IBCEF11(IBXIEN) D:$D(IBXSV(\"VC80\")) VC80L^IBCEF11(IBXIEN,+$G(IBXSV(\"VC80LN\")))\n", "\nExtract data for LDAT record and save it in IBXSAVE("LDAT").\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LDAT\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"LDAT\",Z),U)\n", "\nAttachment report type from field 399.0304/71.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LDAT\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"LDAT\",Z),U,2)\n", "\nAttachment report transmission code from 399.0304/72.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LDAT\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"LDAT\",Z),U,3)'=\"\" IBXDATA(Z)=\"AC\"\n", "\nAlways set to "AC".\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LDAT\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"LDAT\",Z),U,3)\n", "\nAttachment control number from 399.0304/70.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LDAT\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"LDAT\",Z),U,4)'=\"\" IBXDATA(Z)=\"FL\"\n", "\nAlways set to "FL".\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LDAT\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"LDAT\",Z),U,4)\n", "\nOB Anesthesia Additional Units from field 399.0304/74.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nMRD;IB*2.0*516 - Changed to be blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-UB-04 SERVICE LINE (EDI)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D INS^IBCEF2\n", "\n^TMP($J,"IBLCT") keeps track of the last service line # output. Data \nelement is a group data element so multiple occurences of the data element\nare possible in the IBXDATA array. Save the data in the IBXSAVE array for\nlater use. For every service line > 1, output the INS record id.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nMRD;IB*2.0*516 - Changed to be blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LDAT\",Z)) Q:'Z S IBXDATA(Z)=\"6R\"\n", "\nAlways set to "6R".\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LDAT\",Z)) Q:'Z S IBXDATA(Z)=Z_\"_\"_$P(^DGCR(399,IBXIEN,0),U)\n", "\nThis piece contains [service line number]_[claim number], i.e. \n"5_K30002Z".\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LDAT\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"LDAT\",Z),U,5)\n", "\nContains the value of SUB2-8 if available, otherwise contains the value \nof SUB2-6. If both values are not available, this piece is blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LDAT\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"LDAT\",Z),U,6)\n", "\nContains total charges returned by either OUTPT^IBCEF11for CMS-1500 or \nHOS^IBCEF2 for UB-04.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"LDAT\"),IBXSV(\"VC80\"),IBXSV(\"VC80LN\")\n", "\nClear IBXSAVE array for this record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"LOPE\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1,\"LOPE\")\n", "\nGet data for LOPE record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$G(IBXSAVE(\"SLPRV\",Z,\"SLC\")) D:Z>1 ID^IBCEF2(Z,\"LOPE\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U)'=\"\" IBXDATA(Z)=72\n", "\nAlways set to 72.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"INPT\",Z)) Q:'Z S:$P(IBXSAVE(\"INPT\",Z),U)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"INPT\",Z),U)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,6)'=\"\" IBXDATA(Z)=\"XX\"\n", "\nAlways set to XX.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,6)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,7)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,8)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,7)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,9)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,10)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,9)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D INS05^IBCEF2\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,11)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,12)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,11)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"LOP1\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$G(IBXSAVE(\"SLPRV\",Z,\"SLC\")) D:Z>1 ID^IBCEF2(Z,\"LOP1\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1,\"LOP1\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U)'=\"\" IBXDATA(Z)=\"ZZ\"\n", "\nAlways set to ZZ.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nMRD;IB*2.0*516 - Changed to be blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,6)'=\"\" IBXDATA(Z)=\"XX\"\n", "\nAlways set to XX.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,6)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,7)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,8)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,7)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,9)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,10)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,9)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,11)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,12)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D INS09^IBCEF2\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is formatted as a numeric including\ncents, without the decimal.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,11)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"LREN\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1,\"LREN\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$G(IBXSAVE(\"SLPRV\",Z,\"SLC\")) D:Z>1 ID^IBCEF2(Z,\"LREN\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U)'=\"\" IBXDATA(Z)=82\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D INS07^IBCEF2\n", "\nSave the data element in the IBXSAVE("PMOD") array for later use.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,6)'=\"\" IBXDATA(Z)=\"XX\"\n", "\nAlways set to XX.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,6)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,7)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,8)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,7)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,9)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,10)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,9)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,11)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,12)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,11)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=0 F S Z=$O(IBXSAVE(\"PMOD\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"PMOD\",Z),\",\",2) ;I '$O(IBXSAVE(\"PMOD\",Z)) K IBXSAVE(\"PMOD\")\n", "\nThis data element relies on the existence of the variable IBXSAVE("PMOD")\npreviously extracted.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,5)'=\"\" IBXDATA(Z)=\"PE\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,5)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"LPUR\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1,\"LPUR\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z I $D(IBXSAVE(\"SLPRV\",Z,\"SLC\")) S IBXDATA(Z)=$G(IBXSAVE(\"SLPRV\",Z,\"SLC\")) D:Z>1 ID^IBCEF2(Z,\"LPUR\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" I $D(IBXSAVE(\"SLPRV\",Z,\"SLC\")) S IBXDATA(Z)=\"QB\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,6)'=\"\" IBXDATA(Z)=\"XX\"\n", "\nAlways set to XX.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S IBXNOREQ='$$REQ^IBCEF1(3,\"O\",IBXIEN) K IBXDATA Q:IBXNOREQ!$$INPAT^IBCEF(IBXIEN,1) S Z=$$SERVDT^IBCEF(IBXIEN,8,1),Q=0 S:Z'=\"\" IBXSAVE(\"DATE\")=Z D RCDT^IBCEFG1(.IBXSAVE,.IBXDATA,Z)\n", "\nIf data element's value is null, do not output.\nIf this is an inpatient bill do not send this data element. If outpatient,\noutput IBXSAVE("DATE") - STATEMENT FROM DATE or the date from the\nassociated procedure, if it can be determined.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,6)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,7)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,8)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,7)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"LSUP\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1,\"LSUP\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$G(IBXSAVE(\"SLPRV\",Z,\"SLC\")) D:Z>1 ID^IBCEF2(Z,\"LSUP\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U)'=\"\" IBXDATA(Z)=\"DQ\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nMRD;IB*2.0*516 - Changed to be blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,6)'=\"\" IBXDATA(Z)=\"XX\"\n", "\nAlways set to XX.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,6)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,7)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,8)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,7)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,9)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,10)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,9)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,11)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,12)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,11)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXNOREQ=$$NFT^IBCEF1(2,IBXIEN) K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S:$P(IBXSAVE(\"OUTPT\",Z),U,5)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z),U,5)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"LREF\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1,\"LREF\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$G(IBXSAVE(\"SLPRV\",Z,\"SLC\")) D:Z>1 ID^IBCEF2(Z,\"LREF\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U)'=\"\" IBXDATA(Z)=\"DN\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-LAST XRAY\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$S($$FT^IBCEF(IBXIEN)=3:\"\",1:$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")) S:IBXDATA IBXSAVE(\"XRAY-DATE\")=1\n", "\nFIND THE LAST XRAY DATE WHEN CLAIM INVOLVES A SPINAL MANIPULATION\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,6)'=\"\" IBXDATA(Z)=\"XX\"\n", "\nAlways set to XX.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,6)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,7)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,8)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,7)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,9)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,10)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,9)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,11)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,12)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,11)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE) D ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSet up the IBXSAVE array to build the OPR1 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", "\nClean up the IBXSAVE array.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSetup record for OPR2. Sets up IBXSAVE\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", "\nClean up record for OPR2\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSet up IBXSAVE array for OPR3\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-COB TOTAL NON-COVERED AMOUNT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$NOPUNCT^IBCEF($G(IBXDATA))\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", "\nClean up IBXSAVE array\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSet up IBXSAVE array for OPR4 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", "\nClean up for OPR4 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSetup for OPR5 record\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", "\nClean up after OPR5 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSet up the IBXSAVE array for the OPR8 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSet up IBXSAVE array for OPRA record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,PCX S Z=0 F S Z=$O(IBXSAVE(\"INPT\",Z)) Q:'Z S PCX=$P(IBXSAVE(\"INPT\",Z),U,2) S:PCX'=\"\" IBXDATA(Z)=$S(+$G(VC80):PCX,1:$$PRCD^IBCEF1(PCX_\";ICPT(\"))\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSet up IBXSAVE for OP1 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE) I $$FT^IBCEF(IBIFN)=3 D ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSet up IBX Array for OP1A if form type is 3.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", "\nClean up after OP1A record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", "\nSet up IBXSAVE array for OP2 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSet up IBXSAVE for OP4 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSet up IBXSAVE array for the OP8 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"INM\")),U,2)\n", "\nPull off first name of insured from IBXSAVE array previously extracted.\nDon't output data element if its value is null.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-KILL IBXSAVE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE\n", "\nClean up IBXSAVE array. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nSet up IBXSAVE array for the OP9 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE)\n", "\nClean up IBXSAVE array after OP9 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE N LN,NOKILL,IBPCE S LN=0 F S LN=$O(^TMP(\"IBXDATA\",$J,IBXREC,IBXPG,LN)) Q:'LN S NOKILL=0 F IBPCE=4,6,8,10 S:$G(^TMP(\"IBXDATA\",$J,IBXREC,IBXPG,LN,IBPCE))]\"\" NOKILL=1 I IBPCE=10,'NOKILL K ^TMP(\"IBXDATA\",$J,IBXREC,IBXPG,LN)\n", "\nIf pieces 4, 6, 8 and 10 are null remove the line from the output \nformatter.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OI4 COB SETUP\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "M IBXSAVE(\"CCOB\")=IBXDATA K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-COB CLAIM LEVEL AMOUNTS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "M IBXSAVE(\"CCOB\")=IBXDATA N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"CCOB\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"CCOB\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"CCOB\",IBZ,Z,1)),U,2) S IBXDATA(Z0)=\"EAF\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"CCOB\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"CCOB\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"CCOB\",IBZ,Z,1)),U,2) S IBXDATA(Z0)=$$DOLLAR^IBCEFG1($G(IBXDATA(Z0))+$P(IBXSAVE(\"CCOB\",IBZ,Z,1),U,2))\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,\"Z\")\n", "\nPayer Sequence # code\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,\"Z\")\n", "\nPayer Responsibility Sequence # Code\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D AMB^IBCEFP(IBXIEN,.IBXSAVE)\n", "\nSet up Data fields for AMB record(s)\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-KILL IBXSAVE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE\n", "\nClean up the IBXSAVE array. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"AMB\")\n", "\nClean up the IBXSAVE array\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D AMB^IBCEFP(IBXIEN,.IBXSAVE)\n", "\nSet up IBXSAVE Array for AMB1 record\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"AMB\",\"U7\")),U,5) I IBXDATA=\"\" K IBXDATA\n", "\nAmbulance Stretcher Purpose\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXSAVE(\"AMB\")\n", "\nClean up after Ambulance record creation\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"AMB2\"\n", "\nAMB2 Record ID field\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D AMB^IBCEFP(IBXIEN,.IBXSAVE)\n", "\nSet up IBXSAVE array with Ambulance data\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"AMB\",\"U9\")) S IBXDATA=\"07\"\n", "\nSet up Amb Code Categorywith "07" if data exists for this record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"AMB\",\"U9\")) S IBXDATA=\"Y\"\n", "\nSet Y into field Amb Certification Condition Indicator if data exists for \nthe record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"AMB\",\"U9\",1)) I IBXDATA=\"\" K IBXDATA\n", "\nAmb Condition code 1 data\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"AMB\",\"U9\",2)) I IBXDATA=\"\" K IBXDATA\n", "\nAmb Condition code 2\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=\"\"\n", "\nMRD;IB*2.0*516 - Changed to be blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"AMB\",\"U9\",3)) I IBXDATA=\"\" K IBXDATA\n", "\nAmb Condition Code 3\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"AMB\",\"U9\",4)) I IBXDATA=\"\" K IBXDATA\n", "\nAmb Condition Code 4\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"AMB\",\"U9\",5)) I IBXDATA=\"\" K IBXDATA\n", "\nAmb Condition Code 5\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"AMB\")\n", "\nClean up after AMB2 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INS FORM LOC 64\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z1,IBZ M IBZ=IBXDATA K IBXDATA Q:$$COBN^IBCEF(IBXIEN)=1 F Z=1,2 Q:Z=2&($$COBN^IBCEF(IBXIEN)=2) I $D(^DGCR(399,IBXIEN,\"I\"_(Z+1))),$G(IBZ(Z))'=\"\" S IBXDATA(Z)=IBZ(Z)\n", "\nThis is a group data element so more than 1 occurrence of a value is\nalso be made to OI6-6.9 as a calculate only field.\npossible for the data element in the IBXDATA array. If any other insurance\nform locator 64 data is found, the data is output.\n \n This is OI1A-03 also known as the ICN/DCN for the MRA secondary claims. \nIf there is data here in OI1A-03, then we cannot transmit the Other Payer\nsecondary ID and qualifier #2. This is in the OI6 segment, pieces 7 and \n8. For this calculation, OI6-6.9 is set-up very similar to this OI1A-03\npiece to see if there is an ICN/DCN present. So any changes here should\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D LPTRESP^IBCEU1(IBXIEN,.IBXSAVE,.IBXDATA,16)\n", "\nThis data element is the qualifier for the amount piece 17 of this record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D LPTRESP^IBCEU1(IBXIEN,.IBXSAVE,.IBXDATA,17)\n", "\nThis data element is the remaining liability amount per line.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA S IBIFN=IBXIEN S IBXDATA=\"A\"\n", "\nALWAYS SET TO "A".\nMEDICARE ASSIGNMENT CODE: A = ASSIGNED and C = Not Assigned.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-OTH CLAIM QUAL (HCFA 1500)\n", "", "", "", "", "", "", "", "", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-CUR ILL QUAL (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nQualifier for the date\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-OTHER DATE QUAL (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nOther Date Qualifier\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-REFER PROV QUAL (HCFA 1500)\n", "", "", "", "", "", "", "", "", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE 5 (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$ICD9^IBACSV(+IBXDATA,$$BDATE^IBACSV(IBXIEN)),U) D PGDX^IBCEF31(5,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE 6 (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$ICD9^IBACSV(+IBXDATA,$$BDATE^IBACSV(IBXIEN)),U) D PGDX^IBCEF31(6,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE 7 (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$ICD9^IBACSV(+IBXDATA,$$BDATE^IBACSV(IBXIEN)),U) D PGDX^IBCEF31(7,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE 8 (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$ICD9^IBACSV(+IBXDATA,$$BDATE^IBACSV(IBXIEN)),U) D PGDX^IBCEF31(8,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE 9 (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$ICD9^IBACSV(+IBXDATA,$$BDATE^IBACSV(IBXIEN)),U) D PGDX^IBCEF31(9,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE 10(HCFA 1500)\n", "", "", "", "", "", "", "", "S IBXDATA=$P($$ICD9^IBACSV(+IBXDATA,$$BDATE^IBACSV(IBXIEN)),U) D PGDX^IBCEF31(10,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECEIVER ID NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nIf header data has already been extracted, array ^TMP("IBHDR",$J) will\nalready exist. Don't want to extract this field again, so kill data\nelement so there is no output. Also don't output data element if its\nvalue is null.\n\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE 11(HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$ICD9^IBACSV(+IBXDATA,$$BDATE^IBACSV(IBXIEN)),U) D PGDX^IBCEF31(11,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE 12(HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($$ICD9^IBACSV(+IBXDATA,$$BDATE^IBACSV(IBXIEN)),U) D PGDX^IBCEF31(12,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS IND\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nThis indicates if diagnosis codes are ICD9 or ICD10. A "9" indicates ICD9 \nand a "0" indicates ICD10.\n
\n\n"], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-PROVIDER NAME (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["CMS-1500", "NATIONAL,NO EDIT\n", "N-OTHER CLAIM ID (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $P($G(IBXSAVE(\"CI_HPID\",1)),U)'=\"\" S IBXDATA=$P($G(IBXSAVE(\"CI_HPID\",1)),U)\n", "\nIf there is an HPID (Sequence 37, Piece 9), then this field will be 'XV'. \nMRD;IB*2.0*516\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $P($G(IBXSAVE(\"CI_HPID\",1)),U,2)'=\"\" S IBXDATA=$P($G(IBXSAVE(\"CI_HPID\",1)),U,2) D CLEANUP^IBCEF78(.IBXSAVE)\n", "\nThis will be the HPID from the bill/claim. MRD;IB*2.0*516\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LDAT\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"LDAT\",Z),U,7)\n", "\nThis field may contain an additional description of this procedure, which \nthe user is able to enter only for NOC procedures (those procedures which \nend in '99' or whose descriptions contain verbiage such as 'NOT OTHERWISE\nCLASSIFIED', 'NOC', 'NOS', etc.). MRD;IB*2.0*516\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"INPT\",Z)) Q:'Z I $P(IBXSAVE(\"INPT\",Z),U,11)'=\"\" S IBXDATA(Z)=$P(IBXSAVE(\"INPT\",Z),U,11)\n", "\nThis field may contain an NDC enterd by the user for this line of the \nclaim. MRD;IB*2.0*516\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"INPT\",Z)) Q:'Z I $P(IBXSAVE(\"INPT\",Z),U,12)'=\"\" S IBXDATA(Z)=+$TR($J($P(IBXSAVE(\"INPT\",Z),U,12),11,3),\" .\")\n", "\nIf the user added an NDC to this line of the claim, they are then allowed \nto enter a unit. MRD;IB*2.0*516\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nThis data is being moved to CI5[3] with eClaims Iteration III.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"INPT\",Z)) Q:'Z I $P(IBXSAVE(\"INPT\",Z),U,12)'=\"\" S IBXDATA(Z)=$P(IBXSAVE(\"INPT\",Z),U,13) I IBXDATA(Z)=\"\" S IBXDATA(Z)=\"UN\"\n", "\nIf the user added an NDC to this line of the claim, there should also be \na value in the unit field ($P(IBXSAVE("INPT",Z),U,12), and if there is, \nthen this field should be 'UN'. MRD;IB*2.0*516\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"CI2A\"\n", "\nOutput RECORD ID for CI2A record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-BILL DESIGNATION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"CI3A\"\n", "\nOutput RECORD ID for CI3A record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OI1A\"\n", "\nOutput RECORD ID for OI1A record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURANCE SEQUENCE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ,IBW,Z,Z0 D F^IBCEF(\"N-ALL AUTH CODES\",\"IBW\") M IBZ=IBXDATA K IBXDATA I $O(IBXSAVE(1,0)) S (Z,Z0)=0 F S Z=$O(IBXSAVE(1,Z)),Z0=Z0+1 Q:'Z I Z<($F(\"PST\",IBXSAVE(1))-1)!($G(IBW(Z))]\"\") S IBXDATA(Z0)=IBXSAVE(1,Z) I Z0>1 D ID^IBCEF2(Z0,\"OI1A\")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. The IBXSAVE(1) \nvariable holds the indicator of which insurance\n[(P)rimary/(S)econdary/(T)ertiary] is currently responsible for the\nbill. Using this data as a guide, the next insurance for the primary is\nsecondary, then tertiary. For secondary, it's primary then tertiary, and\nfor tertiary, it's primary, then secondary. For other than the first\noccurrence, the RECORD ID 'OI1A' must be output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nJRA IB*2.0*577 Created to replace SUB (Seq 55), field 8 (CLIA #) which was\nmoved to SUB2 (Seq 57), field 13.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"LSR1\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1,\"LSR1\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$G(IBXSAVE(\"SLPRV\",Z,\"SLC\")) D:Z>1 ID^IBCEF2(Z,\"LSR1\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-MAMMOGRAPHY CERT#\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "I $G(IBXDATA)'=\"\" S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA),IBXSAVE(\"MAMMO\")=1\n", "\nExtract and format the mammo# cert number from the claim. If a mammo# is \npresent for the claim then save that fact in IBXSAVE for later usage for \nthe mammo# qualifier field.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,7)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,8)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,7)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,9)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,10)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,9)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,11)'=\"\" IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,12)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,11)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=\"\" S:$P(IBXSAVE(\"SLPRV\",Z),U,5)'=\"\" IBXDATA(Z)=\"AS\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=7 N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"SLPRV\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"SLPRV\",Z),U,5)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CMN RECORD ID 'LQ '\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "DISPLAY ONLY\n", "", "K IBXDATA S IBXDATA=\"LQ \"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PATIENT CONDITION CODE\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "I $$FT^IBCEF(IBXIEN)=3 K IBXDATA\n", "\nSPINAL MANIP. CONDITION CODE; A = Acute Condition, C = Chronic Condition, D = Non-Acute\nE = Non-Life Threatening, F = Routine, G = Symptomatic, M = Acute Manifestation of a Chronic Condition\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "DISPLAY ONLY\n", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"CMNDEX\",Z),U,2) D:Z>1 ID^IBCEF2(Z,\"LQ \")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "DISPLAY ONLY\n", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=\"UT\"\n", "\nThe CMN FORM TYPE QUALIFIER is always 'UT'.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "DISPLAY ONLY\n", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=$$CMNDATA^IBCEF31(IBXIEN,+IBXSAVE(\"CMNDEX\",Z),\"24:2\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "EDITABLE\n", "", "N Z N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=$$CMNDATA^IBCEF31(IBXIEN,+IBXSAVE(\"CMNDEX\",Z),24.01,\"I\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "DISPLAY ONLY\n", "", "N Z,CERTYP K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S CERTYP=$$CMNDATA^IBCEF31(IBXIEN,+IBXSAVE(\"CMNDEX\",Z),24.01,\"I\") I CERTYP=\"R\"!(CERTYP=\"S\") S IBXDATA(Z)=607\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=\"TR\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "EDITABLE\n", "", "K IBXDATA S IBXDATA=$$PTWT^IBCEF31(IBXIEN)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "EDITABLE\n", "", "K IBXDATA S IBXDATA=\"\" I $$PTWT^IBCEF31(IBXIEN) S IBXDATA=\"01\"\n", "\nThis is the PATIENT WEIGHT MODIFIER which is always '01'.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ACUTE MANIFESTATION\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$S($$FT^IBCEF(IBXIEN)=3:\"\",1:$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")) S:IBXDATA IBXSAVE(\"ACUT-DATE\")=1\n", "\nRequired when sequence 51 piece 7 (Spinal Manipulation Nature of Condifion Code) = A or M on spinal\nmanipulation claims and the payer is Medicare\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "EDITABLE\n", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=$$CMNDATA^IBCEF31(IBXIEN,+IBXSAVE(\"CMNDEX\",Z),24.04)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "EDITABLE\n", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=$$DT^IBCEFG1($$CMNDATA^IBCEF31(IBXIEN,+IBXSAVE(\"CMNDEX\",Z),24.05,\"I\"),\"\",\"D8\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "DISPLAY ONLY\n", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=463\n", "\nThe value of CMN DATE THERAPY STARTED QUALIFIER is always '463'.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "EDITABLE\n", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=$$DT^IBCEFG1($$CMNDATA^IBCEF31(IBXIEN,+IBXSAVE(\"CMNDEX\",Z),24.06,\"I\"),\"\",\"D8\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "EDITABLE\n", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=461\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "EDITABLE\n", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=$$DT^IBCEFG1($$CMNDATA^IBCEF31(IBXIEN,+IBXSAVE(\"CMNDEX\",Z),24.07,\"I\"),\"\",\"D8\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "EDITABLE\n", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z I $$CMNDATA^IBCEF31(IBXIEN,+IBXSAVE(\"CMNDEX\",Z),24.08,\"I\") S IBXDATA(Z)=\"ZV\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"PRV \"\n", "\nPRV-1. Literal "PRV ".\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURR INSURED FULL NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"INM\")=$$NAME^IBCEFG1(IBXDATA) K IBXDATA\n", "\nChanges data element (name) into LAST^FIRST^MIDDLE^CRED^SUFFIX format.\nSaves data in IBXSAVE array for use by later fields. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"INM\")),U)\n", "\nPull off last name of insured from IBXSAVE array previously extracted.\nDon't output data element if its value is null.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"PT2 \"\n", "\nOutput RECORD ID for PT2 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"CL1 \"\n", "\nOutput RECORD ID for CL1 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D:$D(IBXSAVE(\"CMNDEX\"))'>1 CMNDEX^IBCEF31(IBXIEN,.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"FRM\") D FRM^IBCEF31(IBXIEN,.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"UB1 \"\n", "\nOutput RECORD ID for UB1 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CMN RECORD ID 'FRM '\n", "", "", "", "NO PAD REQUIRED\n", "", "DISPLAY ONLY\n", "", "K IBXDATA S IBXDATA=\"FRM \"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"FRM\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"FRM\",Z),U)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"FRM\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"FRM\",Z),U,2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"FRM\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"FRM\",Z),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"FRM\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"FRM\",Z),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"FRM\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"FRM\",Z),U,5)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "DISPLAY ONLY\n", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"FRM\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"FRM\",Z),U,6) D:Z>1 ID^IBCEF2(Z,\"FRM \")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "DISPLAY ONLY\n", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"CMNDEX\",Z),U,2) D:Z>1 ID^IBCEF2(Z,\"CMN \")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "", "", "", "", "D:$D(IBXSAVE(\"CMNDEX\"))'>1 CMNDEX^IBCEF31(IBXIEN,.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CMN RECORD ID 'CMN '\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"CMN \"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "Q:'$G(IBXSAVE(\"SERVFACFLAG\")) N Z S Z=$G(IBXSAVE(\"SERVFACDATA\")),IBXDATA=$$GETFAC^IBCEP8(+$P(Z,U,4),$P(Z,U,3),2)\n", "\nSUB-12 lab/facility address line 2\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=\"MO\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=\"Y\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=\"CT\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=\"AD\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=\"09\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=\"38\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CMN RECORD ID 'MEA '\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"MEA \"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D:$D(IBXSAVE(\"CMNDEX\"))'>1 CMNDEX^IBCEF31(IBXIEN,.IBXSAVE)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=$P(IBXSAVE(\"CMNDEX\",Z),U,2) D:Z>1 ID^IBCEF2(Z,\"MEA \")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=\"\" I $$CMNDATA^IBCEF31(IBXIEN,+IBXSAVE(\"CMNDEX\",Z),24.02) S IBXDATA(Z)=\"HT\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"CMNDEX\",Z)) Q:'Z S IBXDATA(Z)=$$CMNDATA^IBCEF31(IBXIEN,+IBXSAVE(\"CMNDEX\",Z),24.02)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-NON VA FACILITY\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$$SNDS2^IBCEFP(.IBXDATA,2)\n", "\nIf the service is performed at an outside facility, output the\nservice facility type of facility if defined for the outside facility.\nIf none defined, output the default of 'FA' for non-lab and 'LI' for lab.\nWith Patch IB*2.0*432 always send '77' if the record is created.\nWith Patch IB*2.0*447 always send if Facility Name is defined in SUB \nrecord. Check by using $$SENDSF^IBCEF79(IBXIEN).\nMRD;IB*2.0*516 - The function $$SENDSF^IBCEF79 now will always return\n'1'.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-NON VA FACILITY\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$$SNDS2^IBCEFP(.IBXDATA,3)\n", "\nOutput the service facility entity as a non-person (2) if service was\nperformed at an outside facility.\nWith Patch IB*2.0*432 always send 2 if the record is created.\nWith Patch IB*2.0*447 always send 2 if the Facility Name is defined in \nthe SUB record. Determine by using $$SENDSF^IBCEF79(IBXIEN).\nMRD;IB*2.0*516 - The function $$SENDSF^IBCEF79 now will always return\n'1'.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OUTSIDE FACILITY NAME\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=\"\"\n", "\nMRD;IB*2.0*516 - Changed to be blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"C\",1,1)),U,1)\n", "\nThe ids returned are screened for valid id qualifiers for the SUB2 record.\nOutput the first 'other' id qualifier.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE) D:$$SNDS2^IBCEFP(.IBXDATA,1.5) ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1) S IBXDATA=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"C\",1,0)),U,1)\n", "\nBuild the IBXSAVE array with the data needed to complete the SUB2 record.\nOnly build if $$SENDSF^IBCEF79(IBXIEN) is true. We only send \nSUB2 if there is a SUB record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"INM\")),U,3)\n", "\nPull off middle name of insured from IBXSAVE array previously extracted.\nDon't output data element if its value is null.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"C\",1,0)),U,2)\n", "\nIf the tax id for the outside facility exists, output it here and kill\nIBXSAVE("EIN") to clean up.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,0)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,0)),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"GEN \"\n", "\nIf header data has already been extracted, array ^TMP("IBHDR",$J) will\nalready exist. Don't want to extract this field again, so kill data\nelement so there is no output. If no header already extracted, output\nrecord id for 'GEN' record.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"SUB \"\n", "\nOutput the record id for the 'SUB' record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXDATA) S IBXDATA=\"CI1 \"\n", "\nIf header data has already been extracted, array ^TMP("IBHDR1",$J) will\nalready exist. Don't want to extract this field again, so kill data\nelement so there is no output. If no header already extracted, output\nthe record id for the 'CI1' record.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"CI2 \"\n", "\nOutput RECORD ID for CI2 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"CI3 \"\n", "\nOutput RECORD ID for CI3 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"PT1 \"\n", "\nOutput RECORD ID for PT1 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURANCE SEQUENCE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ,Z,Z0 M IBZ=IBXDATA K IBXDATA I $O(IBXSAVE(1,0)) S (Z,Z0)=0 F S Z=$O(IBXSAVE(1,Z)) Q:'Z S Z0=Z0+1,IBXDATA(Z0)=IBXSAVE(1,Z) I Z0>1 D ID^IBCEF2(Z0,\"OI2 \")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. The IBXSAVE(1) variable\nholds the indicator of which insurance [(P)rimary/(S)econdary/(T)ertiary] is\ncurrently responsible for the bill. Using this data as a guide, the next\ninsurance for the primary is secondary, then tertiary. For secondary, it's\nprimary then tertiary, and for tertiary, it's primary, then secondary. For\nother than the first occurrence, the RECORD ID 'OI2 ' must be output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\" I $G(IBXSAVE(\"MAMMO\")) S IBXDATA=\"EW\" K IBXSAVE(\"MAMMO\")\n", "\nThis is the mammography certification number qualifier in CL1A-9. If \nthere is a mammo cert number on the claim and transmitted in CL1A-6 then \nthis field will be sent as "EW".\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"BILLING PRV\",IBXIEN,\"C\",1,1)),U,1)\n", "\nCI1A-2 site suffix or facility ID qualifier. This is hard-coded to be G5.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"BILLING PRV\",IBXIEN,\"C\",1,1)),U,2)\n", "\nAlways output 4 characters containing the site suffix padded on the left \nby 0's if necessary. \nExamples: For station# 528, this field is sent as "0000"\n For station# 605GC, this field is sent as "00GC"\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OPR7\"\n", "\nRecord ID for Supervising Provider Name, suffix, qualifier, and ID number.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CLEANUP^IBCEFP1(.IBXSAVE),ALLIDS^IBCEFP(IBXIEN,.IBXSAVE,1)\n", "\nBuilds IBXSAVE array for OPR7 record. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,5,\"NAME\")),U,1)\n", "\nThe FULL NAME data extracted,by SPRVSING PROV FULL NAME,\ninto the array IBXSAVE is parsed and the appropiate piece (1)\nLAST NAME, is stored into IBXDATA for transmission.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OC1 \"\n", "\nOutput RECORD ID for OC1 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,5,\"NAME\")),U,2)\n", "\nThe FULL NAME data extracted,by SPRVSING PROV FULL NAME,\ninto the array IBXSAVE is parsed and the appropiate piece (2)\nFIRST NAME, is stored into IBXDATA for transmission.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OS1 \"\n", "\nOutput RECORD ID for OS1 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"PC1 \"\n", "\nOutput RECORD ID for PC1 record\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"VC1 \"\n", "\nOutput RECORD ID for VC1 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"CC1 \"\n", "\nOutput RECORD ID for CC1 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"DC1 \"\n", "\nOutput RECORD ID for DC1 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OI1 \"\n", "\nOutput the RECORD ID for 'OI1' record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURR INSURED PT RELATION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$PRELCNV^IBCNSP1(IBXDATA,1)\n", "\nCalculates the X12 code for relationship from the DHCP code extracted.\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OI2 \"\n", "\nOutput RECORD ID for 'OI2' record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"PRF \"\n", "\nOutput the record id for 'PRF' record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"INS \"\n", "\nOutput record id for 'INS' record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"RX1 \"\n", "\nOutput record id for 'RX1' record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,5,\"NAME\")),U,3)\n", "\nThe FULL NAME data extracted,by SPRVSING PROV FULL NAME,\ninto the array IBXSAVE is parsed and the appropiate piece (3)\nMIDDLE NAME, is stored into IBXDATA for transmission.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,5,\"NAME\")),U,5)\n", "\nThe FULL NAME data extracted,by SPRVSING PROV FULL NAME,\ninto the array IBXSAVE is parsed and the appropiate piece (5)\nNAME SUFFIX, is stored into IBXDATA for transmission.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,5,0)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,5,0)),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-DATE UNABLE TO WORK FROM\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")\n", "\nFormat data element in CCYYMMDD date format. If data element's value is\nnull, do not output.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-PRINT BILL SUBMIT STATUS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=$J(\"\",+$P($G(^IBE(350.9,1,1)),U,27)),IBXDATA=Z_IBXDATA K ^UTILITY(\"VADM\",$J),^UTILITY(\"VAPA\",$J),^TMP(\"IBXSAVE\",$J),IBXSAVE\n", "\nIf the HCFA ADDRESS COLUMN parameter exists, move the text over to this\ncolumn by adding spaces at the start of it. Initializes utility globals\nand variables used in this form.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURANCE MAILING NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S:$$WNRBILL^IBEFUNC(IBXIEN) IBXDATA=\"MEDICARE\" S Z=\"\",$P(Z,\" \",+$P($G(^IBE(350.9,1,1)),U,27)+1)=\"\" S IBXSAVE(\"INDENT\")=Z S:IBXDATA'=\"\" IBXDATA=Z_IBXDATA\n", "\nIf the HCFA ADDRESS COLUMN parameter exists, move the text over to\nthis column by adding spaces at the start of it. Save the indent parameter\nin IBXSAVE("INDENT") for future use. If the current insurance is MEDICARE\nWNR, output 'MEDICARE'.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CURR INS CO FULL ADDRESS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Y,Z K IBXSAVE(\"CADR\") I $O(IBXDATA(0)) S Y=$G(IBXDATA(6)) D ZIPOUT^VAFADDR S:Y'=\"\" $P(IBXSAVE(\"CADR\"),U,6)=Y F Z=1:1:5,7 S:$D(IBXDATA(Z)) $P(IBXSAVE(\"CADR\"),U,Z)=IBXDATA(Z) I Z=7 D CIADDR^IBCEF1(.IBXDATA,.IBXSAVE,,1)\n", "\nIf the HCFA ADDRESS COLUMN parameter exists, move the text over to this\ncolumn by adding spaces at the start of it. Format the address so each\nstreet address occupies one line, then a line containing city followed by a\nby a comma and space, the state abbreviation, a space and the zip code,\nformatted for zip plus 4 if appropriate.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-PATIENT NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-PATIENT BIRTHDATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(+IBXDATA,1)\n", "\nFormat the date as MM DD YYYY.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA F Z=1,2 I $D(^DGCR(399,IBXIEN,\"I\"_(Z+1))) S IBXDATA(Z)=\"B\"\n", "\nOther insurance patient signature source code. 2320/OI/04.\nThis is group data element for the other insurances. Currently, hard \ncode a "B" for all other insurances.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-PATIENT SEX\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"SEX\")=IBXDATA,IBXDATA=$S($G(IBXSAVE(\"SEX\"))=\"M\":\"X\",1:\"\")\n", "\nSave the value of patient sex in IBXSAVE variable for later use. If the\nvalue is 'M', this field's value is 'X'.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$G(IBXSAVE(\"SEX\"))'=\"M\" IBXDATA=\"X\" K IBXSAVE(\"SEX\")\n", "\nThis field relies on the existence of variable IBXSAVE("SEX") previously\nextracted. If its value is not 'M', assume the sex is female and this\nfield's value will be 'X'.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED FULL NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ D F^IBCEF(\"N-CURRENT INSURED RELATIONSHIP\",\"IBZ\",,IBXIEN) K:$$WNRBILL^IBEFUNC(IBXIEN,+$$COBN^IBCEF(IBXIEN)) IBXDATA I +IBZ=1 S:$D(IBXDATA) IBXDATA=\"SAME\" S IBXSAVE(\"IBSAME\")=1\n", "\nIf the current insured is the patient, the word 'SAME' is printed instead\nof repeating the name.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-DATE UNABLE TO WORK TO\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")\n", "\nFormat data element in CCYYMMDD date format. If data element's value is\nnull, do not output.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-PATIENT STREET ADDRESS 1-3\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z F Z=1:1:3 S IBXDATA=IBXDATA_$S(Z>1:\" \",1:\"\")_$G(^UTILITY(\"VAPA\",$J,Z))\n", "\nConcatenate all 3 lines of the address together, separated by a space.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED PT RELATION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"PREL\")=+IBXDATA,IBXDATA=$S(IBXSAVE(\"PREL\")=1:\"X\",1:\"\")\n", "\nSave the value of patient sex in IBXSAVE variable for later use. If\nthe value is '1' (patient), this field's value is 'X'.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXSAVE(\"PREL\"))=2 S IBXDATA=\"X\"\n", "\nThis field relies on the existence of variable IBXSAVE("PREL")\npreviously extracted. If its value is '2' (spouse), this field's value\nwill be 'X'.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXSAVE(\"PREL\"))=3 S IBXDATA=\"X\"\n", "\nThis field relies on the existence of variable IBXSAVE("PREL") previously\nextracted. If its value is '3' (child), this field's value will be 'X'.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$G(IBXSAVE(\"PREL\"))=\"\"!(\"123\"'[$G(IBXSAVE(\"PREL\"))) IBXDATA=\"X\" K IBXSAVE(\"PREL\")\n", "\nThis field relies on the existence of variable IBXSAVE("PREL") previously\nextracted. If its value is not a '1', '2', or '3', assume it is other and\nthis field's value will be 'X'.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IADR\")),U)\n", "\n\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-PATIENT CITY\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-PATIENT STATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$STATE^IBCEFG1(IBXDATA)\n", "\nOutput the state abbreviation.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-PATIENT MARITAL STATUS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"MSTAT\")=$$MARITAL^IBCEFG1(+IBXDATA),IBXDATA=$S(IBXSAVE(\"MSTAT\")=\"I\":\"X\",1:\"\")\n", "\nSave the value of marital status in IBXSAVE variable for later use. If\nthe value is 'I' (NEVER MARRIED), this field's value is 'X'.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXSAVE(\"MSTAT\"))'=\"\",\"M\"[IBXSAVE(\"MSTAT\") S IBXDATA=\"X\"\n", "\nThis field relies on the existence of variable IBXSAVE("MSTAT")\npreviously extracted. If its value is 'M' (MARRIED), this field's value\nwill be 'X'.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-DIAGNOSES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N A,C,R,Z,E,D M A=IBXDATA S (Z,R)=0,C=1 K IBXDATA F S Z=$O(A(Z)) Q:'Z S A=$TR($P($$ICD9^IBACSV(+A(Z),$$BDATE^IBACSV(IBXIEN)),U),\".\") I A'=\"\" D ID1^IBCEF2(.R,.A,.C,.D,.E) Q:C=\"\" I A'=\"\" S IBXDATA(R)=A\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. Each diagnosis code\nname is stripped of its decimal point and is output on its own DCn entry\nwhere n is a record count that will allow it to be mapped into one of the\n12 available pieces of the 837 diagnosis code record correctly. This is\ndone to accommodate Austin's translator and one of its shortcomings. Save\noff the extract sequence # of each diagnosis output in the global array\n^TMP("IBXSAVE",$J,"DX") for later use.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S($G(IBXSAVE(\"MSTAT\"))=\"\":\"\",\"MI\"'[IBXSAVE(\"MSTAT\"):\"X\",1:\"\") K IBXSAVE(\"MSTAT\")\n", "\nThis field relies on the existence of variable IBXSAVE("MSTAT") previously\nextracted. If its value is not a 'M', or 'I', assume it must be other and\nthis field's value will be 'X'.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-PATIENT ZIP CODE\n", "", "", "", "", "", "", "", "N Y S Y=IBXDATA D ZIPOUT^VAFADDR S IBXDATA=Y\n", "\nFormat zip code as zip plus 4 if needed.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-PATIENT PHONE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $L(IBXDATA)=10 S IBXDATA=$E(IBXDATA,1,3)_\" \"_$E(IBXDATA,4,10)\n", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-PATIENT EMPLOYMENT STATUS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(\",1,2,4,6,\"[(\",\"_+IBXDATA_\",\"):\"X\",1:\"\")\n", "\nIf the value of this field is '1' (EMPLOYED FULL TIME), '2' (EMPLOYED\nPART TIME), '4' (SELF EMPLOYED), or '6' (FULL TIME MILITARY), assume\nemployed and output this field as 'X'.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-OTH INSURED FULL NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ M IBZ=IBXDATA K IBXDATA S IBXDATA=$G(IBZ(1))\n", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED GROUP NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=$$WNRBILL^IBEFUNC(IBXIEN,+$$COBN^IBCEF(IBXIEN)) S:Z IBXDATA=\"NONE\" Q:Z I $$POLICY^IBCEF(IBXIEN,2,$P($G(^DGCR(399,IBXIEN,0)),U,21))=\"\" S IBXDATA=\"\"\n", "\nOnly output the group number if the SUBSCRIBER ID field is non-null.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-OTH INSURED GRP NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N A,IBZ S A=$$WNRBILL^IBEFUNC(IBXIEN) K:A IBXDATA I 'A M IBZ=IBXDATA K IBXDATA,IBXSAVE(\"OINUM\") D:$G(IBZ(1))=\"\" F^IBCEF(\"N-OTH INSURED ID\",\"IBZ\") S:$E($$OTHINS1^IBCEF2(IBXIEN)) (IBXDATA,IBXSAVE(\"OINUM\"))=$G(IBZ(1))\n", "\nSave the value of other insured group number in IBXSAVE variable for later\nuse. Use the first occurrence of other insured group number for this\nfield's value. If the other insurance is a medigap (MEDICARE WNR is\nbefore this insurance on the bill), the group # is preceeded by 'MG'\non output. If no other insured group number is found, use the other\ninsured's policy id number instead.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CONDITION RELATED TO EMPLOY\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"CONDE\")=IBXDATA,IBXDATA=$S(IBXDATA:\"X\",1:\"\")\n", "\nSave the value of condition related to employment in IBXSAVE variable for\nlater use. If this value is 1 (yes), this field's value is 'X'.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:'$G(IBXSAVE(\"CONDE\")) IBXDATA=\"X\" K IBXSAVE(\"CONDE\")\n", "\nThis field relies on the existence of the IBXSAVE("CONDE") variable\npreviously extracted. If this variable's value is 0 or null, this assumes\ncondition is not related and this field's value is 'X'.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2($P($G(IBXSAVE(\"IDEM\")),U),1)\n", "\nThis field relies on the existence of the variable IBXSAVE("IDEM")\npreviously extracted. Format the birthdate as MM DD YYYY.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"DISDT\")) I IBXDATA S IBXDATA=$$DT^IBCEFG1(IBXDATA\\1,\"\",\"D8\")\n", "\nExtract only date from date/time retrieved from IBXSAVE array previously\nextracted. For an outpatient claim not related to an inpatient episode,\nIf data element's value is null, do not output. IB*547 Removed the data \nfor outpatient statement discharge date.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$P($G(IBXSAVE(\"IDEM\")),U,2)=\"M\" IBXDATA=\"X\"\n", "\nThis field relies on the existence of the IBXSAVE("IDEM") variable\npreviously extracted. The second '^' piece contains the sex and if this\nis an 'M', this field's value is 'X'.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:\"M\"'[$P($G(IBXSAVE(\"IDEM\")),U,2) IBXDATA=\"X\"\n", "\nThis field relies on the existence of the IBXSAVE("IDEM") variable\npreviously extracted. The second '^' piece contains the sex and if this\nis not an 'M', this field's value is 'X'.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-OTH INSURED DEMOGRAPHICS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\" I $O(IBXDATA(\"\")) N Z S Z=$G(IBXDATA(1)) K IBXDATA S IBXSAVE(\"OIDEM\")=Z,IBXDATA=$$DATE^IBCF2($P(Z,U),1)\n", "\nSave the other insured's demographic data in IBXSAVE for later use. Format\nthe birthdate as MM DD YYYY.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $P($G(IBXSAVE(\"OIDEM\")),U,2)=\"M\" S IBXDATA=\"X\"\n", "\nThis field relies on the existence of the IBXSAVE("OIDEM") variable\npreviously extracted. The second '^' piece contains the sex and if this\nis an 'M', this field's value is 'X'.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=$P($G(IBXSAVE(\"OIDEM\")),U,2) S:Z'=\"M\"&(Z'=\"\") IBXDATA=\"X\" K IBXSAVE(\"OIDEM\")\n", "\nThis field relies on the existence of the IBXSAVE("OIDEM") variable\npreviously extracted. The second '^' piece contains the sex and if this\nis not a null and is not an 'M', this field's value is 'X'.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CONDITION RELATED TO AUTO\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"CONDA\")=IBXDATA,IBXDATA=$S(IBXDATA:\"X\",1:\"\")\n", "\nSave the value of condition related to auto accident in IBXSAVE variable\nfor later use. If this value is 1 (yes), this field's value is 'X'.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:'$G(IBXSAVE(\"CONDA\")) IBXDATA=\"X\"\n", "\nThis field relies on the existence of the IBXSAVE("CONDA") variable\npreviously extracted. If this variable's value is 0 or null, this assumes\ncondition is not related and this field's value is 'X'.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-AUTO ACCIDENT STATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$STATE^IBCEFG1(IBXDATA) K IBXSAVE(\"CONDA\")\n", "\nOutput state abbreviation.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED EMPLOYER INFO\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P(IBXDATA,U)\n", "\nEmployer name is the first '^' piece of field's value.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-OTH INSURED EMPLOYR INFO\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\" I $O(IBXDATA(\"\")) N Z S Z=$G(IBXDATA(1)) K IBXDATA S IBXDATA=$P(Z,U)\n", "\nUse the first occurrence of other insured employer information. The first\n'^' piece is the employer's name.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-SIMILAR ILLNESS DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nFormat data element in CCYYMMDD date format. If data element's value is\nnull, do not output.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CONDITION RELATED TO OTH ACC\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"CONDOA\")=IBXDATA,IBXDATA=$S(IBXDATA:\"X\",1:\"\")\n", "\nSave the value of condition related to other accident in IBXSAVE variable\nfor later use. If this value is 1 (yes), this field's value is 'X'.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:'$G(IBXSAVE(\"CONDOA\")) IBXDATA=\"X\" K IBXSAVE(\"CONDOA\")\n", "\nThis field relies on the existence of the IBXSAVE("CONDOA") variable\npreviously extracted. If this variable's value is 0 or null, this assumes\ncondition is not related and this field's value is 'X'.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED GROUP NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$WNRBILL^IBEFUNC(IBXIEN) S IBXDATA=\"\"\n", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-OTH INSURED GRP NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"OINUM\") S IBXDATA=\"\" I $O(IBXDATA(\"\")) N C,Z,Z0 S C=$$OTHINS1^IBCEF2(IBXIEN),Z=$G(IBXDATA(1)) K IBXDATA I $E(C) S IBXDATA=$S($$MCRWNR^IBEFUNC(+$G(^DGCR(399,IBXIEN,\"I\"_$E(C)))):\"MEDICARE\",$P(Z,U,2):$P($G(^DIC(36,+Z,0)),U),1:$P(Z,U))\n", "\nUse the first occurrence of other insured group name. The first '^' piece\nof this value has either the group name or the insurance company pointer.\nIf the second '^' piece is a 1, the insurance company name is extracted\nusing the insurance company pointer in the first '^' piece, otherwise, the\nname in the first '^' piece is output.\nMEDICARE WNR always outputs MEDICARE.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-OTHER INSURANCE EXISTS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"OI\")=IBXDATA,IBXDATA=$S(IBXDATA:\"X\",1:\"\")\n", "\nSave the other insurance exists data in the IBXSAVE variable for later\nuse. If the value is 1, output an 'X'.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:'$G(IBXSAVE(\"OI\")) IBXDATA=\"X\" K IBXSAVE(\"OI\")\n", "\nThis field relies on the existence of the IBXSAVE("OI") variable\npreviously extracted. If the value of this data element is null or 0,\noutput an 'X' in this field\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-PATIENT NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=$$NAME^IBCEFG1(IBXDATA),IBXDATA=$P(Z,U,2)_\" \"_$S($P(Z,U,3)'=\"\":$E($P(Z,U,3))_\" \",1:\"\")_$P(Z,U)\n", "\nOutput the patient's name as the signature first middle last name.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED FULL NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=$$NAME^IBCEFG1(IBXDATA),IBXDATA=$P(Z,U,2)_\" \"_$S($P(Z,U,3)'=\"\":$E($P(Z,U,3))_\" \",1:\"\")_$P(Z,U)\n", "\nOutput the current insured's name as the signature first name, middle name\nlast name\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-EVENT DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,1)\n", "\nFormat date as MM DD YYYY.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-SIMILAR ILLNESS DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,1)\n", "\nFormat date as MM DD YYYY.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-DATE LAST SEEN\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I IBXDATA'=\"\" S IBXDATA=$$DT^IBCEFG1(IBXDATA,,\"D8\")\n", "\nFormat the date in X12 8-digit format if data not null.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-DATE UNABLE TO WORK FROM\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,1)\n", "\nFormat date as MM DD YYYY.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-DATE UNABLE TO WORK TO\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,1)\n", "\nFormat date as MM DD YYYY.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D:'$D(IBXSAVE(\"BOX19\")) F^IBCEF(\"N-HCFA 1500 BOX 19\",,,IBXIEN) S IBXDATA=$E($G(IBXSAVE(\"BOX19\")),49,96) K IBXSAVE(\"BOX19\")\n", "\nIf the array that holds the entire box 19 data is not defined, extract it.\nThis field will hold the 49th through 96th characters of the box's data.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 BOX 18 (FR)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,1)\n", "\n'From' date is the first '^' piece of this data. Format date as MM DD YYYY.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 BOX 18 (TO)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D:'IBXDATA&'$$INPAT^IBCEF(IBXIEN,1) F^IBCEF(\"N-STATEMENT COVERS TO DATE\",,,IBXIEN) S IBXDATA=$$DATE^IBCF2(IBXDATA,1)\n", "\nIf there is no date in IBXDATA, set it to Statement Covers To Date then \nformat the resulted date.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IB,IBCT M IB=IBXDATA K IBXDATA X \"N Z S (Z,IBCT)=0 F S Z=$O(IB(Z)) Q:'Z I $G(IB(Z)) S IBCT=IBCT+1 M IBXSAVE(\"\"DX\"\",IBCT)=IB(Z)\" S IBXDATA=$P($G(^ICD9(+$G(IBXSAVE(\"DX\",1)),0)),U) D PGDX^IBCEF31(1,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", "\nSave the diagnoses in the IBXSAVE array for later use. Output the\ndiagnosis code for the first diagnosis. Check for any diagnosis codes\nthat should display in the first position on pages subsequent to page 1\nand output them.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 OUTSIDE LAB\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(IBXDATA:\" \",1:$J(\"\",5))_\"X\"\n", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE 3 (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(^ICD9(+IBXDATA,0)),U) D PGDX^IBCEF31(3,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", "\nOutput the third diagnosis code. Check for any diagnosis codes that should\ndisplay in the third position on pages subsequent to page 1 and output\nthem.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE 2 (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(^ICD9(+IBXDATA,0)),U) D PGDX^IBCEF31(2,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)\n", "\nOutput the second diagnosis code. Check for any diagnosis codes that should\ndisplay in the second position on pages subsequent to page 1 and output\nthem.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-SPECIAL PROGRAM\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I IBXDATA=\"\",$$WNRBILL^IBEFUNC(IBXIEN),$$FT^IBCEF(IBXIEN)=2!($$FT^IBCEF(IBXIEN)=7) S IBXDATA=\"31\"\n", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE 4 (HCFA 1500)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(^ICD9(+IBXDATA,0)),U) D PGDX^IBCEF31(4,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE) K IBXSAVE(\"DX\")\n", "\nOutput the forth diagnosis code. Check for any diagnosis codes that should\ndisplay in the forth position on pages subsequent to page 1 and output\nthem.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CURRENT AUTHORIZATION CODE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$OLAB^IBCEU(IBXIEN) N IBZ S IBZ=IBXDATA D F^IBCEF(\"N-LAB CLIA #\",,,IBXIEN) I IBXDATA=\"\",IBZ'=\"\" S IBXDATA=IBZ\n", "\nIf the bill is for services rendered at an outside lab, get the CLIA number.\nIf this # is not available, use the prior authorization #.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-FEDERAL TAX ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 EIN FLAG (BOX 25)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-AR BILL NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-TOTAL CHARGES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"TOT\")=IBXDATA K IBXDATA S:IBXSAVE(\"TOT\")'=\"\"&($O(^TMP(\"IBXDATA\",$J,IBXREC,\"\"),-1)'>1) IBXDATA=$J(IBXSAVE(\"TOT\"),10,2)\n", "\nSave the total charges in IBXSAVE array for later use. If\ntotal is not null, output as numeric with 2 decimal places in 10 spaces.\nOnly output totals on last page of form.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-FACILITY NAME FOR BILLING\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ D F^IBCEF(\"N-EDI SITE CONTACT PHONE\",\"IBZ\") S IBZ=$$EXPAND^IBTRE(350.9,2.11,IBZ) D:IBZ=\"\" F^IBCEF(\"N-AGENT CASHIER PHONE\",\"IBZ\") S:$L(IBZ)>12 IBZ=$E($$NOPUNCT^IBCEF(IBZ),1,12) S IBXDATA=$E(IBXDATA,1,18)_($J(\"\",30-$L(IBZ)-$L(IBXDATA)))_IBZ\n", "\nThis is the constant we will use as the name of the billing entity.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-ATT/REND PHYSICIAN NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"BOX31\")=IBXDATA,IBXDATA=$$NAME31^IBCF2(IBXIEN,IBXDATA)\n", "\nFormats the name in 21 spaces for block 31 of the HCFA 1500.\nIBXSAVE("BOX31") is the name in format Last,first mi^ien in file 200\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:'$G(IBXSAVE(\"REMOTE\")) IBXDATA I $D(IBXDATA) S IBXDATA=$$GETFAC^IBCEP8(+$G(IBXSAVE(\"IBFAC\")),+$G(IBXSAVE(\"OFAC\")),12)\n", "\nExtract the street address for the rendering facility. Relies on the\nexistence of the array IBXSAVE("IBFAC") extracted previously by the\nrendering facility name field.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-FACILITY STREET ADDRESS 1\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"FSTREET1\")=IBXDATA\n", "\nSave the data in the IBXSAVE array for later use.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-FACILITY STREET ADDRESS 2\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"FSTREET2\")=IBXDATA\n", "\nSave the data in the IBXSAVE array for later use.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-AGENT CASHIER STREET ADDRESS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ D F^IBCEF(\"N-AGENT CASHIER MAIL SYMBOL\",\"IBZ\",,IBXIEN) I $G(IBZ)'=\"\" S IBXDATA=IBXDATA_\" \"_IBZ\n", "\nConcatenate Agent Cashier Mail Symbol to the end of Agent Cashier Street\nAddress.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-DATE FIRST PRINTED\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N A,P,Q,Z S Q=IBXIEN,Z=$$DATE31^IBCF2(IBXDATA,Q),A=$G(IBXSAVE(\"BOX31\")) D GETPRV^IBCEU(Q,3,.P) S P=$G(P(3,1)),A=$S($P(P,U,4)'=\"\":$P(P,U,4),'$D(^DGCR(399,Q,\"PRV\",0)):$E($P(P,U),22,42),1:$$CRED^IBCEU($P(P,U,3),Q,,3)),IBXDATA=A_$J(\"\",11-$L(A))_Z\n", "\nPrint credentials left justified and date right justified. Format date as\nMM/DD/YYYY.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z,ADDR,OK,PCE F Z=1,2 S ADDR=$G(IBXSAVE(\"OTH_PAY_ADDR\",Z)) I ADDR'=\"\" S OK=1 X \"F PCE=1,4,5,6 I $P(ADDR,U,PCE)=\"\"\"\" S OK=0 Q\" I 'OK K IBXSAVE(\"OTH_PAY_ADDR\",Z)\n", "\nIf the other payer address is missing any component among address line 1, \ncity, state, or zip, then blank out the entire address. We can't send \npartial addresses.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:'$G(IBXSAVE(\"REMOTE\")) IBXDATA S:$D(IBXDATA) IBXDATA=$$GETFAC^IBCEP8(+$G(IBXSAVE(\"IBFAC\")),+$G(IBXSAVE(\"OFAC\")),3)\n", "\nExtract the city, state abbreviation and zip code for the rendering\nfacility. Relies on the existence of the array IBXSAVE("IBFAC") extracted\npreviously by the rendering facility name field.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-AGENT CASHIER CITY\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"ACCITY\")=IBXDATA\n", "\nSave the data in the IBXSAVE array for later use.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-AGENT CASHIER STATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"ACSTATE\")=IBXDATA\n", "\nSave the data in the IBXSAVE array for later use.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-AGENT CASHIER ZIP CODE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"ACZIP\")=$E(IBXDATA,1,5)_$S($E(IBXDATA,6,9)'=\"\":\"-\"_$E(IBXDATA,6,9),1:\"\")\n", "\nSave the data in the IBXSAVE array for later use.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=$$STATE^IBCEFG1($G(IBXSAVE(\"ACSTATE\")))_\" \"_$G(IBXSAVE(\"ACZIP\")),IBXDATA=$E($G(IBXSAVE(\"ACCITY\")),1,26-2-$L(Z))_\", \"_Z F Z=\"ACCITY\",\"ACSTATE\",\"ACZIP\" K IBXSAVE(Z)\n", "\nThis data relies on the existence of the IBXSAVE("ACCITY"),\nIBXSAVE("ACSTATE") and IBXSAVE("ACZIP") variables previously extracted.\nThe data consists of the city concatenated with a , and space, the state\nabbreviation, a space and the zip code. The city name is shortened to fit\nin the whole state and zip in the space allowed.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I '$D(^DGCR(399,IBXIEN,\"PRV\",0)) S IBXDATA=$E($P($G(IBXSAVE(\"BOX31\")),U),43,63)\n", "\nThis line is no longer printed on the standard HCFA 1500.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"OTH_PAY_ADDR\",Z)) Q:'Z S IBXDATA(Z)=$P($G(IBXSAVE(\"OTH_PAY_ADDR\",Z)),U,1)\n", "\naddress line 1, multi-valued array\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"OTH_PAY_ADDR\",Z)) Q:'Z S IBXDATA(Z)=$P($G(IBXSAVE(\"OTH_PAY_ADDR\",Z)),U,2)\n", "\nAddress line 2 in a multi-valued array\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I '$O(IBXSAVE(\"BOX24\",0)) D B24^IBCEF3(.IBXSAVE,IBXIEN,1)\n", "\nIf array doesn't already exist, extract it\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-DATE OF SERVICE FROM\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exist\nfor the bill, this outputs the rest on additional bill pages.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-DATE OF SERVICE TO\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 PLACE OF SERVICE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 TYPE OF SERVICE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 PROCEDURES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ,IBZ1,Z,Q M IBZ=IBXDATA K IBXDATA D TEXT24^IBCEU3(\"D1\",.IBXSAVE,.IBXDATA) M IBZ1=IBXDATA K IBXDATA S Z=0 F S Z=$O(IBZ(Z)) Q:'Z S Q=$J(IBZ(Z),6)_\" \"_$TR($G(IBZ1(Z)),\",\") S:Z'>12 IBXDATA(Z)=Q I Z>12 D PG^IBCEF3(Q,Z)\n", "\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS CODE REFS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exist for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 CHARGES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S Z=0 F S Z=$O(IBZ(Z)) Q:'Z S Z0=$S('$G(IBZ(Z,\"T\")):$S(IBZ(Z)?0.1\"-\"1N.N0.1\".\".N:$J(IBZ(Z),9,2),1:IBZ(Z)),1:IBZ(Z)) S:Z'>12 IBXDATA(Z)=Z0 I Z>12 D PG^IBCEF3(Z0,Z)\n", "\nPrint total charge (units * rate) only if not 0. Format numeric values\nwith 2 decimal points. If more than 6 service dates (12 lines) exist for\nthe bill, this outputs the rest on additional bill pages.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 UNITS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S Z=0 F S Z=$O(IBZ(Z)) Q:'Z S Z0=$S('$G(IBZ(Z,\"T\")):$S(IBZ(Z):$J(IBZ(Z),$S($L(IBZ)<3:2,1:3)),1:\"\"),1:IBZ(Z)) S:Z'>12 IBXDATA(Z)=Z0 D:Z>12 PG^IBCEF3(Z0,Z)\n", "\nRight justify numeric values in 3 spaces. If more than 6 service dates\n(12 lines) exist for the bill, this outputs the rest on additional\nbill pages. If the units are being output and they are less than 1, 1 is\nthe default.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $O(^TMP(\"IBXDATA\",$J,IBXREC,1)) N Z,FLDS X \"F Z=1:1:+$O(^IBA(364.6,\"\"ASEQ\"\",2,1,\"\"\"\"),-1) S:(Z'>44!(Z'<57))&(Z'=6)&(Z'=39)&(Z'=41) FLDS(Z)=\"\"\"\"\" F Z=2:1:+$O(^TMP(\"IBXDATA\",$J,IBXREC,Z),-1) D MPG^IBCEF3(Z,.FLDS,2)\n", "\nIf there is more than 1 page of bill extracted, the variable\nFLDS(line,column) holds the lines and columns that should be duplicated on\npages after the first. This takes care of the population of these static\nfields on these subsequent pages.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 BOX 19\n", "", "", "", "", "", "", "", "S IBXSAVE(\"BOX19\")=$S($L(IBXDATA)<49:$J(\"\",48),$L(IBXDATA)<84:$J(\"\",13),1:\"\")_IBXDATA,IBXDATA=$E(IBXSAVE(\"BOX19\"),1,48)\n", "\nThis field holds the 1st through 48th characters of the box's data.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXSAVE(\"PAID\")=$J(0,7,2) I $O(^TMP(\"IBXDATA\",$J,IBXREC,\"\"),-1)'>1 S IBXDATA=IBXSAVE(\"PAID\") K IBXSAVE(\"PAID\")\n", "\nThis field is the prior amounts the patient has paid. This will always\nbe 0 unless VA changes policy.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 BALANCE DUE BOX\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"BDUE\")=$S(IBXDATA:$J(IBXDATA,7,2),1:\"\") K IBXDATA I $O(^TMP(\"IBXDATA\",$J,IBXREC,\"\"),-1)'>1 S IBXDATA=IBXSAVE(\"BDUE\") K IBXSAVE(\"BDUE\"),IBXSAVE(\"PTOT\"),IBXSAVE(\"TOT\")\n", "\nIf not 0, output as numeric with 2 decimals in 7 characters.\nOnly output total on last page of form.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-RENDERING INSTITUTION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N A,Q,Z K IBXSAVE(\"OFAC\") S A=IBXDATA,Z=$P(A,U,2),IBXSAVE(\"IBFAC\")=+A,Q=$$FAC^IBCEU3(IBXIEN) S:+A=+$P($G(^IBE(350.9,1,0)),U,2)&'Z&'Q IBXDATA=\"SAME\" S IBXSAVE(\"REMOTE\")=(IBXDATA>0) S:IBXDATA IBXDATA=$$GETFAC^IBCEP8(+A,+Z,0) S:Z IBXSAVE(\"OFAC\")=1\n", "\nThis returns the name of the INSTITUTION file entry for the non-VA or\nremote site where care was rendered. Save the ien in IBXSAVE("IBFAC") for\nlater use. If the rendering facility is the same as the main facility,\n'SAME' prints as the facility name.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"DX\"),IBXSAVE(\"BOX24\"),IBXSAVE(\"OCC\"),IBXSAVE(\"OCCS\"),IBXSAVE(\"IDEM\"),IBXSAVE(\"IADR\")\n", "\nClean up IBXSAVE array.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CURRENT INS POLICY TYPE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=IBXDATA D F^IBCEF(\"N-CURRENT INSURANCE CO TYPE\") S IBXDATA=$J(\"\",$S(Z=16!(Z=\"MB\")!(Z=\"MA\"):0,Z=\"TV\"!(Z=\"MC\"):7,Z=\"CH\":14,$$CHAMPVA^IBCEU3(IBXIEN)&($P($G(^DIC(36,+$$CURR^IBCEF2(IBXIEN),0)),U,2)=\"Y\"):23,IBXDATA=5:30,1:44))_\"X\"\n", "\nCheck appropriate box for type of insurance\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-REFERRING PROVIDER NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-OUTSIDE LAB TOTAL\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S:$G(IBXSAVE(\"OLAB\")) IBXDATA=$J($G(IBXSAVE(\"OLAB\")),10,2) K IBXSAVE(\"OLAB\")\n", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-ASSIGN OF BENEFITS INDICATOR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=$S(IBXDATA=\"\"!(\"Nn0\"'[IBXDATA):1,1:6) S IBXDATA=$J(\"X\",Z)\n", "\nPrint indicator of ASSIGNMENT OF BENEFITS. Check Yes if data element value\nreturned is null or is not 0,'n', or 'N', otherwise check No.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"OTH_PAY_ADDR\",Z)) Q:'Z S IBXDATA(Z)=$TR($P($G(IBXSAVE(\"OTH_PAY_ADDR\",Z)),U,4),\"-/.,()'\",\" \")\n", "\nOther payer city in a multi-valued array. Do the standard punctuation \nedits for cities.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"OTH_PAY_ADDR\",Z)) Q:'Z S IBXDATA(Z)=$$STATE^IBCEFG1($P($G(IBXSAVE(\"OTH_PAY_ADDR\",Z)),U,5))\n", "\nOther payer state code in a multi-valued array. Use of the state code \nconversion utility.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-MEDICAL RECORD NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA)\n", "\nIf data element's value is null, do not output. Remove any punctuation.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"OTH_PAY_ADDR\",Z)) Q:'Z S IBXDATA(Z)=$P($G(IBXSAVE(\"OTH_PAY_ADDR\",Z)),U,6)\n", "\nOther payer zip code in a multi-valued array.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INSURED NAMES SUFF\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nOther Insurance Subscriber name Suffix.\n
\n\n"], ["File: 364.6, IEN: 1082", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OI3 \"\n", "\nRecord ID for LOOP 2330, Other Payer Patient Information. One record per 2320 record\n
\n\n"], ["File: 364.6, IEN: 1083", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "YES\n", "", "", "N Z,Z1 S (Z,Z1)=0 F S Z=$O(IBXSAVE(1,Z)) Q:'Z S Z1=Z1+1,IBXDATA(Z1)=1\n", ""], ["File: 364.6, IEN: 1085", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z0 K IBXDATA S Z0=0 F S Z0=$O(IBXSAVE(Z0)) Q:'Z0 S IBXDATA(Z0)=$P(IBXSAVE(Z0),U,2)\n", "\nOI3-6\n2330C/NM109\nOther payer patient primary ID\n
\n\n"], ["File: 364.6, IEN: 1086", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z0 K IBXDATA S Z0=0 F S Z0=$O(IBXSAVE(Z0)) Q:'Z0 S IBXDATA(Z0)=$P(IBXSAVE(Z0),U,3)\n", "\nOI3-7\n2330C/REF(1)/01\nOther payer patient secondary ID qualifier #1\n
\n\n"], ["File: 364.6, IEN: 1087", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z0 K IBXDATA S Z0=0 F S Z0=$O(IBXSAVE(Z0)) Q:'Z0 S IBXDATA(Z0)=$P(IBXSAVE(Z0),U,4)\n", "\nOI3-8\n2330C/REF(1)/02\nOther payer patient secondary ID #1\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-UB-04 PROCEDURES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:$$FT^IBCEF(IBXIEN)=2!($$FT^IBCEF(IBXIEN)=7)!'$$INPAT^IBCEF(IBXIEN) IBXDATA N Z S Z=0 F S Z=$O(IBXDATA(Z)) K:'Z IBXDATA Q:'Z I '$D(IBXDATA(Z,\"M\")) S IBXSAVE(\"PROC\",Z)=IBXDATA(Z) I Z'<25 K IBXDATA Q\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. If an institutional\nbill or if the bill is professional and the procedure being extracted was\nnot added as a result of being a modifier with a 5-digit code starting with\n0 ("M" node does not exist), save in an IBXSAVE array for later use. No\noutput.\n\n\n"], ["File: 364.6, IEN: 1088", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z0 K IBXDATA S Z0=0 F S Z0=$O(IBXSAVE(Z0)) Q:'Z0 S IBXDATA(Z0)=$P(IBXSAVE(Z0),U,5)\n", "\nOI3-9\n2330C/REF(2)/01\nOther payer patient secondary ID qualifier #2\n
\n\n"], ["File: 364.6, IEN: 1089", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z0 K IBXDATA S Z0=0 F S Z0=$O(IBXSAVE(Z0)) Q:'Z0 S IBXDATA(Z0)=$P(IBXSAVE(Z0),U,6)\n", "\nOI3-10\n2330C/REF(2)/02\nOther payer patient secondary ID #2\n
\n\n"], ["File: 364.6, IEN: 1090", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z0 K IBXDATA S Z0=0 F S Z0=$O(IBXSAVE(Z0)) Q:'Z0 S IBXDATA(Z0)=$P(IBXSAVE(Z0),U,7)\n", "\nOI3-11\n2330C/REF(3)/01\nOther payer patient secondary ID qualifier #3\n
\n\n"], ["File: 364.6, IEN: 1091", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z0 K IBXDATA S Z0=0 F S Z0=$O(IBXSAVE(Z0)) Q:'Z0 S IBXDATA(Z0)=$P(IBXSAVE(Z0),U,8)\n", "\nOI3-12\n2330C/REF(3)/02\nOther payer patient secondary ID #3\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"BILLING PRV\",IBXIEN,\"C\",1,2)),U,2)\n", "\nExtract the 364.5 definition into an array. Then use piece 1, Blue Cross \nNumber for 8,16 piece 3.. The array will be used for the remaining pieces.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"BILLING PRV\",IBXIEN,\"C\",1,3)),U,1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"BILLING PRV\",IBXIEN,\"C\",1,3)),U,2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Q,R,S,Z,IBZ S (Z,R)=0 D F^IBCEF(\"N-PROCEDURE CODING METHD\",\"IBZ\",,IBXIEN) F S Z=$O(IBXSAVE(\"PROC\",Z)) Q:'Z S Q=$$PROC^IBCEF1($P(IBXSAVE(\"PROC\",Z),U),$S(IBZ=9:\"ICD\",1:\"\")) S:Q'=\"\" R=R+1,IBXDATA(R)=Q\n", "\nEach procedure code found in the IBXSAVE array previously extracted is\nformatted into the name of the CPT or ICD procedure or the code from the\nprocedure modifier.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"CL1A \"\n", "\nOutput RECORD ID for CL1A record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"CI1A\"\n", "\nRecord ID CI1A (Sequence# 28) piece 1. Hard code "CI1A" as the \nfirst piece.\nIB patch 320 - the CI1A segment is a new segment basically replacing the \nPRV1 segment. Billing provider secondary ID's.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"BILLING PRV\",IBXIEN,\"C\",1,0)),U,2)\n", "\nProvider number for the current insurance company for bill entry \nIBXIEN.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S($P($G(IBXSAVE(\"BILLING PRV\",IBXIEN,\"C\",1,0)),U,1)]\"\":\"EI\",1:\"\")\n", "\nKept N-CURRENT INS POLICY TYPE because didn't want to touch previous logic \nthat may set array or TMP.\nthe format code sets array to string with QUALIF and ID for the first \nseven insurances in file #355.97 except some.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0,Z1,R S (Z,Z1,R)=0 F S Z=$O(IBXSAVE(\"PROC\",Z)) Q:'Z S Z0=$$DT^IBCEFG1($P(IBXSAVE(\"PROC\",Z),U,2),\"\",\"D8\") I Z0'=\"\" S Z1=Z1+1,IBXDATA(Z1)=Z0 D ID^IBCEF2(Z1,\"PC\"_$$M^IBCEF2(.R))\n", "\nEach procedure date found in the IBXSAVE array previously extracted is\nformatted into CCYYMMDD date format and is output on its own PCn entry where\nn is a record count that will allow it to be mapped into one of the 12\navailable pieces of the 837 procedure code record correctly. This is done\nto accommodate Austin's translator and one of its shortcomings.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "Q:'$G(IBXSAVE(\"SERVFACFLAG\")) N Z S Z=$G(IBXSAVE(\"SERVFACDATA\")),IBXDATA=$$GETFAC^IBCEP8(+$P(Z,U,4),$P(Z,U,3),\"3C\"),IBXDATA=$TR(IBXDATA,\"-/.,()'\",\" \")\n", "\nSUB-4 lab/facility city name\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", "\nSUB-11\n(P) 2300/AMT(2)/01\nQualifier for the total purchased services charge amount field. Output \nthe qualifier if IBXSAVE("PS$") is true because this indicates a dollar \namount exists in SUB-7.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURR INSURED FULL ADDRESS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"IADR\")=IBXDATA\n", "\nSaves off data element in IBXSAVE array. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0,Z1,Z2 S Z=0 F S Z=$O(IBXSAVE(\"PROC\",Z)) Q:'Z S Z0=$O(IBXSAVE(\"PROC\",Z),-1),Z1=IBXSAVE(\"PROC\",Z),Z2=$S(Z1[\"ICD\":$$ICD0VER^IBACSV(+Z1),1:0) S IBXDATA(Z)=$S('Z0:$S(Z1[\"CPT\":\"BP\",Z2=2:\"BR\",1:\"BBR\"),Z1[\"CPT\":\"BO\",Z2=2:\"BQ\",1:\"BBQ\")\n", "\nIf there are any procedures (not relating to charges) on the bill, output\nthe type of procedure here:\n \nBR = principal procedure and is an ICD code\nBQ = not principal procedure, but is an ICD code\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"SUB2\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"C\",1,1)),U,2)\n", "\nOutput the first 'other' id.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"C\",1,2)),U,1)\n", "\nOutput the second 'other' id qualifier.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"C\",1,2)),U,2)\n", "\nOutput the second 'other' id.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"C\",1,3)),U,1)\n", "\nOutput the third 'other' id qualifier.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"C\",1,3)),U,2)\n", "\nOutput the third 'other' id.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=0 F S Z=$O(^TMP(\"DCX\",$J,1,Z)) Q:'Z S IBXDATA(Z)=$P(^TMP(\"DCX\",$J,1,Z),U,2)\n", "\nThis is diagnosis qualifier.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OPR8\"\n", "\nRecord ID for SUPERVISING PROVIDER SECONDARY ID'S AND QUALIFIERS\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OPR3\"\n", "\nRecord ID ofr Operating Physician Secondary ID and Qualifier.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OPR2\"\n", "\nRecord ID for Attending Provider Secondary ID and Qualifier\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OPR1\"\n", "\nRecord ID for Insurance Specific Provider Information LOPP 2310 , one claim per Claim Data record set.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OPR \"\n", "\nRecord ID for Attending/Other Provider Information, LOOP 2310, one claim per Claim Data record set.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", "\nCalculates the X12 code for employment status from the DHCP code extracted.\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,1)),\"^\",3)\n", "\nAttending Provider Secondary ID Qualifier.\nEI=EMPLOYER, SY=SSN, 0B=STATE LICENSE NUMBER, 1A=BLUE CROSS, 1B=BLUE SHIELD,\n1C=MEDICARE PARTA and PARTB, 1D=MEDICAID, 1G=UPIN Number, 1H=TRICARE\nG2=COMMERCAIL NUMBER, X5=STATE INDUSTRIAL ACCIDENT PROVIDER NUMBER\nN5=PROVIDER PLAN NETWORK ID\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,1)),\"^\",4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,2)),\"^\",3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,2)),\"^\",4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,3)),\"^\",3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,3)),\"^\",4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,4)),\"^\",3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,4)),\"^\",4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PTNM\")),U,2)\n", "\nRetrieves patient's first name from IBXSAVE array previously extracted.\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,2,1)),\"^\",3)\n", "\nOperating Physician Secondary ID and Qualifier.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,2,1)),\"^\",4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,2,2)),\"^\",3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,2,2)),\"^\",4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,2,3)),\"^\",3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,2,3)),\"^\",4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,2,4)),\"^\",3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,2,4)),\"^\",4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PTNM\")),U)\n", "\nRetrieves patient's last name from IBXSAVE array previously extracted.\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,9,1)),\"^\",4),1)\n", "\nOther Provider Secondary Qualifier 1.\nEI=EMPLOYER ID, SY=SSN, 0B=STATE LICENSE #, 1A=BLUE CROSS, 1B=BLUE SHIELD,\n1C=MEDICARE PARTA or PARTB, 1D=MEDICAID, 1G=UPIN #, 1H=TRICARE, G2=COMMERCIAL #\nX5=STATE INDUSTRIAL ACCIDENT PROVIDER #, LU=LOCATION #, N5=PROVIDER PLAN NETWORK ID\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OPR5\"\n", "\nReferring Provider Secondary ID and Qualifier.\n0B=STATE LICENSE #, 1B=BLUE SHILED #, 1C=MEDICARE #, 1D=MEDICAID #\n1G=UPIN #, 1H=TRICARE ID #, G2=COMMERCIAL #, X5=STATE INDUSTRIAL ACCIDENT PROVIDER #\nLU=LOCATION #\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,5,1)),U,3)\n", "\nSupervising Provider Secondary ID Qualifier\nEI=EMPLOYER, SY=SSN, 0B=STATE LICENSE NUMBER, 1A=BLUE CROSS, 1B=BLUE SHIELD,\n1C=MEDICARE PARTA aqnd PARTB, 1D=MEDICAID, 1G=UPIN Number, 1H=TRICARE\nG2=COMMERCAIL NUMBER, X5=STATE INDUSTRIAL ACCIDENT PROVIDER NUMBER\nN5=PROVIDER PLAN NETWORK ID\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,5,1)),U,4),1)\n", "\nSupervising Provider Secondary ID\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,5,2)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,5,2)),U,4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,5,3)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,5,3)),U,4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,5,4)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PTNM\")),U,3)\n", "\nRetrieves patient's middle name from IBXSAVE array previously extracted.\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,5,4)),U,4),1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OI4 \"\n", "\nOther Insured Information, LOOP 2330, one record per 2320 record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OI5 \"\n", "\nOther Insurance Subscriber Information, LOOP 2330\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D ELMADD2^IBCEF7(IBXIEN,1,.IBXDATA)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D ELMADD2^IBCEF7(IBXIEN,2,.IBXDATA)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z D ELMADD2^IBCEF7(IBXIEN,3,.IBXDATA) S Z=0 F S Z=$O(IBXDATA(Z)) Q:'Z S IBXDATA(Z)=$TR(IBXDATA(Z),\"-/.,()'\",\" \")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D ELMADD2^IBCEF7(IBXIEN,4,.IBXDATA)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D ELMADD2^IBCEF7(IBXIEN,5,.IBXDATA)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PATIENT NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"PTNM\")=$$NAME^IBCEFG1(IBXDATA) K IBXDATA\n", "\nChanges data element (name) into LAST^FIRST^MIDDLE format. Saves data in\nIBXSAVE array. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z0 K IBXDATA S Z0=0 F S Z0=$O(IBXSAVE(Z0)) Q:'Z0 S IBXDATA(Z0)=$P(IBXSAVE(Z0),U,3)\n", "\nOI5-9\n2330A/REF(1)/01\nOther payer subscriber secondary ID qualifier #1\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z0 K IBXDATA S Z0=0 F S Z0=$O(IBXSAVE(Z0)) Q:'Z0 S IBXDATA(Z0)=$P(IBXSAVE(Z0),U,4)\n", "\nOI5-10\n2330A/REF(1)/02\nOther payer subscriber secondary ID #1\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OP2 \"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OP3 \"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OP4 \"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-NON-COVERED DAYS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OP7 \"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-STATION NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nIf header data has already been extracted, array ^TMP("IBHDR",$J) will\nalready exist. Don't want to extract this field again, so kill data\nelement so there is no output.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-STATEMENT COVERS TO DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXNOREQ=$$NFT^IBCEF1(3,IBXIEN) S IBXDATA=$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")\n", "\nFormat date in CCYYMMDD format. If data element's value is null, do not\noutput.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OCCS\",Z)) Q:'Z S Z0=$P($$DT^IBCEFG1($P(IBXSAVE(\"OCCS\",Z),U,2),$P(IBXSAVE(\"OCCS\",Z),U,3),\"RD8\"),\"-\",2) I Z0'=\"\" S IBXDATA(Z)=Z0\n", "\nEach occurrence span code to date found in the IBXSAVE array previously\nextracted is formatted into CCYYMMDD date format and is output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0,A,A1 S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S A=$P(IBXSAVE(\"OUTPT\",Z),U),A1=$P(IBXSAVE(\"OUTPT\",Z),U,2),Z0=$S('$$INPAT^IBCEF(IBXIEN):$S(A:A,1:A1),1:A1) I Z0 S IBXDATA(Z)=Z0\n", "\nThis is a group data element so more than 1 occurrence of a value is \npossible for the data element in the previously extract IBXSAVE array. \nIf any service line data is found, the data is output. Data is taken \nfrom the 'from' date if there is no 'to' date.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSV S:'$O(^TMP(\"IBXMSG\",$J,\"\"),-1) IBXDATA=\"BGN \" S:$G(IBXDATA)=\"\" IBXNOREQ=1 S ^TMP(\"IBTX\",$J,IBXIEN)=1\n", "\nIf header data has already been extracted, then kill data element so\nthere is no output. If no header already extracted, output record\nid for 'BGN' record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-SEGMENT DELIMITER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(^TMP(\"IBHDR\",$J)) K IBXDATA S IBXNOREQ=1\n", "\nIf header data has already been extracted, array ^TMP("IBHDR",$J) will\nalready exist. Don't want to extract this field again, so kill data\nelement so there is no output.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-NON-INSTITUTIONAL CLAIM TYPE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)=3 K IBXDATA\n", "\nIf an institutional bill or data element's value is null, no output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=\"\" F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $D(IBXSAVE(\"OUTPT\",Z,\"RX\")) S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z,\"RX\"),U,6)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the quantity '1' is output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nThis is being blanked out with IB patch 377.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D INS12^IBCEF2\n", "\nINS-12 for UB service line detail data.\n \nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is formatted as a numeric \nincluding cents, without the decimal.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA BOX 24H FREE TEXT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Q S Z=0 F S Z=$O(IBXDATA(Z)) Q:'Z S Q=$S('$G(IBXDATA(Z,\"T\")):\" \",1:\"\")_IBXDATA(Z) S:Z'>12 IBXDATA(Z)=Q I Z>12 D PG^IBCEF3(Q,Z)\n", "\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA EMERGENCY INDICATOR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S Z=0 F S Z=$O(IBZ(Z)) Q:'Z S Z0=$S('$G(IBZ(Z,\"T\")):$S(IBZ(Z)=\"Y\":\" Y\",1:\"\"),1:IBZ(Z)) S:Z'>12 IBXDATA(Z)=Z0 D:Z>12 PG^IBCEF3(Z0,Z)\n", "\nPrint a space before the 'Y' if an emergency procedure is indicated.\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA BOX 24J FREE TEXT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA BOX 24K FREE TEXT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)\n", "\nIf more than 6 service dates (12 lines) exists for the bill, this outputs\nthe rest on additional bill pages.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OP8 \"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-HCFA 1500 MODIFIERS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z=0 F S Z=$O(IBXDATA(Z)) Q:'Z D SETMODS^IBCVA1(IBXDATA(Z),Z,.IBXSAVE) S Z0=$P($G(IBXSAVE(\"PROCMODS\",Z)),\",\") I Z0'=\"\" S IBXDATA(Z)=Z0\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nNot currently used. No output\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OCCURRENCE CODES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $$FT^IBCEF(IBXIEN)=7 K IBXSAVE(\"OCC\"),IBXSAVE(\"OCCS\")\n", "\nNo output.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-PRINT BILL SUBMIT STATUS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-FACILITY NAME FOR BILLING\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-UB92 FORM LOCATOR 2\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I IBXDATA'=\"\" S IBXSAVE(\"FL2\")=$E(IBXDATA,30,59),IBXDATA=$E(IBXDATA,1,29)\n", "\nIf this data element returns a value other than null, it can be output on\n2 lines where characters 1-29 print on line 1 and 30-59 print on line 2.\nSave off characters 30-59 in IBXSAVE("FL2") array and set value of this\ndata element to the first 29 characters. If the right margin is 81 instead\nof 80, move the field over 1 space. IBXSAVE("FL2") will be printed at a\nlater time.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-AGENT CASHIER STREET ADDRESS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ D F^IBCEF(\"N-AGENT CASHIER MAIL SYMBOL\",\"IBZ\",,IBXIEN) I $G(IBZ)'=\"\" S IBXDATA=IBXDATA_\" \"_IBZ\n", "\nConcatenate Agent Cashier Mail Symbol to the end of Agent Cashier Street \nAddress.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$D(IBXSAVE(\"FL2\")) IBXDATA=IBXSAVE(\"FL2\") K IBXSAVE(\"FL2\")\n", "\nThis data element's value relies on the existence of the IBXSAVE("FL2")\nvariable previously extracted. Form Locator 2 on the UB92 is split into\n2 lines and this is the 30th-59th character entered for this field.\nIf the right margin is 81 instead of 80, move the field over 1 space.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-AR BILL NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S:$D(IBXSAVE(\"TOB\")) IBXDATA=IBXSAVE(\"TOB\") K IBXSAVE(\"TOB\") I '$D(IBXDATA) S IBXDATA=$$TOB^IBCEF1(IBXIEN)\n", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S IBXDATA=$G(IBXSAVE(\"ACCITY\"))_$G(IBXSAVE(\"ACSTATE\"))_$G(IBXSAVE(\"ACZIP\")) F Z=\"ACCITY\",\"ACSTATE\",\"ACZIP\" K IBXSAVE(Z)\n", "\nThis field consists of a concatenation of 3 fields previously extracted\nand saved in the IBXSAVE array. This is the city, state and zip for the\nagent cashier address line.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-UB92 FORM LOCATOR 11\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I IBXDATA'=\"\" S IBXSAVE(\"FL11\")=$E(IBXDATA,13,25),IBXDATA=$S($G(^TMP(\"IBXSAVE\",$J,\"RM\")):\" \",1:\"\")_$E(IBXDATA,1,12)\n", "\nIf this data element returns a value other than null, it can be output on\n2 lines where characters 1-12 print on line 1 and 13-25 print on line 2.\nSave off characters 13-25 in IBXSAVE("FL11") array and set value of this\ndata element to the first 12 characters. If the right margin is 81 instead\nof 80, move the field over 1 space. IBXSAVE("FL11") will be printed at a\nlater time.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-SITE CONTACT PHONE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D:IBXDATA=\"\" F^IBCEF(\"N-AGENT CASHIER PHONE\",\"\",\"\",IBXIEN) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA)\n", "\nPrint the site contact phone or if no site contact phone #, use agent\ncashier's phone #.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$TR($P($G(IBXSAVE(\"IADR\")),U,2),\"-/.,()'\",\" \")\n", "\nRetrieves insured city data from IBXSAVE array previously extracted. If\ndata element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0,R S (Z,R)=0 F S Z=$O(IBXSAVE(\"OCC\",Z)) Q:'Z S Z0=$$DT^IBCEFG1($P(IBXSAVE(\"OCC\",Z),U,2),\"\",\"D8\") I Z0'=\"\" D ID^IBCEF2(Z,\"OC\"_$$M^IBCEF2(.R)) S IBXDATA(Z)=Z0\n", "\nEach occurrence code date found in the IBXSAVE array previously extracted\nis formatted into CCYYMMDD date format and is output on its own OCn entry\nwhere n is a record count that will allow it to be mapped into one of the\n12 available pieces of the 837 occurrence code record correctly. This is\ndone to accommodate Austin's translator and one of its shortcomings.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-FEDERAL TAX ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-STATEMENT COVERS FROM DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,,1)\n", "\nFormat date in MMDDYY format.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-STATEMENT COVERS TO DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,,1)\n", "\nFormat date in MMDDYY format.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-COVERED DAYS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I IBXDATA S IBXDATA=$E(\"000\",1,3-$L(IBXDATA))_IBXDATA\n", "\nFormat Covered Days to have leading zeroes.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-NON-COVERED DAYS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I 'IBXDATA S IBXDATA=\"\"\n", "\nDisplay a blank if non-covered days field is zero.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-COINSURANCE DAYS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nNot currently used\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nNot currently used.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$D(IBXSAVE(\"FL11\")) IBXDATA=$S($G(^TMP(\"IBXSAVE\",$J,\"RM\")):\" \",1:\"\")_IBXSAVE(\"FL11\") K IBXSAVE(\"FL11\")\n", "\nThis data element's value relies on the existence of the IBXSAVE("FL11")\nvariable previously extracted. Form Locator 11 on the UB92 is split into\n2 lines and this is the 13th-25th character entered for this field.\nIf the right margin is 81 instead of 80, move the field over 1 space.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-PATIENT NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-PATIENT SHORT ADDRESS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OCC\",Z)) Q:'Z S Z0=$P(IBXSAVE(\"OCC\",Z),U) S:Z0'=\"\" IBXDATA(Z)=Z0\n", "\nEach occurrence code found in the IBXSAVE array previously extracted is\noutput.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-UB92 FORM LOCATOR 31\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I IBXDATA'=\"\" S IBXSAVE(\"FL31\")=$E(IBXDATA,6,11),IBXDATA=$S($G(^TMP(\"IBXSAVE\",$J,\"RM\")):\" \",1:\"\")_$E(IBXDATA,1,5)\n", "\nIf this data element returns a value other than null, it can be output on\n2 lines where characters 1-5 print on line 1 and 6-11 print on line 2.\nSave off characters 6-11 in IBXSAVE("FL31") array and set value of this\ndata element to the first 5 characters. If the right margin is 81 instead\nof 80, move the field over 1 space. IBXSAVE("FL31") will be printed at a\nlater time.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-PATIENT BIRTHDATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DATE^IBCF2(IBXDATA,1,1) S:IBXDATA=\"\" IBXDATA=\"00000000\"\n", "\nIf BIRTHDATE exists, format it MMDDYYYY. If it doesn't exist, output\n00000000.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-PATIENT SEX\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:IBXDATA=\"\" IBXDATA=\"U\"\n", "\nIf the data element's value is null, set it equal to 'U'.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-PATIENT MARITAL STATUS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$MARITAL^IBCEFG1(+IBXDATA),IBXDATA=$S(IBXDATA=\"I\":\"S\",\"K\"[IBXDATA:\"U\",1:IBXDATA)\n", "\nTranslate the marital status X12 code to external UB92 format.\nD=='D' M=='M' W=='W' X=='X' I=='S' anything else is 'U'.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-ADMISSION DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"ADTM\")=$$TIME^IBCF3(IBXDATA),IBXDATA=$$DATE^IBCF2($P(IBXDATA,\".\"),,1)\n", "\nSave the admission time in IBXSAVE array for later use. Format date\nwithout the time as MMDDYY.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S('$$INPAT^IBCEF(IBXIEN,1):\"\",$G(IBXSAVE(\"ADTM\"))'=\"\":$E(IBXSAVE(\"ADTM\"),1,2),1:99)\n", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-TYPE OF ADMISSION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-SOURCE OF ADMISSION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-DISCHARGE DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:'$$INPAT^IBCEF(IBXIEN,1) IBXDATA I $D(IBXDATA) S IBXDATA=$S($P(IBXDATA,\".\",2)'=\"\":$$TIME^IBCF3(IBXDATA),1:\"\")\n", "\nIf this is an outpatient bill, no output. For inpatient bills, output the\ntime portion of the discharge date/time or 99 if no time found.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-PATIENT STATUS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-EVENT DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")\n", "\nFormat data element in CCYYMMDD date format. If data element's value is\nnull, do not output.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-MEDICAL RECORD NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)\n", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-CONDITION CODES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=0 K IBXDATA M IBXSAVE(\"CC\")=IBFL(24)\n", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",1))'=\"\" S IBXDATA=IBXSAVE(\"CC\",1) K IBXSAVE(\"CC\",1)\n", "\nData element's array reference is IBFL(24), not default of IBXDATA. This is\na group data element so more than 1 occurrence of a value is possible for\nthe data element in the IBFL(24) array. All occurrences of the data element\nare saved in the IBXSAVE("CC",n) array and only IBXSAVE("CC",1) is output\nin this field. Note: hard code is used to output the\ncodes that exceed the # that will fit on one page if multiple pages of bill\nare printed.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",2))'=\"\" S IBXDATA=IBXSAVE(\"CC\",2) K IBXSAVE(\"CC\",2)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the second occurrence of the array.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",3))'=\"\" S IBXDATA=IBXSAVE(\"CC\",3) K IBXSAVE(\"CC\",3)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the third occurrence of the array.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",4))'=\"\" S IBXDATA=IBXSAVE(\"CC\",4) K IBXSAVE(\"CC\",4)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the fourth occurrence of the array.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",5))'=\"\" S IBXDATA=IBXSAVE(\"CC\",5) K IBXSAVE(\"CC\",5)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the fifth occurrence of the array.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $G(IBXSAVE(\"CC\",6))'=\"\" S IBXDATA=IBXSAVE(\"CC\",6) K IBXSAVE(\"CC\",6)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the sixth occurrence of the array.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$G(IBXSAVE(\"CC\",7))'=\"\" IBXDATA=IBXSAVE(\"CC\",7) K IBXSAVE(\"CC\",7) S Z=0 F S Z=$O(IBXSAVE(\"CC\",Z)) Q:'Z D XCC^IBCEF3(IBXSAVE(\"CC\",Z),Z)\n", "\nData element relies on the data in array IBXSAVE("CC") extracted previously.\nThis field reports the data in the seventh occurrence of the array.\nIf there are more than 7 condition codes present, save them in the global\noverflow array.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$D(IBXSAVE(\"FL31\")) IBXDATA=$S($G(^TMP(\"IBXSAVE\",$J,\"RM\")):\" \",1:\"\")_IBXSAVE(\"FL31\") K IBXSAVE(\"FL31\")\n", "\nThis data element's value relies on the existence of the IBXSAVE("FL31")\nvariable previously extracted. Form Locator 31 on the UB92 is split into\n2 lines and this is the 6th-11th character entered for this field.\nIf the right margin is 81 instead of 80, move the field over 1 space.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,9,\"NAME\")),U,1)\n", "\n \nOperating provider last name\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-UB-04 FORM LOCATOR 64\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXDATA)'=\"\" S:$G(^TMP(\"IBXSAVE\",$J,\"RM\")) IBXDATA=\" \"_IBXDATA\n", "\nIf the right margin is 81 instead of 80, move the output over 1 space.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OP9 \"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OPR4\"\n", "\nRECORD ID FOR OTHER PROVIDER SECONDARY ID\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-OCCURRENCE CODES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z0=0 F Z=1,5 S Z0=Z0+1 S:$G(IBXSAVE(\"OCC\",Z))'=\"\" IBXDATA(Z0)=$P(IBXSAVE(\"OCC\",Z),U)\n", "\nThe data element extracts multiply-occurring data for the occurrence codes\nand occurrence span codes and outputs the first occurrence code here.\nOverflow codes are printed on a separate page.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=1:4 Q:$G(IBXSAVE(\"OCC\",Z))=\"\" S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(\"OCC\",Z),U,2),,1) S:Z'>5 IBXDATA(Z0)=Z1 D:Z>5 XOCC^IBCEF3($P(IBXSAVE(\"OCC\",Z),U)_U_Z1,Z0,32) K IBXSAVE(\"OCC\",Z)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCC") extracted previously. This field outputs the 1st and 5th\noccurrences of occurrence code 'from date' formatted as MMDDYY found in the\nsecond '^' piece of the IBXSAVE("OCC",n) array data element.\nOverflow codes (9,13,...) are printed on a separate page.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,\"1\")\n", "\nHARD CODE PERSON QUALIFIER\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=2:4 Q:$G(IBXSAVE(\"OCC\",Z))=\"\" S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(\"OCC\",Z),U,2),,1) S:Z'>6 IBXDATA(Z0)=Z1 D:Z>6 XOCC^IBCEF3($P(IBXSAVE(\"OCC\",Z),U)_U_Z1,Z0,33) K IBXSAVE(\"OCC\",Z)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCC") extracted previously. This field outputs the 2nd and 6th\noccurrences of occurrence code 'from date' formatted as MMDDYY found in the\nsecond '^' piece of the IBXSAVE("OCC",n) array data element.\nOverflow codes (10,14,...) are printed on a separate page.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,\"82\")\n", "\nQUAL IS 71 FOR INST AND 82 FOR PROF\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,\"I\",2) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=3:4 Q:$G(IBXSAVE(\"OCC\",Z))=\"\" S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(\"OCC\",Z),U,2),,1) S:Z'>7 IBXDATA(Z0)=Z1 D:Z>7 XOCC^IBCEF3($P(IBXSAVE(\"OCC\",Z),U)_U_Z1,Z0,34) K IBXSAVE(\"OCC\",Z)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCC") extracted previously. This field outputs the 3rd and 7th\noccurrences of occurrence code 'from date' formatted as MMDDYY found in the\nsecond '^' piece of the IBXSAVE("OCC",n) array data element.\nAny overflow codes (11,15,...) are output on a separate page.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PATIENT BIRTHDATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")\n", "\nFormat date returned as CCYYMMDD. If data element's value is null, do not\noutput.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,\"I\",3) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,\"1\")\n", "\nHARD CODE PERSON CODE "1"\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,\"I\",1) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,\"Q\",1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,\"Q\",2)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,\"1\")\n", "\nHARD CODE ENTITY TYPE QUALIFIER 1=PERSON\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,\"Q\",1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,\"Q\",2)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,\"Q\",3)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,\"I\",1) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PATIENT CITY\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXDATA)'=\"\" S IBXDATA=$TR(IBXDATA,\"-/.,()'\",\" \")\n", "\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,\"I\",3) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,\"72\")\n", "\nHARD CODE "72" OTHER PAYER OPERATING PROVIDER NAME QUALIFIER\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z)) Q:'Z I $O(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,0)) S IBXDATA(Z)=2\n", "\nOP3-4\nHard code "2".\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,2)),U,1)\n", "\nOP3-7\nLab/Facility, Other Payer, Qualifier #2\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,1)),U,1)\n", "\nOP3-5\nLab/Facility, Other Payer, Qualifier #1\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,3)),U,1)\n", "\nOP3-9\nLab/Facility, Other Payer, Qualifier #3\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,1)),U,2)\n", "\nOP3-6\nLab/Facility, Other Payer, ID #1\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,2)),U,2)\n", "\nOP3-8\nLab/Facility, Other Payer, ID #2\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,3)),U,2) D:Z=2 CLEANUP^IBCEFP1(.IBXSAVE)\n", "\nOP3-10\nLab/Facility, Other Payer, ID #3\nClean up IBXSAVE array when done with this segment.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z)) Q:'Z I $O(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,0)) S IBXDATA(Z)=77\n", "\nOP3-3\nHard code 77\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PATIENT STATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$STATE^IBCEFG1(IBXDATA)\n", "\nFormat data as state's 2-character abbreviation. If data element's value\nis null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,\"1\")\n", "\nHARD CODE ENTITY TYPE\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,\"DN\")\n", "\nHARD CODE REFERRING PROVIDER CODE\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,\"Q\",1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,\"Q\",2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,\"Q\",3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,\"I\",1) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,\"I\",2) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,\"I\",3) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PATIENT ZIP CODE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PATIENT STREET ADDRESS LN 1\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nIf data element's value is null, do not output.\n
\n\n"], ["File: 364.6, IEN: 1161", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,3)),U,2) D:Z=2 CLEANUP^IBCEF75(.IBXSAVE)\n", "\nOP6-10\nlab/facility, other payer, secondary ID #3. Clean up IBXSAVE array nodes \nused here.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,1)),U,1)\n", "\nOP7-5\nLab/Facility, Other Payer, Qualifier #1\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,2)),U,1)\n", "\nOP7-7\nLab/Facility, Other Payer, Qualifier #2\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,3)),U,1)\n", "\nOP7-9\nLab/Facility, Other Payer, Qualifier #3\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,1)),U,2)\n", "\nOP7-6\nLab/Facility, Other Payer, ID #1\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,2)),U,2)\n", "\nOP7-8\nLab/Facility, Other Payer, ID #2\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,3)),U,2) D:Z=2 CLEANUP^IBCEFP1(.IBXSAVE)\n", "\nOP7-10\nLab/Facility, Other Payer, ID #3\nCleanup array when done with segment.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PATIENT STREET ADDRESS LN 2\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z)) Q:'Z I $O(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,0)) S IBXDATA(Z)=2\n", "\nOP7-4\nDefault a 2 for non-person.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z,NVA,TYP S NVA=+$P($G(^DGCR(399,IBXIEN,\"U2\")),U,10),TYP=\"\" S:NVA TYP=77 K IBXDATA S Z=0 F S Z=$O(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z)) Q:'Z I $O(IBXSAVE(\"LAB/FAC\",IBXIEN,\"O\",Z,0)) S IBXDATA(Z)=TYP\n", "\nOP7-3\nDetermine if there is a non-VA facility on the claim. If so, type is 77 \nregardless of what is on file.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z S Z=0 F S Z=$O(IBXSAVE(\"OSQ\",Z)) Q:'Z S IBXDATA(IBXSAVE(\"OSQ\",Z))=1\n", "\nUse the IBXSAVE("OSQ",n) record to determine which 'OTHER PAYER' ids exist.\nOutput the qualifier for a person (1).\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHID^IBCEF71(.IBXSAVE,.IBXDATA,IBXIEN,1,5,1,0)\n", "\nUse the IBXSAVE("OSQ",n) record to determine which 'OTHER PAYER' ids\nexist for the first 'other' id qualifier.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHID^IBCEF71(.IBXSAVE,.IBXDATA,IBXIEN,2,5,1,0)\n", "\nUse the IBXSAVE("OSQ",n) record to determine which 'OTHER PAYER' ids\nexist for the second 'other' id qualifier.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHID^IBCEF71(.IBXSAVE,.IBXDATA,IBXIEN,3,5,1,0)\n", "\nUse the IBXSAVE("OSQ",n) record to determine which 'OTHER PAYER' ids\nexist for the third 'other' id qualifier.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHID^IBCEF71(.IBXSAVE,.IBXDATA,IBXIEN,1,5,0,0) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", "\nUse the IBXSAVE("OSQ",n) record to determine which 'OTHER PAYER' ids\nexist for the first 'other' id.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHID^IBCEF71(.IBXSAVE,.IBXDATA,IBXIEN,2,5,0,0) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", "\nUse the IBXSAVE("OSQ",n) record to determine which 'OTHER PAYER' ids\nexist for the second 'other' id.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHID^IBCEF71(.IBXSAVE,.IBXDATA,IBXIEN,3,5,0,0) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1) K IBXSAVE(\"OSQ\")\n", "\nUse the IBXSAVE("OSQ",n) record to determine which 'OTHER PAYER' ids\nexist for the third 'other' id. Kill the IBXSAVE("OSQ") array to clean up.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "N Z S Z=0 F S Z=$O(IBXSAVE(\"OSQ\",Z)) Q:'Z S IBXDATA(IBXSAVE(\"OSQ\",Z))=\"DQ\"\n", "\nUse the IBXSAVE("OSQ",n) record to determine which 'OTHER PAYER' ids exist.\nOutput the qualifier 'DQ'.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"PRV-BP\",\"ADDR2\"))\n", "\nPRV-11\nBilling provider address line 2\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PATIENT SEX\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$SEX^IBCEFG1(IBXDATA)\n", "\nCalculates the X12 code for sex from the DHCP code extracted. If data\nelement's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,\"Q\",1)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,\"Q\",2)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,\"Q\",3)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,\"I\",1) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,\"I\",2) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,\"I\",3) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",5)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(\"DX\",5),0)),U) K IBXSAVE(\"DX\",5)\n", "\nIf there is a fifth diagnosis, print its name.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",6)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(\"DX\",6),0)),U) K IBXSAVE(\"DX\",6)\n", "\nIf there is a sixth diagnosis, print its name.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",7)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(\"DX\",7),0)),U) K IBXSAVE(\"DX\",7)\n", "\nIf there is a seventh diagnosis, print its name.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",8)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(\"DX\",8),0)),U) K IBXSAVE(\"DX\",8)\n", "\nIf there is an eighth diagnosis, print its name.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", "\nCalculates the X12 code for marital status from the DHCP code extracted.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$D(IBXSAVE(\"DX\",9)) IBXDATA=$P($G(^ICD9(+IBXSAVE(\"DX\",9),0)),U)\n", "\nIf there is a ninth diagnosis, print its name.\nCheck for more than 8 other diagnoses on file. If there is, output on new pg.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-ADMITTING DIAGNOSIS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-DIAGNOSIS E-CODE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nThis data element relies on the existence of the array containing the\ndiagnoses for the bill, previously extracted. This data will be output if\nit is the first 'E-code' dx found.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$D(IBXSAVE(\"FL78\")) IBXDATA=$S($G(^TMP(\"IBXSAVE\",$J,\"RM\")):\" \",1:\"\")_IBXSAVE(\"FL78\") K IBXSAVE(\"FL78\")\n", "\nThis data element's value relies on the existence of the IBXSAVE("FL78")\nvariable previously extracted. Form Locator 78 on the UB92 is split into\n2 lines and this is the 3rd-5th character entered for this field if the\nentire text is greater than 3 characters in length, or is the entire text\nif not. If the right margin is 81 instead of 80, move the field over 1\nspace.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"PRV-82\") D BOX82NM^IBCEU4(IBXIEN,.IBXSAVE) K IBXDATA S IBXDATA=$G(IBXSAVE(\"PRV-82\",1))\n", "\nExtracts all the possible providers into the appropriate line for box 82\nof the UB-92 print claim form. This is the first line extracted.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-PROCEDURE CODING METHD\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I IBXDATA=4 S IBXDATA=5\n", "\nData can only be 5 (HCPCS) or 9 (ICD9). CPT-4 (4) has been rolled into 5\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-UB-04 PROCEDURES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z S Z=\"\" F S Z=$O(IBXDATA(Z)) Q:'Z S $P(IBXDATA(Z),U,2)=$$DATE^IBCF3($P(IBXDATA(Z),U,2)),IBXSAVE(\"PROC\",Z)=IBXDATA(Z) K IBXDATA(Z)\n", "\nThis is a group data element so more than one occurrence of IBXDATA(n) is\npossible. Save off the procedures in the IBXSAVE array. Six procedures\nwill fit on a single page of a bill. If more than 6 procedure codes are\non the bill, multiple pages are used. The format of the IBXSAVE array is:\n the actual code for the ICD9 or ICD0 code^proc date formatted as MMDDYY\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",1)) S IBXDATA=$P(IBXSAVE(\"PROC\",1),U),IBXDATA=$S(IBXDATA[\"ICPT\"!(IBXDATA[\"ICD0\"):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the first occurrence exists, output the code\nreferenced by its first '^' piece.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",1)) S IBXDATA=$P(IBXSAVE(\"PROC\",1),U,2) K IBXSAVE(\"PROC\",1)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the first occurrence exists, output the date\nfound in its second '^' piece.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",2)) S IBXDATA=$P(IBXSAVE(\"PROC\",2),U),IBXDATA=$S(IBXDATA[\"ICD0\"!(IBXDATA[\"ICPT\"):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the second occurrence exists, output the code\nreferenced by its first '^' piece.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nThis element is blank.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",2)) S IBXDATA=$P(IBXSAVE(\"PROC\",2),U,2) K IBXSAVE(\"PROC\",2)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the second occurrence exists, output the date\nfound in its second '^' piece.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",3)) S IBXDATA=$P(IBXSAVE(\"PROC\",3),U),IBXDATA=$S(IBXDATA[\"ICD0\"!(IBXDATA[\"ICPT\"):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the third occurrence exists, output the code\nreferenced by its first '^' piece.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",3)) S IBXDATA=$P(IBXSAVE(\"PROC\",3),U,2) K IBXSAVE(\"PROC\",3)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the third occurrence exists, output the date\nfound in its second '^' piece.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D:'$D(IBXSAVE(\"PRV-82\")) BOX82NM^IBCEU4(IBXIEN,.IBXSAVE) K IBXDATA S IBXDATA=$E($G(IBXSAVE(\"PRV-82\",2)),1,30+$G(^TMP(\"IBXSAVE\",$J,\"RM\")))\n", "\nIf not already done, extract all the possible providers into the\nappropriate line for box 82 on the UB-92 print claim form. This is the\nsecond line extracted.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",4)) S IBXDATA=$P(IBXSAVE(\"PROC\",4),U),IBXDATA=$S(IBXDATA[\"ICD0\"!(IBXDATA[\"ICPT\"):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the fourth occurrence exists, output the code\nreferenced by its first '^' piece.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",4)) S IBXDATA=$P(IBXSAVE(\"PROC\",4),U,2) K IBXSAVE(\"PROC\",4)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the fourth occurrence exists, output the date\nfound in its second '^' piece.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",5)) S IBXDATA=$P(IBXSAVE(\"PROC\",5),U),IBXDATA=$S(IBXDATA[\"ICD0\"!(IBXDATA[\"ICPT\"):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the fifth occurrence exists, output the code\nreferenced by its first '^' piece.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",5)) S IBXDATA=$P(IBXSAVE(\"PROC\",5),U,2) K IBXSAVE(\"PROC\",5)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the fifth occurrence exists, output the date\nfound in its second '^' piece.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $D(IBXSAVE(\"PROC\",6)) S IBXDATA=$P(IBXSAVE(\"PROC\",6),U),IBXDATA=$S(IBXDATA[\"ICD0\"!(IBXDATA[\"ICPT\"):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the sixth occurrence exists, output the code\nreferenced by its first '^' piece.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Q,R S:$D(IBXSAVE(\"PROC\",6)) IBXDATA=$P(IBXSAVE(\"PROC\",6),U,2) S Z=6 F S Z=$O(IBXSAVE(\"PROC\",Z)) Q:'Z S R=IBXSAVE(\"PROC\",Z),Q=$P(R,U,2) D XPROC^IBCEF3($S(R[\"ICPT\"!(R[\"ICD0\"):$P($$PRCD^IBCEF1(R),U),1:$P(R,U))_U_Q,Z)\n", "\nThis data element relies on the existence of the IBXSAVE("PROC") array\npreviously extracted. If the sixth occurrence exists, output the date\nfound in its second '^' piece.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nIf data element's value is null, do not output.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D:'$D(IBXSAVE(\"PRV-82\")) BOX82NM^IBCEU4(IBXIEN,.IBXSAVE) K IBXDATA S IBXDATA=$E($G(IBXSAVE(\"PRV-82\",4)),1,30+$G(^TMP(\"IBXSAVE\",$J,\"RM\")))\n", "\nIf not already done, extract all the possible providers into the\nappropriate line for box 82 on the UB-92 print claim form. This is the\nfourth line extracted.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D:'$D(IBXSAVE(\"PRV-82\")) BOX82NM^IBCEU4(IBXIEN,.IBXSAVE) K IBXDATA S IBXDATA=$G(IBXSAVE(\"PRV-82\",3))\n", "\nIf not already done, extract all the possible providers into the\nappropriate line for box 82 on the UB-92 print claim form. This is the\nthird line extracted.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nNot currently used\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D:'$D(IBXSAVE(\"PRV-82\")) BOX82NM^IBCEU4(IBXIEN,.IBXSAVE) K IBXDATA S IBXDATA=$G(IBXSAVE(\"PRV-82\",5))\n", "\nIf not already done, extract all the possible providers into the\nappropriate line for box 82 on the UB-92 print claim form. This is the\nfifth line extracted.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-CURR INSURANCE MAILING NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$$WNRBILL^IBEFUNC(IBXIEN) IBXDATA=\"MEDICARE\" S:'$D(IBXSAVE(\"LM-UB\")) IBXSAVE(\"LM-UB\")=$P($G(^IBE(350.9,1,1)),U,31)-1 I IBXSAVE(\"LM-UB\") S IBXDATA=$J(\"\",IBXSAVE(\"LM-UB\"))_IBXDATA\n", "\nExtracts the insurance company name from the first piece of IBXDATA.\nIf MEDICARE WNR is current insurance, mailing name is MEDICARE.\nIf the parameter says move the data to another column, set spaces at the\nbeginning to accommodate this.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D:'$D(IBXSAVE(\"PRV-82\")) BOX82NM^IBCEU4(IBXIEN,.IBXSAVE) K IBXDATA S IBXDATA=$E($G(IBXSAVE(\"PRV-82\",6)),1,30+$G(^TMP(\"IBXSAVE\",$J,\"RM\"))) K IBXSAVE(\"PRV-82\")\n", "\nIf not already done, extract all the possible providers into the\nappropriate line for box 82 on the UB-92 print claim form. This is the\nsixth line extracted.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-CURR INS CO FULL ADDRESS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Y,Z K IBXSAVE(\"CADR\") I $O(IBXDATA(0)) S Y=$G(IBXDATA(6)) D ZIPOUT^VAFADDR S:Y'=\"\" $P(IBXSAVE(\"CADR\"),U,6)=Y F Z=1:1:5,7 S:$D(IBXDATA(Z)) $P(IBXSAVE(\"CADR\"),U,Z)=IBXDATA(Z) I Z=7 D CIADDR^IBCEF1(.IBXDATA,.IBXSAVE,1,2)\n", "\nData element extracts full address data into IBXDATA array,\nsaves the data in IBXSAVE("CADR")=Street addr 1^Street addr 2^Street addr 3^\nCity^State^Zip^claim office id # for later use and resets IBXDATA to street\n1 and street 2 of address.\nIf the parameter says move the data to another column, set spaces at the\nbeginning to accommodate this.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:$G(IBXSAVE(\"CADR\"))=\"\" IBXDATA I $D(IBXDATA) D CIADDR^IBCEF1(.IBXDATA,.IBXSAVE,2,2)\n", "\nCombine the city, state and zip code for one line of the address.\nIf the parameter says move the data to another column, set spaces at the\nbeginning to accommodate this.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"SIGNATURE ON FILE\"\n", "\nUse a constant SIGNATURE ON FILE.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-DATE FIRST PRINTED OR SENT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S($G(IBPNT)!'IBXDATA:DT,1:IBXDATA),IBXDATA=$$FMTE^XLFDT(IBXDATA,\"2D\")\n", "\nUse data element value unless the variable IBPNT>0 (indicates reprint) or\nif data element value is null. Format as date in MMDDYY format.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PATIENT STATUS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,\"ZZ\")\n", "\nHARD CODE FORMAT OTH PAYER OTH PROV ID\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"OP1 \"\n", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K ^UTILITY(\"VADM\",$J),^UTILITY(\"VAPA\",$J),^TMP(\"IBXSAVE\",$J),IBXSAVE S ^TMP(\"IBXSAVE\",$J,\"RM\")=$S($G(IOM)>80:1,1:0)\n", "\nKills off globals,other variables to be used, sets right margin variable.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,1)),\"^\",3)\n", "\nRefering Provider Secondary ID Qualifier\nEI=EMPLOYER, SY=SSN, 0B=STATE LICENSE NUMBER, 1A=BLUE CROSS, 1B=BLUE SHIELD,\n1C=MEDICARE PARTA aqnd PARTB, 1D=MEDICAID, 1G=UPIN Number, 1H=TRICARE\nG2=COMMERCIAL NUMBER, X5=STATE INDUSTRIAL ACCIDENT PROVIDER NUMBER\nN5=PROVIDER PLAN NETWORK ID\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,1)),\"^\",4),1)\n", "\nRefering Provider Secondary ID\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,2)),\"^\",3)\n", "\nRefering Provider Secondary ID Qualifier.\nEI=EMPLOYER, SY=SSN, 0B=STATE LICENSE NUMBER, 1A=BLUE CROSS, 1B=BLUE SHIELD,\n1C=MEDICARE PARTA aqnd PARTB, 1D=MEDICAID, 1G=UPIN Number, 1H=TRICARE\nG2=COMMERCAIL NUMBER, X5=STATE INDUSTRIAL ACCIDENT PROVIDER NUMBER\nN5=PROVIDER PLAN NETWORK ID\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,2)),\"^\",4),1)\n", "\nRefering Provider Secondary ID\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,3)),\"^\",3)\n", "\nRefering Provider Secondary ID Qualifier.\nEI=EMPLOYER, SY=SSN, 0B=STATE LICENSE NUMBER, 1A=BLUE CROSS, 1B=BLUE SHIELD,\n1C=MEDICARE PARTA aqnd PARTB, 1D=MEDICAID, 1G=UPIN Number, 1H=TRICARE\nG2=COMMERCAIL NUMBER, X5=STATE INDUSTRIAL ACCIDENT PROVIDER NUMBER\nN5=PROVIDER PLAN NETWORK ID\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$FT^IBCEF(IBXIEN)'=7 S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,3)),\"^\",4),1)\n", "\nRefering Provider Secondary ID\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-AR BILL NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nIf data element's value is null, do not output.\nIf this is a request for an MRA, append the batch number as the 3rd '-'\npiece of the patient control number.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,9,2)),\"^\",4),1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,9,3)),\"^\",4),1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$$NOPUNCT^IBCEF($P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,9,4)),\"^\",4),1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,9,1)),\"^\",3)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,9,2)),\"^\",3)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-UB-04 LOCATION OF CARE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,9,3)),\"^\",3)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,9,4)),\"^\",3)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,\"Q\",3)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,\"I\",2) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)\n", "\nFROM FORMAT IN PROVINF^IBCEF7\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-BILL FREQUENCY\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ROI INDICATOR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S($$ROIDTCK^IBCEU7(IBXIEN):\"Y\",1:\"I\")\n", "\nConverts release of information indicator from DHCP to X12 format.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nMRD;IB*2.0*516 - Changed to be blank.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=4:4 Q:$G(IBXSAVE(\"OCC\",Z))=\"\" S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(\"OCC\",Z),U,2),,1) S:Z'>8 IBXDATA(Z0)=Z1 D:Z>8 XOCC^IBCEF3($P(IBXSAVE(\"OCC\",Z),U)_U_Z1,Z0,35) K IBXSAVE(\"OCC\",Z)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCC") extracted previously. This field outputs the 4th and 8th\noccurrences of occurrence code 'from date' formatted as MMDDYY found in the\nsecond '^' piece of the IBXSAVE("OCC",n) array data element.\nAny overflow codes (12,16,...) are output on a separate page.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z0=0 F Z=1,2 S Z0=Z0+1 S:$G(IBXSAVE(\"OCCS\",Z))'=\"\" IBXDATA(Z0)=$P(IBXSAVE(\"OCCS\",Z),U)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCCS") extracted previously. This field outputs the 1st and 2nd\noccurrences of occurrence span codes found in the IBXSAVE("OCCS",n) array\ndata element. Overflow codes are printed on a separate page.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z0=0 F Z=1,2 S Z0=Z0+1 S:$G(IBXSAVE(\"OCCS\",Z))'=\"\" IBXDATA(Z0)=$$DATE^IBCF2($P(IBXSAVE(\"OCCS\",Z),U,2),,1)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCCS") extracted previously. This field outputs the 1st and 2nd\noccurrences of occurrence span code 'from date' formatted as MMDDYY found\nin the second '^' piece of the IBXSAVE("OCCS",n) array data element.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Q K IBXDATA F Z=1:1 Q:$G(IBXSAVE(\"OCCS\",Z))=\"\" S Q=$$DATE^IBCF2($P(IBXSAVE(\"OCCS\",Z),U,3),,1) S:Z'>2 IBXDATA(Z)=Q D:Z>2 XOCCS^IBCEF3($P(IBXSAVE(\"OCCS\",Z),U)_U_$$DATE^IBCF2($P(IBXSAVE(\"OCCS\",Z),U,2),,1)_U_Q,Z) K IBXSAVE(\"OCCS\",Z)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCCS") extracted previously. This field outputs the 1st and 2nd\noccurrences of occurrence span code 'to date' formatted as MMDDYY found\nin the third '^' piece of the IBXSAVE("OCCS",n) array data element.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-CURR INSURED FULL NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXSAVE(\"RP\",1))'=\"\" S IBXDATA=IBXSAVE(\"RP\",1)\n", "\nThis field relies on the IBXSAVE("RP") array that was previously extracted.\nIf the first occurrence of this array has a non-null value, print it.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IADR\")),U,4)\n", "\nRetrieves insured zip code address data from IBXSAVE array previously\nextracted. If data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0,R S (Z,R)=0 F S Z=$O(IBXSAVE(\"OCCS\",Z)) Q:'Z S Z0=$$DT^IBCEFG1($P(IBXSAVE(\"OCCS\",Z),U,2),\"\",\"D8\") I Z0'=\"\" S IBXDATA(Z)=Z0 D ID^IBCEF2(Z,\"OS\"_$$M^IBCEF2(.R))\n", "\nEach occurrence span code from date found in the IBXSAVE array previously\nextracted is formatted into CCYYMMDD date format and is output on its own\nOCSn entry where n is a record count that will allow it to be mapped into\none of the 12 available pieces of the 837 occurrence span code records\ncorrectly. This is done to accommodate Austin's translator and one of its\nshortcomings.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-VALUE CODES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 S Z=0 F S Z=$O(IBFL(39,Z)) K:'Z IBFL(39) Q:'Z S Z0=$P(IBFL(39,Z),U,2),Z1=$P(IBFL(39,Z),U,3),IBXSAVE(\"VC\",Z)=$P(IBFL(39,Z),U)_U_$S(+Z0'=0:$TR($J(Z0,10,2),\".\",\" \"),1:\" 0000 00\")\n", "\nSave all value codes extracted into IBXSAVE array for later use. The 2\npieces that constitute the IBXSAVE("VC") array are: CODE^VALUE formatted\nusing 8 characters for quantity and using 9 or 10 characters for a dollar\namount. Use 9 if right margin is 80 or less, 10 if > 80.\nOverflow fields are printed on a separate page.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=0 F Z=1:3:10 Q:'$D(IBXSAVE(\"VC\",Z)) S Z0=Z0+1,IBXDATA(Z0)=$P(IBXSAVE(\"VC\",Z),U)\n", "\nThis data element relies on the array IBXSAVE("VC") previously extracted.\nThis is a group data element and can have multiple occurrences. Output is\nthe first piece of each occurrence found.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=1:3 Q:$G(IBXSAVE(\"VC\",Z))=\"\" S Z0=Z0+1,Z1=$P(IBXSAVE(\"VC\",Z),U,2) S:Z'>10 IBXDATA(Z0)=Z1 D:Z>10 XVAL^IBCEF3(IBXSAVE(\"VC\",Z),Z) K IBXSAVE(\"VC\",Z)\n", "\nThis data element relies on the array IBXSAVE("VC") previously extracted.\nThis is a group data element and can have multiple occurrences. Output is\nthe second piece of each occurrence found.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=0 F Z=2:3:11 Q:'$D(IBXSAVE(\"VC\",Z)) S Z0=Z0+1,IBXDATA(Z0)=$P(IBXSAVE(\"VC\",Z),U)\n", "\nThis data element relies on the array IBXSAVE("VC") previously extracted.\nThis is a group data element and can have multiple occurrences. Output is\nthe first piece of each occurrence found.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=2:3 Q:$G(IBXSAVE(\"VC\",Z))=\"\" S Z0=Z0+1,Z1=$P(IBXSAVE(\"VC\",Z),U,2) S:Z'>11 IBXDATA(Z0)=Z1 D:Z>11 XVAL^IBCEF3(IBXSAVE(\"VC\",Z),Z) K IBXSAVE(\"VC\",Z)\n", "\nThis data element relies on the array IBXSAVE("VC") previously extracted.\nThis is a group data element and can have multiple occurrences. Output is\nthe second piece of each occurrence found.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=0 F Z=3:3:12 Q:'$D(IBXSAVE(\"VC\",Z)) S Z0=Z0+1,IBXDATA(Z0)=$P(IBXSAVE(\"VC\",Z),U)\n", "\nThis data element relies on the array IBXSAVE("VC") previously extracted.\nThis is a group data element and can have multiple occurrences. Output is\nthe first piece of each occurrence found. If there are more than 12\nvalue codes, they are stored in the overflow array.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z1,Z0 K IBXDATA S Z0=0 F Z=3:3 Q:$G(IBXSAVE(\"VC\",Z))=\"\" S Z0=Z0+1,Z1=$E($P(IBXSAVE(\"VC\",Z),U,2),2-$G(^TMP(\"IBXSAVE\",$J,\"RM\")),10) S:Z'>12 IBXDATA(Z0)=Z1 D:Z>12 XVAL^IBCEF3(Z1,Z) K IBXSAVE(\"VC\",Z)\n", "\nThis data element relies on the array IBXSAVE("VC") previously extracted.\nThis is a group data element and can have multiple occurrences. Output is\nthe second piece of each occurrence found.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXSAVE(\"RP\",2))'=\"\" S IBXDATA=IBXSAVE(\"RP\",2)\n", "\nThis field relies on the IBXSAVE("RP") array that was previously extracted.\nIf the second occurrence of this array has a non-null value, print it.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXSAVE(\"RP\",3))'=\"\" S IBXDATA=IBXSAVE(\"RP\",3)\n", "\nThis field relies on the IBXSAVE("RP") array that was previously extracted.\nIf the second occurrence of this array has a non-null value, print it.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXSAVE(\"RP\",4))'=\"\" S IBXDATA=IBXSAVE(\"RP\",4)\n", "\nThis field relies on the IBXSAVE("RP") array that was previously extracte\nIf the fourth occurrence of this array has a non-null value, print it.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OCCS\",Z)) Q:'Z S Z0=$P(IBXSAVE(\"OCCS\",Z),U) S:Z0'=\"\" IBXDATA(Z)=Z0\n", "\nEach occurrence span code found in the IBXSAVE array previously extracted is\noutput.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-UB-04 SERVICE LINE (PRINT)\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Q,R F Z=1:1 Q:'$D(^TMP($J,\"IBC-RC\",Z)) S R=^(Z),Q=$S(+R=1:$P(R,U,2),+R=2:$E($P(R,U,2),1,5),1:\"\") S:Z'>21 IBXDATA(Z)=Q D:Z>21 CKREV^IBCEF3(Z,Q) I '$O(^TMP($J,\"IBC-RC\",Z)),Z>23 D FILL^IBCEF3(Z)\n", "\nThis data element is a group data element where more than one occurrence\nSince only 23 lines of service line can appear on one form, if there\nare more than 23 lines, subsequent pages are forced for the remaining data\nlines after 23. Since the page number must print on line 23 for multi-page\nbills, the FILL^IBCEF3 call places the page number text on the last line of\nthe last page.\nmight be expected. It relies on the presence of data in array\nIBXSAVE("REV",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, the data is found in the second '^'\npiece of the array. For text line where the first piece = 2, the text is\nassumed to start in column 1, so the data is extracted from positions 1-5.\nFor text line where the first piece = 3, the text is assumed to start in\ncolumn 6, so there is no data extracted for this field.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,\"IBC-RC\",Z)) S Z1=^(Z),Z0=$S(+Z1=1:$P(Z1,U,3),+Z1=2:$E($P(Z1,U,2),6,30),1:$E($P(Z1,U,2),1,25)) S:Z'>21 IBXDATA(Z)=Z0 D:Z'<21 CKREV^IBCEF3(Z,Z0)\n", "\nThis data element is a group data element where more than one occurrence\nSince only 23 lines of service line can appear on one form, if there\nare more than 23 lines, subsequent pages are forced for the remaining data\nlines after 23.\nmight be expected. It relies on the presence of data in array\nIBXSAVE("REV",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, the data is found in the third '^'\npiece of the array. For text line where the first piece = 2, the text is\nassumed to start in column 1, so the data is extracted from positions 6-30.\nFor text line where the first piece = 3, the text is assumed to start in\ncolumn 6, so the data for this field is extracted from positions 1-25.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,D,T,T4,T5 F Z=1:1 Q:'$G(^TMP($J,\"IBC-RC\",Z)) S D=^(Z),T=$P(D,U,2),T5=$P(D,U,5),T4=$P(D,U,4),Z0=$S(+D=2:$E(T,31,40),+D=3:$E(T,26,35),T4'=\"\"&(T>219):T4,T5'=\"\"&(T<220)&(T>1):$J(T5,7,2),1:\"\") S:Z'>21 IBXDATA(Z)=Z0 D:Z'<21 CKREV^IBCEF3(Z,Z0)\n", "\nThis data element is a group data element where more than one occurrence\nformatted in 7 spaces with 2 decimal places. Since only 23 lines of service\ncan appear on one form, if there are more than 23 lines, subsequent\npages are forced for the remaining data lines after 21 to leave room for a\nblank separating line and the page indicator.\nmight be expected. It relies on the presence of data in global\n^TMP($J,"IBC-RC",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, the data is found in the fourth\n(procedure code and modifiers) or fifth (unit charge) '^' pieces of the\narray. If there is a procedure and a unit charge, only the procedure code\nand its modifiers will print. If there is a unit charge and this is an\ninpatient bill and the revenue code is 100-219, it is printed and\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D DATE45^IBCF33(IBXIEN,.IBXDATA,$G(IBXSAVE(\"DATE\")))\n", "\nThis data element is a group data element where more than one occurrence\nextracted from positions 36-42.\nSince only 23 lines of service line can appear on one form, if there\nare more than 23 lines, subsequent pages are forced for the remaining data\nlines after 23.\nmight be expected. It relies on the presence of data in array\nIBXSAVE("REV",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, output the OUTPATIENT from date that\nwas previously extracted into IBXSAVE("DATE"). For text line where the first\npiece = 2, the text is assumed to start in column 1, so the data is\nextracted from positions 41-47. For text line where the first piece = 3,\nthe text is assumed to start in column 6, so the data for this field is\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,\"IBC-RC\",Z)) S Z1=^(Z),Z0=$S(+Z1=1:\" \"_$P(Z1,U,6),+Z1=2:$E($P(Z1,U,2),48,53),1:$E($P(Z1,U,2),43,48)) S:Z'>21 IBXDATA(Z)=Z0 D:Z'<21 CKREV^IBCEF3(Z,Z0)\n", "\nThis data element is a group data element where more than one occurrence\nfield is extracted from positions 43-48.\nSince only 23 lines of service line can appear on one form, if there\nare more than 23 lines, subsequent pages are forced for the remaining data\nlines after 23.\nmight be expected. It relies on the presence of data in array\nIBXSAVE("REV",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, the data is found in the sixth '^'\npiece of the array and is formmatted preceeded by a space. For text line\nwhere the first piece = 2, the text is assumed to start in column 1, so the\ndata is extracted from positions 48-53. For text line where the first\npiece = 3, the text is assumed to start in column 6, so the data for this\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,\"IBC-RC\",Z)) S Z1=^(Z),Z0=$S(+Z1=1:$J($P(Z1,U,7),11,2),+Z1=2:$E($P(Z1,U,2),54,66),1:$E($P(Z1,U,2),49,61)) S:Z'>21 IBXDATA(Z)=Z0 D:Z'<21 CKREV^IBCEF3(Z,Z0)\n", "\nThis data element is a group data element where more than one occurrence\nfield is extracted from positions 49-61.\nSince only 23 lines of service line can appear on one form, if there\nare more than 23 lines, subsequent pages are forced for the remaining data\nlines after 23.\nmight be expected. It relies on the presence of data in array\nIBXSAVE("REV",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, the data is found in the seventh '^'\npiece of the array and is formmatted preceeded by a space. For text line\nwhere the first piece = 2, the text is assumed to start in column 1, so the\ndata is extracted from positions 54-66. For text line where the first\npiece = 3, the text is assumed to start in column 6, so the data for this\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,\"IBC-RC\",Z)) S Z1=^(Z),Z0=$S(+Z1=1:$S($P(Z1,U,8):$J($P(Z1,U,8),9,2),1:$J(0,9,2)),+Z1=2:$E($P(Z1,U,2),67,77),1:$E($P(Z1,U,2),62,72)) S:Z'>21 IBXDATA(Z)=Z0 D:Z'<21 CKREV^IBCEF3(Z,Z0)\n", "\nThis data element is a group data element where more than one occurrence\nfield is extracted from positions 62-72.\nSince only 23 lines of service line can appear on one form, if there\nare more than 23 lines, subsequent pages are forced for the remaining data\nlines after 23.\nmight be expected. It relies on the presence of data in array\nIBXSAVE("REV",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, the data is found in the eighth '^'\npiece of the array and is formatted preceeded by a space. For text line\nwhere the first piece = 2, the text is assumed to start in column 1, so the\ndata is extracted from positions 67-77. For text line where the first\npiece = 3, the text is assumed to start in column 6, so the data for this\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1,R S R=$G(^TMP(\"IBXSAVE\",$J,\"RM\")) F Z=1:1 Q:'$D(^TMP($J,\"IBC-RC\",Z)) S Z1=^(Z),Z0=$S(+Z1=1:$P(Z1,U,9),+Z1=2:$E($P(Z1,U,2),78,80+R),1:$E($P(Z1,U,2),73,75+R)) S:Z'>21 IBXDATA(Z)=Z0 D:Z'<21 CKREV^IBCEF3(Z,Z0)\n", "\nThis data element is a group data element where more than one occurrence\nThe ending extract point is one less in each case if the right margin is\nonly 80, not 81. Since only 23 lines of service line can appear on one form,\nif there are more than 23 lines, subsequent pages are forced for the\nremaining data lines after 23.\nmight be expected. It relies on the presence of data in array\n^TMP("IBC-RC",n) extracted previously. The first '^' piece of the array\nindicates whether this is a 'normal' service data line (=1) or a text line\n(=2 or =3). For a normal service line, the data is found in the ninth '^'\npiece of the array. For text line where the first piece = 2, the text is\nassumed to start in column 1, so the data is extracted from positions 78-81.\nFor text line where the first piece = 3, the text is assumed to start in\ncolumn 6, so the data for this field is extracted from positions 73-76.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-UB92 FORM LOCATOR 56\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,IBZ M IBZ=IBXDATA K IBXDATA K IBXSAVE(\"FL56\") F Z=1:1:4 S IBXSAVE(\"FL56\",Z+1)=$E(IBZ,14*Z,(14*(Z+1)-1)) I Z=1 S IBXDATA=$E(\" \",+$G(^TMP(\"IBXSAVE\",$J,\"RM\")))_$E(IBZ,1,13)\n", "\nIf this data element returns a value other than null, it can be output on\n5 lines where characters 1-13 print on line 1, 14-27 print on line 2, 28-41\nprint on line 3, 42-55 print on line 4 and 56-69 print on line 5.\nSave off characters 14-69 in IBXSAVE("FL56",line #) array and set value of\nthis data element to the first 13 characters. If the right margin is 81\ninstead of 80, move the field over 1 space. The rest of IBXSAVE("FL56")\nwill be printed at a later time.\n \nIf the Form Locator 56 field has no data then the Prior Bills will be used.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ASSIGN OF BENEFITS INDICATOR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(\"Nn0\"[IBXDATA&(IBXDATA'=\"\"):\"N\",1:\"Y\")\n", "\nConverts assignment of benefits indicator from DHCP to X12 format.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$D(IBXSAVE(\"FL56\",2)) IBXDATA=$E(\" \",+$G(^TMP(\"IBXSAVE\",$J,\"RM\")))_IBXSAVE(\"FL56\",2)\n", "\nThis data element's value relies on the existence of the IBXSAVE("FL56")\nvariable previously extracted. Form Locator 56 on the UB92 is split into\n5 lines and this is the 2nd line (14th-27th characters entered) for this\nfield. If the right margin is 81 instead of 80, move the field over 1 space.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$D(IBXSAVE(\"FL56\",3)) IBXDATA=$E(\" \",+$G(^TMP(\"IBXSAVE\",$J,\"RM\")))_IBXSAVE(\"FL56\",3)\n", "\nThis data element's value relies on the existence of the IBXSAVE("FL56")\nvariable previously extracted. Form Locator 56 on the UB92 is split into\n5 lines and this is the 3rd line (28th-41th characters entered) for this\nfield. If the right margin is 81 instead of 80, move the field over 1 space.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$D(IBXSAVE(\"FL56\",4)) IBXDATA=$E(\" \",+$G(^TMP(\"IBXSAVE\",$J,\"RM\")))_IBXSAVE(\"FL56\",4)\n", "\nThis data element's value relies on the existence of the IBXSAVE("FL56")\nvariable previously extracted. Form Locator 56 on the UB92 is split into\n5 lines and this is the 4th line (42nd-55th characters entered) for this\nfield. If the right margin is 81 instead of 80, move the field over 1 space.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$D(IBXSAVE(\"FL56\",5)) IBXDATA=$E(\" \",+$G(^TMP(\"IBXSAVE\",$J,\"RM\")))_IBXSAVE(\"FL56\",5)\n", "\nThis data element's value relies on the existence of the IBXSAVE("FL56")\nvariable previously extracted. Form Locator 56 on the UB92 is split into\n5 lines and this is the 5th line (56th-69th characters entered) for this\nfield. If the right margin is 81 instead of 80, move the field over 1 space.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-ALL INSURANCE COMPANIES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 M Z0=IBXDATA K IBXDATA S Z=\"\" F S Z=$O(Z0(Z)) Q:'Z I $D(^DGCR(399,IBXIEN,\"I\"_Z)) S IBXDATA(Z)=$S(Z<3&$$WNRBILL^IBEFUNC(IBXIEN,Z):\"MEDICARE\",1:$E($P(Z0(Z),U),1,15))_$S($P(Z0(Z),U,2)'=\"\":\" \"_$P(Z0(Z),U,2),1:\"\")\n", "\nThe first 15 characters of the name of the primary, secondary, and tertiary\ninsurance companies along with the claim office number and payer id, if\nknown. If the primary or secondary insurance is MEDICARE WNR, output\n'MEDICARE'.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-ALL INSURANCE CO PROV NUM\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-ROI INDICATOR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=$S(IBXDATA:\"R\",1:\"Y\") F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,\"I\"_Z))) S IBXDATA(Z)=Z0\n", "\nFor each insurance on file in the bill, print the ROI indicator = 'Y' if\nthe record is not a sensitive record, or 'R' if it is a sensitive record.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-ASSIGN OF BENEFITS INDICATOR\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=$S(IBXDATA=\"\"!(\"Nn0\"'[IBXDATA):\"Y\",1:\"N\") F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,\"I\"_Z))) S IBXDATA(Z)=Z0\n", "\nFor each insurance on file in the bill, print the ASSIGNMENT OF BENEFITS\nindicator = 'Y' if the data element value returned is null or is not 0,'n'\nor 'N', otherwise print 'N'.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-PRIOR PAYMENTS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z F Z=1:1:3 K:'$D(^DGCR(399,IBXIEN,\"I\"_Z)) IBXDATA(Z) I $D(IBXDATA(Z)) S IBXDATA(Z)=$S(IBXDATA(Z)'=\"\":$J(IBXDATA(Z),10,2),1:$J(0,10,2))\n", "\nIf the insurance company for the prior payment does not exist for the bill,\ndon't output the prior payment information.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-TOTAL CHARGES LESS OFFSET\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ S IBZ=$G(IBXDATA) K IBXDATA S Z0=$$COBN^IBCEF(IBXIEN),IBXDATA(Z0)=$J(+IBZ,9,2) F Z=1:1:3 I Z'=Z0,$D(^DGCR(399,IBXIEN,\"I\"_Z)) S IBXDATA(Z)=$J(0,9,2)\n", "\nSet the estimated amt for the current insurance equal to the balance on the\nbill.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-BILL SUBMISSION STATUS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(1[IBXDATA:\"00\",1:\"15\")\n", "\nConverts bill submission status from DHCP to X12 format. '00' is original\nsubmission, '15' is any subsequent submission of this bill.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nNot used\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nNot used yet. No output.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nNot used yet. No output.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-ALL INSURED FULL NAMES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z F Z=1:1:3 I $G(IBXDATA(Z))'=\"\",IBXDATA(Z)'[\",\" S Q=$$NAME^IBCEFG1(IBXDATA(Z),1),IBXDATA(Z)=$P(Q,U)_$S($P(Q,U,2)'=\"\":\",\"_$P(Q,U,2),1:\"\")\n", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-ALL INSURED PT RELATION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-ALL INSURANCE NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-ALL INSURANCE GROUP NAME\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=$$COBN^IBCEF(IBXIEN) F Z=1:1:3 S IBXDATA(Z)=$G(IBXDATA(Z))_\" \" I $D(^DGCR(399,IBXIEN,\"I\"_Z)),$$WNRBILL^IBEFUNC(IBXIEN,Z) S IBXDATA(Z)=\"\"\n", "\nIf the insurance is MEDICARE WNR, do not output the group name.\nAdd a space to the end of the Group Name to separate it from\nthe next field , Group Number.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-ALL INSURANCE GROUP NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 S Z0=$$COBN^IBCEF(IBXIEN) F Z=1:1:3 I $D(^DGCR(399,IBXIEN,\"I\"_Z)),Z0=Z,$$WNRBILL^IBEFUNC(IBXIEN,Z) S IBXDATA(Z)=\"\"\n", "\nIf the insurance is MEDICARE WNR, do not output the group number.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-ALL AUTH CODES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-ALL INSURED EMPLOY STATUS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,A,IBZ S A=\"OIEMP\" M Z0=IBXDATA K IBXSAVE(A),IBXDATA D F^IBCEF(\"N-ALL INSURED EMPLOYER INFO\",\"IBZ\") M IBXSAVE(A)=IBZ I $O(IBXSAVE(A,0)) F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,\"I\"_Z))) S IBXDATA(Z)=$S(Z0(Z)=\"\":9,1:+Z0(Z))\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-STATEMENT COVERS FROM DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")\n", "\nFormat date in CCYYMMDD format. If data element's value is null, do not\noutput.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,IBZ D:'$D(IBXSAVE(\"OIEMP\")) F^IBCEF(\"N-ALL INSURED EMPLOYER INFO\",\"IBZ\",,IBXIEN) K IBXDATA M:$O(IBZ(\"\")) IBXSAVE(\"OIEMP\")=IBZ F Z=1:1:3 I $D(IBXSAVE(\"OIEMP\",Z)) S IBXDATA(Z)=$P(IBXSAVE(\"OIEMP\",Z),U)\n", "\nIf the array IBXSAVE("OIEMP") doesn't already exist, extract it. For each\ninsured on the bill, extract the first piece of the data element for output\nin this field.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,IBZ S Z=\"\" F S Z=$O(IBXSAVE(\"OIEMP\",Z)) K:'Z IBXSAVE(\"OIEMP\") Q:'Z S IBZ=$P(IBXSAVE(\"OIEMP\",Z),U,2),IBZ=IBZ_$S(IBZ'=\"\":\", \",1:\"\")_$P(IBXSAVE(\"OIEMP\",Z),U,3),IBXDATA(Z)=$E($P(IBXSAVE(\"OIEMP\",Z),U,5),1,36-$L(IBZ)-1)_\" \"_IBZ\n", "\nThis data element relies on the existence of the IBXSAVE("OIEMP") array\nextracted previously. The output here is as much of the street address (5th\npiece) that will fit if the whole city and state are printed, then the\nsecond piece (city), a comma if city not null, and the third piece for the\nstate abbreviation.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-UB92 FORM LOCATOR 78\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I IBXDATA'=\"\" N Z S Z=$L(IBXDATA) S:Z>3 IBXSAVE(\"FL78\")=$E(IBXDATA,3,5),IBXDATA=$S($G(^TMP(\"IBXSAVE\",$J,\"RM\")):\" \",1:\"\")_$E(IBXDATA,1,2) S:Z'>3 IBXSAVE(\"FL78\")=$S($G(^TMP(\"IBXSAVE\",$J,\"RM\")):\" \",1:\"\")_IBXDATA,IBXDATA=\"\"\n", "\nIf this data element returns a value other than null, it can be output on\n2 lines if its length is bigger than 3 characters. If less than 3\ncharacters in length, the text prints on line 2 and the entire text is\nsaved in IBXSAVE("FL78"). If the length is greater than 3, characters 1-2\nprint on line 1 and 3-5 print on line 2, save off characters 3-5 in\nIBXSAVE("FL78") array and set value of this data element to the first 2\ncharacters. If the right margin is 81 instead of 80, move the field over 1\nspace. IBXSAVE("FL78") will be printed at a later time.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-DIAGNOSES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N C,Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S (C,Z)=0 F S Z=$O(IBZ(Z)) Q:'Z I '$$ECODE^IBCEU4(+IBZ(Z)) S C=C+1 S:C=1 IBXDATA=$P($G(^ICD9(+IBZ(Z),0)),U) I C>1 S IBXSAVE(\"DX\",C)=+IBZ(Z)\n", "\nThe principal dx is found in the first occurrence of the data element's\nvalues. The rest of the diagnoses are saved off in the IBXSAVE("DX") array\nfor later use. Only allow 1 E-code.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",2)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(\"DX\",2),0)),U) K IBXSAVE(\"DX\",2)\n", "\nIf there is a second diagnosis, print its name.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",3)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(\"DX\",3),0)),U) K IBXSAVE(\"DX\",3)\n", "\nIf there is a third diagnosis, print its name.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXSAVE(\"DX\",4)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(\"DX\",4),0)),U) K IBXSAVE(\"DX\",4)\n", "\nIf there is a fourth diagnosis, print its name.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-HCFA 1500 BALANCE DUE BOX\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:$$FT^IBCEF(IBXIEN)=7 IBXDATA=\"\" S IBXNOREQ='$$REQ^IBCEF1(2,\"\",IBXIEN) S IBXDATA=$$DOLLAR^IBCEFG1(IBXDATA)\n", "\nFormat data element so it is numeric including cents, without the decimal.\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-TOTAL CHARGES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DOLLAR^IBCEFG1(IBXDATA)\n", "\nFormat data element so it is numeric including cents, without the decimal.\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"ADMDT\")) S:$L(IBXDATA)=6 IBXDATA=$$DATE^IBCEU($E(IBXDATA,5,6)_$E(IBXDATA,1,4)) D:$S(IBXDATA=\"\":$$HHLTH^IBCEF1(IBXIEN,1),1:0) F^IBCEF(\"N-STATEMENT COVERS FROM DATE\",,,IBXIEN) I IBXDATA S IBXDATA=$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")\n", "\nIf data exists from the previous extract of IBXSAVE("ADMDT"), output it.\nFormat date in CCYYMMDD format. IB*2.0*547 removed the Outpatient date.\nIB*2.0*574 add Outpatient date for Hospice and Home Health Claims.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z0=0 F Z=2,6 S Z0=Z0+1 S:$G(IBXSAVE(\"OCC\",Z))'=\"\" IBXDATA(Z0)=$P(IBXSAVE(\"OCC\",Z),U)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCC") extracted previously. This field outputs the 2nd and 6th\noccurrences of occurrence codes found in the IBXSAVE("OCC",n) array data\nelement. Overflow codes are printed on a separate page.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-KILL IBXSAVE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE\n", "\nCleans up IBXSAVE array. No output.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z0=0 F Z=3,7 S Z0=Z0+1 S:$G(IBXSAVE(\"OCC\",Z))'=\"\" IBXDATA(Z0)=$P(IBXSAVE(\"OCC\",Z),U)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCC") extracted previously. This field outputs the 3rd and 7th\noccurrences of occurrence codes found in the IBXSAVE("OCC",n) array data\nelement. Overflow codes are printed on a separate page.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S Z0=0 F Z=4,8 S Z0=Z0+1 S:$G(IBXSAVE(\"OCC\",Z))'=\"\" IBXDATA(Z0)=$P(IBXSAVE(\"OCC\",Z),U)\n", "\nThis data element is a group data element where more than one occurrence\nmight be expected. It relies on the presence of data in array\nIBXSAVE("OCC") extracted previously. This field outputs the 4th and 8th\noccurrences of occurrence codes found in the IBXSAVE("OCC",n) array data\nelement. Overflow codes are printed on a separate page.\n\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-AGENT CASHIER CITY\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:IBXDATA'=\"\" IBXSAVE(\"ACCITY\")=IBXDATA_\" \"\n", "\nIf the agent cashier city is defined, save it in array IBXSAVE for later\nuse. Include the space to be used between city and state.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-AGENT CASHIER STATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I IBXDATA'=\"\" S IBXSAVE(\"ACSTATE\")=$$STATE^IBCEFG1(IBXDATA)_\" \"\n", "\nIf the agent cashier state is defined, save the 2-character state\nabbreviation in array IBXSAVE for later use. Include the space to be used\nbetween state and zip code.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-AGENT CASHIER ZIP CODE\n", "", "", "", "", "", "", "", "I IBXDATA'=\"\" S IBXSAVE(\"ACZIP\")=$E(IBXDATA,1,5)_$S($E(IBXDATA,6,9)'=\"\":\"-\"_$E(IBXDATA,6,9),1:\"\")\n", "\nIf the agent cashier zip code is defined, save the zip code in array IBXSAVE\nfor later use.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-CURR INSURED FULL ADDRESS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $TR(IBXDATA,\" ^\")'=\"\" N Q,Y S IBXSAVE(\"RP\",1)=$P(IBXDATA,U,5),Q=1 X \"N Z,A F Z=6,7 S A=$P(IBXDATA,U,Z) I A'=\"\"\"\" S Q=Q+1,IBXSAVE(\"\"RP\"\",Q)=A\" S Y=$P(IBXDATA,U,4) D ZIPOUT^VAFADDR S IBXSAVE(\"RP\",Q+1)=$P(IBXDATA,U,2)_\", \"_$P(IBXDATA,U,3)_\" \"_Y\n", "\nTakes data extracted from current insured's address and the city/state/zip\nand saves the values in IBXSAVE array.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D CKPGUB^IBCEF3\n", "\nChecks for multi-page output, adds the static fields to subsequent pages.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-UB-04 BILL CLASSIFICATION\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nIf data element's value is null, do not output.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IADR\")),U,2)\n", "\nThis field relies on the existence of variable IBXSAVE("IADR") previously\nextracted.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED FULL ADDRESS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I '$G(IBXSAVE(\"IBSAME\")) S IBXSAVE(\"IADR\")=IBXDATA\n", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IADR\")),U,3)\n", "\nThis field relies on the existence of variable IBXSAVE("IADR") previously\nextracted. Output the state abbreviation.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IADR\")),U,4)\n", "\nThis field relies on the existence of variable IBXSAVE("IADR") previously\nextracted. Output the insured's zip code.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S('$G(IBXSAVE(\"IBSAME\")):$P($G(IBXSAVE(\"IDEM\")),U,3),1:\"\") K IBXSAVE(\"IBSAME\") I $L(IBXDATA)=10 S IBXDATA=$E(IBXDATA,1,3)_\" \"_$E(IBXDATA,4,10)\n", "\nThis field relies on the existence of the variable IBXSAVE("IDEM")\npreviously extracted.\n\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURED DEMOGRAPHICS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"IDEM\")=IBXDATA\n", "\nSave the insured's demographic data in IBXSAVE("IDEM").\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nField is not currently used by the V.A\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,\"NAME\")),U,5)\n", "\nFinds SSN for ATTENDING or RENDERING PROVIDER\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-CURR INSURANCE CO PROV #\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ S IBZ=$$WNRBILL^IBEFUNC(IBXIEN,+$$COBN^IBCEF(IBXIEN)) S:IBZ IBXDATA=\"VA0\"_$P($$SITE^VASITE,U,3)\n", "\nIf MRA is needed, use default of VA0 and the site #. For other than MRA,\nuse the provider number assigned to the site by the insurance co.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURR INSURED DEMOGRAPHICS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXSAVE(\"IDEM\")=$$DT^IBCEFG1($P(IBXDATA,U),\"\",\"D8\")_U_$P(IBXDATA,U,2)_U_$$NOPUNCT^IBCEF($P(IBXDATA,U,3),1) K IBXDATA\n", "\nSaves off data element in IBXSAVE array with the first '^' piece of the\ndata reformatted to a date format of CCYYMMDD and phone # stripped of\npunctuation. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IADR\")),U,3)\n", "\nRetrieves insured state data from IBXSAVE array previously extracted. If\ndata element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PATIENT PHONE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)\n", "\nStrip all punctuation from phone number.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-SET 837 INS CO HDR NODE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nSet ^TMP("IBHDR",$J) global node so the header data is not extracted again.\nNo output needed.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"COB1\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,IBZ K IBXDATA S (Z,IBZ)=0 F S IBZ=$O(IBXSAVE(\"CCOB\",IBZ)) Q:'IBZ I IBZ<$$COBN^IBCEF(IBXIEN) S Z=Z+1,IBXDATA(Z)=$E(\"PST\",IBZ) I Z>1 D ID^IBCEF2(Z,\"COB1\")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. It relies on the\nexistence of the IBXSAVE("CCOB",COBSEQ) array that was previously extracted.\nFor other than the first occurrence, the RECORD ID 'COB1' must be output.\nOnly output 1 record per COB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D INS13^IBCEF2\n", "\nDepending on the revenue code found, this field is set to DA or UN to\nspecify the type of units being billed for.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA I $P($G(IBXSAVE(\"CADR\")),U,2)'=\"\" S IBXDATA=$E($P(IBXSAVE(\"CADR\"),U,2)_\" \"_$P(IBXSAVE(\"CADR\"),U,3),1,30)\n", "\nIf header data has already been extracted, array ^TMP("IBHDR1",$J) will\nalready exist. Don't want to extract this field again, so kill data\nelement so there is no output. Also don't output data element if its\nvalue is null.\nThis data relies on the presence of the IBXSAVE("CADR") array that should\nhave been set in a previous data field.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURR INS CO FULL ADDRESS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"CADR\") I $D(IBXDATA) N Q,Y,Z S Q=\"CADR\",Y=$G(IBXDATA(6)) D ZIPOUT^VAFADDR S:Y'=\"\" $P(IBXSAVE(Q),U,6)=Y F Z=1:1:5,7 I $D(IBXDATA(Z)) S $P(IBXSAVE(Q),U,Z)=IBXDATA(Z)\n", "\nData element extracts address data into IBXDATA array\nSave the data in IBXSAVE("CADR")=Street addr 1^Street addr 2^Street addr 3^\nCity^State^Zip^claim office id # for later use.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-COB CLAIM LEVEL AMOUNTS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "M IBXSAVE(\"CCOB\")=IBXDATA K IBXDATA\n", "\nMove data to IBXSAVE for later use.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCOB",COB,n,1) array. Extract the second piece\nfor this data. Output the sum of each COB sequence as 1 IBXDATA(n) entry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-KILL IBXSAVE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE,^TMP(\"IBTX\",$J,IBXIEN)\n", "\nCleans up the IBXSAVE array. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"MOA1\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"MIA1\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"MIA2\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"CCAS\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:$$INPAT^IBCEF(IBXIEN,1) IBXDATA I $D(IBXDATA) N Z,IBZ K IBXDATA S (Z,IBZ)=0 F S IBZ=$O(IBXSAVE(\"MOA\",IBZ)) Q:'IBZ S Z=Z+1,IBXDATA(Z)=$E(\"PST\",IBZ) I Z>1 D ID^IBCEF2(Z,\"MOA1\")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. It relies on the\nexistence of the IBXSAVE("MOA") array that was previously extracted.\nFor other than the first occurrence, the RECORD ID 'MOA1' must be output.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:'$$INPAT^IBCEF(IBXIEN,1) IBXDATA I $D(IBXDATA) N Z,IBZ K IBXDATA S (Z,IBZ)=0 F S IBZ=$O(IBXSAVE(\"MIA45\",IBZ)) Q:'IBZ S Z=Z+1,IBXDATA(Z)=$E(\"PST\",IBZ) I Z>1 D ID^IBCEF2(Z,\"MIA1\")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. It relies on the\nexistence of the IBXSAVE("MIA45") array that was previously extracted.\nFor other than the first occurrence, the RECORD ID 'MIA1' must be output.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:'$$INPAT^IBCEF(IBXIEN,1) IBXDATA I $D(IBXDATA) N Z,IBZ K IBXDATA S (Z,IBZ)=0 F S IBZ=$O(IBXSAVE(\"MIA45\",IBZ)) Q:'IBZ S Z=Z+1,IBXDATA(Z)=$E(\"PST\",IBZ) I Z>1 D ID^IBCEF2(Z,\"MIA2\")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. It relies on the\nexistence of the IBXSAVE("MIA45") array that was previously extracted.\nFor other than the first occurrence, the RECORD ID 'MIA2' must be output.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1,IBXDATA(Z1)=$E(\"PST\",Z) I Z1>1 D ID^IBCEF2(Z1,\"CCAS\")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. It relies on the\nexistence of the IBXSAVE("CCAS") array that was previously extracted.\nFor other than the first occurrence, the RECORD ID 'CCAS' must be output.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-MEDICARE OUTPT CLAIM COB AMT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"MOA\") M IBXSAVE(\"MOA\")=IBXDATA K IBXDATA\n", "\nMove the IBXDATA array to the IBXSAVE array for later use.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-MEDICARE INPT CLAIM COB AMTS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"MIA45\") M IBXSAVE(\"MIA45\")=IBXDATA K IBXDATA\n", "\nMove the IBXDATA array to the IBXSAVE array for later use.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-KILL IBXSAVE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE\n", "\nCleans up the IBXSAVE array. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-COB CLAIM LEVEL ADJUSTMENTS\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"CCAS\") M IBXSAVE(\"CCAS\")=IBXDATA K IBXDATA\n", "\nMove the IBXDATA array to the IBXSAVE array for later use.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MIA45\",Z2=4,Z3=12 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the twelveth\npiece for this data. Output the sum of each COB sequence as 1 IBXDATA(n)\nentry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"MOA\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"MOA\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"MOA\",IBZ,Z,3)),U) S IBXDATA(Z0)=$G(IBXDATA(Z0))+$$DOLLAR^IBCEFG1($P(IBXSAVE(\"MOA\",IBZ,Z,3),U))\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MOA",COB,n,3) array. Extract the first piece\nfor this data. Output the sum of each COB sequence as 1 IBXDATA(n) entry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"MIA45\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"MIA45\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"MIA45\",IBZ,Z,4)),U,1)'=\"\" S IBXDATA(Z0)=$G(IBXDATA(Z0))+$P(IBXSAVE(\"MIA45\",IBZ,Z,4),U)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the first piece\nfor this data. Output the sum of each COB sequence as 1 IBXDATA(n) entry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0)),U)'=\"\",$O(IBXSAVE(\"CCAS\",Z,Z0,0)) S IBXDATA(Z1)=$P(IBXSAVE(\"CCAS\",Z,Z0),U)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n) array. Extract the first\npiece for this data.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"MIA45\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"MIA45\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"MIA45\",IBZ,Z,5)),U)'=\"\" S IBXDATA(Z0)=$P(IBXSAVE(\"MIA45\",IBZ,Z,5),U) Q\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,5) array. Extract the first\npiece for this data. Output only the first REMARKS CODE(1) found for each\nCOB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,1)),U)'=\"\" S IBXDATA(Z1)=$P(IBXSAVE(\"CCAS\",Z,Z0,1),U)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,1) array. Extract the first piece\nif not null for this data.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,2)),U)'=\"\" S IBXDATA(Z1)=$P(IBXSAVE(\"CCAS\",Z,Z0,2),U)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,2) array. Extract the first piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nMRD;IB*2.0*516 - Changed to be blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,A,B K IBXDATA S:'$D(IBXSAVE(\"LCOB\")) IBXNOREQ=1 S (Z,B)=0 F S Z=$O(IBXSAVE(\"LCOB\",Z)) Q:'Z S:'$O(IBXSAVE(\"LCOB\",Z,\"COB\",0)) IBXNOREQ=1 S A=0 F S A=$O(IBXSAVE(\"LCOB\",Z,\"COB\",A)) Q:'A S B=B+1,IBXDATA(B)=Z I B>1 D ID^IBCEF2(B,\"LCOB\")\n", "\nThis data element assumes the existence of the IBXSAVE array for each line\nitem (LCOB) that was previously extracted. If the line has COB data\nassociated with it, output the line # for each COB sequence found for the\nline. For every line output > 1, output the 'LCOB' record id.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"LCOB\"\n", "\nOutput record id for 'LCOB' record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $$COBN^IBCEF(IBXIEN)>1 D COBPYRID^IBCEU1(IBXIEN,.IBXSAVE,.IBXDATA)\n", "\nThis data element assumes the existence of the IBXSAVE array for each line\nitem (LCOB) that was previously extracted. If the line has COB data\nassociated with it, output the payer id for each COB sequence found for the\nline.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-RECORD ID\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"LCAS\"\n", "\nOutput record id for 'LCAS' record.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,2)\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Each time\nwe encounter a new line item (after the first), a new group code, or more\nthan 6 reason codes for a given group code, output the 'LCAS' record id as\nthese each need a new record.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,3)\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Each time\nwe encounter a new group code, or more than 6 reason codes for a given\ngroup code, output the group code as these each need a new record.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,4)\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nreason codes can be output on a single record for the same line and group\ncode. This extracts the first, seventh, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,7)\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nreason codes can be output on a single record for the same line and group\ncode. This extracts the second, eighth, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,5) I $D(IBXDATA) S Z=0 F S Z=$O(IBXDATA(Z)) Q:'Z S IBXDATA(Z)=$$DOLLAR^IBCEFG1(IBXDATA(Z))\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nadj amts can be output on a single record for the same line and group\ncode. This extracts the first, seventh, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-KILL IBXSAVE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE,^TMP(\"DCX\",$J)\n", "\nCleans up IBXSAVE and ^TMP("DCX") arrays. No output.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nMRD;IB*2.0*516 - Changed to be blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"\"\n", "\nMRD;IB*2.0*516 - Changed to be blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MOA\",Z2=3,Z3=2 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MOA",COB,n,3) array. Extract the second piece\nfor this data. Output the sum of each COB sequence as 1 IBXDATA(n) entry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"MOA\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"MOA\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"MOA\",IBZ,Z,3)),U,3)'=\"\" S IBXDATA(Z0)=$P(IBXSAVE(\"MOA\",IBZ,Z,3),U,3) Q\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MOA",COB,n,3) array. Extract the third\npiece for this data. Output only the first REMARKS CODE(1) found for each\nCOB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"MOA\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"MOA\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"MOA\",IBZ,Z,3)),U,4)'=\"\" S IBXDATA(Z0)=$P(IBXSAVE(\"MOA\",IBZ,Z,3),U,4) Q\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MOA",COB,n,3) array. Extract the fourth\npiece for this data. Output only the first REMARKS CODE(2) found for each\nCOB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"MOA\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"MOA\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"MOA\",IBZ,Z,3)),U,5)'=\"\" S IBXDATA(Z0)=$P(IBXSAVE(\"MOA\",IBZ,Z,3),U,5) Q\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MOA",COB,n,3) array. Extract the fifth\npiece for this data. Output only the first REMARKS CODE(3) found for each\nCOB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-KILL IBXSAVE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE\n", "\nCleans up IBXSAVE array. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"MOA\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"MOA\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"MOA\",IBZ,Z,3)),U,6)'=\"\" S IBXDATA(Z0)=$P(IBXSAVE(\"MOA\",IBZ,Z,3),U,6) Q\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MOA",COB,n,3) array. Extract the sixth\npiece for this data. Output only the first REMARKS CODE(4) found for each\nCOB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MOA\",Z2=3,Z3=8 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MOA",COB,n,3) array. Extract the eighth piece\nfor this data. Output the sum of each COB sequence as 1 IBXDATA(n) entry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MOA\",Z2=3,Z3=9 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MOA",COB,n,3) array. Extract the ninth piece\nfor this data. Output the sum of each COB sequence as 1 IBXDATA(n) entry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MIA45\",Z2=4,Z3=3 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the third piece\nfor this data. Output the sum of each COB sequence as 1 IBXDATA(n) entry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-DRG USED\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:$$FT^IBCEF(IBXIEN)=7 IBXDATA I +$G(IBXDATA)=0 K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MIA45\",Z2=4,Z3=5 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the fifth piece\nfor this data. Output the sum of each COB sequence as 1 IBXDATA(n) entry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MIA45\",Z2=4,Z3=6 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the sixth piece\nfor this data. Output the sum of each COB sequence as 1 IBXDATA(n) entry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MIA45\",Z2=4,Z3=7 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the seventh\npiece for this data. Output the sum of each COB sequence as 1 IBXDATA(n)\nentry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MIA45\",Z2=4,Z3=8 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the eighth\npiece for this data. Output the sum of each COB sequence as 1 IBXDATA(n)\nentry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z2 S Z1=\"MIA45\",Z2=4,Z3=9 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the ninth\npiece for this data. Output the sum of each COB sequence as 1 IBXDATA(n)\nentry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-KILL IBXSAVE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE\n", "\nCleans up the IBXSAVE array. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MIA45\",Z2=4,Z3=10 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the tenth\npiece for this data. Output the sum of each COB sequence as 1 IBXDATA(n)\nentry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MIA45\",Z2=4,Z3=11 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the eleventh\npiece for this data. Output the sum of each COB sequence as 1 IBXDATA(n)\nentry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MIA45\",Z2=4,Z3=13 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the thirteenth\npiece for this data. Output the sum of each COB sequence as 1 IBXDATA(n)\nentry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"MIA45\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"MIA45\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"MIA45\",IBZ,Z,4)),U,14) S IBXDATA(Z0)=$G(IBXDATA(Z0))+$P(IBXSAVE(\"MIA45\",IBZ,Z,4),U,14)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the fourteenth\npiece for this data. Output the sum of each COB sequence as 1 IBXDATA(n)\nentry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MIA45\",Z2=4,Z3=15 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the fifteenth\npiece for this data. Output the sum of each COB sequence as 1 IBXDATA(n)\nentry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MIA45\",Z2=4,Z3=18 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the eighteenth\npiece for this data. Output the sum of each COB sequence as 1 IBXDATA(n)\nentry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"MIA45\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"MIA45\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"MIA45\",IBZ,Z,5)),U,2)'=\"\" S IBXDATA(Z0)=$P(IBXSAVE(\"MIA45\",IBZ,Z,5),U,2) Q\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,5) array. Extract the second\npiece for this data. Output only the first REMARKS CODE(2) found for each\nCOB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"MIA45\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"MIA45\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"MIA45\",IBZ,Z,5)),U,3)'=\"\" S IBXDATA(Z0)=$P(IBXSAVE(\"MIA45\",IBZ,Z,5),U,3) Q\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,5) array. Extract the third\npiece for this data. Output only the first REMARKS CODE(3) found for each\nCOB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"MIA45\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"MIA45\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"MIA45\",IBZ,Z,5)),U,4)'=\"\" S IBXDATA(Z0)=$P(IBXSAVE(\"MIA45\",IBZ,Z,5),U,4) Q\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,5) array. Extract the fourth\npiece for this data. Output only the first REMARKS CODE(4) found for each\nCOB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"MIA45\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"MIA45\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"MIA45\",IBZ,Z,5)),U,5)'=\"\" S IBXDATA(Z0)=$P(IBXSAVE(\"MIA45\",IBZ,Z,5),U,5) Q\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the fifth\npiece for this data. Output only the first REMARKS CODE(5) found for each\nCOB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-KILL IBXSAVE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE\n", "\nCleans up IBXSAVE array. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MIA45\",Z2=4,Z3=16 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the sixteenth\npiece for this data. Output the sum of each COB sequence as 1 IBXDATA(n)\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MIA45\",Z2=4,Z3=17 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the seventeenth\npiece for this data. Output the sum of each COB sequence as 1 IBXDATA(n)\nentry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,1)),U,2)'=\"\" S IBXDATA(Z1)=$$DOLLAR^IBCEFG1($P(IBXSAVE(\"CCAS\",Z,Z0,1),U,2))\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,1) array. Extract the second piece\nif not null for this data.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,3)),U)'=\"\" S IBXDATA(Z1)=$P(IBXSAVE(\"CCAS\",Z,Z0,3),U)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,3) array. Extract the first piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,1)),U,3)'=\"\" S IBXDATA(Z1)=$P(IBXSAVE(\"CCAS\",Z,Z0,1),U,3)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,1) array. Extract the third piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,2)),U,2)'=\"\" S IBXDATA(Z1)=$$DOLLAR^IBCEFG1($P(IBXSAVE(\"CCAS\",Z,Z0,2),U,2))\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,2) array. Extract the second piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,3)),U,2)'=\"\" S IBXDATA(Z1)=$$DOLLAR^IBCEFG1($P(IBXSAVE(\"CCAS\",Z,Z0,3),U,2))\n", "\nhis data element relies on the previous extract of COB data for other\nnsurance into the IBXSAVE("CCAS",COB,n,3) array. Extract the second piece\nor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,2)),U,3)'=\"\" S IBXDATA(Z1)=$P(IBXSAVE(\"CCAS\",Z,Z0,2),U,3)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,2) array. Extract the third piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,3)),U,3)'=\"\" S IBXDATA(Z1)=$P(IBXSAVE(\"CCAS\",Z,Z0,3),U,3)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,3) array. Extract the third piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,4)),U,3)'=\"\" S IBXDATA(Z1)=$P(IBXSAVE(\"CCAS\",Z,Z0,4),U,3)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,4) array. Extract the third piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=\"\"\n", "\nMRD;IB*2.0*516 - Changed to be blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,5)),U,3)'=\"\" S IBXDATA(Z1)=$P(IBXSAVE(\"CCAS\",Z,Z0,5),U,3)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,5) array. Extract the third piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,6)),U,3)'=\"\" S IBXDATA(Z1)=$P(IBXSAVE(\"CCAS\",Z,Z0,6),U,3)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,6) array. Extract the third piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,4)),U,2)'=\"\" S IBXDATA(Z1)=$$DOLLAR^IBCEFG1($P(IBXSAVE(\"CCAS\",Z,Z0,4),U,2))\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,4) array. Extract the second piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,6)),U,2)'=\"\" S IBXDATA(Z1)=$$DOLLAR^IBCEFG1($P(IBXSAVE(\"CCAS\",Z,Z0,6),U,2))\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,6) array. Extract the second piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,4)),U)'=\"\" S IBXDATA(Z1)=$P(IBXSAVE(\"CCAS\",Z,Z0,4),U)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,4) array. Extract the first piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,5)),U)'=\"\" S IBXDATA(Z1)=$P(IBXSAVE(\"CCAS\",Z,Z0,5),U)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,5) array. Extract the first piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,5)),U,2)'=\"\" S IBXDATA(Z1)=$$DOLLAR^IBCEFG1($P(IBXSAVE(\"CCAS\",Z,Z0,5),U,2))\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,5) array. Extract the second piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F S Z=$O(IBXSAVE(\"CCAS\",Z)) Q:'Z S Z0=0 F S Z0=$O(IBXSAVE(\"CCAS\",Z,Z0)) Q:'Z0 S Z1=Z1+1 I $P($G(IBXSAVE(\"CCAS\",Z,Z0,6)),U)'=\"\" S IBXDATA(Z1)=$P(IBXSAVE(\"CCAS\",Z,Z0,6),U)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("CCAS",COB,n,6) array. Extract the first piece\nfor this data, if not null.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F S IBZ=$O(IBXSAVE(\"MOA\",IBZ)) Q:'IBZ S Z0=Z0+1,Z=0 F S Z=$O(IBXSAVE(\"MOA\",IBZ,Z)) Q:'Z I $P($G(IBXSAVE(\"MOA\",IBZ,Z,3)),U,7)'=\"\" S IBXDATA(Z0)=$P(IBXSAVE(\"MOA\",IBZ,Z,3),U,7) Q\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MOA",COB,n,3) array. Extract the seventh\npiece for this data. Output only the first REMARKS CODE(5) found for each\nCOB sequence.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S:$P(IBXSAVE(\"OUTPT\",Z),U,13)'=\"\" IBXDATA(Z)=$P(\"N^Y\",U,$P(IBXSAVE(\"OUTPT\",Z),U,13)+1)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extracted IBXSAVE array.\nOnly output the data for service lines that have data.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "NO\n", "", "", "S IBXDATA=\"\"\n", "\nMRD;IB*2.0*516 - Changed to be blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z1,Z2,Z3 S Z1=\"MIA45\",Z2=4,Z3=4 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)\n", "\nThis data element relies on the previous extract of COB data for other\ninsurance into the IBXSAVE("MIA45",COB,n,4) array. Extract the fourth\npiece for this data. Output the sum of each COB sequence as 1 IBXDATA(n)\nentry.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P(IBXSAVE(\"OUTPT\",Z),U,4) S IBXDATA(Z)=$S(Z0'=7:\"UN\",1:\"MJ\")\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\nIf the type of service not = 7 (anesthesia), this is units (UN) and for\nanesthesia, it's minutes (MJ)\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CMS-1500 PURCH SVC TOTAL\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE(\"PS$\") K:'$G(IBXDATA) IBXDATA I $G(IBXDATA) S IBXDATA=$$DOLLAR^IBCEFG1(IBXDATA),IBXSAVE(\"PS$\")=1\n", "\nSUB-7\n(P) 2300/AMT(2)/02\nFormat the total purchased service charges amount into an EDI dollar \nformat before transmitting. Save the IBXSAVE("PS$") flag to indicate \nthat a dollar amount exists and that the qualifier in SUB-11 is needed.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,\"NAME\")),U,5)\n", "\nFinds SSN for REFERING PROVIDER\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,\"NAME\")),U,1)\n", "\nChanges data element (name) into LAST^FIRST^MIDDLE format. Saves data in\nIBXSAVE array for use by later fields.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,2,\"NAME\")),U,1)\n", "\nChanges data element (name) into LAST^FIRST^MIDDLE format. Saves data in\nIBXSAVE array for use by later fields.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,2,\"NAME\")),U,5)\n", "\nFinds the Operating Physicians SSN \n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURRENT INS POLICY TYPE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", "\nThis is the X12 definition for the current insurance plan type\n(Refer to the 837 v4010 field 2000B/SBR/09.)\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"IDEM\")),U,2)\n", "\nRetrieves insured demographics from IBXSAVE array previously extracted. If\ndata element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-KILL IBXSAVE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE\n", "\nClean up IBXSAVE array. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-COB TOTAL NON-COVERED AMOUNT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$S(IBXDATA]\"\":\"A8\",1:\"\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTH INS POL TYPES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $P($G(IBZ),U,Z)'=\"\",$D(^DGCR(399,IBXIEN,\"I\"_(Z+1))) S IBXDATA(Z)=$P(IBZ,U,Z)\n", "\nThis is the X12 interpretation of the 'other' insurance plan types\n CI = COMMERCIAL (default if none defined),1,2\n 15 = INDEMNITY\n(see codes below or refer to the 837 v4010 field 2000B/SBR/09.)\n X12 CODES: MA = MEDICARE PART A 3\n MB = MEDICARE PART B 3\n HM = HMO\n MC = MEDICAID 4\n 12 = PPO\n CH = TRICARE 5\n WC = WORKERS COMP\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTHER INSURED AUTH CODES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $G(IBZ(Z))'=\"\" S IBXDATA(Z)=\"G1\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-KILL IBXSAVE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE\n", "\nClean up the IBXSAVE array. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,\"NAME\")),U,1)\n", "\nChanges data element (name) into LAST^FIRST^MIDDLE^CREDENTIALS format. Saves\ndata in IBXSAVE array for use by later fields.\nIf the provider name is blank and the provider id is SLF000 (self), this\nfield is not required.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,\"NAME\")),U,2)\n", "\nIf the attending/rendering provider exists, output the first name from the\nsecond '^' piece.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,9,\"NAME\")),U,2)\n", "\nOperating provider first name\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,2,\"NAME\")),U,2)\n", "\nIf the operating provider exists, output the first name from the second '^'\npiece.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,1,\"NAME\")),U,2)\n", "\nIf the referring provider exists, output the first name from the second '^'\npiece.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,9,\"NAME\")),U,5)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-KILL IBXSAVE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE\n", "\nCleans up the IBXSAVE array. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=\"AT\" I $G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,\"TAXONOMY\"))']\"\" S IBXDATA=\"\"\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,\"TAXONOMY\"))\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nThis field is blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P($G(IBXSAVE(\"PROCMODS\",Z)),\",\",2) I Z0'=\"\" S IBXDATA(Z)=Z0\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P($G(IBXSAVE(\"PROCMODS\",Z)),\",\",3) I Z0'=\"\" S IBXDATA(Z)=Z0\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z,Z0 S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S Z0=$P($G(IBXSAVE(\"PROCMODS\",Z)),\",\",4) K IBXSAVE(\"PROCMODS\",Z) I Z0'=\"\" S IBXDATA(Z)=Z0\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extract IBXSAVE array. If\nany service line data is found, the data is output.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-BILLING SITE\n", "", "", "", "ZERO PAD ON LEFT\n", "", "", "", "S IBXDATA=$E($P(IBXDATA,U,3),4,7) I $TR(IBXDATA,0)=\"\" K IBXDATA\n", "\nAlways 0-fill data to the left. If primary site, don't output. If not\nprimary site, this is the site suffix (up to 4 digits)\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-UB-04 FORM LOCATOR 64B\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXDATA)'=\"\" S:$G(^TMP(\"IBXSAVE\",$J,\"RM\")) IBXDATA=\" \"_IBXDATA\n", "\nIf the right margin is 81 instead of 80, move the output over 1 space.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-KILL IBXSAVE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE\n", "\nCleans up the IBXSAVE array ... no output.\n
\n\n"], ["LEGACY UB-92", "NATIONAL,NO EDIT\n", "N-UB-04 FORM LOCATOR 64C\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $G(IBXDATA)'=\"\" S:$G(^TMP(\"IBXSAVE\",$J,\"RM\")) IBXDATA=\" \"_IBXDATA\n", "\nIf the right margin is 81 instead of 80, move the output over 1 space.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-OTHER INSURED AUTH CODES\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $G(IBZ(Z))'=\"\" S IBXDATA(Z)=IBZ(Z)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the IBXDATA array. If any other insurance\ncompany data is found, these authorization codes are output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CURRENT AUTHORIZATION CODE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"INPT\",Z)) Q:'Z I $P(IBXSAVE(\"INPT\",Z),U,11)'=\"\" S IBXDATA(Z)=\"N4\"\n", "\nIf data element's value is null, do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", "\nExplanation of benefits indicator should always be set to "y"\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ACCIDENT DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")\n", "\nFormat data element in CCYYMMDD date format. If data element's value is\nnull, do not output.\n
\n\n"], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-STATEMENT COVERS FROM DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$FMTE^XLFDT(IBXDATA,\"5D\")\n", "\nFormat data element in MM/DD/CCYY date format.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PATIENT DATE OF DEATH\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S:IBXDATA IBXDATA=$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $P(IBXSAVE(\"OUTPT\",Z),U,16)'=\"\" S IBXDATA(Z)=+$TR($J($P(IBXSAVE(\"OUTPT\",Z),U,16),11,3),\" .\")\n", "\nThis element is blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CONDITION RELATED TO AUTO\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:'IBXDATA IBXDATA I $D(IBXDATA) S IBXSAVE(\"CONDA\")=IBXDATA,IBXDATA=\"AA\"\n", "\nIf IBXDATA does not have a value that is greater than 0, no output. If \ndata element > 0, save off value in IBXSAVE array for later use, output\nas 'AA'.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S:$P($G(IBXSAVE(\"OUTPT\",Z,\"AUX\")),U,3)'=\"\" IBXDATA(Z)=$P(\"N^Y\",U,$P(IBXSAVE(\"OUTPT\",Z,\"AUX\"),U,3)+1)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extracted IBXSAVE array.\nOnly output the data for service lines that have data.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $P(IBXSAVE(\"OUTPT\",Z),U,16)'=\"\" S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z),U,17) I IBXDATA(Z)=\"\" S IBXDATA(Z)=\"UN\"\n", "\nThis element is blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nThis element is blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nThis element is blank.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z S:$P($G(IBXSAVE(\"OUTPT\",Z,\"AUX\")),U,7)'=\"\" IBXDATA(Z)=$P(\"N^Y\",U,$P(IBXSAVE(\"OUTPT\",Z,\"AUX\"),U,7)+1)\n", "\nThis is a group data element so more than 1 occurrence of a value is\npossible for the data element in the previously extracted IBXSAVE array.\nOnly output the data for service lines that have data.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$G(IBXSAVE(\"PRV-BP\",\"NAME\"))\n", "\nPRV-3\nBilling provider name\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-LAST MENSTRUAL PERIOD\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$DT^IBCEFG1(IBXDATA,\"\",\"D8\")\n", "\nFormat data element in CCYYMMDD date format. If data element's value is \nnull do not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-LAB CLIA NUMBER\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA)\n", "\nFormat code for the CLIA# in SUB-8. Just remove any punctuation.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", "\nSUB-9 lab/facility primary ID#\nRemove punctuation from the returned tax ID number.\n \nesg - 6/25/09 - IB*2*400 - Tie SUB-9 and SUB-13 together as an \nID/qualifier pair for purchased services.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-PURCHASED SERVICE TYPE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "I '$$SUB1OK^IBCEP8A(IBXIEN) K IBXDATA\n", "\nThe data element calls N-PURCHASED SERVICE TYPE which extracts the NON-VA \nor 2 then Austin populates the purchased service loop 2310C.\n \nInvoke the $$SUB1OK function to determine if this claim is for purchased \nservices. If $$SUB1OK is true, then leave the value of IBXDATA alone as \nextracted from the data element. But if $$SUB1OK is false, then kill \nIBXDATA to make this field blank.\nCARE TYPE field from the claim (399,233).\n \n1:FEE BASIS, NON-LAB\n2:FEE BASIS, LAB\n3:NON-FEE BASIS, NON-LAB\n4:NON-FEE BASIS, LAB\n \nAustin uses this field for professional claims only. If the value is 1 \n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-AUTO ACCIDENT STATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$$STATE^IBCEFG1(IBXDATA)\n", "\nFormat data element as the 2-character state abbreviation. If data element\nis null, no output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $P(IBXSAVE(\"OUTPT\",Z),U,15)'=\"\" S IBXDATA(Z)=\"N4\"\n", "\nAdded NDC code in piece 22 as part of IB*2.0*516.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA N Z S Z=0 F S Z=$O(IBXSAVE(\"OUTPT\",Z)) Q:'Z I $P(IBXSAVE(\"OUTPT\",Z),U,15)'=\"\" S IBXDATA(Z)=$P(IBXSAVE(\"OUTPT\",Z),U,15)\n", "\nesg - 8/18/06 - IB patch 348 - New CMS-1500 claim form project\n \nBox 24K no longer exists on the 1500 form. Austin FSC was not mapping \nthis field to anything anyway.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA\n", "\nIB patch 320. Move the data in this field to CI1A-3.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N S,N K IBXDATA S S=4 D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,S) S N=0 F S N=$O(IBXDATA(N)) Q:'N S IBXDATA(N)=$$DOLLAR^IBCEFG1(IBXDATA(N))\n", "\nThis data element assumes the existence of the IBXSAVE array for each \nline item (LCOB) that was previously extracted. If the line has COB data \nassociated with it, output the amount paid for each COB sequence found for\nthe line.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N S K IBXDATA S S=5 D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,S)\n", "\nThis data element assumes the existence of the IBXSAVE array for each line\nitem (LCOB) that was previously extracted. If the line has COB data\nassociated with it, output the procedure for each COB sequence found for the\nline.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N S K IBXDATA S S=11 D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,S)\n", "\nThis data element assumes the existence of the IBXSAVE array for each line\nitem (LCOB) that was previously extracted. If the line has COB data\nassociated with it, output the revenue code for each COB sequence found for\nthe line.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CONDITION RELATED TO EMPLOY\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:'IBXDATA IBXDATA I $D(IBXDATA) S IBXDATA=\"EM\"\n", "\nIf IBXDATA does not have a value that is greater than 0, no output. If\ndata element > 0, output as 'EM'.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D COBMOD^IBCEU0(.IBXSAVE,.IBXDATA,1)\n", "\nThis data element assumes the existence of the IBXSAVE array for each line\nitem (LCOB) that was previously extracted. If the line has COB data\nassociated with it, output the modifier 1 for each COB sequence found for\nthe line.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D COBMOD^IBCEU0(.IBXSAVE,.IBXDATA,2)\n", "\nThis data element assumes the existence of the IBXSAVE array for each line\nitem (LCOB) that was previously extracted. If the line has COB data\nassociated with it, output the modifier 2 for each COB sequence found for\nthe line.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D COBMOD^IBCEU0(.IBXSAVE,.IBXDATA,3)\n", "\nThis data element assumes the existence of the IBXSAVE array for each line\nitem (LCOB) that was previously extracted. If the line has COB data\nassociated with it, output the modifier 3 for each COB sequence found for\nthe line.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D COBMOD^IBCEU0(.IBXSAVE,.IBXDATA,4)\n", "\nThis data element assumes the existence of the IBXSAVE array for each line\nitem (LCOB) that was previously extracted. If the line has COB data\nassociated with it, output the modifier 4 for each COB sequence found for\nthe line.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,10)\n", "\nThis data element assumes the existence of the IBXSAVE array for each line\nitem (LCOB) that was previously extracted. If the line has COB data\nassociated with it, output the description for each COB sequence found for\nthe line.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N S,N K IBXDATA S S=12 D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,S) S N=0 F S N=$O(IBXDATA(N)) Q:'N S:$G(IBXDATA(N)) IBXDATA(N)=$FN(IBXDATA(N),\"\",0)\n", "\nThis data element assumes the existence of the IBXSAVE array for each line\nitem (LCOB) that was previously extracted. If the line has COB data\nassociated with it, output the paid units for each COB sequence found for\nthe line.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N S K IBXDATA S S=13 D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,S) K:'$G(IBXTRA) IBXDATA\n", "\nThis data element assumes the existence of the IBXSAVE array for each line\nitem (LCOB) that was previously extracted. If the line has COB data\nassociated with it, output the assigned line # for each COB sequence found\nfor the line.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N S,N K IBXDATA S S=20 D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,S) S N=0 F S N=$O(IBXDATA(N)) Q:'N S:$G(IBXDATA(N)) IBXDATA(N)=$$DT^IBCEFG1(IBXDATA(N),\"\",\"D8\")\n", "\nThis data element assumes the existence of the IBXSAVE array for each line\nitem (LCOB) that was previously extracted. If the line has COB data\nassociated with it, output the date paid for each COB sequence found for\nthe line. This data is only stored at the claim level, not the line level,\nso it is assumed it applies to every line item on the EOB.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,6)\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nadj quantity can be output on a single record for the same line and group\ncode. This extracts the first, seventh, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,8) I $D(IBXDATA) S Z=0 F S Z=$O(IBXDATA(Z)) Q:'Z S IBXDATA(Z)=$$DOLLAR^IBCEFG1(IBXDATA(Z))\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nadj amts can be output on a single record for the same line and group\ncode. This extracts the second, eighth, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-CONDITION RELATED TO OTH ACC\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K:'IBXDATA IBXDATA I $D(IBXDATA) S IBXDATA=\"OA\"\n", "\nIf IBXDATA does not have a value that is greater than 0, no output. If\ndata element > 0, output as 'OA'.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,10)\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nreason codes can be output on a single record for the same line and group\ncode. This extracts the third, ninth, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,13)\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nreason codes can be output on a single record for the same line and group\ncode. This extracts the fourth, tenth, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,16)\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nreason codes can be output on a single record for the same line and group\ncode. This extracts the fifth, eleventh, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,21)\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nadj quantity can be output on a single record for the same line and group\ncode. This extracts the sixth, twelveth, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,19)\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nreason codes can be output on a single record for the same line and group\ncode. This extracts the sixth, twelveth, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,14) I $D(IBXDATA) S Z=0 F S Z=$O(IBXDATA(Z)) Q:'Z S IBXDATA(Z)=$$DOLLAR^IBCEFG1(IBXDATA(Z))\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nadj amts can be output on a single record for the same line and group\ncode. This extracts the fourth, tenth, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,12)\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nadj quantity can be output on a single record for the same line and group\ncode. This extracts the third, ninth, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,18)\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nadj quantity can be output on a single record for the same line and group\ncode. This extracts the fifth, eleventh, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,11) I $D(IBXDATA) S Z=0 F S Z=$O(IBXDATA(Z)) Q:'Z S IBXDATA(Z)=$$DOLLAR^IBCEFG1(IBXDATA(Z))\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nadj amts can be output on a single record for the same line and group\ncode. This extracts the third, ninth, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,15)\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nadj quantity can be output on a single record for the same line and group\ncode. This extracts the fourth, tenth, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-ADMISSION DATE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N A,IBZ,%DT,Y,X S IBZ=$S($$FT^IBCEF(IBXIEN)=7:IBXDATA,$$HHLTH^IBCEF1(IBXIEN,1):IBXDATA,1:\"\"),A=$S(IBZ?6N:IBZ,1:\"\") K IBXDATA S:A=\"\" Y=IBZ S X=A,%DT=\"PX\" D:A'=\"\" ^%DT S IBXSAVE(\"ADMDT\")=$S(Y>0:Y,1:\"\")\n", "\nSave off data element's value in IBXSAVE array. No output. IB*547 \nrequirement to use only Inpatient Admission Date/Time.\nIB*574 - added date for Outpatient Home health and hospice\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,17) I $D(IBXDATA) S Z=0 F S Z=$O(IBXDATA(Z)) Q:'Z S IBXDATA(Z)=$$DOLLAR^IBCEFG1(IBXDATA(Z))\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nadj amts can be output on a single record for the same line and group\ncode. This extracts the fifth, eleventh, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,9)\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nadj quantity can be output on a single record for the same line and group\ncode. This extracts the second, eighth, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,20) I $D(IBXDATA) S Z=0 F S Z=$O(IBXDATA(Z)) Q:'Z S IBXDATA(Z)=$$DOLLAR^IBCEFG1(IBXDATA(Z))\n", "\nThis data element assumes the existence of the IBXSAVE("LCOB") array that\nwas previously extracted with COB data for specific line items. Up to 6\nadj amts can be output on a single record for the same line and group\ncode. This extracts the sixth, twelveth, etc onto separate records.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-KILL IBXSAVE\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXSAVE\n", "\nCleans up the IBXSAVE array. No output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N Z,Z0 K IBXDATA I $$COBN^IBCEF(IBXIEN)>1 F Z0=\"INPT\",\"OUTPT\",\"RX\" S Z=0 F S Z=$O(IBXSAVE(Z0,Z)) K:'Z IBXSAVE(Z0) Q:'Z D CKCOBTST^IBCEU1(IBXIEN,.IBXSAVE,Z0,Z,+$G(IBRSBTST))\n", "\nThe arrays IBXSAVE("INPT"), IBXSAVE("OUTPT") and IBXSAVE("RX") are created\nwhen the line items on the bill are produced. This field takes the data\nfrom these arrays and creates a new IBXSAVE("LCOB") array with just the COB\ndata and deletes the original IBXSAVE arrays.\n\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,0)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,4,0)),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=\"\"\n", "\nIf there is no street address, don't use the rest of the address either.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "K IBXDATA S IBXDATA=$$ADMHR^IBCEU(IBXIEN,$G(IBXSAVE(\"ADMDT\")))\n", "\nExtract time from date/time retrieved from IBXSAVE array previously\nextracted. Format time in HHMM format. If data element's value is null,\ndo not output.\n
\n\n"], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,2,0)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,9,0)),U,3)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,9,0)),U,4)\n", ""], ["IB 837 TRANSMISSION", "NATIONAL,NO EDIT\n", "N-GET FROM PREVIOUS EXTRACT\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$P($G(IBXSAVE(\"PROVINF\",IBXIEN,\"C\",1,2,0)),U,4)\n", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 BOX 13\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "S IBXDATA=$J(\"\",6)_IBXDATA\n", ""], ["LEGACY HCFA-1500", "NATIONAL,NO EDIT\n", "N-HCFA 1500 BOX 12\n", "", "", "", "NO PAD REQUIRED\n", "", "", "", "N IBZ D F^IBCEF(\"N-ROI INDICATOR\",\"IBZ\") I IBZ S IBXDATA=\"MODIFIED/RESTRICTED RELEASE \"_IBXDATA\n", ""]]}