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Global: ^IBE(356.8

Package: Integrated Billing

Global: ^IBE(356.8


Information

FileMan FileNo FileMan Filename Package
356.8 CLAIMS TRACKING NON-BILLABLE REASONS Integrated Billing

Description

Directly Accessed By Routines, Total: 45

Package Total Routines
Integrated Billing 40 IB20P123    IB20P132    IB20P159    IB20P247    IB20P276    IB20P339    IB20P384    IB20P486
IB20P510    IB20P587    IBCC1    IBCONS3    IBCOPV1    IBCU81    IBJDB21    IBJDB22
IBNCPBB    IBNCPDP1    IBNCPDP4    IBNCPDPI    IBNCPDPU    IBNCPDR2    IBNCPDR4    IBPP
IBPU2    IBRSUTL    IBTOECT    IBTOSA    IBTOSUM2    IBTOUA    IBTOUR3    IBTRED0
IBTRKR31    IBY155PO    IBY399P1    IBY434PO    IBY452PO    IBYJPT    IBYP458    ^IBE(356.8
E Claims Management Engine 5 BPSBUTL    BPSECMP2    BPSOSU    BPSRPT6    BPSSCRU6    

Accessed By FileMan Db Calls, Total: 17

Package Total Routines
Integrated Billing 16 IB20P123    IB20P132    IB20P159    IB20P247    IB20P339    IB20P384    IB20P486    IB20P510
IB20P587    IBPU2    IBY155PO    IBY399P1    IBY434PO    IBY452PO    IBYJPT    IBYP458
E Claims Management Engine 1 BPSSCRCL    

Pointed To By FileMan Files, Total: 4

Package Total FileMan Files
E Claims Management Engine 2 BPS REQUESTS(#9002313.77)[7.02]    BPS CLAIMS(#9002313.02)[904]    
Integrated Billing 2 IB NCPDP EVENT LOG(#366.14)[#366.141(.307)]    CLAIMS TRACKING(#356)[.19]    

Fields, Total: 6

Field # Name Loc Type Details
.001 NUMBER NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  SEP 30, 1993
  • HELP-PROMPT:  Type a Number between 1 and 9999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the number of the reason not billable. It is used for look-up purposes only.
.01 NAME 0;1 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>30!(X?.N)!($L(X)<3)!'(X'?1P.E) X
  • HELP-PROMPT:  NAME MUST BE 3-30 CHARACTERS, NOT NUMERIC OR STARTING WITH PUNCTUATION
  • DESCRIPTION:  Enter the name of the reason that a visit is not billable. This is the name that will appear on displays and outputs. If a claims tracking entry is assigned a reaon not billable then it will be considered to not be
    billable. Users may select whether visits that have a reason not billable assigned should appear on the patients with visits and insurance reports.
  • CROSS-REFERENCE:  356.8^B
    1)= S ^IBE(356.8,"B",$E(X,1,30),DA)=""
    2)= K ^IBE(356.8,"B",$E(X,1,30),DA)
.02 ECME FLAG 0;2 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  FEB 24, 2005
  • HELP-PROMPT:  Enter 'Yes' if the record may be used as ECME Close Claim Reason.
  • DESCRIPTION:  
    This field is flagging the record to be used as ECME CLOSE CLAIM REASON. The default value is 'NO'. If the field is set to 'YES' the NON-BILLABLE REASON will appear as an option in the ECME CLOSE CLAIM SCREEN.
.03 ECME PAPER FLAG 0;3 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  FEB 24, 2005
  • HELP-PROMPT:  Enter 'YES' if the closed ECME claim may be paper-billable.
  • DESCRIPTION:  This flag is related to NON-BILLABLE REASONs that are marked with ECME FLAG to be used as ECME CLOSE CLAIM REASON. If this field 'ECME PAPER FLAG' is set to 'YES', it indicates that the NON BILLABLE REASON may be
    potentially billable "on paper". When the ECME user (OPECC) is closing the e-Pharmacy claim and enters the NON BILLABLE REASON as a CLOSE CLAIM REASON, the additional prompt will be issued to the user - should the claim be
    billed "on paper"?
.04 CODE 0;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>5!($L(X)<3) X
  • LAST EDITED:  OCT 21, 2008
  • HELP-PROMPT:  Answer must be 3-5 characters in length.
  • DESCRIPTION:  This code uniquely identifies a particular RNB by group and number. Format is Group_# where group sorts like RNBs into the following: BL-Billing, CV-Insurance Coverage, DC-Documentation, MC-Miscellaneous, MN-Medical
    Necessity, RX-Pharmacy, VA-VA Specific.
  • CROSS-REFERENCE:  356.8^C
    1)= S ^IBE(356.8,"C",$E(X,1,30),DA)=""
    2)= K ^IBE(356.8,"C",$E(X,1,30),DA)
.05 INACTIVE 0;5 SET
  • '0' FOR ACTIVE;
  • '1' FOR INACTIVE;

  • LAST EDITED:  MAR 23, 2009
  • HELP-PROMPT:  Enter INACTIVE to Inactivate this Reason Not Billable.
  • DESCRIPTION:  
    This indicates if the RNB is inactive and should no longer be used.

Found Entries, Total: 117

NAME: 72 HOUR RULE    NAME: 90 DAY RX FILL NOT COVERED    NAME: AGENT ORANGE    NAME: ALL BILLABLE CPT CODES BILLED    NAME: ANCILLARY PROVIDER AT CBOC    NAME: APPT CANCELLED/PT NOT SEEN    NAME: BENEFITS MAXED    NAME: BILL PURGED    
NAME: BILLED INSTITUTIONAL ONLY    NAME: BILLED PROFESSIONAL ONLY    NAME: C&P EXAM/REGISTRY EXAM    NAME: CAMP LEJEUNE TREATMENT    NAME: CHAMPVA INPATIENT/DISCHARGE    NAME: CHAMPVA PT SEEN AS VETERAN    NAME: CHARGES SPLIT    NAME: COMBAT VETERAN    
NAME: COMBINED CHARGES    NAME: CONCURRENT CARE    NAME: COVERAGE CANCELED    NAME: COVERED BY MEDICARE AT 100%    NAME: CREDENTIALING ISSUE    NAME: CUSTODIAL/RESIDENTIAL CARE    NAME: DATE OF BIRTH MISMATCH    NAME: DRUG NOT BILLABLE    
NAME: DUPLICATE ENCOUNTER    NAME: EMPLOYEE HEALTH    NAME: ENCOUNTER DURING INPT STAY    NAME: EST PT/NO EXAM/NO COMPLEXITY    NAME: EST PT/NO HX/NO COMPLEXITY    NAME: EST PT/NO HX/NO EXAM    NAME: FILING TIMEFRAME NOT MET    NAME: GLOBAL SURGERY    
NAME: HDHP PLAN NOT BILLED    NAME: HEAD/NECK CANCER    NAME: HMO POLICY    NAME: INPATIENT RX AUTO-REVERSAL    NAME: INSUFFICIENT DOCUMENTATION    NAME: INVALID MULTIPLES PER DAY SUPP    NAME: INVALID NDC FROM CMOP    NAME: INVALID PRESCRIPTION ENTRY    
NAME: IONIZING RADIATION    NAME: LOD NOT OBTAINED    NAME: MED NEC-CPT NOT COVERED    NAME: MED NEC-DX NOT COVERED    NAME: MED NEC-LCD EDIT    NAME: MED NEC-OTHER    NAME: MEDICARE EXCLUDED SERVICE    NAME: MEDICARE REPLACEMENT POLICY    
NAME: MILITARY SEXUAL TRAUMA    NAME: MRA REC'D. NO SEC RESP EXISTS    NAME: MRA REC'D. SEC NOT BILLED    NAME: NEEDS SC DETERMINATION    NAME: NEW PT/NO COMPLEXITY    NAME: NEW PT/NO EXAM    NAME: NEW PT/NO HX    NAME: NO CHIEF COMPLAINT    
NAME: NO DENTAL COVERAGE    NAME: NO DIAGNOSIS/SYMPTOMS IN NOTE    NAME: NO DOCUMENTATION    NAME: NO INPATIENT COVERAGE    NAME: NO INPT PROF FEES BILLED    NAME: NO LTC COVERAGE    NAME: NO MENTAL HEALTH COVERAGE    NAME: NO OUTPATIENT COVERAGE    
NAME: NO PHARMACY COVERAGE    NAME: NO PHYSICIAN ORDER    NAME: NO PLAN OF CARE    NAME: NO PROSTHETIC COVERAGE    NAME: NO TX PROVIDED/ADVICE ONLY    NAME: NO VISION COVERAGE    NAME: NON COVERED DRUG PER PLAN    NAME: NON-BILLABLE APPOINTMENT TYPE    
NAME: NON-BILLABLE CLINIC    NAME: NON-BILLABLE DME/PROSTHETIC    NAME: NON-BILLABLE PROCEDURE    NAME: NON-BILLABLE PROVIDER (OTHER)    NAME: NON-BILLABLE PROVIDER (RESID.)    NAME: NON-BILLABLE STOP CODE    NAME: NON-COVERED DIAGNOSIS    NAME: NON-COVERED PROVIDER    
NAME: NON-COVERED ROUTINE CARE    NAME: NOT A CONTRACTED PROVIDER    NAME: NOT INSURED    NAME: NOT RELATED TO WC/TORT/NF    NAME: NOTE NOT WRITTEN TIMELY    NAME: NPI/TAXONOMY/PPN ISSUES    NAME: OBSERVATION-OP BILLED    NAME: OTHER    
NAME: OTHER COMPLIANCE    NAME: OUT OF NETWORK (PPO)    NAME: PENDING CODE SET UPDATE    NAME: PENDING RC CHARGE UPDATE    NAME: PRE-CERT NOT OBTAINED    NAME: PRESCRIPTION DELETED    NAME: PRESCRIPTION NOT RELEASED    NAME: PROJECT 112/SHAD    
NAME: REFILL ON VISIT DATE    NAME: REFILL TOO SOON    NAME: REFUSES TO SIGN RELEASE (ROI)    NAME: REPETITIVE SERVICES    NAME: RESEARCH VISIT    NAME: RESIDENT SUPERVISION NOT MET    NAME: ROI NOT OBTAINED    NAME: RX DISCOUNT CARD    
NAME: RX DUR REJECT    NAME: RX MEDICARE PART D    NAME: RX PRIOR AUTH NOT OBTAINED    NAME: SC TREATMENT    NAME: SEEN BY PROVIDER ON SAME DAY    NAME: SERVICE NOT COVERED    NAME: SOUTHWEST ASIA    NAME: STUDENT NOTE ONLY    
NAME: TELEPHONE ENCOUNTER    NAME: TRICARE INPATIENT/DISCHARGE    NAME: TRICARE PT SEEN AS VETERAN    NAME: UNBUNDLED SERVICE    NAME: UNSIGNED DOCUMENT    

ICR, Total: 1

ICR LINK Subscribing Package(s) Fields Referenced Description
ICR #4710
  • E Claims Management Engine
  • NAME (.01).
    Access: Direct Global Read & w/Fileman

    ECME PAPER FLAG (.03).
    Access: Direct Global Read & w/Fileman

    ECME FLAG (.02).
    Access: Direct Global Read & w/Fileman

    direct read

    Global Variables Directly Accessed

    Name Line Occurrences  (* Changed,  ! Killed)
    ^IBE(356.8 - [#356.8] .01(XREF 1S), .01(XREF 1K), .04(XREF 1S), .04(XREF 1K)

    Naked Globals

    Name Field # of Occurrence
    ^(0 ID.04+1

    Local Variables

    Legend:

    >> Not killed explicitly
    * Changed
    ! Killed
    ~ Newed

    Name Field # of Occurrence
    >> DA .01(XREF 1S), .01(XREF 1K), .04(XREF 1S), .04(XREF 1K)
    >> DIC ID.05+1
    U ID.04+1
    X .001+1!, .01+1!, .01(XREF 1S), .01(XREF 1K), .04+1!, .04(XREF 1S), .04(XREF 1K)
    Info |  Desc |  Directly Accessed By Routines |  Accessed By FileMan Db Calls |  Pointed To By FileMan Files |  Fields |  ICR |  Found Entries |  Global Variables Directly Accessed |  Naked Globals |  Local Variables  | All