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Global: ^IBT(356.1

Package: Integrated Billing

Global: ^IBT(356.1


Information

FileMan FileNo FileMan Filename Package
356.1 HOSPITAL REVIEW Integrated Billing

Description

Directly Accessed By Routines, Total: 29

Package Total Routines
Integrated Billing 20 IBTOBI3    IBTOTR    IBTOUR2    IBTOUR5    IBTRE1    IBTRED01    IBTRKR    IBTRPR01
IBTRV    IBTRV1    IBTRV3    IBTRV31    IBTRVD    IBTRVD0    IBTRVD1    IBTUTL2
IBYZ20R    REASON FOR NON-ACUTE ADMISSION    REASON FOR NON-ACUTE DAYS    ^IBT(356.1    
Utilization Management Rollup 7 IBQL356    IBQLCHK    IBQLLD    IBQLLD2    IBQLPL1    IBQLPL3    IBQYPT    

Accessed By FileMan Db Calls, Total: 6

Package Total Routines
Integrated Billing 5 IBTRE1    IBTRV1    IBTRV31    IBTRVD1    IBTUTL2    
Utilization Management Rollup 1 IBQLPOST    

Pointed To By FileMan Files, Total: 2

Package Total FileMan Files
Integrated Billing 2 HOSPITAL REVIEW(#356.1)[.24]    INSURANCE REVIEW(#356.2)[.03]    

Pointer To FileMan Files, Total: 7

Package Total FileMan Files
Integrated Billing 5 CLAIMS TRACKING REVIEW TYPE(#356.11)[.22]    CLAIMS TRACKING SI/IS CATEGORIES(#356.3)[.04.05.08.09.12.13]    CLAIMS TRACKING NON-ACUTE CLASSIFICATIONS(#356.4)[#356.112(.01)#356.113(.01)]    CLAIMS TRACKING(#356)[.02]    HOSPITAL REVIEW(#356.1)[.24]    
Kernel 1 NEW PERSON(#200)[1.021.041.06]
Registration 1 FACILITY TREATING SPECIALTY(#45.7)[.07]    

Fields, Total: 34

Field # Name Loc Type Details
.01 REVIEW DATE 0;1 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUL 14, 1993
  • DESCRIPTION:  This is the date of the Review. Normally, reviews are done for UR purposes on days 3, 6, 9, 14, 21, 28 and every 7 days thereafter. This field contains the date of these reviews.
    There are 2 related fields,  DAY FOR REVIEW, and DATE ENTERED.  The field DAY FOR REVIEW will generally be computed for you based on the REVIEW DATE.  The DATE ENTERED is the date the review was entered into the computer
    and is automatically generated for you.
    Normally the REVIEW DATEs are done in order. The pre-cert or urgent admission review is done before the continued stay reviews which in turn are normally done before the Discharge review.  The order of reviews shown on the
    main review screen is based on REVIEW DATE.
  • CROSS-REFERENCE:  356.1^B
    1)= S ^IBT(356.1,"B",$E(X,1,30),DA)=""
    2)= K ^IBT(356.1,"B",$E(X,1,30),DA)
  • CROSS-REFERENCE:  356.1^ATIDT^MUMPS
    1)= S:$P(^IBT(356.1,DA,0),U,2) ^IBT(356.1,"ATIDT",$P(^(0),U,2),-X,DA)=""
    2)= K ^IBT(356.1,"ATIDT",+$P(^IBT(356.1,DA,0),U,2),-X,DA)
    Cross reference in inverse date order of all reviews for a tracking entry.
.02 TRACKING ID 0;2 POINTER TO CLAIMS TRACKING FILE (#356) CLAIMS TRACKING(#356)

  • LAST EDITED:  SEP 04, 1993
  • DESCRIPTION:  This is the Claims Tracking entry that is being reviewed. Generally only inpatient admissions will have reviews performed.
  • CROSS-REFERENCE:  356.1^C
    1)= S ^IBT(356.1,"C",$E(X,1,30),DA)=""
    2)= K ^IBT(356.1,"C",$E(X,1,30),DA)
  • CROSS-REFERENCE:  356.1^ATIDT1^MUMPS
    1)= S:+^IBT(356.1,DA,0) ^IBT(356.1,"ATIDT",X,-$P(^(0),U),DA)=""
    2)= K ^IBT(356.1,"ATIDT",X,-$P(^IBT(356.1,DA,0),U),DA)
    Cross reference in inverse date order of all reviews for a tracking  entry.
  • CROSS-REFERENCE:  356.1^ATRTP1^MUMPS
    1)= S:$P(^IBT(356.1,DA,0),U,22) ^IBT(356.1,"ATRTP",X,+$P($G(^IBE(356.11,+$P(^(0),U,22),0)),U,2),DA)=""
    2)= K ^IBT(356.1,"ATRTP",X,+$P($G(^IBE(356.11,+$P(^IBT(356.1,DA,0),U,22),0)),U,2),DA)
    Cross reference of all reviews for a tracking entry by type of review code.
.03 DAY FOR REVIEW 0;3 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  JUL 14, 1993
  • HELP-PROMPT:  Enter the numeric day of this review, ie, 3, 6, 9, 14, 21, 28, etc. Type a Number between 0 and 99999, 0 Decimal Digits
  • DESCRIPTION:  This is the number of the day of a continued stay review. Continued stay reviews for UR purposes are generally done on days 3, 6, 9, 14, 21, 28, and every 7 days thereafter. This field is normally computed from the
    Review date field.  However, it may be changed for reviews that are not solely for UR purposes.
    Pre-certification reviews, Urgent Admission reviews, and Discharge reviews will not have any data in this field.
.04 SEVERITY OF ILLNESS 0;4 POINTER TO CLAIMS TRACKING SI/IS CATEGORIES FILE (#356.3) CLAIMS TRACKING SI/IS CATEGORIES(#356.3)

  • LAST EDITED:  MAR 14, 1996
  • DESCRIPTION:  
    Enter the Severity of Illness (SI) category that best describes the criteria met for continued stay days of care.  Select the PRIMARY category for this review.
.05 INTENSITY OF SERVICE 0;5 POINTER TO CLAIMS TRACKING SI/IS CATEGORIES FILE (#356.3) CLAIMS TRACKING SI/IS CATEGORIES(#356.3)

  • LAST EDITED:  JUL 19, 1993
  • DESCRIPTION:  
    Enter the Intensity of Service (IS) category that best describes the criteria met for continued stay days of care.  Select the PRIMARY category for this review.
.06 CRITERIA MET IN 24 HOURS 0;6 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • DESCRIPTION:  For Pre-certification Reviews and Urgent Admission reviews enter if the patient met IS or SI criteria for acute admissions within 24 hours of admission. If the criteria was not met, then selection of a REASON FOR
    NON-ACUTE ADMISSIONS will be required.
.07 SPECIALTY FOR REVIEW 0;7 POINTER TO FACILITY TREATING SPECIALTY FILE (#45.7) FACILITY TREATING SPECIALTY(#45.7)

  • LAST EDITED:  FEB 16, 1994
  • DESCRIPTION:  
    Enter the specialty that is treating the patient for this review.  Normally this will automatically be retrieved from the admission/transfer records and you will only need to confirm.
  • CROSS-REFERENCE:  356.1^ASPC
    1)= S ^IBT(356.1,"ASPC",$E(X,1,30),DA)=""
    2)= K ^IBT(356.1,"ASPC",$E(X,1,30),DA)
.08 SPECIALIZED UNIT SI 0;8 POINTER TO CLAIMS TRACKING SI/IS CATEGORIES FILE (#356.3) CLAIMS TRACKING SI/IS CATEGORIES(#356.3)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),U,2)=1" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  JUL 19, 1993
  • DESCRIPTION:  Enter the Severity of Illness (SI) category that best describes the criteria met for continued stay days of care. Select the PRIMARY category for this review.
    For patients in specialized units the SI categories are different than for non-specialized units.  The definition of specialized units for interqual is different than what we normally consider intensive care units.
  • SCREEN:  S DIC("S")="I $P(^(0),U,2)=1"
  • EXPLANATION:  Only categories for special units may be selected!
.09 SPECIALIZED UNIT IS 0;9 POINTER TO CLAIMS TRACKING SI/IS CATEGORIES FILE (#356.3) CLAIMS TRACKING SI/IS CATEGORIES(#356.3)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),U,2)=1" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  JUL 19, 1993
  • DESCRIPTION:  Enter the Intensity of Service (IS) category that best describes the criteria met for continued stay days of care. Select the PRIMARY category for this review.
    For patient in specialized units the IS categories are different than for non-specialized units.  The definition of specialized units for interqual is different than what we normally consider intensive care units.
  • SCREEN:  S DIC("S")="I $P(^(0),U,2)=1"
  • EXPLANATION:  Only categories for special units may be selected!
.1 PROVIDER INTERVIEWED? 0;10 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  JUN 10, 1993
  • DESCRIPTION:  
    For Pre-certification reviews and Urgent Admission reviews enter whether or not UR interviewed the provider regarding the appropriateness of the admission.
.11 ADMISSION DECISION INFLUENCED 0;11 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  JUN 10, 1993
  • DESCRIPTION:  
    If the provider was interviewed about the appropriateness of admission then answer whether or not the decision to admit the patient was influenced.
.12 D/C SCREENS MET 0;12 POINTER TO CLAIMS TRACKING SI/IS CATEGORIES FILE (#356.3) CLAIMS TRACKING SI/IS CATEGORIES(#356.3)

  • LAST EDITED:  JUL 19, 1993
  • DESCRIPTION:  
    Enter the Intensity of Service category whose discharge screens were met.
.13 SPECIAL CARE D/C SCREENS MET 0;13 POINTER TO CLAIMS TRACKING SI/IS CATEGORIES FILE (#356.3) CLAIMS TRACKING SI/IS CATEGORIES(#356.3)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),U,2)=1" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  JUL 19, 1993
  • DESCRIPTION:  
    Enter the Intesity of Service Category whose discharge screens were met.
  • SCREEN:  S DIC("S")="I $P(^(0),U,2)=1"
  • EXPLANATION:  Only categories for specialized units may be selected!
.14 SI/IS APPLY ALL DAYS 0;14 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  JUN 10, 1993
  • DESCRIPTION:  Answer whether or not the Severity of Illness (SI) or Intensity of Service (IS) criteria apply to all days. If not, then the number of non-acute days and the reason for non-acute days should be answered.
    The dates of non-acute care should be entered in the comments field.
.19 ACTIVE 0;19 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  JUN 10, 1993
  • HELP-PROMPT:  Enter whether this Review is ACTIVE or not. Answering "NO" has a similar effect to deleting the entry, it will no longer appear on reports or input screens.
  • DESCRIPTION:  Enter if this review is active or not. If a review is not active it will not be used or displayed on input screens or reports.
    Inactivating an entry has the same effect as deleting the entry, with the added benefit of leaving the data for later review if necessary.
.2 NEXT REVIEW DATE 0;20 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUL 22, 1993
  • DESCRIPTION:  This is the date that this review should be reviewed next. If the review status is entered then this field will contain the date it was entered. If the review status is complete then the data in this field is
    automatically deleted.
    This field is used to create your pending work lists.  Enter the date that you want to be reminded to follow-up on this review.
  • NOTES:  TRIGGERED by the REVIEW STATUS field of the HOSPITAL REVIEW File
  • CROSS-REFERENCE:  356.1^APEND
    1)= S ^IBT(356.1,"APEND",$E(X,1,30),DA)=""
    2)= K ^IBT(356.1,"APEND",$E(X,1,30),DA)
    Cross reference of all non-completed reviews so it can be used as a tickler file.
.21 REVIEW STATUS 0;21 SET
  • '0' FOR INACTIVE;
  • '1' FOR ENTERED;
  • '2' FOR PENDING;
  • '10' FOR COMPLETE;

  • LAST EDITED:  JUL 28, 2004
  • HELP-PROMPT:  Enter the status of this review. Reviews that are not completed will continue to appear on your pending work lists.
  • DESCRIPTION:  This is the status of this review. Reviews that are entered or pending should contain a next review date. Once a review is completed, the next review date is automatically deleted. If a review status is changed from
    complete to any other status then the next review date is automatically set to today, but may be edited.
  • CROSS-REFERENCE:  356.1^AC
    1)= S ^IBT(356.1,"AC",$E(X,1,30),DA)=""
    2)= K ^IBT(356.1,"AC",$E(X,1,30),DA)
  • CROSS-REFERENCE:  ^^TRIGGER^356.1^1.05
    1)= X ^DD(356.1,.21,1,2,1.3) I X S X=DIV S Y(1)=$S($D(^IBT(356.1,D0,1)):^(1),1:"") S X=$P(Y(1),U,5),X=X S DIU=X K Y S X=DIV N %I,%H,% D NOW^%DTC S X=% X ^DD(356.1,.21,1,2,1.4)
    1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(3)=$S($D(^IBT(356.1,D0,1)):^(1),1:"") S X=Y(0),X=X S X=X=10,Y(1)=$G(X),Y(2)=$G(X) S X=$P(Y(3),U,5)="",Y=X,X=Y(1),X=X&Y
    1.4)= S DIH=$G(^IBT(356.1,DIV(0),1)),DIV=X S $P(^(1),U,5)=DIV,DIH=356.1,DIG=1.05 D ^DICR
    2)= Q
    CREATE CONDITION)= ((INTERNAL(#.21)=10)&((#1.05)=""))
    CREATE VALUE)= NOW
    DELETE VALUE)= NO EFFECT
    FIELD)= #1.05
    Trigger date completed when status changes to complete
  • CROSS-REFERENCE:  ^^TRIGGER^356.1^1.06
    1)= X ^DD(356.1,.21,1,3,1.3) I X S X=DIV S Y(1)=$S($D(^IBT(356.1,D0,1)):^(1),1:"") S X=$P(Y(1),U,6),X=X S DIU=X K Y S X=DIV S X=DUZ S DIH=$G(^IBT(356.1,DIV(0),1)),DIV=X S $P(^(1),U,6)=DIV,DIH=356.1,DIG=1.06 D ^DICR
    1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(3)=$S($D(^IBT(356.1,D0,1)):^(1),1:"") S X=Y(0),X=X S X=X=10,Y(1)=$G(X),Y(2)=$G(X) S X=$P($G(^VA(200,+$P(Y(3),U,6),0)),U)="",Y=X,X=Y(1),X=X&Y
    2)= Q
    CREATE CONDITION)= ((INTERNAL(#.21)=10)&((#1.06)=""))
    CREATE VALUE)= S X=DUZ
    DELETE VALUE)= NO EFFECT
    FIELD)= #1.06
    Trigger completed by when status changes to complete
  • CROSS-REFERENCE:  ^^TRIGGER^356.1^.2
    1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X I $P(^IBT(356.1,DA,0),U,21)=10 I X S X=DIV S Y(1)=$S($D(^IBT(356.1,D0,0)):^(0),1:"") S X=$P(Y(1),U,20),X=X S DIU=X K Y S X="" X ^DD(356.1,.21,1,4,1.4)
    1.4)= S DIH=$S($D(^IBT(356.1,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,20)=DIV,DIH=356.1,DIG=.2 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
    2)= Q
    CREATE CONDITION)= I $P(^IBT(356.1,DA,0),U,21)=10
    CREATE VALUE)= @
    DELETE VALUE)= NO EFFECT
    FIELD)= #.2
    Deletes the Next Review Date whenever the status is set to completed.
.22 TYPE OF REVIEW 0;22 POINTER TO CLAIMS TRACKING REVIEW TYPE FILE (#356.11)
************************REQUIRED FIELD************************
CLAIMS TRACKING REVIEW TYPE(#356.11)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),U,2)=15!($P(^(0),U,2)=30)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  SEP 01, 1993
  • DESCRIPTION:  
    Enter whether or not this is an admission review or a continued stay review.
  • SCREEN:  S DIC("S")="I $P(^(0),U,2)=15!($P(^(0),U,2)=30)"
  • EXPLANATION:  Only admission review types may be selected!
  • CROSS-REFERENCE:  356.1^AD
    1)= S ^IBT(356.1,"AD",$E(X,1,30),DA)=""
    2)= K ^IBT(356.1,"AD",$E(X,1,30),DA)
  • CROSS-REFERENCE:  356.1^ATRTP^MUMPS
    1)= S:$P(^IBT(356.1,DA,0),U,2) ^IBT(356.1,"ATRTP",$P(^(0),U,2),+$P($G(^IBE(356.11,X,0)),U,2),DA)=""
    2)= K ^IBT(356.1,"ATRTP",+$P(^IBT(356.1,DA,0),U,2),+$P($G(^IBE(356.11,X,0)),U,2),DA)
    Cross reference of all reviews for a tracking entry by type of review code.
.23 REVIEW METHODOLOGY 0;23 SET
  • '1' FOR INTERQUAL;
  • '2' FOR MILLIMAN & ROBERTSON;
  • '999' FOR OTHER;

  • LAST EDITED:  JAN 27, 1994
  • DESCRIPTION:  Enter the Review Methodology being used for this review. Generally the INTERQUAL method is being used as the methodology for UR required review. Insurance carriers may require other review methodologies.
    Currently, if the type of review methodology is INTERQUAL then the categories for severity of illness and intensity of service will be prompted.  This data will be used for national roll-up purposes for UR.
.24 REVIEW COPIED FROM 0;24 POINTER TO HOSPITAL REVIEW FILE (#356.1) HOSPITAL REVIEW(#356.1)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(O),U,2)=$P(^IBT(356.1,DA,0),U,2)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  SEP 04, 1993
  • DESCRIPTION:  
    If this review was automatically copied during the editing of a review then this is the review it was copied from.
  • SCREEN:  S DIC("S")="I $P(^(O),U,2)=$P(^IBT(356.1,DA,0),U,2)"
  • EXPLANATION:  Must be for the same claims tracking id
1.01 DATE ENTERED 1;1 DATE

  • INPUT TRANSFORM:  S %DT="ETX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUL 14, 1993
  • DESCRIPTION:  
    This is the date this review was entered into the computer.  It is generated when the review is entered and not editable by the user.
1.02 ENTERED BY 1;2 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  JUN 10, 1993
  • DESCRIPTION:  This is the user who was signed on to the computer system when this review was created. If this review was created automatically by the computer from an admission or outpatient visit, then this might be a user for MAS,
    IRM or other service.
1.03 LAST EDIT ON 1;3 DATE

  • INPUT TRANSFORM:  S %DT="ETX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUL 14, 1993
  • DESCRIPTION:  
    This is the date that this review was last edited by a user using the input options.  Every time any field other than the UR COMMENT field is edited this field is updated to the current date.
1.04 LAST EDITED BY 1;4 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  JUN 10, 1993
  • DESCRIPTION:  This is the signed on user who last edited this entry using the input screens. Every time a review is edited with the input screens, this field is updated. (If only the UR COMMENTS field is updated then this field is not
    changed.)
1.05 DATE COMPLETED 1;5 DATE

  • INPUT TRANSFORM:  S %DT="ETX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUL 14, 1993
  • DESCRIPTION:  
    This is the date that this review was completed.  It is triggered by the REVIEW STATUS field every time the review is completed.
  • NOTES:  TRIGGERED by the REVIEW STATUS field of the HOSPITAL REVIEW File
1.06 COMPLETED BY 1;6 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  JUN 10, 1993
  • DESCRIPTION:  
    This is the user who completed this review.  It is triggered by the REVIEW STATUS field when the status chages to complete.
  • NOTES:  TRIGGERED by the REVIEW STATUS field of the HOSPITAL REVIEW File
1.13 ADD NEXT REVIEW 1;13 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  AUG 30, 1993
  • DESCRIPTION:  If you wish to add the next day reviewed at this time answer YEand you may procede directly into the next review. Answer NO and you will be returned to the Hospital Review Screen. You may add another day for review at
    any time.
1.14 NEXT REVIEW EXACTLY THE SAME 1;14 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  AUG 30, 1993
  • DESCRIPTION:  If the Next Day for Review is exactly the same as the day you just finished entering answer YES and the computer will copy this days review into the next days review so you don't have to do all the data entry. Answer No
    and you will be asked each prompt as appropriate.
    A review that was copied may be edited at any time if necessary.
1.15 ADDITIONAL REVIEWS REQUIRED 1;15 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  AUG 30, 1993
  • DESCRIPTION:  If this visit does not require any additional reviews then answer NO and the computer will not create any more reviews automatically unless there is a change is service. Answer YES or leave blank if additional reviews are
    required.
1.17 ACUTE CARE DISCHARGE DATE 1;17 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  DEC 04, 1995
  • DESCRIPTION:  
    If the patient no longer requires acute care, then this is the date that the patient left an acute status.
  • CROSS-REFERENCE:  ^^TRIGGER^356^1.09
    1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 X ^DD(356.1,1.17,1,1,89.2) S X=$P(Y(101),U,9) S D0=I(0,0) S DIU=X K Y S X=DIV S X=DIV X ^DD(356.1,1.17,1,1,1.4)
    1.4)= S DIH=$S($D(^IBT(356,DIV(0),1)):^(1),1:""),DIV=X I $D(^(0)) S $P(^(1),U,9)=DIV,DIH=356,DIG=1.09 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
    2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 X ^DD(356.1,1.17,1,1,89.2) S X=$P(Y(101),U,9) S D0=I(0,0) S DIU=X K Y X ^DD(356.1,1.17,1,1,2.1) X ^DD(356.1,1.17,1,1,2.4)
    2.1)= S X=DIV S Y(1)=$S($D(^IBT(356.1,D0,1)):^(1),1:"") S X=$P(Y(1),U,17)
    2.4)= S DIH=$S($D(^IBT(356,DIV(0),1)):^(1),1:""),DIV=X I $D(^(0)) S $P(^(1),U,9)=DIV,DIH=356,DIG=1.09 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
    89.2)= S I(0,0)=$S($D(D0):D0,1:""),Y(1)=$S($D(^IBT(356.1,D0,0)):^(0),1:""),D0=$P(Y(1),U,2) S:'$D(^IBT(356,+D0,0)) D0=-1 S DIV(0)=D0 S Y(101)=$S($D(^IBT(356,D0,1)):^(1),1:"")
    CREATE VALUE)= ACUTE CARE DISCHARGE DATE
    DELETE VALUE)= ACUTE CARE DISCHARGE DATE
    FIELD)= TRACKING ID:ACUTE CARE DISCHARGE DATE
    For use in the UTILIZATION MANAGEMENT ROLLUP package, this trigger cross-reference fills the ACUTE CARE DISCHARGE DATE Field (#1.09) of the CLAIMS TRACKING File (#356) with data from the ACUTE CARE DISCHARGE DATE Field
    (#1.17) of the HOSPITAL REVIEW File (#356.1).
11 UTILIZATION REVIEW COMMENTS 11;0 WORD-PROCESSING #356.111

  • DESCRIPTION:  
    This field is used to store comments about the UR Review.  It can be used to document reasons for non-acute admissions, non-acute days, or other items that require a greater explanation.
12 REASON FOR NON-ACUTE ADMISSION 12;0 POINTER Multiple #356.112 356.112

  • DESCRIPTION:  If this patient did not meet criteria for an acute admission within 24 hours enter the reasons that best describe why the admission didn't meet criteria. If no reason can be determined enter 8.02 other.
    This reason will be transmitted to the national database when it becomes available.
  • SCREEN:  S DIC("S")="I $P(^(0),U,5)=1"
  • EXPLANATION:  Only reasons for non-acute admissions may be selected!
13 REASON FOR NON-ACUTE DAYS 13;0 POINTER Multiple #356.113 356.113

  • DESCRIPTION:  
    If this patient had non-acute days of care during this review, enter reasons that best describe the reason for the non-acute days.  If no reason can be deteremined select the reason 8.01, Other.
  • SCREEN:  S DIC("S")="I $P(^(0),U,5)=2"
  • EXPLANATION:  Only reasons for non-acute days of care may be selected!
21 PATIENT COMPUTED

  • MUMPS CODE:  X ^DD(356.1,21,9.2) S Y(356.1,21,101)=$S($D(^IBT(356,D0,0)):^(0),1:"") S X=$S('$D(^DPT(+$P(Y(356.1,21,101),U,2),0)):"",1:$P(^(0),U,1)) S D0=Y(356.1,21,80)
    9.2 = S Y(356.1,21,80)=$S($D(D0):D0,1:""),Y(356.1,21,1)=$S($D(^IBT(356.1,D0,0)):^(0),1:""),D0=$P(Y(356.1,21,1),U,2) S:'$D(^IBT(356,+D0,0)) D0=-1
  • ALGORITHM:  TRACKING ID:PATIENT
  • DESCRIPTION:  
    This is the patient whose tracking entry this review is for.

ICR, Total: 2

ICR LINK Subscribing Package(s) Fields Referenced Description
ICR #1351
  • UTILIZATION MANAGEMENT ROLLUP
  • DAY OF REVIEW (.03).
    Access: Direct Global Read & w/Fileman

    SEVERITY OF ILLNESS (.04).
    Access: Direct Global Read & w/Fileman

    INTENSITY OF SERVICE (.05).
    Access: Direct Global Read & w/Fileman

    CRITERIA MET IN 24 HOURS? (.06).
    Access: Direct Global Read & w/Fileman

    SPECIALTY FOR REVIEWS (.07).
    Access: Direct Global Read & w/Fileman

    SPECIALIZED UNIT SI (.08).
    Access: Direct Global Read & w/Fileman

    SPECIALIZED UNIT IS (.09).
    Access: Direct Global Read & w/Fileman

    PROVIDER INTERVIEWED? (.1).
    Access: Direct Global Read & w/Fileman

    ADMISSION DECISION INFLUENCED (.11).
    Access: Direct Global Read & w/Fileman

    D/C SCREEN MET (.12).
    Access: Direct Global Read & w/Fileman

    ACTIVE (.19).
    Access: Direct Global Read & w/Fileman

    REVIEW STATUS (.21).
    Access: Direct Global Read & w/Fileman

    REASONS FOR NON-ACUTE ADMISSION (356.112,.01).
    Access: Direct Global Read & w/Fileman

    REASONS FOR NON-ACUTE DAYS (356.113,.01).
    Access: Direct Global Read & w/Fileman

    The 'C' x-ref is used to retrieve information on thedays of review, given it's parent Claims Tracking number.
    ICR #5314
  • INSURANCE CAPTURE BUFFER
  • External References

    Name Field # of Occurrence
    ^%DT .01+1, .2+1, 1.01+1, 1.03+1, 1.05+1, 1.17+1
    NOW^%DTC .21(XREF 2S)
    ^DIC .08+1, .09+1, .13+1, .22+1, .24+1
    ^DICR .21(XREF 2n1.4), .21(XREF 3S), .21(XREF 4n1.4), 1.17(XREF 1n1.4), 1.17(XREF 1n2.4)
    Y^DIQ ID.02+1, ID.22+1

    Global Variables Directly Accessed

    Name Line Occurrences  (* Changed,  ! Killed)
    ^DD( .21(XREF 4n1.4), 1.17(XREF 1n1.4), 1.17(XREF 1n2.4)
    ^DD(356 ID.02+1
    ^DD(356.1 .21(XREF 2S), .21(XREF 3S), .21(XREF 4S), 1.17(XREF 1S), 1.17(XREF 1K), 21+1
    ^DD(356.11 ID.22+1
    ^DPT - [#2] 21+1
    ^IBE(356.11 - [#356.11] ID.22+1, .02(XREF 3S), .02(XREF 3K), .22(XREF 2S), .22(XREF 2K)
    ^IBT(356 - [#356] ID.02+1, 1.17(XREF 1n1.4), 1.17(XREF 1n2.4), 1.17(XREF 1n89.2), 21+1, 21OF9.2+1
    ^IBT(356.1 - [#356.1] .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2K), .02(XREF 1S), .02(XREF 1K), .02(XREF 2S), .02(XREF 2K), .02(XREF 3S), .02(XREF 3K)
    .07(XREF 1S), .07(XREF 1K), .2(XREF 1S), .2(XREF 1K), .21(XREF 1S), .21(XREF 1K), .21(XREF 2S), .21(XREF 2n1.3), .21(XREF 2n1.4), .21(XREF 3S)
    .21(XREF 3n1.3), .21(XREF 4S), .21(XREF 4n1.4), .22(XREF 1S), .22(XREF 1K), .22(XREF 2S), .22(XREF 2K), 1.17(XREF 1n2.1), 1.17(XREF 1n89.2), 21OF9.2+1
    ^VA(200 - [#200] .21(XREF 3n1.3)

    Naked Globals

    Name Field # of Occurrence
    ^(0 ID.02+1, ID.22+1, .01(XREF 2S), .02(XREF 2S), .02(XREF 3S), .21(XREF 4S), .21(XREF 4n1.4), .22(XREF 2S), 1.17(XREF 1n1.4), 1.17(XREF 1n2.4)
    1.17(XREF 1n89.2), 21+1, 21OF9.2+1
    ^(1 .21(XREF 2S), .21(XREF 2n1.3), .21(XREF 2n1.4), .21(XREF 3S), .21(XREF 3n1.3), 1.17(XREF 1n1.4), 1.17(XREF 1n2.1), 1.17(XREF 1n2.4), 1.17(XREF 1n89.2)

    Local Variables

    Legend:

    >> Not killed explicitly
    * Changed
    ! Killed
    ~ Newed

    Name Field # of Occurrence
    % .21(XREF 2S)
    >> %DT .01+1*, .2+1*, 1.01+1*, 1.03+1*, 1.05+1*, 1.17+1*
    %H .21(XREF 2S)
    %I ID.02+1*!, ID.22+1*!, .21(XREF 2S)
    >> C ID.02+1*, ID.22+1*
    >> D0 .21(XREF 2S), .21(XREF 2n1.3), .21(XREF 3S), .21(XREF 3n1.3), .21(XREF 4S), 1.17(XREF 1S), 1.17(XREF 1K), 1.17(XREF 1n2.1), 1.17(XREF 1n89.2), 21+1*
    , 21OF9.2+1*
    >> DA .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2K), .02(XREF 1S), .02(XREF 1K), .02(XREF 2S), .02(XREF 2K), .02(XREF 3S), .02(XREF 3K)
    .07(XREF 1S), .07(XREF 1K), .2(XREF 1S), .2(XREF 1K), .21(XREF 1S), .21(XREF 1K), .21(XREF 2n1.3), .21(XREF 3n1.3), .21(XREF 4S), .22(XREF 1S)
    .22(XREF 1K), .22(XREF 2S), .22(XREF 2K), 1.17(XREF 1S), 1.17(XREF 1K)
    DIC ID.02+1, ID.21+1, ID.22+1, .08+1!*, .09+1!*, .13+1!*, .22+1!*, .24+1!*
    DIC("S" .08+1*, .08SCR+1*, .09+1*, .09SCR+1*, .13+1*, .13SCR+1*, .22+1*, .22SCR+1*, .24+1*, .24SCR+1*
    >> DIE .08+1, .09+1, .13+1, .22+1, .24+1
    >> DIG .21(XREF 2n1.4), .21(XREF 3S), .21(XREF 4n1.4), 1.17(XREF 1n1.4), 1.17(XREF 1n2.4)
    >> DIH .21(XREF 2n1.4), .21(XREF 3S), .21(XREF 4n1.4), 1.17(XREF 1n1.4), 1.17(XREF 1n2.4)
    >> DIU .21(XREF 2S), .21(XREF 3S), .21(XREF 4S), 1.17(XREF 1S), 1.17(XREF 1K)
    DIV .21(XREF 2S), .21(XREF 2n1.3), .21(XREF 2n1.4), .21(XREF 3S), .21(XREF 3n1.3), .21(XREF 4S), .21(XREF 4n1.4), 1.17(XREF 1S), 1.17(XREF 1n1.4), 1.17(XREF 1K)
    1.17(XREF 1n2.1), 1.17(XREF 1n2.4)
    DIV(0 .21(XREF 2n1.3), .21(XREF 2n1.4), .21(XREF 3S), .21(XREF 3n1.3), .21(XREF 4S), .21(XREF 4n1.4), 1.17(XREF 1S), 1.17(XREF 1n1.4), 1.17(XREF 1K), 1.17(XREF 1n2.4)
    1.17(XREF 1n89.2)
    DUZ .21(XREF 3S)
    >> I(0 1.17(XREF 1S), 1.17(XREF 1K), 1.17(XREF 1n89.2)
    U ID.02+1, ID.22+1, .01(XREF 2S), .01(XREF 2K), .02(XREF 2S), .02(XREF 2K), .02(XREF 3S), .02(XREF 3K), .21(XREF 2S), .21(XREF 2n1.3)
    .21(XREF 2n1.4), .21(XREF 3S), .21(XREF 3n1.3), .21(XREF 4S), .21(XREF 4n1.4), .22(XREF 2S), .22(XREF 2K), 1.17(XREF 1S), 1.17(XREF 1n1.4), 1.17(XREF 1K)
    1.17(XREF 1n2.1), 1.17(XREF 1n2.4), 1.17(XREF 1n89.2), 21+1, 21OF9.2+1
    X .01+1*!, .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2K), .02(XREF 1S), .02(XREF 1K), .02(XREF 2S), .02(XREF 2K), .02(XREF 3S)
    .02(XREF 3K), .03+1!, .07(XREF 1S), .07(XREF 1K), .08+1*!, .09+1*!, .13+1*!, .2+1*!, .2(XREF 1S), .2(XREF 1K)
    .21(XREF 1S), .21(XREF 1K), .21(XREF 2S), .21(XREF 2n1.3), .21(XREF 2n1.4), .21(XREF 3S), .21(XREF 3n1.3), .21(XREF 4S), .21(XREF 4n1.4), .22+1*!
    .22(XREF 1S), .22(XREF 1K), .22(XREF 2S), .22(XREF 2K), .24+1*!, 1.01+1*!, 1.03+1*!, 1.05+1*!, 1.17+1*!, 1.17(XREF 1S)
    1.17(XREF 1n1.4), 1.17(XREF 1K), 1.17(XREF 1n2.1), 1.17(XREF 1n2.4), 21+1*
    Y ID.02+1*, ID.22+1*, .01+1, .08+1, .09+1, .13+1, .2+1, .21(XREF 2S), .21(XREF 2n1.3), .21(XREF 3S)
    .21(XREF 3n1.3), .21(XREF 4S), .22+1, .24+1, 1.01+1, 1.03+1, 1.05+1, 1.17+1, 1.17(XREF 1S), 1.17(XREF 1K)
    Y( 21+1*, 21OF9.2+1*
    Y(0 .21(XREF 2n1.3), .21(XREF 3n1.3), .21(XREF 4S)
    Y(1 .21(XREF 2S), .21(XREF 2n1.3), .21(XREF 3S), .21(XREF 3n1.3), .21(XREF 4S), 1.17(XREF 1n2.1), 1.17(XREF 1n89.2)
    Y(101 1.17(XREF 1S), 1.17(XREF 1K), 1.17(XREF 1n89.2)
    Y(2 .21(XREF 2n1.3), .21(XREF 3n1.3)
    Y(3 .21(XREF 2n1.3), .21(XREF 3n1.3)
    Info |  Desc |  Directly Accessed By Routines |  Accessed By FileMan Db Calls |  Pointed To By FileMan Files |  Pointer To FileMan Files |  Fields |  ICR |  Found Entries |  External References |  Global Variables Directly Accessed |  Naked Globals |  Local Variables |  All