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Sub-Field: 361.11511

Package: Integrated Billing

EXPLANATION OF BENEFITS(#361.1)-->361.115-->361.1151-->361.11511

Sub-Field: 361.11511


Information

Parent File Name Number Package
361.1151 REASONS 361.11511 Integrated Billing

Details

Field # Name Loc Type Details
.01 REASON CODE 0;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<1) X
  • LAST EDITED:  OCT 06, 1998
  • HELP-PROMPT:  Answer must be 1-10 characters in length.
  • DESCRIPTION:  
    This is the reason code for the adjustment
  • TECHNICAL DESCR:  
    This data is found in the electronic eob (835) in the data elements CAS-02,5,8,11,14,17
  • CROSS-REFERENCE:  361.11511^B
    1)= S ^IBM(361.1,DA(3),15,DA(2),1,DA(1),1,"B",$E(X,1,30),DA)=""
    2)= K ^IBM(361.1,DA(3),15,DA(2),1,DA(1),1,"B",$E(X,1,30),DA)
.02 AMOUNT 0;2 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?."-".N.1".".2N!(X>9999999999)!(X<-9999999999) X
  • LAST EDITED:  APR 11, 2003
  • HELP-PROMPT:  Type a Dollar Amount between -9999999999 and 9999999999, 2 Decimal Digits
  • DESCRIPTION:  
    This is the adjusted amount for the reason code
  • TECHNICAL DESCR:  
    This data is found in the electronic eob (835) in the data elements CAS-03,6,9,12,15,18
.03 QUANTITY 0;3 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999999)!(X<-9999999)!(X?.E1"."1.N) X
  • LAST EDITED:  AUG 22, 2003
  • HELP-PROMPT:  Type a number between -9999999 and 9999999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the quantity for the item adjusted
  • TECHNICAL DESCR:  
    This data is found in the electronic eob (835) in the data elements CAS-04,7,10,13,16,19
.04 REASON TEXT 0;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>190!($L(X)<1) X
  • LAST EDITED:  OCT 07, 1998
  • HELP-PROMPT:  Answer must be 1-190 characters in length.
  • DESCRIPTION:  
    This is the free text interpretation of the reason code, if available
  • TECHNICAL DESCR:  
    This is provided by the Austin AAC to accelerate the recognition of these codes.  It may be an abbreviated version of the actual message.
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