GLOBAL MAP DATA DICTIONARY #351.9 -- CLAIMSMANAGER BILLS FILE 6/27/25 PAGE 1
STORED IN ^IBA(351.9, *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 2.0)
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This file contains information on bills that have been sent to the Ingenix ClaimsManager.
The entries in this file have matching entries in the BILL/CLAIMS file (399). The internal number in file 399 is the same as the
internal number in the CLAIMSMANAGER BILLS file.
Per VHA Directive 10-93-142, this file definition should not be modified.
CROSS
REFERENCED BY: DATE/TIME LAST EDITED(ADE), LAST EDITED BY(AEB), ERROR CODE(AEC), ASSIGNED TO(ASN), STATUS(AST), CLAIM(B)
^IBA(351.9,D0,0)= (#.01) CLAIM [1P:399] ^ (#.02) STATUS [2P:351.91] ^ (#.03) LAST SENT TO CLAIMSMANAGER [3D] ^ (#.04) TIMES SENT
==>TO CLAIMSMANAGER [4F] ^ (#.05) SENT BY [5P:200] ^ (#.06) DATE/TIME ENTERED [6D] ^ (#.07) ENTERED BY [7P:200] ^
==>(#.08) DATE/TIME LAST EDITED [8D] ^ (#.09) LAST EDITED BY [9P:200] ^ (#.1) OVERRIDDEN? [10S] ^ (#.11)
==>OVERRIDDEN BY [11P:200] ^ (#.12) ASSIGNED TO [12P:200] ^ (#.13) COMMENT DATE/TIME [13D] ^ (#.14) COMMENT
==>ENTERED BY [14P:200] ^ (#.15) RECEIVED BY CLAIMSMANAGER [15S] ^
^IBA(351.9,D0,1,0)=^351.9001A^^ (#1.01) ERROR CODE
^IBA(351.9,D0,1,D1,0)= (#.01) ERROR CODE [1F] ^ (#.02) ERROR DATA [2F] ^
^IBA(351.9,D0,1,D1,1,0)=^351.9004^^ (#.03) ERROR TEXT
^IBA(351.9,D0,1,D1,1,D2,0)= (#.01) ERROR TEXT [1W] ^
^IBA(351.9,D0,2,0)=^351.9002^^ (#2.01) COMMENTS
^IBA(351.9,D0,2,D1,0)= (#.01) COMMENTS [1W] ^
^IBA(351.9,D0,3)= (#3.01) PATIENT ID [1F] ^ (#3.02) PT LAST NAME [2F] ^ (#3.03) PT MIDDLE NAME [3F] ^ (#3.04) PT FIRST NAME [4F]
==>^ (#3.05) PT DOB [5F] ^ (#3.06) PT GENDER [6F] ^ (#3.07) ENTRY DATE/TIME [7F] ^ (#3.08) REF PHYS ID [8F] ^
==>(#3.09) REF PHYS LAST NAME [9F] ^ (#3.1) REF PHYS MIDDLE NAME [10F] ^ (#3.11) REF PHYS FIRST NAME [11F] ^
==>(#3.12) REF PHYS TITLE [12F] ^
^IBA(351.9,D0,4)= (#4.01) REF PHYS DEPT [1F] ^ (#4.02) REF PHYS SPEC [2F] ^ (#4.03) REF PHYS DEGREE ID [3F] ^ (#4.04) REF PHYS
==>UPIN [4F] ^
^IBA(351.9,D0,5,0)=^351.9003A^^ (#5.01) LINE SEGMENT
^IBA(351.9,D0,5,D1,0)= (#.01) LINE SEGMENT [1N] ^ (#.02) EXT LINE ID [2F] ^ (#.03) ORG GROUP ID [3F] ^ (#.04) ORG ID [4F] ^
==>(#.05) LINE STATUS [5S] ^ (#.06) BEG DATE OF SERVICE [6F] ^ (#.07) END DATE OF SERVICE [7F] ^ (#.08) PLACE
==>OF SERVICE [8F] ^ (#.09) SUBMITTED PROCEDURE CODE [9F] ^ (#.1) ADJUSTED PROCEDURE CODE [10F] ^ (#.11)
==>SUBMITTED AMOUNT [11F] ^ (#.12) PRE AUTHORIZATION CODE [12F] ^ (#.13) SERVICE PROVIDER ID [13F] ^
^IBA(351.9,D0,5,D1,1)= (#1.01) SRVC PRV LAST NAME [1F] ^ (#1.02) SRVC PRV MIDDLE NAME [2F] ^ (#1.03) SRVC PRV FIRST NAME [3F] ^
==>(#1.04) SRVC PRV TITLE [4F] ^ (#1.05) SRVC PRV DEPT [5F] ^ (#1.06) SRVC PRV SPEC [6F] ^ (#1.07) SRVC PRV
==>DEGREE ID [7F] ^ (#1.08) SRVC PRV UPIN [8F] ^ (#1.09) BILL PRV ID [9F] ^
^IBA(351.9,D0,5,D1,2)= (#2.01) BILL PRV LAST NAME [1F] ^ (#2.02) BILL PRV MIDDLE NAME [2F] ^ (#2.03) BILL PRV FIRST NAME [3F] ^
==>(#2.04) BILL PRV TITLE [4F] ^ (#2.05) BILL PRV DEPT [5F] ^ (#2.06) BILL PRV SPEC [6F] ^ (#2.07) BILL PRV
==>DEGREE ID [7F] ^ (#2.08) BILL PRV UPIN [8F] ^ (#2.09) PRIMARY PAYER ID [9F] ^ (#2.1) SECONDARY PAYER ID
==>[10F] ^ (#2.11) TYPE OF SERVICE [11F] ^ (#2.12) UNITS [12F] ^
^IBA(351.9,D0,5,D1,3)= (#3.01) MODIFIERS [1F] ^
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