STANDARD DATA DICTIONARY #162.7 -- FEE BASIS UNAUTHORIZED CLAIMS FILE 6/27/25 PAGE 1
STORED IN ^FB583( *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 3.5)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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This file contains unauthorized claim information for active fee programs. Sites have the ability to either track only complete
claims or incomplete claims, depending upon the value in the site parameter field. A claim is considered complete once all
information is received in order to make a determination (dispostion).
Per VHA Directive 10-93-142, this file definition should not be modified.
DD ACCESS: @
RD ACCESS: #
WR ACCESS: #
DEL ACCESS: #
LAYGO ACCESS: #
IDENTIFIED BY: VENDOR (#1)[R], VETERAN (#2)[R], STATUS (#24)[R]
"WRITE": S FBZ=$$FBZ^FBUCUTL(Y) W:FBZ]"" ! W:$P(FBZ,U,5) ?7,"Treatment From: ",$$DATX^FBAAUTL($P(FBZ,U,5)) W:$P(FBZ,U,6) ?35,
"Treatment To: ",$$DATX^FBAAUTL($P(FBZ,U,6)) K FBZ
POINTED TO BY: ASSOCIATED 7078/583 field (#.055) of the AUTHORIZATION sub-field (#161.01) of the FEE BASIS PATIENT File (#161)
ASSOCIATED 7078/583 field (#27) of the SERVICE PROVIDED sub-field (#162.03) of the INITIAL TREATMENT DATE sub-field
(#162.02) of the VENDOR sub-field (#162.01) of the FEE BASIS PAYMENT File (#162)
ASSOCIATED 7078/583 field (#26) of the PRESCRIPTION NUMBER sub-field (#162.11) of the FEE BASIS PHARMACY INVOICE
File (#162.1)
ASSOCIATED 7078/583 field (#4) of the FEE BASIS INVOICE File (#162.5)
MASTER CLAIM field (#20) of the FEE BASIS UNAUTHORIZED CLAIMS File (#162.7)
UNAUTHORIZED CLAIM field (#.02) of the FEE BASIS UNAUTHORIZED CLAIMS PENDING INFO File (#162.8)
CROSS
REFERENCED BY: AUTHORIZED FROM DATE(AA), FEE PROGRAM(AA1), DISPOSITION(AC), AUTHORIZED TO DATE(AD), FEE PROGRAM(AD1),
STATUS(AES), EXPIRATION DATE OF CLAIM(AES1), DATE CLAIM RECEIVED(AID), PRINT LETTER?(AL), DATE LETTER SENT(ALP),
MASTER CLAIM(AMC), MASTER CLAIM(AMP), MASTER CLAIM(AMS), CLAIM SUBMITTED BY(AOMS), MASTER CLAIM(AOMS1),
STATUS(AOMS2), STATUS(AOS), CLAIM SUBMITTED BY(AOS1), VETERAN(APF), TREATMENT FROM DATE(APF1), VETERAN(APMS),
MASTER CLAIM(APMS1), STATUS(APMS2), VETERAN(APS), STATUS(APS1), STATUS(AS), STATUS(ASD),
DATE OF CURRENT STATUS(ASD1), VENDOR(AVF), TREATMENT FROM DATE(AVF1), VENDOR(AVMS), MASTER CLAIM(AVMS1),
STATUS(AVMS2), VENDOR(AVS), STATUS(AVS1), DATE CLAIM RECEIVED(B), VENDOR(C), VETERAN(D)
INDEXED BY: FPPS CLAIM ID (AFC), DATE LETTER SENT (AILT), STATUS & DISPOSITION & DATE CLAIM RECEIVED & DATE REQ INFO SENT & DATE
VALID CLAIM RECEIVED & DATE OF DISPOSITION & REOPEN CLAIM DATE & NOTICE OF DISAGREEMENT RECV'D & STATEMENT OF THE
CASE ISSUED & DATE SUBSTANTIVE APPEAL RECV'D & DATE APPEAL DISPOSITIONED & DATE APPEALED TO COVA & DATE COVA APPEAL
DISPOSITIONED (AUD)
LAST MODIFIED: OCT 14,2016@13:53:19
162.7,.01 DATE CLAIM RECEIVED 0;1 DATE (Required)
INPUT TRANSFORM: S %DT="EX",%DT(0)=-DT D ^%DT K %DT S X=Y K:Y<1 X
LAST EDITED: FEB 27, 2014
HELP-PROMPT: Enter when an Unauthorized Claim, complete or incomplete, is received.
DESCRIPTION: This is the Date that the valid 583 was accepted for processing. Usually the date the claim is
being entered.
DELETE TEST: .01,0)= D DEL^FBUCDD1(DA)
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 162.7^B
1)= S ^FB583("B",$E(X,1,30),DA)=""
2)= K ^FB583("B",$E(X,1,30),DA)
CROSS-REFERENCE: 162.7^AID^MUMPS
1)= S ^FB583("AID",-X,DA)=""
2)= K ^FB583("AID",-X,DA)
Sort entries by inverse date unauthorized claim received.
RECORD INDEXES: AUD (#1210)
162.7,.5 FEE PROGRAM 0;2 POINTER TO FEE BASIS PROGRAM FILE (#161.8) (Required)
INPUT TRANSFORM: S DIC("S")="I +$P(^(0),U,3)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: MAR 29, 1994
HELP-PROMPT: Enter the appropriate active fee program to which this claim pertains.
DESCRIPTION: The appropriate fee program to which this unauthorized claim pertains. Only active fee programs
can be selected.
SCREEN: S DIC("S")="I +$P(^(0),U,3)"
EXPLANATION: Only active fee programs can be selected.
CROSS-REFERENCE: 162.7^AA1^MUMPS
1)= S:$P(^FB583(DA,0),U,13) ^FB583("AA",X,$P(^(0),U,13),DA)=""
2)= K:$P(^FB583(DA,0),U,13) ^FB583("AA",X,$P(^(0),U,13),DA)
Cross reference by fee program, authorization from date.
CROSS-REFERENCE: 162.7^AD1^MUMPS
1)= S:$P(^FB583(DA,0),U,14) ^FB583("AD",X,$P(^(0),U,14),DA)=""
2)= K:$P(^FB583(DA,0),U,14) ^FB583("AD",X,$P(^(0),U,14),DA)
Cross reference by fee program and authorization to date.
162.7,1 VENDOR 0;3 POINTER TO FEE BASIS VENDOR FILE (#161.2) (Required)
LAST EDITED: JUL 02, 1993
HELP-PROMPT: Enter the vendor who provided the services being charged.
DESCRIPTION:
The vendor who provided the services being charged.
CROSS-REFERENCE: 162.7^C
1)= S ^FB583("C",$E(X,1,30),DA)=""
2)= K ^FB583("C",$E(X,1,30),DA)
CROSS-REFERENCE: 162.7^AVF^MUMPS
1)= S:$P(^FB583(DA,0),U,5) ^FB583("AVF",X,$P(^(0),U,5),DA)=""
2)= K:$P(^FB583(DA,0),U,5) ^FB583("AVF",X,$P(^(0),U,5),DA)
Cross reference by vendor, treatment from date and record number.
CROSS-REFERENCE: 162.7^AVS^MUMPS
1)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) S:$P(FBZ,U,24) ^FB583("AVS",X,$P(FBZ,U,24),DA)="" K FBZ
2)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) K:$P(FBZ,U,24) ^FB583("AVS",X,$P(FBZ,U,24),DA) K FBZ
Cross-reference used to group claims by vendor and status.
CROSS-REFERENCE: 162.7^AVMS^MUMPS
1)= D MSIX^FBUCDD(X,DA,1,1,"AVMS")
2)= D MSIX^FBUCDD(X,DA,1,2,"AVMS")
This cross-reference sets/kill the 'AVMS' cross-reference. It is used to display the relationship
between primary/secondary claims. Fields involved are: Vendor, Master Claim and Status, having
the respective index of 'AVMS', 'AVMS1' or 'AVMS2'. In order to re-set the 'AVMS' index you only
need to re-index ONE of these fields.
162.7,2 VETERAN 0;4 POINTER TO PATIENT FILE (#2) (Required)
LAST EDITED: JUL 02, 1993
HELP-PROMPT: Enter the veteran who received the services being claimed.
DESCRIPTION:
The name of the veteran who received the services being claimed.
CROSS-REFERENCE: 162.7^D
1)= S ^FB583("D",$E(X,1,30),DA)=""
2)= K ^FB583("D",$E(X,1,30),DA)
CROSS-REFERENCE: 162.7^APF^MUMPS
1)= S:$P(^FB583(DA,0),U,5) ^FB583("APF",X,$P(^(0),U,5),DA)=""
2)= K:$P(^FB583(DA,0),U,5) ^FB583("APF",X,$P(^(0),U,5),DA)
Cross reference by patient, treatment from date, record number.
CROSS-REFERENCE: 162.7^APS^MUMPS
1)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) S:$P(FBZ,U,24) ^FB583("APS",X,$P(FBZ,U,24),DA)="" K FBZ
2)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) K:$P(FBZ,U,24) ^FB583("APS",X,$P(FBZ,U,24),DA) K FBZ
Cross-reference used to group claims by veteran (patient) and status.
CROSS-REFERENCE: 162.7^APMS^MUMPS
1)= D MSIX^FBUCDD(X,DA,2,1,"APMS")
2)= D MSIX^FBUCDD(X,DA,2,2,"APMS")
This cross-reference sets/kill the 'APMS' cross-reference. It is used to display the relationship
between primary/secondary claims. Fields involved are: Patient, Master Claim and Status, having
the respective index of 'APMS', 'APMS1' or 'APMS2'. In order to re-set the 'APMS' index you only
need to re-index ONE of these fields.
162.7,3 TREATMENT FROM DATE 0;5 DATE (Required)
INPUT TRANSFORM: S %DT="EPX",%DT(0)=-DT D ^%DT K %DT(0) S X=Y K:Y<1 X
LAST EDITED: MAY 05, 1993
HELP-PROMPT: Enter the date treatment began for this particular Fee program and claim. Date can not be in the
future.
DESCRIPTION:
Date which treatment began for submitted unauthorized claim. Date cannot be in the future.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 162.7^APF1^MUMPS
1)= S:$P(^FB583(DA,0),U,4) ^FB583("APF",$P(^(0),U,4),X,DA)=""
2)= K:$P(^FB583(DA,0),U,4) ^FB583("APF",$P(^(0),U,4),X,DA)
Cross reference by patient, treatment from date and record number.
CROSS-REFERENCE: 162.7^AVF1^MUMPS
1)= S:$P(^FB583(DA,0),U,3) ^FB583("AVF",$P(^(0),U,3),X,DA)=""
2)= K:$P(^FB583(DA,0),U,3) ^FB583("AVF",$P(^(0),U,3),X,DA)
Cross reference by vendor, treatment from date and record number.
162.7,4 TREATMENT TO DATE 0;6 DATE (Required)
INPUT TRANSFORM: S %DT="EPX",%DT(0)=-DT D ^%DT K %DT(0) S X=Y Q:'$G(DA) S FBZZ=4 K:$$INPUT^FBUCDD(DA,X,Y,FBZZ) X K
FBZZ
LAST EDITED: SEP 16, 1993
HELP-PROMPT: Enter the date treatment ended for this particular Fee program and claim. Date cannot be in the
future. Treatment To Date cannot be earlier than Treatment From Date.
DESCRIPTION: Date which treatment ended for sumbitted unauthorized claim. Date cannot be in the future or be
earlier than Treatment From date.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
162.7,5 DIAGNOSIS DX;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>120!($L(X)<3) X
HELP-PROMPT: Answer must be 3-120 characters in length.
DESCRIPTION:
Enter the diagnosis upon which services were rendered.
162.7,5.1 ICD DIAGNOSIS DX;2 POINTER TO ICD DIAGNOSIS FILE (#80)
LAST EDITED: MAR 26, 2012
HELP-PROMPT: Select the Diagnosis.
DESCRIPTION: Patient's diagnosis for which this authorization is being issued. This field is only for ICD-10 and
later.
162.7,6 PRIMARY SERVICE FACILITY 0;7 POINTER TO INSTITUTION FILE (#4)
HELP-PROMPT: Enter the facility which is responsible for reimbursing the COJ.
DESCRIPTION:
The name of the facility which will reimburse the COJ.
162.7,7 DATE VALID CLAIM RECEIVED 0;8 DATE
INPUT TRANSFORM: S %DT="EX",%DT(0)=-DT D ^%DT K %DT S X=Y S FBZZ=7 K:$$INPUT^FBUCDD(DA,X,Y,FBZZ) X K FBZZ
LAST EDITED: FEB 27, 2014
HELP-PROMPT: Enter date valid claim was received. Valid claim includes all supporting
information/documentation.
DESCRIPTION:
Date complete (valid) unauthorized claim received for medical review.
TECHNICAL DESCR:
This field is automatically updated in the update routine.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
RECORD INDEXES: AUD (#1210)
162.7,8 AMOUNT CLAIMED 0;9 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999999.99)!(X<0) X
LAST EDITED: JAN 08, 2009
HELP-PROMPT: Type a Dollar Amount between 0 and 9999999.99, 2 Decimal Digits
DESCRIPTION:
The dollar amount being claimed.
162.7,9 PATIENT TYPE CODE 0;10 SET (Required)
TREATING SPECIALTY
'00' FOR SURGICAL;
'10' FOR MEDICAL;
'86' FOR PSYCHIATRIC;
LAST EDITED: SEP 12, 1990
HELP-PROMPT: Enter the appropriate patient type code for services received.
DESCRIPTION:
The appropriate patient type code for services which were received.
162.7,10 DISPOSITION 0;11 POINTER TO FEE BASIS UNAUTHORIZED CLAIMS DISPOSITIONS FILE (#162.91)
INPUT TRANSFORM: S DIC("S")="I $P(^(0),U,2)" D ^DIC K DIC S DIC=DIE,X=+Y S FBZZ=10 K:$$INPUT^FBUCDD(DA,X,Y,FBZZ) X K
FBZZ
LAST EDITED: FEB 27, 2014
HELP-PROMPT: Select the appropriate disposition reason. An approved, approved to stabilization or disapproved
disposition requires a Complete status.
DESCRIPTION: Only active dispositions can be selected. If the disposition has been approved, or approved to
stabilization and payments made, then the disposition can not be changed unless the FBAASUPERVISOR
key is held. An approved, approved to stabilization, or disapproved disposition requires a
Complete status.
TECHNICAL DESCR: If date valid claim received is null, then only reason for disposition
should be for cancelled/withdrawn or abandoned. If a disposition is not
approved, and there are payments made against
the claim, the user may change the value only if s/he holds the
supervisor security key.
When the status or disposition changes, a letter needs to be printed. Once printed, the expiration
date is calculated. The number of days is derived from the status.
SCREEN: S DIC("S")="I $P(^(0),U,2)"
EXPLANATION: Allow selection of active dispositions.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 162.7^AC^MUMPS
1)= S ^FB583("AC",$E(X,1,30),DA)=""
2)= K ^FB583("AC",$E(X,1,30),DA)
RECORD INDEXES: AUD (#1210)
162.7,10.5 DISPOSITION REMARKS 4;0 WORD-PROCESSING #162.702 (NOWRAP)
LAST EDITED: NOV 15, 2001
DESCRIPTION: Special remarks regarding the initial disposition that should be included on a disposition letter
to the claimant. (Optional)
LAST EDITED: NOV 15, 2001
DESCRIPTION: Special remarks regarding the initial disposition that should be included on a disposition letter
to the claimant. (Optional)
162.7,10.6 APPEAL DISPOSITION REMARKS A1;0 WORD-PROCESSING #162.703 (NOWRAP)
DESCRIPTION: Special remarks regarding the disposition of an appeal that should be included on a disposition
letter to the claimant. (Optional)
LAST EDITED: NOV 15, 2001
DESCRIPTION: Special remarks regarding the disposition of an appeal that should be included on a disposition
letter to the claimant. (Optional)
162.7,10.7 COVA DISPOSITION REMARKS A2;0 WORD-PROCESSING #162.704 (NOWRAP)
LAST EDITED: AUG 16, 2002
DESCRIPTION: Special remarks regarding the disposition of a COVA appeal that should be included on a disposition
letter to the claimant. (Optional)
LAST EDITED: AUG 16, 2002
DESCRIPTION: Special remarks regarding the disposition of a COVA appeal that should be included on a
disposition letter to the claimant. (Optional)
162.7,11 DATE OF DISPOSITION 0;12 DATE
INPUT TRANSFORM: S %DT="EX",%DT(0)=-DT D ^%DT K %DT S X=Y K:Y<1 X
LAST EDITED: FEB 27, 2014
HELP-PROMPT: Enter date claim dispositioned.
DESCRIPTION:
The date the claim was dispositioned.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
RECORD INDEXES: AUD (#1210)
162.7,12 AUTHORIZED FROM DATE 0;13 DATE
INPUT TRANSFORM: S %DT="EPX",%DT(0)=-DT D ^%DT K %DT(0) S X=Y Q:'$D(DA) S FBZZ=12 K:$$INPUT^FBUCDD(DA,X,Y,FBZZ) X K
FBZZ
LAST EDITED: MAY 05, 1993
HELP-PROMPT: Enter the beginning date which fee services are authorized. Date cannot be in the future. Date
cannot be before Treatment From date or after Treatment To date.
DESCRIPTION: The beginning date from which fee services for unauthorized claim are authorized. Date cannot be
in the future or before Treatment From date.
EXECUTABLE HELP: W !?5,"Treatment From: ",$$DATX^FBAAUTL(+$P(^FB583(DA,0),U,5))," Treatment To: ",$$DATX^FBAAUTL(+$
P(^FB583(DA,0),U,6)),!
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 162.7^AA^MUMPS
1)= S:$P(^FB583(DA,0),U,2) ^FB583("AA",$P(^(0),U,2),X,DA)=""
2)= K:$P(^FB583(DA,0),U,2) ^FB583("AA",$P(^(0),U,2),X,DA)
Cross refernece by fee program and authorization from date.
162.7,13 AUTHORIZED TO DATE 0;14 DATE
INPUT TRANSFORM: S %DT="EPX",%DT(0)=-DT D ^%DT K %DT(0) S X=Y Q:'$D(DA) S FBZZ=13 K:$$INPUT^FBUCDD(DA,X,Y,FBZZ) X K
FBZZ
LAST EDITED: MAY 05, 1993
HELP-PROMPT: Enter the date treatment authorized to. Date cannot be in the future or earlier than the
Authorized From Date. Authorized To date cannot be after Treatment To date.
DESCRIPTION: The ending date which fee services are authorized. Date cannot be in the future or before the
Authorized From date. Authorized To date cannot be greater than Treatment To date.
EXECUTABLE HELP: W !?5,"Treatment From: ",$$DATX^FBAAUTL(+$P(^FB583(DA,0),U,5))," Treatment To: ",$$DATX^FBAAUTL(+$
P(^FB583(DA,0),U,6)),!
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 162.7^AD^MUMPS
1)= S:$P(^FB583(DA,0),U,2) ^FB583("AD",$P(^(0),U,2),X,DA)=""
2)= K:$P(^FB583(DA,0),U,2) ^FB583("AD",$P(^(0),U,2),X,DA)
Cross reference by fee programs, authorization to date.
162.7,14 AMOUNT APPROVED 0;15 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999999.99)!(X<.01) X
LAST EDITED: JAN 08, 2009
HELP-PROMPT: Type a Dollar Amount between .01 and 9999999.99, 2 Decimal Digits
DESCRIPTION:
The authorized amount for payment of an unauthorized claim.
162.7,15 REASON FOR DISAPPROVAL D;0 POINTER Multiple #162.715 (Add New Entry without Asking)
DESCRIPTION:
Provides reason(s) why a claim was disapproved.
TECHNICAL DESCR:
Only completed if disposition is DISAPPROVED.
SCREEN: S DIC("S")="I $P(^(0),U,2),$P(^FB583(DA,0),U,11)>1"
EXPLANATION: Allow selection of active disapproval reason(s) for claim with a dispostion of other than APPROVED.
162.715,.01 REASON FOR DISAPPROVAL 0;1 POINTER TO FEE BASIS UNAUTHORIZED DISAPPROVAL REASONS FILE (#162.94) (Multiply asked)
INPUT TRANSFORM: S DIC("S")="I $P(^(0),U,2)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: APR 02, 1993
HELP-PROMPT: Identify the reason(s) why the unauthorized claim was disapproved.
DESCRIPTION:
Reason why claim was not approved.
TECHNICAL DESCR: Reason for disapproval is only prompted if the disposition type is other
than APPROVED. If the disposition was changed to APPROVED, all disapproval reason will be
deleted.
SCREEN: S DIC("S")="I $P(^(0),U,2)"
EXPLANATION: Select only active disapproval reasons if the unauthorized claim has a disposition of other than ap
proved.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE:162.715^B
1)= S ^FB583(DA(1),"D","B",$E(X,1,30),DA)=""
2)= K ^FB583(DA(1),"D","B",$E(X,1,30),DA)
162.7,16 *DISPOSITON DESCRIPTION 1;0 WORD-PROCESSING #162.716 (NOWRAP)
LAST EDITED: MAY 11, 1993
DESCRIPTION:
The description of the disposition. Replaced by the REASON FOR DISAPPROVAL field.
162.7,17 *REASON FOR PENDING 2;0 WORD-PROCESSING #162.717 (NOWRAP)
LAST EDITED: MAY 11, 1993
DESCRIPTION: The reason the claim was pending. Replaced by the FEE BASIS UNAUTHORIZED REQUESTED INFORMATION
file (# 162.93).
LAST EDITED: AUG 22, 1990
162.7,19 PRINT LETTER? 0;16 SET
'1' FOR YES;
LAST EDITED: APR 05, 1993
HELP-PROMPT: Enter YES if letter needs to be printed.
DESCRIPTION:
If this field has a YES value, an unauthorized claim letter needs to be printed.
TECHNICAL DESCR: When the status or disposition changes, a letter needs to be printed. Once printed, the expiration
date is calculated. The number of days is derived from the status. This field is automatically
updated.
CROSS-REFERENCE: 162.7^AL
1)= S ^FB583("AL",$E(X,1,30),DA)=""
2)= K ^FB583("AL",$E(X,1,30),DA)
Cross-reference is used to determine which claims need a letter printed.
162.7,19.5 DATE LETTER SENT 0;19 DATE
INPUT TRANSFORM: S %DT="EX",%DT(0)=-DT D ^%DT K %DT S X=Y K:Y<1 X
LAST EDITED: FEB 04, 2014
HELP-PROMPT: Enter the date the follow-up or disposition letter was sent to submitter. Date can not be in the
future.
DESCRIPTION:
Date letter sent to submitter.
TECHNICAL DESCR: When the status or disposition changes, a letter needs to be printed. Once printed, the expiration
date is calculated. The number of days is derived from the status. This field is automatically
updated.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 162.7^ALP
1)= S ^FB583("ALP",$E(X,1,30),DA)=""
2)= K ^FB583("ALP",$E(X,1,30),DA)
Cross-reference is used to determine if a letter has been printed. It may be used to reprint
letters.
FIELD INDEX: AILT (#1152) MUMPS ACTION
Short Descr: Trigger letter date for request information letter.
Description: This cross-reference copies the new value of the DATE LETTER SENT field to the DATE REQ INFO SENT
field when the status of the claim is INCOMPLETE UNAUTHORIZED CLAIM. The DATE LETTER SENT field
contains the date for both the request for information letter and the disposition letter. This
trigger populates the DATE REQ INFO SENT field so the date of the request for information letter is
retained.
Set Logic: D LTRDT^FBUCAUD(1)
Set Cond: S X=$S(X1(1)=X2(1):0,1:1)
Kill Logic: D LTRDT^FBUCAUD(0)
Kill Cond: S X=$S(X1(1)=X2(1):0,1:1)
X(1): DATE LETTER SENT (162.7,19.5) (forwards)
162.7,19.6 DATE REQ INFO SENT 6;1 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:X<1 X
LAST EDITED: FEB 27, 2014
HELP-PROMPT: Enter date a request for additional information letter was sent.
DESCRIPTION: This field contains the most recent date a request for additional information letter was sent for
the claim. This field is automatically populated by the software.
TECHNICAL DESCR: The DATE REQ INFO LETTER field was added by patch FB*3.5*151 and does not reflect actions taken
prior to patch installation
WRITE AUTHORITY: ^
UNEDITABLE
RECORD INDEXES: AUD (#1210)
162.7,20 MASTER CLAIM 0;20 POINTER TO FEE BASIS UNAUTHORIZED CLAIMS FILE (#162.7) (Required)
INPUT TRANSFORM: S DIC("S")="S FBZ=^FB583(DA,0) I $P(^FB583(+Y,0),U,4)=$P(FBZ,U,4),'+$P(^FB583(+Y,0),U,11) K FBZ" D
^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: MAY 21, 1993
HELP-PROMPT: Enter the existing claim which this claim relates to. If there is none, relate it to itself.
DESCRIPTION: Enter the claim to which this claim is related. It may be related to itself. Select only those
records containing the same veteran which have no disposition.
TECHNICAL DESCR: Automatically set upon entry of claim. If claim submission involves different fee programs for the
same episode of care, claims entered after the first for that episode of care will point to the
first. The first one becomes the 'master'. Used for displaying claims.
SCREEN: S DIC("S")="S FBZ=^FB583(DA,0) I $P(^FB583(+Y,0),U,4)=$P(FBZ,U,4),'+$P(^FB583(+Y,0),U,11) K FBZ"
EXPLANATION: Select only those records containing the same veteran, having no dispostion.
CROSS-REFERENCE: 162.7^AMS^MUMPS
1)= S:X'=DA ^FB583("AMS",X,DA)=""
2)= K:X'=DA ^FB583("AMS",X,DA)
Cross-reference secondary claims...those claims which point to another.
CROSS-REFERENCE: 162.7^AMP^MUMPS
1)= S:X=DA ^FB583("AMP",X,DA)=""
2)= K:X=DA ^FB583("AMP",X,DA)
Cross reference primary claims...those master claims which point to themselves.
CROSS-REFERENCE: 162.7^AMC
1)= S ^FB583("AMC",$E(X,1,30),DA)=""
2)= K ^FB583("AMC",$E(X,1,30),DA)
Cross-reference claims by master number for sorting.
CROSS-REFERENCE: 162.7^APMS1^MUMPS
1)= D MSIX^FBUCDD(X,DA,20,1,"APMS")
2)= D MSIX^FBUCDD(X,DA,20,2,"APMS")
This cross-reference sets/kill the 'APMS' cross-reference. It is used to display the relationship
between primary/secondary claims. Fields involved are: Patient, Master Claim and Status, having
the respective index of 'APMS', 'APMS1' or 'APMS2'. In order to re-set the 'APMS' index you only
need to re-index ONE of these fields.
CROSS-REFERENCE: 162.7^AVMS1^MUMPS
1)= D MSIX^FBUCDD(X,DA,20,1,"AVMS")
2)= D MSIX^FBUCDD(X,DA,20,2,"AVMS")
This cross-reference sets/kill the 'AVMS' cross-reference. It is used to display the relationship
between primary/secondary claims. Fields involved are: Vendor, Master Claim and Status, having
the respective index of 'AVMS', 'AVMS1' or 'AVMS2'. In order to re-set the 'AVMS' index you only
need to re-index ONE of these fields.
CROSS-REFERENCE: 162.7^AOMS1^MUMPS
1)= D MSIX^FBUCDD(X,DA,20,1,"AOMS")
2)= D MSIX^FBUCDD(X,DA,20,2,"AOMS")
This cross-reference sets/kill the 'AOMS' cross-reference. It is used to display the relationship
between primary/secondary claims. Fields involved are: Submitter, Master Claim and Status, having
the respective index of 'AOMS', 'AOMS1' or 'AOMS2'. In order to re-set the 'AOMS' index you only
need to re-index ONE of these fields.
162.7,21 REOPEN CLAIM DATE 0;21 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: FEB 27, 2014
HELP-PROMPT: Enter date dispositioned claim reopened (not appealed) for review.
DESCRIPTION:
Date dispositioned claim reopended for review.
TECHNICAL DESCR: Automatically updated when claim is reopened.
(Edit template will stuff if action type is REOpen.)
RECORD INDEXES: AUD (#1210)
162.7,22 DATE OF ORIGINAL DISPOSITION 0;22 DATE
INPUT TRANSFORM: S %DT="EX",%DT(0)=-DT D ^%DT K %DT S X=Y K:Y<1 X
LAST EDITED: OCT 15, 1993
HELP-PROMPT: Enter date unauthorized claim was originally dispositioned.
DESCRIPTION: Date unauthorized claim was originally dispostioned. Used in determining expiration date in the
case of appeal status'.
TECHNICAL DESCR:
Automatically updated when status is determined.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
162.7,23 CLAIM SUBMITTED BY 0;23 VARIABLE POINTER (Required)
FILE ORDER PREFIX LAYGO MESSAGE
2 1 p n Patient
161.2 2 v n Vendor
200 3 o n Other party
INPUT TRANSFORM: Q:'$G(DA) N FBZZ S FBZZ=23 K:$$INPUT^FBUCDD(DA,X,Y,FBZZ) X K FBZZ
LAST EDITED: SEP 10, 1993
HELP-PROMPT: Identify the submitter of the Unauthorized Claim. If the submitter is a vendor, must be same value
as entered in the VENDOR field; if veteran, must be same as VETERAN field.
DESCRIPTION: Identify the submitter of the unauthorized claim. The submitter may differ from the vendor or
veteran involved with the claim.
If the submitter is a vendor, must be same value as entered in the VENDOR field; if veteran, must
be same as VETERAN field.
TECHNICAL DESCR: The address for correspondence is determined from this field. If there is no entry, the default is
the veteran's address.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 162.7^AOS1^MUMPS
1)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) S:$P(FBZ,U,24)&(X["VA(200") ^FB583("AOS",+X,$P(FBZ,U,24),DA)="" K
FBZ
2)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) S:$P(FBZ,U,24)&(X["VA(200") ^FB583("AOS",+X,$P(FBZ,U,24),DA)="" K
FBZ
Cross-reference used to group claims by other party (new persons) and status.
CROSS-REFERENCE: 162.7^AOMS^MUMPS
1)= D:X["VA(200" MSIX^FBUCDD(X,DA,23,1,"AOMS")
2)= D:X["VA(200" MSIX^FBUCDD(X,DA,23,2,"AOMS")
This cross-reference sets/kill the 'AOMS' cross-reference. It is used to display the relationship
between primary/secondary claims. Fields involved are: Submitter, Master Claim and Status, having
the respective index of 'AOMS', 'AOMS1' or 'AOMS2'. In order to re-set the 'AOMS' index you only
need to re-index ONE of these fields.
162.7,24 STATUS 0;24 POINTER TO FEE BASIS UNAUTHORIZED CLAIMS STATUS FILE (#162.92) (Required)
INPUT TRANSFORM: S DIC("S")="I $P(^(0),U,2)" D ^DIC K DIC S DIC=DIE,X=+Y S FBZZ=24 K:$$INPUT^FBUCDD(DA,X,Y,FBZZ) X K
FBZZ
LAST EDITED: FEB 27, 2014
HELP-PROMPT: Select an active status for this unauthorized claim.
DESCRIPTION: Select the appropriate status from FEE BASIS UNAUTHORIZED CLAIMS STATUS file. Status is
automatically determined and stuffed, it should not be edited.
TECHNICAL DESCR: Only active status' can be selected. If valid claim received, status should be greater
than informal or returned. If claim is dipositioned, status should only be dispositioned. If
claim has not been dispositioned, status should not be dispositioned.
Status is automatically determined, based on the status order field in 162.92.
When the status or disposition changes, a letter needs to be printed. Once printed, the expiration
date is calculated. The number of days is derived from the status. This field is automatically
updated.
SCREEN: S DIC("S")="I $P(^(0),U,2)"
EXPLANATION: Allow selection of active status.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 162.7^ASD^MUMPS
1)= S:$P(^FB583(DA,0),U,25) ^FB583("ASD",X,$P(^(0),U,25),DA)=""
2)= K:$P(^FB583(DA,0),U,25) ^FB583("ASD",X,$P(^(0),U,25),DA)
Cross reference by status, status date and record number.
CROSS-REFERENCE: 162.7^APMS2^MUMPS
1)= D MSIX^FBUCDD(X,DA,24,1,"APMS")
2)= D MSIX^FBUCDD(X,DA,24,2,"APMS")
This cross-reference sets/kill the 'APMS' cross-reference. It is used to display the relationship
between primary/secondary claims. Fields involved are: Patient, Master Claim and Status, having
the respective index of 'APMS', 'APMS1' or 'APMS2'. In order to re-set the 'APMS' index you only
need to re-index ONE of these fields.
CROSS-REFERENCE: 162.7^AES^MUMPS
1)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) S:$P(FBZ,U,26) ^FB583("AES",$$ORDER^FBUCUTL(+X),-$P(FBZ,U,26),DA)
="" K FBZ
2)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) K:$P(FBZ,U,26) ^FB583("AES",$$ORDER^FBUCUTL(+X),-$P(FBZ,U,26),DA)
K FBZ
Cross-reference by status order and inverse expiration date.
CROSS-REFERENCE: 162.7^APS1^MUMPS
1)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) S:$P(FBZ,U,4) ^FB583("APS",$P(FBZ,U,4),X,DA)="" K FBZ
2)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) K:$P(FBZ,U,4) ^FB583("APS",$P(FBZ,U,4),X,DA) K FBZ
Cross-reference used to group claims by veteran (patient) and status.
CROSS-REFERENCE: 162.7^AVS1^MUMPS
1)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) S:$P(FBZ,U,3) ^FB583("AVS",$P(FBZ,U,3),X,DA)="" K FBZ
2)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) K:$P(FBZ,U,3) ^FB583("AVS",$P(FBZ,U,3),X,DA) K FBZ
Cross-reference used to group claims by vendor and status.
CROSS-REFERENCE: 162.7^AS
1)= S ^FB583("AS",$E(X,1,30),DA)=""
2)= K ^FB583("AS",$E(X,1,30),DA)
Cross-refernece claims by status.
CROSS-REFERENCE: 162.7^AOS^MUMPS
1)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) S:$P(FBZ,U,23)["VA(200" ^FB583("AOS",+$P(FBZ,U,23),X,DA)="" K FBZ
2)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) K:$P(FBZ,U,23)["VA(200" ^FB583("AOS",+$P(FBZ,U,23),X,DA) K FBZ
Cross-reference used to group claims by other party (new persons) and status.
CROSS-REFERENCE: 162.7^AVMS2^MUMPS
1)= D MSIX^FBUCDD(X,DA,24,1,"AVMS")
2)= D MSIX^FBUCDD(X,DA,24,2,"AVMS")
This cross-reference sets/kill the 'AVMS' cross-reference. It is used to display the relationship
between primary/secondary claims. Fields involved are: Vendor, Master Claim and Status, having
the respective index of 'AVMS', 'AVMS1' or 'AVMS2'. In order to re-set the 'AVMS' index you only
need to re-index ONE of these fields.
CROSS-REFERENCE: 162.7^AOMS2^MUMPS
1)= D MSIX^FBUCDD(X,DA,24,1,"AOMS")
2)= D MSIX^FBUCDD(X,DA,24,2,"AOMS")
This cross-reference sets/kill the 'AOMS' cross-reference. It is used to display the relationship
between primary/secondary claims. Fields involved are: Submitter, Master Claim and Status, having
the respective index of 'AOMS', 'AOMS1' or 'AOMS2'. In order to re-set the 'AOMS' index you only
need to re-index ONE of these fields.
RECORD INDEXES: AUD (#1210)
162.7,25 DATE OF CURRENT STATUS 0;25 DATE (Required)
INPUT TRANSFORM: S %DT="EX",%DT(0)=-DT D ^%DT K %DT S X=Y K:Y<1 X
LAST EDITED: OCT 15, 1993
HELP-PROMPT: Enter the date on which the current status was updated.
DESCRIPTION:
This field contains the date on which the current status was entered or updated.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 162.7^ASD1^MUMPS
1)= S:$P(^FB583(DA,0),U,24) ^FB583("ASD",$P(^(0),U,24),X,DA)=""
2)= K:$P(^FB583(DA,0),U,24) ^FB583("ASD",$P(^(0),U,24),X,DA)
Cross reference by status, status date and record number.
162.7,26 EXPIRATION DATE OF CLAIM 0;26 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JUL 06, 1993
HELP-PROMPT: Enter the date, if applicable, by which a response should be received.
DESCRIPTION: The date by which a response should be received before the claim expires. If the expiration date
arrives with no response, then the appropriate action may need to be taken (action varies with
status of claim). No further processing should be allowed. (If awaiting information, claim should
be dispositioned to abandoned; if already dispostioned, appeal or BVA appeal can not be entered.)
This field is automatically updated.
TECHNICAL DESCR: When the status or disposition changes, a letter needs to be printed. Once printed, the expiration
date is calculated. The number of days is derived from the status. This field is automatically
updated.
CROSS-REFERENCE: 162.7^AES1^MUMPS
1)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) S:$P(FBZ,U,24) ^FB583("AES",$$ORDER^FBUCUTL(+$P(FBZ,U,24)),-X,DA)
="" K FBZ
2)= N FBZ S FBZ=$$FBZ^FBUCUTL(DA) K:$P(FBZ,U,24) ^FB583("AES",$$ORDER^FBUCUTL(+$P(FBZ,U,24)),-X,DA)
K FBZ
Cross-reference by status order and inverse expiration date.
162.7,26.5 EXTENSIONS 3;0 DATE Multiple #162.701
162.701,.01 EXTENSION ENTERED DATE/TIME 0;1 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: OCT 09, 2001
HELP-PROMPT: Enter the date/time when the extension was granted.
DESCRIPTION: The date/time when the extension was entered into the computer. This field is automatically
populated.
CROSS-REFERENCE: 162.701^B
1)= S ^FB583(DA(1),3,"B",$E(X,1,30),DA)=""
2)= K ^FB583(DA(1),3,"B",$E(X,1,30),DA)
162.701,.02 ENTERED BY 0;2 POINTER TO NEW PERSON FILE (#200) (Required)
LAST EDITED: OCT 09, 2001
DESCRIPTION:
User that entered the extension. Automatically populated.
162.701,.03 FOR STATUS 0;3 POINTER TO FEE BASIS UNAUTHORIZED CLAIMS STATUS FILE (#162.92) (Required)
LAST EDITED: OCT 09, 2001
DESCRIPTION:
Status for which the extension is being granted.
162.701,.04 EXTENSION DATE 0;4 DATE (Required)
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: OCT 09, 2001
HELP-PROMPT: Enter the extension date.
DESCRIPTION:
New extension date granted.
162.701,.05 COMMENTS 1;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>80!($L(X)<3) X
LAST EDITED: OCT 09, 2001
HELP-PROMPT: Answer must be 3-80 characters in length.
DESCRIPTION:
Enter any comments related to the extension.
162.7,27 ENTERED/LAST EDITED BY 0;17 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: JUL 31, 1993
HELP-PROMPT: Enter the person who entered the claim.
DESCRIPTION:
The name of the person who entered the claim.
162.7,28 DATE ENTERED/LAST EDITED 0;18 DATE
INPUT TRANSFORM: S %DT="EX",%DT(0)=-DT D ^%DT K %DT S X=Y K:Y<1 X
LAST EDITED: OCT 15, 1993
HELP-PROMPT: Enter the date on which the claim was entered.
DESCRIPTION:
The date on which the unauthorized claim was entered.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
162.7,29 DISCHARGE TYPE ; COMPUTED
MUMPS CODE: S X=$$DISCHTYP^FBUCDD(D0)
ALGORITHM: S X=$$DISCHTYP^FBUCDD(D0)
LAST EDITED: NOV 20, 1995
DESCRIPTION:
Display DISCHARGE TYPE of related entry in authorization subfile.
TECHNICAL DESCR: Fee Basis Patient file (161), Authorization sub-file (161.01), Discharge Type field (.06) is
referenced is entry is found in the field's 'AG' cross-reference. The value of the set is
displayed.
162.7,30 AUTHORIZATION 0;27 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JUL 20, 1993
HELP-PROMPT: Enter the authorization to which this unauthorized claim is related.
DESCRIPTION:
This field is set to the internal entry number of the appropriate authorization in file 161.
162.7,31 38 U.S.C. 1725 0;28 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: JUN 21, 2001
HELP-PROMPT: Enter YES if claim is being considered under Millennium Act 38 U.S.C. 1725.
DESCRIPTION: If this field has a YES value, the software will treat this claim as an emergency care claim that
is being considered under the provisions of the Millennium Act 38 U.S.C. 1725.
162.7,32 FPPS CLAIM ID 5;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>32!($L(X)<1)!'(X?1(1"1",1"2",1"3",1"4",1"5",1"6",1"7",1"8",1"9").31N) X
LAST EDITED: JUN 26, 2003
HELP-PROMPT: Enter a non-zero number from 1 to 32 digits long, 0 decimal digits.
DESCRIPTION: Enter the entire FPPS Claim ID as shown on the invoice document. (1-32 character text ID created
by FPPS system).
FIELD INDEX: AFC (#302) REGULAR IR SORTING ONLY
Short Descr: Cross-reference on FPPS CLAIM ID.
Description: This is a regular cross-reference on the FPPS CLAIM ID (1-32 characters long).
Set Logic: S ^FB583("AFC",$E(X,1,32),DA)=""
Kill Logic: K ^FB583("AFC",$E(X,1,32),DA)
Whole Kill: K ^FB583("AFC")
X(1): FPPS CLAIM ID (162.7,32) (Subscr 1) (Len 32) (forwards)
162.7,50 NOTICE OF DISAGREEMENT RECV'D A;1 DATE
DATE NOTICE OF DISAGREEMENT RECV'D
INPUT TRANSFORM: S %DT="EX",%DT(0)=-DT D ^%DT K %DT S X=Y K:Y<1 X
LAST EDITED: FEB 27, 2014
HELP-PROMPT: Enter date Notice of Agreement (VAF 21-4138) was received.
DESCRIPTION:
Date Notice of Agreement (VAF 21-4138) received.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
RECORD INDEXES: AUD (#1210)
162.7,51 STATEMENT OF THE CASE ISSUED A;2 DATE
DATE STATEMENT OF THE CASE ISSUED
INPUT TRANSFORM: S %DT="EX",%DT(0)=-DT D ^%DT K %DT S X=Y K:Y<1 X
LAST EDITED: FEB 27, 2014
HELP-PROMPT: Enter date Statement of the Case was issued.
DESCRIPTION:
Date Statement of the Case was issued.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
RECORD INDEXES: AUD (#1210)
162.7,52 DATE SUBSTANTIVE APPEAL RECV'D A;3 DATE
INPUT TRANSFORM: S %DT="EX",%DT(0)=-DT D ^%DT K %DT S X=Y K:Y<1 X
LAST EDITED: FEB 27, 2014
HELP-PROMPT: Enter date Substantive Appeal (VAF 1-9) was received.
DESCRIPTION:
Date Substantive Appeal was received.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
RECORD INDEXES: AUD (#1210)
162.7,53 DATE APPEAL DISPOSITIONED A;4 DATE
INPUT TRANSFORM: S %DT="EX",%DT(0)=-DT D ^%DT K %DT S X=Y K:Y<1 X
LAST EDITED: FEB 27, 2014
HELP-PROMPT: Enter date BVA decided appeal.
DESCRIPTION:
Date appeal decision rendered by Board of Veterans Appeal (BVA).
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
RECORD INDEXES: AUD (#1210)
162.7,54 DATE APPEALED TO COVA A;5 DATE
INPUT TRANSFORM: S %DT="EX",%DT(0)=-DT D ^%DT K %DT S X=Y K:Y<1 X
LAST EDITED: FEB 27, 2014
HELP-PROMPT: Enter date BVA decision was appealed to Court of Veteran Affairs (COVA).
DESCRIPTION: Date Board of Veterans Appeal decision was appealed to Court of Veteran Affairs (COVA). A timely
appeal must be within 120 days of the BVA decision.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
RECORD INDEXES: AUD (#1210)
162.7,55 DATE COVA APPEAL DISPOSITIONED A;6 DATE
INPUT TRANSFORM: S %DT="EX",%DT(0)=-DT D ^%DT K %DT S X=Y K:Y<1 X
LAST EDITED: FEB 27, 2014
HELP-PROMPT: Enter date a dispositon to a COVA appeal made.
DESCRIPTION:
Date a decision to a COVA appeal rendered.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
RECORD INDEXES: AUD (#1210)
162.7,292 USER AUDIT LOG1;0 DATE Multiple #162.792
DESCRIPTION:
The user audit tracks users that enter or edit the unauthorized claim.
TECHNICAL DESCR: The USER AUDIT multiple was added by patch FB*3.5*154 and does not reflect actions taken prior to
patch installation with one exception. During the install the patch attempts to create one entry in
the multiple for each pre-existing claim using data from the DATE ENTERED/LAST EDITED (#28) and
ENTERED/LAST EDITED BY (#27) fields.
INDEXED BY: EDITED BY (AU)
162.792,.01 DATE/TIME EDITED 0;1 DATE
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:X<1 X
LAST EDITED: FEB 03, 2014
HELP-PROMPT: Enter the date/time the claim was entered or edited.
DESCRIPTION:
This field is automatically populated by the software.
UNEDITABLE
CROSS-REFERENCE: 162.792^B
1)= S ^FB583(DA(1),"LOG1","B",$E(X,1,30),DA)=""
2)= K ^FB583(DA(1),"LOG1","B",$E(X,1,30),DA)
162.792,1 EDITED BY 0;2 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: FEB 03, 2014
HELP-PROMPT: Select the user that entered or edited the claim.
DESCRIPTION:
This field is automatically populated by the software.
UNEDITABLE
FIELD INDEX: AU (#1394) REGULAR IR SORTING ONLY
Short Descr: Index of users that edited the claim.
Description: This is a regular cross-reference of the users that entered or edited the unauthorized claim. It
is accessed during payment processing to enforce separation of duty.
Set Logic: S ^FB583(DA(1),"LOG1","AU",X,DA)=""
Kill Logic: K ^FB583(DA(1),"LOG1","AU",X,DA)
Whole Kill: K ^FB583(DA(1),"LOG1","AU")
X(1): EDITED BY (162.792,1) (Subscr 1) (forwards)
162.792,2 COMMENTS 0;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>60!($L(X)<3) X
LAST EDITED: FEB 25, 2014
HELP-PROMPT: Answer must be 3-60 characters in length.
DESCRIPTION: This field contains optional comments about the nature of the edit. This field is automatically
populated by the software.
UNEDITABLE
162.7,293 DATA AUDIT LOG2;0 DATE Multiple #162.793
DESCRIPTION:
The data audit multiple stores historical information for selected fields.
TECHNICAL DESCR: The AUD index tracks changes to selected fields and populates the DATA AUDIT multiple. The multiple
was added by patch FB*3.5*151 and does not reflect actions taken prior to patch installation.
162.793,.01 CHANGED DATE/TIME 0;1 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:X<1 X
LAST EDITED: JAN 23, 2014
HELP-PROMPT: Enter the date and time the field value was changed.
DESCRIPTION:
This field is automatically populated by the software.
UNEDITABLE
CROSS-REFERENCE: 162.793^B
1)= S ^FB583(DA(1),"LOG2","B",$E(X,1,30),DA)=""
2)= K ^FB583(DA(1),"LOG2","B",$E(X,1,30),DA)
162.793,1 FIELD 0;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X
OUTPUT TRANSFORM: S Y=$$GET1^DID(162.7,Y,,"LABEL")
LAST EDITED: JAN 24, 2014
HELP-PROMPT: Enter field number of changed field.
DESCRIPTION:
This field is automatically populated by the software.
162.793,2 OLD VALUE 0;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X
OUTPUT TRANSFORM: D OUTX^FBUCAUD
LAST EDITED: JAN 23, 2014
HELP-PROMPT: Enter old value of field.
DESCRIPTION:
This field is automatically populated by the software.
UNEDITABLE
162.793,3 NEW VALUE 0;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X
OUTPUT TRANSFORM: D OUTX^FBUCAUD
LAST EDITED: JAN 23, 2014
HELP-PROMPT: Enter new value of field.
DESCRIPTION:
This field is automatically populated by the software.
UNEDITABLE
162.793,4 CHANGED BY 0;5 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: JAN 23, 2014
HELP-PROMPT: Enter person that changed the field value.
DESCRIPTION:
This field is automatically populated by the software.
UNEDITABLE
FILES POINTED TO FIELDS
FEE BASIS PROGRAM (#161.8) FEE PROGRAM (#.5)
FEE BASIS UNAUTHORIZED CLAIMS
(#162.7) MASTER CLAIM (#20)
FEE BASIS UNAUTHORIZED CLAIMS
(#162.92) DISPOSITION (#10)
STATUS (#24)
EXTENSIONS:FOR STATUS (#.03)
FEE BASIS UNAUTHORIZED DISAPPR
(#162.94) REASON FOR DISAPPROVAL:REASON FOR DISAPPROVAL (#.01)
FEE BASIS VENDOR (#161.2) VENDOR (#1)
CLAIM SUBMITTED BY (#23)
ICD DIAGNOSIS (#80) ICD DIAGNOSIS (#5.1)
INSTITUTION (#4) PRIMARY SERVICE FACILITY (#6)
NEW PERSON (#200) CLAIM SUBMITTED BY (#23)
ENTERED/LAST EDITED BY (#27)
EXTENSIONS:ENTERED BY (#.02)
USER AUDIT:EDITED BY (#1)
DATA AUDIT:CHANGED BY (#4)
PATIENT (#2) VETERAN (#2)
CLAIM SUBMITTED BY (#23)
File #162.7
Record Indexes:
AUD (#1210) RECORD MUMPS ACTION
Short Descr: This index populates the DATA AUDIT multiple.
Description: This cross reference audits selected fields. The DATA AUDIT multiple is populated by this cross reference.
Routine FBUCAUD must be updated if the list of fields in this cross-reference is modified.
Set Logic: D AUD^FBUCAUD(1)
Kill Logic: D AUD^FBUCAUD(0)
X(1): STATUS (162.7,24) (forwards)
X(2): DISPOSITION (162.7,10) (forwards)
X(3): DATE CLAIM RECEIVED (162.7,.01) (forwards)
X(4): DATE REQ INFO SENT (162.7,19.6) (forwards)
X(5): DATE VALID CLAIM RECEIVED (162.7,7) (forwards)
X(6): DATE OF DISPOSITION (162.7,11) (forwards)
X(7): REOPEN CLAIM DATE (162.7,21) (forwards)
X(8): NOTICE OF DISAGREEMENT RECV'D (162.7,50) (forwards)
X(9): STATEMENT OF THE CASE ISSUED (162.7,51) (forwards)
X(10): DATE SUBSTANTIVE APPEAL RECV'D (162.7,52) (forwards)
X(11): DATE APPEAL DISPOSITIONED (162.7,53) (forwards)
X(12): DATE APPEALED TO COVA (162.7,54) (forwards)
X(13): DATE COVA APPEAL DISPOSITIONED (162.7,55) (forwards)
INPUT TEMPLATE(S):
FB UNAUTHORIZED APPEAL NOV 15, 2001@16:54 USER #0
Initiate appeal of unauthorized claim
FB UNAUTHORIZED APPEAL EDIT NOV 15, 2001@16:53 USER #0
Edit unauthorized claim
FB UNAUTHORIZED COVA APPEAL NOV 15, 2001@16:51 USER #0
COVA appeal enter/edit
FB UNAUTHORIZED DISPOSITION NOV 15, 2001@16:40 USER #0
Disposition an unauthorized claim
FB UNAUTHORIZED EDIT MAR 12, 2013@10:06 USER #0
Modify/reopen an unauthorized claim
FB UNAUTHORIZED ENTER FEB 20, 2015@12:48 USER #0
Enter unauthorized claim
FB UNAUTHORIZED LETTER UPDATE NOV 29, 2001@18:52 USER #0
Update unauthorized claim with information regarding letter (used if not sending letters with software)
FB UNAUTHORIZED PREVIOUS SEP 10, 2012@06:33 USER #0
Return previous values due to incomplete transaction
FB UNAUTHORIZED UPDATE OCT 12, 1993@12:41 USER #10116
Update certain unauthorized claims fields upon completion of enter/edit
PRINT TEMPLATE(S):
FBUC STATUS BY PATIENT JUL 06, 1993@14:35 USER #10116 STATUS LISTING OF UNAUTHORIZED CLAIMS
Status listing of unauthorized claims by patient
FBUC STATUS BY VENDOR JUL 06, 1993@14:49 USER #10116 STATUS LISTING OF UNAUTHORIZED CLAIMS
Status listing of unauthorized claims by vendor
SORT TEMPLATE(S):
FBUC STATUS BY PATIENT APR 22, 1994@12:48 USER #10226
SORT BY: @'DATE CLAIM RECEIVED// (User is asked range)
WITHIN DATE CLAIM RECEIVED, SORT BY: #+PRIMARY SERVICE FACILITY// (User is asked range)
WITHIN PRIMARY SERVICE FACILITY, SORT BY: @STATUS:;S2//
FEE BASIS UNAUTHORIZED CLAIMS STATUS FIELD: STATUS ORDER// (User is asked range)
WITHIN STATUS ORDER, SORT BY: '+STATUS//
WITHIN STATUS, SORT BY: VETERAN// (User is asked range)
WITHIN VETERAN, SORT BY: VENDOR// (User is asked range)
WITHIN VENDOR, SORT BY: EXPIRATION DATE OF CLAIM// (User is asked range)
Status listing of unauthorized claims by patient
FBUC STATUS BY VENDOR APR 22, 1994@12:49 USER #10226
SORT BY: @'DATE CLAIM RECEIVED// (User is asked range)
WITHIN DATE CLAIM RECEIVED, SORT BY: #+PRIMARY SERVICE FACILITY// (User is asked range)
WITHIN PRIMARY SERVICE FACILITY, SORT BY: @STATUS:;S2//
FEE BASIS UNAUTHORIZED CLAIMS STATUS FIELD: STATUS ORDER// (User is asked range)
WITHIN STATUS ORDER, SORT BY: '+STATUS//
WITHIN STATUS, SORT BY: VENDOR// (User is asked range)
WITHIN VENDOR, SORT BY: VETERAN// (User is asked range)
WITHIN VETERAN, SORT BY: EXPIRATION DATE OF CLAIM// (User is asked range)
Status listing of unauthorized claims by vendor
FORM(S)/BLOCK(S):