STANDARD DATA DICTIONARY #351.61 -- TRANSFER PRICING TRANSACTIONS FILE 3/24/25 PAGE 1
STORED IN ^IBAT(351.61, *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 2.0)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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Per VHA Directive 10-93-142, this file definition should not be modified.
This file holds all transfer pricing transactions
DD ACCESS: @
RD ACCESS: @
WR ACCESS: @
DEL ACCESS: @
LAYGO ACCESS: @
AUDIT ACCESS: @
POINTED TO BY: PARENT TRANSACTION POINTER field (#.08) of the TRANSFER PRICING TRANSACTIONS File (#351.61)
CROSS
REFERENCED BY: EVENT SOURCE(AD), PRICED DATE(AE), TRANSACTION STATUS(AF), EVENT DATE(AG), PARENT TRANSACTION POINTER(AI),
TRANSACTION NUMBER(B), TRANSFER PRICING PATIENT(C)
INDEXED BY: TRANSFER PRICING PATIENT & EVENT DATE (AH)
351.61,.01 TRANSACTION NUMBER 0;1 NUMBER (Required)
INPUT TRANSFORM: K:+X'=X!(X>999999999999)!(X<1000)!(X?.E1"."1N.N) X
LAST EDITED: DEC 04, 1998
HELP-PROMPT: Type a Number between 1000 and 999999999999, 0 Decimal Digits
DESCRIPTION: This is the Transfer Pricing transaction number. This number is generated automatically in the
format of station number with a sequential number after.
CROSS-REFERENCE: 351.61^B
1)= S ^IBAT(351.61,"B",$E(X,1,30),DA)=""
2)= K ^IBAT(351.61,"B",$E(X,1,30),DA)
351.61,.02 TRANSFER PRICING PATIENT 0;2 POINTER TO TRANSFER PRICING PATIENT FILE (#351.6) (Required)
LAST EDITED: MAY 23, 2000
HELP-PROMPT: Select a Transfer Pricing patient
DESCRIPTION: This is a pointer to the transfer pricing patient file (351.6), which is the same ien as in the
patient file (#2).
CROSS-REFERENCE: 351.61^C
1)= S ^IBAT(351.61,"C",$E(X,1,30),DA)=""
2)= K ^IBAT(351.61,"C",$E(X,1,30),DA)
RECORD INDEXES: AH (#42)
351.61,.03 TRANSACTION DATE 0;3 DATE
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: DEC 04, 1998
HELP-PROMPT: This is the date the transaction was created
DESCRIPTION:
This is the date this transaction was added to the file.
351.61,.04 EVENT DATE 0;4 DATE
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: MAY 23, 2000
HELP-PROMPT: This is the date of the event.
DESCRIPTION: This is the date of the event.
Outpatient Visits = Visit Date
Inpatient Stays = Admission Date
Prescriptions = Drug Dispense Date
Prosthetics = Date Prosthetic Device issued to Patient
CROSS-REFERENCE: 351.61^AG
1)= S ^IBAT(351.61,"AG",$E(X,1,30),DA)=""
2)= K ^IBAT(351.61,"AG",$E(X,1,30),DA)
RECORD INDEXES: AH (#42)
351.61,.05 TRANSACTION STATUS 0;5 SET
'X' FOR CANCELLED;
'E' FOR ENTERED;
'C' FOR COMPLETED;
'P' FOR PRICED;
LAST EDITED: APR 21, 2000
HELP-PROMPT: This is the status of the transaction
DESCRIPTION: The status of the transaction.
Entered = only used for inpatient upon admission.
Completed = used for when the transaction information has been fully entered, but not yet priced.
For inpatient this usually means the patient has been discharged, but the PTF has not yet been
coded. This can also mean that any other type of transaction could not be priced for various
reasons.
Priced = transaction is complete.
Cancelled = treating facility has cancelled transaction.
CROSS-REFERENCE: 351.61^AF
1)= S ^IBAT(351.61,"AF",$E(X,1,30),DA)=""
2)= K ^IBAT(351.61,"AF",$E(X,1,30),DA)
CROSS-REFERENCE: ^^TRIGGER^351.61^.13
1)= X ^DD(351.61,.05,1,2,1.3) I X S X=DIV S Y(1)=$S($D(^IBAT(351.61,D0,0)):^(0),1:"") S X=$P(Y(1),U
,13),X=X S DIU=X K Y S X=DIV N %I,%H,% D NOW^%DTC X ^DD(351.61,.05,1,2,1.4)
1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$S($D(^DD(351.61,.05,0)):$P(^(0),U,3),1:
"") S X=$P($P(Y(1),$C(59)_Y(0)_":",2),$C(59),1)="PRICED"
1.4)= S DIH=$S($D(^IBAT(351.61,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,13)=DIV,DIH=351.61,DIG=.13 D
^DICR:$O(^DD(DIH,DIG,1,0))>0
2)= Q
CREATE CONDITION)= TRANSACTION STATUS="PRICED"
CREATE VALUE)= TODAY
DELETE VALUE)= NO EFFECT
FIELD)= PRICED DATE
351.61,.06 APPROVAL DATE 0;6 DATE
INPUT TRANSFORM: S %DT="EST" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 17, 2000
HELP-PROMPT: This is the date the transaction was approved
DESCRIPTION: This is the date the transaction was set to a complete status. Once a transaction is complete, it
can no longer be edited. It can only be cancelled and a new transaction created. This date is
used for report printing since another site cannot be billed until a transaction is complete. An
inpatient transaction can be completed as an interim transaction and a new one started.
DELETE AUTHORITY:
351.61,.07 INTERIM TRANSACTION FLAG 0;7 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: MAY 18, 2000
HELP-PROMPT: This indicates an interim transaction
DESCRIPTION: Only used on inpatient transactions, this flag indicates if this transaction is an interim
transaction or not.
351.61,.08 PARENT TRANSACTION POINTER 0;8 POINTER TO TRANSFER PRICING TRANSACTIONS FILE (#351.61) (Required)
LAST EDITED: FEB 25, 2000
HELP-PROMPT: This points to the parent transaction
DESCRIPTION: Used to lookup transactions and adjustment to transactions for future adjustments. The parent
should always have this filled in pointing to it self, children should always have this filled in
pointing to their parent.
CROSS-REFERENCE: 351.61^AI
1)= S ^IBAT(351.61,"AI",$E(X,1,30),DA)=""
2)= K ^IBAT(351.61,"AI",$E(X,1,30),DA)
This is used to find all the transactions that relate to one another.
351.61,.09 FROM DATE 0;9 DATE
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: DEC 04, 1998
HELP-PROMPT: Date the transaction covers from
DESCRIPTION:
This is the period this service is covered from.
351.61,.1 TO DATE 0;10 DATE
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: DEC 04, 1998
HELP-PROMPT: Date the transaction covers to
DESCRIPTION:
This is the period this service is covered to.
351.61,.11 PREFERRED FACILITY 0;11 POINTER TO INSTITUTION FILE (#4)
LAST EDITED: MAR 06, 1999
HELP-PROMPT: This is the preferred facility for this transaction.
DESCRIPTION: This indicates which facility is the patient's preferred facility at the time of the transaction.
This is used to identify what facility this transaction is for.
351.61,.12 EVENT SOURCE 0;12 FREE TEXT
INPUT TRANSFORM: K:$L(X)>20!($L(X)<3) X
LAST EDITED: FEB 16, 1999
HELP-PROMPT: Answer must be 3-20 characters in length.
DESCRIPTION: This is the source of the event.
Inpatient = ien in file #405;DGPM( Outpatient = ien in file #409.68;SCE( Pharmacy = ien
in file #52;PSRX(;fill/refill no Prosthetics = ien in file #660;RMPR(660,
CROSS-REFERENCE: 351.61^AD
1)= S ^IBAT(351.61,"AD",$E(X,1,30),DA)=""
2)= K ^IBAT(351.61,"AD",$E(X,1,30),DA)
351.61,.13 PRICED DATE 0;13 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: MAR 06, 1999
HELP-PROMPT: This is the date the transaction became priced.
DESCRIPTION:
This is the date the transaction was priced.
NOTES: TRIGGERED by the TRANSACTION STATUS field of the TRANSFER PRICING TRANSACTIONS File
CROSS-REFERENCE: 351.61^AE
1)= S ^IBAT(351.61,"AE",$E(X,1,30),DA)=""
2)= K ^IBAT(351.61,"AE",$E(X,1,30),DA)
351.61,1.01 DRG 1;1 POINTER TO DRG FILE (#80.2)
LAST EDITED: MAR 11, 1999
HELP-PROMPT: This is the DRG used to determine the cost
DESCRIPTION: This is the inpatient DRG that was calculated for the admission that the costing of this
transaction is based upon.
351.61,1.02 DRG AMOUNT 1;2 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999.99)!(X<.01) X
LAST EDITED: MAY 26, 2000
HELP-PROMPT: Type a Dollar Amount between .01 and 9999.99, 2 Decimal Digits
DESCRIPTION:
This is the dollar amount the DRG was priced at.
351.61,1.03 INPATIENT LOS 1;3 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: MAR 11, 1999
HELP-PROMPT: Type a Number between 1 and 99999, 0 Decimal Digits
DESCRIPTION:
This is the total length of stay for this inpatient stay.
351.61,1.04 HIGH TRIM DAYS 1;4 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: MAR 11, 1999
HELP-PROMPT: Type a Number between 0 and 99999, 0 Decimal Digits
DESCRIPTION: This is the arithmetic means LOS, or the outlier threshold. This corresponds to the DRG file
(#80.2), field HIGH TRIM(days) (#4). Any stays over this number will be calculated at the outlier
rate.
351.61,1.05 OUTLIER DAYS 1;5 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: MAR 16, 1999
HELP-PROMPT: Type a Number between 0 and 999999, 0 Decimal Digits
DESCRIPTION: This is the number of days to calculate charge at the outlier rates. This number is calculated by:
INPATIENT LOS - HIGH TRIM DAYS = OUTLIER DAYS
CROSS-REFERENCE: ^^TRIGGER^351.61^6.01
1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^IBAT(351.61,D0,6)):^(6),1:"") S X=$P(Y(1),U,1),X=X
S DIU=X K Y S X=DIV S X=DIV X ^DD(351.61,1.05,1,1,1.4)
1.4)= S DIH=$S($D(^IBAT(351.61,DIV(0),6)):^(6),1:""),DIV=X S $P(^(6),U,1)=DIV,DIH=351.61,DIG=6.01 D
^DICR:$O(^DD(DIH,DIG,1,0))>0
2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^IBAT(351.61,D0,6)):^(6),1:"") S X=$P(Y(1),U,1),X=X
S DIU=X K Y X ^DD(351.61,1.05,1,1,2.1) X ^DD(351.61,1.05,1,1,2.4)
2.1)= S X=DIV S Y(1)=$S($D(^IBAT(351.61,D0,1)):^(1),1:"") S X=$P(Y(1),U,5)
2.4)= S DIH=$S($D(^IBAT(351.61,DIV(0),6)):^(6),1:""),DIV=X S $P(^(6),U,1)=DIV,DIH=351.61,DIG=6.01 D
^DICR:$O(^DD(DIH,DIG,1,0))>0
CREATE VALUE)= OUTLIER DAYS
DELETE VALUE)= OUTLIER DAYS
FIELD)= TOTAL OUTLIER DAYS
351.61,1.06 OUTLIER RATE 1;6 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999.99)!(X<.01) X
LAST EDITED: MAY 26, 2000
HELP-PROMPT: Type a Dollar Amount between .01 and 999.99, 2 Decimal Digits
DESCRIPTION:
This is the daily rate for the outlier days. This is based upon 80% of the tort rate.
351.61,1.07 PTF POINTER 1;7 POINTER TO PTF FILE (#45)
LAST EDITED: MAR 11, 1999
HELP-PROMPT: This is the pointer to the PTF file
DESCRIPTION:
This is the pointer to the PTF record for which the charge was calculated.
351.61,1.08 DISCHARGE MOVEMENT 1;8 POINTER TO PATIENT MOVEMENT FILE (#405)
LAST EDITED: MAR 13, 1999
HELP-PROMPT: This is the pointer to the discharge movement
DESCRIPTION:
This is to store the discharge movement.
351.61,2 ICD DIAGNOSIS 2;0 POINTER Multiple #351.612
DESCRIPTION:
This is the diagnosis codes for this event. This will play into the DRG calculation.
351.612,.01 ICD DIAGNOSIS 0;1 POINTER TO ICD DIAGNOSIS FILE (#80)
INPUT TRANSFORM:S DIC("S")="I $$ICD9ACT^IBACSV(+Y,$P($G(^IBAT(351.61,+$G(DA(1)),0)),U,4))" D ^DIC K DIC S DIC=$G(DI
E),X=+Y K:Y<0 X
LAST EDITED: APR 21, 2003
HELP-PROMPT: This is the diagnosis codes for this transaction.
DESCRIPTION:
This is the diagnosis codes for this event. This will play into the DRG calculation.
SCREEN: S DIC("S")="I $$ICD9ACT^IBACSV(+Y,$P($G(^IBAT(351.61,+$G(DA(1)),0)),U,4))"
EXPLANATION: Only codes active on the Event Date may be selected.
CROSS-REFERENCE:351.612^B
1)= S ^IBAT(351.61,DA(1),2,"B",$E(X,1,30),DA)=""
2)= K ^IBAT(351.61,DA(1),2,"B",$E(X,1,30),DA)
351.61,3 PROCEDURES 3;0 POINTER Multiple #351.613
DESCRIPTION:
This is the multiple where the procedures performed either inpatient or outpatient are stored.
351.613,.01 PROCEDURES 0;1 POINTER TO CPT FILE (#81) (Multiply asked)
INPUT TRANSFORM:S DIC("S")="I $$CPTACT^IBACSV(+Y,$P($G(^IBAT(351.61,+$G(DA(1)),0)),U,4))" D ^DIC K DIC S DIC=$G(DIE
),X=+Y K:Y<0 X
LAST EDITED: APR 21, 2003
HELP-PROMPT: Select a procedure to determine the price of this transaction.
DESCRIPTION: This is the multiple where the procedures performed either inpatient or outpatient are stored. The
procedures are used to calculate the transaction price.
SCREEN: S DIC("S")="I $$CPTACT^IBACSV(+Y,$P($G(^IBAT(351.61,+$G(DA(1)),0)),U,4))"
EXPLANATION: Only codes active on the Event Date may be selected.
CROSS-REFERENCE:351.613^B
1)= S ^IBAT(351.61,DA(1),3,"B",$E(X,1,30),DA)=""
2)= K ^IBAT(351.61,DA(1),3,"B",$E(X,1,30),DA)
3)= Required Index for Variable Pointer
351.613,.02 QUANTITY 0;2 NUMBER
INPUT TRANSFORM:K:+X'=X!(X>9999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: MAR 01, 1999
HELP-PROMPT: Type a Number between 1 and 9999, 0 Decimal Digits
DESCRIPTION:
This is the number of times this procedure was performed.
351.613,.03 PROCEDURE COST 0;3 NUMBER
INPUT TRANSFORM:S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999.99)!(X<0) X
LAST EDITED: MAY 26, 2000
HELP-PROMPT: Type a Dollar Amount between 0 and 9999.99, 2 Decimal Digits
DESCRIPTION:
This is the unit cost per procedure.
351.61,4.01 DRUG 4;1 POINTER TO DRUG FILE (#50)
LAST EDITED: DEC 04, 1998
HELP-PROMPT: This is a pointer to the drug for this transaction
DESCRIPTION:
This pointer to the drug file indicates what prescription was issued.
351.61,4.02 QUANTITY 4;2 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: DEC 04, 1998
HELP-PROMPT: Type a Number between 1 and 999, 0 Decimal Digits
DESCRIPTION:
This is the quantity of the drug issued.
351.61,4.03 DRUG COST 4;3 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999.999)!(X<.001)!(X?.E1"."4N.N) X
LAST EDITED: MAR 16, 1999
HELP-PROMPT: Type a Number between .001 and 9999.999, 3 Decimal Digits
DESCRIPTION:
This is the cost per unit of the drug.
351.61,4.04 *PROSTHETIC ITEM 4;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>20!($L(X)<1) X
OUTPUT TRANSFORM: PROSTHETIC ITEM:NAME:NAME:SHORT DESCRIPTION
LAST EDITED: MAR 07, 2008
HELP-PROMPT: This is a pointer to the prosthetic device for this transaction
DESCRIPTION:
This is a pointer to the prosthetic item file for the prosthetic device issued to the patient.
TECHNICAL DESCR: This field was marked for deletion 04/01/08. Field was a pointer to PROS ITEM MASTER (#661) which
is out of date.
351.61,4.05 PROSTHETIC ITEM COST 4;5 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999999.99)!(X<0) X
LAST EDITED: APR 11, 2000
HELP-PROMPT: Type a Dollar Amount between 0 and 9999999.99, 2 Decimal Digits
DESCRIPTION: This is the cost of the prosthetic device. Determined by looking at file 660 at the TOTAL COST
field.
351.61,5.01 AUTHORIZING PERSON 5;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>50!($L(X)<3) X
LAST EDITED: DEC 04, 1998
HELP-PROMPT: Answer must be 3-50 characters in length.
DESCRIPTION:
This is the name of the person authorizing this transaction from the patient's preferred facility.
351.61,6.01 TOTAL OUTLIER DAYS 6;1 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: DEC 29, 1998
HELP-PROMPT: Type a Number between 0 and 9999, 0 Decimal Digits
DESCRIPTION:
This is the total of the outlier days for all the DRGs.
NOTES: TRIGGERED by the OUTLIER DAYS field of the TRANSFER PRICING TRANSACTIONS File
351.61,6.02 GROSS BILL AMOUNT 6;2 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999999.99)!(X<.01) X
LAST EDITED: JUL 29, 1999
HELP-PROMPT: Type a Dollar Amount between .01 and 9999999.99, 2 Decimal Digits
DESCRIPTION: This is the gross amount either from the drg's, cpt's, or rx's before any deductions of billed
amounts.
351.61,6.03 CATAGORY C BILL AMOUNT 6;3 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999999.99)!(X<0) X
LAST EDITED: DEC 29, 1998
HELP-PROMPT: Type a Dollar Amount between 0 and 9999999.99, 2 Decimal Digits
DESCRIPTION:
This is the dollar amount billed for the cat c patient's co-payment(s).
351.61,6.04 INSURANCE BILL AMOUNT 6;4 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999.99)!(X<0) X
LAST EDITED: DEC 29, 1998
HELP-PROMPT: Type a Dollar Amount between 0 and 999999.99, 2 Decimal Digits
DESCRIPTION:
This is the amount of the insurance bill to be deducted from the total amount.
351.61,6.05 NET AMOUNT 6;5 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999.99)!(X<.01) X
LAST EDITED: DEC 29, 1998
HELP-PROMPT: Type a Dollar Amount between .01 and 999999.99, 2 Decimal Digits
DESCRIPTION: This is the total bill amount that is due from the preferred facility. This is calculated based
upon the service provided less any other reimbursements.
FILES POINTED TO FIELDS
CPT (#81) PROCEDURES:PROCEDURES (#.01)
DRG (#80.2) DRG (#1.01)
DRUG (#50) DRUG (#4.01)
ICD DIAGNOSIS (#80) ICD DIAGNOSIS:ICD DIAGNOSIS (#.01)
INSTITUTION (#4) PREFERRED FACILITY (#.11)
PATIENT MOVEMENT (#405) DISCHARGE MOVEMENT (#1.08)
PTF (#45) PTF POINTER (#1.07)
TRANSFER PRICING PATIENT
(#351.6) TRANSFER PRICING PATIENT (#.02)
TRANSFER PRICING TRANSACTIONS
(#351.61) PARENT TRANSACTION POINTER (#.08)
File #351.61
Record Indexes:
AH (#42) RECORD REGULAR IR SORTING ONLY
Short Descr: XREF BETWEEN PATIENT AND EVENT DATE FOR SORTING
Set Logic: S ^IBAT(351.61,"AH",X(1),X(2),DA)=""
Kill Logic: K ^IBAT(351.61,"AH",X(1),X(2),DA)
Whole Kill: K ^IBAT(351.61,"AH")
X(1): TRANSFER PRICING PATIENT (351.61,.02) (Subscr 1) (forwards)
X(2): EVENT DATE (351.61,.04) (Subscr 2) (forwards)
INPUT TEMPLATE(S):
IBAT OUT PRICING EDIT APR 13, 1999@11:05 USER #0
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):