STANDARD DATA DICTIONARY #352.3 -- NON-BILLABLE CLINIC STOP CODES FILE 6/27/25 PAGE 1
STORED IN ^IBE(352.3, (31 ENTRIES) SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 2.0)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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This file shall be used to flag clinic stop codes in the CLINIC STOP (#40.7) file as either billable or non-billable for Means Test
Billing and Third Party Billing. It may also be used to flag billable stops so the Third Party auto biller will not create bills
for them. The flagging of the stop codes is date-sensitive, so the ability to not bill can be turned on or off. The default
billing action is TO BILL ALL stop codes; thus, it is only necessary to add entries to this file if billing of a particular clinic
stop code is not desired.
The routine IBEFUNC contains the function call to determine if a clinic stop code should not be billed on a specific date.
Per VHA Directive 10-93-142, this file definition should not be modified.
DD ACCESS: @
RD ACCESS: @
WR ACCESS: @
DEL ACCESS: @
LAYGO ACCESS: @
AUDIT ACCESS: @
CROSS
REFERENCED BY: CLINIC STOP CODE(AIVDT), EFFECTIVE DATE(AIVDT1), TYPE(AIVDT2), CLINIC STOP CODE(AIVDTT), EFFECTIVE DATE(AIVDTT1),
TYPE(AIVDTT2), CLINIC STOP CODE(B)
352.3,.01 CLINIC STOP CODE 0;1 POINTER TO CLINIC STOP FILE (#40.7) (Required)
LAST EDITED: JAN 30, 1996
HELP-PROMPT: Please enter a clinic stop code.
DESCRIPTION: This field is a pointer to the CLINIC STOP (#40.7) file and identifies the clinic stop code which
is being established as either billable or non-billable.
CROSS-REFERENCE: 352.3^B
1)= S ^IBE(352.3,"B",$E(X,1,30),DA)=""
2)= K ^IBE(352.3,"B",$E(X,1,30),DA)
CROSS-REFERENCE: 352.3^AIVDT^MUMPS
1)= I $P($G(^IBE(352.3,DA,0)),"^",4)=1,$P(^(0),"^",2) S ^IBE(352.3,"AIVDT",X,-$P(^(0),"^",2),DA)=""
2)= I $P($G(^IBE(352.3,DA,0)),"^",4)=1,$P(^(0),"^",2) K ^IBE(352.3,"AIVDT",X,-$P(^(0),"^",2),DA)
This cross-reference on the CLINIC STOP CODE (#.01) field and the EFFECTIVE DATE (#.02) field is
used to locate the appropriate record for a clinic stop code on a specific effective date. Entries
created only for Means Test billing.
CROSS-REFERENCE: 352.3^AIVDTT^MUMPS
1)= I $P($G(^IBE(352.3,DA,0)),"^",4)>1,$P(^(0),"^",2) S ^IBE(352.3,"AIVDTT"_$P(^(0),"^",4),X,-$P(^(
0),"^",2),DA)=""
2)= I $P($G(^IBE(352.3,DA,0)),"^",4)>1,$P(^(0),"^",2) K ^IBE(352.3,"AIVDTT"_$P(^(0),"^",4),X,-$P(^(
0),"^",2),DA)
Cross-reference on CLINIC STOP CODE (.01) and EFFECTIVE DATE (.02) for quick reference to a clinics
Third Party status on any given date.
352.3,.02 EFFECTIVE DATE 0;2 DATE (Required)
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JAN 30, 1996
HELP-PROMPT: Please enter an effective date.
DESCRIPTION:
This is the date on which billing for this clinic stop code should be activated or ignored.
CROSS-REFERENCE: 352.3^AIVDT1^MUMPS
1)= I $P($G(^IBE(352.3,DA,0)),"^",4)=1,+^(0) S ^IBE(352.3,"AIVDT",+^(0),-X,DA)=""
2)= I $P($G(^IBE(352.3,DA,0)),"^",4)=1,+^(0) K ^IBE(352.3,"AIVDT",+^(0),-X,DA)
This cross-reference on the CLINIC STOP CODE (#.01) field and the EFFECTIVE DATE (#.02) field is
used to locate the appropriate record for a clinic stop code on a specific effective date. Entries
created only for Means Test billing.
CROSS-REFERENCE: 352.3^AIVDTT1^MUMPS
1)= I $P($G(^IBE(352.3,DA,0)),"^",4)>1,+^(0) S ^IBE(352.3,"AIVDTT"_$P(^(0),"^",4),+^(0),-X,DA)=""
2)= I $P($G(^IBE(352.3,DA,0)),"^",4)>1,+^(0) K ^IBE(352.3,"AIVDTT"_$P(^(0),"^",4),+^(0),-X,DA)
Cross-reference on CLINIC STOP CODE (.01) and EFFECTIVE DATE (.02) for quick reference to a stops
Third Party status on any given date.
352.3,.03 IGNORE MEANS TEST BILLING? 0;3 SET (Required)
'1' FOR YES;
'0' FOR NO;
LAST EDITED: AUG 05, 1993
HELP-PROMPT: Please enter 'YES' or 'NO.'
DESCRIPTION: This field is used to determine whether Means Test billing should be activated or ignored, as of
the EFFECTIVE DATE (field #.02).
Please note that you only need an entry in this file for a clinic stop code for which you would
like Means Test billing to be IGNORED.
352.3,.04 TYPE 0;4 SET (Required)
'1' FOR MEANS TEST;
'2' FOR THIRD PARTY;
LAST EDITED: FEB 28, 1996
HELP-PROMPT: Enter the type of billing this entry applies to.
DESCRIPTION:
This specifies the type of billing this bill/not bill Stop Code flag applies to.
CROSS-REFERENCE: 352.3^AIVDT2^MUMPS
1)= I X=1,+$G(^IBE(352.3,DA,0)),$P(^(0),"^",2) S ^IBE(352.3,"AIVDT",+^(0),-$P(^(0),"^",2),DA)=""
2)= I X=1,+$G(^IBE(352.3,DA,0)),$P(^(0),"^",2) K ^IBE(352.3,"AIVDT",+^(0),-$P(^(0),"^",2),DA)
Cross-reference on CLINIC STOP CODE (.01) and EFFECTIVE DATE (.02) for quick reference to a stops
Means Test status on any given date.
CROSS-REFERENCE: 352.3^AIVDTT2^MUMPS
1)= I X>1,+$G(^IBE(352.3,DA,0)),$P(^(0),"^",2) S ^IBE(352.3,"AIVDTT"_X,+^(0),-$P(^(0),"^",2),DA)=""
2)= I X>1,+$G(^IBE(352.3,DA,0)),$P(^(0),"^",2) K ^IBE(352.3,"AIVDTT"_X,+^(0),-$P(^(0),"^",2),DA)
Cross-reference on CLINIC STOP CODE (.01) and EFFECTIVE DATE (.02) for quick reference to a stops
Third Party status on any given date.
352.3,.05 THIRD PARTY NON-BILLABLE 0;5 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: JAN 30, 1996
HELP-PROMPT: Enter 'Yes' if this stop code is not billable to a third party.
DESCRIPTION:
This field is used to determine if the stop code should be billed to a Third Party payer.
CROSS-REFERENCE: ^^TRIGGER^352.3^.06
1)= X ^DD(352.3,.05,1,1,1.3) I X S X=DIV S Y(1)=$S($D(^IBE(352.3,D0,0)):^(0),1:"") S X=$P(Y(1),U,6)
,X=X S DIU=X K Y S X="" X ^DD(352.3,.05,1,1,1.4)
1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(2)=$C(59)_$S($D(^DD(352.3,.06,0)):$P(^(0),U,3),1:"
"),Y(1)=$S($D(^IBE(352.3,D0,0)):^(0),1:"") S X=$P($P(Y(2),$C(59)_$P(Y(1),U,6)_":",2),$C(59),1)="NO"
1.4)= S DIH=$S($D(^IBE(352.3,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,6)=DIV,DIH=352.3,DIG=.06 D ^DI
CR:$O(^DD(DIH,DIG,1,0))>0
2)= X ^DD(352.3,.05,1,1,2.3) I X S X=DIV S Y(1)=$S($D(^IBE(352.3,D0,0)):^(0),1:"") S X=$P(Y(1),U,6)
,X=X S DIU=X K Y S X="" X ^DD(352.3,.05,1,1,2.4)
2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(2)=$C(59)_$S($D(^DD(352.3,.06,0)):$P(^(0),U,3),1:"
"),Y(1)=$S($D(^IBE(352.3,D0,0)):^(0),1:"") S X=$P($P(Y(2),$C(59)_$P(Y(1),U,6)_":",2),$C(59),1)="NO"
2.4)= S DIH=$S($D(^IBE(352.3,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,6)=DIV,DIH=352.3,DIG=.06 D ^DI
CR:$O(^DD(DIH,DIG,1,0))>0
CREATE CONDITION)= THIRD PARTY AUTO BILL="NO"
CREATE VALUE)= @
DELETE CONDITION)= THIRD PARTY AUTO BILL="NO"
DELETE VALUE)= @
FIELD)= THIRD PARTY AUTO BILL
Deletes the flag that stops auto billing for this stop code whenever the non-billable status of the
stop code changes.
352.3,.06 THIRD PARTY AUTO BILL 0;6 SET
'1' FOR NO;
'0' FOR YES;
LAST EDITED: JAN 30, 1996
HELP-PROMPT: Should visits with this stop code be automatically billed?
DESCRIPTION: Enter 'No' if the Third Party auto biller should NOT create bills for visits with this stop code.
This should only be set for stops that are billable.
NOTES: TRIGGERED by the THIRD PARTY NON-BILLABLE field of the NON-BILLABLE CLINIC STOP CODES File
FILES POINTED TO FIELDS
CLINIC STOP (#40.7) CLINIC STOP CODE (#.01)
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):