STANDARD DATA DICTIONARY #355.31 -- PLAN LIMITATION CATEGORY FILE                                                 3/24/25    PAGE 1
STORED IN ^IBE(355.31,  (8 ENTRIES)   SITE: WWW.BMIRWIN.COM   UCI: VISTA,VISTA                                                     

DATA          NAME                  GLOBAL        DATA
ELEMENT       TITLE                 LOCATION      TYPE
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This table file contains elements that can be checked for an insurance company policy to determine if third party billing is valid.  
For example, the general categories of coverage the policy may exclude.  


IDENTIFIED BY: DESCRIPTION (#.02)

POINTED TO BY: COVERAGE CATEGORY field (#.02) of the PLAN COVERAGE LIMITATIONS File (#355.32) 
               

CROSS
REFERENCED BY: NAME(B)



355.31,.01    NAME                   0;1 FREE TEXT (Required)

              INPUT TRANSFORM:  K:$L(X)>30!($L(X)<2)!'(X'?1P.E) X
              LAST EDITED:      JUL 27, 1995 
              HELP-PROMPT:      Answer must be 2-30 characters in length. 
              DESCRIPTION:
                                The name of the coverage to be limited 

              CROSS-REFERENCE:  355.31^B 
                                1)= S ^IBE(355.31,"B",$E(X,1,30),DA)=""
                                2)= K ^IBE(355.31,"B",$E(X,1,30),DA)


355.31,.02    DESCRIPTION            0;2 FREE TEXT

              INPUT TRANSFORM:  K:$L(X)>40!($L(X)<1) X
              LAST EDITED:      JUL 27, 1995 
              HELP-PROMPT:      Answer must be 1-40 characters in length. 
              DESCRIPTION:
                                A free text description of the type of coverage 


355.31,.03    RIDER                  0;3 POINTER TO INSURANCE RIDERS FILE (#355.6)

              LAST EDITED:      AUG 17, 1995 
              DESCRIPTION:      This is the rider that covers this limitation category.  If a patient has this rider, this category
                                of coverage will be considered billable for that patient.  



      FILES POINTED TO                      FIELDS

INSURANCE RIDERS (#355.6)         RIDER (#.03)



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