STANDARD DATA DICTIONARY #355.32 -- PLAN COVERAGE LIMITATIONS FILE 3/24/25 PAGE 1
STORED IN ^IBA(355.32, *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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This file contains the detail by plan and effective date of the categories that may be restricted for insurance coverage.
IDENTIFIED BY: COVERAGE CATEGORY (#.02)[R], EFFECTIVE DATE (#.03)[R]
CROSS
REFERENCED BY: PLAN(APCD), COVERAGE CATEGORY(APCD1), EFFECTIVE DATE(APCD2), PLAN(B)
INDEXED BY: LAST EDITED BY (LAST)
LAST MODIFIED: APR 10,2024@12:13:53
355.32,.01 PLAN 0;1 POINTER TO GROUP INSURANCE PLAN FILE (#355.3) (Required)
LAST EDITED: AUG 16, 1995
HELP-PROMPT: Enter the plan that this limitation applies to.
DESCRIPTION:
The plan that this limitation will apply to.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 355.32^B
1)= S ^IBA(355.32,"B",$E(X,1,30),DA)=""
2)= K ^IBA(355.32,"B",$E(X,1,30),DA)
CROSS-REFERENCE: 355.32^APCD^MUMPS
1)= I $P($G(^IBA(355.32,DA,0)),U,2)'="",$P(^(0),U,3)'="" S ^IBA(355.32,"APCD",$E(X,1,30),$P(^IBA(35
5.32,DA,0),U,2),-$P(^IBA(355.32,DA,0),U,3),DA)=""
2)= I $P($G(^IBA(355.32,DA,0)),U,2)'="",$P(^(0),U,3)'="" K ^IBA(355.32,DA,"APCD",$E(X,1,30),$P(^IBA
(355.32,DA,0),U,2),-$P(^IBA(355.32,DA,0),U,3),DA)
3)= DO NOT DELETE
Multiple xref on plan, coverage, and -effective date
CROSS-REFERENCE: ^^TRIGGER^355.32^1.01
1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$S($D(^IBA(355.32,D0,1)):^(1),1:"") S X=$P(Y(1),U
,1)="" I X S X=DIV S Y(1)=$S($D(^IBA(355.32,D0,1)):^(1),1:"") S X=$P(Y(1),U,1),X=X S DIU=X K Y X ^D
D(355.32,.01,1,3,1.1) X ^DD(355.32,.01,1,3,1.4)
1.1)= S X=DIV N %I,%H,% D NOW^%DTC S X=%
1.4)= S DIH=$S($D(^IBA(355.32,DIV(0),1)):^(1),1:""),DIV=X S $P(^(1),U,1)=DIV,DIH=355.32,DIG=1.01 D
^DICR:$O(^DD(DIH,DIG,1,0))>0
2)= Q
CREATE CONDITION)= #1.01=""
CREATE VALUE)= NOW
DELETE VALUE)= NO EFFECT
FIELD)= #1.01
Triggers the date/time entered when creating a new entry.
CROSS-REFERENCE: ^^TRIGGER^355.32^1.02
1)= X ^DD(355.32,.01,1,4,1.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.32,D0,1)):^(1),1:"") S X=$P(Y(1),U,
2),X=X S DIU=X K Y S X=DIV S X=DUZ X ^DD(355.32,.01,1,4,1.4)
1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$S($D(^IBA(355.32,D0,1)):^(1),1:"") S X=$S('$D(
^VA(200,+$P(Y(1),U,2),0)):"",1:$P(^(0),U,1))=""
1.4)= S DIH=$S($D(^IBA(355.32,DIV(0),1)):^(1),1:""),DIV=X S $P(^(1),U,2)=DIV,DIH=355.32,DIG=1.02 D
^DICR:$O(^DD(DIH,DIG,1,0))>0
2)= Q
CREATE CONDITION)= #1.02=""
CREATE VALUE)= S X=DUZ
DELETE VALUE)= NO EFFECT
FIELD)= #1.02
Triggers the user who created this entry.
355.32,.02 COVERAGE CATEGORY 0;2 POINTER TO PLAN LIMITATION CATEGORY FILE (#355.31) (Required)
LAST EDITED: AUG 08, 1995
HELP-PROMPT: Enter the type of coverage that will be limited.
DESCRIPTION:
The type of coverage that the insurance company plan has reimbursement limits on.
CROSS-REFERENCE: 355.32^APCD1^MUMPS
1)= I $P($G(^IBA(355.32,DA,0)),U)'="",$P(^(0),U,3)'="" S ^IBA(355.32,"APCD",$P(^IBA(355.32,DA,0),U)
,$E(X,1,30),-$P(^IBA(355.32,DA,0),U,3),DA)=""
2)= I $P($G(^IBA(355.32,DA,0)),U)'="",$P(^(0),U,3)'="" K ^IBA(355.32,"APCD",$P(^IBA(355.32,DA,0),U)
,$E(X,1,30),-$P(^IBA(355.32,DA,0),U,3),DA)
3)= DO NOT DELETE
Multiple xref on plan, coverage, and -effective date
355.32,.03 EFFECTIVE DATE 0;3 DATE (Required)
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JUL 27, 1995
HELP-PROMPT: Enter the date that this limitation is effective.
DESCRIPTION: The date on which the type of coverage for this limitation becomes limited for insurance billing
purposes.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 355.32^APCD2^MUMPS
1)= I $P($G(^IBA(355.32,DA,0)),U)'="",$P(^(0),U,2)'="" S ^IBA(355.32,"APCD",$P(^IBA(355.32,DA,0),U)
,$P(^IBA(355.32,DA,0),U,2),-$E(X,1,30),DA)=""
2)= I $P($G(^IBA(355.32,DA,0)),U)'="",$P(^(0),U,2)'="" K ^IBA(355.32,"APCD",$P(^IBA(355.32,DA,0),U)
,$P(^IBA(355.32,DA,0),U,2),-$E(X,1,30),DA)
3)= DO NOT DELETE
Multiple xref on plan, coverage, and -effective date
355.32,.04 COVERAGE STATUS 0;4 SET (Required)
'0' FOR NOT COVERED;
'1' FOR COVERED;
'2' FOR CONDITIONAL COVERAGE;
LAST EDITED: AUG 29, 1995
HELP-PROMPT: The status of this coverage for this plan as of the effective date.
DESCRIPTION: This is the status of the coverage associated with this record on the effective date associated
with this record.
355.32,1.01 DATE ENTERED 1;1 DATE
INPUT TRANSFORM: S %DT="ETX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: AUG 16, 1995
DESCRIPTION:
This is the date this limitation was entered. It is triggered by the creation of this entry.
NOTES: TRIGGERED by the PLAN field of the PLAN COVERAGE LIMITATIONS File
355.32,1.02 ENTERED BY 1;2 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: AUG 16, 1995
DESCRIPTION: This is the user who created this entry. It is automatically triggered by the creation of this
entry.
NOTES: TRIGGERED by the PLAN field of the PLAN COVERAGE LIMITATIONS File
355.32,1.03 DATE LAST EDITED 1;3 DATE
INPUT TRANSFORM: S %DT="ETX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: AUG 16, 1995
DESCRIPTION: This is the date this limitation was last edited. It is automatically updated any time the
limitation is edited using one of the options provided.
355.32,1.04 LAST EDITED BY 1;4 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: JAN 12, 2024
HELP-PROMPT: Enter the name of the person who last edited the entry.
DESCRIPTION: This is the user who last edited this limitation. It is automatically updated any time a person
edits this limitation using one of the options provided.
FIELD INDEX: LAST (#1541) MUMPS LOOKUP & SORTING
Short Descr: Multiple xref on PLAN, -DATE LAST EDITED, and LAST EDITED BY
Description: Multiple xref on PLAN (#.01), -DATE LAST EDITIED (#1.03), and LAST EDITED BY (#1.04).
Re-Indexing is not allowed due to possible corruption in the field. If a site has certain
corrupted records this cross reference will not be rebuilt during a Re-Index. Cross reference was
introduced with IB*2.0*763. If the cross reference needs to be rebuilt, use code to check that all
field are NOT null then call the re-index function in FileMan for one entry. (Refer to
NEWINDX^IBY771PO).
Set Logic: S ^IBA(355.32,"LAST",X(3),-X(2),X,DA)=""
Kill Logic: K ^IBA(355.32,"LAST",X(3),-X(2),X,DA)
Whole Kill: K ^IBA(355.32,"LAST")
X(1): LAST EDITED BY (355.32,1.04) (Subscr 1) (forwards)
X(2): Computed Code: S X=$P($G(^IBA(355.32,DA,1)),U,3)
X(3): Computed Code: S X=$P($G(^IBA(355.32,DA,0)),U)
NO RE-INDEXING ALLOWED!
355.32,2 LIMITATION COMMENT 2;0 Multiple #355.321 (Add New Entry without Asking)
355.321,.01 LIMITATION COMMENT 0;1 FREE TEXT (Multiply asked)
INPUT TRANSFORM: K:$L(X)>25!($L(X)<1) X
LAST EDITED: AUG 16, 1995
HELP-PROMPT: Answer must be 1-25 characters in length.
DESCRIPTION: This is a brief description of the limitations on this coverage. For example, Age>18 or Enrolled
over 6 months. This is informational only, no actual edit checks are performed using this data.
CROSS-REFERENCE: 355.321^B
1)= S ^IBA(355.32,DA(1),2,"B",$E(X,1,30),DA)=""
2)= K ^IBA(355.32,DA(1),2,"B",$E(X,1,30),DA)
FILES POINTED TO FIELDS
GROUP INSURANCE PLAN (#355.3) PLAN (#.01)
NEW PERSON (#200) ENTERED BY (#1.02)
LAST EDITED BY (#1.04)
PLAN LIMITATION CATEGORY
(#355.31) COVERAGE CATEGORY (#.02)
INPUT TEMPLATE(S):
IBCNBC CV DN EDIT MAY 20, 2015@04:19 USER #0
IBCNBC CV IP EDIT AUG 25, 2015@10:15 USER #0
IBCNBC CV LT EDIT MAY 20, 2015@11:04 USER #0
IBCNBC CV MH EDIT MAR 25, 2015@05:51 USER #0
IBCNBC CV OP EDIT MAY 20, 2015@04:09 USER #0
IBCNBC CV PH EDIT MAY 20, 2015@04:11 USER #0
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