STANDARD DATA DICTIONARY #355.93 -- IB NON/OTHER VA BILLING PROVIDER FILE 3/24/25 PAGE 1
STORED IN ^IBA(355.93, *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 2.0)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
-----------------------------------------------------------------------------------------------------------------------------------
This file contains data for non-VA facilities that provide services for VA patients who have reimbursable insurance for these
services. VA pays for these services and in turn submits the charges to the insurance co for reimbursement.
DD ACCESS: @
RD ACCESS:
WR ACCESS:
DEL ACCESS:
LAYGO ACCESS:
AUDIT ACCESS: @
IDENTIFIED BY: PROVIDER TYPE (#.02)[R]
POINTED TO BY: IB NON/OTHER PROVIDER field (#.07) of the FEE BASIS PAID TO IB File (#161.9)
PRACTITIONER field (#.01) of the IB BILLING PRACTITIONER ID File (#355.9)
NON-VA PROVIDER field (#.18) of the IB NON/OTHER VA BILLING PROVIDER File (#355.93)
PROVIDER field (#.03) of the PATIENT EVENT PROVIDER sub-field (#356.2213) of the HCS REVIEW TRANSMISSION File
(#356.22)
PROVIDER field (#.03) of the SERVICE PROVIDER sub-field (#356.22168) of the SERVICE LINE sub-field (#356.2216) of
the HCS REVIEW TRANSMISSION File (#356.22)
NON-VA FACILITY field (#232) of the BILL/CLAIMS File (#399)
PERFORMED BY field (#.02) of the PROVIDER sub-field (#399.0222) of the BILL/CLAIMS File (#399)
LINE PERFORMED BY field (#.02) of the LINE PROVIDER sub-field (#399.0404) of the PROCEDURES sub-field (#399.0304) of
the BILL/CLAIMS File (#399)
CROSS
REFERENCED BY: NAME(B), NPI(NPI), NPI(NPIHISTORY), STATUS(TAXSTATUS)
INDEXED BY: NPI (NPI42)
LAST MODIFIED: SEP 19,2022@15:16
355.93,.01 NAME 0;1 FREE TEXT (Required)
INPUT TRANSFORM: K:($L(X)>60)!($L(X)<3) X I $D(X) D PRVFMT^IBCEP8
MAXIMUM LENGTH: 60
LAST EDITED: APR 27, 2017
HELP-PROMPT: Enter the name of a NON-VA provider/facility or other VA. Name must start with a letter and can
have letters,numbers,comma,space,dash only. Names aren't valid if they exist in the NEW PERSON
file.
DESCRIPTION: This is the name of either an individual NON-VA provider or a NON-VA or another VA facility that
provides services to the V.A. for which the V.A. can in turn bill an insurance company for
reimbursement.
For individual type entries: The name should be entered in LAST,FIRST MIDDLE format. Enter only
data that is actually part of the provider's name. Do not include extra titles, identification,
flags, local information, etc. All individual provider names will be converted to the
'standardized' format. 'Standardized' for individuals means all punctuation except '-' and space
are removed, the name is changed to all uppercase, 2 or more successive '-' or spaces are converted
to a single '-' or space and any words for birth position (1ST-10TH) are changed to their Roman
numeral equivalents.
For facility type entries: The name MUST start with an Alpha character. The name may contain
numerals, spaces, commas, periods, and a hyphen or dash. No other punctuation characters are
allowed in the name.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 355.93^B
1)= S ^IBA(355.93,"B",$E(X,1,30),DA)=""
2)= K ^IBA(355.93,"B",$E(X,1,30),DA)
CROSS-REFERENCE: ^^TRIGGER^355.93^.02
1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S X=IBFLPFLP I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0))
:^(0),1:"") S X=$P(Y(1),U,2),X=X S DIU=X K Y S X=DIV S X=IBFLPFLP X ^DD(355.93,.01,1,2,1.4)
1.4)= S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,2)=DIV,DIH=355.93,DIG=.02 D ^DICR
2)= Q
3)= Do not delete
CREATE CONDITION)= S X=IBFLPFLP
CREATE VALUE)= S X=IBFLPFLP
DELETE VALUE)= NO EFFECT
FIELD)= PROVIDER TYPE
Trigger to change provider type based on user input during add/edit of the NAME field (#.01).
Population of this field is based on the value of the IBFLPFLP variable returned by the NAME field
input transform.
355.93,.02 PROVIDER TYPE 0;2 SET (Required)
'1' FOR FACILITY/GROUP;
'2' FOR INDIVIDUAL;
INPUT TRANSFORM: K:$L(X)>1!($L(X)<1) X Q:$G(IBIFN)="" I $$INDIVIDUAL^IBCU4(IBIFN,X,"")=0 K X
LAST EDITED: MAR 22, 2022
HELP-PROMPT: Enter 1 or 2 to designate this entry as a facility or an individual.
DESCRIPTION: This field identifies the type of provider being defined. Facility providers can be used to fill
in the name and address of the non-VA facility where services were rendered (box 32 on the
CMS-1500). An individual provider can be selected as the rendering, attending, referring or
operating provider on a bill.
EXECUTABLE HELP: D INDIVHELP^IBCU4
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
TRIGGERED by the NAME field of the IB NON/OTHER VA BILLING PROVIDER File
CROSS-REFERENCE: ^^TRIGGER^355.93^.03
1)= Q
2)= X ^DD(355.93,.02,1,1,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,
3),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,3)=DIV,DIH=355.93,DIG=.
03 D ^DICR
2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(
Y(1),$C(59)_X_":",2),$C(59))="INDIVIDUAL"
3)= Do not delete
CREATE VALUE)= NO EFFECT
DELETE CONDITION)= OLD PROVIDER TYPE="INDIVIDUAL"
DELETE VALUE)= @
FIELD)= CRE
This trigger deletes the value of the CREDENTIALS field if the type is no longer an individual
provider type.
CROSS-REFERENCE: ^^TRIGGER^355.93^.04
1)= Q
2)= X ^DD(355.93,.02,1,2,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,
4),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,4)=DIV,DIH=355.93,DIG=.
04 D ^DICR
2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(
Y(1),$C(59)_X_":",2),$C(59))="INDIVIDUAL"
3)= Do not delete
CREATE VALUE)= NO EFFECT
DELETE CONDITION)= OLD PROVIDER TYPE="INDIVIDUAL"
DELETE VALUE)= @
FIELD)= SPE
This trigger deletes the value of the SPECIALTY field if the type is no longer an individual
provider type.
CROSS-REFERENCE: ^^TRIGGER^355.93^.05
1)= Q
2)= X ^DD(355.93,.02,1,3,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,
5),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,5)=DIV,DIH=355.93,DIG=.
05 D ^DICR
2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(
Y(1),$C(59)_X_":",2),$C(59))="FACILITY/GROUP"
3)= Do not delete
CREATE VALUE)= NO EFFECT
DELETE CONDITION)= OLD PROVIDER TYPE="FACILITY/GROUP"
DELETE VALUE)= @
FIELD)= STREET ADDRESS
This trigger deletes the value of the STREET ADDRESS field if the type is no longer a facility type
provider.
CROSS-REFERENCE: ^^TRIGGER^355.93^.06
1)= Q
2)= X ^DD(355.93,.02,1,4,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,
6),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,6)=DIV,DIH=355.93,DIG=.
06 D ^DICR
2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(
Y(1),$C(59)_X_":",2),$C(59))="FACILITY/GROUP"
3)= Do not delete
CREATE VALUE)= NO EFFECT
DELETE CONDITION)= OLD PROVIDER TYPE="FACILITY/GROUP"
DELETE VALUE)= @
FIELD)= CITY
This trigger deletes the value of the CITY field if the type is no longer a facility type provider.
CROSS-REFERENCE: ^^TRIGGER^355.93^.07
1)= Q
2)= X ^DD(355.93,.02,1,5,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,
7),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,7)=DIV,DIH=355.93,DIG=.
07 D ^DICR
2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(
Y(1),$C(59)_X_":",2),$C(59))="FACILITY/GROUP"
3)= Do not delete
CREATE VALUE)= NO EFFECT
DELETE CONDITION)= OLD PROVIDER TYPE="FACILITY/GROUP"
DELETE VALUE)= @
FIELD)= STATE
This trigger deletes the value of the STATE field if the type is no longer a facility type
provider.
CROSS-REFERENCE: ^^TRIGGER^355.93^.08
1)= Q
2)= X ^DD(355.93,.02,1,6,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,
8),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,8)=DIV,DIH=355.93,DIG=.
08 D ^DICR
2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(
Y(1),$C(59)_X_":",2),$C(59))="FACILITY/GROUP"
3)= Do not delete
CREATE VALUE)= NO EFFECT
DELETE CONDITION)= OLD PROVIDER TYPE="FACILITY/GROUP"
DELETE VALUE)= @
FIELD)= ZIP
This trigger deletes the value of the ZIP CODE field if the type is no longer a facility type
provider.
CROSS-REFERENCE: ^^TRIGGER^355.93^.09
1)= Q
2)= X ^DD(355.93,.02,1,7,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,
9),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,9)=DIV,DIH=355.93,DIG=.
09 D ^DICR
2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(
Y(1),$C(59)_X_":",2),$C(59))="FACILITY/GROUP"
3)= Do not delete
CREATE VALUE)= NO EFFECT
DELETE CONDITION)= OLD PROVIDER TYPE="FACILITY/GROUP"
DELETE VALUE)= @
FIELD)= FACILITY DEFAULT ID NUMBER
This trigger deletes the value of the FACILITY DEFAULT ID NUMBER field if the type is no longer a
facility type provider.
CROSS-REFERENCE: ^^TRIGGER^355.93^.1
1)= Q
2)= X ^DD(355.93,.02,1,8,2.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,
10),X=X S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,10)=DIV,DIH=355.93,DIG
=.1 D ^DICR
2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(355.93,.02,0)),U,3) S X=$P($P(
Y(1),$C(59)_X_":",2),$C(59))="FACILITY/GROUP"
3)= Do not delete
CREATE VALUE)= NO EFFECT
DELETE CONDITION)= OLD PROVIDER TYPE="FACILITY/GROUP"
DELETE VALUE)= @
FIELD)= STREET ADDRESS LINE 2
This trigger deletes the value of the STREET ADDRESS LINE 2 field if the provider type is no longer
a facility type provider.
CROSS-REFERENCE: ^^TRIGGER^355.93^.13
1)= X ^DD(355.93,.02,1,9,1.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,
13),X=X S DIU=X K Y S X=DIV S X="16" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,13)=DIV,DIH=
355.93,DIG=.13 D ^DICR
1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(2)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=Y(0),X=
X S X=X="1",Y(1)=$G(X) S X=$P(Y(2),U,9)]"",Y=X,X=Y(1),X=X&Y
2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,13),X=X
S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,13)=DIV,DIH=355.93,DIG=.13 D ^
DICR
CREATE CONDITION)= INTERNAL(PROVIDER TYPE)="1"&(FACILITY DEFAULT ID NUMBER]"")
CREATE VALUE)= "16"
DELETE VALUE)= @
FIELD)= PRIMARY ID QUALIFIER
This trigger sets the primary id qualifier to the default value of 16 if the provider type is a
facility and the FACILITY DEFAULT ID NUMBER is not null.
355.93,.03 CREDENTIALS 0;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>3!($L(X)<1) X I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)'=2 K X
LAST EDITED: OCT 05, 2000
HELP-PROMPT: Answer must be 1-3 characters in length.
DESCRIPTION: This is the 1 to 3 digits that represents the credentials for this provider. This field is only
valid for INDIVIDUAL providers.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
355.93,.04 SPECIALTY 0;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>2!($L(X)<2) X I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)'=2 K X
LAST EDITED: OCT 05, 2000
HELP-PROMPT: Answer must be 2 characters in length.
DESCRIPTION: This is the 2 digits that represent the specialty for this provider. This field is only valid for
INDIVIDUAL providers.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
355.93,.05 STREET ADDRESS 0;5 FREE TEXT (Required)
INPUT TRANSFORM: S X=$$UP^XLFSTR(X) K:$L(X)>55!($L(X)<1)!$$BADADD^IBCEP8B(X) X I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)
'=1 K X
MAXIMUM LENGTH: 55
LAST EDITED: APR 27, 2017
HELP-PROMPT: Answer must be 1-55 characters in length. Cannot be a post office box.
DESCRIPTION: This is the street address of the non-VA facility that rendered the care that is being billed by
the VA. It is only valid for FACILITY providers. It cannot be a post office box.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
355.93,.06 CITY 0;6 FREE TEXT
INPUT TRANSFORM: K:$L(X)>20!($L(X)<1) X I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)'=1 K X
LAST EDITED: OCT 05, 2000
HELP-PROMPT: Answer must be 1-20 characters in length.
DESCRIPTION: This is the city of the non-VA facility that rendered the care that is being billed by the VA. It
is only valid for FACILITY providers.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
355.93,.07 STATE 0;7 POINTER TO STATE FILE (#5)
INPUT TRANSFORM: I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)'=1 K X
LAST EDITED: OCT 05, 2000
HELP-PROMPT: Enter a valid state where the facility is located
DESCRIPTION: This is the state of the non-VA facility that rendered the care that is being billed by the VA. It
is only valid for FACILITY providers.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
355.93,.08 ZIP CODE 0;8 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>10!($L(X)<9)!'((X?9N)!(X?5N1"-"4N))!($E(X,$L(X)-3,$L(X))="0000") X I $D(X),$P($G(^IBA(355.9
3,DA,0)),U,2)'=1 K X
LAST EDITED: MAR 12, 2014
HELP-PROMPT: Answer must be nine (999999999) or ten digits (99999-9999) in length. The last 4 digits cannot be
"0000".
DESCRIPTION: This is the zip code of the non-VA facility that rendered the care that is being billed by the VA.
It is only valid for FACILITY providers. The ZIP code must be a nine digit ZIP code number and not
ending in "0000" (four consecutive zeros).
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
355.93,.09 FACILITY DEFAULT ID NUMBER 0;9 FREE TEXT
INPUT TRANSFORM: K:$L(X)>10!($L(X)<1) X I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)'=1 K X
LAST EDITED: MAR 28, 2006
HELP-PROMPT: Enter the Federal Tax ID of the outside facility.
DESCRIPTION:
Enter the Federal Tax ID of the outside facility.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
CROSS-REFERENCE: ^^TRIGGER^355.93^.13
1)= X ^DD(355.93,.09,1,1,1.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,
13),X=X S DIU=X K Y S X=DIV S X="16" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,13)=DIV,DIH=
355.93,DIG=.13 D ^DICR
1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1)
,U,2),X=X S X=X="1",Y(2)=$G(X) S X=Y(0)]"",Y=X,X=Y(2),X=X&Y
2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^IBA(355.93,D0,0)):^(0),1:"") S X=$P(Y(1),U,13),X=X
S DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),0)),DIV=X S $P(^(0),U,13)=DIV,DIH=355.93,DIG=.13 D ^
DICR
CREATE CONDITION)= INTERNAL(PROVIDER TYPE)="1"&(FACILITY DEFAULT ID NUMBER]"")
CREATE VALUE)= "16"
DELETE VALUE)= @
FIELD)= PRIMARY ID QUALIFIER
355.93,.1 STREET ADDRESS LINE 2 0;10 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X I $D(X),$P($G(^IBA(355.93,DA,0)),U,2)'=1 K X
LAST EDITED: JUL 21, 2010
HELP-PROMPT: Answer must be 1-30 characters in length.
DESCRIPTION: This is line 2 of the street address of the non-VA facility that rendered the care that is being
billed by the VA. It is only valid for FACILITY providers.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
355.93,.11 X12 TYPE OF FACILITY 0;11 SET
'77' FOR SERVICE LOCATION;
'FA' FOR FACILITY;
'LI' FOR INDEPENDENT LAB;
'TL' FOR TESTING LAB;
LAST EDITED: JUN 19, 2007
HELP-PROMPT: Enter a code to describe the type of facility for professional claims. Type Facility (FA) will
automatically be sent on institutional claims.
DESCRIPTION: This is the code for the type of facility as identified in the X12 documents. It is used to
describe the type of facility for professional claims. Facility (FA) will automatically be sent on
institutional claims.
355.93,.12 STATE LICENSE # 0;12 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X
LAST EDITED: AUG 25, 2003
HELP-PROMPT: Answer must be 1-30 characters in length.
DESCRIPTION: This is the State license # for the non-VA provider. Note, there can be only 1 state license # on
file for non-VA/other VA providers. Enter multiple entries for the provider if multiple state
license numbers are required (one for each state).
NOTES: TRIGGERED by the STATE field of the IB NON/OTHER VA BILLING PROVIDER File
355.93,.13 PRIMARY ID QUALIFIER 0;13 POINTER TO IB PROVIDER ID # TYPE FILE (#355.97)
INPUT TRANSFORM: S DIC("S")="I $P($G(^(1)),U,4)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: MAR 09, 2006
HELP-PROMPT: The only Qualifier allowed is the TAX ID.
DESCRIPTION:
This is the Qualifier associated with the FACILITY DEFAULT ID NUMBER.
SCREEN: S DIC("S")="I $P($G(^(1)),U,4)"
EXPLANATION: Only TAX ID allowed
NOTES: TRIGGERED by the FACILITY DEFAULT ID NUMBER field of the IB NON/OTHER VA BILLING PROVIDER File
TRIGGERED by the PROVIDER TYPE field of the IB NON/OTHER VA BILLING PROVIDER File
355.93,.15 MAMMOGRAPHY CERTIFICATION # 0;15 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<3) X
LAST EDITED: MAR 09, 2006
HELP-PROMPT: Enter the Mammography Certification Number for this facility. Must be 3-15 characters.
DESCRIPTION: This is the mammography certification number for the non-VA facility which is used as a default on
the claim when mammography services are performed. It is required by some insurance companies.
355.93,.16 LICENSE STATE 0;16 POINTER TO STATE FILE (#5)
LAST EDITED: NOV 08, 2011
HELP-PROMPT: Enter the state which issued the license of the individual or facility.
DESCRIPTION: This is the state which issued the STATE LICENSE #(#.12) field of the non-VA individual or facility
that rendered the care that is being billed by the VA.
355.93,.17 SOLE PROPRIETORSHIP 0;17 SET
Sole Proprietorship?
'Y' FOR YES;
'N' FOR NO;
LAST EDITED: SEP 15, 2014
HELP-PROMPT: Enter Y if this is a sole proprietorship, N if it is not.
DESCRIPTION:
A sole proprietorship is a Non-VA facility that is owned by a single Non-VA provider.
TECHNICAL DESCR: This field provides the ability to mark the organization as a sole proprietorship, which allows use
of the single provider's NPI for the organization. Duplicate use of an NPI would otherwise not be
permitted.
355.93,.18 NON-VA PROVIDER 0;18 POINTER TO IB NON/OTHER VA BILLING PROVIDER FILE (#355.93)
Non-VA Provider
INPUT TRANSFORM: S DIC("S")="I $P($G(^(0)),U,2)=2" D ^DIC K DIC S DIC=$G(DIE),X=+Y K:Y<0 X
LAST EDITED: SEP 08, 2014
HELP-PROMPT: Enter the Non-VA Provider that functions as the sole-proprietor of this facility.
DESCRIPTION:
Non-VA provider associated with this facility.
SCREEN: S DIC("S")="I $P($G(^(0)),U,2)=2"
EXPLANATION: Only individuals can function as a Sole-proprietor.
355.93,1.01 P&C CONTACT NAME 1;1 FREE TEXT
P&C Contact Name
INPUT TRANSFORM: K:$L(X)>30!($L(X)<3) X
LAST EDITED: JAN 25, 2013
HELP-PROMPT: Enter the Contact Person (3-30 characters) at this Lab/Facility (Last Name,First Name).
DESCRIPTION: For use with property and casualty claims, this is the name of the contact person at this
Lab/Facility (Last Name, First Name).
355.93,1.02 P&C CONTACT PHONE NUMBER 1;2 FREE TEXT
P&C Contact Phone Number
INPUT TRANSFORM: K:$L(X)>15!($L(X)<10) X
LAST EDITED: JAN 25, 2013
HELP-PROMPT: Answer must be 10-15 characters in length.
DESCRIPTION: For use with property and casualty claims, this is the area code and phone number of the contact
person at this facility.
CROSS-REFERENCE: ^^TRIGGER^355.93^1.03
1)= Q
2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^IBA(355.93,D0,1)):^(1),1:"") S X=$P(Y(1),U,3),X=X S
DIU=X K Y S X="" S DIH=$G(^IBA(355.93,DIV(0),1)),DIV=X S $P(^(1),U,3)=DIV,DIH=355.93,DIG=1.03 D ^D
ICR
CREATE VALUE)= NO EFFECT
DELETE VALUE)= S X=""
FIELD)= CONTACT PHONE EXTENSION
If Contact Phone is deleted, extension will be deleted also.
355.93,1.03 P&C CONTACT PHONE EXTENSION 1;3 NUMBER
P&C Contact Phone Extension
INPUT TRANSFORM: K:+X'=X!(X>9999999999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: JAN 25, 2013
HELP-PROMPT: Type a number between 0 and 9999999999, 0 decimal digits.
DESCRIPTION: For use with property and casualty claims, this is the phone extension of the contact person at
this facility, if known.
NOTES: TRIGGERED by the P&C CONTACT PHONE NUMBER field of the IB NON/OTHER VA BILLING PROVIDER File
355.93,40 DATE/TIME OF LAST NPI CHANGE NPISTATUS;0 DATE Multiple #355.9301 (Add New Entry without Asking)
355.9301,.01 DATE/TIME OF LAST NPI CHANGE 0;1 DATE
INPUT TRANSFORM: S %DT="ETXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: DEC 18, 2006
HELP-PROMPT: Enter the date/time of the last change to this NPI.
DESCRIPTION:
This is the date and time of the last change to the NPI value.
CROSS-REFERENCE: 355.9301^B
1)= S ^IBA(355.93,DA(1),"NPISTATUS","B",$E(X,1,30),DA)=""
2)= K ^IBA(355.93,DA(1),"NPISTATUS","B",$E(X,1,30),DA)
355.9301,.02 STATUS 0;2 SET
'1' FOR ACTIVE;
'0' FOR INACTIVE;
LAST EDITED: DEC 18, 2006
HELP-PROMPT: Enter a 1 for 'ACTIVE', 0 for 'INACTIVE'
DESCRIPTION: The Status of an NPI is either 'ACTIVE' or 'INACTIVE'. If 'ACTIVE', then the NPI will be
accessible by end-users to document a particular provider. If 'INACTIVE', then the NPI will only
be accessible by the application to display legacy data.
CROSS-REFERENCE: 355.9301^NPISTATUS
1)= S ^IBA(355.93,DA(1),"NPISTATUS","NPISTATUS",$E(X,1,30),DA)=""
2)= K ^IBA(355.93,DA(1),"NPISTATUS","NPISTATUS",$E(X,1,30),DA)
This cross reference is for identifying active, inactive, or deleted NPIs.
355.9301,.03 NPI 0;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>10!($L(X)<10)!('$$CHKDGT^XUSNPI(X)) X
LAST EDITED: DEC 18, 2006
HELP-PROMPT: Answer must be 10 characters in length.
DESCRIPTION: Unique National Provider Identifier. A unique integer assigned to providers by CMS. This field
contains all of the NPIs associated with this provider. The current NPI will be set as active in
the STATUS field of this multiple. All others will be set as inactive. There can only be one
active NPI.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 355.9301^C
1)= S ^IBA(355.93,DA(1),"NPISTATUS","C",$E(X,1,30),DA)=""
2)= K ^IBA(355.93,DA(1),"NPISTATUS","C",$E(X,1,30),DA)
This x-ref (along with the NPI42 whole file x-ref) is used by Kernel when checking for existing
NPI entries in this file before allowing them to be used in files 200 (NEW PERSON) or 4
(INSTITUTION).
FIELD INDEX: NPI42 (#705) REGULAR IR LOOKUP & SORTING WHOLE FILE (#355.93)
Short Descr: NPI42 X-REF
Set Logic: S ^IBA(355.93,"NPI42",$E(X,1,10),DA(1),DA)=""
Kill Logic: K ^IBA(355.93,"NPI42",$E(X,1,10),DA(1),DA)
Whole Kill: K ^IBA(355.93,"NPI42")
X(1): NPI (355.9301,.03) (Subscr 1) (Len 10) (forwards)
355.9301,.04 PERSON AFFECTING LAST CHANGE 0;4 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: DEC 18, 2006
HELP-PROMPT: Enter the name of the person last changing this NPI.
DESCRIPTION:
This is the name of the person who last changed the NPI.
355.93,41.01 NPI 0;14 FREE TEXT
INPUT TRANSFORM: N IBOLDNPI S IBOLDNPI=$P($G(^IBA(355.93,DA,0)),U,14) K:$L(X)>10!($L(X)<10)!'$$CHKDGT^XUSNPI(X)!$$NP
IUSED^IBCEP81(X,IBOLDNPI,DA,$S(X=IBOLDNPI:2,1:0),"XUSNPIMTL") X
LAST EDITED: MAY 12, 2008
HELP-PROMPT: Answer must be 10 characters in length and a valid unique NPI number.
DESCRIPTION: Unique National Provider Identifier. A unique integer assigned to a provider by CMS. This field
contains the current NPI for this provider.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 355.93^NPI
1)= S ^IBA(355.93,"NPI",$E(X,1,30),DA)=""
2)= K ^IBA(355.93,"NPI",$E(X,1,30),DA)
This cross reference holds a list of the active NPIs in this file.
CROSS-REFERENCE: 355.93^NPIHISTORY
1)= S ^IBA(355.93,"NPIHISTORY",$E(X,1,30),DA)=""
2)= K ^IBA(355.93,"NPIHISTORY",$E(X,1,30),DA)
3)= An entry into the NPI History cross reference should not be deleted
This cross reference holds the entire history of the NPIs used in the file.
355.93,42 TAXONOMY CODE TAXONOMY;0 POINTER Multiple #355.9342
IDENTIFIED BY:
355.9342,.01 TAXONOMY CODE 0;1 POINTER TO PERSON CLASS FILE (#8932.1) (Multiply asked)
INPUT TRANSFORM:S DIC("S")="I $TR($P($G(^(90002)),U,2),""IN"",""21"")=$P(^IBA(355.93,DA(1),0),U,2)" D ^DIC K DIC S
DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: AUG 30, 2006
HELP-PROMPT: Enter the NUCC recognized taxonomy code
DESCRIPTION:
This multiple field holds the NUCC recognized taxonomy code for an individual or an organization.
SCREEN: S DIC("S")="I $TR($P($G(^(90002)),U,2),""IN"",""21"")=$P(^IBA(355.93,DA(1),0),U,2)"
EXPLANATION: INDIVIDUAL/NON-INDIVIDUAL (FACILITY)
DELETE TEST: 1,0)= I 1 W *7,!,"TAXONOMY CODES SHOULD NOT BE DELETED. SET THE STATUS FLAG TO INACTIVE INSTEAD."
CROSS-REFERENCE:355.9342^B
1)= S ^IBA(355.93,DA(1),"TAXONOMY","B",$E(X,1,30),DA)=""
2)= K ^IBA(355.93,DA(1),"TAXONOMY","B",$E(X,1,30),DA)
355.9342,.02 PRIMARY CODE 0;2 SET (Required)
'1' FOR YES;
'0' FOR NO;
LAST EDITED: AUG 24, 2006
HELP-PROMPT: Enter a 1 if this is the provider's primary taxonomy code or a 0 for non-primary.
DESCRIPTION: Only one code can be the primary taxonomy code for a provider. When a specific taxonomy code is
identified as the primary code then that code will be the default taxonomy code.
CROSS-REFERENCE:355.9342^D^MUMPS
1)= D XR^IBCEP82
2)= D KXR^IBCEP82
This x-ref is used to make sure that a maximum of one taxonomy is allowed to be marked as primary.
355.9342,.03 STATUS 0;3 SET (Required)
'A' FOR ACTIVE;
'I' FOR INACTIVE;
LAST EDITED: AUG 24, 2006
HELP-PROMPT: Enter an 'A' for active code, or an 'I' for an inactive code.
DESCRIPTION: If a taxonomy code listed for a provider is a currently active code (one they use today), then the
status should be marked with an 'A'. At times a provider will no longer use a taxonomy code. This
code will be marked with an 'I' for inactive. Codes should not be removed from a provider's list.
They should be either active or inactive.
CROSS-REFERENCE:355.93^TAXSTATUS
1)= S ^IBA(355.93,"TAXSTATUS",$E(X,1,30),DA(1),DA)=""
2)= K ^IBA(355.93,"TAXSTATUS",$E(X,1,30),DA(1),DA)
355.93,50 DATE/TIME LAST FB UPDATE 4;0 DATE Multiple #355.935 (Add New Entry without Asking)
DESCRIPTION:
This multiple tracks updates to this file that are made by the FEE BASIS PAID TO IB background job.
355.935,.01 DATE/TIME LAST FB UPDATE 0;1 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:X<1 X
LAST EDITED: MAY 30, 2012
HELP-PROMPT: Enter the date this record was modified by Fee Basis interface.
DESCRIPTION:
This field tracks when updates were made by the Fee Basis Paid to IB interface.
CROSS-REFERENCE: 355.935^B
1)= S ^IBA(355.93,DA(1),4,"B",$E(X,1,30),DA)=""
2)= K ^IBA(355.93,DA(1),4,"B",$E(X,1,30),DA)
355.935,.02 FB SUPERVISOR 0;2 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: MAY 30, 2012
HELP-PROMPT: Enter the Fee Basis Supervisor who certified the batch.
DESCRIPTION: This field identifies the Fee Basis Supervisor who released the batch that contained provider
information added/updated to this record.
355.935,.03 CREATED BY FB PAID TO IB 0;3 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: MAY 30, 2012
HELP-PROMPT: Enter YES if FB PAID TO IB created this record.
DESCRIPTION:
This field is set to YES if the FB PAID TO IB background job created this record.
355.93,51 DATE/TIME ALLOW FB UPDATE 3;0 DATE Multiple #355.9351 (Add New Entry without Asking)
DESCRIPTION: This multiple stores information that the Fee Basis interface uses to control whether updates to
this record should be allowed. Historical information is saved, and the most recent entry is used
by the interface.
355.9351,.01 DATE/TIME ALLOW FB UPDATE 0;1 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:X<1 X
LAST EDITED: MAY 30, 2012
HELP-PROMPT: Enter the date/time the IB user toggled allow/disallow.
DESCRIPTION: This field tracks when an IB user chooses to allow/disallow updates to this record by FB PAID TO
IB.
CROSS-REFERENCE: 355.9351^B
1)= S ^IBA(355.93,DA(1),3,"B",$E(X,1,30),DA)=""
2)= K ^IBA(355.93,DA(1),3,"B",$E(X,1,30),DA)
355.9351,.02 ALLOW UPDATES 0;2 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: MAY 30, 2012
HELP-PROMPT: Allow updates?
DESCRIPTION:
This field notes whether the FB PAID TO IB option is allowed to update this record.
355.9351,.03 IB USER WHO CHANGED 0;3 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: MAY 30, 2012
HELP-PROMPT: Enter the IB USER who changed the ALLOW UPDATES value.
DESCRIPTION:
This field identifies the IB USER who changed the ALLOW UPDATES (#.02) value.
FILES POINTED TO FIELDS
IB NON/OTHER VA BILLING PROVID
(#355.93) NON-VA PROVIDER (#.18)
IB PROVIDER ID # TYPE (#355.97) PRIMARY ID QUALIFIER (#.13)
NEW PERSON (#200) DATE/TIME OF LAST NPI CHANGE:PERSON AFFECTING LAST CHANGE (#.04)
DATE/TIME LAST FB UPDATE:FB SUPERVISOR (#.02)
DATE/TIME ALLOW FB UPDATE:IB USER WHO CHANGED (#.03)
PERSON CLASS (#8932.1) TAXONOMY CODE:TAXONOMY CODE (#.01)
STATE (#5) STATE (#.07)
LICENSE STATE (#.16)
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
IB PROVIDERS FROM FB MAY 29, 2012@13:60 USER #0
SORT BY: DATE/TIME LAST FB UPDATE;S1//
DATE/TIME LAST FB UPDATE SUB-FIELD: DATE/TIME LAST FB UPDATE// (User is asked range)
WITHIN DATE/TIME LAST FB UPDATE, SORT BY: PROVIDER TYPE;S1// (User is asked range)
WITHIN PROVIDER TYPE, SORT BY: DATE/TIME LAST FB UPDATE//
DATE/TIME LAST FB UPDATE SUB-FIELD: CREATED BY FB PAID TO IB// (User is asked range)
Displays entries created by the FB PAID TO IB task
FORM(S)/BLOCK(S):