STANDARD DATA DICTIONARY #355.96 -- IB INS CO PROVIDER ID CARE UNIT FILE 3/24/25 PAGE 1
STORED IN ^IBA(355.96, *** 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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This file defines the 'list' of care units that an insurance company uses to assign provider id's. Each record must have an
insurance company, a provider type and a care unit entry. The sum total of all the records in this file for a given insurance
company comprises the complete list of care units the insurance company requires the V.A. to use when determining provider id's for
any claims sent to them.
DD ACCESS: @
RD ACCESS:
WR ACCESS: @
DEL ACCESS: @
LAYGO ACCESS: @
AUDIT ACCESS:
IDENTIFIED BY: FORM TYPE APPLIED TO (#.04)[R], BILL CARE TYPE (#.05)[R], ID TYPE (#.06)[R]
POINTED TO BY: PROVIDER ID CARE UNIT field (#.03) of the IB BILLING PRACTITIONER ID File (#355.9)
PROVIDER ID CARE UNIT field (#.03) of the IB INSURANCE CO LEVEL BILLING PROV ID File (#355.91)
DELETE 2006 .09 field (#.09) of the PROVIDER sub-field (#399.0222) of the BILL/CLAIMS File (#399)
DELETE 2006 .1 field (#.1) of the PROVIDER sub-field (#399.0222) of the BILL/CLAIMS File (#399)
DELETE 2006 .11 field (#.11) of the PROVIDER sub-field (#399.0222) of the BILL/CLAIMS File (#399)
DELETE 2006 1.01 field (#1.01) of the PROVIDER sub-field (#399.0222) of the BILL/CLAIMS File (#399)
DELETE 2006 1.02 field (#1.02) of the PROVIDER sub-field (#399.0222) of the BILL/CLAIMS File (#399)
DELETE 2006 1.03 field (#1.03) of the PROVIDER sub-field (#399.0222) of the BILL/CLAIMS File (#399)
CROSS
REFERENCED BY: CARE UNIT(B), ID TYPE(C)
INDEXED BY: INSURANCE COMPANY & ID TYPE (AC), INSURANCE COMPANY & FORM TYPE APPLIED TO & BILL CARE TYPE & ID TYPE (AD), CARE
UNIT & INSURANCE COMPANY (AE), INSURANCE COMPANY & CARE UNIT & FORM TYPE APPLIED TO & BILL CARE TYPE & ID TYPE
(AUNIQ), INSURANCE COMPANY & ID TYPE (D)
355.96,.01 CARE UNIT 0;1 POINTER TO IB PROVIDER ID CARE UNIT FILE (#355.95) (Required)
INPUT TRANSFORM: S DIC("S")="I $S('$P($G(^IBA(355.95,+Y,0)),U,3):1,1:$P($G(^IBA(355.95,+Y,0)),U,3)=+$G(^IBA(355.96,+
$G(DA),0)))" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: AUG 01, 2001
HELP-PROMPT: Enter the name of a care unit
DESCRIPTION:
This is the care unit for which the insurance company requires a specific provider id number.
SCREEN: S DIC("S")="I $S('$P($G(^IBA(355.95,+Y,0)),U,3):1,1:$P($G(^IBA(355.95,+Y,0)),U,3)=+$G(^IBA(355.96,+
$G(DA),0)))"
EXPLANATION: Must be a care unit for the same insurance co
DELETE TEST: .01,0)= I $O(^IBA(355.91,"ACARE",D0,0))!$O(^IBA(355.9,"ACARE",D0,0)) D EN^DDIOL("Can't delete this
entry - a provider ID is still using it","","?5")
CROSS-REFERENCE: 355.96^B
1)= S ^IBA(355.96,"B",$E(X,1,30),DA)=""
2)= K ^IBA(355.96,"B",$E(X,1,30),DA)
CROSS-REFERENCE: ^^TRIGGER^355.96^.04
1)= X ^DD(355.96,.01,1,2,1.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.96,D0,0)):^(0),1:"") S X=$P(Y(1),U,
4),X=X S DIU=X K Y S X=DIV S X=0 S DIH=$G(^IBA(355.96,DIV(0),0)),DIV=X S $P(^(0),U,4)=DIV,DIH=355.9
6,DIG=.04 D ^DICR
1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(2)=$C(59)_$P($G(^DD(355.96,.04,0)),U,3),Y(1)=$S($D
(^IBA(355.96,D0,0)):^(0),1:"") S X=$P($P(Y(2),$C(59)_$P(Y(1),U,4)_":",2),$C(59),1)=""
2)= Q
3)= Do not delete
CREATE CONDITION)= FORM TYPE APPLIED TO=""
CREATE VALUE)= S X=0
DELETE VALUE)= NO EFFECT
FIELD)= FORM TYPE APPLIED TO
This xref defaults the FORM TYPE APPLIED TO field to be both form types
CROSS-REFERENCE: ^^TRIGGER^355.96^.05
1)= X ^DD(355.96,.01,1,3,1.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.96,D0,0)):^(0),1:"") S X=$P(Y(1),U,
5),X=X S DIU=X K Y S X=DIV S X=0 S DIH=$G(^IBA(355.96,DIV(0),0)),DIV=X S $P(^(0),U,5)=DIV,DIH=355.9
6,DIG=.05 D ^DICR
1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(2)=$C(59)_$P($G(^DD(355.96,.05,0)),U,3),Y(1)=$S($D
(^IBA(355.96,D0,0)):^(0),1:"") S X=$P($P(Y(2),$C(59)_$P(Y(1),U,5)_":",2),$C(59),1)=""
2)= Q
3)= Do not delete
CREATE CONDITION)= BILL CARE TYPE=""
CREATE VALUE)= S X=0
DELETE VALUE)= NO EFFECT
FIELD)= BILL CARE TYPE
This xref defaults the BILL CARE TYPE field to be both inpatient and outpatient.
RECORD INDEXES: AE (#126), AUNIQ (#127)
355.96,.03 INSURANCE COMPANY 0;3 POINTER TO INSURANCE COMPANY FILE (#36) (Required)
INPUT TRANSFORM: S DIC("S")="I $P($G(^IBA(355.95,+Y,0)),U,3)=+$G(^IBA(355.96,+$G(DA),0)),U,3)" D ^DIC K DIC S DIC=DI
E,X=+Y K:Y<0 X
LAST EDITED: AUG 01, 2001
HELP-PROMPT: This is the insurance company that is associated with the selected care
DESCRIPTION:
This is the insurance company that is associated with the selected care type.
SCREEN: S DIC("S")="I $P($G(^IBA(355.95,+Y,0)),U,3)=+$G(^IBA(355.96,+$G(DA),0)),U,3)"
EXPLANATION: Care unit must be defined for the same insurance company
RECORD INDEXES: AC (#124), AD (#125), AE (#126), AUNIQ (#127), D (#128)
355.96,.04 FORM TYPE APPLIED TO 0;4 SET (Required)
'0' FOR BOTH UB-04 AND CMS-1500 FORMS;
'1' FOR UB-04 FORM ONLY;
'2' FOR CMS-1500 FORM ONLY;
LAST EDITED: JAN 16, 2007
HELP-PROMPT: Select one or both forms that the provider id will apply to.
DESCRIPTION: This designates whether the id number is to be used for just UB-04 form types, just CMS-1500 form
types or both form types.
NOTES: TRIGGERED by the CARE UNIT field of the IB INS CO PROVIDER ID CARE UNIT File
RECORD INDEXES: AD (#125), AUNIQ (#127)
355.96,.05 BILL CARE TYPE 0;5 SET (Required)
'0' FOR BOTH INPATIENT AND OUTPATIENT;
'1' FOR INPATIENT ONLY;
'2' FOR OUTPATIENT ONLY;
'3' FOR PRESCRIPTION ONLY;
LAST EDITED: AUG 01, 2001
HELP-PROMPT: Enter the type of care (inpatient/outpatient/Rx) that this id # will apply to.
DESCRIPTION: This designates whether the id number is to be used for just inpatient bills, just outpatient
bills, both inpatient and outpatient bills or just prescriptions.
NOTES: TRIGGERED by the CARE UNIT field of the IB INS CO PROVIDER ID CARE UNIT File
RECORD INDEXES: AD (#125), AUNIQ (#127)
355.96,.06 ID TYPE 0;6 POINTER TO IB PROVIDER ID # TYPE FILE (#355.97) (Required)
INPUT TRANSFORM: S DIC("S")="I $$RAINS^IBCEPU(Y)" D ^DIC K DIC S DIC=$G(DIE),X=+Y K:Y<0 X
LAST EDITED: APR 18, 2006
HELP-PROMPT: Enter the provider id type that this care unit is to apply to.
DESCRIPTION:
This is the type of provider ID that the set of care unit is being defined for.
SCREEN: S DIC("S")="I $$RAINS^IBCEPU(Y)"
EXPLANATION: Must be for a type that includes insurance co
CROSS-REFERENCE: 355.96^C
1)= S ^IBA(355.96,"C",$E(X,1,30),DA)=""
2)= K ^IBA(355.96,"C",$E(X,1,30),DA)
3)= Do not delete
Allow lookup by provider id type
RECORD INDEXES: AC (#124), AD (#125), AUNIQ (#127), D (#128)
FILES POINTED TO FIELDS
IB PROVIDER ID # TYPE (#355.97) ID TYPE (#.06)
IB PROVIDER ID CARE UNIT
(#355.95) CARE UNIT (#.01)
INSURANCE COMPANY (#36) INSURANCE COMPANY (#.03)
File #355.96
Record Indexes:
AC (#124) RECORD REGULAR IR SORTING ONLY
Short Descr: Xref by insurance company, provider type
Description: This cross reference is used to easily find all care units for an insurance company and provider id type.
Set Logic: S ^IBA(355.96,"AC",X(1),X(2),DA)=""
Kill Logic: K ^IBA(355.96,"AC",X(1),X(2),DA)
Whole Kill: K ^IBA(355.96,"AC")
X(1): INSURANCE COMPANY (355.96,.03) (Subscr 1) (forwards)
X(2): ID TYPE (355.96,.06) (Subscr 2) (forwards)
AD (#125) RECORD REGULAR IR SORTING ONLY
Short Descr: Xref by insurance co, form type, bill care type, provider type
Set Logic: S ^IBA(355.96,"AD",X(1),X(2),X(3),X(4),DA)=""
Kill Logic: K ^IBA(355.96,"AD",X(1),X(2),X(3),X(4),DA)
Whole Kill: K ^IBA(355.96,"AD")
X(1): INSURANCE COMPANY (355.96,.03) (Subscr 1) (forwards)
X(2): FORM TYPE APPLIED TO (355.96,.04) (Subscr 2) (forwards)
X(3): BILL CARE TYPE (355.96,.05) (Subscr 3) (forwards)
X(4): ID TYPE (355.96,.06) (Subscr 4) (forwards)
AE (#126) RECORD REGULAR IR SORTING ONLY
Short Descr: Xref by care unit and insurance co
Description: This cross reference provides easy access to all insurance companies for a care unit entry.
Set Logic: S ^IBA(355.96,"AE",X(1),X(2),DA)=""
Kill Logic: K ^IBA(355.96,"AE",X(1),X(2),DA)
Whole Kill: K ^IBA(355.96,"AE")
X(1): CARE UNIT (355.96,.01) (Subscr 1) (forwards)
X(2): INSURANCE COMPANY (355.96,.03) (Subscr 2) (forwards)
AUNIQ (#127) RECORD REGULAR IR SORTING ONLY
Short Descr: Xref by ins co,care unit,form type,pt stat,prov type
Description: This cross reference provides an index to insure that each record in this file has a unique combination of
insurance company, form type, bill type and provider id type.
Set Logic: S ^IBA(355.96,"AUNIQ",X(1),X(2),X(3),X(4),X(5),DA)=""
Kill Logic: K ^IBA(355.96,"AUNIQ",X(1),X(2),X(3),X(4),X(5),DA)
Whole Kill: K ^IBA(355.96,"AUNIQ")
X(1): INSURANCE COMPANY (355.96,.03) (Subscr 1) (forwards)
X(2): CARE UNIT (355.96,.01) (Subscr 2) (forwards)
X(3): FORM TYPE APPLIED TO (355.96,.04) (Subscr 3) (forwards)
X(4): BILL CARE TYPE (355.96,.05) (Subscr 4) (forwards)
X(5): ID TYPE (355.96,.06) (Subscr 5) (forwards)
D (#128) RECORD REGULAR IR LOOKUP & SORTING
Short Descr: Lookup xref by insurance co and provider id type
Description: This xref provides an easy way to lookup the entries in this file by insurance co and provider id type.
Set Logic: S ^IBA(355.96,"D",X(1),X(2),DA)=""
Kill Logic: K ^IBA(355.96,"D",X(1),X(2),DA)
Whole Kill: K ^IBA(355.96,"D")
X(1): INSURANCE COMPANY (355.96,.03) (Subscr 1) (forwards)
X(2): ID TYPE (355.96,.06) (Subscr 2) (forwards)
Lookup Prompt: CARE UNIT:
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):