STANDARD DATA DICTIONARY #356.8 -- CLAIMS TRACKING NON-BILLABLE REASONS FILE 3/24/25 PAGE 1
STORED IN ^IBE(356.8, (128 ENTRIES) SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 2.0)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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This is a file of reasons that may be entered into the claims tracking module to specify why a potential claim isn't billable.
Do NOT add, edit, or delete entries in this file without instructions from your ISC.
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: @
IDENTIFIED BY: CODE (#.04), INACTIVE (#.05)
POINTED TO BY: REASON NOT BILLABLE field (#.19) of the CLAIMS TRACKING File (#356)
CLOSE REASON field (#.307) of the EVENT sub-field (#366.141) of the IB NCPDP EVENT LOG File (#366.14)
CLOSED REASON field (#904) of the BPS CLAIMS File (#9002313.02)
CLOSE AFT REV REASON field (#7.02) of the BPS REQUESTS File (#9002313.77)
CROSS
REFERENCED BY: NAME(B), CODE(C)
356.8,.001 NUMBER NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: SEP 30, 1993
HELP-PROMPT: Type a Number between 1 and 9999, 0 Decimal Digits
DESCRIPTION:
This is the number of the reason not billable. It is used for look-up purposes only.
356.8,.01 NAME 0;1 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>30!(X?.N)!($L(X)<3)!'(X'?1P.E) X
HELP-PROMPT: NAME MUST BE 3-30 CHARACTERS, NOT NUMERIC OR STARTING WITH PUNCTUATION
DESCRIPTION: Enter the name of the reason that a visit is not billable. This is the name that will appear on
displays and outputs. If a claims tracking entry is assigned a reaon not billable then it will be
considered to not be billable. Users may select whether visits that have a reason not billable
assigned should appear on the patients with visits and insurance reports.
CROSS-REFERENCE: 356.8^B
1)= S ^IBE(356.8,"B",$E(X,1,30),DA)=""
2)= K ^IBE(356.8,"B",$E(X,1,30),DA)
356.8,.02 ECME FLAG 0;2 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: FEB 24, 2005
HELP-PROMPT: Enter 'Yes' if the record may be used as ECME Close Claim Reason.
DESCRIPTION: This field is flagging the record to be used as ECME CLOSE CLAIM REASON. The default value is 'NO'.
If the field is set to 'YES' the NON-BILLABLE REASON will appear as an option in the ECME CLOSE
CLAIM SCREEN.
356.8,.03 ECME PAPER FLAG 0;3 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: FEB 24, 2005
HELP-PROMPT: Enter 'YES' if the closed ECME claim may be paper-billable.
DESCRIPTION: This flag is related to NON-BILLABLE REASONs that are marked with ECME FLAG to be used as ECME
CLOSE CLAIM REASON. If this field 'ECME PAPER FLAG' is set to 'YES', it indicates that the NON
BILLABLE REASON may be potentially billable "on paper". When the ECME user (OPECC) is closing the
e-Pharmacy claim and enters the NON BILLABLE REASON as a CLOSE CLAIM REASON, the additional prompt
will be issued to the user - should the claim be billed "on paper"?
356.8,.04 CODE 0;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>5!($L(X)<3) X
LAST EDITED: OCT 21, 2008
HELP-PROMPT: Answer must be 3-5 characters in length.
DESCRIPTION: This code uniquely identifies a particular RNB by group and number. Format is Group_# where group
sorts like RNBs into the following: BL-Billing, CV-Insurance Coverage, DC-Documentation,
MC-Miscellaneous, MN-Medical Necessity, RX-Pharmacy, VA-VA Specific.
CROSS-REFERENCE: 356.8^C
1)= S ^IBE(356.8,"C",$E(X,1,30),DA)=""
2)= K ^IBE(356.8,"C",$E(X,1,30),DA)
356.8,.05 INACTIVE 0;5 SET
'0' FOR ACTIVE;
'1' FOR INACTIVE;
LAST EDITED: MAR 23, 2009
HELP-PROMPT: Enter INACTIVE to Inactivate this Reason Not Billable.
DESCRIPTION:
This indicates if the RNB is inactive and should no longer be used.
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):