STANDARD DATA DICTIONARY #373 -- PFSS CHARGE CACHE FILE 3/24/25 PAGE 1
STORED IN ^IBBAD(373, *** 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 is used to store charge data from various VistA applications so that a background process can create an HL7 P03 message
from each record. The messages are batched and sent to the external medical billing system.
Under no circumstances may records be created or modified directly via FileMan or other methods. Record creation and data update
is allowed only through CHARGE^IBBAPI.
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: @
CROSS
REFERENCED BY: PATIENT(AC), DEPARTMENT(AOX), HL7 MESSAGE ID(AOX), UNIQUE CHARGE ID(C)
373,.01 CHARGE NUMBER 0;1 NUMBER (Required)
INPUT TRANSFORM: S DINUM=X K:+X'=X!(X>9999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: APR 26, 2005
DESCRIPTION: A sequential integer used for both the internal entry number and #.01 field for each record created
in the file.
TECHNICAL DESCR:
The file is DINUM'd; the internal entry number and #.01 field are the same value.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
373,.02 PFSS ACCOUNT REFERENCE 0;2 POINTER TO PFSS ACCOUNT FILE (#375) (Required)
LAST EDITED: JUN 10, 2005
DESCRIPTION: The PFSS Account Reference (i.e., internal entry number to PFSS ACCOUNT file #375) associated with
the charge (debit or credit) contained in this record.
TECHNICAL DESCR: This pointer to the PFSS ACCOUNT file (#375) is used to retrieve the value in the EXTERNAL ACCOUNT
NUMBER field (#02) for the PFSS HL7 DFT message, PV1 Segment, Sequence 19. All additional data for
both the PV1 and PV2 Segments is also taken directly from the PFSS ACCOUNT record.
373,.03 PATIENT 0;3 POINTER TO PATIENT FILE (#2) (Required)
LAST EDITED: JUN 02, 2005
DESCRIPTION:
The Patient identifier associated with the billing account identified in field #.02.
TECHNICAL DESCR: This pointer to the PATIENT file (#2) is used to construct the HL7 PID Segment for PFSS DFT
messages.
The "OX" cross-reference depends upon field #.03.
S ^IBBAD(373,"OX",X1,X2,DA)=""
where: X1=field #.03
X2=field #.04
The "OX" cross-reference should be set only through SAOX^IBBAADD; it should be killed only through
KAOX^IBBAADD.
CROSS-REFERENCE: 373^AC
1)= S ^IBBAD(373,"AC",$E(X,1,30),DA)=""
2)= K ^IBBAD(373,"AC",$E(X,1,30),DA)
The is a regular cross-reference by PATIENT (field #.03). The principal purpose of this
cross-reference is to allow the Patient Merge processor (Kernel) to operate efficiently in the
event that patient's with records in file #373 are merged.
373,.04 UNIQUE CHARGE ID 0;4 NUMBER (Required)
INPUT TRANSFORM: K:+X'=X!(X>99999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: SEP 20, 2005
HELP-PROMPT: Type a Number between 0 and 0, 0 Decimal Digits
DESCRIPTION: A numeric identifier of not more than 8 digits that uniquely identifies the charge item in the
external medical billing system.
This data item is referred to as the "PFSS Charge Identifier" within the PFSS project
documentation.
TECHNICAL DESCR: The application providing the data to the PFSS CHARGE CACHE file uses $$GETCHGID^IBBAPI to obtain a
unique identifying number for the original charge.
The "OX" cross-reference depends upon field #.04.
S ^IBBAD(373,"OX",X1,X2,DA)=""
where: X1=field #.03
X2=field #.04
The "OX" cross-reference should be set only through SAOX^IBBAADD; it should be killed only through
KAOX^IBBAADD.
CROSS-REFERENCE: 373^C
1)= S ^IBBAD(373,"C",$E(X,1,30),DA)=""
2)= K ^IBBAD(373,"C",$E(X,1,30),DA)
A simple cross-reference using the Unique Charge ID.
373,.05 TYPE 0;5 SET (Required)
'CG' FOR CHARGE;
'CD' FOR CREDIT;
LAST EDITED: FEB 24, 2005
DESCRIPTION:
Identifies the charge item as either account debit or account credit.
373,.06 DEPARTMENT 0;6 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>3!($L(X)<3) X
LAST EDITED: APR 18, 2005
HELP-PROMPT: Answer must be 3 characters in length.
DESCRIPTION: The Department code associated by the sending-application with the charge.
Department Codes are defined as follows for the various service areas:
108 - Laboratory; 160 - Pharmacy; 419 - Anesthesiology; 423 - Prosthetics;
Surgery (based on Surgical Specialty): 180 - Oral Surgery; 401 - General Surgery; 402 - Cardiac
Surgery; 403 - Otorhinolaryngology (ENT); 404 - Gynecology; 406 - Neurosurgery; 407 -
Ophthalmology; 409 - Orthopedics; 410 - Plastic Surgery (inc. H&N); 411 - Podiatry; 412 -
Proctology; 413 - Thoracic Surgery; 415 - Peripheral Vascular; 457 - Transplantation;
Radiology (based on Imaging Type): 105 - General Radiology; 109 - Nuclear Medicine; 109 -
Cardiology Studies (Nuc Med); 115 - Ultrasound; 150 - CT Scan; 151 - Magnetic Resonance Imaging;
152 - Angio-Neuro-Interventional; 421 - Vascular Lab; 703 - Mammography;
All CPT-based charges coming through PCE, which are not already associated with one of the
Department Codes listed above, are assigned a Department Code. The Department Code assigned is the
Stop Code associated (in the HOSPITAL LOCATION file, #44) with the Hospital Location of the patient
visit/encounter.
CROSS-REFERENCE: 373^AOX^MUMPS
1)= I X D SAOX^IBBAADD(DA)
2)= Q
373,.07 SERVICE CODE 0;7 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>6!($L(X)<6) X
LAST EDITED: FEB 24, 2005
HELP-PROMPT: Answer must be 6 characters in length.
DESCRIPTION: The value for SERVICE CODE is taken from the PFSS SERVICE MASTER file (#374), SERVICE CODE field
(#.01).
Selection of a SERVICE CODE from file #374 is based upon the CPT or HCPCS Code and Date of Service
provided by the application sending data to the PFSS CHARGE CACHE file.
373,.08 ORDER IEN 0;8 POINTER TO ORDER FILE (#100)
LAST EDITED: MAR 18, 2005
DESCRIPTION: The ORDER file (#100) internal entry number for the service order which resulted in this charge in
PFSS.
All data provided to the PFSS CHARGE CACHE file by PCE will include the ORDER file IEN, if known by
PCE. If the charge is the result of a Radiology exam, then IBB will query OERR to obtain the PFSS
Account Reference associated with the order IEN. IBB will then convert that PFSS Account Reference
to its external medical billing system equivalent using $$EXTNUM^IBBAACCT. This external billing
system number is included in the outbound charge message as a Secondary Visit Number, so that the
Radiology charge can be related to back to the original outpatient visit or inpatient episode by
the billing system.
373,.09 CLINICAL EVENT ID 0;9 FREE TEXT
INPUT TRANSFORM: K:$L(X)>18!($L(X)<3) X
LAST EDITED: NOV 03, 2005
HELP-PROMPT: Answer must be 3-18 characters in length.
DESCRIPTION: The Clinical Event Identifier is passed to CHARGE^IBBAPI in IBBFT1(2). The free text data item is
used by certain applications, such as PCE, as a way of linking billable items to a specific event
(e.g., visit).
The format of the identifier is
_
373,.1 DATE/TIME CREATED 0;10 DATE (Required)
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: FEB 24, 2005
DESCRIPTION:
The date/time at which the charge cache record was created.
373,.11 HL7 MESSAGE ID 0;11 FREE TEXT
INPUT TRANSFORM: K:$L(X)>24!($L(X)<3) X
LAST EDITED: APR 18, 2005
HELP-PROMPT: Answer must be 3-24 characters in length.
DESCRIPTION: he batch message identifier (from CREATE^HLTF) followed by a hyphen and the sequence number for the
individual charge message. Identifies the exact batch location in which data from this charge
record is transmitted to the external medical billing system.
CROSS-REFERENCE: 373^AOX^MUMPS
1)= I X'="" D KAOX^IBBAADD(DA)
2)= Q
373,.2 TEST PATIENT 0;20 SET
'1' FOR YES;
LAST EDITED: MAY 11, 2005
DESCRIPTION: If the DFN for this patient indicates a test patient as a result of a call to $$TESTPAT^VADPT, then
this field is set to "YES".
TECHNICAL DESCR:
PFSS HL7 messages will not be constructed for any record in this file where TEST PATIENT = "YES".
373,3.03 PROCEDURE CODE PR1;3 POINTER TO CPT FILE (#81) (Required)
LAST EDITED: FEB 24, 2005
DESCRIPTION: Charge data being filed into the PFSS CHARGE CACHE comes from one of three sources - Outpatient
Pharmacy, Prosthetics, or PCE.
Charges passed to IBB via PCE are ultimately based on CPT Codes, while those from Prosthetics are
based on HCPCS Codes, both of which are found in the CPT file (#81). This field holds the file #81
pointer related to the charge from PCE or Prosthetics.
Outpatient Pharmacy charges are not associated with file #81.
TECHNICAL DESCR:
PFSS HL7 DFT message data; PR1 Segment, Sequence 3.
373,3.05 PROCEDURE DATE/TIME PR1;5 DATE (Required)
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: FEB 24, 2005
DESCRIPTION: Charge data being filed into the PFSS CHARGE CACHE comes from one of three sources - Outpatient
Pharmacy, Prosthetics, or PCE.
For charges passed to IBB via PCE this field contains the EVENT DATE AND TIME (field #1201) from
the V CPT file (#900010.18).
Outpatient Pharmacy and Prosthetics charges do not use this field.
TECHNICAL DESCR:
PFSS HL7 DFT message data; PR1 Segment, Sequence 5.
373,3.06 FUNCTIONAL TYPE PR1;6 FREE TEXT
INPUT TRANSFORM: K:$L(X)>1!($L(X)<1) X
LAST EDITED: MAY 27, 2005
HELP-PROMPT: Answer must be 1 character in length.
DESCRIPTION: Charge data being filed into the PFSS CHARGE CACHE comes from one of three sources - Outpatient
Pharmacy, Prosthetics, or PCE.
For charges passed to IBB by Prosthetics, this field contains a coded-value as follows:
O = Home Oxygen
P = Purchasing
I = Stock Issue
Outpatient Pharmacy and PCE charges do not use this field.
TECHNICAL DESCR:
PFSS HL7 ADT message data; PR1 Segment; Sequence 6.
373,3.11 SURGEON PR1;11 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: MAY 26, 2005
DESCRIPTION: Charge data being filed into the PFSS CHARGE CACHE comes from one of three sources - Outpatient
Pharmacy, Prosthetics, or PCE.
If PCE passes to IBB charge data that originated in Surgery, then this field provides the identity
of the Principal Surgeon as a pointer to the NEW PERSON file (#200).
Outpatient Pharmacy and Prosthetics charges do not use this field.
TECHNICAL DESCR:
PFSS HL7 DFT message data; PR1 Segment, Sequence 11.
373,3.12 ATTENDING SURGEON PR1;12 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: MAY 26, 2005
DESCRIPTION: Charge data being filed into the PFSS CHARGE CACHE comes from one of three sources - Outpatient
Pharmacy, Prosthetics, or PCE.
If PCE passes to IBB charge data that originated in Surgery, then this field provides the identity
of the Attending Surgeon as a pointer to the NEW PERSON file (#200).
Outpatient Pharmacy and Prosthetics charges do not use this field.
TECHNICAL DESCR:
PFSS HL7 DFT message data; PR1 Segment, Sequence 12.
373,3.16 PROCEDURE CODE MODIFIER(S) PR1;16 FREE TEXT
INPUT TRANSFORM: K:$L(X)>25!($L(X)<1) X
LAST EDITED: FEB 24, 2005
HELP-PROMPT: Answer must be 1-25 characters in length.
DESCRIPTION: Charge data being filed into the PFSS CHARGE CACHE comes from one of three sources - Outpatient
Pharmacy, Prosthetics, or PCE.
Charges passed to IBB via PCE or from Prosthetics are based on codes contained the CPT file (#81).
These CPT or HCPCS codes may be "modified" by the sending application using codes found in the CPT
MODIFIER file (#81.3).
This field may contain one or more modifiers as a string of numbers delimited by semi-colons; each
number is a pointer to the CPT MODIFIER file (#81.3). Example: 68;245;74;318;
Outpatient Pharmacy charges do not use this field.
TECHNICAL DESCR:
PFSS HL7 DFT message data; PR1 Segment, Sequence 16.
373,4 DIAGNOSIS DG1;0 Multiple #373.04 (Add New Entry without Asking)
DESCRIPTION: Multiple DG1 Segments are allowed within a DFT-PO3 message. Each subrecord in subfile #373.04
contains data for an individual DG1 Segment.
373.04,.01 SET ID 0;1 NUMBER (Required)
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: FEB 24, 2005
HELP-PROMPT: Type a Number between 1 and 99, 0 Decimal Digits
DESCRIPTION: Charge data being filed into the PFSS CHARGE CACHE comes from one of three sources - Outpatient
Pharmacy, Prosthetics, or PCE.
Each application sending charge data to IBB will provide one or more related diagnoses. If more
than one, then these diagnoses are passed to IBB in priority order; i.e., the first diagnosis is
the primary diagnosis related to the charge, the second diagnosis is the secondary diagnosis
related to the charge, etc. IBB files the data into subfile #373.04 in that same order. This
field indicates the exact order in which the diagnoses were received and filed.
TECHNICAL DESCR:
PFSS HL7 DFT message data; DG1 Segment, Sequence 1.
CROSS-REFERENCE: 373.04^B
1)= S ^IBBAD(373,DA(1),"DG1","B",$E(X,1,30),DA)=""
2)= K ^IBBAD(373,DA(1),"DG1","B",$E(X,1,30),DA)
373.04,.03 DIAGNOSIS CODE 0;3 POINTER TO ICD DIAGNOSIS FILE (#80) (Required)
LAST EDITED: FEB 24, 2005
DESCRIPTION: Charge data being filed into the PFSS CHARGE CACHE comes from one of three sources - Outpatient
Pharmacy, Prosthetics, or PCE.
The applications sending charge data to IBB will provide one or more related diagnoses. Each
diagnosis is provided as a pointer to the ICD DIAGNOSIS file (#80).
TECHNICAL DESCR:
PFSS HL7 DFT message data; DG1 Segment, Sequence 3.
373.04,.06 DIAGNOSIS TYPE 0;6 SET (Required)
'A' FOR ADMITTING;
'D' FOR DISCHARGE;
'W' FOR WORKING;
'F' FOR FINAL;
LAST EDITED: APR 20, 2005
DESCRIPTION: The applications passing charge data to IBB must define each diagnosis code included in the
charge data as being one of the following: A(dmitting), W(orking), D(ischarging), or F(inal).
TECHNICAL DESCR:
PFSS HL7 DFT message data; DG1 Segment, Sequence 6.
373,5 SC/EI CLASSIFICATION ZCL;0 Multiple #373.05 (Add New Entry without Asking)
LAST EDITED: MAR 04, 2005
DESCRIPTION: Multiple ZCL Segments are allowed within a DFT-PO3 message. Each subrecord in subfile #373.05
contains data for an individual ZCL Segment.
373.05,.01 SET ID 0;1 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JUL 14, 2005
HELP-PROMPT: Type a Number between 1 and 9, 0 Decimal Digits
DESCRIPTION: SC/EI Classification data related to the charge is usually a set of classification codes, which
causes multiple records to be created in subfile #373.05. The value in this field merely
indicates the order in which the subfile record was created.
TECHNICAL DESCR:
PFSS HL7 DFT message data; ZCL Segment, Sequence 1.
373.05,.02 TYPE 0;2 SET
'1' FOR AO;
'2' FOR IR;
'3' FOR SC;
'4' FOR EC;
'5' FOR MST;
'6' FOR HNC;
'7' FOR CV;
'8' FOR SHAD;
LAST EDITED: MAY 26, 2005
DESCRIPTION: SC/EI Classification data related to the charge can only be one of the following types: AO, IR,
SC, EC, MST, HNC, CV, or SHAD.
TECHNICAL DESCR:
PFSS HL7 DFT message data; ZCL Segment, Sequence 2.
373.05,.03 VALUE 0;3 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: MAR 04, 2005
DESCRIPTION: SC/EI Classification data related to the charge can have any of the following values: Yes (1), No
(0), or Unknown (null).
TECHNICAL DESCR:
PFSS HL7 DFT message data; ZCL Segment, Sequence 3.
373,6.04 TRANSACTION DATE FT1;4 DATE
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JUL 14, 2005
DESCRIPTION: The definition of this data item depends upon the application that is the originating source of the
data. PCE - Event Date and Time OP PHARMACY - Fill Date or Refill Date PROSTHETICS - Delivery Date
TECHNICAL DESCR:
PFSS HL7 DFT message data; FT1 Segment, Sequence 4.
373,6.06 TRANSACTION TYPE FT1;6 SET (Required)
'CG' FOR CHARGE;
'CD' FOR CREDIT;
LAST EDITED: FEB 24, 2005
DESCRIPTION: An indicator to the external medical billing system that tells whether the data in this charge
transaction should be handled as a debit ("CG") or a credit ("CD") to the account.
TECHNICAL DESCR:
PFSS HL7 DFT message data; FT1 Segment, Sequence 6.
373,6.07 CHARGE CODE FT1;7 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<100000000)!(X?.E1"."1N.N) X
LAST EDITED: MAY 11, 2005
HELP-PROMPT: Type a Number between 100000000 and 999999999, 0 Decimal Digits
DESCRIPTION: The value in this field descibes the charge and is formed by concatenating the 6-digit SERVICE CODE
(field #.07) to the 3-digit DEPARTMENT CODE (field #.06).
TECHNICAL DESCR:
PFSS HL7 DFT message data; FT1 Segment, Sequence 7.
373,6.1 TRANSACTION QUANTITY FT1;10 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: FEB 24, 2005
HELP-PROMPT: Type a Number between 1 and 99999, 0 Decimal Digits
DESCRIPTION:
This field will hold an integer value that describes the quantity being charged.
TECHNICAL DESCR:
PFSS HL7 DFT message data; FT1 Segment, Sequence 10.
373,6.13 DEPARTMENT CODE FT1;13 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>3!($L(X)<3) X
LAST EDITED: FEB 24, 2005
HELP-PROMPT: Answer must be 3 characters in length.
DESCRIPTION: The 3-digit Department Code provided by the sending application. The data value in this field is
the same as in field #.06, DEPARTMENT. It is placed here to simplify the message build.
TECHNICAL DESCR:
PFSS HL7 DFT message data; FT1 Segment, Sequence 13.
373,6.16 ASSIGNED PATIENT LOCATION FT1;16 POINTER TO HOSPITAL LOCATION FILE (#44)
LAST EDITED: FEB 24, 2005
TECHNICAL DESCR:
PFSS HL7 DFT message data; FT1 Segment, Sequence 16.
373,6.18 PATIENT TYPE FT1;18 SET
'0' FOR NOT RX COPAY EXEMPT;
'1' FOR RX COPAY EXEMPT;
LAST EDITED: MAR 24, 2005
DESCRIPTION: Used by Ooutpatient Pharmacy only; holds an indicator to show whether the patient being charged for
the prescription is "Rx Copay Exempt" or "Not Exempt".
TECHNICAL DESCR:
PFSS HL7 DFT message data; FT1 Segment; Sequence 18.
373,6.2 PERFORMED BY FT1;20 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: FEB 24, 2005
DESCRIPTION: Used for charge data from PCE only; a pointer to the NEW PERSON file (#200) which supplies the
identity of the Rendering Provider for the procedure.
TECHNICAL DESCR:
PFSS HL7 DFT message data; FT1 Segment, Sequence 20.
373,6.21 ORDERED BY FT1;21 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: JUL 13, 2005
DESCRIPTION: A pointer to the NEW PERSON file (#200) which supplies the identity of the Odering Provider for the
CPT procedure, HCPCS item, or Prescription Fill/Refill.
TECHNICAL DESCR:
PFSS HL7 DFT message data; FT1 Segment, Sequence 21.
373,6.22 UNIT COST FT1;22 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>99999.99)!(X<0) X
LAST EDITED: FEB 24, 2005
HELP-PROMPT: Type a Dollar Amount between 0 and 99999.99, 2 Decimal Digits
DESCRIPTION: Used by Outpatient Pharmacy and Prosthetics to indicate the cost per unit of the HCPCS item or
pharmacy item being charged.
TECHNICAL DESCR:
PFSS HL7 DFT message data; FT1 Segment, Sequence 22.
373,6.29 NDC FT1;29 FREE TEXT
INPUT TRANSFORM: K:$L(X)>65!($L(X)<3) X
LAST EDITED: MAR 24, 2005
HELP-PROMPT: Answer must be 3-65 characters in length.
DESCRIPTION: Used by Outpatient Pharmacy only to provide the National Drug Code and Generic Drug Name for the
prescription being charged.
1st "; piece is NDC Code and 2nd "; piece is Generic Drug Name. Example:
0258-3581-05;THEOPHYLLINE (THEOCHRON) 300MG SA TAB
TECHNICAL DESCR:
PFSS HL7 DFT message data; FT1 Segment, Sequence 29.
373,6.31 TRANSACTION REF. KEY FT1;31 SET
'1' FOR PSO NSC RX COPAY;
'2' FOR PSO SC RX COPAY;
'3' FOR PSO NSC RX COPAY CANCEL;
'4' FOR PSO NSC RX COPAY UPDATE;
'5' FOR PSO SC RX COPAY CANCEL;
'6' FOR PSO SC RX COPAY UPDATE;
LAST EDITED: MAY 05, 2005
DESCRIPTION: Used by Outpatient Pharmacy only; indicates the type of copay transaction that has been associated
with the pharmacy item. The following types are available: PSO NSC RX COPAY; FOR PSO SC RX COPAY;
FOR PSO NSC RX COPAY CANCEL; FOR PSO NSC RX COPAY UPDATE; FOR PSO SC RX COPAY CANCEL; FOR PSO SC RX
COPAY UPDATE.
TECHNICAL DESCR:
PFSS HL7 DFT message data; FT1 Segment; Sequence 31.
373,7.01 QUANTITY/TIMING RXE;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>12!($L(X)<3) X
LAST EDITED: MAR 24, 2005
HELP-PROMPT: Answer must be 3-12 characters in length.
DESCRIPTION: Used by Outpatient Pharmacy only to specify the Quantity and Days Supply for the pharmacy item
being charged.
1st ";" piece is Quantity and 3rd ";" piece is Days Supply. Example: 180;;90
TECHNICAL DESCR:
PFSS HL7 DFT message data; RXE Segment; Sequence 1.
373,7.15 RX NUMBER RXE;15 FREE TEXT
INPUT TRANSFORM: K:$L(X)>20!($L(X)<1) X
LAST EDITED: JUN 13, 2005
HELP-PROMPT: Answer must be 1-20 characters in length.
DESCRIPTION: The Rx number for the presciption fill/refill being charged. Data is taken from field #1.5 of the
PFSS ACCOUNT file (#375) record pointed to by field #.02 of this record.
373,7.17 REFILLS DISPENSED RXE;17 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: MAR 24, 2005
HELP-PROMPT: Type a Number between 0 and 99, 0 Decimal Digits
DESCRIPTION: Used by Outpatient Pharmacy only to indicate the number of refills dispensed for the prescription
being charged. The charge data for the original fill will show 0 in this field.
TECHNICAL DESCR:
PFSS HL7 DFT message data; RXE Segment; Sequence 17.
373,7.18 DATE OF MOST RECENT FILL RXE;18 DATE
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JUN 01, 2005
DESCRIPTION: Used by Outpatient Pharmacy only to indicate the date/time of the most recent fill for the
prescription being charged.
TECHNICAL DESCR:
PFSS HL7 DFT message data; RXE Segment; Sequence 18.
373,7.31 SUPPLEMENTARY CODE RXE;31 FREE TEXT
INPUT TRANSFORM: K:$L(X)>6!($L(X)<1) X
LAST EDITED: MAR 24, 2005
HELP-PROMPT: Answer must be 1-6 characters in length.
DESCRIPTION: Used by Outpatient Pharmacy only to send all DEA and Special Handling codes associated with the
prescription being charged.
TECHNICAL DESCR:
PFSS HL7 DFT message data; RXE Segment; Sequence 31.
373,11 PROCEDURE TEXT 11;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>200!($L(X)<3) X
LAST EDITED: MAY 05, 2005
HELP-PROMPT: Answer must be 3-200 characters in length.
DESCRIPTION: The calling application may provide data for this field that is used to enhance or add detail to
the CPT or HCPCS code provided in field #3.03.
TECHNICAL DESCR:
PFSS HL7 DFT message data; PR1 Segment; Sequence 4.
373,23.01 VENDOR 23;1 POINTER TO VENDOR FILE (#440)
LAST EDITED: MAR 17, 2005
DESCRIPTION: Used for charges related to Prosthetics only; the Vendor associated with the Prosthetics item.
Provided by Prosthetics as a pointer to the VENDOR file (#440).
TECHNICAL DESCR:
PFSS HL7 DFT message data; RQ1 Segment, Sequence 4.
373,23.02 OBL# 23;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X
LAST EDITED: MAR 17, 2005
HELP-PROMPT: Answer must be 1-30 characters in length.
DESCRIPTION:
Used for charges related to Prosthetics only; the OBL# associated with the Prosthetics item.
TECHNICAL DESCR:
PFSS HL7 DFT message data; RQ1 Segment, Sequence 5.
373,99.01 STATUS 99;1 SET
'E' FOR ERROR;
LAST EDITED: FEB 24, 2005
DESCRIPTION: The status of the charge record. A status of "Error indicates that a fatal HL7 error condition
was encountered during batch charge processing.
373,99.02 ERROR TEXT 99;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>200!($L(X)<3) X
LAST EDITED: APR 26, 2005
HELP-PROMPT: Answer must be 3-200 characters in length.
DESCRIPTION: If a fatal HL7 error condition was encountered during batch charge processing on this record, the
HL7 error text will be placed in this field.
373,99.03 ERROR DATE/TIME 99;3 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 26, 2005
DESCRIPTION: If a fatal HL7 error condition was encountered during batch charge processing on this record, the
error date/time will be placed in this field.
FILES POINTED TO FIELDS
CPT (#81) PROCEDURE CODE (#3.03)
HOSPITAL LOCATION (#44) ASSIGNED PATIENT LOCATION (#6.16)
ICD DIAGNOSIS (#80) DIAGNOSIS:DIAGNOSIS CODE (#.03)
NEW PERSON (#200) SURGEON (#3.11)
ATTENDING SURGEON (#3.12)
PERFORMED BY (#6.2)
ORDERED BY (#6.21)
ORDER (#100) ORDER IEN (#.08)
PATIENT (#2) PATIENT (#.03)
PFSS ACCOUNT (#375) PFSS ACCOUNT REFERENCE (#.02)
VENDOR (#440) VENDOR (#23.01)
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):