STANDARD DATA DICTIONARY #399.1 -- MCCR UTILITY FILE 3/24/25 PAGE 1
STORED IN ^DGCR(399.1, (683 ENTRIES) SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 2.0)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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This file contains all of the Occurrence Codes, Discharge Bedsections, Discharge Statuses and Value Codes which may be used on the
Third Party claim forms.
Per VHA Directive 10-93-142, this file definition should not be modified.
DD ACCESS: @
IDENTIFIED BY: CODE (#.02)
POINTED TO BY: BILLING RATE BEDSECTION field (#5) of the SPECIALTY File (#42.4)
BILLABLE SERVICE field (#.04) of the RATE SCHEDULE File (#363)
BILLABLE EVENT field (#.03) of the CHARGE SET File (#363.1)
DEFAULT BEDSECTION field (#.06) of the CHARGE SET File (#363.1)
NAME field (#.01) of the CHARGE ITEM File (#363.2)
UB-04 BILL CLASSIFICATION field (#.25) of the BILL/CLAIMS File (#399)
DISCHARGE BEDSECTION field (#161) of the BILL/CLAIMS File (#399)
DISCHARGE STATUS field (#162) of the BILL/CLAIMS File (#399)
CONDITION CODE field (#.01) of the CONDITION CODE sub-field (#399.04) of the BILL/CLAIMS File (#399)
OCCURRENCE CODE field (#.01) of the OCCURRENCE CODE sub-field (#399.041) of the BILL/CLAIMS File (#399)
BEDSECTION field (#.05) of the REVENUE CODE sub-field (#399.042) of the BILL/CLAIMS File (#399)
VALUE CODE field (#.01) of the VALUE CODE sub-field (#399.047) of the BILL/CLAIMS File (#399)
OTHER CARE field (#.01) of the OTHER CARE sub-field (#399.048) of the BILL/CLAIMS File (#399)
OTHER CARE field (#.25) of the MCCR UTILITY File (#399.1)
BILLING BEDSECTION field (#.02) of the BILLING RATES File (#399.5)
CROSS
REFERENCED BY: IB ACTION TYPE (COPAYMENT)(AC), NAME(B), CODE(C), CODE(C1), ABBREVIATION(D)
LAST MODIFIED: SEP 19,2022@15:16:01
399.1,.001 NUMBER NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JUN 06, 1988
HELP-PROMPT: Enter the internal file number of this entry.
DESCRIPTION:
This is the internal file number of this entry.
399.1,.01 NAME 0;1 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>60!($L(X)<3)!'(X'?1P.E) X
LAST EDITED: APR 30, 1992
HELP-PROMPT: Answer must be 3-60 characters in length.
DESCRIPTION:
This is the full name/description of this entry.
CROSS-REFERENCE: 399.1^B
1)= S ^DGCR(399.1,"B",$E(X,1,30),DA)=""
2)= K ^DGCR(399.1,"B",$E(X,1,30),DA)
399.1,.02 CODE 0;2 FREE TEXT
INPUT TRANSFORM: K:X[""""!($A(X)=45) X I $D(X) K:$L(X)>3!($L(X)<1) X
LAST EDITED: AUG 31, 1988
HELP-PROMPT: Enter code or number which corresponds to this entry.
DESCRIPTION:
This identifies the code or number associated with this entry.
CROSS-REFERENCE: 399.1^C
1)= S ^DGCR(399.1,"C",$E(X,1,30),DA)=""
2)= K ^DGCR(399.1,"C",$E(X,1,30),DA)
CROSS-REFERENCE: 399.1^C1^MUMPS
1)= I +X S ^DGCR(399.1,"C1",+X,DA)=""
2)= K ^DGCR(399.1,"C1",+X,DA)
Cross reference of the codes that identify the entries.
399.1,.03 ABBREVIATION 0;3 FREE TEXT
INPUT TRANSFORM: K:X[""""!($A(X)=45) X I $D(X) K:$L(X)>20!($L(X)<2) X
HELP-PROMPT: Enter the 2-20 character abbreviation (if any) of the name of this entry.
DESCRIPTION:
This is the abbreviation (if any) of the name of this entry.
CROSS-REFERENCE: 399.1^D
1)= S ^DGCR(399.1,"D",$E(X,1,30),DA)=""
2)= K ^DGCR(399.1,"D",$E(X,1,30),DA)
399.1,.11 OCCURRENCE CODE 0;4 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: OCT 03, 1990
HELP-PROMPT: Enter the code which indicates whether or not this is an Occurrence Code.
DESCRIPTION:
This indicates whether or not this entry is an Occurrence Code.
399.1,.12 BEDSECTION 0;5 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: OCT 03, 1990
HELP-PROMPT: Enter the code which indicates whether or not this is a Bedsection.
DESCRIPTION:
This indicates whether or not this entry is a Bedsection.
399.1,.13 DISCHARGE STATUS 0;6 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: OCT 03, 1990
HELP-PROMPT: Enter the code which indicates whether or not this is a Discharge Status.
DESCRIPTION:
This indicates whether or not this entry is a Discharge Status.
399.1,.14 IB ACTION TYPE (COPAYMENT) 0;7 POINTER TO IB ACTION TYPE FILE (#350.1)
LAST EDITED: APR 07, 1992
DESCRIPTION: This field will only be used for those bedsections which are included in the billing of Means
Test/Category C charges.
The field is a pointer to the IB ACTION TYPE file. Once the bedsection is derived from the
patient's treating specialty, the IB ACTION TYPE for the Category C Inpatient/NHC co-payment charge
can be determined.
CROSS-REFERENCE: 399.1^AC
1)= S ^DGCR(399.1,"AC",$E(X,1,30),DA)=""
2)= K ^DGCR(399.1,"AC",$E(X,1,30),DA)
This cross-reference is used to determine the billable bedsection for an Integrated Billing ACTION
TYPE (file #350.2) for Means Test Inpatient or Nursing Home Care co-payment charges. The actual
charge for the action type is then found in the BILLING RATES file (#399.5), based on the
bedsection and date of care.
399.1,.15 IB ACTION TYPE (PER DIEM) 0;8 POINTER TO IB ACTION TYPE FILE (#350.1)
LAST EDITED: APR 08, 1992
DESCRIPTION: This field will only be used for those bedsections which are included in the billing of Means
Test/Category C charges.
The field is a pointer to the IB ACTION TYPE file. Once the bedsection is derived from the
patient's treating specialty, the IB ACTION TYPE for the Category C Inpatient/NHC per diem charge
can be determined.
399.1,.16 OCC RELATED TO 0;9 SET
'1' FOR EMPLOYMENT;
'2' FOR AUTO ACCIDENT;
'3' FOR OTHER ACCIDENT;
LAST EDITED: JAN 31, 2007
HELP-PROMPT: Enter the code that most accurately relates to the Occurence Code.
DESCRIPTION:
Relates the Occurrence Codes to the 'Condition Related To' question on the CMS-1500, box 10.
SCREEN: S DIC("S")="I $P(^DGCR(399.1,+DA,0),U,4)=1"
EXPLANATION: Valid MCCR Occurrence Codes only!
399.1,.17 OCCURRENCE SPAN 0;10 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: JAN 03, 1994
HELP-PROMPT: Enter Yes if this Occurrence code has two related dates associated with it.
DESCRIPTION:
A code and related dates that identify an event that relates to the payment of the claim.
TECHNICAL DESCR: For Occurrence Spans both this flag and Occurrence Code must be set. Setting this flag indicates
two dates are required.
SCREEN: S DIC("S")="I +$P(^DGCR(399.1,+DA,0),U,4)"
EXPLANATION: Only Valid Occurrence Codes!
399.1,.18 VALUE CODE 0;11 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: DEC 21, 1993
HELP-PROMPT: Enter Yes if this is a Value Code.
399.1,.19 VALUE CODE AMOUNT 0;12 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: JAN 03, 1994
HELP-PROMPT: Enter Yes if the value associated with this code is a dollar amount.
DESCRIPTION: Enter Yes if the value amount associated with this value code should be right justified to the
right of the delimiter, ie with cents printed.
TECHNICAL DESCR: If this is true then the value amount for the value code is a dollar amount and should be right
justified to the right of the delimiter. The value amounts for all other value codes will be right
justified to the left of the delimiter.
SCREEN: S DIC("S")="I +$P(^DGCR(399.1,+DA,0),U,11)"
EXPLANATION: Only applies to value codes.
399.1,.2 BILLABLE SERVICE 0;13 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: JUL 01, 1996
HELP-PROMPT: Enter Yes if this is a billable service.
DESCRIPTION:
These are the types of services a patient may receive that may be billable to a payer.
399.1,.21 BILLABLE EVENT 0;14 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: JUL 01, 1996
HELP-PROMPT: Enter Yes if this is a type of event that may be billed.
DESCRIPTION: These are the types of events used to itemize on the bill the care provided to the patient and are
billable for at least one payer rate.
399.1,.22 CONDITION CODE 0;15 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: SEP 10, 1997
HELP-PROMPT: Enter Yes if this is a Condition Code.
DESCRIPTION:
This indicates whether or not this entry is a Condition Code.
399.1,.23 BILL CLASSIFICATION 0;23 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: SEP 08, 1998
HELP-PROMPT: Enter the code which indicates whether or not this is a bill classification code
DESCRIPTION:
This indicates whether or not this entry is a bill classification code.
399.1,.24 VALID LOCATION OF CARE VALUES 0;24 FREE TEXT
INPUT TRANSFORM: K:$L(X)>10!($L(X)<1) X
LAST EDITED: SEP 08, 1998
HELP-PROMPT: Answer must be 1-10 characters in length.
DESCRIPTION: This is the list of valid location of care values that are consistent with the bill classification
code. More than 1 value can be entered, separated by commas.
399.1,.25 OTHER CARE 0;25 POINTER TO MCCR UTILITY FILE (#399.1)
INPUT TRANSFORM: S DIC("S")="I +$P(^(0),U,13),$P(^DGCR(399.1,+DA,0),U,5)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: JAN 22, 2004
HELP-PROMPT: Enter the Billable Service this Bedsection is related to.
DESCRIPTION: If this Bedsection is associated with an 'Other Type of Care', then this Billable Service will
identify the Rate Schedules that apply.
SCREEN: S DIC("S")="I +$P(^(0),U,13),$P(^DGCR(399.1,+DA,0),U,5)"
EXPLANATION: Only Valid Billable Services!
399.1,.26 VALUE CODE OBSOLETE DATE 0;26 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:X<1 X
LAST EDITED: APR 12, 2007
HELP-PROMPT: (No range limit on date)
399.1,1 VALUE CODE HELP TEXT 1;0 WORD-PROCESSING #399.11
LAST EDITED: APR 06, 2007
DESCRIPTION: This field is for the help text specific to this value code. It will be used when adding value
codes to the bill.
399.1,2 VALUE CODE AMOUNT SCREEN 2;E1,245 MUMPS
INPUT TRANSFORM: D VCSCREEN^IBCVC(.X) Q:'$D(X) K:$L(X)>245 X D:$D(X) ^DIM
LAST EDITED: MAR 16, 2022
HELP-PROMPT: Enter some MUMPS code or the space bar and press Enter to enter the interface.
DESCRIPTION: This field is only editable by a developer.
Standard MUMPS code can be entered to screen the values entered for the VALUE CODE AMOUNT field in
file #399
The screen API VCSCREEN^IBCVC provides a simple interface for the developer to add standard screens
that automatically insert code to take advantage of the IB ERROR functionality.
Or the developer can enter simple MUMPS code to screen the entries.
Enter some MUMPS code or the space bar and press Enter to enter the interface.
WRITE AUTHORITY: @
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
FILES POINTED TO FIELDS
IB ACTION TYPE (#350.1) IB ACTION TYPE (COPAYMENT) (#.14)
IB ACTION TYPE (PER DIEM) (#.15)
MCCR UTILITY (#399.1) OTHER CARE (#.25)
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):