STANDARD DATA DICTIONARY #399.5 -- BILLING RATES FILE 6/27/25 PAGE 1
STORED IN ^DGCR(399.5, (379 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 the historical billing rates, associated with revenue codes and bedsections that the DVA has legislative
authority to bill third parties for reimbursement.
It is used to automatically associate revenue codes, bedsections and amounts with a bill.
Per VHA Directive 10-93-142, this file definition should not be modified.
This file has been replaced by functionality in the Charge Master and will no longer be used after patch IB*2*52 is released.
DD ACCESS: @
RD ACCESS: dD
WR ACCESS: d
DEL ACCESS: d
LAYGO ACCESS: d
AUDIT ACCESS: d
IDENTIFIED BY: BILLING BEDSECTION (#.02)[R], REVENUE CODE (#.03)[R], AMOUNT (#.04)[R], ACTIVE (#.05)
CROSS
REFERENCED BY: EFFECTIVE DATE(AIVDT), BILLING BEDSECTION(AIVDT1), REVENUE CODE(AIVDT2), EFFECTIVE DATE(B), REVENUE CODE(D)
399.5,.01 EFFECTIVE DATE 0;1 DATE (Required)
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:2991001X) X
LAST EDITED: MAY 25, 1990
HELP-PROMPT: TYPE A DATE BETWEEN 10/1/1986 AND 10/1/1999
DESCRIPTION: This is the date in which changes in billing rates will take effect. A new entry, with a new
effective date is necessary to change a previous entry. The most recent effective date's entry
data will be used (even if its null) in calculating current charges.
CROSS-REFERENCE: 399.5^B
1)= S ^DGCR(399.5,"B",$E(X,1,30),DA)=""
2)= K ^DGCR(399.5,"B",$E(X,1,30),DA)
CROSS-REFERENCE: 399.5^AIVDT^MUMPS
1)= S:$P(^DGCR(399.5,DA,0),U,2)&($P(^(0),U,3)) ^DGCR(399.5,"AIVDT",$P(^(0),U,2),-X,$P(^(0),U,3),DA)
=""
2)= K:$P(^DGCR(399.5,DA,0),U,2)&($P(^(0),U,3)) ^DGCR(399.5,"AIVDT",$P(^(0),U,2),-X,$P(^(0),U,3),DA)
3)= DON'T DELETE
All rates by revenue code, bedsection, and inverse date effective.
399.5,.02 BILLING BEDSECTION 0;2 POINTER TO MCCR UTILITY FILE (#399.1) (Required)
INPUT TRANSFORM: S DIC("S")="I $P(^DGCR(399.1,+Y,0),U,5)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: MAY 04, 1990
DESCRIPTION:
This is the Specialty for which we have approved billing rates.
SCREEN: S DIC("S")="I $P(^DGCR(399.1,+Y,0),U,5)"
EXPLANATION: VALID BILLING BEDSECTIONS ONLY
CROSS-REFERENCE: 399.5^AIVDT1^MUMPS
1)= S:$P(^DGCR(399.5,DA,0),U,3) ^DGCR(399.5,"AIVDT",X,-^(0),$P(^(0),U,3),DA)=""
2)= K:$P(^DGCR(399.5,DA,0),U,3) ^DGCR(399.5,"AIVDT",X,-^(0),$P(^(0),U,3),DA)
3)= DON'T DELETE
All rates by revenue code, bedsection, and inverse date effective.
399.5,.03 REVENUE CODE 0;3 POINTER TO REVENUE CODE FILE (#399.2) (Required)
INPUT TRANSFORM: S DIC("S")="I $P(^DGCR(399.2,+Y,0),U,3)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: MAY 01, 1990
DESCRIPTION:
This is the revenue code that will automatically be used with this rate.
SCREEN: S DIC("S")="I $P(^DGCR(399.2,+Y,0),U,3)"
EXPLANATION: Select Active Revenue Codes Only!
CROSS-REFERENCE: 399.5^D
1)= S ^DGCR(399.5,"D",$E(X,1,30),DA)=""
2)= K ^DGCR(399.5,"D",$E(X,1,30),DA)
3)= Don't delete this.
CROSS-REFERENCE: 399.5^AIVDT2^MUMPS
1)= S:$P(^DGCR(399.5,DA,0),U,2) ^DGCR(399.5,"AIVDT",$P(^(0),U,2),-^(0),X,DA)=""
2)= K:$P(^DGCR(399.5,DA,0),U,2) ^DGCR(399.5,"AIVDT",$P(^(0),U,2),-^(0),X,DA)
3)= DON'T DELETE
All rates by revenue code, bedsection, and inverse date effective.
399.5,.04 AMOUNT 0;4 NUMBER (Required)
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999)!(X<1) X
OUTPUT TRANSFORM: S X=Y,X2="2$" D COMMA^%DTC S Y=X
LAST EDITED: MAY 29, 1990
HELP-PROMPT: Type a Dollar Amount between 1 and 9999, 2 Decimal Digits
DESCRIPTION:
This is the unit charge dollar amount for this rate.
399.5,.05 ACTIVE 0;5 SET
'0' FOR NOT ACTIVE;
'1' FOR YES, ACTIVE;
LAST EDITED: MAY 01, 1990
DESCRIPTION: If a rate is no longer to be used it should be inactivated. This may be necessary if you are
building rates for the same care using different Revenue Codes and would like to keep the old
entries in the file for reference purposes.
399.5,.06 PAYORS TO USE WITH 0;6 SET
'i' FOR INSURANCE CO.;
'p' FOR PATIENTS;
'o' FOR OTHER (INSTITUTIONS);
'op' FOR PATIENTS & INSTITUTIONS;
'iop' FOR ALL BUT CAT C'S;
'iopc' FOR ALL;
'c' FOR CAT C. BILLS ONLY;
'opc' FOR ALL BUT INSURANCE CO.'S;
LAST EDITED: MAY 04, 1990
DESCRIPTION: Enter the payors that this Billing Rate is to be used with. For the purposes of this field, the
choices for payer are:
i - Insurance companies
o - Other (Institutions
p - Patients
c - Means Test/Cat C bills
All bills to patients will be considered patient bills except for Means test Co-payment bills,
which may have a different amount or maximum associated with it.
399.5,.07 NON-STANDARD RATE 0;7 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: MAY 15, 1990
HELP-PROMPT: Enter whether or not this Billing Rate should NOT be set up automatically for bills to the
identified payors and bedsections.
DESCRIPTION: This field should be answered 'YES' if this billing rate should not be automatically set up for all
payers identified in the field 'PAYORS TO USE WITH." This billing rate will only be used with
insurance companies where this revenue code has been listed in the DIFFERENT REVENUE CODES TO USE
field of the Insurance Company File.
If this field is left blank or answered 'NO' then this Revenue Code and amount will be set up
automatically for this bedsection when a bill is created.
FILES POINTED TO FIELDS
MCCR UTILITY (#399.1) BILLING BEDSECTION (#.02)
REVENUE CODE (#399.2) REVENUE CODE (#.03)
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
IB BILLING RATES MAY 29, 1990@10:00 USER #0 BILLING RATES LIST
List billing rates.
SORT TEMPLATE(S):
IB BILLING RATES MAY 29, 1990@09:58 USER #0
SORT BY: 'BILLING BEDSECTION//
WITHIN BILLING BEDSECTION, SORT BY: EFFECTIVE DATE// (User is asked range)
WITHIN EFFECTIVE DATE, SORT BY: BILLING BEDSECTION;S2//
WITHIN BILLING BEDSECTION, SORT BY: ACTIVE//
WITHIN ACTIVE, SORT BY: REVENUE CODE//
Billing Rates List.
FORM(S)/BLOCK(S):