STANDARD DATA DICTIONARY #538 -- UTILIZATION MANAGEMENT ROLLUP FILE 3/24/25 PAGE 1
STORED IN ^IBQ(538, *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 1.0)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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This file is maintained at both the National Database and at the local sites. It contains all information needed for transmission
of the National Rollup data to the National Database. Information is gathered into this file through IBQ Utilization Management
menus extracting data from the IB Claims Tracking package. This file is maintained by menus in the IBQ Utilization Management
Rollup package.
Per VHA Directive 10-93-142, this file definition should not be modified.
IDENTIFIED BY: SSN (#.03)[R], ACUTE CARE DISCHARGE DATE (#.1)
CROSS
REFERENCED BY: ACUTE CARE DISCHARGE DATE(ADIS), SITE(ASITE), ROLLUP DATE(ASITE1), ENTRY ID(B), SSN(C)
538,.01 ENTRY ID 0;1 NUMBER (Required)
INPUT TRANSFORM: K:+X'=X!(X>99999999999)!(X<1001)!(X?.E1"."1N.N) X
LAST EDITED: JUN 29, 1995
HELP-PROMPT: Type a Number between 1001 and 99999999999, 0 Decimal Digits
DESCRIPTION: This is a unique number assigned by the Claims Tracking entry. The first 3 characters of the number
are the stations site number.
CROSS-REFERENCE: 538^B
1)= S ^IBQ(538,"B",$E(X,1,30),DA)=""
2)= K ^IBQ(538,"B",$E(X,1,30),DA)
538,.02 SITE 0;2 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>7!($L(X)<3) X
LAST EDITED: SEP 28, 1995
HELP-PROMPT: Answer must be 3-7 characters in length.
DESCRIPTION:
This is a 3 digit station number plus any modifiers.
CROSS-REFERENCE: 538^ASITE^MUMPS
1)= S IBQ=$P($G(^IBQ(538,DA,1)),"^",8) I IBQ]"" S ^IBQ(538,"ASITE",X,IBQ,DA)=""
2)= S IBQ=$P($G(^IBQ(538,DA,1)),"^",8) I IBQ]"" K ^IBQ(538,"ASITE",X,IBQ,DA)
This MUMPS cross-reference index 'ASITE' of the SITE field works with the MUMPS cross-reference
index 'ASITE1' of the ROLLUP DATE in setting up the "ASITE" cross reference.
538,.03 SSN 0;3 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>9!($L(X)<9) X
LAST EDITED: AUG 09, 1995
HELP-PROMPT: Answer must be 9 characters in length.
DESCRIPTION:
This is a nine digit Social Security Number field.
CROSS-REFERENCE: 538^C
1)= S ^IBQ(538,"C",$E(X,1,30),DA)=""
2)= K ^IBQ(538,"C",$E(X,1,30),DA)
Cross reference used to lookup Entry ID by SSN.
538,.04 ADMITTING DIAGNOSIS 0;4 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>7!($L(X)<1) X
LAST EDITED: JUN 29, 1995
HELP-PROMPT: Answer must be 1-7 characters in length.
DESCRIPTION:
ICD 9 Code Number
538,.05 ENROLLEMENT CODE 0;5 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>5!($L(X)<3) X
LAST EDITED: APR 18, 1995
HELP-PROMPT: Answer must be 3-5 characters in length.
DESCRIPTION: This field contains the three internal enrollement sample codes (Random, Disease specific, or
Local) from the Claims Tracking entry seperated by hyphens. Example: 1--, 0-3-0, 0-0-1.
538,.06 ADMITTING PHYSICIAN CODE 0;6 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: APR 18, 1995
HELP-PROMPT: Type a NEW PERSON IEN Number between 1 and 999999999, 0 Decimal Digits
DESCRIPTION:
Contains the Physician's IEN number from the NEW PERSON File (#200)
538,.07 ATTENDING PHYSICIAN CODE 0;7 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: APR 18, 1995
HELP-PROMPT: Type a NEW PERSON IEN Number between 1 and 999999999, 0 Decimal Digits
DESCRIPTION:
Contains the Physician's IEN number from the NEW PERSON File (#200).
538,.08 RESIDENT PHYSICIAN CODE 0;8 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: APR 18, 1995
HELP-PROMPT: Type a NEW PERSON IEN Number between 1 and 999999999, 0 Decimal Digits
DESCRIPTION:
Contains the Physician's IEN number from the NEW PERSON File (#200).
538,.09 ACUTE CARE ADMISSION DATE 0;9 DATE (Required)
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 18, 1995
538,.1 ACUTE CARE DISCHARGE DATE 0;10 DATE
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 18, 1995
CROSS-REFERENCE: 538^ADIS
1)= S ^IBQ(538,"ADIS",$E(X,1,30),DA)=""
2)= K ^IBQ(538,"ADIS",$E(X,1,30),DA)
This is a regular cross-reference indexing ACUTE CARE DISCHARGE DATE for quicker date range
reporting.
538,.11 WARD 0;11 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>30!($L(X)<2) X
LAST EDITED: JUN 29, 1995
HELP-PROMPT: Enter the ward on which the patient was placed.
DESCRIPTION:
Enter in this field the name of the ward location as selectable using bed control options in MAS.
538,.12 TREATING SPECIALTY 0;12 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>30!($L(X)<3) X
LAST EDITED: JUN 29, 1995
HELP-PROMPT: Enter the Treating Specialty assigned to this patient with this movement.
DESCRIPTION: Contains the name of the facility treating specialty. Types of treating specialties may vary
between Facilities.
538,.13 ACUTE ADMISSION (Y/N)? 0;13 SET (Required)
'1' FOR YES;
'0' FOR NO;
LAST EDITED: APR 18, 1995
538,1.01 SEVERITY OF ILLNESS 1;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>2!($L(X)<2) X
LAST EDITED: JUN 29, 1995
HELP-PROMPT: Answer with SI/IS CATEGORIES CODE, 2 characters in length.
DESCRIPTION: Enter the Severity of Illness (SI) category code that best describes the criteria met for continued
stay days of care. Select the PRIMARY category for the reason.
538,1.02 INTENSITY OF SERVICE 1;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>2!($L(X)<2) X
LAST EDITED: JUN 29, 1995
HELP-PROMPT: Answer with SI/IS CATEGORIES CODE, 2 characters in length.
DESCRIPTION: Enter the Intensity of Service (IS) category code that best describes the criteria met for
continued stay days of care. Select the PRIMARY category for this reason.
538,1.03 REASON FOR NON-ACUTE ADMISSION 1;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>18!($L(X)<4) X
LAST EDITED: JUN 29, 1995
HELP-PROMPT: Answer with NON-ACUTE CLASSIFICATIONS CODE seperated by space if more than one, 4-18 characters in
length.
DESCRIPTION:
This is the external reference which is uniquely known.
538,1.04 PROVIDER INTERVIEWED (Y/N)? 1;4 SET (Required)
'1' FOR YES;
'0' FOR NO;
LAST EDITED: APR 18, 1995
538,1.05 ADMISSION INFLUENCED (Y/N)? 1;5 SET (Required)
'1' FOR YES;
'0' FOR NO;
LAST EDITED: APR 18, 1995
538,1.06 LOCAL, NATIONAL, OR BOTH 1;6 SET (Required)
'L' FOR LOCAL;
'N' FOR NATIONAL;
'B' FOR BOTH;
LAST EDITED: MAY 12, 1995
538,1.07 SERVICE 1;7 SET (Required)
'M' FOR MEDICINE;
'S' FOR SURGERY;
'P' FOR PSYCHIATRY;
'NH' FOR NHCU;
'NE' FOR NEUROLOGY;
'I' FOR INTERMEDIATE MED;
'R' FOR REHAB MEDICINE;
'SCI' FOR SPINAL CORD INJURY;
'D' FOR DOMICILIARY;
'B' FOR BLIND REHAB;
'RE' FOR RESPITE CARE;
LAST EDITED: JUL 06, 1995
HELP-PROMPT: Enter the SERVICE Code describing this admission review.
DESCRIPTION:
This field contains the Service code for the entries Admission review.
538,1.08 ROLLUP DATE 1;8 DATE
INPUT TRANSFORM: S %DT="E" D ^%DT S X=Y K:Y<1 X
LAST EDITED: SEP 26, 1995
DESCRIPTION: This field is for National Database use. It will hold the date of transmission to the National
Database.
CROSS-REFERENCE: 538^ASITE1^MUMPS
1)= S IBQ=$P(^IBQ(538,DA,0),"^",2) I IBQ]"" S ^IBQ(538,"ASITE",IBQ,X,DA)=""
2)= S IBQ=$P(^IBQ(538,DA,0),"^",2) I IBQ]"" K ^IBQ(538,"ASITE",IBQ,X,DA)
This cross reference index 'ASITE1' of the ROLLUP DATE field works with the MUMPS cross reference
index 'ASITE' of the SITE field in setting up the "ASITE" cross reference.
538,1.09 ARCHIVED? 1;9 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: SEP 26, 1995
DESCRIPTION: This field is for National Database use. This field will be true on the National Database if the
entry has been archived to tape.
538,13 DAY 13;0 Multiple #538.113
DESCRIPTION:
Contains Continued Stay Reviews.
538.113,.01 DAY 0;1 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: JUN 30, 1995
HELP-PROMPT: Enter a numeric day of this review, number between 0 and 99999, 0 Decimal Digits
DESCRIPTION: This is the number of the day of continued stay review. This field is normally computed from the
Review date field of the HOSPITAL REVIEW File (#356.1).
CROSS-REFERENCE: 538.113^B
1)= S ^IBQ(538,DA(1),13,"B",$E(X,1,30),DA)=""
2)= K ^IBQ(538,DA(1),13,"B",$E(X,1,30),DA)
538.113,.02 INTENSITY OF SERVICE 0;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>4!($L(X)<2) X
LAST EDITED: JUN 29, 1995
HELP-PROMPT: Answer with SI/IS CATEGORIES CODE, or 24??. 2-4 characters in length.
DESCRIPTION: Enter the Intensity of Service (IS) category that best describes the criteria met for continued
stay day of care. Select the PRIMARY category for this reason.
Also, holds 24 Hour Rule/Interqual Process code, 24??.
24 Hour Rule/Interqual Process (using data entered in HOSPITAL REVIEW File #356.1):
A continued stay day meets this criteria if there is no INTENSITY
OF SERVICE, no DISCHARGE SCREEN, no REASONS CODE, and INTENSITY
OF SERVICE was met on the previous day.
538.113,.03 SEVERITY OF ILLNESS 0;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>2!($L(X)<2) X
LAST EDITED: JUN 29, 1995
HELP-PROMPT: Answer with SI/IS CATEGORIES CODE, 2 characters in length.
DESCRIPTION: Enter the Severity of Illness (SI) category that best describes the criteria met for continued
stay day of care. Select the PRIMARY category for this reason.
538.113,.04 D/C SCREENS MET 0;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>2!($L(X)<2) X
LAST EDITED: JUN 29, 1995
HELP-PROMPT: Answer must be 2 characters in length.
DESCRIPTION: Enter the 2 digit code from the CLAIMS TRACKING SI/IS CATEGORIES File which is appropriate with
this entry.
538.113,.05 INTERVIEWED (Y/N)? 0;5 SET (Required)
'1' FOR YES;
'0' FOR NO;
LAST EDITED: APR 18, 1995
538.113,.06 REASON FOR NON-ACUTE STAY 0;6 FREE TEXT
INPUT TRANSFORM: K:$L(X)>18!($L(X)<4) X
LAST EDITED: JUN 29, 1995
HELP-PROMPT: Answer with NON-ACUTE CLASSIFICATIONS CODE seperate by space if more the one, 4-18 characters in
length.
DESCRIPTION:
This is the external reference with is uniquely known.
538.113,.07 TREATING SPECIALTY 0;7 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<3) X
LAST EDITED: JUN 29, 1995
HELP-PROMPT: Enter the Treating Specialty assigned to this patient with this movement.
DESCRIPTION: Contains the name of the facility treating specialty. Types of treating specialties may vary
between Facilities.
538.113,.08 SERVICE 0;8 SET (Required)
'M' FOR MEDICINE;
'S' FOR SURGERY;
'P' FOR PSYCHIATRY;
'NH' FOR NHCU;
'NE' FOR NEUROLOGY;
'I' FOR INTERMEDIATE MED;
'R' FOR REHAB MEDICINE;
'SCI' FOR SPINAL CORD INJURY;
'D' FOR DOMICILIARY;
'B' FOR BLIND REHAB;
'RE' FOR RESPITE CARE;
LAST EDITED: JUL 06, 1995
HELP-PROMPT: Enter the SERVICE Code describing this continued stay review.
DESCRIPTION: This field contains the SERVICE Code from the SPECIALTY File (#42.4) which describes this entries
contiued stay review for this day.
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):