GLOBAL MAP DATA DICTIONARY #364.9 -- ACC X12 ENCOUNTERS FILE                                                      5/26/26    PAGE 1
STORED IN ^IBA(364.9,  *** NO DATA STORED YET ***   SITE: WWW.BMIRWIN.COM   UCI: VISTA,VISTA                       (VERSION 2.0)   
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This file contains the Automated Community Care (ACC) X12 837 claim encounter data as received from Payer EDI.  


CROSS
REFERENCED BY: ASSIGNED TO GROUP(AC), STATUS(AD), PROVIDER NPI(ANPI), DATE/TIME ENTERED(B), CLAIM NUMBER(C), 
               X12 CLAIM NUMBER(D), READY FOR POWER BI EXTRACT?(E), PATIENT(F), PATIENT LAST NAME(G)



^IBA(364.9,D0,0)= (#.01) DATE/TIME ENTERED [1D] ^ (#.02) PATIENT LAST NAME [2F] ^ (#.03) PATIENT FIRST NAME [3F] ^ (#.04) PATIENT 
               ==>MIDDLE NAME [4F] ^ (#.05) IN-PATIENT/OUT-PATIENT [5S] ^ (#.06) FORM TYPE [6P:353] ^ (#.07) PROVIDER [7F] ^ 
               ==>(#.08) PROVIDER TYPE [8S] ^ (#.09) PROVIDER NPI [9F] ^ (#.1) PATIENT DOB [10D] ^ (#.11) PATIENT SSN [11F] ^ 
               ==>(#.12) SERVICE DATE [12D] ^ (#.13) CPT [13F] ^ (#.14) PRIMARY DX [14F] ^ (#.15) X12 CLAIM NUMBER [15F] ^ (#.16) 
               ==>STATUS [16S] ^ (#.17) PRIMARY INS [17P:36] ^ (#.18) SECONDARY INS [18P:36] ^ (#.19) TERTIARY INS [19P:36] ^ 
               ==>(#.2) SITE NUMBER [20F] ^ (#.21) READY FOR POWER BI EXTRACT? [21S] ^ (#.22) STATUS DATE CHANGED [22D] ^  ^ 
               ==>(#.24) SITE NUMBER IN JSON [24F] ^ (#.25) SERVICE FACILITY [25F] ^ (#.26) SERVICE FACILITY NPI [26F] ^ (#.27) 
               ==>PAID AMOUNT [27N] ^ (#.28) CHARGE AMOUNT [28N] ^ (#.29) PAYER CLAIM CONTROL NUMBER [29F] ^ (#.3) SECONDARY DX 
               ==>[30F] ^ (#.31) EXEMPT FROM SC/SA [31S] ^ 
^IBA(364.9,D0,1,0)=^364.9001A^^  (#1.01) SEGMENT
^IBA(364.9,D0,1,D1,0)= (#.01) SEGMENT [1F] ^ 
^IBA(364.9,D0,2)= (#2.01) PATIENT [1P:2] ^ (#2.02) CLAIM NUMBER [2P:399] ^ (#2.03) AUTHORIZED? [3S] ^ 
^IBA(364.9,D0,3)= (#3.01) ASSIGNED TO GROUP [1S] ^ (#3.02) INITIAL ASSIGNED GROUP [2S] ^ (#3.03) DATE ASSIGNED [3D] ^ 
^IBA(364.9,D0,4,0)=^364.94DA^^  (#4) PREVIOUS ACTIVITY
^IBA(364.9,D0,4,D1,0)= (#.01) DATE/TIME ENTERED [1D] ^ (#.02) ENTERED BY [2P:200] ^ (#.03) ACTIVITY CODE [3P:364.92] ^ (#.04) 
                    ==>ASSIGNING GROUP [4S] ^ (#.05) REASSIGNED TO GROUP [5S] ^ (#.06) ENTERED BY (FT) [6F] ^ 
^IBA(364.9,D0,4,D1,10,0)=^364.9401^^  (#10) PREVIOUS ACTIVITY COMMENTS
^IBA(364.9,D0,4,D1,10,D2,0)= (#.01) PREVIOUS ACTIVITY COMMENTS [1W] ^ 
^IBA(364.9,D0,5,0)=^364.95PA^^  (#5) REASONS NOT AUTOBILLED
^IBA(364.9,D0,5,D1,0)= (#.01) REASON NOT AUTOBILLED [1P:364.91] ^ (#.02) REASON NOTE [2F] ^ (#.03) WORKLIST [3S] ^ (#.04) 
                    ==>PROVIDER NPI [4F] ^ 
^IBA(364.9,D0,6,0)=^364.96A^^  (#6) SERVICE LINE NUMBER
^IBA(364.9,D0,6,D1,0)= (#.01) SERVICE LINE NUMBER [1N] ^ (#.02) LINE PAYMENT AMOUNT [2N] ^ 
^IBA(364.9,D0,7,0)=^364.97PA^^  (#7) INITIAL REASON NOT AUTOBILLED
^IBA(364.9,D0,7,D1,0)= (#.01) INITIAL REASON NOT AUTOBILLED [1P:364.91] ^ (#.02) REASON NOTE [2F] ^ (#.03) WORKLIST [3S] ^ (#.04) 
                    ==>PROVIDER NPI [4F] ^ 


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