source: WorldVistAEHR/trunk/g/FBAA.zwr@ 1582

Last change on this file since 1582 was 613, checked in by George Lilly, 15 years ago

initial load of WorldVistAEHR
File size: 31.1 KB
Line 
1FirstRelease WVEHR VER VOE1.0
2Cache 31-Jan-2008 23:07:04 ZWR
3^FBAA(161.21,0)="FEE BASIS CNH CONTRACT^161.21I^^"
4^FBAA(161.22,0)="FEE BASIS CNH RATE^161.22^^"
5^FBAA(161.23,0)="FEE BASIS CNH AUTHORIZATION RATE^161.23D^^"
6^FBAA(161.25,0)="FEE BASIS VENDOR CORRECTION^161.25P^^"
7^FBAA(161.26,0)="FEE BASIS PATIENT MRA^161.26P^^"
8^FBAA(161.27,0)="FEE BASIS SUSPENSION^161.27I^19^19"
9^FBAA(161.27,1,0)="1"
10^FBAA(161.27,1,1,0)="^^1^1^2920903^^^^"
11^FBAA(161.27,1,1,1,0)="Charge exceeds maximum amount payable in accordance with VA policy."
12^FBAA(161.27,1,2)="Charge exceeds maximum payable"
13^FBAA(161.27,2,0)="2"
14^FBAA(161.27,2,1,0)="^^1^1^2880601^^^^"
15^FBAA(161.27,2,1,1,0)="Adjustment was made to correct mathematical error on your invoice."
16^FBAA(161.27,2,2)="Math error"
17^FBAA(161.27,3,0)="3"
18^FBAA(161.27,3,1,0)="^^2^2^2880601^^^^"
19^FBAA(161.27,3,1,1,0)="Medical service/Rx was provided for condition which is not authorized"
20^FBAA(161.27,3,1,2,0)="at VA expense."
21^FBAA(161.27,3,2)="Not entitled to treatment"
22^FBAA(161.27,4,0)="4"
23^FBAA(161.27,4,1,0)="^^2^2^2920903^^^^"
24^FBAA(161.27,4,1,1,0)="Amount differs from amount claimed. Explanatory letter being forwarded"
25^FBAA(161.27,4,1,2,0)="under separate cover."
26^FBAA(161.27,4,2)="Other"
27^FBAA(161.27,5,0)="5"
28^FBAA(161.27,5,1,0)="^^2^2^2880601^^^^"
29^FBAA(161.27,5,1,1,0)="Fees for service previously processed. If payment not received, notify"
30^FBAA(161.27,5,1,2,0)="Fiscal Service."
31^FBAA(161.27,5,2)="Previously paid"
32^FBAA(161.27,6,0)="6"
33^FBAA(161.27,6,1,0)="^^2^2^2880601^^^^"
34^FBAA(161.27,6,1,1,0)="Fees for this invoice exceed the monthly dollar limitation established"
35^FBAA(161.27,6,1,2,0)="for this veteran."
36^FBAA(161.27,6,2)="Exceed monthly dollar limitation"
37^FBAA(161.27,7,0)="7"
38^FBAA(161.27,7,1,0)="^^1^1^2880601^^^^"
39^FBAA(161.27,7,1,1,0)="Physician's signature missing on Rx."
40^FBAA(161.27,7,2)="Physician's signature missing"
41^FBAA(161.27,8,0)="8"
42^FBAA(161.27,8,1,0)="^^1^1^2880601^^^^"
43^FBAA(161.27,8,1,1,0)="Patient/representative's signature missing on Statement of Receipt."
44^FBAA(161.27,8,2)="Patient's signature missing"
45^FBAA(161.27,9,0)="9"
46^FBAA(161.27,9,1,0)="^^1^1^2931112^^^^"
47^FBAA(161.27,9,1,1,0)="No evidence of record that medication needed immediately."
48^FBAA(161.27,9,2)="Medication not emergent."
49^FBAA(161.27,10,0)="A"
50^FBAA(161.27,10,1,0)="^^1^1^2880601^^^"
51^FBAA(161.27,10,1,1,0)="Pharmacist's certification missing on copy."
52^FBAA(161.27,10,2)="Pharmacist's certification missing"
53^FBAA(161.27,11,0)="B"
54^FBAA(161.27,11,1,0)="^^1^1^2880601^^^^"
55^FBAA(161.27,11,1,1,0)="Certification not signed by pharmacist."
56^FBAA(161.27,11,2)="Pharmacist's signature missing"
57^FBAA(161.27,12,0)="C"
58^FBAA(161.27,12,1,0)="^^2^2^2880601^^^^"
59^FBAA(161.27,12,1,1,0)="NDC Code, name of manufacturer, brand name, strength"
60^FBAA(161.27,12,1,2,0)="or quantity dispensed, is missing."
61^FBAA(161.27,12,2)="Required drug information missing"
62^FBAA(161.27,13,0)="D"
63^FBAA(161.27,13,1,0)="^^2^2^2880601^^^^"
64^FBAA(161.27,13,1,1,0)="Item not a medical requisite paid for by the VA. (Do not return"
65^FBAA(161.27,13,1,2,0)="prescription.)"
66^FBAA(161.27,13,2)="Item not on payable list"
67^FBAA(161.27,14,0)="E"
68^FBAA(161.27,14,1,0)="^^1^1^2880601^^^^"
69^FBAA(161.27,14,1,1,0)="Veteran's full name, address or social security number missing."
70^FBAA(161.27,14,2)="Veteran information missing"
71^FBAA(161.27,15,0)="F"
72^FBAA(161.27,15,1,0)="^^1^1^2880601^^^^"
73^FBAA(161.27,15,1,1,0)="Payment for personal items or private room not permitted."
74^FBAA(161.27,15,2)="Personal items/Private Room"
75^FBAA(161.27,16,0)="G"
76^FBAA(161.27,16,1,0)="^^2^2^2880601^^^^"
77^FBAA(161.27,16,1,1,0)="Veteran refused transfer to VA hospital. Payment made to date"
78^FBAA(161.27,16,1,2,0)="stabilized or date of refusal."
79^FBAA(161.27,16,2)="Vet refused transfer"
80^FBAA(161.27,17,0)="H"
81^FBAA(161.27,17,1,0)="^^2^2^2880601^^^"
82^FBAA(161.27,17,1,1,0)="Rx is for a recurring/refill medication not paid by VA."
83^FBAA(161.27,17,1,2,0)="(Do not return this prescription.)"
84^FBAA(161.27,17,2)="For recurring or refill medication"
85^FBAA(161.27,18,0)="I"
86^FBAA(161.27,18,1,0)="^^2^2^2940425^^^^"
87^FBAA(161.27,18,1,1,0)="Payment for generic equivalent. Prescription did not prohibit"
88^FBAA(161.27,18,1,2,0)="substitution."
89^FBAA(161.27,18,2)="Payment made for Generic drug"
90^FBAA(161.27,19,0)="J"
91^FBAA(161.27,19,1,0)="^^2^2^3020204"
92^FBAA(161.27,19,1,1,0)="Payment in Accordance with pricing for claims approved under 38 USC 1725"
93^FBAA(161.27,19,1,2,0)="payer of last resort."
94^FBAA(161.27,19,2)="Mill Bill Authority, 38 U.S.C. 1725"
95^FBAA(161.27,"B",1,1)=""
96^FBAA(161.27,"B",2,2)=""
97^FBAA(161.27,"B",3,3)=""
98^FBAA(161.27,"B",4,4)=""
99^FBAA(161.27,"B",5,5)=""
100^FBAA(161.27,"B",6,6)=""
101^FBAA(161.27,"B",7,7)=""
102^FBAA(161.27,"B",8,8)=""
103^FBAA(161.27,"B",9,9)=""
104^FBAA(161.27,"B","A",10)=""
105^FBAA(161.27,"B","B",11)=""
106^FBAA(161.27,"B","C",12)=""
107^FBAA(161.27,"B","D",13)=""
108^FBAA(161.27,"B","E",14)=""
109^FBAA(161.27,"B","F",15)=""
110^FBAA(161.27,"B","G",16)=""
111^FBAA(161.27,"B","H",17)=""
112^FBAA(161.27,"B","I",18)=""
113^FBAA(161.27,"B","J",19)=""
114^FBAA(161.27,"C","CHARGE EXCEEDS MAXIMUM PAYABLE",1)=""
115^FBAA(161.27,"C","EXCEED MONTHLY DOLLAR LIMITATI",6)=""
116^FBAA(161.27,"C","FOR RECURRING OR REFILL MEDICA",17)=""
117^FBAA(161.27,"C","ITEM NOT ON PAYABLE LIST",13)=""
118^FBAA(161.27,"C","MATH ERROR",2)=""
119^FBAA(161.27,"C","MEDICATION NOT EMERGENT.",9)=""
120^FBAA(161.27,"C","MILL BILL AUTHORITY, 38 U.S.C.",19)=""
121^FBAA(161.27,"C","NOT ENTITLED TO TREATMENT",3)=""
122^FBAA(161.27,"C","OTHER",4)=""
123^FBAA(161.27,"C","PATIENT'S SIGNATURE MISSING",8)=""
124^FBAA(161.27,"C","PAYMENT MADE FOR GENERIC DRUG",18)=""
125^FBAA(161.27,"C","PERSONAL ITEMS/PRIVATE ROOM",15)=""
126^FBAA(161.27,"C","PHARMACIST'S CERTIFICATION MIS",10)=""
127^FBAA(161.27,"C","PHARMACIST'S SIGNATURE MISSING",11)=""
128^FBAA(161.27,"C","PHYSICIAN'S SIGNATURE MISSING",7)=""
129^FBAA(161.27,"C","PREVIOUSLY PAID",5)=""
130^FBAA(161.27,"C","REQUIRED DRUG INFORMATION MISS",12)=""
131^FBAA(161.27,"C","VET REFUSED TRANSFER",16)=""
132^FBAA(161.27,"C","VETERAN INFORMATION MISSING",14)=""
133^FBAA(161.3,0)="FEE BASIS LETTER^161.3^5^5"
134^FBAA(161.3,1,0)="SAMPLE SUSPENSION"
135^FBAA(161.3,1,1,0)="^^3^3^2941227^^^^"
136^FBAA(161.3,1,1,1,0)="We recently processed your invoice(s) and for various reasons adjustments"
137^FBAA(161.3,1,1,2,0)="had to be made to line items. The following is a list of those items"
138^FBAA(161.3,1,1,3,0)="that were changed and the reasons why:"
139^FBAA(161.3,1,2,0)="^^4^4^2941227^^^^"
140^FBAA(161.3,1,2,1,0)="Should you have any questions regarding this letter, feel free to contact"
141^FBAA(161.3,1,2,2,0)="us at the VA Medical Center. Thank you for your cooperation."
142^FBAA(161.3,1,2,3,0)=" Medical Center Director"
143^FBAA(161.3,1,2,4,0)=" James A Jones, MD"
144^FBAA(161.3,2,0)="UNAUTHORIZED DISPOSITION^1"
145^FBAA(161.3,2,1,0)="^^2^2^2930917^^^^"
146^FBAA(161.3,2,1,1,0)="We have carefully reviewed your claim for payment of unauthorized medical"
147^FBAA(161.3,2,1,2,0)="services. The following decision has been made:"
148^FBAA(161.3,2,2,0)="^^15^15^2930917^^^^"
149^FBAA(161.3,2,2,1,0)="If you do not agree with the decision you have the right to appeal. Your"
150^FBAA(161.3,2,2,2,0)="appeal rights should be attached for your review, if your claim was not "
151^FBAA(161.3,2,2,3,0)="approved."
152^FBAA(161.3,2,2,4,0)=" "
153^FBAA(161.3,2,2,5,0)="If you have any questions concerning this matter, please contact us at the"
154^FBAA(161.3,2,2,6,0)="above address. A copy of this letter is being furnished to the provider(s)"
155^FBAA(161.3,2,2,7,0)="of care, if applicable."
156^FBAA(161.3,2,2,8,0)=" "
157^FBAA(161.3,2,2,9,0)=" "
158^FBAA(161.3,2,2,10,0)="Sincerely,"
159^FBAA(161.3,2,2,11,0)=" "
160^FBAA(161.3,2,2,12,0)=" "
161^FBAA(161.3,2,2,13,0)=" "
162^FBAA(161.3,2,2,14,0)=" "
163^FBAA(161.3,2,2,15,0)="Chief, Medical Administration Service"
164^FBAA(161.3,3,0)="UNAUTHORIZED REQUEST INFO^1"
165^FBAA(161.3,3,1,0)="^^1^1^2931014^^^^"
166^FBAA(161.3,3,1,1,0)="We have received your request for payment of medical services which were not authorized. Before we are able to process your claim the following information is needed:"
167^FBAA(161.3,3,2,0)="^^15^15^2931014^^^^"
168^FBAA(161.3,3,2,1,0)="We ask that you be prompt in supplying the requested information. Failure to provide all the information within a year will result in an automatic disapproval."
169^FBAA(161.3,3,2,2,0)="Legislation requires that we notify you if your claim cannot be processed if entitlement to the services rendered has not been established. Without the information requested above, we cannot consider your request"
170^FBAA(161.3,3,2,3,0)="for payment as a proper invoice."
171^FBAA(161.3,3,2,4,0)=" "
172^FBAA(161.3,3,2,5,0)="If you wish us to process this claim, please resubmit the entire claim with the items listed to the above address. We will notify you of our decision."
173^FBAA(161.3,3,2,6,0)=" "
174^FBAA(161.3,3,2,7,0)="The U.S. Department of Veterans Affairs assumes no financial responsibility for any costs incurred in obtaining the above information."
175^FBAA(161.3,3,2,8,0)=" "
176^FBAA(161.3,3,2,9,0)=" "
177^FBAA(161.3,3,2,10,0)="Sincerely,"
178^FBAA(161.3,3,2,11,0)=" "
179^FBAA(161.3,3,2,12,0)=" "
180^FBAA(161.3,3,2,13,0)=" "
181^FBAA(161.3,3,2,14,0)=" "
182^FBAA(161.3,3,2,15,0)="Chief, Medical Administration Service"
183^FBAA(161.3,4,0)="1725 DISPOSITION^1"
184^FBAA(161.3,4,1,0)="^161.31^3^3^3010709^^^^"
185^FBAA(161.3,4,1,1,0)="Consideration of possible VA financial assistance has been given your"
186^FBAA(161.3,4,1,2,0)="claim under the Veterans Millennium Health care and Benefits Act, H.R."
187^FBAA(161.3,4,1,3,0)="2116. The following decision has been made:"
188^FBAA(161.3,4,2,0)="^161.32^10^10^3010709^^"
189^FBAA(161.3,4,2,1,0)="If you have any questions or concerns, please contact us at the above"
190^FBAA(161.3,4,2,2,0)="address. A copy of this letter is being sent to the provider(s) of care,"
191^FBAA(161.3,4,2,3,0)="for their information."
192^FBAA(161.3,4,2,4,0)=" "
193^FBAA(161.3,4,2,5,0)="Sincerely,"
194^FBAA(161.3,4,2,6,0)=" "
195^FBAA(161.3,4,2,7,0)=" "
196^FBAA(161.3,4,2,8,0)=" "
197^FBAA(161.3,4,2,9,0)=" "
198^FBAA(161.3,4,2,10,0)="Chief, Medical Administration Service "
199^FBAA(161.3,5,0)="1725 REQUEST INFO^1"
200^FBAA(161.3,5,1,0)="^161.31^4^4^3010709^^^^"
201^FBAA(161.3,5,1,1,0)="Consideration of possible VA financial assistance is being given your"
202^FBAA(161.3,5,1,2,0)="claim under the Veterans Millennium Health Care and Benefits Act, H.R."
203^FBAA(161.3,5,1,3,0)="2116. However, before your claim can be reviewed it will be necessary"
204^FBAA(161.3,5,1,4,0)="that we receive the following information:"
205^FBAA(161.3,5,2,0)="^161.32^17^17^3010709^^"
206^FBAA(161.3,5,2,1,0)="If the formal claim(s) and/or additional evidence, statement(s), etc., as"
207^FBAA(161.3,5,2,2,0)="requested above, are not received within (30) days from the date of this"
208^FBAA(161.3,5,2,3,0)="letter, your claim will be deemed abandoned and payment/reimbursement will"
209^FBAA(161.3,5,2,4,0)="not be considered on the basis of such abandoned claim, or any future"
210^FBAA(161.3,5,2,5,0)="claim for the same expenses. If an extension is required to submit the"
211^FBAA(161.3,5,2,6,0)="requested documentation, it will be necessary that you contact the VA"
212^FBAA(161.3,5,2,7,0)="facility designated as the clinic of jurisdiction for your area."
213^FBAA(161.3,5,2,8,0)=" "
214^FBAA(161.3,5,2,9,0)="The Department of Veterans Affairs will assume no financial responsibility"
215^FBAA(161.3,5,2,10,0)="for the costs incurred in obtaining the above information."
216^FBAA(161.3,5,2,11,0)=" "
217^FBAA(161.3,5,2,12,0)="Sincerely,"
218^FBAA(161.3,5,2,13,0)=" "
219^FBAA(161.3,5,2,14,0)=" "
220^FBAA(161.3,5,2,15,0)=" "
221^FBAA(161.3,5,2,16,0)=" "
222^FBAA(161.3,5,2,17,0)="Chief, Medical Administration Service"
223^FBAA(161.3,"B","1725 DISPOSITION",4)=""
224^FBAA(161.3,"B","1725 REQUEST INFO",5)=""
225^FBAA(161.3,"B","SAMPLE SUSPENSION",1)=""
226^FBAA(161.3,"B","UNAUTHORIZED DISPOSITION",2)=""
227^FBAA(161.3,"B","UNAUTHORIZED REQUEST INFO",3)=""
228^FBAA(161.4,0)="FEE BASIS SITE PARAMETERS^161.4^^"
229^FBAA(161.45,0)="FEE BASIS PAYMENT MOVES^161.45^^"
230^FBAA(161.5,0)="FEE CH REPORT OF CONTACT^161.5PI^^"
231^FBAA(161.6,0)="FEE BASIS SPECIALTY CODE^161.6I^36^36"
232^FBAA(161.6,1,0)="ALLERGY AND IMMUNOLOGY^16"
233^FBAA(161.6,2,0)="ANESTHESIOLOGY^01"
234^FBAA(161.6,3,0)="DERMATOLOGY^30"
235^FBAA(161.6,4,0)="INTERNAL MEDICINE^32"
236^FBAA(161.6,5,0)="NEUROLOGICAL SURGERY^04"
237^FBAA(161.6,6,0)="NEUROLOGY^50"
238^FBAA(161.6,7,0)="OBSTETRICS AND GYNECOLOGY^03"
239^FBAA(161.6,8,0)="OPHTHALMOLOGY^06"
240^FBAA(161.6,9,0)="ORTHOPEDIC^07"
241^FBAA(161.6,10,0)="OTOLARYNGOLOGY (ENT)^08"
242^FBAA(161.6,11,0)="FAMILY PRACTICE^15"
243^FBAA(161.6,12,0)="NUCLEAR MEDICINE^17"
244^FBAA(161.6,13,0)="PATHOLOGY^72"
245^FBAA(161.6,14,0)="PEDIATRICS^40"
246^FBAA(161.6,15,0)="PHYSICAL MEDICINE AND REHAB.^73"
247^FBAA(161.6,16,0)="PLASTIC SURGERY^09"
248^FBAA(161.6,17,0)="PREVENTIVE MED./PUBLIC HEALTH^41"
249^FBAA(161.6,18,0)="COLON AND RECTAL SURGERY^10"
250^FBAA(161.6,19,0)="PSYCHIATRY^51"
251^FBAA(161.6,20,0)="PSYCHIATRY AND NEUROLOGY^52"
252^FBAA(161.6,21,0)="RADIOLOGY^61"
253^FBAA(161.6,22,0)="SURGERY^02"
254^FBAA(161.6,23,0)="THORACIC SURGERY^11"
255^FBAA(161.6,24,0)="UROLOGY^12"
256^FBAA(161.6,25,0)="PHYSICIANS-NONDIPLOMATS^99"
257^FBAA(161.6,26,0)="PULMONARY^13"
258^FBAA(161.6,27,0)="CARDIOLOGY^14"
259^FBAA(161.6,28,0)="NEPHROLOGY^18"
260^FBAA(161.6,29,0)="INFECTIOUS DISEASE^19"
261^FBAA(161.6,30,0)="OPTOMETRY^20"
262^FBAA(161.6,31,0)="RHEUMATOLOGY^21"
263^FBAA(161.6,32,0)="GASTROENTEROLOGY^22"
264^FBAA(161.6,33,0)="PODIATRY^23"
265^FBAA(161.6,34,0)="ONCOLOGY^24"
266^FBAA(161.6,35,0)="ENDOCRINOLOGY^25"
267^FBAA(161.6,36,0)="CHIROPRACTIC^53"
268^FBAA(161.6,"B","ALLERGY AND IMMUNOLOGY",1)=""
269^FBAA(161.6,"B","ANESTHESIOLOGY",2)=""
270^FBAA(161.6,"B","CARDIOLOGY",27)=""
271^FBAA(161.6,"B","CHIROPRACTIC",36)=""
272^FBAA(161.6,"B","COLON AND RECTAL SURGERY",18)=""
273^FBAA(161.6,"B","DERMATOLOGY",3)=""
274^FBAA(161.6,"B","ENDOCRINOLOGY",35)=""
275^FBAA(161.6,"B","FAMILY PRACTICE",11)=""
276^FBAA(161.6,"B","GASTROENTEROLOGY",32)=""
277^FBAA(161.6,"B","INFECTIOUS DISEASE",29)=""
278^FBAA(161.6,"B","INTERNAL MEDICINE",4)=""
279^FBAA(161.6,"B","NEPHROLOGY",28)=""
280^FBAA(161.6,"B","NEUROLOGICAL SURGERY",5)=""
281^FBAA(161.6,"B","NEUROLOGY",6)=""
282^FBAA(161.6,"B","NUCLEAR MEDICINE",12)=""
283^FBAA(161.6,"B","OBSTETRICS AND GYNECOLOGY",7)=""
284^FBAA(161.6,"B","ONCOLOGY",34)=""
285^FBAA(161.6,"B","OPHTHALMOLOGY",8)=""
286^FBAA(161.6,"B","OPTOMETRY",30)=""
287^FBAA(161.6,"B","ORTHOPEDIC",9)=""
288^FBAA(161.6,"B","OTOLARYNGOLOGY (ENT)",10)=""
289^FBAA(161.6,"B","PATHOLOGY",13)=""
290^FBAA(161.6,"B","PEDIATRICS",14)=""
291^FBAA(161.6,"B","PHYSICAL MEDICINE AND REHAB.",15)=""
292^FBAA(161.6,"B","PHYSICIANS-NONDIPLOMATS",25)=""
293^FBAA(161.6,"B","PLASTIC SURGERY",16)=""
294^FBAA(161.6,"B","PODIATRY",33)=""
295^FBAA(161.6,"B","PREVENTIVE MED./PUBLIC HEALTH",17)=""
296^FBAA(161.6,"B","PSYCHIATRY",19)=""
297^FBAA(161.6,"B","PSYCHIATRY AND NEUROLOGY",20)=""
298^FBAA(161.6,"B","PULMONARY",26)=""
299^FBAA(161.6,"B","RADIOLOGY",21)=""
300^FBAA(161.6,"B","RHEUMATOLOGY",31)=""
301^FBAA(161.6,"B","SURGERY",22)=""
302^FBAA(161.6,"B","THORACIC SURGERY",23)=""
303^FBAA(161.6,"B","UROLOGY",24)=""
304^FBAA(161.6,"C",10,18)=""
305^FBAA(161.6,"C",11,23)=""
306^FBAA(161.6,"C",12,24)=""
307^FBAA(161.6,"C",13,26)=""
308^FBAA(161.6,"C",14,27)=""
309^FBAA(161.6,"C",15,11)=""
310^FBAA(161.6,"C",16,1)=""
311^FBAA(161.6,"C",17,12)=""
312^FBAA(161.6,"C",18,28)=""
313^FBAA(161.6,"C",19,29)=""
314^FBAA(161.6,"C",20,30)=""
315^FBAA(161.6,"C",21,31)=""
316^FBAA(161.6,"C",22,32)=""
317^FBAA(161.6,"C",23,33)=""
318^FBAA(161.6,"C",24,34)=""
319^FBAA(161.6,"C",25,35)=""
320^FBAA(161.6,"C",30,3)=""
321^FBAA(161.6,"C",32,4)=""
322^FBAA(161.6,"C",40,14)=""
323^FBAA(161.6,"C",41,17)=""
324^FBAA(161.6,"C",50,6)=""
325^FBAA(161.6,"C",51,19)=""
326^FBAA(161.6,"C",52,20)=""
327^FBAA(161.6,"C",53,36)=""
328^FBAA(161.6,"C",61,21)=""
329^FBAA(161.6,"C",72,13)=""
330^FBAA(161.6,"C",73,15)=""
331^FBAA(161.6,"C",99,25)=""
332^FBAA(161.6,"C","01",2)=""
333^FBAA(161.6,"C","02",22)=""
334^FBAA(161.6,"C","03",7)=""
335^FBAA(161.6,"C","04",5)=""
336^FBAA(161.6,"C","06",8)=""
337^FBAA(161.6,"C","07",9)=""
338^FBAA(161.6,"C","08",10)=""
339^FBAA(161.6,"C","09",16)=""
340^FBAA(161.7,0)="FEE BASIS BATCH^161.7I^^"
341^FBAA(161.8,0)="FEE BASIS PROGRAM^161.8^15^14"
342^FBAA(161.8,2,0)="OUTPATIENT^3^1"
343^FBAA(161.8,3,0)="PHARMACY^5^1"
344^FBAA(161.8,4,0)="COMP & PENSION^3"
345^FBAA(161.8,5,0)="DENTAL^3"
346^FBAA(161.8,6,0)="CIVIL HOSPITAL^9^1"
347^FBAA(161.8,7,0)="CONTRACT NURSING HOME^9^1"
348^FBAA(161.8,8,0)="CHAMPVA^7"
349^FBAA(161.8,9,0)="CONTRACT READJUSTMENT COUNSELING^3"
350^FBAA(161.8,10,0)="CONTRACT HALFWAY HOUSES^3"
351^FBAA(161.8,11,0)="HOME HEALTH SERVICES^3"
352^FBAA(161.8,12,0)="OTHER INSTITUTIONAL SERVICES^3"
353^FBAA(161.8,13,0)="DIALYSIS^3"
354^FBAA(161.8,14,0)="OXYGEN SERVICES^3"
355^FBAA(161.8,15,0)="STATE HOME^^1"
356^FBAA(161.8,"B","CHAMPVA",8)=""
357^FBAA(161.8,"B","CIVIL HOSPITAL",6)=""
358^FBAA(161.8,"B","COMP & PENSION",4)=""
359^FBAA(161.8,"B","CONTRACT HALFWAY HOUSES",10)=""
360^FBAA(161.8,"B","CONTRACT NURSING HOME",7)=""
361^FBAA(161.8,"B","CONTRACT READJUSTMENT COUNSELI",9)=""
362^FBAA(161.8,"B","DENTAL",5)=""
363^FBAA(161.8,"B","DIALYSIS",13)=""
364^FBAA(161.8,"B","HOME HEALTH SERVICES",11)=""
365^FBAA(161.8,"B","OTHER INSTITUTIONAL SERVICES",12)=""
366^FBAA(161.8,"B","OUTPATIENT",2)=""
367^FBAA(161.8,"B","OXYGEN SERVICES",14)=""
368^FBAA(161.8,"B","PHARMACY",3)=""
369^FBAA(161.8,"B","STATE HOME",15)=""
370^FBAA(161.81,0)="FEE BASIS PARTICIPATION CODE^161.81I^15^15"
371^FBAA(161.81,1,0)="DOCTOR OF MEDICINE^01"
372^FBAA(161.81,2,0)="DOCTOR OF OSTEOPATHY^02"
373^FBAA(161.81,3,0)="HOME NURSING CARE^03"
374^FBAA(161.81,4,0)="DENTIST^04"
375^FBAA(161.81,5,0)="COMMUNITY NURSING HOME^05"
376^FBAA(161.81,6,0)="NON-VA HOSPITAL^06"
377^FBAA(161.81,7,0)="CONTRACT READJUSTMENT COUNSELING^07"
378^FBAA(161.81,8,0)="CONTRACT HALFWAY HOUSES^08"
379^FBAA(161.81,9,0)="HOME IMPROVEMENT AND STRUCTURAL ALTERATION^09"
380^FBAA(161.81,10,0)="HOME HEALTH SERVICES^10"
381^FBAA(161.81,11,0)="DIALYSIS^11"
382^FBAA(161.81,12,0)="ALL OTHER INDIVIDUAL PARTICIPANTS^12"
383^FBAA(161.81,13,0)="ALL OTHER PARTICIPANTS, NOT INDIVIDUALS^13"
384^FBAA(161.81,14,0)="PHARMACY^ "
385^FBAA(161.81,15,0)="DOCTOR OF CHIROPRACTIC^15"
386^FBAA(161.81,"B","ALL OTHER INDIVIDUAL PARTICIPA",12)=""
387^FBAA(161.81,"B","ALL OTHER PARTICIPANTS, NOT IN",13)=""
388^FBAA(161.81,"B","COMMUNITY NURSING HOME",5)=""
389^FBAA(161.81,"B","CONTRACT HALFWAY HOUSES",8)=""
390^FBAA(161.81,"B","CONTRACT READJUSTMENT COUNSELI",7)=""
391^FBAA(161.81,"B","DENTIST",4)=""
392^FBAA(161.81,"B","DIALYSIS",11)=""
393^FBAA(161.81,"B","DOCTOR OF CHIROPRACTIC",15)=""
394^FBAA(161.81,"B","DOCTOR OF MEDICINE",1)=""
395^FBAA(161.81,"B","DOCTOR OF OSTEOPATHY",2)=""
396^FBAA(161.81,"B","HOME HEALTH SERVICES",10)=""
397^FBAA(161.81,"B","HOME IMPROVEMENT AND STRUCTURA",9)=""
398^FBAA(161.81,"B","HOME NURSING CARE",3)=""
399^FBAA(161.81,"B","NON-VA HOSPITAL",6)=""
400^FBAA(161.81,"B","PHARMACY",14)=""
401^FBAA(161.81,"C",10,10)=""
402^FBAA(161.81,"C",11,11)=""
403^FBAA(161.81,"C",12,12)=""
404^FBAA(161.81,"C",13,13)=""
405^FBAA(161.81,"C",15,15)=""
406^FBAA(161.81,"C"," ",14)=""
407^FBAA(161.81,"C","01",1)=""
408^FBAA(161.81,"C","02",2)=""
409^FBAA(161.81,"C","03",3)=""
410^FBAA(161.81,"C","04",4)=""
411^FBAA(161.81,"C","05",5)=""
412^FBAA(161.81,"C","06",6)=""
413^FBAA(161.81,"C","07",7)=""
414^FBAA(161.81,"C","08",8)=""
415^FBAA(161.81,"C","09",9)=""
416^FBAA(161.82,0)="FEE BASIS PURPOSE OF VISIT^161.82I^55^31"
417^FBAA(161.82,1,0)="UNAUTHORIZED CLAIM - OUTPATIENT^^02"
418^FBAA(161.82,2,0)="HOSPICE CARE (INPT.) CONTRACT/SHARING AGREEMENT^6^37"
419^FBAA(161.82,3,0)="HOSPICE CARE (INPT.) FEE BASIS AUTHORITY (CFR 17.50b)^6^38"
420^FBAA(161.82,4,0)="HOSPICE & PALLIATIVE CARE (OPT) - CONTRACT/SHARING AGREEMENT^2^77^3"
421^FBAA(161.82,5,0)="HOSPICE & PALLIATIVE CARE (OPT) - FEE BASIS AUTHORITY (CFR 17.50b)^2^78^3"
422^FBAA(161.82,15,0)="CLASS I DENTAL TREATMENT^2^15"
423^FBAA(161.82,16,0)="CLASS II DENTAL TREATMENT^2^16"
424^FBAA(161.82,17,0)="CLASS IIa DENTAL TREATMENT^2^17"
425^FBAA(161.82,18,0)="CLASS IIb DENTAL TREATMENT^2^18"
426^FBAA(161.82,19,0)="CLASS IIc DENTAL TREATMENT^2^19"
427^FBAA(161.82,20,0)="CLASS IIr DENTAL TREATMENT^2^20"
428^FBAA(161.82,21,0)="CLASS III DENTAL TREATMENT^2^21"
429^FBAA(161.82,22,0)="CLASS IV DENTAL TREATMENT^2^22"
430^FBAA(161.82,23,0)="CLASS V DENTAL TREATMENT^2^23"
431^FBAA(161.82,24,0)="CLASS VI DENTAL TREATMENT^2^24"
432^FBAA(161.82,39,0)="INPATIENT 38 U.S.C. 1725^6^39"
433^FBAA(161.82,43,0)="CNH HOSPICE^7^43^2"
434^FBAA(161.82,44,0)="CNH RESPITE CARE^7^44^1"
435^FBAA(161.82,52,0)="OUTPATIENT 38 U.S.C. 1725^^52"
436^FBAA(161.82,55,0)="MILITARY SEXUAL TRAUMA SERVICES^2^55"
437^FBAA(161.82,71,0)="HOMEMAKER/HOME HEALTH AID SERVICES^2^71^3"
438^FBAA(161.82,72,0)="RESPITE CARE IN HOMEMAKER/HOME HEALTH AID SERVICES^2^72^1"
439^FBAA(161.82,73,0)="RESPITE CARE IN ADHC^2^73^1"
440^FBAA(161.82,74,0)="HOME HEALTH SERVICES (NON-NURSING PROFESSIONAL)^2^74^3"
441^FBAA(161.82,75,0)="CHIROPRACTIC CARE^2^75"
442^FBAA(161.82,76,0)="ADHC^2^76^1"
443^FBAA(161.82,79,0)="RESPITE CARE (OTHER)^2^79^1"
444^FBAA(161.82,86,0)="STATE HOME ADHC^15^86"
445^FBAA(161.82,87,0)="STATE HOME DOM^15^87"
446^FBAA(161.82,88,0)="STATE HOME HOSPITAL^15^88"
447^FBAA(161.82,89,0)="STATE HOME NH^15^89"
448^FBAA(161.82,"AC",15,15)=""
449^FBAA(161.82,"AC",16,16)=""
450^FBAA(161.82,"AC",17,17)=""
451^FBAA(161.82,"AC",18,18)=""
452^FBAA(161.82,"AC",19,19)=""
453^FBAA(161.82,"AC",20,20)=""
454^FBAA(161.82,"AC",21,21)=""
455^FBAA(161.82,"AC",22,22)=""
456^FBAA(161.82,"AC",23,23)=""
457^FBAA(161.82,"AC",24,24)=""
458^FBAA(161.82,"AC",37,2)=""
459^FBAA(161.82,"AC",38,3)=""
460^FBAA(161.82,"AC",39,39)=""
461^FBAA(161.82,"AC",43,43)=""
462^FBAA(161.82,"AC",44,44)=""
463^FBAA(161.82,"AC",52,52)=""
464^FBAA(161.82,"AC",55,55)=""
465^FBAA(161.82,"AC",71,71)=""
466^FBAA(161.82,"AC",72,72)=""
467^FBAA(161.82,"AC",73,73)=""
468^FBAA(161.82,"AC",74,74)=""
469^FBAA(161.82,"AC",75,75)=""
470^FBAA(161.82,"AC",76,76)=""
471^FBAA(161.82,"AC",77,4)=""
472^FBAA(161.82,"AC",78,5)=""
473^FBAA(161.82,"AC",79,79)=""
474^FBAA(161.82,"AC",86,86)=""
475^FBAA(161.82,"AC",87,87)=""
476^FBAA(161.82,"AC",88,88)=""
477^FBAA(161.82,"AC",89,89)=""
478^FBAA(161.82,"AC","02",1)=""
479^FBAA(161.82,"B","ADHC",76)=""
480^FBAA(161.82,"B","CHIROPRACTIC CARE",75)=""
481^FBAA(161.82,"B","CLASS I DENTAL TREATMENT",15)=""
482^FBAA(161.82,"B","CLASS II DENTAL TREATMENT",16)=""
483^FBAA(161.82,"B","CLASS III DENTAL TREATMENT",21)=""
484^FBAA(161.82,"B","CLASS IIa DENTAL TREATMENT",17)=""
485^FBAA(161.82,"B","CLASS IIb DENTAL TREATMENT",18)=""
486^FBAA(161.82,"B","CLASS IIc DENTAL TREATMENT",19)=""
487^FBAA(161.82,"B","CLASS IIr DENTAL TREATMENT",20)=""
488^FBAA(161.82,"B","CLASS IV DENTAL TREATMENT",22)=""
489^FBAA(161.82,"B","CLASS V DENTAL TREATMENT",23)=""
490^FBAA(161.82,"B","CLASS VI DENTAL TREATMENT",24)=""
491^FBAA(161.82,"B","CNH HOSPICE",43)=""
492^FBAA(161.82,"B","CNH RESPITE CARE",44)=""
493^FBAA(161.82,"B","HOME HEALTH SERVICES (NON-NURSING PROFESSIONAL)",74)=""
494^FBAA(161.82,"B","HOMEMAKER/HOME HEALTH AID SERVICES",71)=""
495^FBAA(161.82,"B","HOSPICE & PALLIATIVE CARE (OPT) - CONTRACT/SHARING AGREEMENT",4)=""
496^FBAA(161.82,"B","HOSPICE & PALLIATIVE CARE (OPT) - FEE BASIS AUTHORITY (CFR 17.5",5)=""
497^FBAA(161.82,"B","HOSPICE CARE (INPT.) CONTRACT/SHARING AGREEMENT",2)=""
498^FBAA(161.82,"B","HOSPICE CARE (INPT.) FEE BASIS AUTHORITY (CFR 17.50b)",3)=""
499^FBAA(161.82,"B","INPATIENT 38 U.S.C. 1725",39)=""
500^FBAA(161.82,"B","MILITARY SEXUAL TRAUMA SERVICES",55)=""
501^FBAA(161.82,"B","OUTPATIENT 38 U.S.C. 1725",52)=""
502^FBAA(161.82,"B","RESPITE CARE (OTHER)",79)=""
503^FBAA(161.82,"B","RESPITE CARE IN ADHC",73)=""
504^FBAA(161.82,"B","RESPITE CARE IN HOMEMAKER/HOME HEALTH AID SERVICES",72)=""
505^FBAA(161.82,"B","STATE HOME ADHC",86)=""
506^FBAA(161.82,"B","STATE HOME DOM",87)=""
507^FBAA(161.82,"B","STATE HOME HOSPITAL",88)=""
508^FBAA(161.82,"B","STATE HOME NH",89)=""
509^FBAA(161.82,"B","UNAUTHORIZED CLAIM - OUTPATIENT",1)=""
510^FBAA(161.82,"C",15,15)=""
511^FBAA(161.82,"C",16,16)=""
512^FBAA(161.82,"C",17,17)=""
513^FBAA(161.82,"C",18,18)=""
514^FBAA(161.82,"C",19,19)=""
515^FBAA(161.82,"C",20,20)=""
516^FBAA(161.82,"C",21,21)=""
517^FBAA(161.82,"C",22,22)=""
518^FBAA(161.82,"C",23,23)=""
519^FBAA(161.82,"C",24,24)=""
520^FBAA(161.82,"C",37,2)=""
521^FBAA(161.82,"C",38,3)=""
522^FBAA(161.82,"C",39,39)=""
523^FBAA(161.82,"C",43,43)=""
524^FBAA(161.82,"C",44,44)=""
525^FBAA(161.82,"C",52,52)=""
526^FBAA(161.82,"C",55,55)=""
527^FBAA(161.82,"C",71,71)=""
528^FBAA(161.82,"C",72,72)=""
529^FBAA(161.82,"C",73,73)=""
530^FBAA(161.82,"C",74,74)=""
531^FBAA(161.82,"C",75,75)=""
532^FBAA(161.82,"C",76,76)=""
533^FBAA(161.82,"C",77,4)=""
534^FBAA(161.82,"C",78,5)=""
535^FBAA(161.82,"C",79,79)=""
536^FBAA(161.82,"C",86,86)=""
537^FBAA(161.82,"C",87,87)=""
538^FBAA(161.82,"C",88,88)=""
539^FBAA(161.82,"C",89,89)=""
540^FBAA(161.82,"C","02",1)=""
541^FBAA(161.83,0)="FEE BASIS ID CARD AUDIT^161.83P^^"
542^FBAA(162.1,0)="FEE BASIS PHARMACY INVOICE^162.1^^"
543^FBAA(162.2,0)="FEE NOTIFICATION/REQUEST^162.2DI^^"
544^FBAA(162.6,0)="FEE BASIS DISPOSITION CODE^162.6^9^9"
545^FBAA(162.6,1,0)="TO HOME OR SELF CARE^1"
546^FBAA(162.6,2,0)="TO ANOTHER SHORT-TERM FACILITY^2"
547^FBAA(162.6,3,0)="TO SKILLED NURSING FACILITY^3"
548^FBAA(162.6,4,0)="TO INTERMEDIATE NURSING FACILITY^4"
549^FBAA(162.6,5,0)="TO ANOTHER TYPE OF FACILITY^5"
550^FBAA(162.6,6,0)="TO HOME FOR HOME HEALTH SERVICES^6"
551^FBAA(162.6,7,0)="LEFT AGAINST MEDICAL ADVICE^7"
552^FBAA(162.6,8,0)="DIED^20"
553^FBAA(162.6,9,0)="STILL A PATIENT^30"
554^FBAA(162.6,"B","DIED",8)=""
555^FBAA(162.6,"B","LEFT AGAINST MEDICAL ADVICE",7)=""
556^FBAA(162.6,"B","STILL A PATIENT",9)=""
557^FBAA(162.6,"B","TO ANOTHER SHORT-TERM FACILITY",2)=""
558^FBAA(162.6,"B","TO ANOTHER TYPE OF FACILITY",5)=""
559^FBAA(162.6,"B","TO HOME FOR HOME HEALTH SERVIC",6)=""
560^FBAA(162.6,"B","TO HOME OR SELF CARE",1)=""
561^FBAA(162.6,"B","TO INTERMEDIATE NURSING FACILI",4)=""
562^FBAA(162.6,"B","TO SKILLED NURSING FACILITY",3)=""
563^FBAA(162.6,"C",1,1)=""
564^FBAA(162.6,"C",2,2)=""
565^FBAA(162.6,"C",3,3)=""
566^FBAA(162.6,"C",4,4)=""
567^FBAA(162.6,"C",5,5)=""
568^FBAA(162.6,"C",6,6)=""
569^FBAA(162.6,"C",7,7)=""
570^FBAA(162.6,"C",20,8)=""
571^FBAA(162.6,"C",30,9)=""
572^FBAA(162.6,"D",20,8)=""
573^FBAA(162.6,"D",30,9)=""
574^FBAA(162.6,"D","01",1)=""
575^FBAA(162.6,"D","02",2)=""
576^FBAA(162.6,"D","03",3)=""
577^FBAA(162.6,"D","04",4)=""
578^FBAA(162.6,"D","05",5)=""
579^FBAA(162.6,"D","06",6)=""
580^FBAA(162.6,"D","07",7)=""
581^FBAA(162.8,0)="FEE BASIS UNAUTHORIZED CLAIMS PENDING INFO^162.8D^^"
582^FBAA(163.85,0)="FEE BASIS VA TYPE OF SERVICE^163.85I^15^14"
583^FBAA(163.85,1,0)="GENERAL MEDICINE^01"
584^FBAA(163.85,1,1,0)="^^6^6^2920611^^"
585^FBAA(163.85,1,1,1,0)="Includes general medicine evaluation and treatment, allergy and"
586^FBAA(163.85,1,1,2,0)="immunology, cardiology, dermatology, endocrine disorders,"
587^FBAA(163.85,1,1,3,0)="gastroenterology, hematology, hypertension, infectious diseases,"
588^FBAA(163.85,1,1,4,0)="pacemaker follow-up, pulmonary-chest, renal-nephrology disorders,"
589^FBAA(163.85,1,1,5,0)="rheumatology-arthritis, neurology, oncology-tumor, and geriatric"
590^FBAA(163.85,1,1,6,0)="clinics. Equates to CDR account 2110.00."
591^FBAA(163.85,2,0)="DIAGNOSTIC^02"
592^FBAA(163.85,2,1,0)="^^4^4^2941024^^^"
593^FBAA(163.85,2,1,1,0)="Includes diagnostic testing such as pulmonary function, laboratory,"
594^FBAA(163.85,2,1,2,0)="radiology, EEG, EKG, nuclear medicine, evoked potential, "
595^FBAA(163.85,2,1,3,0)="topographical brain monitoring, prolonged video EEG and ultrasound."
596^FBAA(163.85,2,1,4,0)="Equates to CDR account 2612.00."
597^FBAA(163.85,3,0)="ANCILLARY^03"
598^FBAA(163.85,3,1,0)="^^2^2^2920609^"
599^FBAA(163.85,3,1,1,0)="Includes nursing, dietetics and nutrition and social work"
600^FBAA(163.85,3,1,2,0)="services. Equates to CDR account 2610.00."
601^FBAA(163.85,4,0)="ROUTINE AMBULATORY PROCEDURES^04"
602^FBAA(163.85,4,1,0)="^^7^7^2920609^"
603^FBAA(163.85,4,1,1,0)="Includes the following clinics/treatment and performance of routine"
604^FBAA(163.85,4,1,2,0)="procedures as follows: anesthesia pre-op, neurosurgery, gynecology,"
605^FBAA(163.85,4,1,3,0)="ophthalmology, optometry, ENT, plastic surgery, hand surgery, orthopedics,"
606^FBAA(163.85,4,1,4,0)="podiatry, thoracic surgery, urology, vascular surgery, pain clinic,"
607^FBAA(163.85,4,1,5,0)="vascular lab, and cast application and removal. Includes the general"
608^FBAA(163.85,4,1,6,0)="clinic visit and completion of procedures which are not considered"
609^FBAA(163.85,4,1,7,0)="to be Nationally Active by the VA. Equates to CDR account 2210.00."
610^FBAA(163.85,6,0)="DENTAL^05"
611^FBAA(163.85,6,1,0)="^^2^2^2920615^^"
612^FBAA(163.85,6,1,1,0)="Includes dental examinations and treatments. Equates to CDR"
613^FBAA(163.85,6,1,2,0)="account 2710.00."
614^FBAA(163.85,7,0)="DRUG, ALCOHOL, and/or SUBSTANCE ABUSE^06"
615^FBAA(163.85,7,1,0)="^^2^2^2920615^^"
616^FBAA(163.85,7,1,1,0)="Includes drug, alcohol, and/or substance abuse or dependence"
617^FBAA(163.85,7,1,2,0)="treatment or counseling. Equates to CDR account 2316.00."
618^FBAA(163.85,8,0)="REHABILITATIVE MEDICINE^07"
619^FBAA(163.85,8,1,0)="^^3^3^2920615^^"
620^FBAA(163.85,8,1,1,0)="Includes rehabilitative medicine, audiology, speach pathology,"
621^FBAA(163.85,8,1,2,0)="physical therapy, occupational therapy, EMG, corrective therapy,"
622^FBAA(163.85,8,1,3,0)="and amputation follow-up. Equates to CDR account 2611.00."
623^FBAA(163.85,9,0)="PSYCHIATRY/PSYCHOLOGY, GROUP^08"
624^FBAA(163.85,9,1,0)="^^2^2^2920611^^"
625^FBAA(163.85,9,1,1,0)="Includes any group therapy (including Post Traumatic Stress"
626^FBAA(163.85,9,1,2,0)="Disorder [PTSD]). Equates to CDR account 2310.00."
627^FBAA(163.85,10,0)="PSYCHIATRY/PSYCHOLOGY, INDIVIDUAL^09"
628^FBAA(163.85,10,1,0)="^^2^2^2920611^^"
629^FBAA(163.85,10,1,1,0)="Includes any individual therapy, including PTSD. Equates"
630^FBAA(163.85,10,1,2,0)="to CDR account 2311.00."
631^FBAA(163.85,11,0)="DIALYSIS^10"
632^FBAA(163.85,11,1,0)="^^4^4^2920609^"
633^FBAA(163.85,11,1,1,0)="Includes, but is not limited to, hemodialysis, peritoneal"
634^FBAA(163.85,11,1,2,0)="dialysis, limited self-care dialysis, home hemodialysis"
635^FBAA(163.85,11,1,3,0)="training, and limited self peritoneal dialysis. Equates"
636^FBAA(163.85,11,1,4,0)="to CDR account 2510.00."
637^FBAA(163.85,12,0)="ADULT DAY HEALTH CARE^11"
638^FBAA(163.85,12,1,0)="^^3^3^2920609^"
639^FBAA(163.85,12,1,1,0)="Includes VA approved adult day health care programs which provide"
640^FBAA(163.85,12,1,2,0)="medical and rehabilitation services. Equates to CDR account"
641^FBAA(163.85,12,1,3,0)="2510.00."
642^FBAA(163.85,13,0)="PROSTETICS/ORTHOTICS^12"
643^FBAA(163.85,13,1,0)="^^4^4^2920609^"
644^FBAA(163.85,13,1,1,0)="Includes prosthetic services as a follow-up from an amputation,"
645^FBAA(163.85,13,1,2,0)="measuring and fitting for a prosthetic device or instruction"
646^FBAA(163.85,13,1,3,0)="regarding use of a prosthetic device. Equates to CDR account"
647^FBAA(163.85,13,1,4,0)="2614.00."
648^FBAA(163.85,14,0)="HOME BASED HEALTH CARE^13"
649^FBAA(163.85,14,1,0)="^^5^5^2920609^"
650^FBAA(163.85,14,1,1,0)="Includes health care provided in the home (include home health"
651^FBAA(163.85,14,1,2,0)="and home nursing services). This equates to CDR account 5110.00"
652^FBAA(163.85,14,1,3,0)="which is used for VACO approved Home Based Health Care programs."
653^FBAA(163.85,14,1,4,0)="Only facilities who have a VACO approved HBHC program should use"
654^FBAA(163.85,14,1,5,0)="this VA Type of Care code."
655^FBAA(163.85,15,0)="OTHER^99"
656^FBAA(163.85,15,1,0)="^^2^2^2920609^"
657^FBAA(163.85,15,1,1,0)="Types of non-VA outpatient care that cannot be ""categorized"""
658^FBAA(163.85,15,1,2,0)="consistent with the reporting of VA outpatient treatment."
659^FBAA(163.85,"B","ADULT DAY HEALTH CARE",12)=""
660^FBAA(163.85,"B","ANCILLARY",3)=""
661^FBAA(163.85,"B","DENTAL",6)=""
662^FBAA(163.85,"B","DIAGNOSTIC",2)=""
663^FBAA(163.85,"B","DIALYSIS",11)=""
664^FBAA(163.85,"B","DRUG, ALCOHOL, and/or SUBSTANC",7)=""
665^FBAA(163.85,"B","GENERAL MEDICINE",1)=""
666^FBAA(163.85,"B","HOME BASED HEALTH CARE",14)=""
667^FBAA(163.85,"B","OTHER",15)=""
668^FBAA(163.85,"B","PROSTETICS/ORTHOTICS",13)=""
669^FBAA(163.85,"B","PSYCHIATRY/PSYCHOLOGY, GROUP",9)=""
670^FBAA(163.85,"B","PSYCHIATRY/PSYCHOLOGY, INDIVID",10)=""
671^FBAA(163.85,"B","REHABILITATIVE MEDICINE",8)=""
672^FBAA(163.85,"B","ROUTINE AMBULATORY PROCEDURES",4)=""
673^FBAA(163.85,"C",10,11)=""
674^FBAA(163.85,"C",11,12)=""
675^FBAA(163.85,"C",12,13)=""
676^FBAA(163.85,"C",13,14)=""
677^FBAA(163.85,"C",99,15)=""
678^FBAA(163.85,"C","01",1)=""
679^FBAA(163.85,"C","02",2)=""
680^FBAA(163.85,"C","03",3)=""
681^FBAA(163.85,"C","04",4)=""
682^FBAA(163.85,"C","05",6)=""
683^FBAA(163.85,"C","06",7)=""
684^FBAA(163.85,"C","07",8)=""
685^FBAA(163.85,"C","08",9)=""
686^FBAA(163.85,"C","09",10)=""
687^FBAA(163.99,0)="FEE BASIS FEE SCHEDULE^163.99I^^"
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