Files > FEE BASIS INVOICE

name

FEE BASIS INVOICE

number

162.5

location

^FBAAI(

description

This file contains the payment data associated with the inpatient hospital programs of FEE Basis. Per VHA Directive 10-93-142, this file definition should not be modified.

Fields

#	Name	Location	Type	Details	Index	Description
.01	number(+)	0;1	NUMERIC		B	This field contains the internal entry number for the Fee Basis Invoice.
1	invoice date received(+)	0;2	DATE-TIME			This field contains the date the correct invoice was received. It is used by Austin for the calculation of any applicable interest payments.
2	vendor(+)	0;3	POINTER	161.2	C	Reference to the vendor file, this field contains the name of the vendor associated with this invoice.
3	veteran(+)	0;4	POINTER	161	D	Reference the Fee Basis Patient file, this field contains the name of the veteran for which this invoice is established.
4	associated 7078/583	0;5	VARIABLE-POINTER	162.4, 162.7		This field contains the pointer to the appropriate 7078 or 583 file.
5	treatment from date(+)	0;6	DATE-TIME			Information in this field indicates the starting date for this invoice. (i.e. the starting treatment date for which this billing covers).
6	treatment to date(+)	0;7	DATE-TIME			Information in this field indicates the ending date for this invoice. (i.e. the ending treatment date this billing covers).
6.5	discharge type code	0;21	POINTER	162.6		This field contains the code pertaining to the type of discharge associated with this invoice.
6.6	billed charges(+)	0;22	NUMERIC			This field contains cost information on the amount the VA was initially billed by the vendor for an inpatient stay.
6.7	payment by medicare/fed agency(+)	0;23	FREE TEXT			Answer 'Yes' if Medicare or some other federal agency has paid some of the bill for contract hospital.
7	amount claimed(+)	0;8	NUMERIC			The portion of the billed charges that the vendor is requesting payment for from the VA. Usually the billed charges and the amount claimed will be the same.
8	amount paid(+)	0;9	NUMERIC			The dollar amount that was actually paid to the vendor for the service provided.
9	amount suspended	0;10	NUMERIC			The difference between the amount claimed and the amount paid.
10	suspend code	0;11	POINTER	161.27		If an amount was suspended, the user is requested to indicate the reason for suspense from the selection of suspense codes.
11	fee program(+)	0;12	POINTER	161.8		This field contains the valid Fee Program associated with this Invoice as contained in the Fee Basis Program file (i.e. Contract Hospital or Community Nursing Home for an inpatient stay).
12	payment type code	0;13	SET OF CODES	R:REIMBURSEMENT V:VENDOR S:STATISTICAL SR:STAT-REIMBURSEMENT		An entry of 'R' will indicate the invoice is for a reimbursement to the veteran for services that he/she has already paid. An entry of 'V' will indicate the invoice is for a payment directly to a vendor. An entry of 'S' will indicate the invoice was paid "out of system" to a vendor and allows the update of the payment history files. An entry of 'SR' will indicate a statistical reimbursement to a party other than the vendor.
13	reject status	FBREJ;1	SET OF CODES	P:REJECTED, PENDING ACTION C:REJECTED, COMPLETED		An entry in this field will indicate that the invoice has been rejected. An entry of 'P' will indicate the invoice has been rejected and it is awaiting action. An entry of 'C' will indicate the invoice has been rejected and action on it has been completed.
14	reject reason	FBREJ;2	FREE TEXT			If the invoice has a status of rejected, the user will be prompted to enter a reason that the reject has occurred.
15	old batch number	FBREJ;3	POINTER	161.7		This field is populated only if there is a reject pending. It will contain the batch number of the old batch associated with the invoice. This is to provide a link back to that batch if the user deletes the reject.
15.3	interface reject	FBREJ;4	BOOLEAN	1:YES		This field is populated by the FBAA BATCH SERVER and FBAA REJECT SERVER server options when a payment line item is rejected via the interface with Central Fee. This field is used to distinguish line items that were locally rejected from those that were rejected by a downstream system. This field is not populated for a local reject.
15.6	reject code	FBREJC;0	MULTIPLE	162.515		The REJECT CODE multiple is populated with one to four reject codes by the FBAA BATCH SERVER and FBAA REJECT SERVER server options when a line item is rejected via the interface with Central Fee. The REJECT CODE multiple is not used for local rejects. The reason for a local reject is entered into the REJECT REASON (#14) field.
16	void payment	0;14	SET OF CODES	VP:VOIDED PAYMENT		Entry into this field is made when the user indicates the payment must be voided.
16.5	reason for voided payment	R;1	FREE TEXT			This field is only populated if the Void Payment field is flagged for a void. The user is prompted to enter a reason the payment was voided.
17	supervisor who voided	0;15	POINTER	200		This field is only populated when the Void Payment field is flagged for a void. The field is stuffed with the user who voided the payment (and in all instances, the user must be a supervisor).
18	description of suspension	1;0	WORD-PROCESSING			This field is only populated when there is a dollar amount that has been suspended. The user is prompted to enter a description of the suspension in word-processing format.
19	date finalized	0;16	DATE-TIME		AD	This field contains the date the invoice was vouchered by Fiscal.
20	batch number	0;17	POINTER	161.7		This field contains the batch number associated with this invoice. (The batch number that the invoice resides in).
21	purpose of visit	0;18	POINTER	161.82		Contains the valid Purpose of Visit code as defined in the Fee Basis Purpose of Visit file.
22	patient type code	0;19	SET OF CODES	00:SURGICAL 10:MEDICAL 60:HOME NURSING SERVICE 85:PSYCHIATRIC-CONTRACT 86:PSYCHIATRIC 95:NEUROLOGICAL-CONTRACT 96:NEUROLOGICAL		This field requires the entry of the type of treatment being provided to the patient (i.e. Surgical, Medical, Home Nursing Service, etc.)
23	primary service facility	0;20	POINTER	4		The VA Hospital responsible for that Veterans care.
24	discharge drg	0;24	POINTER	80.2		This field should contain the discharge DRG that is returned from the Austin Pricer System.
24.5	drg weight	2;12	NUMERIC			Enter the DRG weight as reported by the Austin Pricer.
25	resubmission	0;25	BOOLEAN	1:YES		Entry into this field indicates that this invoice is a resubmission. Failure to annotate an invoice in such a manner would cause Austin to reject the payment as duplicate.
26	nvh pricer amount	0;26	NUMERIC			The amount for this payment as determined by the Austin Pricer.
30	icd1(+)	DX;1	POINTER	80		The first valid ICD code associated with this payment.
30.02	poa1	POA;1	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD1 field.
31	icd2	DX;2	POINTER	80		The second valid ICD code (if one exists) associated with this payment.
31.02	poa2	POA;2	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD2 field.
32	icd3	DX;3	POINTER	80		The third valid ICD code (if one exists) associated with this payment.
32.02	poa3	POA;3	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD3 field.
33	icd4	DX;4	POINTER	80		The fourth valid ICD code (if one exists) associated with this payment.
33.02	poa4	POA;4	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD4 field.
34	icd5	DX;5	POINTER	80		The fifth valid ICD code (if one exists) associated with this payment.
34.02	poa5	POA;5	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD5 field.
35	icd6	DX;6	POINTER	80		The sixth valid ICD code (if one exists) associated with this payment.
35.02	poa6	POA;6	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD6 field.
35.1	icd7	DX;7	POINTER	80		The seventh valid ICD code (if one exists) associated with this payment.
35.12	poa7	POA;7	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD7 field.
35.2	icd8	DX;8	POINTER	80		The eighth valid ICD code (if one exists) associated with this payment.
35.22	poa8	POA;8	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD8 field.
35.3	icd9	DX;9	POINTER	80		The ninth valid ICD code (if one exists) associated with this payment.
35.32	poa9	POA;9	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD9 field.
35.4	icd10	DX;10	POINTER	80		The tenth valid ICD code (if one exists) associated with this payment.
35.42	poa10	POA;10	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD10 field.
35.5	icd11	DX;11	POINTER	80		The eleventh valid ICD code (if one exists) associated with this payment.
35.52	poa11	POA;11	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD11 field.
35.6	icd12	DX;12	POINTER	80		The twelfth valid ICD code (if one exists) associated with this payment.
35.62	poa12	POA;12	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD12 field.
35.7	icd13	DX;13	POINTER	80		The thirteenth valid ICD code (if one exists) associated with this payment.
35.72	poa13	POA;13	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD13 field.
35.8	icd14	DX;14	POINTER	80		The fourteenth valid ICD code (if one exists) associated with this payment.
35.82	poa14	POA;14	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD14 field.
35.9	icd15	DX;15	POINTER	80		The fifteenth valid ICD code (if one exists) associated with this payment.
35.92	poa15	POA;15	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD15 field.
36	icd16	DX;16	POINTER	80		The sixteenth valid ICD code (if one exists) associated with this payment.
36.02	poa16	POA;16	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD16 field.
36.1	icd17	DX;17	POINTER	80		The seventeenth valid ICD code (if one exists) associated with this payment.
36.12	poa17	POA;17	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD17 field.
36.2	icd18	DX;18	POINTER	80		The eighteenth valid ICD code (if one exists) associated with this payment.
36.22	poa18	POA;18	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD18 field.
36.3	icd19	DX;19	POINTER	80		The nineteenth valid ICD code (if one exists) associated with this payment.
36.32	poa19	POA;19	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD19 field.
36.4	icd20	DX;20	POINTER	80		The twentieth valid ICD code (if one exists) associated with this payment.
36.42	poa20	POA;20	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD20 field.
36.5	icd21	DX;21	POINTER	80		The twenty-first valid ICD code (if one exists) associated with this payment.
36.52	poa21	POA;21	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD21 field.
36.6	icd22	DX;22	POINTER	80		The twenty-second valid ICD code (if one exists) associated with this payment.
36.62	poa22	POA;22	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD22 field.
36.7	icd23	DX;23	POINTER	80		The twenty-third valid ICD code (if one exists) associated with this payment.
36.72	poa23	POA;23	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD23 field.
36.8	icd24	DX;24	POINTER	80		The twenty-fourth valid ICD code (if one exists) associated with this payment.
36.82	poa24	POA;24	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD24 field.
36.9	icd25	DX;25	POINTER	80		The twenty-fifth valid ICD code (if one exists) associated with this payment.
36.92	poa25	POA;25	POINTER	161.94		This field contains the present on admission (POA) indicator for the diagnosis in the ICD25 field.
39	admitting diagnosis(+)	5;9	POINTER	80		This is the admitting diagnosis code from the claim.
40	proc1	PROC;1	POINTER	80.1		The first valid procedure code (if one exists) associated with this payment.
41	proc2	PROC;2	POINTER	80.1		The second valid procedure code (if one exists) associated with this payment.
42	proc3	PROC;3	POINTER	80.1		The third valid procedure code (if one exists) associated with this payment.
43	proc4	PROC;4	POINTER	80.1		The fourth valid procedure code (if one exists) associated with this payment.
44	proc5	PROC;5	POINTER	80.1		The fifth valid procedure code (if one exists) associated with this payment.
44.06	proc6	PROC;6	POINTER	80.1		The sixth valid procedure code (if one exists) associated with this payment.
44.07	proc7	PROC;7	POINTER	80.1		The seventh valid procedure code (if one exists) associated with this payment.
44.08	proc8	PROC;8	POINTER	80.1		The eighth valid procedure code (if one exists) associated with this payment.
44.09	proc9	PROC;9	POINTER	80.1		The ninth valid procedure code (if one exists) associated with this payment.
44.1	proc10	PROC;10	POINTER	80.1		The tenth valid procedure code (if one exists) associated with this payment.
44.11	proc11	PROC;11	POINTER	80.1		The eleventh valid procedure code (if one exists) associated with this payment.
44.12	proc12	PROC;12	POINTER	80.1		The twelfth valid procedure code (if one exists) associated with this payment.
44.13	proc13	PROC;13	POINTER	80.1		The thirteenth valid procedure code (if one exists) associated with this payment.
44.14	proc14	PROC;14	POINTER	80.1		The fourteenth valid procedure code (if one exists) associated with this payment.
44.15	proc15	PROC;15	POINTER	80.1		The fifteenth valid procedure code (if one exists) associated with this payment.
44.16	proc16	PROC;16	POINTER	80.1		The sixteenth valid procedure code (if one exists) associated with this payment.
44.17	proc17	PROC;17	POINTER	80.1		The seventeenth valid procedure code (if one exists) associated with this payment.
44.18	proc18	PROC;18	POINTER	80.1		The eighteenth valid procedure code (if one exists) associated with this payment.
44.19	proc19	PROC;19	POINTER	80.1		The nineteenth valid procedure code (if one exists) associated with this payment.
44.2	proc20	PROC;20	POINTER	80.1		The twentieth valid procedure code (if one exists) associated with this payment.
44.21	proc21	PROC;21	POINTER	80.1		The twenty-first valid procedure code (if one exists) associated with this payment.
44.22	proc22	PROC;22	POINTER	80.1		The twenty-second valid procedure code (if one exists) associated with this payment.
44.23	proc23	PROC;23	POINTER	80.1		The twenty-third valid procedure code (if one exists) associated with this payment.
44.24	proc24	PROC;24	POINTER	80.1		The twenty-fourth valid procedure code (if one exists) associated with this payment.
44.25	proc25	PROC;25	POINTER	80.1		The twenty-fifth valid procedure code (if one exists) associated with this payment.
45	date paid	2;1	DATE-TIME			This is the date of the check, as issued by the treasury. This information will be passed back to DHCP from the Financial Management System (FMS) when the check is issued to the vendor. This field will use the check date beginning with version 3.5 of Fee Basis.
46	vendor invoice date(+)	2;2	DATE-TIME			This is the date that the vendor issued the invoice.
47	prompt pay type	2;3	SET OF CODES	1:MONEY MANAGED		Field is set to 1 if the payment is subject to interest payments (prompt pay).
48	check number	2;4	FREE TEXT			Contains the check number as issued by the treasury. This field is updated after the check is issued, through a server option that records actual payment information for each Fee payment made.
49	cancellation date	2;5	DATE-TIME			This is the date the treasury cancelled the check. This field is updated through a server option that records cancellations of previously recorded payment data.
50	reason code	2;6	POINTER	162.95		This field contains a pointer to the Fee Basis Check Cancellation Reason file. It is populated through a server option that updates the payment record when the treasury cancels a check that was previously payed.
51	cancellation activity	2;7	SET OF CODES	R:WILL BE REPLACED C:WILL BE REISSUED X:WILL NOT BE REISSUED		This field is populated when a cancellation is recorded for the payment referenced. This field will always remain populated, to indicate that there was cancellation activity on this payment at one time. New payments will replace the cancellation date and reason code fields, but the cancellation activity flag will not be overwritten. This flag will allow the user to know that previous cancellation activity existed, and to review the cancellation history output for further information.
52	disbursed amount	2;8	NUMERIC			This is the dollar amount paid by the treasury, less any interest paid.
53	interest amount	2;9	NUMERIC			The interest amount paid on this line item by the treasury.
54	covered days(+)	2;10	NUMERIC			This is the number of total number of Inpatient days that the Fee Staff has determined will be paid. Enter number of inpatient days to be paid.
55	patient control number	2;11	FREE TEXT			Please enter the Patient control number. This could be either the Patient Identification Number or Patient Account Number from the vendor's invoice.
56	fpps claim id	3;1	FREE TEXT			Enter the entire FPPS Claim ID as shown on the invoice document. (1-32 character text ID created by FPPS system).
57	fpps line item	3;2	FREE TEXT			Enter the line item sequence number associated with this charge. Each charge on the FPPS invoice document will have a line item sequence number associated with it. A line item can be entered individually or a group of charges from multiple lines can be entered. If all line items in a group are in numerical sequence, you may enter the first line item sequence number followed by a hyphen and the last line item sequence number. If the grouped charges are not in sequential order, each line item must be entered individually, followed by a comma.
58	adjustment	8;0	MULTIPLE	162.558
59	remittance remark	9;0	MULTIPLE	162.559
60	contract	5;8	POINTER	161.43	ACN	If the payment is for contracted services, the contract number can be specified in this field. The selected contract must be active and applicable to the vendor being paid.
61	routing number	2;13	FREE TEXT			Enter the financial routing number information that was returned with the payment from Central Fee for Electronic Fund Transfer (EFT) entries. This information will be forwarded to FPPS so that the vendor can be notified of the payment. This field must be 9 characters, including any leading zeros. Note: The Central Fee nightly update will automatically set this field if the data is included in their message.
62	account number	2;14	FREE TEXT			Enter the financial account number information that was returned with the payment from Central Fee for Electronic Fund Transfer (EFT) entries. This information will be forwarded to FPPS so that the vendor can be notified of the payment. This field must be 1-17 characters, including any leading zeros. Note: The Central Fee nightly update will automatically set this field if the data is included in their message.
63	financial institution	2;15	FREE TEXT			Enter the financial institution name that was returned with the payment from Central Fee for Electronic Fund Transfer (EFT) entries. This information will be forwarded to FPPS so that the vendor can be notified of the payment. Note: The Central Fee nightly update will automatically set this field if the data is included in their message.
64	attending prov name	4;1	FREE TEXT			Enter the Attending Provider's name found in the claim information.
65	attending prov npi	4;2	FREE TEXT			Enter the Attending Provider's National Provider Identifier (NPI) found in the claim information. This value must be 10 characters, including any leading zeros.
66	attending prov taxonomy code	4;3	FREE TEXT			Enter the Attending Provider's Taxonomy code found in the claim information. This value must be 10 characters, including any leading zeros.
67	operating prov name	4;4	FREE TEXT			Enter the Operating Provider's name found in the claim information.
68	operating prov npi	4;5	FREE TEXT			Enter the Operating Provider's National Provider Identifier (NPI) found in the claim information. This value must be 10 characters, including any leading zeros.
69	rendering prov name	4;6	FREE TEXT			Enter the Rendering Provider's name found in the claim information.
70	rendering prov npi	4;7	FREE TEXT			Enter the Rendering Provider's National Provider Identifier (NPI) found in the claim information. This value must be 10 characters, including any leading zeros.
71	rendering prov taxonomy code	4;8	FREE TEXT			Enter the Rendering Provider's Taxonomy code found in the claim information. This value must be 10 characters, including any leading zeros.
72	servicing prov name	4;9	FREE TEXT			Enter the Servicing Provider's name found in the claim information.
73	servicing prov npi	4;10	FREE TEXT			Enter the Servicing Provider's National Provider Identifier (NPI) found in the claim information. This value must be 10 characters, including any leading zeros.
74	referring prov name	4;11	FREE TEXT			Enter the Referring Provider's name found in the claim information.
75	referring prov npi	4;12	FREE TEXT			Enter the Referring Provider's National Provider Identifier (NPI) found in the claim information. This value must be 10 characters, including any leading zeros.
79	line item rendering prov	RPROV;0	MULTIPLE	162.579		This multiple stores Rendering Provider information that is specific to a line item on the claim. A record should only be added to this multiple if the Rendering Provider for a line item is different from the Rendering Provider at the claim level. Example, if the PROC1 code is entered and has a different Rendering Provider than the claim Rendering Provider (field #70) the multiple will store the different data. Line item #1 would be referencing PROC1; Line Item #5 would reference PROC5.
80	servicing facility address	5;1	FREE TEXT			Enter the Servicing Facility street address found in the claim information.
81	servicing facility city	5;2	FREE TEXT			Enter the Servicing Facility city found in the claim information.
82	servicing facility state	5;3	POINTER	5		Enter the Servicing Facility state found in the claim information.
83	servicing facility zip	5;4	FREE TEXT			Enter the Servicing Facility zip code, in either the 5 digit format (e.g. 12345) or 9 digit format (e.g. 12345-6789 or 123456789).
85	unique claim identifier	5;5	FREE TEXT			This field contains a unique identifier for tracking claims. Fee5010 Project.
86	dod invoice number	5;7	FREE TEXT		DODI	The DoD invoice number that is associated with the invoice. Note that if the invoice vendor is not a federal vendor then this field is null.
87	ipac vendor agreement	5;10	POINTER	161.95	IPAC	The IPAC Agreement record that is associated with this invoice. Note that if the invoice vendor is not a federal vendor this is field is null.