Per VHA Directive 10-93-142, this file definition should not be modified. This file holds all transfer pricing transactions
.01transaction number(+)0;1NUMERICBThis is the Transfer Pricing transaction number. This number is generated automatically in the format of station number with a sequential number after.
.02transfer pricing patient(+)0;2POINTER351.6CThis is a pointer to the transfer pricing patient file (351.6), which is the same ien as in the patient file (#2).
.03transaction date0;3DATE-TIMEThis is the date this transaction was added to the file.
.04event date0;4DATE-TIMEThis is the date of the event. Outpatient Visits = Visit Date Inpatient Stays = Admission Date Prescriptions = Drug Dispense Date Prosthetics = Date Prosthetic Device issued to Patient
.05transaction status0;5SET OF CODESX:CANCELLED
AFThe status of the transaction. Entered = only used for inpatient upon admission. Completed = used for when the transaction information has been fully entered, but not yet priced. For inpatient this usually means the patient has been discharged, but the PTF has not yet been coded. This can also mean that any other type of transaction could not be priced for various reasons. Priced = transaction is complete. Cancelled = treating facility has cancelled transaction.
.06approval date0;6DATE-TIMEThis is the date the transaction was set to a complete status. Once a transaction is complete, it can no longer be edited. It can only be cancelled and a new transaction created. This date is used for report printing since another site cannot be billed until a transaction is complete. An inpatient transaction can be completed as an interim transaction and a new one started.
.07interim transaction flag0;7BOOLEAN0:NO
Only used on inpatient transactions, this flag indicates if this transaction is an interim transaction or not.
.08parent transaction pointer(+)0;8POINTER351.61AIUsed to lookup transactions and adjustment to transactions for future adjustments. The parent should always have this filled in pointing to it self, children should always have this filled in pointing to their parent.
.09from date0;9DATE-TIMEThis is the period this service is covered from.
.1to date0;10DATE-TIMEThis is the period this service is covered to.
.11preferred facility0;11POINTER4This indicates which facility is the patient's preferred facility at the time of the transaction. This is used to identify what facility this transaction is for.
.12event source0;12FREE TEXTADThis is the source of the event. Inpatient = ien in file #405;DGPM( Outpatient = ien in file #409.68;SCE( Pharmacy = ien in file #52;PSRX(;fill/refill no Prosthetics = ien in file #660;RMPR(660,
.13priced date0;13DATE-TIMEAEThis is the date the transaction was priced.
1.01drg1;1POINTER80.2This is the inpatient DRG that was calculated for the admission that the costing of this transaction is based upon.
1.02drg amount1;2NUMERICThis is the dollar amount the DRG was priced at.
1.03inpatient los1;3NUMERICThis is the total length of stay for this inpatient stay.
1.04high trim days1;4NUMERICThis is the arithmetic means LOS, or the outlier threshold. This corresponds to the DRG file (#80.2), field HIGH TRIM(days) (#4). Any stays over this number will be calculated at the outlier rate.
1.05outlier days1;5NUMERICThis is the number of days to calculate charge at the outlier rates. This number is calculated by: INPATIENT LOS - HIGH TRIM DAYS = OUTLIER DAYS
1.06outlier rate1;6NUMERICThis is the daily rate for the outlier days. This is based upon 80% of the tort rate.
1.07ptf pointer1;7POINTER45This is the pointer to the PTF record for which the charge was calculated.
1.08discharge movement1;8POINTER405This is to store the discharge movement.
2icd diagnosis2;0MULTIPLE351.612This is the diagnosis codes for this event. This will play into the DRG calculation.
3procedures3;0MULTIPLE351.613This is the multiple where the procedures performed either inpatient or outpatient are stored.
4.01drug4;1POINTER50This pointer to the drug file indicates what prescription was issued.
4.02quantity4;2NUMERICThis is the quantity of the drug issued.
4.03drug cost4;3NUMERICThis is the cost per unit of the drug.
4.04*prosthetic item4;4FREE TEXTThis is a pointer to the prosthetic item file for the prosthetic device issued to the patient.
4.05prosthetic item cost4;5NUMERICThis is the cost of the prosthetic device. Determined by looking at file 660 at the TOTAL COST field.
5.01authorizing person5;1FREE TEXTThis is the name of the person authorizing this transaction from the patient's preferred facility.
6.01total outlier days6;1NUMERICThis is the total of the outlier days for all the DRGs.
6.02gross bill amount6;2NUMERICThis is the gross amount either from the drg's, cpt's, or rx's before any deductions of billed amounts.
6.03catagory c bill amount6;3NUMERICThis is the dollar amount billed for the cat c patient's co-payment(s).
6.04insurance bill amount6;4NUMERICThis is the amount of the insurance bill to be deducted from the total amount.
6.05net amount6;5NUMERICThis is the total bill amount that is due from the preferred facility. This is calculated based upon the service provided less any other reimbursements.

Referenced by 1 types

  1. TRANSFER PRICING TRANSACTIONS (351.61) -- parent transaction pointer