# | Name | Location | Type | Details | Index | Description |
---|---|---|---|---|---|---|
.01 | line function | 0;1 | SET OF CODES | 1:REFERRING 2:OPERATING 3:RENDERING 4:ATTENDING 5:SUPERVISING 9:OTHER OPERATING | B | There are providers who performed specific functions for the services on this claim line. These providers are needed to enable the V.A. to collect reimbursement when more than one provider function is involved in the billable episode (like an operating physician or referring provider). This data identifies the type of function that was performed by a provider. There can only be 1 provider recorded for each function on a claim line. |
.02 | line performed by | 0;2 | VARIABLE-POINTER | 200, 355.93 | Providers may be VA providers found in the VistA NEW PERSON file or NON-VA providers found in the IB NON VA BILLING PROVIDER file. | |
.03 | credentials | 0;3 | FREE TEXT | This field should contain the 1-3 digit code for the provider's credentials as they apply to the services being billed for. | ||
.04 | state | 0;4 | POINTER | 5 | This is the state of the Referring Provider. This is only used for referring provider types. | |
.05 | primary ins co id number | 0;5 | FREE TEXT | This is the primary insurance co specific provider's secondary id number. | ||
.06 | secondary ins co id number | 0;6 | FREE TEXT | This is the secondary ins company's specific secondary provider id number. | ||
.07 | tertiary ins co id number | 0;7 | FREE TEXT | This is the tertiary ins company's specific secondary provider id number. | ||
.08 | specialty | 0;8 | FREE TEXT | This field contains the specialty code for the provider if the provider is not resident in VistA's NEW PERSON file. | ||
.12 | prim ins provider id type | 0;12 | POINTER | 355.97 | This is the type of id the primary payer uses as a secondary id. | |
.13 | sec ins provider id type | 0;13 | POINTER | 355.97 | This is the type of id the secondary payer requires as a secondary id. | |
.14 | tert ins provider id type | 0;14 | POINTER | 355.97 | This is the type of id the tertiary payer uses as a secondary id. | |
.15 | line taxonomy | 0;15 | POINTER | 8932.1 | This is the Taxonomy Code associated with this entry. |
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