| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | item | 0;1 | POINTER | 661 | B | This field is a pointer to the master item list of possible appliances. The master list is set up so that appliances fall into groups which are types of appliances. |
| 2 | qty | 0;2 | NUMERIC | The number of units ordered for this item. Keep in mind that this will be governed by the UNIT OF ISSUE. | ||
| 3 | unit of issue | 0;3 | POINTER | 420.5 | This is the unit by which items/services are issued (e.g. each, pair, box, case, etc.). | |
| 4 | unit cost | 0;4 | NUMERIC | The cost per unit associated with the requested item/service. | ||
| 5 | appliance/repair | 0;5 | POINTER | 660 | Pointer to associated RECORD OF PROS APPLIANCE/REPAIR entry in file 660. | |
| 6 | work order number | 0;6 | POINTER | 664.2 | This is a permanent number used to identify and track the Lab request. It is built from both information the user enters and a sequence number assigned by the computer (e.g., 644-95-2-O-0016). 644 = Station Number 95 = Fiscal Year 2 = Quarter O = Type of Laboratory (Orthotics, Restoration, Shoe Last Clinic, Wheelchair Repair Shop, National Foot Center, and Denver Distribution Center) 0016 = Sequence number assigned by the computer | |
| 6.5 | brief description | 0;10 | FREE TEXT | This is a brief description ( 3 - 70 characters long) of the item/service requested. | ||
| 7 | extended description | 1;0 | WORD-PROCESSING | This is a more detailed description of the item being ordered. | ||
| 8 | type of transaction(+) | 0;7 | SET OF CODES | I:INITIAL X:REPAIR S:SPARE R:REPLACE | This field indicates if this request is for an initial issue of an item, to replace an item, to provide a spare item, or to repair an item. | |
| 9 | patient category | 0;8 | SET OF CODES | 1:SC/OP 2:SC/IP 3:NSC/IP 4:NSC/OP | Enter the Patient category at the time of this request. | |
| 10 | special category | 0;9 | SET OF CODES | 1:SPECIAL LEGISLATION 2:A&A 3:PHC 4:ELIGIBILITY REFORM | If the patient is NSC/OP, then this field must also be set. Special category is also used in counting AMIS. | |
| 11 | total cost | 0;11 | NUMERIC | This is the total cost for the item including materials and labor. | ||
| 12 | serial number | 0;12 | FREE TEXT | This is the serial number of the item, if there is one. | ||
| 13 | psas hcpcs(+) | 2;1 | POINTER | 661.1 | Health Care Financing Administration Common Procedure Coding System (HCPCS). This field should have the HCPCS code for the Item you are selecting. HCPCS is a uniform method for healthcare providers and medical suppliers to report professional services, procedures and supplies. | |
| 13.1 | cpt modifier | 2;2 | FREE TEXT | CPT MODIFIERS in a comma delimited format, consistent with the HCFA published manuals. | ||
| 13.2 | high tech item | 2;3 | SET OF CODES | 1:YES 2:NO | This is a determination by the Prosthetics Laboratory Technician. 1=YES this is a High Tech Item. | |
| 14 | source | 3;1 | SET OF CODES | V:VA C:COMMERCIAL | This is the SOURCE of an item. | |
| 15 | vendor | 3;2 | POINTER | 440 | This is a pointer to the Vendor file. | |
| 16 | psas item | 3;3 | FREE TEXT | This is the PSAS ITEM. This field is mainly for Prosthetics Inventory. | ||
| 17 | item location | 3;4 | POINTER | 661.3 | ||
| 18 | inventory point | 0;13 | POINTER | 445 | This is a pointer to Generic Inventory file. This field is only populated if the site is running GIP and the item is not in Prosthetic Inventory. |
Error: Invalid Global File Type: 664.16