form_misc_billing_options


If there is patient data for this table the file for this export will be found in the extracted zip folder location under the filename of form_misc_billing_options.csv

If there are non-patient data column elements that are not part of the designated record set they will be marked in the Comment's column for that data element

Description

Contains encounter claims billing options that modifies the claims submitted for this encounter

Columns

Column Type Size Nulls Auto Default Children Parents Comments
id BIGINT 19 √ null
date DATETIME 19 √ null
pid BIGINT 19 √ null
patient_data.pid Defined in XML R

The internal patient identifier
user VARCHAR 255 √ null
groupname VARCHAR 255 √ null
authorized TINYINT 3 √ null
activity TINYINT 3 √ null
employment_related BIT 1 √ null
auto_accident BIT 1 √ null
accident_state VARCHAR 2 √ null
other_accident BIT 1 √ null
medicaid_referral_code VARCHAR 2 √ null
epsdt_flag BIT 1 √ null
provider_qualifier_code VARCHAR 2 √ null
provider_id INT 10 √ null
outside_lab BIT 1 √ null
lab_amount DECIMAL 5,2 √ null
is_unable_to_work BIT 1 √ null
onset_date DATE 10 √ null
date_initial_treatment DATE 10 √ null
off_work_from DATE 10 √ null
off_work_to DATE 10 √ null
is_hospitalized BIT 1 √ null
hospitalization_date_from DATE 10 √ null
hospitalization_date_to DATE 10 √ null
medicaid_resubmission_code VARCHAR 10 √ null
medicaid_original_reference VARCHAR 15 √ null
prior_auth_number VARCHAR 20 √ null
comments VARCHAR 255 √ null
replacement_claim BIT 1 √ 0
icn_resubmission_number VARCHAR 35 √ null
box_14_date_qual CHAR 3 √ null
box_15_date_qual CHAR 3 √ null

Indexes

Constraint Name Type Sort Column(s)
PRIMARY Primary key Asc id

Relationships

Close relationships within degrees of separation