ABN_CROSS_REFERENCE



Column Section Top of Page


Table-level Detail

Description: ABN Cross Reference
Definition: Cross references order catalog items with cpt-4 codes using the catalog_cd and the nomenclature_id.
Table Type: REFERENCE





Column Detail - ABN_CROSS_REFERENCE


Column Name Type Null? Definition
ABN_CROSS_REFERENCE_ID DOUBLE N primary key
ACTIVE_IND DOUBLE N The table row is active or inactive. A row is generally active unless it is in an inactive state such as logically deleted, combined away, pending purge, etc.
ACTIVE_STATUS_CD DOUBLE N Indicates the status of the row itself (not the data in the row) such as active, inactive, combined away, pending purge, etc.
ACTIVE_STATUS_DT_TM DATETIME Y The date and time that the active_status_cd was set.
ACTIVE_STATUS_PRSNL_ID DOUBLE N The person who caused the active_status_cd to be set or change.
BEG_EFFECTIVE_DT_TM DATETIME Y The date and time for which this table row becomes effective. Normally, this will be the date and time the row is added, but could be a past or future date and time.
CATALOG_CD DOUBLE N Catalog Code from order_catalog and code_set that this row points to.
CPT_NOMEN_ID DOUBLE N nomenclature id of the associated cpt-4 code
END_EFFECTIVE_DT_TM DATETIME Y The date/time after which the row is no longer valid as active current data. This may be valued with the date that the row became inactive.
UPDT_APPLCTX DOUBLE N The application context number from the record info block. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_CNT DOUBLE N Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_DT_TM DATETIME N The date and time the row was last inserted or updated. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_ID DOUBLE N The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_TASK DOUBLE N The registered (assigned) task number for the process that inserted or updated the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.


ABN_RULE



Column Section Relationship Section Top of Page


Table-level Detail

Description: ABN RULE
Definition: Contains 'rules' around a particular icd-9/cpt-4 combination to determine if it's reimburseable.
Table Type: REFERENCE





Column Detail - ABN_RULE


Column Name Type Null? Definition
ABN_RULE_ID DOUBLE N primary key for this table
ACTION_CD DOUBLE N Code value associated with a certain action. For example AD for added diagnosis code
ACTION_CD_DT_TM DATETIME Y date associated with the certain action code.
ACTION_CODE VARCHAR(200) Y Action Code
ACTIVE_IND DOUBLE Y The table row is active or inactive. A row is generally active unless it is in an inactive state such as logically deleted, combined away, pending purge, etc.
ACTIVE_STATUS_CD DOUBLE N Indicates the status of the row itself (not the data in the row) such as active, inactive, combined away, pending purge, etc.
ACTIVE_STATUS_DT_TM DATETIME Y The date and time that the active_status_cd was set.
ACTIVE_STATUS_PRSNL_ID DOUBLE N The person who caused the active_status_cd to be set or change.
AGE_RESTRICTION_CODE VARCHAR(50) Y Age restriction for the procedure. "<" means less than or equal to and ">" means greater than or equal to. For example, >50 means that a service is limited to someone 50 years of age or older.
BEG_EFFECTIVE_DT_TM DATETIME Y The date and time for which this table row becomes effective. Normally, this will be the date and time the row is added, but could be a past or future date and time.
CARRIER_ID DOUBLE N ID FOR THE INSURANCE CARRIER. Obsolete Column. Not used
CONTRIBUTOR_SYSTEM_CD DOUBLE N Contributor system identifies the source feed of data from which a row was populated. This is mainly used to determine how to update a set of data that may have originated from more than one source feed.
CPT_NOMEN_ID DOUBLE N Nomenclature id of the CPT-4 code.
ENCNTR_GROUP_CD DOUBLE N Encounter Group Code
ENCNTR_TYPE_CD DOUBLE N Encounter type code that this rule qualifies for
END_EFFECTIVE_DT_TM DATETIME Y The date/time after which the row is no longer valid as active current data. This may be valued with the date that the row became inactive.
FIN_CLASS_CD DOUBLE N Financial class code that this rule qualifies for
FIN_GROUP_CD DOUBLE N Financial Group Code
FREQUENCY_REST_CODE VARCHAR(50) Y Frequency restriction for a procedure. Standard format is one procedure per certain time period. For instance , no more than 2 x-rays per week/month/year etc. Written with number and time period, e.g. 11M means one procedure every eleven months.
HEALTH_PLAN_ID DOUBLE N Health plan id associated with the rule.
ICD9_NOMEN_ID DOUBLE N Nomenclature id for the diagnosis code
INFOX_POLICY_NUMBER VARCHAR(100) Y Info-X Policy Number
LONG_TEXT_ID DOUBLE N Long_text_id for the corresponding memo in the long text table.
MEDICARE_POLICY_NUMBER VARCHAR(100) Y Medicare Policy Number
PARAMETER_CD DOUBLE N Parameters or additional info related with abn_rule. For example, screening tests - no ICD-9 codes required, non-covered procedures, and non-covered diagnosis explicitly listed in policies.
POLICY_DISCRIPTION VARCHAR(200) Y A brief description of the policy.
POLICY_NAME VARCHAR(100) Y Policy name
POLICY_NUMBER DOUBLE Y Policy number
SEX_RESTRICTION_CODE VARCHAR(10) Y Sex restriction for the procedure.
TYPE_CD DOUBLE N Type or category. For example, anesthesiology, neurology, medications, and radiology etc.
UPDT_APPLCTX DOUBLE N The application context number from the record info block. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_CNT DOUBLE N Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_DT_TM DATETIME N The date and time the row was last inserted or updated. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_ID DOUBLE N The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_TASK DOUBLE N The registered (assigned) task number for the process that inserted or updated the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
URL VARCHAR(100) Y WorldWideWeb (WWW) link if available for a given policy.
VALID_DIAG_FLG DOUBLE Y Tells if this diagnosis is, is not, or none are reimbursable on this CPT-4.



Relationship Detail - ABN_RULE


Child Column in ABN_RULE(FK) Parent Table Name Parent Column Name
Parents: HEALTH_PLAN_ID HEALTH_PLAN HEALTH_PLAN_ID


EEM_ABN_ACTION



Column Section Relationship Section Top of Page


Table-level Detail

Description: EEM ABN Action
Definition: This table is used to track the actions performed on an ABN.
Table Type: ACTIVITY





Column Detail - EEM_ABN_ACTION


Column Name Type Null? Definition
ABN_ACTION_CD DOUBLE N The action taken on the ABN. For example: Check, Print, Signed, Not Signed, View, etc.
ABN_ACTION_ID DOUBLE N The unique primary key of this table.
ABN_CHECK_ID DOUBLE N The ABN check associated with the ABN action. A foreign key to the EEM_ABN_CHECK table.
ABN_FORM_ID DOUBLE N The ABN form associated to the ABN action. A foreign key to the EEM_ABN_CHECK table.
ABN_STATE_CD DOUBLE N The state of the ABN. For example: Checked, Signed, Printed, Not Signed, etc.
ACTION_DT_TM DATETIME N The date and time the action was performed.
ACTION_MEANING VARCHAR(12) N A 12-char description corresponding to the Action Code.
ACTION_PRSNL_ID DOUBLE N The ID of the personnel that performed the action.
ACTIVE_IND DOUBLE Y The table row is active or inactive. A row is generally active unless it is in an inactive state such as logically deleted, combined away, pending purge, etc.
ACTIVE_STATUS_CD DOUBLE N Indicates the status of the row itself (not the data in the row) such as active, inactive, combined away, pending purge, etc.
ACTIVE_STATUS_DT_TM DATETIME Y The date and time that the active_status_cd was set.
ACTIVE_STATUS_PRSNL_ID DOUBLE N The person who caused the active_status_cd to be set or change.
APPLICATION_NUMBER DOUBLE N The Application Number of the Application that the update was performed from.
BEG_EFFECTIVE_DT_TM DATETIME Y The date and time for which this table row becomes effective. Normally, this will be the date and time the row is added, but could be a past or future date and time.
CONVERSATION_ID DOUBLE N Scheduling Conversation Identifier. This identifier is used to track all the abn checks which happened in the same transaction. This field makes debugging much easier
END_EFFECTIVE_DT_TM DATETIME Y The date/time after which the row is no longer valid as active current data. This may be valued with the date that the row became inactive.
FORM_ACTION_ID DOUBLE N Form Action Identifier
STATE_MEANING VARCHAR(12) N A 12-char description corresponding to the ABN State Code.
UPDT_APPLCTX DOUBLE N The application context number from the record info block. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_CNT DOUBLE N Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_DT_TM DATETIME N The date and time the row was last inserted or updated. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_ID DOUBLE N The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_TASK DOUBLE N The registered (assigned) task number for the process that inserted or updated the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.



Relationship Detail - EEM_ABN_ACTION


Child Column in EEM_ABN_ACTION(FK) Parent Table Name Parent Column Name
Parents: ABN_ACTION_CD CODE_VALUE CODE_VALUE
ABN_STATE_CD CODE_VALUE CODE_VALUE
ABN_CHECK_ID EEM_ABN_CHECK ABN_CHECK_ID
ABN_FORM_ID EEM_ABN_FORM ABN_FORM_ID
FORM_ACTION_ID EEM_ACTION EEM_ACTION_ID
ACTION_PRSNL_ID PRSNL PERSON_ID




Parent Column in EEM_ABN_ACTION (PK) Child Table Name Child Column Name
Children: ABN_ACTION_ID EEM_ABN_FORM ABN_FORM_ID


EEM_ABN_CHECK



Column Section Relationship Section Top of Page


Table-level Detail

Description: EEM ABN Check
Definition: This table is used to log all ABN checks performed.
Table Type: ACTIVITY





Column Detail - EEM_ABN_CHECK


Column Name Type Null? Definition
ABN_CHECK_ID DOUBLE N The unique primary key of this table.
ABN_STATE_CD DOUBLE N The state of the ABN. For example: Checked, Signed, Printed, Not Signed, etc.
ABN_STATE_MEANING VARCHAR(12) Y A 12-char description corresponding to the ABN State Code.
ABN_TRACKING_ID DOUBLE N The ID associated to the row in this table that is the tracking identifier for this ABN check.
ACTIVE_IND DOUBLE Y The table row is active or inactive. A row is generally active unless it is in an inactive state such as logically deleted, combined away, pending purge, etc.
ACTIVE_STATUS_CD DOUBLE N Indicates the status of the row itself (not the data in the row) such as active, inactive, combined away, pending purge, etc.
ACTIVE_STATUS_DT_TM DATETIME Y The date and time that the active_status_cd was set.
ACTIVE_STATUS_PRSNL_ID DOUBLE N The person who caused the active_status_cd to be set or change.
BEG_EFFECTIVE_DT_TM DATETIME Y The date and time for which this table row becomes effective. Normally, this will be the date and time the row is added, but could be a past or future date and time.
BIRTH_DT_TM DATETIME Y The date of birth.
BIRTH_TZ DOUBLE Y Time zone associated with the corresponding BIRTH_DT_TM column.
CHECK_SEQ DOUBLE N The sequence of the check.
DIAG_NOMEN_ID DOUBLE N This is the value of the unique primary identifier of the nomenclature table. It is an internal system assigned number.
DIAG_SOURCE_IDENT VARCHAR(50) N The identifier of the diagnosis source.
DIAG_VOCAB_CD DOUBLE N The code value for the source vocabulary for the diagnosis.
DIAG_VOCAB_MEANING VARCHAR(12) Y A text representation of the meaning for DIAG_VOCAB_CD.
DUP_CHECK_IND DOUBLE N Indicates if there is duplicate checking.
DUP_KEY VARCHAR(255) Y Duplicate Key column
EDI_TRANSACTION_IDENT VARCHAR(50) Y Unique identifier provided by transaction services to uniquely identify a call to transaction services for medical necessity check.
EEM_FILE_ID DOUBLE N The ID of the row in EEM_FILE related to this ABN check.
ENCNTR_ID DOUBLE N This is the value of the unique primary identifier of the encounter table. It is an internal system assigned number.
END_EFFECTIVE_DT_TM DATETIME Y The date/time after which the row is no longer valid as active current data. This may be valued with the date that the row became inactive.
EST_SERVICE_IND DOUBLE N An indicator for estimated service.
FINANCIAL_CLASS_CD DOUBLE N The financial classification used for a given encounter. Examples may include Worker's Comp, Self Pay, etc.
GENDER_CD DOUBLE N Specifies the gender.
GENDER_MEANING VARCHAR(12) Y A textual representation of the gender.
HEALTH_PLAN_ID DOUBLE N This is the value of the unique primary identifier of the health plan table. It is an internal system assigned number.
HIGH_STATUS_CD DOUBLE N The high status code. Examples are Form Required or Form Not Required.
HIGH_STATUS_MEANING VARCHAR(12) Y A textual representation of the high status.
INPATIENT_IND DOUBLE N Indicates if the check is for an inpatient or not.
LOCATION_CD DOUBLE N The Location that the procedure was checked against.
MED_STATUS_CD DOUBLE N The medium status code for the ABN check. For example, meets medical necessity, Does not meet Medical Necessity, policy not defined, ambiguous, etc.
MED_STATUS_MEANING VARCHAR(12) Y A text representation of the meaning for MED_STATUS_CD.
PARENT1_ID DOUBLE N Id of table 1 the ABN check is associated to.
PARENT1_TABLE VARCHAR(30) Y The name of the parent 1 table the ABN check is associated to.
PARENT2_ID DOUBLE N The Id of the parent 2 table the ABN check is associated to.
PARENT2_TABLE VARCHAR(30) Y The name of the parent 2 table the ABN check is associated to.
PARENT3_ID DOUBLE N The Id of the parent 3 table the ABN check is associated to.
PARENT3_TABLE VARCHAR(30) Y The name of the parent 3 table the ABN check is associated to.
PARENT_MNEMONIC VARCHAR(100) Y A mnemonic for the parent the ABN check is associated to.
PAYER_ID DOUBLE N This is the value of the unique primary identifier of the organization table. It is an internal system assigned number.
PERSON_ID DOUBLE N This is the value of the unique primary identifier of the person table. It is an internal system assigned number.
PROC_DISPLAY_ID DOUBLE N Identifier where the procedure display is linked to (appt_synonym_cd/synonym_id)
PROC_DISPLAY_TABLE VARCHAR(30) Y Identifies the table where the procedure display is linked to (CODE_VALUE/ORDER_CATALOG_SYNONYM)
PROC_GROUP_DISPLAY_ID DOUBLE N The Id of the procedure group display associated to the ABN check.
PROC_GROUP_DISPLAY_TABLE VARCHAR(30) Y The table name associated with the procedure group display. E.G. CODE_VALUE, etc.
PROC_GROUP_PARENT_ID DOUBLE N The Id of the procedure group parent.
PROC_GROUP_PARENT_TABLE VARCHAR(30) Y The table name of the procedure group parent.
PROC_NOMEN_ID DOUBLE N This is the value of the unique primary identifier of the nomenclature table. It is an internal system assigned number.
PROC_PARENT_ID DOUBLE N Identifier where then procedures are linked to (appt_type_cd/catalog_cd)
PROC_PARENT_TABLE VARCHAR(30) Y Identifies the table where the procedures are linked to (i.e. CODE_VALUE)
PROC_SOURCE_IDENT VARCHAR(50) N The identifier of the procedure source.
PROC_VOCAB_CD DOUBLE N The source vocabulary for the procedure.
PROC_VOCAB_MEANING VARCHAR(12) Y The textual representation of the PROC_VOCAB_CD.
SERVICE_DT_TM DATETIME Y The service date and time for the ABN check.
SPONSOR_ID DOUBLE N This is the value of the unique primary identifier of the organization table. It is an internal system assigned number.
UPDT_APPLCTX DOUBLE N The application context number from the record info block. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_CNT DOUBLE N Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_DT_TM DATETIME N The date and time the row was last inserted or updated. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_ID DOUBLE N The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_TASK DOUBLE N The registered (assigned) task number for the process that inserted or updated the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
USE_SERVICE_IND DOUBLE N Use Service Date and Time Indicator



Relationship Detail - EEM_ABN_CHECK


Child Column in EEM_ABN_CHECK(FK) Parent Table Name Parent Column Name
Parents: ABN_STATE_CD CODE_VALUE CODE_VALUE
GENDER_CD CODE_VALUE CODE_VALUE
HIGH_STATUS_CD CODE_VALUE CODE_VALUE
MED_STATUS_CD CODE_VALUE CODE_VALUE
PROC_VOCAB_CD CODE_VALUE CODE_VALUE
ABN_TRACKING_ID EEM_ABN_CHECK ABN_CHECK_ID
EEM_FILE_ID EEM_FILE EEM_FILE_ID
ENCNTR_ID ENCOUNTER ENCNTR_ID
HEALTH_PLAN_ID HEALTH_PLAN HEALTH_PLAN_ID
LOCATION_CD LOCATION LOCATION_CD
DIAG_NOMEN_ID NOMENCLATURE NOMENCLATURE_ID
PROC_NOMEN_ID NOMENCLATURE NOMENCLATURE_ID
PAYER_ID ORGANIZATION ORGANIZATION_ID
SPONSOR_ID ORGANIZATION ORGANIZATION_ID
PERSON_ID PERSON PERSON_ID




Parent Column in EEM_ABN_CHECK (PK) Child Table Name Child Column Name
Children: ABN_CHECK_ID EEM_ABN_ACTION ABN_CHECK_ID
EEM_ABN_CHECK ABN_TRACKING_ID
EEM_ABN_DIAG ABN_CHECK_ID
EEM_ABN_INDEX ABN_CHECK_ID
EEM_ABN_LOW ABN_CHECK_ID
EEM_ABN_MOD ABN_CHECK_ID


EEM_ABN_DATA



Column Section Relationship Section Top of Page


Table-level Detail

Description: Hold additional attributes for an ABN code pair
Definition: EEM ABN Data
Table Type: REFERENCE





Column Detail - EEM_ABN_DATA


Column Name Type Null? Definition
ABN_ATTR_ID DOUBLE N ABN Attribute Identifier
ACTIVE_IND DOUBLE Y The table row is active or inactive. A row is generally active unless it is in an inactive state such as logically deleted, combined away, pending purge, etc.
ACTIVE_STATUS_CD DOUBLE N Indicates the status of the row itself (not the data in the row) such as active, inactive, combined away, pending purge, etc.
ACTIVE_STATUS_DT_TM DATETIME Y The date and time that the active_status_cd was set.
ACTIVE_STATUS_PRSNL_ID DOUBLE N The person who caused the active_status_cd to be set or change.
ATTR_TYPE_CD DOUBLE N Attribute Type Code
ATTR_TYPE_MEANING VARCHAR(12) Y Attribute Type Meaning
BEG_EFFECTIVE_DT_TM DATETIME Y The date and time for which this table row becomes effective. Normally, this will be the date and time the row is added, but could be a past or future date and time.
BEG_IDENTIFIER VARCHAR(50) Y This field contains the begin SOURCE_IDENTIFIER for a range of NOMENCLATURE values.
BEG_SEQ DOUBLE N Denote the first import sequence to contain the record
COMP_TYPE_CD DOUBLE N Comparison Type Code
COMP_TYPE_MEANING VARCHAR(12) Y Comparison Type Meaning
DATA_TYPE_CD DOUBLE N A unique identifier for the Data Type Code.
DATA_TYPE_MEANING VARCHAR(12) Y A 12-char description corresponding to the Data Type.
DATE_VALUE DATETIME Y Date/Time Value
DOUBLE_VALUE DOUBLE Y Double Value (any numerical value)
EEM_FILE_ID DOUBLE N EEM Content File Identifier value
END_EFFECTIVE_DT_TM DATETIME Y The date/time after which the row is no longer valid as active current data. This may be valued with the date that the row became inactive.
END_IDENTIFIER VARCHAR(50) Y This field contains the ;last SOURCE_IDENTIFIER for a range of NOMENCLATURE values.
END_SEQ DOUBLE N Denote the last content file to contain the record.
KEY_FIELD DOUBLE N This field provides a link between the code pair in EEM_ABN_RULE and the additional attributes stored in EEM_ABN_DATA.
LONG_TEXT_ID DOUBLE N Id of long text row containing note
PARENT_ID DOUBLE N Parent Identifier
PARENT_MEANING VARCHAR(12) Y Parent Meaning
PARENT_TABLE VARCHAR(30) Y Parent Table
SEQ_NBR DOUBLE N Determines the order among the children of a group.
STRING_VALUE VARCHAR(255) Y String Value
UNITS_CD DOUBLE N Denotes the Units of Measure
UNITS_MEANING VARCHAR(12) Y Denotes the Units of Measure
UPDT_APPLCTX DOUBLE N The application context number from the record info block.
UPDT_CNT DOUBLE N Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row.
UPDT_DT_TM DATETIME N The date and time the row was last inserted or updated.
UPDT_ID DOUBLE N The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table.
UPDT_TASK DOUBLE N The registered (assigned) task number for the process that inserted or updated the row.
VOCABULARY_CD DOUBLE N Nomenclature Vocabulary Code
VOCABULARY_MEANING VARCHAR(12) Y Nomenclature Vocabulary Meaning



Relationship Detail - EEM_ABN_DATA


Child Column in EEM_ABN_DATA(FK) Parent Table Name Parent Column Name
Parents: ATTR_TYPE_CD CODE_VALUE CODE_VALUE
COMP_TYPE_CD CODE_VALUE CODE_VALUE
DATA_TYPE_CD CODE_VALUE CODE_VALUE
UNITS_CD CODE_VALUE CODE_VALUE
VOCABULARY_CD CODE_VALUE CODE_VALUE
EEM_FILE_ID EEM_FILE EEM_FILE_ID
LONG_TEXT_ID LONG_TEXT_REFERENCE LONG_TEXT_ID