Infor Healthcare Revenue Cycle Management - US Lab Code Table Guide. Version 3.4.0.0

Infor Healthcare Revenue Cycle Management - US Lab Code Table Guide Version 3.4.0.0

Copyright Copyright 2014 Infor Important Notices The material contained in this publication (including any supplementary information) constitutes and contains confidential and proprietary information of Infor. By gaining access to the attached, you acknowledge and agree that the material (including any modification, translation or adaptation of the material) and all copyright, trade secrets and all other right, title and interest therein, are the sole property of Infor and that you shall not gain right, title or interest in the material (including any modification, translation or adaptation of the material) by virtue of your review thereof other than the non-exclusive right to use the material solely in connection with and the furtherance of your license and use of software made available to your company from Infor pursuant to a separate agreement, the terms of which separate agreement shall govern your use of this material and all supplemental related materials ("Purpose"). In addition, by accessing the enclosed material, you acknowledge and agree that you are required to maintain such material in strict confidence and that your use of such material is limited to the Purpose described above. Although Infor has taken due care to ensure that the material included in this publication is accurate and complete, Infor cannot warrant that the information contained in this publication is complete, does not contain typographical or other errors, or will meet your specific requirements. As such, Infor does not assume and hereby disclaims all liability, consequential or otherwise, for any loss or damage to any person or entity which is caused by or relates to errors or omissions in this publication (including any supplementary information), whether such errors or omissions result from negligence, accident or any other cause. Without limitation, U.S. export control laws and other applicable export and import laws govern your use of this material and you will neither export or re-export, directly or indirectly, this material nor any related materials or supplemental information in violation of such laws, or use such materials for any purpose prohibited by such laws. Trademark Acknowledgements The word and design marks set forth herein are trademarks and/or registered trademarks of Infor and/or related affiliates and subsidiaries. All rights reserved. All other company, product, trade or service names referenced may be registered trademarks or trademarks of their respective owners. Publication Information Release: Healthcare Revenue Cycle Management Version 3.4.0.0 Publication date: July 2, 2014 Document code: RCM-MSARL-34TG-02 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Contents Contents Chapter 1 Introduction... 7 About This Guide... 7 Intended Audience... 7 HRCM Application Overview... 7 Documentation... 8 Document Layout and Nomenclature... 8 FIELD... 8 TYPE... 8 TABLE.COLUMN... 9 DESCRIPTION... 9 Related Documents... 9 Documentation Updates... 9 Audit Trail... 9 Support... 10 Chapter 2 Code Tables... 11 Level 0... 11 Currency Table... 11 Denomination Table... 12 Company Codes... 13 Tax Information... 14 Options... 14 Custom Field Headings... 15 Manage Representatives... 17 Manage Logins... 19 Manage Profiles... 21 Level 1... 23 Transaction Type... 23 Financial Class Codes... 24 Patient Type... 26 Discharge Status... 27 InforUS Lab Table Reference GuideHealthcare Revenue Cycle Management 3.4 US Lab Table Code Guide 3

Contents Clinic Codes... 28 State Codes... 30 Address Types... 31 Phone Types... 33 System Printers... 34 Level 2... 37 Payor Codes... 37 Payor Plan Codes... 38 Payor Org ID... 41 Pre-Authorization & Cross Reference... 42 Insurance Type... 43 Physician Codes... 44 Deficiency Codes... 49 Deficiency Assignment Codes... 50 Diagnosis... 52 Business Unit... 54 Department... 55 GL Account... 56 GL Code Combinations... 57 Combined GL Editors... 58 Business Units Tab... 58 Departments Tab... 59 GL Accounts Tab... 59 GL Combinations Tab... 60 A/R GL Account... 61 Billing Request Codes... 63 Level 3... 68 Transaction Codes... 68 Transaction Rates... 71 Transaction Billing Codes... 74 Transaction GL Codes... 76 Transaction Diagnosis Codes... 78 Transaction Explode Codes... 80 Transaction Roll-up Codes... 82 Billing Rules... 85 Lab Codes... 97 Level 4... 99 Standard Note... 99 4 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Contents Note Identification... 100 Letter Codes... 101 Manage Work Queues... 102 Denial Maintenance... 105 Level 5... 107 Load Layout... 107 Recurring Status... 108 Client Logo... 109 Interest Rate... 110 Small Balance Write-Off... 112 Patient Cycling Parameters... 114 Credit Cycle Parameters... 116 Credit Cycle Master... 118 Adjustment Reasons... 120 Claim Status Codes... 121 EDI Parameters... 122 Remittance Advice Rules... 124 History Purge Rules... 126 Document Codes... 128 User Defined Field... 129 OBX Fields... 130 Claim Filing Indicator... 131 Country Codes... 132 Insurance Category Type... 133 Physician Type... 134 Provider ID Qualifier... 135 Release Information... 136 Signature Source... 137 Appendix A ERD Diagram... 139 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 5

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Chapter 1 Introduction 1 About This Guide This guide provides reference to the Infor Healthcare Revenue Cycle Management (HRCM) 3.4 front-end application code tables. The file can be viewed using Adobe Reader (http://www.adobe.com). For more information on the HRCM application, refer to the Healthcare Revenue Cycle Management 3.4 User Guide or access InforXtreme.com. The structure of the document is organized according to levels that determine the priority sequence of populating the code tables. Level 0 code tables must be populated first; Level 5 code tables are populated last. Required fields must be populated before a record can be saved. Intended Audience This guide is intended for technical users administering the HRCM system and is available only in PDF file format. HRCM Application Overview HRCM is a comprehensive patient billing and accounts receivable system that meets the needs of regions, districts, single or multi-site organizations and labs. It streamlines the billing processes, monitors and captures payments from government health departments and third-party insurance companies, and resolves payment delay issues. NOTE: This product has undergone a name change. Prior versions referred to name MediAR, Healthcare Revenue Management, or HRM. You may see this application referred to as MediAR, Healthcare Revenue Management (HRM), Revenue Cycle Management (RCM), or Healthcare Revenue Cycle Management (HRCM.) This HRCM product is synonymous with MediAR, HRM, and RCM. InforUS Lab Table Reference GuideHealthcare Revenue Cycle Management 3.4 US Lab Table Code Guide 7

Introduction Documentation Document Layout and Nomenclature Code tables are used to create entries for drop-down lists in the front-end user interface. The information is stored in the RCM database. Each section of this document describes a specific code table, including a screen capture of the RCM window, menu access, and field descriptions. Field definitions are provided in table form, as shown in the following example. Company 2n ptmaster.compno Company Number entry required. Must be a valid code. Select from the drop-down list. 30c company.compname Non-enterable field. Company name displays. Amount 13,2n pttrans.amount Amount entry optional. FIELD The FIELD column lists field labels as they appear in the HRCM user interface. TYPE The TYPE column specifies the information allowed in a field and the field size limit. Each field has a maximum number of characters that can be entered or displayed. Also, fields vary according to the type of information that can be entered or displayed; for example, 8n indicates that up to eight numeric characters can be entered or displayed in the field. Some numeric fields are defined with a comma separating two numbers. The first number is the length of the field; the second number is the decimal placement. For example, for a field type of 13,2n the number would be formatted as 9,999,999,999.99 (where 9 represents any number). If a percentage (%) must be entered, only one decimal place can be used. Fields are defined using the following abbreviations: n = Numeric field. This field accepts only numeric characters, plus signs (+), minus signs (-), commas (,), or periods (.). c = Character field. This field accepts any alpha-numeric character. d = Date field. The format of date fields is specified during installation (for example: mm/dd/yyyy, dd-mon-yyyy, yyyy/mm/dd, etc.). If a date format specifies special characters such as / or -, these characters can be omitted during entry, and the date will display in the correct format after validation. Also, the century portion of a year (first two digits) can be omitted in a date as the system will fill in the closest century. Dates can also be entered as plus (+) or minus (-) a 8 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Introduction specified number of days for example, -1 returns yesterday s date, while +1 returns tomorrow s date. TABLE.COLUMN The TABLE.COLUMN column lists the HRCM database table and column names defining each code table field. The table and column names are separated by a period. All code table fields are associated with database tables and columns. DESCRIPTION The DESCRIPTION column provides information on each field, such as required or optional entries, required entry procedures, and processing that occurs in the field. Related Documents Product documentation is available on www.infor.com/inforxtreme. Throughout this user guide, references to specific documents and Infor Knowledge Base articles may be provided to help you locate more detailed information. You can find documentation posted to the product records on the Product Downloads page. Look here first for installation guides and release notes. You can search for reference documentation on the Knowledge Base page. Documentation Updates Updates to the following related documentation are included with this release. Document Name RCM-MSARH_RCM-MSARL-34RN-01 Description Healthcare Revenue Cycle Management Release Notes updated with new features and enhancements for version 3.4.0.0. Audit Trail Two audit trail fields are appended to each code table, specifying the representative and date/time of the last change to the record. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 9

Introduction 3c 21d <Table Name>.changerep <Table Name>.changedate Non-enterable field. Displays the entry rep or the last rep to change the record. Non-enterable field. Displays the date and time of the entry or last record change. Support If you have an Infor Customer ID and you have access to InforXtreme.com: Please submit all technical support requests via InforXtreme Support at www.infor.com/inforxtreme. If you wish to speak to someone from InforXtreme Support, please refer to www.infor.com/support/contact-support for a list of the support phone numbers and hours of operation. For U.S., call 1-800-772-4111 and enter your Infor Customer ID. If you do not have an InforXtreme Support login and you do not have access to InforXtreme.com: Please ask your company s Infor Administrator to setup access for you or if your company does not have an Infor Administrator, please visit www.infor.com/inforxtreme, click on First Time User to register. 10 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Chapter 2 Code Tables 2 Level 0 Currency Table Base rate Check box Base rate check box to indicate rate used within the system Code 3c currency.currencycode Conversion Rate 10,6n currency.conversionrate Format 40c currency.format Description 40c currency.description Change Rep 3c currency.changerep Change Date 10d currency.changedate Symbol 3c currency.symbol Currency Symbol. Some currency may have multiple characters Symbol InforUS Lab Table Reference GuideHealthcare Revenue Cycle Management 3.4 US Lab Table Code Guide 11

Code Tables Level 0 Denomination Table Denomination ID n denomination.denominationid Currency Code 3c denomination.currencycode Value 9,4n denomination.value Receipt Description 40c denomination.receiptdescription Description 40c denomination.description Change Rep 3c denomination.changerep Change Date 10d denomination.changedate 12 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 0 Company Codes Menu Tools > Manage Code Tables > Company Codes Function Description The Company Codes window is used to maintain detailed company information. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 13

Code Tables Level 0 Company 2n company.compno Company Number entry required. N.P.I. 10c company.npid National Provider Identifier optional. Name 30c company.name Company Name entry optional. Address1 40c company.addr1 Address line 1 entry optional. Address2 40c company.addr2 Address line 2 entry optional. City 20c company.city City entry optional. State 2c company.state State Code entry optional. Must be a valid code. Select from the State/Country Selection drop-down list. Zip Code 10c company.zip Zip Code entry optional. Country 4c company.country Country Code entry optional. Must be a valid code. Select from the State/Country Selection drop-down list. Telephone 3n 7n company.area company.phone Area code and phone number entry optional. Fax 3n 7n company.area2 company.phone2 Area code and fax number entry optional. Tax Information Tax Number 10c company.fedid Federal Tax ID Number entry optional. Interest 6,3n company.intrate Interest Rate entry optional. Monthly interest rate to be charged to self pay accounts. Min. Interest Amount Fiscal Year End Month 13,2n company.intmin Minimum Interest Rate entry optional. Minimum Monthly interest rate to be charged to self pay accounts. 2n company.fyemon Fiscal Year End Month entry optional. Options Close Type 1c company.closetype Month End or Period end Close Type M = Month End close P = Period close 14 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 0 Conversion Date Date or 10d company.convdate Date of data conversion Paid Trans Type 4 company.paytype Paid Trans Code 8c company.paycode Client Fee Schedule Master Diagnosis Self-Pay Payor Self-Pay Plan 8c company.feesched Client fee schedule code optional 1c company.masterdx Master Diagnosis flag Optional Y = Assign from Master N = Do Not assign from of Master S = Skip edit of Master 4n company.selfno Self Pay Payor Code 3n company.selfsub Self Pay Plan Code Custom Field Headings Medical Record Account Number 6c company.medrectitle Medical Record Number field heading entry optional. This value becomes the heading for all medical record number fields in the system. 6c company.acctnotitle Account Number field heading entry optional. This value becomes the heading for all account number fields in the system. Client 6c company.clienttitle Client Number field heading entry optional. This value becomes the heading for all client number fields in the system. Onset of Illness 16c company.onsettitle Onset of Illness field heading entry optional. This value becomes the heading for all onset of illness fields in the system. Plan Type 16c company.plantypetitle Plan Type field heading entry optional. This value becomes the heading for all plan type fields in the system. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 15

Code Tables Level 0 Physician 1 10c company.phystitle1 Primary Physician field heading entry optional. This value becomes the heading for all primary physician fields in the system. Physician 2 10c company.phystitle2 Secondary Physician field heading entry optional. This value becomes the heading for all secondary physician fields in the system. Header 60c company.billremark1 Statement Remark Lines Header entry optional. Enter remarks to appear at the top of the patient statement. Footer 60c company.billremark2 Statement Remark Lines Footer entry optional. Enter remarks to appear at the bottom of the patient statement. 16 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 0 Manage Representatives Menu Tools > Security > Manage Representatives Function Description The Manage Representatives window is used to define account representatives and their associations. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 17

Code Tables Level 0 Representative 3c acctrep.repno Account Representative code entry required. Login name 255c acctrep.userid Login name entry optional. Must be a valid ID. Select from the dropdown list. Name 40c acctrep.name Account Representative full name entry optional. Title 30c acctrep.title Account Representative title entry optional Telephone 3n, 7n acctrep.area, acctrep.phone Account Representative telephone entry optional Ext. 6n acctrep.ext Account Representative extension entry optional Email 100c acctrep.email Account Representative email address entry optional Company 2n acctrep.homecom pno Company code entry optional. Must be a valid code. Select from dropdown list. Clinic 6c acctrep.campus Clinic entry optional. Must be a valid code. Select from drop-down list. Lab 4c acctrep.lab Lab entry optional. Must be a valid code. Select from drop-down list. Automatically Print Receipts Security Patient Types Campus Codes Company Codes 1c acctrep.to_print Automatically print receipts check box entry optional. Allowed Patient Types or all Allowed Clinics or all Allowed Companies or all 18 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 0 Manage Logins Menu Tools > Security > Manage Logins Function Description The Manage Logins window is used to setup RCM users and to define security settings for application access. User name Account is disabled 255c login.userid Login name entry required. Must be a valid ID. Select the user record from the list. 1c login.disabled Disable account check box entry required. N or Y Name 30c login.name Full user name entry optional. Select the user record from the list. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 19

Code Tables Level 0 Effective From Effective To Account Type Domain Username Date login.fromdate Password Effective start date entry optional Date login.thrudate Password Effective end date entry optional 1c login.accounttype Account Login Type A = Active Directory login C = Classic RCM login 80c login.ntusername For Account Type = C, defines the Active Directory User ID Password 10c login.passwrd Password entry optional. Enter a user password and click Set. To reset the password, click Reset. Minimum Password Length Password change days Password save days 2n login. minpwdlen Minimum password length optional. Minimum length required for classic login passwords. 5n login.pwdchgdays Force password change day optional. Classic login days before password change required. 5n login.pwdsavedays Password save days. Classic login number of days to save old passwords 20 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 0 Manage Profiles Menu Tools > Security > Manage Profiles Function Description The Profile Manager window allows you to define security access profiles for roles/tasks that are common amongst users. Multiple profiles can be assigned to one user. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 21

Code Tables Level 0 Profile Name 255c profile.profileid Profile name entry required. Description 512c profile.description Profile description entry optional 22 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 1 Level 1 Transaction Type Menu Tools > Manage Code Tables > Transaction Type Function Description The Transaction Type window is used to maintain transaction type code information. Code 1c trantype.trantype Transaction Type Code entry required. Description 30c trantype.descript Transaction Type Description entry required. InforUS Lab Table Reference GuideHealthcare Revenue Cycle Management 3.4 US Lab Table Code Guide 23

Code Tables Level 1 Financial Class Codes Menu Tools > Manage Code Tables > Financial Class Codes Function Description The Financial Class Codes window is used to maintain financial class information, including crossreference financial class codes. Code 2n finclass.fc Financial Class Code entry required. Description 30c finclass.descript Financial Class Description entry optional. Cross Reference Self Pay Payor 6c finclass.xreffc Cross Reference Financial Class Code entry is optional. 4n finclass.insno Payor (Insurance) Code entry required. Must be a valid code. Select from the drop-down list. Self Pay Payor for this Financial Class. Enter 9999 for all codes. 24 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 1 Self Pay Plan Default Price FC Business Unit 6n finclass.inssub Payor (Insurance) Code entry required. Must be a valid code. Select from the drop-down list. Self Pay Plan for this Financial Class. Enter 999999 for all codes. 2n finclass.pricefc Default Pricing Financial Class Code entry optional. Enter the Financial Class to use when using default pricing, or leave blank to use original Financial Class. 5c finclass.bunit Business Unit entry optional. Select from the drop-down list. Department 20c finclass.deptno Department entry optional. Select from the drop-down list. GL Account 20c finclass.glacct GL Account entry optional. Select from drop-down list. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 25

Code Tables Level 1 Patient Type Menu Tools > Manage Code Tables > Patient Type Function Description The Patient Type window is used to maintain patient type codes and descriptions. Type 2n ptype.ptype Patient Type Code entry required. Description 30c ptype.descript Patient Type Description entry required. Patient/Client 1c ptype.patient_client Patient Type Patient/Client required. P = Patient C = Client 26 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 1 Discharge Status Menu Tools > Manage Code Tables > Discharge Status Function Description The Discharge Status window is used to maintain discharge status code information. Code 4c disstat.disstat Discharge Status Code entry required. Description 30c disstat.descript Diagnosis Status Code Description entry required. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 27

Code Tables Level 1 Clinic Codes Menu Tools > Manage Code Tables > Clinic Codes Function Description The Clinic Codes window is used to maintain clinic codes, including clinic cross-reference codes. Clinic Code 6c campus.campus Clinic Code entry required. Description 30c campus.descript Description entry optional. Cross Ref 10c campus.xrefcampus Cross Reference Clinic Code entry optional. Address 30c campus.addr1 Address line 1 entry optional. 30c campus.addr2 Address line 2 entry optional. City 20c campus.city City entry optional. State/Prov. 2c campus.state State/Province entry optional. Must be a valid code. Select from the drop-down list. 28 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 1 Zip/Postal 10c campus.zip Zip/Postal Code entry required. Must be a valid code. Select from the drop-down list. Country 4c campus.country Country entry optional. Must be a valid code. Select from the drop-down list. Telephone 3n 7n campus.area campus.phone Area code and phone number entry optional. Patient Type 2n campus.ptype Patient Type entry optional. Select from the drop-down list. Payor 4n campus.insno Clinic s Payor Code Plan 6n campus.inssub Clinic s Payor Plan Code Lab 4c campus.lab Lab entry optional. Company 2n campus.compno Company entry optional. Select from the drop-down list. Facility Admin 40c campus.facilityadmin Facility Admin entry optional Region 40c campus.region Region entry optional Op. Start Date Op. End Date Date campus.opstartdate Op.Start Date entry optional Date campus.openddate Op. End Date entry optional E-mail 200c campus.email E-mail address entry optional Clinic Type 40c campus.clinictype Clinic Type entry optional. Select from the drop-down list. Group Division 40c campus.groupdivision Group Division entry optional. Dept VP 40c campus.deptvp Dept VP entry optional Regional Director Central Office 40c campus.rod Regional Director entry optional 40c campus.cbo Central Office entry optional. Note 40c campus.note Note entry optional. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 29

Code Tables Level 1 State Codes Menu Tools > Manage Code Tables > State Codes Function Description The State Codes window is used to maintain state/country codes and names. State Code State Name 2c statectry.state State Code entry required. 20c statectry.name State or Country Name entry optional. Country 4c statectry.country Country Code entry required. 30 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 1 Address Types Menu Tools > Manage Code Tables > Address Types Function Description The Address Codes window is used to maintain address type code information. Company 2n addrcd.compno Company code entry required. Address Code 2n addrcd.addrno Address Code entry required. Address ID 4c addrcd.addrid Address ID entry optional. Description 30c addrcd.descript Address Description entry optional. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 31

Code Tables Level 1 Audit 1c addrcd.auditflg Audit Address Changes that occur in: M = Manual Entry Only I = Interface Only B = Manual Entry and Interface N = No Audit Audit Review Cross Reference 1c addrcd.auditrev Audit Review check to create audit as review note 15c addrcdxref.addrcdxref Cross reference addresses in interface 32 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 1 Phone Types Menu Tools > Manage Code Tables > Phone Types Function Description The Phone Types window is used to maintain phone type codes and descriptions. Code 4c phonetype.phonetype Phone Type Code entry required. Description 30c phonetype.descript Phone Type Description entry required. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 33

Code Tables Level 1 System Printers Menu Tools > Manage Code Tables > System Printers Function Description The System Printers window is used to maintain system printer information. Code 20c printers.printer Printer Code entry required. The following special printers should also be setup: SCREEN - displays report onscreen DEFAULT - sends report to desktop default printer FILE - sends report to a file Description 30c printers.descript Printer Description entry required. Printer Path 255c printers.printerpath The network name of the printer 34 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 1 Font Face 255c printers.fontface Paper billing Font Face Font Pitch 5,2n printers.fontpitch Paper billing Font Pitch Left Margin 12n printers.leftmargin Paper billing Left Margin Top Margin 12n printers.topmargin Paper billing Top Margin Right Margin Bottom Margin Spacing Offset 12n printers.rightmargin Paper billing Right Margin 12n printers.bottommargin Paper billing Bottom Margin 6,2n printers.linespacing Paper billing Spacing Offset Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 35

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Code Tables Level 2 Level 2 Payor Codes Menu Tools > Manage Code Tables > Payor Codes Tools > Manage Code Tables > Payor Plan Codes > New Payor button Function Description The Payor Codes window is used to maintain payor code information as an extension of the Payors code table. It can also be launched by clicking the New Payor button in the Payors Plan code table. Code 4n payor.insno Payor Code entry required. Description 40c payor.name Payor Description entry required. InforUS Lab Table Reference GuideHealthcare Revenue Cycle Management 3.4 US Lab Table Code Guide 37

Code Tables Level 3 Payor Plan Codes Menu Tools > Manage Code Tables > Payor Plan Codes Function Description The Payor Plan Codes window is used to maintain payor plan (insurance) information. To create new Payor records, click the New Payor button. 38 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Payor 4n insurance.insno Payor code and sub-code entry required. Select from the drop-down list. Plan 6n insurance.inssub Payor Plan Code entry required. To have the system auto-generate the next available code, leave the sub-code field blank. Plan Type 10c insurance.plantype Plan Type entry Name 40c insurance.name Payor name entry required. Plan Name 40c insurance.planname Insurance plan name entry optional. Client Account 16c insurance.policyid Client Account Number entry optional. This number will usually match the insurance sub-number. Links the payor to a client account. Address 30c insurance.addr1 Address Line 1 entry optional. Address 30c insurance.addr2 Address Line 2 entry optional. City 20c insurance.city City entry optional. Select from the drop-down list. State 2c insurance.state State/Province code entry optional. Must be a valid code. Select from the dropdown list. Zip 10c insurance.zip Zip/postal code entry optional. Must be a valid code. Select from the dropdown list. Country 4c insurance.country Country entry optional. Must be a valid code. Select from the drop-down list. Telephone 3n 7n insurance.area insurance.phone Area code and phone number entry optional. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 39

Code Tables Level 3 Fax 3n 7n insurance.faxarea insurance.faxphone Area code and fax number entry optional. Category 6c insurance.inscat Insurance Category entry optional Employer 5c insurance.empno Employer entry optional from drop down list Capitation Code Verification date Verification URL Contract Number Timely Filing(days) 8c insurance.captrancode Capitation charge to be billed to Capitated Payors. Capitation code is optional, but when populated must be a valid code. Select from drop down list entry optional. Date insurance.chgdate Insurance Verification Date entry optional. 250c insurance.url Patient Verification URL entry optional. Enter the Web URL for patient verification. 20c insurance.contractlab Contract Number entry optional 4n insurance.timelyfiling Timely Filing (days) entry optional Notes 80c insurance.note Notes entry optional. Contact 30c insurance.contact Contact entry optional. Financial Class 2n 30c insurance.fc finclass.descript Financial Class Code entry required. Must be a valid code. Select from the dropdown list. Description is a nonenterable field. Financial class description displays. Transaction Type 1c insurance.trantype Transaction Type entry optional. Must be a valid code. Select from the dropdown list. This is the transaction type used when the account is transferred to client billing. 40 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Transaction Code 8c insurance.trancode Transaction Code entry optional. Must be a valid code. Select from the dropdown list. This is the transaction code used when the account is transferred to client billing. Effective From Date insurance.fromdate Effective From date entry optional. Select from the drop-down calendar. Effective To Date insurance.thrudate Effective To date entry optional. Select from the drop-down calendar. Plan Indicator 1c insurance.mailto Plan Indicator entry optional. Substitutes the Payor Subcode with either the clinic or lab code from the charge during the billing process. This determines the billing location. C = Clinic L = Lab Coverage 40c insurance.coverage Coverage Note entry optional. Process Secondary EDI Remittances 1c insurance.process_ secondary_pay Process Secondary EDI Remittances entry optional. Select check box. If not checked, payments received thru EDI for the payor as a secondary on a patient account will be ignored. Payor Org ID Billing Eligibility Claim Status 10c insurance.payorgid insurance.payorid270 insurance.payorid276 Payor Organization Identification entry optional. This ID number is required for electronic billing. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 41

Code Tables Level 3 Pre-Authorization & Cross Reference Pre- Authorization Type Sundry Account 1c Insurance.preauth Used to indicate if claim balance on patient accounts should be automatically transferred or paid. S=Sundry Account transfer to client account T=Trust transfer to Trust acct B=Generate bank payment 16c Insurance.policyid Can be populated with client account to transfer claim balance to. Clinic 6c Insurance.campus Can be used to indicate if the payor plan is associated with a specific clinic. Allow Over Drafts 1c Insurance.overdraft Used with Trust Pre- Authorization type to indicate if transfer of balance to trust account can leave trust account in an overdraft state. Interest Rate 13,2n Insurance.int_rate If interest can be charged on balances outstanding for this payor, indicates interest rate. Days Late n Insurance.days_late Number of days payments can be delayed before charging interest. Min Balance 13,2n Insurance.min_bal Minimum balance required before interest is assessed. Interest Transaction type Interest Transaction Code Cross Reference 1c Insurance.int_trantype Transaction type used to add interest. 8c Insurance.int_trancode Transaction code used to add interest. 10c Insxref.xrefno Cross reference used to locate payor plan code in interfaces. 42 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Insurance Type Menu Tools > Manage Code Tables > Insurance Type Function Description The Insurance Type window is used to maintain insurance type code information. Plan Type 10c plantype.insurancetype Insurance Type Code entry required. Description 40c plantype.descript Insurance Type Description entry required. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 43

Code Tables Level 3 Physician Codes Menu Tools > Manage Code Tables > Physician Codes Function Description The Physicians Information tab is used to maintain physician code information. Physician Code 8n physician.physno Physician Code entry required. To have the system autogenerate the next available code, leave the sub-code field blank. Surname 20c physician.lname Physician s last name entry optional. Given Name Middle Initial 15c physician.fname Physician s first name entry optional. 1c physician.mname Physician s middle name initials entry optional. 44 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Title 10c physician.title Physician s title entry optional. Address 40c physician.addr1 Address line 1 entry optional. 40c physician.addr2 Address line 2 entry optional. City 20c physician.city City entry optional. State 2c physician.state State Code entry optional. Must be a valid code. Select from the drop-down list. Country 4c physician.country Country Code entry optional. Must be a valid code. Select from the drop-down list. Zip Code 10c physician.zip Zip Code entry optional. Telephone 3n, 7n physician.area physician.phone Fax 3n, 7n physician.farea physician.faxno Area code and phone number entry optional. Area code and fax number entry optional. Location 4c physician.location Location entry optional Physician Sign-Off Required 1c physician.physsignoffreq Physician Sign-Off Required Checkbox entry optional. Email 80c physician.email Email address entry optional. Effective From Effective To Date physician.fromdate Effective From date entry optional. Select from the drop-down calendar. Date physician.thrudate Effective To date entry optional. Select from the drop-down calendar. Specialty 7c physician.specialty Specialty entry optional Refer Type 12c physician.reftype Refer Type entry optional License # 15c physician.licno License Number entry optional. UPIN 12c physician.upin UPIN entry optional. EIN 10c physician.eino Employer ID Number entry optional. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 45

Code Tables Level 3 NPID 10c physician.npid National Provider Number entry optional. SSN/SIN 10c physician.ssno Social Security/Insurance Number entry optional. Taxonomy 10c physician.subspecial Submitter Specialty/Taxonomy Code entry optional. Note 30c physician.note Note Text entry optional. Clinic Code 6c physclinic.campus Clinic Code entry required. Must be a valid code. Select from the drop-down list. 40c campus.descript Non-enterable field. Displays clinic code description. 46 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Physician ID Financial Class Clinic Code 12c physid.physid Physician ID entry required. 2n physid.fc Financial Class entry required. Must be a valid code. Select from the dropdown list. Defaults to 99 (all codes). 6c physclinic.campus Clinic Code entry required. Must be a valid code. Select from the drop-down list. Defaults to 999999 (all codes). Payor 4n physid.insno Payor Code entry required. Must be a valid code. Select from the drop-down list. Defaults to 9999 (all codes). Plan 6n physid.inssub Plan code entry required. Must be a valid code. Select from the drop-down list. Defaults to 999999 (all codes). Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 47

Code Tables Level 3 Physician 8n physxref.physno Physician code defaulted Application 10c physxref.appl Application entry required. Cross Ref Code 10c physxref.physcode Cross Ref Code entry required. 48 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Deficiency Codes Menu Tools > Manage Code Tables > Deficiency Codes Function Description The Deficiency Codes window is used to maintain deficiency code information. Code 2c deficiency.deficiency Deficiency Code entry required. Description 30c deficiency.descript Deficiency Description entry optional. Review Note 1c deficiency.revnote Review Note entry optional. 1 = One Time Note R = Apply Review Note Y = Apply Note and Set Account Level Deficiency Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 49

Code Tables Level 3 Deficiency Assignment Codes Menu Tools > Manage Code Tables > Deficiency Assignment Codes Function Description The Deficiency Assignment Codes window is used to maintain account deficiency assignment code information. These deficiencies are assigned to accounts when the account is registered. 50 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Patient Type 2n defassign.ptype Patient Type entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Clinic 6c defassign.campus Clinic Code entry optional. Must be a valid code. Select from the dropdown list. Defaults to 999999 (all codes). Primary FC Primary Payor Primary Plan 2n defassign.fc Primary Financial Class Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). 4n defassign.insno Primary Payor Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 9999 (all codes). 6n defassign.inssub Primary Plan Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 999999 (all codes). Client FC 2n defassign.fc2 Secondary Financial Class Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Client Payor Client Plan Deficiency Status 4n defassign.insno2 Secondary Payor Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 9999 (all codes). 6n defassign.inssub2 Secondary Plan Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 999999 (all codes). 9c defassign.deficiency Deficiency Status Code entry optional. Must be a valid code. Select from the drop-down list. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 51

Code Tables Level 3 Diagnosis Menu Tools > Manage Code Tables > Diagnosis Function Description The Diagnosis window is used to maintain diagnosis code information. Code 9c diagnosis.diag Diagnosis Code entry required. Description 30c diagnosis.descript Diagnosis Description entry required. Effective From Effective Thru Date diagnosis.fromdate Effective From date entry optional. Select from the drop-down calendar. Date diagnosis.thrudate Effective To date entry optional. Select from the drop-down calendar. Code Type 2c diagnosis.codetype Indicates type of diagnosis code (9 = ICD-9, 10 = ICD-10) 52 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Cross Reference Diagnosis Code Cross Reference Code Type 9c diagnosis.xdiag Cross Referenced Diagnosis. 2c diagnosis.xcodetype Cross Referenced Diagnosis code type. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 53

Code Tables Level 3 Business Unit Menu Tools > Manage Code Tables > Business Unit Function Description The Business Unit window is used to maintain business unit code information. Code 5c bunit.bunit Business Unit Code entry required. Description 40c bunit.description Business Unit Description entry required. 54 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Department Menu Tools > Manage Code Tables > Department Function Description The Department window is used to maintain department code information. Code 20c department.deptno Department Code entry required. Description 40c department.description Department Description entry required. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 55

Code Tables Level 3 GL Account Menu Tools > Manage Code Tables > G/L Account Function Description The G/L Account window is used to maintain general ledger account code information. Code 20c glaccount.glacctno General Ledger Account Code entry required. Description 40c glaccount.description General Ledger Account Description entry required. Code 20c arglaccount.glacctno General Ledger Account Code entry required. Description 40c arglaccount.description General Ledger Account Description entry required. 56 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 GL Code Combinations Menu Tools > Manage Code Tables > General Ledger Code Combinations Function Description The GL Code Combinations window is used to maintain business unit, department, and GL account number combinations. Business Unit 5c gl_chart.bunit Business Unit Code entry required. Must be a valid code. Select from the dropdown list. Department 20c gl_chart.deptno Department Number Code entry required. Must be a valid code. Select from the drop-down list. GL Account 20c gl_chart.glacctno General Ledger Account Number entry required. Must be a valid code. Select from the drop-down list. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 57

Code Tables Level 3 Combined GL Editors Menu Tools > Manage Code Tables > Combined GL Editors Function Description The Combined GL Editors screen allows you to maintain the four GL maintenance screens in one window. It combines Business Unit, Department, GL Account and GL Combination tables on a single screen. It allows drill down from Business Unit to Department showing only departments associated with that Business Unit in the GL combinations table. It allows drill down from the Department table to the GL Accounts table only showing GL accounts associated with the Business Unit and Department in the GL combinations table. Business Units Tab A detailed description and code table can be found in the Business Unit section of this document. 58 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Departments Tab A detailed description and code table can be found in the Department section of this document. GL Accounts Tab A detailed description and code table can be found in the GL Accounts section of this document. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 59

Code Tables Level 3 GL Combinations Tab A detailed description and code table can be found in the GL Code Combinations section of this document. 60 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 A/R GL Account Menu Tools > Manage Code Tables > A/R General Ledger Account Function Description The A/R GL Account window is used to maintain A/R general ledger account assignment. A/R GL accounts are selected at Period End Close based on Lab, Clinic, Patient Type, and Financial Class rules. Lab 2n arglaccount.compno Lab entry optional Clinic 6c arglaccount.campus Clinic Code entry optional. Must be a valid code. Select from the dropdown list. Defaults to 999999 (all codes). Patient Type 2n arglaccount.ptype Patient Type entry optional. Must be a valid code. Select from the dropdown list. Defaults to 99 (all codes). Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 61

Code Tables Level 3 Financial Class Business Unit Dept Number GL Account Effective From Effective To 2n arglaccount.fc Financial Class Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). 5c arglaccount.bunit Business Unit Code entry optional. Must be a valid code. Select from the drop-down list. 20c arglaccount.deptno Department Number Code entry optional. Must be a valid code. Select from the drop-down list. 20c arglaccount.glacctno General Ledger Account Number Code entry optional. Must be a valid code. Select from the drop-down list. Date arglaccount.fromdate Effective From date entry optional. Select from the drop-down calendar. Date arglaccount.thrudate Effective To date entry optional. Select from the drop-down calendar. 62 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Billing Request Codes Menu Tools > Manage Code Tables > Billing Requests Function Description The Billing Request Codes window is used to maintain billing request codes and associated information. Billing Request codes identify types or queues of billings and associate those types or queues with billing formats/programs. Code 8c reqtype.reqcode Billing Request Code entry required. Select from the dropdown list. Description 100c reqtype.descript Billing Request Description entry optional. Program Name 200c reqtype.pgmname Program Name entry optional. Billing Reports program runs when bills are generated. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 63

Code Tables Level 3 Program Type Sequence Type Master Req. Code Lines Per Page 1c reqtype.progtype Program Type Code defaults to null. It indicates the application used to print billing requests. 1c reqtype.seqtype Sequence Type defaults to None. Select from the drop-down list. Sequence type indicates whether billing will be to: I = Insurance Address A = Patient Address B = Both Insurance or Patient Address 8c reqtype.mastreqtype Billing Request Code entry optional. If this bill is one of many sent to a payor based on the transaction code, enter the Master Billing Request Code. Must be a valid code. Select from the dropdown list. 3n reqtype.pagecnt Number of lines per page allowed on the billing form. Entry optional. Claim Lines 4n reqtype.maxlines Maximum charge lines per claim entry optional. File name 200c reqtype.filename File name entry optional. Default file/directory for output. Page Break 2n reqtype.breakfld Break Code entry optional. Select from the drop-down list. This is the rule used when grouping charges to fit on a bill. 1 = Transaction/Service Date 2 = Transaction Code + Transaction/Service Date + Transaction Note 3 = Batch Number 4 = Transaction/Service Date + Transaction Bill Code + first 3 characters of Transaction Code Print Device 256c reqtype.printdev Print Device entry optional. Must be a valid System Printer code. Sets the default printer/output type for the billing. Select from the dropdown list. 64 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 EC Billing # 12c reqtype.ecbillno EC Billing # entry optional Custom Report 1c non-database Custom Report entry optional. Check box to indicate billing is a custom billing form to be found in the client s custom report billing directory. Statement 1c reqtype.stmtflg Statement entry optional. Check box to indicate the billing is a statement and Patient/Client cycling should only produce at required interval. Line Feed Letters Codes Check box Check box reqtype.linefeeds non-database Line Feed entry optional. Check box to indicate output file should include line feeds between each line. Line Feed entry optional. Check box to indicate if billing allows for letter codes and letter code can be entered when demanding billing. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 65

Code Tables Level 3 Name 30c reqtype.subname Submitter Name entry optional. Mailbox 20c reqtype.sendermailbox Submitter email address entry optional. ID 17c reqtype.subid Submitter ID entry optional. Type 6c reqtype.subtype Submitter Type Code entry optional. Taxonomy Code Submitter ETIN 20c reqtype.subspecial Taxonomy Code entry optional. 40c reqtype.subetin Submitter ETIN entry optional Name 30c reqtype.rcvname Receiver Name entry optional. ID 17c reqtype.rcvid Electronic Billing Receiver ID entry optional. Type 1c reqtype.rcvtype Electronic Billing Receiver Type entry optional. 66 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 ETIN 20c reqtype.rcvetin Receiver Electronic Transmission Identification Number. Number 10c reqtype.rcvno Number entry optional. Type 4c reqtype.prod Select Production or Test database from the drop-down list. Entry optional. National 5c reqtype.versionnat Electronic Billing National Version Number entry optional. Location 5c reqtype.versionloc Version Location entry optional. Software 10c reqtype.vensoft Electronic Billing Vendor Software Type entry optional. Update 2c reqtype.venupdt Vendor Update entry optional. Password 10c reqtype.password Password for submission of electronic bill entry optional. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 67

Code Tables Level 3 Level 3 Transaction Codes Menu Tools > Manage Code Tables > Transaction > Codes Function Description The Transaction Codes window is used to maintain transaction codes and associated information. Transaction Type Transaction Code 1c trancode.trantype Transaction Type entry optional. Must be a valid code. Select from the drop-down list. 8c trancode.trancode Transaction Code entry required. 68 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Description 30c trancode.descript Transaction Description entry optional. Patient Type 2n trancode.ptype Patient Type entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all patient types). Clinic 4c trancode.clinic Clinic entry optional. Must be a valid code. Select from the dropdown list. Standard Amount Price List Code 9,3n trancode.techamount Standard Amount entry optional. 4c trancode.pricelist Price List Code entry optional. The price list code is used to group transaction codes with like classifications. Billing Code 9c trancode.billcode Default Billing Code entry optional. Frequency Alias 10c trancode.freqallias Frequency Alias entry optional. Frequency 1c trancode.frequency Frequency Code entry optional. Select from the drop-down list. A = Annual S = Semi-annual Q = Quarterly M = Monthly W = Weekly D = Daily Action Code 1c trancode.actioncode Action Code entry optional. J = J-Out R = Review Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 69

Code Tables Level 3 Effective From Effective To Type Of Service Auto Write Off Specimen Draw Flag Date or 10d Date or 10d trancode.fromdate trancode.thrudate Effective From date entry optional. Select from the drop-down calendar. Effective To date entry optional. Select from the drop-down calendar. 2c trancode.tos Type Of Service. Must be a valid code. Select from the drop-down list. 1c trancode.autowo Auto Write off entry optional. Disabled by default. Select to enable. 1c trancode.specimendrawflg Specimen Draw Flag entry optional. Disabled by default. Select to enable. Liter Priced 1c trancode.literprice Liter Priced entry optional. Disabled by default. Select to enable. 70 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Transaction Rates Menu Tools > Manage Code Tables > Transaction > Rates Function Description The Transaction Rates window is used to maintain transaction rate information. These rates are assigned as the charge amount and would be considered revenue rates. Company 2n tranrate.compno Company entry required. Clinic 6c tranrate.campus Clinic entry optional. Must be a valid code. Select from drop-down list. Defaults to 999999 (all codes). Patient Type 2n tranrate.ptype Patient Type entry optional. Must be a valid code. Select from the dropdown list. Defaults to 99 (all codes). Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 71

Code Tables Level 3 Primary FC 2n tranrate.fc Financial Class entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Primary Payor Primary Plan 4n tranrate.insno Payor Code and sub-code entry optional. Must be a valid code. Select from drop-down lists. 6n tranrate.inssub Primary Plan. Must be a valid code. Select from drop-down list. Client FC 2n tranrate.fc2 Financial Class entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Client Payor 4n tranrate.insno2 Payor Code and sub-code entry optional. Must be a valid code. Select from the drop-down lists. Client Plan 6n tranrate.inssub2 Payor Code and sub-code entry optional. Must be a valid code. Select from the drop-down lists. Price List 4c tranrate.pricelist Price List Code entry optional. The price list code is used to group transaction codes with like classifications. Transaction Code 9c tranrate.trancode Transaction Code entry optional. Must be a valid code. Select from the drop-down list. Frequency 1c tranrate.mflag Frequency entry optional. Must be a valid code. Select from the dropdown list. A = Annual D = Day M = Monthly Q = Quarterly S = Semi-Annual W = Weekly Frequency Count 2n tranrate.perfreqcnt Frequency Count entry optional. 72 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Benefit Coord 1c tranrate.cobind Coordination of Benefits (C.O.B.) entry optional. 1 = Primary 2 = Secondary 9 = Self Rollup 1c tranrate.rollflag Rollup flag entry optional. Enter Y to flag this record as a component of a rollup. Amount 8,2n tranrate.techamount Amount entry optional. Fee Schedule Rate Multiplier 9c tranrate.feesched Fee Schedule entry optional. 11,5n tranrate.ratemult Rate Multiplier entry optional. The value entered in this field will be multiplied by the value in the Amount field in the Transaction Code window, and the new value will be used. If there is no value entered in this field, the value in the Amount field in this window will be used. If the Amount field is not entered in this window, the value from the Amount field from the Transaction Code screen is used. Effective From Date, 10d trancode.fromdate Effective From date entry optional. Select from the drop-down calendar. Effective To Date, 10d trancode.thrudate Effective To date entry optional. Select from the drop-down calendar. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 73

Code Tables Level 3 Transaction Billing Codes Menu Tools > Manage Code Tables > Transaction > Billing Codes Function Description The Transaction Billing Codes window is used to maintain transaction billing codes and associated information. These billing codes are assigned to charge transactions to indicate what code(s) should be used when billing transactions to specific payors. Company 2n tranbill.compno Company entry required. Must be a valid code. Select from the drop-down list. Patient Type 2n tranbill.ptype Patient Type entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). 74 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Financial Class 2n tranbill.fc1 Financial Class Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Payor 4n tranbill.insno Payor Code and Sub-code entry optional. Must be valid codes. Select from the drop-down lists. Plan 6n tranbill.inssub Plan code entry optional. Must be a valid code. Select from the drop-down list. Tran Code 8c tranbill.trancode Transaction Code entry optional. Must be a valid code or 99999999 (all codes). Select from the drop-down list. Bill Code 9c tranbill.billcode Billing Code entry required. This code is used when billing the charge and can be used instead of the Transaction Code to bill the Payor. Deficiency Code 5c tranbill.defic Deficiency Code entry optional. Must be a valid code. Select from the dropdown list. Repeat 1c tranbill.repeat Repeat Code entry optional. Enter Y to indicate this billing code requires a modifier if it is a repeat code. Modifier Code POS Override Effective From 2c tranbill.modifier Modifier Code entry optional. 2c tranbill.hcfapos Override Place of Service for charge Date tranbill.fromdate Effective From date entry optional. Select from the drop-down calendar. Effective To Date tranbill.thrudate Effective To date entry optional. Select from the drop-down calendar. Description 30c trancode.descript Non-enterable field. Transaction Code description displays. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 75

Code Tables Level 3 Transaction GL Codes Menu Tools > Manage Code Tables > Transaction > GL Codes Function Description The Transaction GL Codes window is used to maintain general ledger transaction information. This information is used to identify the Revenue, Expense, Bank, etc GL accounts to be assigned to specific transactions. Clinic 6c tranrate.campus Clinic entry optional. Must be a valid code. Select from the drop-down list. Defaults to 999999 (all codes). Patient Type 2n tranrate.ptype Patient Type entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). 76 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Lab 4c tranrate.lab Lab Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 9999 (all codes). Tran Type Tran Code Financial Class Business Unit 1c trangenl.trantype Transaction Type entry optional. Must be a valid code. Select from the dropdown list. 8c tranrate.trancode Transaction Code entry optional. Must be a valid code or 99999999 (all codes). Select from the drop-down list. 2n tranrate.fc Financial Class Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). 5c arglaccount.bunit Business Unit Code entry optional. Must be a valid code. Select from the drop-down list. Dept Number 20c arglaccount.deptn o Department Number Code entry optional. Must be a valid code. Select from the drop-down list. GL Account 20c arglaccount.glacct no General Ledger Account Number Code entry optional. Must be a valid code. Select from the drop-down list. Effective From Effective To Date trangenl.fromdate Effective From date entry optional. Select from the drop-down calendar. Date trangenl.thrudate Effective To date entry optional. Select from the drop-down calendar. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 77

Code Tables Level 3 Transaction Diagnosis Codes Menu Tools > Manage Code Tables > Transaction > Diagnoses Mapping Function Description The Transaction Diagnosis Mapping window is used to maintain transaction diagnosis information. This information is used to decide how to assign diagnosis on Patient Master/Case to individual charge transactions. It is used by the Assign Diagnosis to Transactions feature. Patient Type Financial Class 2n trandiag.ptype Patient Type Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). 2n trandiag.fc Financial Class Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). 78 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Insurance 4n, 6n trandiag.insno trandiag.inssub Primary Insurance Code and Sub-code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 9999-999999 (all codes). Bill code 9c trandiag.billcode Billing Code entry optional. Tran code 8c trandiag.trancode Transaction Code entry optional. Must be a valid code. Select from the drop-down list or enter 99999999 (all codes). Description 30c trancode.descript Non-enterable field. Transaction Code Description displays. Priority Code Position Code Diagnosis Code Effective From Effective To 1n trandiag.priority Priority Code entry required. 0 = Required 1 = Highest Priority 1c trandiag.position Position Code entry required. P = Primary S = Secondary X = Not applicable 9c trandiag.diag Diagnosis Code entry optional. Must be a valid code. Select from the drop-down list. Date trandiag.fromdate Effective From date entry optional. Select from the dropdown calendar. Date trandiag.thrudate Effective To date entry optional. Select from the drop-down calendar. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 79

Code Tables Level 3 Transaction Explode Codes Menu Tools > Manage Code Tables > Transaction > Explode Codes Function Description The Transaction Explode Codes window is used to maintain transaction explode information. Charges set-up to explode will explode at time of entry or interface. Company 2n explodemaster.company Company code entry required. Must be valid code. Select from the drop-down list. Defaults to current company. Enter 99 for all companies. Clinic 6c explodemaster.campus Clinic entry required. Must be a valid code. Select from the dropdown list. Defaults to 999999 (all codes). 80 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Patient Type Financial Class 2n explodemaster.ptype Patient Type Code entry required. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). 2n explodemaster.fc Financial Class Code entry required. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Payor Plan 4n, 6n explodemaster.insno explodemaster.inssub Payor Code and Sub-code entry required. Must be valid codes. Select from the drop-down list. Defaults to 9999 999999 (all codes). Tran Code 8c explodemaster.trancode Transaction Code entry required. Must be a valid code. Select from the drop-down list. Explode Rule 1c explodemaster.exploderule Explode Rule entry required. Must be a valid code. Select from the drop-down list. 1 New Code Rate = Create new charges using rate of new charge code. 2 Old Rate/Amounts = Create new charges prorating old charge amount across new charges based on the dollar amount of the new charge. 3 Old Rate/Quantities = Create new charges prorating old charge amount across new charges based on the quantity of the new charges created. Explosion Details Transaction Code 8c explodedetail.newtrancode Transaction Code entry required. Must be a valid code. Select from the drop-down list. New code to be created by the explosion. Quantity 3n explodedetail.quantity Quantity of new charge to be created. Will default to 1. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 81

Code Tables Level 3 Transaction Roll-up Codes Menu Tools > Manage Code Tables > Transaction > Roll-up Codes Function Description The Transaction Roll-up Codes window defines procedures to roll-up multiple transactions into one code for billing. Roll-up rules are triggered during Day End processing prior to billing of charges. Company 2n rollupmaster.compno Company Code required. Must be a valid code. Select from drop-down list. Will default to current company. Enter 99 for all companies. Rule ID 10c rollupmaster.ruleid Rule ID Required. Unique name used to identify the rule. Tran Code 8c rollupmaster.newtrancode Transaction Code required. Must be a valid code. Select from drop-down list. Resulting transaction code from the rollup. 82 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Rollup Rule 1c tranrollup.ruleno Roll-up Rule entry required. 1 = Old Codes Amount > New Code Amount 2 = All Codes Exist 3 = All COB Backout Type 1c tranrollup.backoutcd Back-out type entry required. 1 = J-Out 2 = Reverse Dollar Amount (not Quantity) 3 = Prorate by Dollar Amount 4 = Prorate by Quantity Roll-up Details Price List Code Rollup Quantity Tran Code Patient Type Financial Class 4c tranrollup.pricelist Price List Code entry optional. The price list code is used to group transaction codes with like classifications. 2n tranrollup.quantity Roll-up Quantity entry optional. 8c tranrollup.trancode Transaction Code entry optional. Must be a valid code. Select from the dropdown list. 2n tranrollup.ptype Patient Type entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). 2n tranrollup.fc Financial Class Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Payor 4n, 6n tranrollup.insno tranrollup.inssub Payor Code and Sub-Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 9999-999999 (all codes). Effective From Effective To Date tranrollup.fromdate Effective From date entry optional. Select from the drop-down calendar. Date tranrollup.thrudate Effective To date entry optional. Select from the drop-down calendar. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 83

Code Tables Level 3 Optional 1c tranrollup.optional Check box to indicate the roll-up rule detail is optional (charge does not need to exist to perform roll-up but will be included if rollup occurs). Priorities Financial Class 2n rolluppriority.fc Financial Class Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Payor 4n, 6n rolluppriority.insno rolluppriority.inssub Payor Code and Sub-Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 9999-999999 (all codes). Priority 2n rolluppriority.priority Priority number 1-99. Enter priority 0 to skip the roll-up entirely. 84 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Billing Rules Menu Tools > Manage Code Tables > Billing Rules Function Description The Billing Rules window is used to define the rules used for payor billing. Billing forms and prebilling edits can be selected. Patient Type 2n provider.ptype Patient Type Code entry required. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Financial Class 2n provider.fc Financial Class Code entry required. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 85

Code Tables Level 3 Payor 4n provider.insno Payor Code entry required. Must be a valid code. Select from the drop-down list. Defaults to 9999 (all codes). Plan 6n provider.inssub Plan Code entry required. Must be a valid code. Select from the drop-down list. Defaults to 999999 (all codes). Clinic Code 6c provider.campus Clinic Code entry required. Must be a valid code. Select from drop-down list. Defaults to 999999 (all codes). Federal Tax ID Provider Number Elec. Prov. Num Elec. Sub. Num 10c provider.fedid Federal Tax ID to be used when billing this rule. 15c provider.provno Provider Number entry optional. Provider number to be printed on the billing form. 15c provider.ecprovno Electronic Claims Provider Number entry optional. 10c provider.ecsubmitno Electric Claims Submit Number entry optional. Hold Days 3n provider.billholddays Hold Days entry optional. Enter the number of days to hold the bill. Billing Types 2c provider.billtype Billing Request Code entry optional. Must be a valid code. Select from the drop-down list. 2c provider.billtype2 Secondary Billing Request Code entry optional. Must be a valid code. Select from the drop-down list. Message Codes 2c provider.reqtype1 Message Code entry optional. Must be a valid code. Select from the drop-down list. 2c provider.reqtype2 Secondary Message Code entry optional. Must be a valid code. Select from the drop-down list. Pay Source 2c provider.paysrc Pay Source entry optional. 86 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 NPI 1c provider.npiflag NPI output to use in electronic billing. Entry is optional: N = Do not use NPI in EDI O = Send Only NPI in EDI Y = Send NPI (also sends other IDs) NOTE: with newest EDI version, O = Send only NPI should be used unless directed otherwise. Claim Break 1c provider.claimgrp Indicates when new claim should be generated for services being billed. Entry optional A = Create separate claim for each Accession D = Create separate claim for each Date of service Remittance Address Claim Filing Indicator Provider ID Qualifier Referring ID Qualifier Rendering ID Qualifier Signature Source Release Information Insurance Type 10c provider.lockbox Remittance Address / Lockbox Address to use on Electronic or Paper billing. Details set-up in Lock Box maintenance screen. Entry optional 2c provider.edipaytype Claim Filing Indicator entry optional. Select from the dropdown list. 2c provider.idqualifier Provider ID Qualifier optional. Select from the drop-down list. 2c provider.refidqual Referring Physician ID Qualifier optional. Select from the dropdown list. 2c provider.rendidqual Rendering Physician ID Qualifier optional. Select from the dropdown list. 1c provider.sigsource Signature Source entry optional. Select from the drop-down list. 1c provider.relinfocd Release of Information entry optional. Select from the dropdown list. 3c provider.instype Insurance Type entry optional. Select from the drop-down list. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 87

Code Tables Level 3 Billing Physician Type Billing Diagnosis Type Bill Edit Exceptions 10c provider.phystype Physician Type entry optional. Select from the drop-down list. 2c provider.codetype Diagnosis code type to use for billing (ICD-9, ICD-10). 20c provider.defexcept Billing Edit Exceptions entry optional. The account will still be billed if these deficiencies exist. Select from the drop-down list. Billing List 1c provider.billlist Billing list entry optional. Select to bill the list amount in the Transaction Code window. Show Detail View Accept Assignment 1c provider.billdetailsum Billing Detail View entry optional. Select to display billing detail information. 1c provider.assign Accept Assignment entry optional. Select to indicate acceptance of the assignment. Value prints in box 27 on the HCFA. EOB Detail 1c provider.eobdetail Explaination of Benefits Detail flag optional. Select to indicate EDI billing should include detail EOB information. Use Secondary Billing Codes Bill Primary Payor Only 1c provider.secbillcodeflag User Secondary Billing Codes flag optional. Select to cause EDI to look-up billing codes when billing as secondary payor. Leave blank to use primary billing codes when billing secondary. 1c provider.billprimaryonly Only use this billing rule when billing for a primary payor. Skip this rule when billing for secondary payor on a claim. Note: Billing code defaults to 99 when inserting a new row. 88 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 The Demographic Edits and Transaction Edits tabs are used to enter deficiencies for specific account and transaction billing edits. The daily processing and billing functions check for these deficiencies based on the items entered. When finished selecting deficiencies, press [Ctrl+S] to save the settings. Missing/Invalid SIN/SSN Missing Gender Information Missing Date of Birth Missing Employer Missing Group ID Number Missing Policy ID Number 2c provider.flgssno Deficiency assigned if SSNO blank or contains less than 9 numeric digits 2c provider.flgsex Deficiency assigned if gender/sex is blank 2c provider.flgdob Deficiency assigned if Date of Birth is blank 2c provider.flgemp Deficiency assigned if Employer name on insurance is blank. 1c provider.flggroup Deficiency assigned if Insurance Group ID is blank. 2c provider.flgpolid Deficiency assigned if insurance policy ID is blank. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 89

Code Tables Level 3 Invalid MediCare Policy ID Format Missing Patient Address MediCaid 3 Month Warning 33 Month COB Check Missing/Invalid Physician/NPI Missing/Invalid Clinic Missing/Invalid Diagnosis Criteria Missing Primary Effective Dates Missing/Invalid Patient Relationship Missing Onset of Illness Needs Deficiency 2c provider.flgpolidfmt Deficiency assigned if insurance FC = System Table MediCareFC and Policy ID length is less than 10 characters, character 10 is not Alpha, or first 9 characters are not numeric. 2c provider.flgpataddr Deficiency assigned if patient address is missing or contains blank address fields. 2c provider.flgmcaid3 Deficiency assigned if first date of dialysis or admit date is more than 2.5 months ago and deficiency has not been assigned before. 2c provider.cob33mnthc hk Deficiency assigned if first date of dialysis is more than 32.5 months ago and deficiency has not be assigned before 2c provider.flgphysupin Deficiency assigned if Account level attending physician is blank or does not have an NPI assigned. 2c provider.flgclinic Deficiency assigned if Account level clinic is blank or invalid. 2c provider.flgdiagcrit Deficiency assigned if no Account level diagnosis assigned. 2c provider.flgprimdate Deficiency assigned if Patient Insurance does not have effective date. 2c provider.flgpatrel Not implemented 2c provider.flgfdd Deficiency assigned if First Date of Dialysis is blank. 2c provider.flgdef Deficiency assigned if insurance has billable transactions for the patient. NOTE: On the Transaction Edits tab, enter the Physician UPIN Format as follows: A = alphanumeric; 9 = numeric; C = character only (i.e., A99999). 90 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Primary Payor Eligibility Period Secondary Payor Eligibility Period Invalid Billing Payor Missing Physician Sign-Off Missing/Invalid Referring Physician Clinic 2c provider.flgprimpay Deficiency assigned if no primary/client payor found for the service date of charge. 2c provider.flgsecpay Deficiency assigned if patient does not have Secondary payor for charge service date. 2c provider.flgvalidpay Deficiency assigned if no valid payor for service date. 2c provider.physsignoffflg Deficiency assigned if charge does not have Physician Sign off and Physician Requires Sign off 2c provider.flgrphysclnc Deficiency assigned if Referring Physician is not assigned to clinic assigned to charge. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 91

Code Tables Level 3 Missing/Invalid Referring Physician Code/NPI Missing/Invalid Test/Transaction Code 2c provider.flgrphysupin Deficiency assigned if charge referring physician blank or physician does not have an NPI. 2c provider.flgtrancode Deficiency assigned if transaction code on charge is invalid. Missing Bill Code 1c provider.billcodeflg Deficiency assigned if bill code field on charge is blank. Missing/Invalid Clinic Clinic not Covered by Contract Invalid Frequency Check Missing Diagnosis Code Missing Pre- Authorization Transaction Date Greater Than Today 2c provider.flgclinic Not used 2c provider.flgnotcontracted Deficiency assigned if insurance has contract, but contract not effective for clinic on charge during service date. 2c provider.flgfreq Deficiency assigned if transaction breaks frequency rule (some of transactions w/in defined frequency for transaction code greater than allowed) 2c provider.flgdiag Deficiency assigned if transaction has no diagnosis or invalid diagnosis 2c provider.flgpreauth Deficiency added if payor does not have authorization assigned for service date. 2c provider.flgtdate Deficiency assigned if service date of charge is greater than current date. 92 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 CCI Edits 2c provider.ccieditflg Value required to perform CCI edits. Deficiency assigned if transaction fails CCI edits and action indicates to assign deficiency. Physician NPI format 1 & 2 20c 20c provider.upinfmt1 provider.upinfmt2 Not currently used Medical Necessity Fields Medical Necessity 2c provider.mednecflg Value required to perform Medical Necessity edits. Deficiency assigned if transaction fails medical necessity and action indicates to assign deficiency. Fiscal Intermediary 5c provider.mednec_fiscalim Fiscal InterRCMy rules to use when performing Medical Necessity edits. ABN Action 1c provider.mednecaction_abn Action to perform if transaction fails Medical Necessity edit and ABN flag is checked. ABN Modifier 2c provider.mednecmod_abn Modifier to add if transaction fails Medical Necessity edit, has ABN flag checked and action indicates to add modifier. No ABN Action 1c provider.mednecaction_noabn Action to perform if transaction fails Medical Necessity edit and ABN flag is not checked. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 93

Code Tables Level 3 No ABN Modifier 2c provider.mednecmod_noabn Modifier to add if transaction fails Medical Necessity edit, ABN flag is not checked and action indicates to add modifier. The HCFA Fields tab is used to define values for various fields and boxes on HCFA 1500 printed claim form. When finished values, press [Ctrl+S] to save the settings. Policy ID 3c provider.policybox Identifies which box on HCFA form to print policy id. Either box 1A or 9A may be selected. Place of Service 2c provider.hcfapos Value to print in box 24b Place of service field on HCFA form. 94 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Outside Lab POS Type of Service 2c provider.outsidelab_hcfapos Value to print in box 24b Place of service field on HCFA form when lab claim is printing for is outside lab. 2c provider.tos Can be used to define Type of Service. No longer printed on HCFA form. HCFA Box 1 Following fields define which check box is populated in Box 1 of HCFA form. Medicare 1c provider.medicare Populate with X if rule is printing claim for Medicare Medicaid 1c provider.medicaid Populate with X if rule is printing claim for Medicaid Champus 1c provider.champus Populate with X if rule is printing claim for Champus Champva 1c provider.champva Populate with X if rule is printing claim for Champva Group Health Plan FECA Black Lung 1c provider.grphlthplan Populate with X if rule is printing claim for Group Health Plan 1c provider.fecablklung Populate with X if rule is printing claim for FECA or Blank Lung Other 1c provider.otherpayor Populate with X if rule is printing claim for Other type of payor Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 95

Code Tables Level 3 Provider/Defaults Each of the following fields can be populated with a specific value to place in the indicated box on the HCFA Claim form, or own of the following variables can be used to dynamically grab value from other location: NULL = leave box blank @AUTHNO = Payor Authorization Number @AUTHDATE = Payor Authorization Date @UPIN = Provider UPIN @PHYSID = Physician ID from Physician ID table @SSN = Provider SSN @EINO = Provider EIN @NPID = Provider NPI @NAME = Physician Name @CLIA = Lab CLIA# Box 17A 15c provider.box17a See above Box 19 15c provider.box19 See above Box 23 15c provider.box23 See above Box 24H 15c provider.box24h See above Box 24I 15c provider.box24i See above Box 24Ja 15c provider.box24k See above Box 24Jb 15c provider.box24kb See above Box 31 20c provider.box31 See above Box 32L 15c provider.box32a See above Box 32R 15c provider.box32 See above Box 33L 15c provider.box33l See above Box 33R 15c provider.box33r See above 96 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 3 Lab Codes Menu Tools > Manage Code Tables > Lab Codes Function Description The Lab Codes window is used to maintain lab-specific information. Lab Code 4c lab.lab Lab Code entry required. Outside Lab 1c lab.outsidelab Outside Lab entry optional. Select to indicate that this is an outside lab. Description 40c lab.descript Lab Description entry optional. Address 30c lab.addr1 Address line 1 entry optional. Address 30c lab.addr2 Address line 2 entry optional. City 20c lab.city City entry optional. State/Prov. 2c lab.state State/Province entry optional. Must be a valid code. Select from the dropdown list. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 97

Code Tables Level 3 Zip 10c lab.zip Zip Code entry required. Must be a valid zip code. Select from the dropdown list. Country 4c lab.country Country entry optional. Must be a valid code. Select from the drop-down list. Area 3n lab.area Area code entry optional. Telephone 7n lab.phone Phone number entry optional. Extension 20c lab.extension Phone extension entry optional. CLIA Number 15c lab.cliano CLIA Number entry optional. This number is used for HCFA 1500 billing. NPI 10c lab.npid NPI Assigned to the lab EIN 10c lab.eino EIN Assigned to the lab Note 40c lab.note Note entry optional. 98 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 4 Level 4 Standard Note Menu Tools > Manage Code Tables > Standard Note Function Description The Standard Note window is used to maintain standard note code information. Code 2c stdnote.notecode Note Code entry required. Description 60c stdnote.note Note Description entry required. InforUS Lab Table Reference GuideHealthcare Revenue Cycle Management 3.4 US Lab Table Code Guide 99

Code Tables Level 4 Note Identification Menu Tools > Manage Code Tables > Note Identification Function Description The Note Identification window is used to maintain note ID code information. Code 2c noteid.noteid Note ID Code entry required. Description 30c noteid.descript Note ID Description entry required. 100 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 4 Letter Codes Menu Tools > Manage Code Tables > Collection Cycle > Letter Codes Function Description The Letter Codes window is used to maintain letter and message codes. Letter and statement text, including bulleted text items, can be formatted to print on letters or statements. Code 2c letter.letterno Letter Code entry required. Description 30c letter.descript Letter Description entry optional. Text 4000c letter.text Letter Text entry optional. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 101

Code Tables Level 4 Manage Work Queues Menu Tools > Manage Code Tables > Manage Work Queues Function Description The Manage Work Queues window is used to maintain assignment of accounts to account representative s work queues. Review Type 2c repassign.revtype Review Type entry required. Must be a valid code. Select from the drop-down list. A = Account Review C = Collection Review N = Note Review 102 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 4 Clinic 6c repassign.campus Clinic Code entry required. Must be a valid code. Select from the drop-down list. Defaults to 999999 (all codes). Patient Type 2n repassign.ptype Patient Type Code entry required. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Financial Class 2n repassign.fc Primary Financial Class Code entry required. Must be a valid code. Select from the dropdown list. Defaults to 99 (all codes). Payor 4n repassign.insno Primary Payor Code entry required. Must be a valid code. Select from the drop-down list. Defaults to 9999 (all codes). Plan 6n repassign.inssub Primary Plan Code required. Must be a valid code. Select from the drop-down list. Defaults to 999999 (all codes). Clinic Country 2c repassign. campuscountry Clinic State 2c repassign. campusstate Clinic Country entry required. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Clinic State entry required. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Range From 3c repassign.fromrange Range From entry optional. Range To 3c repassign.thrurange Range To entry optional. Age 3n repassign.age Account Age entry optional. Deficiency 2c repassign.deficiency Deficiency entry optional. Must be a valid code. Select from the drop-down list. Representative 3c repassign.repno Account Representative entry required. Must be a valid code. Select from the drop-down list. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 103

Code Tables Level 4 40c acctrep.name Non-enterable field. Account representative s name displays. 104 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 4 Denial Maintenance Menu Tools > Manage Code Tables > Denial Maintenance Function Description The Denial Codes window is used to maintain denial codes and associated information. Note Codes, Letter Codes and Credit Status can be assigned to specific denials. Denial Resolution Codes Maintenance Screen: Denial Resolution codes are used to resolve denials. They may have automated actions associated with them which are triggered when the resolution is saved. The Resolution code NEW defines what actions to take when a new Denial is added. Denial Code 4c denial.denial Denial Code entry required. Description 70c denial.descript Denial Code Description entry optional. Abbreviation 15c denial.abbreviation Denial Abbreviation Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 105

Code Tables Level 4 Review Type HIPAA Code 2c denial.revtype Work Queue assignment review type 10c denial.hipaadenialcd Denial code to be used for secondary billing EOB information Discontinue Date denial.thrudate Denial code deactivation date Payor Denial Code Cross Reference Payor 4n denialxref.insno Denial Payor Code Plan 6n denialxref.inssub Denial Plan Code Denial Code 10c denialxref.denxref Payor specific Denial Code 106 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 Level 5 Load Layout The Load Layout table is used to set-up load layout codes and descriptions to identify layouts that can be used in the Batch Charge Load module. See User Guide section on Loading a Charge File to set-up details for the load layout. Layout C8 LOADLAYOUT.LAYOUT Load Layout code Description C30 LOADLAYOUT.DESCRIPT Server Directory C256 LOADLAYOUT.DIRECTORY List description for Load layout Oracle working directory location Data File C64 LOADLAYOUT.LOCATION Default data file name InforUS Lab Table Reference GuideHealthcare Revenue Cycle Management 3.4 US Lab Table Code Guide 107

Code Tables Level 5 Recurring Status This table is used to identify Recurring Payment/Charge types. This table will be prepopulated with all possible Recurring Status types. New recurring status types should not be added to this table except under direction of Infor. Recurring Status C2 TRANSTATUS.STATUS Recurring Status code Description C30 TRANSTATUS.DESCRIPT GL Lookup C1 TRANSTATUS.GLLOOKUP List description for recurring status Flag can be checked to indicate if non-variable recurring status codes should perform GL look-up when creating new transactions rather than using GL fields from existing transaction. 108 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 Client Logo This table is used to indicate logos that can be used in receipts, invoices, statements and other semi-custom billing forms. Company N2 CLIENTLOGO.COMPNO Campus C6 CLIENTLOGO.CAMPUS Used to identify the company logo should be used for. Used to identify campus logo should be used for or 999999 if logo should be used for all campuses. Load image button Pressing button will open windows dialog for locating logo image file. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 109

Code Tables Level 5 Clear image button Pressing button will remove previously loaded logo. Logo image CLIENTLOGO.LOGO Will display logo image. Interest Rate This table can be used to set-up rules for applying interest to claims with outstanding balances. Interest will be applied to claims with outstanding balances that match identified rules in End of Day INTEREST procedure. Financial Class N2 INTRATE.FC Financial Class rule applies to or 99 if rule applies to all Financial Classes. 110 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 Payor N4 INTRATE.INSNO Plan N6 INTRATE.INSSUB Interest Rate N6,3 INTRATE.INTRATE Transaction Type Transaction Code C1 C8 INTRATE.TRANTYPE INTRATE.TRANCODE Delay Days N4 INTRATE.MINDAYSOLD Minimum Interest N13,2 INTRATE.INTMIN Payor that the rule applies to or 9999 if rule applies to all payors. Payor Plan that the rule applies to or 999999 if rule applies to all plans within identified payor. Annual Rate of interest to be applied on outstanding claim balance. Transaction Type to be used for applying interest. Transaction Code to be used for applying interest. Interest will not be applied until claim is at least as old as Delay Days identified for the rule. Minimum amount of interest that would be applied to a claim. Interest will not be applied if it does not exceed this amount. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 111

Code Tables Level 5 Small Balance Write-Off Menu Tools > Manage Code Tables > Small Balance Write-Off Function Description The Small Balance Write-Off window is used to maintain small balance write-off parameters. Patient Type Financial Class 2n smallbal.ptype Patient Type Code entry required. Must be a valid code. Select from the drop-down list. 2n smallbal.fc Current Payor Financial Class Code entry required. Must be a valid code. Select from the drop-down list. Payor 4n smallbal.insno Payor Code entry required. Must be a valid code. Select from the drop-down list. 112 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 Plan 6n smallbal.inssub Payor Plan code entry required. Must be a valid code. Select from the dropdown list. Balance From Balance Thru Delay Days Trans Type Trans Code 13,2n smallbal.frombal From Balance entry required. 13,2n smallbal.thrubal Thru Balance entry required. 3n smallbal.delaydays Claim Delay Days entry required. Enter the number of days before the claim can be written off. 1c smallbal.trantype Write Off Transaction Type entry optional. Must be a valid code. Select from the drop-down list. 8c smallbal.trancode Write Off Transaction Code entry optional. Must be a valid code. Select from the drop-down list. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 113

Code Tables Level 5 Patient Cycling Parameters Menu Tools > Manage Code Tables > Collection Cycle > Patient Cycling Parameters Function Description The Patient Cycling Parameters window is used to maintain patient claim cycling information. Account Type 1c crmedrec.sundry Account Type entry required. P = Patient S = Sundry Claim Age 5n crmedrec.claimage Claim Age entry required. Statement Days Review Days 5n crmedrec.days Statement Days entry required. Enter the number of days of the billing cycle for this group. 5n crmedrec.nextrev Review Days entry optional. Enter the number of days until next review. 114 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 Stmt/Letter Code Message Code Rep. Assignment 2c crmedrec.billtype Statement/Letter Code entry optional. Must be a valid code. Select from the drop-down list. 2c crmedrec.letterno Message Code entry optional. Must be a valid code. Select from the dropdown list. 1c crmedrec.repflag Rep Assignment Flag entry optional. Enter Y if the account needs to go through rep assignment. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 115

Code Tables Level 5 Credit Cycle Parameters Menu Tools > Manage Code Tables > Collection Cycle > Credit Cycle Parameters Function Description The Credit Cycle Parameters window is used to maintain credit cycling information. When cycling a claim, the claim s current credit status is matched to the credit status of the parameter group selected. If the claim has been at that status longer than the number of days indicated in the Cycle Days field, the status is changed to one of those in the Next Credit Status fields. The status to be used depends on the amount of payment received at the current credit status. If no payment is received, the new status is the entry in the No Payment field. If payment is less than the minimum required, the new status is the entry in the Minimum Payment field. If payment is greater than or equal to the minimum required, the new status is the entry in the Payment field. If the payment is over the payment amount, the new status is the entry in the Overpayment field. After changing the status of the claim, a letter or billing form can be queued, based on the entry in the Statement/Letter Code field, which includes the letter or bulleted text indicated by the entry in the Message Code field. If Review Days is entered, a review note is generated, and then reviewed after the number of days entered has passed. 116 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 The fields in the Next Credit Status are used to indicate the next credit status to move to, based on the type of payment received. Each entry must match a Credit Status line. Group 3n crparam.groupid Group Code entry required. Credit Status 4c crparam.crstat Credit Status Code entry required. Statement/ Letter Code Message Code 2c crparam.slflag Statement or Letter Indicator entry optional. Must be a valid code. Select from the drop-down list. 2c crparam.msgcode Message Code to be printed on letter or statement. Must be a valid code. Select from the drop-down list. Review Days 3n crparam.nxtrev Review Days entry optional. Enter the number of days until next account review. Cycle Days 3n crparam.nxtcyc Cycle Days entry optional. Enter the number of days in the credit cycle. Next Credit Status No Payment 4c crparam.nxtcrnp Entry optional. Enter credit status to change to, if no payment is received. Minimum Payment 4c crparam.nxtcrmp Entry optional. Enter credit status to change to, if minimum payment is received. Payment 4c crparam.nxtcrpy Entry optional. Enter credit status to change to, if payment is received. Overpayment 2c crparam.nxtcrop Entry optional. Enter credit status to change to, if an overpayment is received. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 117

Code Tables Level 5 Credit Cycle Master Menu Tools > Manage Code Tables > Collection Cycle > Credit Cycle Master Function Description The Credit Cycle window is used to maintain the credit cycle master information. Patient Type 2n crmast.ptype Patient Type code entry required. Must be a valid code. Select from the dropdown list. Defaults to 99 (all codes). Financial Class 2n crmast.fc Financial Class code entry required. Must be a valid code. Select from the drop-down list. Defaults to 99 (all financial classes). 118 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 Payor 4n crmast.insno Payor code entry required. Must be a valid code. Select from the drop-down list. Defaults 9999 (all payors). Plan 6n crmast.inssub Plan code entry required. Must be a valid code. Select from the drop-down list. Defaults 999999 (all plans). Payment Terms Secondary Start Minimum Payment Amount Minimum Payment Percentage 1c crmast.contpmt Enter Y to indicate the payment terms set up for the patient account are used to determine whether minimum payment has been received. 2c crmast.crstat2 Entry optional. Credit Status to start at after payment cycling. 9n crmast.pamount Minimum Payment Amount entry optional. Enter the minimum payment amount value (whole dollars). 3n crmast.ppercent Minimum Acceptable Payment Percentage entry optional. Enter the minimum payment percentage value. Cycle Group 3n crmast.groupid Cycle Group Code entry required. Used to link cycle parameters to cycle masters. Write-off Tran Type Write-off Tran Code Reassign Representative 1c crmast.trantype Write-Off Transaction Type Code entry optional. Must be a valid code. Select from the drop-down list. 8c crmast.trancode Write-Off Transaction Code entry optional. Must be a valid code. Select from the drop-down list. 1c crmast.rflag Enter Y to re-assign the account representative if the financial class changes. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 119

Code Tables Level 5 Adjustment Reasons Menu Tools > Manage Code Tables > Adjustment Reasons Function Description The Adjustment Reason Codes window is used to maintain codes used in the Remittance Advice Rules window for adjustment processing. Adjustment 5c adjreason.adjcd Adjustment Code entry required. Code Code Type 1c adjreason.cdtype Code Type entry required. Select from the drop-down list. Description 200c adjreason.descript Description entry optional. 120 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 Claim Status Codes Menu Tools > Manage Code Tables > Claim Status Codes Function Description The Claim Status Codes window is used to maintain category, code, and entity information for the 277 Claim Status Response. The Claim Status Process Rules window is used to set up the rules for these codes. Status Element Status Code 1n claimstatus.position Status Element entry required. Select from the drop-down list. 3c claimstatus.statuscd Status Code entry required. Description 80c claimstatus.descript Status Code Description entry optional. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 121

Code Tables Level 5 EDI Parameters Menu Tools > Manage Code Tables > EDI Parameters Function Description The EDI Parameters window is used to maintain default values and parameters for EDI File Processing. Type 5c ediparam.transet EDI File Type entry required. Description 30c ediparam.descript EDI File Description entry optional. File Direction Server Path 1c ediparam.inorout File Direction entry optional. Select from the drop-down list. 100c ediparam.srvrpath Server Path entry optional. The path entered must point to a location with read/write permissions enabled. 122 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 Client Path 100c ediparam.clntpath Client Path entry optional. The path entered must point to a location that the user has access to. File Name 100c ediparam.filename File Name entry optional. Enter a default filename for the EDI process run. Report Name 100c ediparam.rptname Report Name entry optional. Enter a default report name for the EDI process run. Procedure 100c ediparam.ediproc Procedure entry optional. Enter an EDI database procedure to be executed. Parameters 200c ediparam.paramlist Parameters entry optional. Enter a List of parameters to be passed to the EDI procedure. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 123

Code Tables Level 5 Remittance Advice Rules Menu Tools > Manage Code Tables > Remittance Advice Rules Function Description The Remittance Advice Rules window is used to define the rules for 835 remittance processing. Financial Class 2n rarules.fc Financial Class code entry required. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Payor 4n rarules.insno Payor code entry required. Must be a valid code. Select from the dropdown list. Defaults to 9999 (all codes). 124 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 Plan 6n rarules.inssub Plan code entry required. Must be a valid code. Select from the dropdown list. Defaults to 999999 (all codes). Group Code 2c rarules.grpcd Claim Adjustment Group Code entry optional. Adjustment Codes 5c rarules.adjcd1- adjcd3 Adjustment Code or Remark Message Code entry optional. Must be a valid code. Select from the drop-down lists. Defaults to 99999 (all codes). Rule Description Transaction Type 30c rarules.descript Rule Description entry optional. 1c rarules.trantype Transaction Type entry required if the Post Amount field is selected. If the transaction type and transaction code are not entered, an account note is generated by the system at the time of remit. Tran Code 10c rarules.trancode Transaction Code entry required if the Post Amount field is selected. If the transaction type and transaction code are not entered, an account note is generated by the system at the time of remit. Post Amount 1c rarules.postamt Select to post the specified amount. If not selected, amount of 0 is posted. Review Note 1c rarules.insnote Select to insert a note for the reviewing account representative. Payment Cycle 1c rarules.cycle Select to cycle the payment, or leave it blank to delay the payment cycle. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 125

Code Tables Level 5 History Purge Rules Menu Tools > Manage Code Tables > History Purge Rules Function Description The History Purge Rules window is used to maintain the purge rules for account histories. Patient Type 2n historypurge.ptype Patient Type Code entry optional. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). Financial Class 2n historypurge.fc Financial Class Code entry required. Must be a valid code. Select from the drop-down list. Defaults to 99 (all codes). 126 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 Purge Type 1c historypurge.purgetype Purge Type entry required. A = Account C = Claim T = Transactions Close Days History Days 5n historypurge.closedays Close Days entry optional. Enter close account days. 5n historypurge.histdays History Days entry optional. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 127

Code Tables Level 5 Document Codes Menu Tools > Manage Code Tables > Document Codes Function Description The Document Codes window is used to maintain document code information. Code 4c document.doccode Document Code entry required. Description 30c document.descript Document Code Description entry optional. Required 1c document.reqd Enter Y to indicate another document is required on the account in order to provide service. Authorization 1c document.authflag Enter Y to indicate the document is an authorization. 128 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 User Defined Field Menu Tools > Manage Code Tables > User Defined Field Function Description The User Defined Field window is used to maintain user defined fields for entering miscellaneous information. Code 2n infodef.fieldno Code entry required. Use values 1 20. Description 20c infodef.title Description entry required. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 129

Code Tables Level 5 OBX Fields Menu Tools > Manage Code Tables > OBX Fields Function Description The OBX Fields window is used to maintain fields for the HL7 interface. Field Name Field Code 30c obxfield.fieldname Non-enterable field. Displays fields that support valuing from OBX segments in the HL7 program. 30c obxfield.fieldcode OBX Field Code entry required. Indicates OBX segment field title to be copied into corresponding field. 130 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 Claim Filing Indicator Menu Tools > Manage Code Tables > Claim Filing Indicator Function Description The Claim Filing Indicator window is used to maintain claim filing indicator code information. Code 10c claimfilingindicator.claimfilingindicator Claim Filing Indicator Code entry required. Description 40c claimfilingindicator.description Claim Filing Indicator Description entry required. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 131

Code Tables Level 5 Country Codes Menu Tools > Manage Code Tables > Country Codes Tools > Manage Code Tables > State Codes > New Country button Function Description The Country Codes window is used to maintain country code information. It can also be launched by clicking the New Country button in the State Codes code table. Code 5c country.countrycode Country Code entry required. Description 30c country.description Country Code Description entry required. 132 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 Insurance Category Type Menu Tools > Manage Code Tables > Insurance Category Type Function Description The Insurance Category Type window is used to maintain insurance category type information. Code 10c insurancecategorytype.insurancecat egorytype Insurance Category Type Code entry required. Description 40c insurancecategorytype.description Insurance Category Type Description entry required. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 133

Code Tables Level 5 Physician Type Menu Tools > Manage Code Tables > Physician Type Function Description The Physician Type window is used to maintain physician type code information. Code 30c physiciantype. physiciantypecode Physician Types Code entry required. Add a new physician type or select an existing record for deletion. 134 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 Provider ID Qualifier Menu Tools > Manage Code Tables > Provider ID Qualifier Function Description The Provider ID Qualifier window is used to maintain provider identification qualifier information. Code 10c provideridqualifier. provideridqualifier Description 40c provideridqualifier. description Provider ID Qualifier Code entry required. Provider ID Qualifier Description entry required. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 135

Code Tables Level 5 Release Information Menu Tools > Manage Code Tables > Release Information Function Description The Release Information window is used to maintain release information codes. Code 10c releaseinformationcode. releaseinformationcode Description 40c releaseinformationcode. description Release Information Code entry required. Release Information Description entry required. 136 Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide

Code Tables Level 5 Signature Source Menu Tools > Manage Code Tables > Signature Source Function Description The Signature Source window is used to maintain signature source code information. Code 10c signaturesource. signaturesource Description 40c signaturesource. description Signature Source Code entry required. Signature Source Description entry required. Infor Healthcare Revenue Cycle Management 3.4 US Lab Code Table Guide 137

Appendix A ERD Diagram InforUS Lab Table Reference GuideHealthcare Revenue Cycle Management 3.4 US Lab Table Code Guide 139