IVMZ7CCD ;BAJ - HL7 Z07 CONSISTENCY CHECKER -- CATASTROPHIC DISABILITY SUBROUTINE ; 11/9/05 9:30am ;;2.0;INCOME VERIFICATION MATCH;**105**;JUL 8,1996;Build 2 ; ; Catastrophic Disability Consistency Checks ; This routine checks the various elements of catastrophic disability information ; prior to building a Z07 record. Any tests which fail consistency check will be ; saved to the ^DGIN(38.6 record for the patient. ; ; ; Must be called from entry point Q ; EN(DFN) ; entry point. Patient DFN is sent from calling routine. ; initialize working variables N RULE,Y,DGCDIS,PASS,FILERR ; patient array DGCDIS can be populated by a call to $$GET^DGENCDA(DFN,.DGCDIS) as follows: ; ; S PASS=$$GET^DGENCDA(DFN,.DGCDIS) ; ; and creates an array similar to this: ; DGCDIS("BY")="DR. JOHN" ; DGCDIS("COND",1)="48" ; DGCDIS("DATE")="3050926" ; DGCDIS("DIAG",1)="8" ; DGCDIS("DTFACIRV")="" ; DGCDIS("DTVETNOT")="" ; DGCDIS("FACDET")="16660" ; DGCDIS("METDET")="3" ; DGCDIS("PERM",1)="1" ; DGCDIS("REVDTE")="3050926" ; DGCDIS("SCORE",1)="6" ; DGCDIS("VCD")="Y" ; DGCDIS("VETREQDT")="" ; ; if the patient has no CD data on file, the API will return the following: ; DGCDIS="" ; DGCDIS("BY")="" ; DGCDIS("DATE")="" ; DGCDIS("DTFACIRV")="" ; DGCDIS("DTVETNOT")="" ; DGCDIS("FACDET")="" ; DGCDIS("METDET")="" ; DGCDIS("REVDTE")="" ; DGCDIS("VCD")="" ; DGCDIS("VETREQDT")="" ; S PASS=$$GET^DGENCDA(DFN,.DGCDIS) ; ; In cases where patient is not listed as catastrophically disabled, routine should check to see if patient could potentially ; qualify for CD. If patient qualifies and is not listed as CD, an inconsistency should be filed. Otherwise continue. ; If patient is not listed as CD, regardless of potential, further checks are not necessary as the rest depend on CD="YES" ; I '$$CD(DGCDIS("VCD")="Y") D Q . I $D(FILERR) D FILE ; ; loop through rules in INCONSISTENT DATA ELEMENTS file. ; execute only the rules where CHECK/DON'T CHECK and INCLUDE IN Z07 CHECKS fields are turned ON. ; ; ***NOTE loop boundary (701-726) must be changed if rule numbers are added *** F RULE=701:1:726 I $D(^DGIN(38.6,RULE)) D . S Y=^DGIN(38.6,RULE,0) . I '$P(Y,"^",5),$P(Y,"^",6) D @RULE I $D(FILERR) D FILE Q ; CD(VCD) ; Is Patient Catastrophically disabled? If not, we need to examine patient's record to see if qualified for CD ; Whether qualified or not, if patient is listed as NOT CD, the rest of the rules should not be checked. Therefore, ; if DGCDIS("VCD") does not = "Y" system will exit after this rule without checking any further. I VCD Q 1 I $$ISCD^DGENCDA1(.DGCDIS) S FILERR(720)="" Q 0 ; 701 ;Catastrophic Disability 'Decided By' Cannot be 'HINQ' I $G(DGCDIS("BY"))="HINQ" S FILERR(RULE)="" Q ; 702 ;Catastrophic Disability 'Decided By' not valid I ($L(DGCDIS("BY"))<3)!($L(DGCDIS("BY"))>35) S FILERR(RULE)="" Q 703 ;"Catastrophic Disability 'Decided By' required" I $G(DGCDIS("BY"))="" S FILERR(RULE)="" Q ; 704 ;"Catastrophic Disability Review Date Required" I $G(DGCDIS("REVDTE"))="" S FILERR(RULE)="" Q ; 705 ;"Catastrophic Disability Review Date Invalid" N RESULT D CHK^DIE(2,.394,,DGCDIS("REVDTE"),.RESULT) I RESULT="^" S FILERR(RULE)="" Q ; 706 ;"CD Condition Score not valid" N ITEM,ERR S ITEM="",ERR=0 F S ITEM=$O(DGCDIS("COND",ITEM)) Q:ITEM="" D . I '$$VALID^DGENA5(DGCDIS("COND",ITEM),$G(DGCDIS("SCORE",ITEM))) S ERR=1 I ERR S FILERR(RULE)="" Q ; 707 ;"CD Review Date greater than CD Date of Determination" I $G(DGCDIS("REVDTE"))>$G(DGCDIS("DATE")) S FILERR(RULE)="" Q ; 708 ;"CD Status Affected Extremity' Invalid" N ITEM,EIEN,ERR S ITEM="",ERR=0 F S ITEM=$O(DGCDIS("PROC",ITEM)) Q:ITEM="" D . S EIEN="" F S EIEN=$O(DGCDIS("EXT",ITEM,EIEN)) Q:EIEN="" D . . I '$$LIMBOK^DGENA5(DGCDIS("PROC",ITEM),DGCDIS("EXT",ITEM,EIEN)) S ERR=1 I ERR S FILERR(RULE)="" Q ; 709 ;"CD Status Diagnoses' Not Valid" ; .396 CD STATUS DIAGNOSES field (multiple): N ITEM,ERR S ITEM="",ERR=0 F S ITEM=$O(DGCDIS("DIAG",ITEM)) Q:ITEM="" D . I $$TYPE^DGENA5(DGCDIS("DIAG",ITEM))'="D" S ERR=1 I ERR S FILERR(RULE)="" Q ; 710 ;"'CD Status Procedure' Not Valid" ; .397 CD STATUS PROCEDURES field (multiple): N ITEM,ERR S ITEM="",ERR=0 F S ITEM=$O(DGCDIS("PROC",ITEM)) Q:ITEM="" D . I $$TYPE^DGENA5(DGCDIS("PROC",ITEM))'="P" S ERR=1 I ERR S FILERR(RULE)="" Q ; 711 ;"'CD Status Reason' Not Present" I '($D(DGCDIS("DIAG"))!$D(DGCDIS("PROC"))!$D(DGCDIS("COND"))) S FILERR(RULE)="" Q ; 712 ;"'Date Of Catastophic Disability Decision' Not Valid" N RESULT,OK,EXTERNAL S OK=0 I $G(DGCDIS("DATE"))'="" S OK=1 D . S EXTERNAL=$$EXTERNAL^DILFD(2,.392,"",DGCDIS("DATE")) . I EXTERNAL="" S OK=0 Q . D CHK^DIE(2,.392,,EXTERNAL,.RESULT) I RESULT="^" S OK=0 I 'OK S FILERR(RULE)="" Q ; 713 ;"'Date Of Catastophic Disability Decision' Required" I $G(DGCDIS("DATE"))="" S FILERR(RULE)="" Q ; 714 ;"'Facility Making Catastrophic Disability Determination' Not Valid" I DGCDIS("VCD")'=""!(DGCDIS("FACDET")'=""),$$EXTERNAL^DILFD(2,.393,"",$G(DGCDIS("FACDET")))="" S FILERR(RULE)="" Q ; 715 ;"'Method Of Determination' Is A Required Value" I $G(DGCDIS("METDET"))="" S FILERR(RULE)="" Q ; 716 ;"'Method Of Determination' Not Valid" I ".2.3."'[("."_$G(DGCDIS("METDET"))_".") S FILERR(RULE)="" Q ; 717 ;"Not Enough Diagnoses/Procedures/Conditions To Qualify For CD Status" I '$$ISCD^DGENCDA1(.DGCDIS) S FILERR(RULE)="" Q ; 718 ;"Permanent Status Indicator' Not Valid" N ITEM S ITEM="" F S ITEM=$O(DGCDIS("COND",ITEM)) Q:ITEM="" D . I ".1.2.3."'[("."_DGCDIS("PERM",ITEM)_".") S FILERR(RULE)="" Q ; 719 ;"'Veteran Catastrophically Disabled?' Field Must Have A Response" ; .39 VETERAN CATASTROPHICALLY DISABLED? field. I DGCDIS("VCD")="" S FILERR(RULE)="" Q ; 720 ;"Veteran Has Enough Diagnoses/Procedures/Conditions To Qualify For CD Status" ; We check this rule at the beginning of the routine. No need to check it here, ; but we need the label as a place holder. Q ; 723 ;"Catastrophic Disability Review date must be a precise date" N RESULT D CHK^DIE(2,.394,,DGCDIS("REVDTE"),.RESULT) I RESULT="^" S FILERR(RULE)="" Q ; 724 ;"Catastrophic Disability Date of Decision must be a precise date" N RESULT D CHK^DIE(2,.392,,DGCDIS("DATE"),.RESULT) I RESULT="^" S FILERR(RULE)="" Q ; 725 ;"Catastrophic Disability Procedure code must be accompanied with an Affected Extremity field" ; Procedure list = DGCDIS("PROC",ITEM) ; Affected Extremity list = DGCDIS("EXT",ITEM) ; This tag makes sure that there is at least one Affected Extremity for each procedure code. N ITEM,ERR S ERR=0,ITEM="" F S ITEM=$O(DGCDIS("PROC",ITEM)) Q:ITEM="" D . I '$D(DGCDIS("EXT",ITEM)) S ERR=1 Q . I $G(DGCDIS("EXT",ITEM))="" S ERR=1 I ERR S FILERR(RULE)="" Q ; 726 ;"Catastrophic Disablity condition code requires a Score field" ; Condition list = DGCDIS("COND",ITEM) ; Score list = DGCDIS("SCORE",ITEM) N ITEM,ERR S ERR=0,ITEM="" F S ITEM=$O(DGCDIS("COND",ITEM)) Q:ITEM="" D . I '$D(DGCDIS("SCORE",ITEM)) S ERR=1 Q . I $G(DGCDIS("SCORE",ITEM))="" S ERR=1 I ERR S FILERR(RULE)="" Q ; FILE ;file the inconsistencies in a temp global M ^TMP($J,DFN)=FILERR Q ;