IBCBB21 ;ALB/AAS - CONTINUATION OF EDIT CHECK ROUTINE FOR UB-04 ;2-NOV-89 ;;2.0;INTEGRATED BILLING;**51,137,210,232,155,291,348,349**;21-MAR-94;Build 46 ;;Per VHA Directive 2004-038, this routine should not be modified. ; EN(IBZPRC92) ; ; N ECODE,IBTXMT,IBXDATA,IBLPRT,IBI,Z,Z0,Z1,IBREQMRA I '$D(IBZPRC92) D ALLPROC^IBCVA1(IBIFN,.IBZPRC92) S IBREQMRA=$$REQMRA^IBEFUNC(IBIFN) ; MRA? K IBQUIT S IBQUIT=0 S (Z,Z0,Z1)=0 F S Z=$O(IBZPRC92(Z)) Q:'Z S:IBZPRC92(Z)["CPT" Z0=Z0+1 S:IBZPRC92(Z)["ICD" Z1=Z1+1 S IBTXMT=$$TXMT^IBCEF4(IBIFN) S IBZPRC92=Z0_U_Z1 ;Save # of CPT's and ICD9's ; More than 50 procedures on a bill - must print locally I IBTXMT,(+IBZPRC92>50!(+$P(IBZPRC92,U,2)>50)) D Q:IBQUIT . I 'IBREQMRA S IBQUIT=$$IBER^IBCBB3(.IBER,308) Q . I '$P(IBNDTX,U,9) S IBQUIT=$$IBER^IBCBB3(.IBER,325) ; If ICD9 procedures with dates and charges, bill 11x or 83x needs operating physician I IBTOB12="11",$P(IBZPRC92,U,2),'$$CKPROV^IBCEU(IBIFN,2) S IBER=IBER_"IB304;" I IBTOB12="83",$P(IBZPRC92,U,2),'$$CKPROV^IBCEU(IBIFN,2) S IBER=IBER_"IB312;" ; ; If any CPT procedures have more than 2 modifiers, warn S Z=0 F S Z=$O(IBZPRC92(Z)) Q:'Z I $P(IBZPRC92(Z),U)["ICPT(",$L($P(IBZPRC92(Z),U,15),",")>2 S Z0="Proc "_$$PRCD^IBCEF1($P(IBZPRC92(Z),U))_" has > 2 modifiers - only first 2 will be used" D WARN^IBCBB11(Z0) ; I $$WNRBILL^IBEFUNC(IBIFN),$$MRATYPE^IBEFUNC(IBIFN)'="A" S IBER=IBER_"IB086;" ; ; UB-04 Diagnosis Codes K IBXDATA D F^IBCEF("N-DIAGNOSES",,,IBIFN) ; ; Only 9 dx's allowed per claim plus 1 E-code S (Z,ECODE,IBI)=0 F S Z=$O(IBXDATA(Z)) Q:'Z D Q:IBER["309;" . S IBI=IBI+1 . I $E($$ICD9^IBACSV(+$P(IBXDATA(Z),U)))="E" S:ECODE IBQUIT=$$IBER^IBCBB3(.IBER,301) S:'ECODE IBI=IBI-1,ECODE=1 . ; max DX check does not apply to MRAs . I IBTXMT,IBI>9 D .. I 'IBREQMRA Q:$P(IBNDTX,U,8) S IBER=IBER_"IB309;" Q .. I '$P(IBNDTX,U,9) S IBER=IBER_"IB326;" ; I 'IBI S IBER=IBER_"IB071;" ;Require Diag code NOIS:OKL-0304-72495 I IBI,$$INPAT^IBCEF(IBIFN,1),$E($$ICD9^IBACSV(+$P(IBXDATA(1),U)))="V" S Z="Principal Dx V-code may not be valid" D WARN^IBCBB11(Z) I '$$OCC10^IBCBB2(IBIFN,.IBXDATA,3) S IBER=IBER_"IB093;" ; K ^TMP($J,"IBC-RC") D F^IBCEF("N-UB-04 SERVICE LINE (PRINT)",,,IBIFN) S (Z0,IBI)=0 F S IBI=$O(^TMP($J,"IBC-RC",IBI)) Q:'IBI S Z=$G(^(IBI)) Q:+$P(Z,U,2)=1 I $P(Z,U,2),$P(Z,U,1)=1 D . I IBER'["IB090;",$P(Z,U,2)>1,($P(Z,U,7)>99999.99!($P(Z,U,8)>99999.99)) S IBER=IBER_"IB090;" . Q:$P(Z,U,2)'<180&($P(Z,U,2)'>189) ;Pass days (LOA) don't matter . I '$P(Z,U,7),'$P(Z,U,8),'Z0,$$COBN^IBCEF(IBIFN)'>1 S Z0="Rev Code(s) having a 0-charge will not be transmitted for the bill" D WARN^IBCBB11(Z0) S Z0=1 K ^TMP($J,"IBC-RC") Q ;