IBCD4 ;ALB/ARH - AUTOMATED BILLER (ADD NEW BILL - GATHER DX AND PROCEDURES) ;9/5/93 ;;2.0;INTEGRATED BILLING;**14,80,106,160,309,276,347**;21-MAR-94;Build 24 ;;Per VHA Directive 2004-038, this routine should not be modified. ; ; IDX(PTF,DT1,DT2) ; find 501 movement Diagnosis and 701 Discharge Diagnosisfor a PTF record within bill range ; check for billable bedsection and SC treatement and duplicates ; results: IBT = number of billable movements within date range ; IBMSG(X)=" error message " if any errors found ; ^TMP("IBDX",$J)= PTF IFN ; ^TMP("IBDX",$J,DX)="" ; ^TMP("IBDX",$J,-MOVE DATE, x) = Dx N IBMVT,IBN,IBDT,IBCNT,IBBS,IBSC,IBMV,IBDX,IBI,IBX K IBMSG,IBT,^TMP("IBDX",$J) ; D PTFDXDT^IBCSC4F(PTF,DT1,DT2) S IBMVT="M" I +$P($G(^TMP($J,"IBDX","D")),U,3) S IBMVT="D" ; S ^TMP("IBDX",$J)=+PTF S (IBT,IBBS,IBSC)=0,IBCNT=1 F IBN="D","M" S IBDT="" F S IBDT=$O(^TMP($J,"IBDX",IBN,IBDT)) Q:'IBDT D . S IBMV=$G(^TMP($J,"IBDX",IBN,IBDT)) Q:IBMV="" . ; . I IBN="M" S IBT=IBT+1,IBX="" D Q:+IBX .. I $P(IBMV,U,3)=1 S IBSC=IBSC+1,IBMSG(IBCNT)=$$FMTE^XLFDT(IBDT)_" movement related to an SC condition.",IBCNT=IBCNT+1,IBX=1 .. I $P($G(^DIC(42.4,+$P(IBMV,U,2),0)),U,5)="" S IBBS=IBBS+1,IBMSG(IBCNT)=$$FMTE^XLFDT(IBDT)_" movement is for a non-billable bedsection.",IBCNT=IBCNT+1,IBX=1 .. I '$P(IBMV,U,4) S IBMSG(IBCNT)=$$FMTE^XLFDT(IBDT)_" movement does not have a DRG as required for Reasonable Charges.",IBCNT=IBCNT+1 . I IBN'=IBMVT Q . ; . S IBI="" F S IBI=$O(^TMP($J,"IBDX",IBN,IBDT,IBI)) Q:'IBI D .. S IBDX=$G(^TMP($J,"IBDX",IBN,IBDT,IBI)) Q:'IBDX .. I '$P(IBDX,U,2),IBDT>+$G(^TMP("IBDX",$J,"DX",+IBDX)) S ^TMP("IBDX",$J,"DX",+IBDX)=IBDT_U_IBI ; S IBDX="" F S IBDX=$O(^TMP("IBDX",$J,"DX",IBDX)) Q:'IBDX D . S IBX=^TMP("IBDX",$J,"DX",IBDX) I +IBX S ^TMP("IBDX",$J,-IBX,+$P(IBX,U,2))=IBDX K ^TMP($J,"IBDX") ; I +IBSC S IBMSG(IBCNT)="PTF record indicates "_+IBSC_" of "_IBT_" movements are for Service Connected Care.",IBCNT=IBCNT+1 I +IBBS S IBMSG(IBCNT)="PTF record indicates "_+IBBS_" of "_IBT_" movements are for a non-billable bedsection.",IBCNT=IBCNT+1 S IBT=IBT-IBSC-IBBS I 'IBT S IBMSG(IBCNT)="0 movements are billable." IDXE Q ; IPRC(PTF,DT1,DT2) ;find 401 and 601 procedures for a PTF record ;results: ^TMP("IBIPRC",$J,PROC DATE)=PROC1^ ... ^PROC5 ;where PROC DATE = (45.01,45.01,.01) and (45,45.05,.01) and PROC = (45,45.01,8-12) and (45,45.05,4-8) N IBX,IBY,IBZ,IBI K ^TMP("IBIPRC",$J) I '$D(^DGPT(+$G(PTF),0)) G IPRCE S DT1=$S(+$G(DT1):+DT1,1:0),DT2=$S(+$G(DT2):+DT2,1:9999999),^TMP("IBIPRC",$J)=+PTF S IBX=0 F S IBX=$O(^DGPT(+PTF,"S",IBX)) Q:'IBX S IBY=$G(^DGPT(+PTF,"S",IBX,0)) I +IBY'DT2 D . S IBZ="" F IBI=8:1:12 I +$P(IBY,U,IBI) S IBZ=IBZ_+$P(IBY,U,IBI)_U . I +IBZ S ^TMP("IBIPRC",$J,+IBY)=$G(^TMP("IBIPRC",$J,+IBY))_IBZ S IBX=0 F S IBX=$O(^DGPT(+PTF,"P",IBX)) Q:'IBX S IBY=$G(^DGPT(+PTF,"P",IBX,0)) I +IBY'DT2 D . S IBZ="" F IBI=5:1:9 I +$P(IBY,U,IBI) S IBZ=IBZ_+$P(IBY,U,IBI)_U . I +IBZ S ^TMP("IBIPRC",$J,+IBY)=$G(^TMP("IBIPRC",$J,+IBY))_IBZ IPRCE Q ; RXRF(PIFN,RIFN,IBDT) ; returns data on fill on date for rx (RX # ^ DRUG ^ DAYS SUPPLY ^ FILL DATE ^ QTY ^ NDC #) N X,Y,PLN,RLN,IBFILL,PDFN,LIST,NODE S X="" S PDFN=$$FILE^IBRXUTL(PIFN,2) S LIST="IBRXARR" S NODE="R^^" I +$G(PIFN) S PLN=$$RXZERO^IBRXUTL(PDFN,PIFN) I PLN'="" D . D RX^PSO52API(PDFN,LIST,PIFN,,NODE,,) . I $G(IBDT) D REF^PSO52EX($G(IBDT),$G(IBDT),LIST) S RIFN=$O(^TMP($J,LIST,"AD",IBDT,PIFN,"")) . S RLN="",IBFILL="^^" I $G(RIFN)="" S X="" Q . I (RIFN=0)!(RIFN=-1) S RLN=$$RXSEC^IBRXUTL(PDFN,PIFN) Q:RLN="" S IBFILL=$P(PLN,U,8)_"^"_$P(RLN,U,2)_"^"_$P(PLN,U,7) . I RIFN>0 S RLN=$$ZEROSUB^IBRXUTL(PDFN,PIFN,RIFN) Q:RLN="" S IBFILL=$P(RLN,U,10)_"^"_$P(RLN,U,1)_"^"_$P(RLN,U,4) . S X=$P(PLN,U,1)_"^"_$P(PLN,U,6)_"^"_IBFILL_"^"_$$GETNDC^PSONDCUT(+PIFN,+RIFN) E S X="" K ^TMP($J,LIST) Q X ; CHK() ;other checks N X S X=1 I $G(^DPT(+$G(IBDFN),0))="" S X="0^Patient information lacking." Q X ; CHKSYS() ;various checks to determine if bill can be created, returns true if passes XXXXXX ;if fails then returns "0^error message" ;requires nothing N X,Y,I S X=1 I '$P($G(^IBE(350.9,1,1)),U,14) S X="0^MAS SERVICE PARAMETER UNKNOWN" G CHKSYSE I +$P($$SITE^VASITE,U,3)<1 S X="0^ACILITY UNDEFINED" G CHKSYSE ;G:$D(IBB) CHKSYSE ;I '$D(DUZ(0)) S X="0^FILEMAN ACCESS UNDEFINED" G CHKSYSE ;I $S($D(DLAYGO):2\1-(DLAYGO\1),1:1),DUZ(0)'="@",$D(^DIC(399,0,"LAYGO")) S DLAYGO=399 CHKSYSE Q X ; ;GVARS(IFN) ;get data on bill IFN (commented out patch 80, does not appear to be used) ;N I S X=1 I '$G(^DGCR(399,+$G(IFN),0)) S X=0 G GVARSE ;F I=0,"M" S IB(I)=$G(^DGCR(399,+IFN,I)) ;S DGINPAR=$P($G(^DIC(36,+IB("MP"),0)),U,6,10) ;GVARSE Q X