IBCEF77 ;WOIFO/SS - FORMATTER/EXTRACT BILL FUNCTIONS ;31-JUL-03 ;;2.0;INTEGRATED BILLING;**232,280,155,290,291,320,348,349**;21-MAR-94;Build 46 ;;Per VHA Directive 2004-038, this routine should not be modified. ; SORT(IBPRNUM,IBPRTYP,IB399,IBSRC,IBDST,IBN,IBEXC,IBSEQ,IBLIMIT) ; N IBXIEN,IBXDATA,IBNET,IBTRI,IB1,IB2,IBID,Z,IBZ,IBZ1,IBSVP S (IB1,IB2,IBZ,IBZ1,IBTRI)="" D F^IBCEF("N-ALL ATT/RENDERING PROV SSN","IBZ",,IB399) S IBZ1=$$ALLPTYP^IBCEF3(IB399) F Z=1:1:3 S $P(IBZ1,U,Z)=$S($P(IBZ1,U,Z)="CH":1,1:"") S:$P(IBZ1,U,Z) IBTRI=1 S IBNET=$$NETID^IBCEP() ; netwrk id type I $G(IBN) D . S Z=0 F S Z=$O(IBDST(IBPRNUM,IBPRTYP,Z)) Q:'Z S IBID(+$P(IBDST(IBPRNUM,IBPRTYP,Z),U,9))="" F S IB1=$O(IBSRC(IB1)) Q:IB1="" D Q:IBN=IBLIMIT . N OK,IBSTLIC . S IBSTLIC="" . F S IB2=$O(IBSRC(IB1,IB2)) Q:IB2="" D Q:IBN=IBLIMIT . . S IBSVP=$P(IBSRC(IB1,IB2),U) . . ; If ID overridden, output no others of this type . . I $G(IBEXC),$P($G(IBSRC(IB1,IB2)),U,9)=IBEXC Q . . ; Ck state of care/lic match if st lic# . . I $P($G(IBSRC(IB1,IB2)),U,3)="0B" S OK=1 D Q:'OK . . . I +$$CAREST^IBCEP2A(IB399)'=$P(IBSRC(IB1,IB2),U,7) S IBSTLIC=1 Q . . . I $G(IBSTLIC(0))'="" S OK=0 Q . . . S IBSTLIC(0)=$G(IBSRC(IB1,IB2)),OK=0 . . ; Exclude SSN from sec ids unless required . . I $P($G(IBSRC(IB1,IB2)),U,3)="SY" Q . . ; Only 1 of each prov id type . . Q:$D(IBID(+$P($G(IBSRC(IB1,IB2)),U,9))) . . S IBN=IBN+1,IBID(+$P($G(IBSRC(IB1,IB2)),U,9))="" . . S IBDST(IBPRNUM,IBPRTYP,IBN)=$G(IBSRC(IB1,IB2)) . I IBN'=IBLIMIT,'$G(IBSTLIC),$G(IBSTLIC(0))'="" S IBN=IBN+1,IBDST(IBPRNUM,IBPRTYP,IBN)=IBSTLIC(0) I $$FT^IBCEF(IB399)=2,$G(IBID(IBNET))="",IBTRI,$P(IBZ1,U,IBSEQ) D ; WCJ 02/13/2006 . Q:$P(IBZ,U,IBPRTYP)="" . ; here, no network id & TRICARE ins co. . N Z . S Z=+$O(^DGCR(399,IB399,"PRV","B",IBPRTYP,0)),Z=$P($G(^DGCR(399,IB399,"PRV",Z,0)),U,2) . S IBN=IBN+1,IBDST(IBPRNUM,IBPRTYP,IBN)=Z_U_+$$POLICY^IBCEF(IB399,1,IBSEQ)_U_$P($G(^IBE(355.97,IBNET,0)),U,3)_U_$P(IBZ,U,IBPRTYP)_U_"0^0^^^"_IBNET Q ; ; esg - 8/25/06 - IB*2*348 - CFIDS function ; CFIDS(IBIFN,PRVTYP,ALLOWIDS) ; Claim Form IDs for human providers ; Function returns a 3 piece string: [1] default secondary ID qual ; [2] default secondary ID ; [3] NPI ; Input: IBIFN - internal claim# ; PRVTYP - internal provider type ID number ; - 1:REFER;2:OPER;3:REND;4:ATT;5:SUPER;9:OTHER ; - if blank, then default Att/Rend based on form type ; ALLOWIDS - List of allowable Secondary IDS ^ delimited. ; ex "^1A^1B^1C^1H^G2^LU^N5^" ; UB-04 only wants IDs provided by the payer, not the providers own IDS ; Also, they want the qualifier to be G2 (Commercial) ; if it is a payer provided ID NEW ID,FT,IBZ,IBQ,IBSID,IBNPI,I,OK S ID="" I '$G(IBIFN) G CFIDSX S FT=$$FT^IBCEF(IBIFN) I '$G(PRVTYP) S PRVTYP=3 I FT=3 S PRVTYP=4 D ALLIDS^IBCEF75(IBIFN,.IBZ,1) S OK=0 I $G(ALLOWIDS)="" S OK=1 F I=1:1 D Q:OK . S IBQ=$P($G(IBZ("PROVINF",IBIFN,"C",1,PRVTYP,I)),U,3) ; qualifier . S IBSID=$P($G(IBZ("PROVINF",IBIFN,"C",1,PRVTYP,I)),U,4) ; ID# . I IBQ="",IBSID="" S OK=1 Q . Q:OK . I $G(ALLOWIDS)[(U_IBQ_U) S OK=1,IBQ="G2" Q . S (IBQ,IBSID)="" S IBNPI="" D F^IBCEF("N-PROVIDER NPI CODES","IBNPI",,IBIFN) S IBNPI=$P(IBNPI,U,PRVTYP) ; NPI ; ; special check for the referring doc I PRVTYP=1,$D(IBZ("PROVINF",IBIFN,"C",1,PRVTYP)),IBQ="",IBSID="" S IBQ="1G",IBSID="VAD000" ; ; If UB-04 and no IDs, use VA UPIN as deafult I $D(IBZ("PROVINF",IBIFN,"C",1,PRVTYP)),FT=3,IBQ="",IBSID="" S IBQ="1G",IBSID="VAD000" ; ; determine if legacy ID's should be displayed I '$$PRTLID(IBIFN,IBNPI) S (IBQ,IBSID)="" ; S ID=IBQ_U_IBSID_U_IBNPI CFIDSX ; Q ID ; DOL(AMT,LEN,DEC) ; format dollar amounts for printed claim forms ; AMT = amount to be formatted ; LEN = length of field - right justified to this length ; DEC = flag to include the decimal point or not ; DEFAULT value is to not include the decimal point ; if DEC is not defined or 0, assume no decimal point ; so 15 will be returned as 1500, 6.77 will be returned as 677 ; if DEC is 1, then the decimal point will be included ; S LEN=$G(LEN,10),DEC=$G(DEC,0) ; defaults S AMT=$FN(+$G(AMT),"",2) ; format # with 2 decimals I 'DEC S AMT=$TR(AMT,".") ; strip or leave decimal S AMT=$J(AMT,LEN) ; right justify Q AMT ; PRTLID(IBIFN,NPI) ; YMG; Print Legacy IDs on the CMS-1500 or UB-04 form ; Function fetches form type associated with given claim number ; (values: 2 - CMS-1500 form, 3 - UB-04 form), then looks at ; "Print Legacy ID" site parameter for this particular form type. ; ; Possible site parameter values are: ; "Y" - always print Legacy ID ; "N" - never print Legacy ID ; "C" - only print Legacy ID if NPI is not available. ; ; This information is used to determine if Legacy ID should be printed ; for claim number in question. ; ; Note: Situation when "Print Legacy ID" site parameter is not set is treated ; as if this parameter was set to "Y" - always print Legacy ID. ; ; Input: ; IBIFN - internal claim number ; NPI - NPI number (or "" if no NPI is available) ; ; Returns: ; 0 - Legacy ID should not be printed ; 1 - Legacy ID should be printed ; Q $S(NPI="":"YC",1:"Y")[$P($G(^IBE(350.9,1,1)),U,$S($$FT^IBCEF(IBIFN)=2:32,1:33)) ; REMARK(IBIFN,IBXDATA,OFLG) ; procedure to return array of UB-04 remark text ; for claim IBIFN. Data pulled from field# 402 of file 399 and ; formatted into an array IBXDATA(n) where each line is not greater ; than 24 characters long. This will fit into UB-04 FL-80. ; ; OFLG=1 only when called in the output formatter. In this case, only ; 4 lines in IBXDATA will be returned. ; NEW TEXT,LEN,IBZ,J,PCE,CHS,NEWCHS,IBK,J,TX K IBXDATA S TEXT=$P($G(^DGCR(399,+$G(IBIFN),"UF2")),U,3) I TEXT="" Q ; ; need to break up large words for word wrapping purposes to get ; as many characters as possible in the box. S LEN=17 F PCE=1:1 Q:PCE>$L(TEXT," ") S CHS=$P(TEXT," ",PCE) I $L(CHS)>LEN D . S NEWCHS=$E(CHS,1,LEN)_" "_$E(CHS,LEN+1,999) . S $P(TEXT," ",PCE)=NEWCHS . Q ; ; When calling FSTRNG^IBJU1 which calls ^DIWP, FileMan builds the ; array with strings of max length=1 less than what you tell it. ; S LEN=20 ; line 1 is 19 chars D FSTRNG^IBJU1(TEXT,LEN,.IBZ) ; build IBZ array S IBK=$$TRIM^XLFSTR($G(IBZ(1))) ; save off the first line S TEXT=$P(TEXT,IBK,2,99) ; restore the rest of the text S TEXT=$$TRIM^XLFSTR(TEXT) ; trim spaces ; S LEN=25 ; the rest is 24 chars D FSTRNG^IBJU1(TEXT,LEN,.IBZ) ; build IBZ array S IBXDATA(1)=" "_IBK ; line 1 S J=0 F S J=$O(IBZ(J)) Q:'J D ; lines 2-n . I J>3,$G(OFLG) Q ; only 4 lines for output formatter . S TX=$$TRIM^XLFSTR($G(IBZ(J))) . I TX'="" S IBXDATA(J+1)=TX . Q Q ;