IBCRER1 ;ALB/ARH - RATES: CM RC NATIONAL ENTER/EDIT OPTION (CONT) ; 13-FEB-2007 ;;2.0;INTEGRATED BILLING;**370**;21-MAR-94;Build 5 ;;Per VHA Directive 2004-038, this routine should not be modified. ; ; CHGLN(IBEFF,IBTYP,IBLINE) ; get all user data for charge ; Input: pass by reference to get/retain defaults: Effective Date, Inst/Prof ; Output: IBLINE if passed by reference ; IBLINE = 'cpt ifn^eff dt^mod ifn^type (I/P)^charge^incr type (PR/ML/HR/MN)^incr charge^inpt^snf^opt^free' ; or null if no CPT, or -1 if invalid (exit) N IBCPT,IBMOD,IBCHGU,IBINCR,IBCHGI,IBINP,IBSNF,IBOPT,IBFS S IBEFF=$G(IBEFF),IBTYP=$G(IBTYP),IBLINE="" ; S IBCPT=$$GETCPT(IBEFF) I IBCPT<1 S IBLINE=-1 Q ; active cpt code S IBEFF=$$GETEFF(IBEFF) Q:IBEFF<1 ; charge effective date S IBMOD=$$GETMOD() Q:IBMOD<0 ; modifier for procedure charge S IBTYP=$$GETTYP(IBTYP) Q:IBTYP<0 ; charge type, inst/prof S IBCHGU=$$GETCHGU() Q:IBCHGU<0 W ! ; unit charge ; S IBINCR=$$GETINCR() Q:IBINCR<0 ; type of incremental charge S IBCHGI=$$GETCHGI(IBINCR) Q:IBCHGI<0 W ! ; incremental charge ; S IBINP=$$GETIINP() Q:IBINP<0 ; inpatient indicator S IBSNF=$$GETISNF() Q:IBSNF<0 ; snf indicator S IBOPT=$$GETIOPT() Q:IBOPT<0 ; outpatient indictor S IBFS=$$GETIFS() Q:IBFS<0 ; freestanding indicator ; S IBLINE=+IBCPT_U_+IBEFF_U_IBMOD_U_IBTYP_U_IBCHGU_U_IBINCR_U_IBCHGI_U_IBINP_U_IBSNF_U_IBOPT_U_IBFS Q ; GETCPT(EFFDT) ; Get CPT/HCPCS procedure associated with charge ; Returns: IFN of CPT/HCPCS selected, -1 if invalid N IBX,DIC,DIE,DA,DR,I,X,Y,DTOUT,DUOUT S IBX=-1 ; S DIC("A")="Select PROCEDURE CPT/HCPCS: " I +$G(EFFDT) S DIC("S")="I $$CPTACT^IBACSV(+Y,EFFDT)" S DIC="^ICPT(",DIC(0)="AEMNQ" D ^DIC K DIC I +Y>0 S IBX=+Y I $D(DTOUT)!$D(DUOUT) S IBX=-1 Q IBX ; GETEFF(DEFAULT) ; Get Effective Date for charge, must be within date range of current version ; returns valid effective date, -1 if invalid N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y,IBY,IBI,IBZ,IBA,IBMIN S IBMIN="",IBA="",IBX=-1 S IBY=$$VERSALL^IBCRHBRV() F IBI=1:1 S IBZ=$P(IBY,U,IBI) Q:IBZ="" S IBMIN=IBZ S DIR("?",1)="Charge Effective Date must be within the date range of the current RC" S DIR("?",2)="version, v"_+IBMIN_". Date must be between "_$$DATE(+$P(IBMIN,";",2))_" and Today.",DIR("?",3)="" S DIR("?")="Enter Effective Date of Charge." ; S DIR("A")="EFFECTIVE DATE" I +$G(DEFAULT)>0 S DIR("B")=$$DATE(DEFAULT),IBA="A",DIR("A")=DIR("A")_": " S DIR(0)="D"_IBA_"^"_+$P(IBMIN,";",2)_":"_DT_":EX" D ^DIR K DIR I Y?7N S IBX=+Y I $D(DTOUT)!$D(DUOUT) S IBX=-1 Q IBX ; GETMOD() ; Get Modifier associated with the procedure charge ; Modifier not limited to valid CPTs since that list is often out of date ; Returns: IFN of selected modifier, null if no modifier selected, -1 if invalid N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX="" S DIR("?",1)="Modifier is optional. If a modifier is added then the charge will only" S DIR("?",2)="be applied if the modifier is assigned to the procedure on the bill.",DIR("?",3)="" S DIR("?")="Enter the Modifier associated with the procedure charge." ; S DIR("A")="MODIFIER" S DIR(0)="PO^DIC(81.3,:AEMQ" D ^DIR K DIR I Y>0 S IBX=+Y I $D(DUOUT)!$D(DTOUT) S IBX=-1 Q IBX ; GETTYP(DEFAULT) ; Get Charge Type: Institutional or Professional ; Returns: I for Institutional, P for Professional, -1 if invalid N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=-1 I $G(DEFAULT)'="" S DEFAULT=$S(DEFAULT="I":"Institutional",DEFAULT="P":"Professional",1:"") S DIR("?")="Enter the type of charge, either Institutional or Professional." ; S DIR("A")="CHARGE TYPE" I $G(DEFAULT)'="" S DIR("B")=DEFAULT S DIR(0)="SB^I:Institutional;P:Professional" D ^DIR S IBX=Y I $D(DTOUT)!$D(DUOUT) S IBX=-1 Q IBX ; GETCHGU() ; get procedures unit charge ; Returns: dollar amount (non-zero), -1 if invalid N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=-1 S DIR("?",1)="The dollar amount to be added to a bill for each of this procedure on the bill." S DIR("?",2)="Enter an amount greater than zero and less than 99999, 2 decimal digits." S DIR("?")="Enter the unit charge for Procedure to be used at all sites." ; S DIR("A")="UNIT CHARGE: " S DIR(0)="NA^.001:99999:2" D ^DIR K DIR I +Y>0 S IBX=Y I $D(DTOUT)!$D(DUOUT) S IBX=-1 Q IBX ; GETINCR() ; get the type of charge, identifies Charge Method and incremental calculations ; Returns: PR for standard, HR for observation, MN for anesthesia, ML for ambulance, -1 if invalid N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=-1 S DIR("?",1)="Most charges are a standard charge per procedure. There are three types of" S DIR("?",2)="charges that require special calculations that add charge based on an " S DIR("?",3)="increment of units: Anesthesia, Observation, Ambulance." S DIR("?")="Enter type of care that will identify the charge calculation." ; S DIR("A")="Standard, Observation, Anesthesia, or Ambulance",DIR("B")="Standard" S DIR(0)="SB^PR:Standard;HR:Observation;MN:Anesthesia;ML:Ambulance" D ^DIR S IBX=Y I $D(DTOUT)!$D(DUOUT) S IBX=-1 ; Q IBX ; GETCHGI(TYPE) ; if a special charge then get the incremental charge amount, anesthesia and observation only ; Returns: dollar amount if applicable (non-zero), null if not applicable, -1 if invalid N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y,IBTYP S TYPE=$G(TYPE),IBX=-1 S IBTYP=$S(TYPE="MN":"Anesthesia",TYPE="HR":"Observation",1:"") I IBTYP="" S IBX="" S DIR("?",1)="Anesthesia and Observation have a unit charge added to a base/incremental" S DIR("?",2)="charge that is multiplied by the time associated with the procedure." S DIR("?",3)="Enter an amount greater than zero and less than 99999, 2 decimal digits.",DIR("?",4)="" S DIR("?")="Enter the base or incremental "_IBTYP_" charge for this procedure." ; S DIR("A")=IBTYP_" BASE CHARGE: " I IBTYP'="" S DIR(0)="NA^.001:99999:2" D ^DIR K DIR I +Y>0 S IBX=Y I $D(DTOUT)!$D(DUOUT) S IBX=-1 Q IBX ; GETIINP() ; Get Inpatient Indicator, is this charge billable for Inpatient care ; Returns: 1 for Yes Billable for Inpatient care, 0 for not billable, -1 if invalid N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=0 S DIR("?")="Enter Yes if this charge is billable for Inpatient care, No otherwise." ; S DIR(0)="Y",DIR("A")="INPATIENT",DIR("B")="No" D ^DIR I Y=1 S IBX=1 I $D(DTOUT)!$D(DUOUT) S IBX=-1 Q IBX ; GETISNF() ; Get SNF Indicator, is this charge billable for Skilled Nursing care ; Returns: 1 for Yes Billable for SNF care, 0 for not billable, -1 if invalid N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=0 S DIR("?")="Enter Yes if this charge is billable for SNF care, No otherwise." ; S DIR(0)="Y",DIR("A")="SKILLED NURSING",DIR("B")="Yes" D ^DIR I Y=1 S IBX=1 I $D(DTOUT)!$D(DUOUT) S IBX=-1 Q IBX ; GETIOPT() ; Get Outpatient Indicator, is this charge billable for Outpatient care ; Returns: 1 for Yes Billable for outpatient care, 0 for not billable, -1 if invalid N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=0 S DIR("?")="Enter Yes if this charge is billable for Outpatient care, No otherwise." ; S DIR(0)="Y",DIR("A")="OUTPATIENT",DIR("B")="Yes" D ^DIR I Y=1 S IBX=1 I $D(DTOUT)!$D(DUOUT) S IBX=-1 Q IBX ; GETIFS() ; Get Freestanding Indicator, is this charge billable at Freestanding Sites ; Returns: 1 for Yes Billable at Non-Provider Based/Freestanding sites, 0 for not billable, -1 if invalid N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=0 S DIR("?",1)="All charges for Freestanding sites will be stored as Professional charges." S DIR("?")="Enter Yes if this charge is billable at Freestanding Sites, No otherwise." ; S DIR(0)="Y",DIR("A")="FREESTANDING",DIR("B")="Yes" D ^DIR I Y=1 S IBX=1 I $D(DTOUT)!$D(DUOUT) S IBX=-1 Q IBX ; DATE(X) ; returns VA date in external form N Y S Y="" I $G(X)?7N.E S Y=$E(X,4,5)_"/"_$E(X,6,7)_"/"_$E(X,2,3) Q Y