IBCU81 ;ALB/ARH - THIRD PARTY BILLING UTILITIES (AUTOMATED BILLER) ;02 JUL 93 ;;2.0;INTEGRATED BILLING;**55,91,106,124,160,174,260,347**;21-MAR-94;Build 24 ;;Per VHA Directive 2004-038, this routine should not be modified. ; EABD(IBETYP,IBTDT) ; -- compute earliest auto bill date: date entered plus days delay for event type ;the difference betwieen this and EABD^IBTUTL is that the autobill of the event type may be turned off ;and this procedure will still return a date ; -- input IBETYPE = pointer to type of entry file ; IBTDT = episode date, if not passed in uses DT ; N X,X1,X2,Y,IBETYPD S Y="" I '$G(IBETYP) G EABDQ S IBETYPD=$G(^IBE(356.6,+IBETYP,0)) I '$G(IBTDT) S IBTDT=DT S X2=+$P(IBETYPD,"^",6) ;set earliest autobill date to entered date plus days delay S X1=IBTDT D C^%DTC S Y=X\1 EABDQ Q Y ; EVBILL(IBTRN) ;check if event is auto billable, return EABD if it is, the difference between this and BILL^IBTUTL is that ;this procedure will return a date if the auto biller is turned off for this event type ;returns "^error message" if it is not billable N X,Y,Z,E,IBTRND S (X,Y,E)="" S IBTRND=$G(^IBT(356,+$G(IBTRN),0)) I IBTRND="" G BILLQ ; ; -- billed and bill not cancelled and not inpt interim first or continuous S Z=$$BILLED^IBCU8(IBTRN),Y=$P(Z,U,2) I +Z,'Y S E="^Event already billed on "_$P($G(^DGCR(399,+Z,0)),U,1)_"." G BILLQ ; ; -- special type (not riem. ins), not billable, inactive I +$P(IBTRND,U,12) S E="^Bill may not be Reimbursable Insurance, possibly "_$$EXSET^IBEFUNC(+$P(IBTRND,U,12),356,.12)_"." G BILLQ I +$P(IBTRND,U,19) S E="^Event has a Reason Not Billable: "_$P($G(^IBE(356.8,+$P(IBTRND,U,19),0)),U,1)_"." G BILLQ I '$P(IBTRND,U,20) S E="^Event is Inactive." G BILLQ I 'Y S Y=+$G(^IBT(356,+$G(IBTRN),1)) I 'Y S Y=DT S X=$$EABD(+$P(IBTRND,U,18),Y) BILLQ Q X_E ; RXRF(IBTRN) ; returns rx # and fill date for given claims tracking rx entry N IBX,IBY,IBZ,X S (X,IBY)="" S IBX=$G(^IBT(356,+$G(IBTRN),0)) I IBX'="" S IBY=$$FILE^IBRXUTL(+$P(IBX,U,8),.01) I IBY'="",$P(IBX,U,10)=0 S IBZ=$$FILE^IBRXUTL(+$P(IBX,U,8),"22","I") I +IBZ S X=IBY_"^"_IBZ I IBY'="",+$P(IBX,U,10) S IBZ=+$$ZEROSUB^IBRXUTL(+$P(IBX,U,2),+$P(IBX,U,8),+$P(IBX,U,10)) I +IBZ S X=IBY_"^"_IBZ Q X ; NABSCT(IBTRN) ; -- true if CT outpatient visit should NOT be auto billed, based only on stop (1) and clinic (2) auto billable ; returns true only for those stops (352.3) and clinics (352.4) specifically flagged as not auto billable N IBX,IBY,IBTRND S IBX=0,IBTRND="" I +$G(IBTRN) S IBTRND=$G(^IBT(356,+IBTRN,0)) I +$P(IBTRND,U,4) S IBY=$$SCE^IBSDU(+$P(IBTRND,U,4)) I +IBY D . I +$P(IBY,U,3),$$NABST^IBEFUNC($P(IBY,U,3),DT) S IBX=1 Q . I +$P(IBY,U,4),$$NABCT^IBEFUNC($P(IBY,U,4),DT) S IBX=2 Q IBX ; NBOE(IBOE,IBOE0) ; returns true if outpatient encounter is non-billable, "" otherwise ; input: IBOE - pointer to encounter (409.68) ; IBOE0 - 0-node of the encounter (optional) ; output: "" or x^message, where x=1 if SC, x=2 if NB Stop code, x=3 if NB Clinic, x=4 if NB Appt Status N IBOED,IBOEP,IBX,IBCK,IBZ,IBPB,IBAPST,IBDT,DFN S IBX="" I $G(IBOE0)="" S IBOE0=$$SCE^IBSDU(IBOE) I 'IBOE0 G NBOEQ S DFN=$P(IBOE0,"^",2),IBDT=+IBOE0 F IBZ=7,12,13 S IBCK(IBZ)="" S IBZ=$$BILLCK^IBAMTEDU(IBOE,IBOE0,.IBCK,.IBPB) S IBAPST="" I $G(IBPB)=13 S IBAPST=$E($$EXPAND^IBTRE(409.68,.12,$P(IBOE0,U,12)),1,10) ; check out sc and other questions I $G(IBPB)="" S IBAPST=$$CL^IBTRKR41(IBOE0) I $L(IBAPST) S IBPB=$S(IBAPST="SC TREATMENT":11,1:13) S:$G(IBPB)'="" IBX=$S(IBPB=11:"1^SC VISIT",IBPB=7:"2^NB STOP CODE",IBPB=12:"3^NB CLINIC",IBPB=13:"4^"_IBAPST,1:"") NBOEQ Q IBX ; OEDX(IBOE,IBDXA,IBDXB) ; returns arrays containing encounters diagnosis (includes duplicates) ; IBDXA(ORDER,DATE/TIME,IBOE,DX IFN)=DX ^ PCE ORDER ^ IBOE ^ DATE/TIME ^ TRUE IF NON-BILLABLE ^ NB MES ^ CLINIC ; IBDXB(IBDX) = 1 for each billable dx found ; N IBNBOE,X,IBPOV,IBDXN,IBPCE,IBPCEI,IBDT,IBOE0,IBZERR Q:'$G(IBOE) S IBOE0=$$SCE^IBSDU(+IBOE),IBDT=+IBOE0 Q:'IBDT I '$$BDSRC^IBEFUNC3($P(IBOE0,U,5)) Q ; non-billable visit data source S IBNBOE=$$NBOE(IBOE,IBOE0) ; D GETDX^SDOE(IBOE,"IBPOV","IBZERR") S IBDXN=0 F S IBDXN=$O(IBPOV(IBDXN)) Q:'IBDXN D . S IBPCE=IBPOV(IBDXN),IBPCEI=$P(IBPCE,U,12) . S IBDXA($S(IBPCEI="P":1,IBPCEI="S":2,1:999),IBDT,IBOE,IBDXN)=+IBPCE_U_IBPCEI_U_IBOE_U_IBDT_U_$P(IBNBOE,U,1)_U_$P(IBNBOE,U,2)_U_+$P(IBOE0,U,4) . I 'IBNBOE S IBDXB(+IBPCE)=1 ; Q ;