source: FOIAVistA/tag/r/OUTPATIENT_PHARMACY-PSO-APSP-HUIP/PSOBPSU1.m@ 636

Last change on this file since 636 was 636, checked in by George Lilly, 14 years ago

WorldVistAEHR overlayed on FOIAVistA
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[628]1PSOBPSU1 ;BIRM/MFR - BPS (ECME) Utilities 1 ;10/15/04
[636]2 ;;7.0;OUTPATIENT PHARMACY;**148,260**;DEC 1997;Build 84
[628]3 ;Reference to $$EN^BPSNCPDP supported by IA 4415
4 ;References to $$NDCFMT^PSSNDCUT,$$GETNDC^PSSNDCUT supported by IA 4707
5 ;References to $$ECMEON^BPSUTIL,$$CMOPON^BPSUTIL supported by IA 4410
6 ;References to STORESP^IBNCPDP supported by IA 4299
7 ;
8ECMESND(RX,RFL,DATE,FROM,NDC,CMOP,RVTX,OVRC,CNDC,RESP,IGSW,ALTX,CLA,PA) ; - Sends Rx Release information to ECME/IB and
9 ; updates NDC in the DRUG/PRESCRIPTION files
10 ;Reference to routine EN^BPSNCPDP supported by DBIA #4304
11 ;Input: (r) RX - Rx IEN (#52)
12 ; (o) RFL - Refill # (Default: most recent)
13 ; (r) DATE - Date of Service
14 ; (r) FROM - Function within OP (See BWHERE param. in EN^BPSNCPDP api)
15 ; (o) NDC - NDC Number (If not passed, will be retrieved from DRUG file)
16 ; (o) CMOP - CMOP Prescription (1-YES/0-NO) (Default: 0)
17 ; (o) RVTX - REVERSE text (e.g., RX EDIT, RX RELEASE-NDC CHANGE, etc)
18 ; (o) OVRC - Set of 3 NCPDP override codes separated by "^":
19 ; Piece 1: NCPDP Professional Service Code for overriding DUR REJECTS
20 ; Piece 2: NCPDP Reason for Service Code for overriding DUR REJECTS
21 ; Piece 3: NCPDP Result of Service Code for overriding DUR REJECTS
22 ; (o) CNDC - Changed NDC? 1 - Yes / 0 - No (Default: NO)
23 ; (o) IGSW - Ignore Switches (Master and CMOP)? 1 - Yes / 0 - No (Default: NO)
24 ; (o) ALTX - Alternative Text to be placed in the Rx ECME Activity Log
25 ; (o) CLA - NCPDP Clarification Code for overriding DUR/RTS REJECTS
26 ; (o) PA - NCPDP Prior Authorization Type and Number (separated by "^")
27 ;Output: RESP - Response from $$EN^BPSNCPDP api
28 ;
29 ; - Retrieving the NDC code from the DRUG file if not passed in, then save it in the DRUG file
30 N ACT,NDCACT,DA
31 ;
32 I '$D(RFL) S RFL=$$LSTRFL(RX)
33 ;
34 ; - ECME is not turned ON for the Rx's Division
35 I '$G(IGSW),'$$ECMEON^BPSUTIL($$RXSITE^PSOBPSUT(RX,RFL)) S RESP="-1^ECME SWITCH OFF" Q
36 ;
37 ; - ECME CMOP is not turned ON for the Rx's Division
38 I '$G(IGSW),$G(CMOP),'$$CMOPON^BPSUTIL($$RXSITE^PSOBPSUT(RX,RFL)) S RESP="-1^CMOP SWITCH OFF" Q
39 ;
40 ; - Saving the NDC to be displayed on the ECME Activity Log
41 I $G(CNDC) D
42 . I $G(NDC)'="" S NDCACT=NDC Q
43 . S NDCACT=$$GETNDC^PSONDCUT(RX,RFL)
44 ;
45 I $$NDCFMT^PSSNDCUT($G(NDC))="" D
46 . S NDC=$$GETNDC^PSSNDCUT($$GET1^DIQ(52,RX,6,"I"),$$RXSITE^PSOBPSUT(RX,RFL),+$G(CMOP))
[636]47 . I $G(NDC)'="" D SAVNDC^PSONDCUT(RX,RFL,NDC,+$G(CMOP))
[628]48 ;
49 ; - Creating ECME Activity Log on the PRESCRIPTION file
50 S ACT="Submitted" I $$STATUS^PSOBPSUT(RX,RFL)="E PAYABLE" S ACT="Reversal/Re-submit sent"
51 S ACT=ACT_" to ECME:"
52 ;
53 ; - Marked any 'unresolved' REJECTS as 'resolved' (Reason: 1 - Claim re-submitted)
54 N CLSCOM,COD1,COD2,COD3
55 S COD2=$P($G(OVRC),"^"),COD1=$P($G(OVRC),"^",2),COD3=$P($G(OVRC),"^",3)
56 I $G(COD3)'="" S CLSCOM="DUR Override Codes "_COD1_"/"_COD2_"/"_COD3_" submitted."
57 I $G(CLA)'="" S CLSCOM="Clarification Code "_CLA_" submitted."
58 I $G(PA)'="" S CLSCOM="Prior Authorization Code ("_$P(PA,"^")_"/"_$P(PA,"^",2)_") submitted."
59 D CLSALL^PSOREJUT(RX,RFL,DUZ,1,$G(CLSCOM),$G(COD1),$G(COD2),$G(COD3),$G(CLA),$G(PA))
60 ;
61 ; - Call to ECME (NEWing STAT because ECME was overwriting it - Important variable for CMOP release PSXVND)
62 N STAT
63 I $G(RVTX)="",FROM="ED" S RVTX="RX EDITED"
64 S RESP=$$EN^BPSNCPDP(RX,RFL,$$DOS(RX,RFL,.DATE),FROM,NDC,$G(RVTX),$G(OVRC),,$G(CLA),$G(PA))
65 ;
66 ; - Reseting the Re-transmission flag
67 D RETRXF^PSOREJU2(RX,RFL,0)
68 ;
69 ; - Logging ECME Activity Log to the PRESCRIPTION file
70 I $G(ALTX)="" D
[636]71 . N X S X=""
72 . S:FROM="OF" X="WINDOW FILL(NDC:"_$$GETNDC^PSONDCUT(RX,RFL)_")"
73 . S:FROM="RF" X="WINDOW REFILL(NDC:"_$$GETNDC^PSONDCUT(RX,RFL)_")"
[628]74 . S:FROM="RN" X="RX RENEWED(NDC:"_$$GETNDC^PSONDCUT(RX,RFL)_")"
[636]75 . S:FROM="PL" X="SUSP LABEL PRINTED(NDC:"_$$GETNDC^PSONDCUT(RX,RFL)_")"
[628]76 . S:FROM="PE"!(FROM="PP") X="PULLED FROM SUSPENSE(NDC:"_$$GETNDC^PSONDCUT(RX,RFL)_")"
77 . S:FROM="PC" X="CMOP TRANSMISSION(NDC:"_$$GETNDC^PSONDCUT(RX,RFL)_")"
78 . S:FROM="RRL" X="RELEASED RX PREVIOUSLY REVERSED"
79 . S:FROM="ED" X="RX EDITED"
80 . S:$G(RVTX)'="" X=RVTX
81 . S:$G(OVRC)'="" X="DUR OVERRIDE CODES("_$G(COD1)_"/"_$G(COD2)_"/"_$G(COD3)_")"
82 . S:$G(CNDC) X=X_"(NDC:"_NDCACT_")" S ACT=ACT_X
83 . S ACT=ACT_$$STS(RX,RFL,RESP)
84 I $G(ALTX)'="" S ACT=ACT_ALTX_$$STS(RX,RFL,RESP)
85 I +RESP=2 S ACT="Not ECME Billable: "_$P(RESP,"^",2)
86 I +RESP=10 S ACT="ECME reversed/NOT re-submitted: "_$P(RESP,"^",2)
87 D RXACT^PSOBPSU2(RX,RFL,ACT,"M",DUZ)
88 ;
89 ; -Logs an ECME Activity Log if Rx Quantity is different than Billing Quantity
90 I 'RESP,$T(NCPDPQTY^PSSBPSUT)'="" D
91 . N DRUG,RXQTY,BLQTY,BLDU,Z
92 . S DRUG=$$GET1^DIQ(52,RX,6,"I")
93 . S RXQTY=$S('RFL:$$GET1^DIQ(52,RX,7,"I"),1:$$GET1^DIQ(52.1,RFL_","_RX,1))/1
94 . S Z=$$NCPDPQTY^PSSBPSUT(DRUG,RXQTY),BLQTY=Z/1,BLDU=$P(Z,"^",2)
95 . I RXQTY'=BLQTY D
96 . . D RXACT^PSOBPSU2(RX,RFL,"BILLING QUANTITY submitted: "_$J(BLQTY,0,$L($P(BLQTY,".",2)))_" ("_BLDU_")","M",DUZ)
97 ;
98 Q
99 ;
100REVERSE(RX,RFL,FROM,RSN,RTXT,IGRL,NDC) ; - Reverse a claim and close all OPEN/UNRESOLVED Rejects
101 ;Input: (r) RX - Rx IEN (#52)
102 ; (o) RFL - Refill # (Default: most recent)
103 ; (r) FROM - Function within OP (See BWHERE param. in EN^BPSNCPDP api)
104 ; (o) RSN - Close Reason (2:RX ON HOLD;4: RX RETURNED TO STOCK,5:RX DELETED,etc...)
105 ; (o) RTXT - Close Reason TEXT (Usually no passed if RSN is passed)
106 ; (o) IGRL - Ignore RELEASE DATE, reverse anyway
107 ; (o) NDC - NDC number related to the reversal (Note: might be an invalid NDC)
108 ;
109 I '$D(RFL) S RFL=$$LSTRFL(RX)
110 ;
111 I $$STATUS^PSOBPSUT(RX,RFL)="" Q
112 ;
113 N RESP,STS,ACT,STAT,DA,STATUS,NOACT S RSN=+$G(RSN),RTXT=$G(RTXT)
114 I RTXT="",RSN D
115 . S:RSN=2 RTXT="RX PLACED ON HOLD" S:RSN=3 RTXT="RX SUSPENDED" S:RSN=4 RTXT="RX RETURNED TO STOCK"
116 . S:RSN=5 RTXT="RX DELETED" S:RSN=7 RTXT="RX DISCONTINUED" S:RSN=8 RTXT="RX EDITED"
117 ;
118 D CLSALL^PSOREJUT(RX,RFL,DUZ,RSN,RTXT)
119 ;
120 I '$G(IGRL),$$RXRLDT^PSOBPSUT(RX,RFL) Q
121 ;
122 ; - Reseting the Re-transmission flag if Rx is being suspended
123 I RSN=3!($$GET1^DIQ(52,RX,100,"I")=5) D RETRXF^PSOREJU2(RX,RFL,1)
124 ;
125 S STATUS=$$STATUS^PSOBPSUT(RX,RFL),NOACT=0
126 I STATUS'="E PAYABLE",STATUS'="IN PROGRESS",STATUS'="E REVERSAL REJECTED",STATUS'="E REVERSAL STRANDED",STATUS'="E DUPLICATE" S NOACT=1
127 ;
128 S RESP=$$EN^BPSNCPDP(RX,RFL,$$DOS(RX,RFL),FROM,$$GETNDC^PSONDCUT(RX,RFL),RTXT)
129 ;
130 ; - Logging ECME Activity Log
131 I '$G(NOACT) D
132 . S ACT="Reversal sent to ECME: "_RTXT_$S($G(NDC)'="":" ("_NDC_")",1:"")_$$STS(RX,RFL,+RESP)
133 . D RXACT^PSOBPSU2(RX,RFL,ACT,"M",DUZ)
134 ;
135 Q
136 ;
137DOS(RX,RFL,DATE) ; Return the Date Of Service for ECME
138 ;Input: (r) RX - Rx IEN (#52)
139 ; (o) RFL - Refill # (Default: most recent)
140 ; (o) DATE - Possible Date Of Service
141 ;Output: DOS - Actual Date Of Service
142 ;
143 I '$D(RFL) S RFL=$$LSTRFL(RX)
144 ;
145 ; - Retrieving FILL DATE from the PRESCRIPTION file if not passed
146 I $G(DATE)="" S DATE=$$RXRLDT^PSOBPSUT(RX,RFL)
147 ; - Retrieving FILL DATE from the PRESCRIPTION file if not passed
148 I 'DATE S DATE=$$RXFLDT^PSOBPSUT(RX,RFL)
149 ; - Future Date not allowed
150 I DATE>DT!'DATE S DATE=DT
151 ;
152 Q (DATE\1)
153 ;
154RELEASE(RX,RFL,USR) ; - Notifies IB that the Rx was RELEASED
155 ;Input: (r) RX - Rx IEN (#52)
156 ; (o) RFL - Refill # (Default: most recent)
157 ; (o) USR - User responsible for releasing the Rx (Default: .5 - Postmaster)
158 ;
159 N IBAR,RXAR,FLDT,RFAR
160 ;
161 S:'$D(RFL) RFL=$$LSTRFL(RX)
162 S:'$D(USR) USR=.5
163 ;
164 D GETS^DIQ(52,RX_",",".01;2;6;7;8;22","I","RXAR")
165 S DFN=+$G(RXAR(52,RX_",",2,"I"))
166 S IBAR("PRESCRIPTION")=RX,IBAR("RX NO")=$G(RXAR(52,RX_",",.01,"I"))
167 S IBAR("CLAIMID")=$E((RX#10000000)+10000000,2,8),IBAR("USER")=USR
168 S IBAR("DRUG")=RXAR(52,RX_",",6,"I"),IBAR("NDC")=$$GETNDC^PSONDCUT(RX,RFL)
169 S FLDT=$$RXFLDT^PSOBPSUT(RX,RFL) I FLDT>DT S FLDT=DT
170 S IBAR("FILL NUMBER")=RFL,IBAR("FILL DATE")=FLDT
171 S IBAR("QTY")=$G(RXAR(52,RX_",",7,"I")),IBAR("DAYS SUPPLY")=$G(RXAR(52,RX_",",8,"I"))
172 ;
173 I RFL D
174 . D GETS^DIQ(52.1,RFL_","_RX_",",".01;1;1.1","I","RFAR")
175 . S IBAR("QTY")=$G(RFAR(52.1,RFL_","_RX_",",1,"I"))
176 . S IBAR("DAYS SUPPLY")=$G(RFAR(52.1,RFL_","_RX_",",1.1,"I"))
177 ;
178 S IBAR("STATUS")="RELEASED" D STORESP^IBNCPDP(DFN,.IBAR)
179 ;
180 Q
181 ;
182LSTRFL(RX) ; - Returns the latest fill for the Prescription
183 ; Input: (r) RX - Rx IEN (#52)
184 ;Output: LSTRFL - Most recent refill #
185 N I,LSTRFL
186 S (I,LSTRFL)=0 F S I=$O(^PSRX(RX,1,I)) Q:'I S LSTRFL=I
187 Q LSTRFL
188 ;
189ECMEACT(RX,RFL,COMM,USR) ; - Add an Activity to the ECME Activity Log (PRESCRIPTION file)
190 ;Input: (r) RX - Rx IEN (#52)
191 ; (o) RFL - Refill # (Default: most recent)
192 ; (r) COMM - Comments (up to 75 characters)
193 ; (o) USR - User logging the comments (Default: DUZ)
194 ;
195 S:'$D(RFL) RFL=$$LSTRFL^PSOBPSU1(RX)
196 D RXACT^PSOBPSU2(RX,RFL,COMM,"M",+$G(USR))
197 Q
198 ;
199STS(RX,RFL,RSP) ; Adds the Status to the ECME Activity Log according to Rx/fill claim status Response
200 N STS
201 S STS=$S($$STATUS^PSOBPSUT(RX,RFL)'="IN PROGRESS"&($$STATUS^PSOBPSUT(RX,RFL)'=""):"-"_$$STATUS^PSOBPSUT(RX,RFL),1:"")
202 S:+RSP=1 STS="-NO SUBMISSION THROUGH ECME" S:+RSP=3 STS="-NO REVERSAL NEEDED" S:+RSP=4 STS="-NOT PROCESSED"
203 S:+RSP=5 STS="-SOFTWARE ERROR"
204 I +RSP=2,$$STATUS^PSOBPSUT(RX,RFL)'="" S STS="-NOT BILLABLE:"_$P(RSP,"^",2)
205 Q STS
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