1 | RMPRPFFS ;Hines OIFO/HNC - REMOTE PROCEDURE, LIST NPPD DATA ;9/8/03 07:23
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2 | ;;3.0;PROSTHETICS;**96,60**;Feb 09, 1996;Build 18
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3 | ;
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4 | ; patch 96 - HNC
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5 | ; -DBIA #4419 for INSUR^IBBAPI
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6 | ; -DBIA #3990 for ICDDX^ICDCODE
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7 | ; -DBIA #1997 for STATCHK^ICPTAPIU
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8 | ; -DBIA #3823 for read file 355.3, field .04
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9 | ;RESULTS passed to broker in ^TMP($J,
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10 | ;delimited by "^"
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11 | ;piece 1 = ENTRY DATE
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12 | ;piece 2 = PATIENT NAME
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13 | ;piece 3 = PSAS HCPCS with * if hcpcs has Calculation Flag
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14 | ;piece 4 = QTY
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15 | ;piece 5 = Insurance with * if more insurance info available
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16 | ;piece 6 = Insurance Effective Date
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17 | ;piece 7 = TOTAL COST
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18 | ;piece 8 = DESCRIPTION (ITEM, BRIEF DESCRIPTION WITH ~R~ FOR REPAIR)
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19 | ;piece 9 = Coding Errors
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20 | ;piece 10 = Insurance Holder
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21 | ;piece 11 = STATION
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22 | ;piece 12 = ICD9 Description
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23 | ;piece 13 = Billing Group Number
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24 | ;piece 14 = Subscriber ID
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25 | ;piece 15 = SSN
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26 | ;piece 16 = IEN TO FILE 660
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27 | ;piece 17 = HCPCS SHORT DESCRIPTION
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28 | ;piece 18 = ICD9 code
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29 | ;piece 19 = Delivery Date
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30 | ;piece 20 = Expiration Insurance Date
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31 | ;piece 21 = Hcpcs-Icd9 Flag, this routine will set field 4.9 in file 660
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32 | ;all records will have a 1
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33 | ;ICD9, 2
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34 | ;HCPCS, 3
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35 | ;Not Billable 4
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36 | ;
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37 | ;No errors, number 1.
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38 | ;PSAS HCPCS, Not Billable Item, number 14.
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39 | ;ICD9 error, number 12.
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40 | ;HCPCS error, number 13.
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41 | ;Both ICD9 and HCPCS error, number 132.
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42 | ;Both ICD9 error and Not Billable Item, number 142.
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43 | Q
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44 | ;
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45 | EN(RESULT,DATE1,DATE2) ;broker entry point
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46 | ;
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47 | K ^TMP($J)
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48 | I '$D(DATE1)!('$D(DATE2)) G EXIT
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49 | S DATE=DATE1-1
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50 | F S DATE=$O(^RMPR(660,"B",DATE)) Q:(DATE="")!($P(DATE,".",1)>DATE2) D
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51 | .S RMPRB=0
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52 | .F S RMPRB=$O(^RMPR(660,"B",DATE,RMPRB)) Q:RMPRB="" D
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53 | ..Q:$P(^RMPR(660,RMPRB,0),U,15)["*"
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54 | ..Q:$P(^RMPR(660,RMPRB,0),U,14)'["C"
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55 | ..;Q:$P(^RMPR(660,RMPRB,0),U,12)=""
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56 | ..Q:$P($G(^RMPR(660,RMPRB,"AM")),U,3)<2
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57 | ..;end of filter
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58 | ..S PHCPCS=$P($G(^RMPR(660,RMPRB,1)),U,4)
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59 | ..Q:PHCPCS=""
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60 | ..Q:PHCPCS'>0
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61 | ..S HDES=$P(^RMPR(661.1,PHCPCS,0),U,2)
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62 | ..;code set versioning check
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63 | ..S RICP=""
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64 | ..S RICP=$P(^RMPR(661.1,PHCPCS,0),U,1)
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65 | ..S RICPP="",CODERR="Alert",CODEFLG=1
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66 | ..I RICP'="" D
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67 | ...I $A($E(RICP,2,2))>64 S CODERR=" Non Billable Item",CODEFLG=CODEFLG_4 Q
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68 | ...I $A($E(RICP,2,2))<65 S RICPP=$$STATCHK^ICPTAPIU(RICP,$P(^RMPR(660,RMPRB,0),U,1))
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69 | ..I RICPP'="" D
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70 | ...I $P(RICPP,U,1)=0 S CODERR=CODERR_" HCPCS Inactive",CODEFLG=CODEFLG_3
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71 | ..S TYPE=$P($G(^RMPR(660,RMPRB,0)),U,4)
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72 | ..I TYPE'="X" S LINE=$P(^RMPR(661.1,PHCPCS,0),U,7)
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73 | ..I TYPE="X" S LINE=$P(^RMPR(661.1,PHCPCS,0),U,6)
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74 | ..S CAL=$P(^RMPR(661.1,PHCPCS,0),U,8)
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75 | ..I CAL'="" S CAL="*"
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76 | ..S DFN=$P(^RMPR(660,RMPRB,0),U,2)
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77 | ..D DEM^VADPT
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78 | ..D SVC^VADPT
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79 | ..S RMPROEOI=$S(VASV(11)>0:"<!>",VASV(12)>0:"<!>",VASV(13)>0:"<!>",1:0)
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80 | ..S (RMI,HOLDER,SUBID,INSUR,INSURE,INSURG,INSURGG,INICD9D,INICD9E,RMPRDELD,RMPRIND,RMPRDEL)=""
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81 | ..S RMPRDELD=$P(^RMPR(660,RMPRB,0),U,12)
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82 | ..I RMPRDELD'="" S RMPRDEL=$E(RMPRDELD,4,5)_"/"_$E(RMPRDELD,6,7)_"/"_(($E(RMPRDELD,1,3))+1700)
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83 | ..S X=$$INSUR^IBBAPI(DFN,,"RBA",.RMI,"*") I $D(RMI) D
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84 | ...;format the RMI array
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85 | ...;look for primary insurance
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86 | ...;RMI("IBBAPI","INSUR",n,7)=1^PRIMARY
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87 | ...S X="" F S X=$O(RMI("IBBAPI","INSUR",X)) Q:'X D
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88 | ....;I $P(RMI("IBBAPI","INSUR",X,7),U,2)'="PRIMARY" Q
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89 | ....S INSUR=$P(RMI("IBBAPI","INSUR",X,1),U,2)
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90 | ....I X>1 S INSUR="*"_INSUR
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91 | ....S SUBID=$P(RMI("IBBAPI","INSUR",X,14),U,1)
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92 | ....S HOLDER=$P(RMI("IBBAPI","INSUR",X,12),U,2)
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93 | ....S RMPRIND=$P(RMI("IBBAPI","INSUR",X,11),U,1)
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94 | ....I RMPRIND'="" S RMPRIND=$E(RMPRIND,4,5)_"/"_$E(RMPRIND,6,7)_"/"_(($E(RMPRIND,1,3))+1700)
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95 | ....S INSURE=$P(RMI("IBBAPI","INSUR",X,10),U,1)
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96 | ....I INSURE'="" S INSURE=$E(INSURE,4,5)_"/"_$E(INSURE,6,7)_"/"_(($E(INSURE,1,3))+1700)
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97 | ....S INSURG=$P(RMI("IBBAPI","INSUR",X,8),U,1)
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98 | ....S INSURGG=$$GET1^DIQ(355.3,INSURG_",",.04)
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99 | ..I '$D(RMI) D
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100 | ...S INSUR="No Insurance Information"
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101 | ...S SUBID=""
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102 | ...S HOLDER=""
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103 | ...S INSURE=""
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104 | ...S INSURGG=""
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105 | ...S RMPRIND=""
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106 | ..;get icd9 data
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107 | ..S INICD9I=$P($G(^RMPR(660,RMPRB,10)),U,8)
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108 | ..I INICD9I'="" D
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109 | ...S INICD9=$$ICDDX^ICDCODE(INICD9I,$P(^RMPR(660,RMPRB,0),U,1))
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110 | ...I INICD9'="" S INICD9E=$P(INICD9,U,2),INICD9D=$P(INICD9,U,4)
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111 | ...I $P(INICD9,U,10)=0 S CODERR=CODERR_" ICD9 Inactive",CODEFLG=CODEFLG_2
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112 | ..D DATA
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113 | S RESULT=$NA(^TMP($J))
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114 | Q
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115 | ;
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116 | DATA ;
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117 | S B=RMPRB
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118 | D GETS^DIQ(660,B,".01;.02;2;4.5;5;7;8;8.3;11;12;14;24;27;68","","RMXM")
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119 | S $P(^TMP($J,B),U,1)=$G(RMXM(660,B_",",.01))
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120 | ;Check for OEF/OIF
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121 | I RMPROEOI="<!>" S RMXM(660,B_",",.02)="<!>"_RMXM(660,B_",",.02)
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122 | S $P(^TMP($J,B),U,2)=$G(RMXM(660,B_",",.02))
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123 | S $P(^TMP($J,B),U,3)=$G(RMXM(660,B_",",4.5))_CAL
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124 | S $P(^TMP($J,B),U,4)=$G(RMXM(660,B_",",5))
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125 | ;change to insurance
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126 | I INSUR="" S INSUR="Incomplete Insurance Information"
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127 | S $P(^TMP($J,B),U,5)=INSUR
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128 | ;change to effective insurance date
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129 | S $P(^TMP($J,B),U,6)=INSURE
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130 | S $P(^TMP($J,B),U,7)=$G(RMXM(660,B_",",14))
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131 | ;patch 77 remove the " for Excel CSV
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132 | ;append ~R~ for repair items
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133 | I $G(RMXM(660,B_",",2))="REPAIR" S RMXM(660,B_",",24)="~R~"_RMXM(660,B_",",24)
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134 | S $P(^TMP($J,B),U,8)=$TR($G(RMXM(660,B_",",24)),"""","'")
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135 | ;change to coding errors
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136 | I CODERR="Alert" S CODERR=""
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137 | S $P(^TMP($J,B),U,9)=CODERR
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138 | ;change to holder
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139 | S $P(^TMP($J,B),U,10)=HOLDER
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140 | S $P(^TMP($J,B),U,11)=$G(RMXM(660,B_",",8))
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141 | ;change to ICD9 description
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142 | S $P(^TMP($J,B),U,12)=INICD9D
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143 | ;change to Billing Group
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144 | S $P(^TMP($J,B),U,13)=INSURGG
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145 | ;change to subscriber ID
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146 | S $P(^TMP($J,B),U,14)=SUBID
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147 | S $P(^TMP($J,B),U,15)=$P(VADM(2),U,2)
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148 | S $P(^TMP($J,B),U,16)=B
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149 | S $P(^TMP($J,B),U,17)=HDES
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150 | ;change to ICD9 code
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151 | S $P(^TMP($J,B),U,18)=INICD9E
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152 | ;add Delivery Date
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153 | S $P(^TMP($J,B),U,20)=RMPRDEL
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154 | ;add Insurance Expiration Date
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155 | S $P(^TMP($J,B),U,19)=RMPRIND
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156 | ;hcpcs-icd9 code flag
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157 | S $P(^TMP($J,B),U,21)=CODEFLG
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158 | S $P(^RMPR(660,RMPRB,1),U,11)=CODEFLG
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159 | S $P(^RMPR(660,RMPRB,1),U,12)=DT
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160 | K RMXM,VADM,CAL
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161 | D KVAR^VADPT
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162 | Q
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163 | EXIT ;common exit point
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164 | N RESULTS D KILL^XUSCLEAN
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165 | Q
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166 | ;END
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