1 | BPSOSO2 ;BHAM ISC/FCS/DRS/DLF - NCPDP Override-Fman utils ;06/01/2004
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2 | ;;1.0;E CLAIMS MGMT ENGINE;**1,3,5**;JUN 2004;Build 45
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3 | ;;Per VHA Directive 2004-038, this routine should not be modified.
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4 | Q
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5 | ; EDIT,EDITGEN are called from the menus in BPSOSO1,
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6 | ; typically reached from the pharmacy package's call
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7 | ; to OVERRIDE^BPSOSO
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8 | ; GET511 is called from BPSOSCD during claim construction
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9 | ;
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10 | ;IHS/SD/lwj 8/01/02 NCPDP 5.1 changes to GET511 subroutine
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11 | ; Routine was changed to look at an exceptions list, if the
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12 | ; field being processed is in the exceptions list it will
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13 | ; create a "claim header" and "claim rx" entry. The reason
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14 | ; for this is that several 300 range fields were moved to the
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15 | ; claim rx area within the 5.1 segments creating duplicate flds.
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16 | ; (i.e. the <402 and >402 rule is no longer valid)
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17 | ;
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18 | ; New routine (PRIORA) added to handle the input of the prior
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19 | ; authorization information at prescription creation time.
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20 | ;
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21 | EDIT(IEN,FIELDNUM) ;
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22 | I '$D(FIELDNUM) D EDITGEN(IEN) Q
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23 | ; Editing one field
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24 | N DIE,DA,DR,DIDEL,DTOUT,FIELDNAM
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25 | S DA=$$HASVALUE(IEN,FIELDNUM)
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26 | ; Make sure the entry exists in the subfile.
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27 | ; Create an empty one if necessary.
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28 | I 'DA S DA=$$SETVALUE(IEN,FIELDNUM,"")
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29 | ; edit the value field in the subfile
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30 | S DIE="^BPS(9002313.511,"_IEN_",1,",DA(1)=IEN
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31 | S DR=.02_$TR($$FIELDNAM(FIELDNUM),""";~","")
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32 | D ^DIE
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33 | ; If the value is null, then delete the entire FIELDNUM entry
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34 | I $$GETVALUE(IEN,FIELDNUM)="" D DELVALUE(IEN,FIELDNUM)
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35 | Q
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36 | EDITGEN(IEN) ; general edit
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37 | ; First pass: quick & dirty Fileman ^DIE call
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38 | ; Future: Screenman interface
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39 | N DIE,DA,DR,DIDEL,DTOUT
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40 | S DA=IEN,DIE=$$FILENUM,DR=1 D ^DIE
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41 | ; And we need to delete any entries with null values
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42 | N A S A=0 F S A=$O(^BPS(9002313.511,IEN,1,A)) Q:'A D
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43 | . N X S X=^BPS(9002313.511,IEN,1,A,0)
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44 | . I $P(X,U,2)="" D
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45 | . . N FIELDNUM S FIELDNUM=$P(^BPSF(9002313.91,$P(X,U),0),U)
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46 | . . D DELVALUE(IEN,FIELDNUM)
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47 | Q
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48 | GET511(IEN,ARR101,ARR402) ;EP - from BPSOSCD - load arrays with data from IEN
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49 | ;
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50 | N A,C S A=0,C=0
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51 | N X,F,HDRLST,MULTLST,TFLD,BPFLDNUM
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52 | ;
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53 | ; Build the exception lists
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54 | S HDRLST=",524,",MULTLST=",308,315,316,317,318,319,320,327,"
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55 | ;
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56 | F S A=$O(^BPS(9002313.511,IEN,1,A)) Q:'A D
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57 | . S X=^BPS(9002313.511,IEN,1,A,0)
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58 | . S F=$P(X,U) ; Field IEN, points to 9002313.91
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59 | . ; Store in either claim header or claim detail, based on field #
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60 | . ; Note that logic below will put 401 field in both header and detail
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61 | . S BPFLDNUM=+$$FIELDNUM(F)
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62 | . S TFLD=","_BPFLDNUM_","
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63 | . I BPFLDNUM<402!(HDRLST[TFLD) S @ARR101@(F)=$P(X,U,2)
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64 | . I BPFLDNUM>400!(MULTLST[TFLD) S @ARR402@(F)=$P(X,U,2)
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65 | . ;
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66 | . S C=C+1
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67 | Q C
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68 | ;
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69 | ; Generalized utilities - good for everything, not just auth #
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70 | LOCK() L +^BPS(9002313.511,IEN):300 Q $T
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71 | UNLOCK L -^BPS(9002313.511,IEN) Q
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72 | FILENUM() Q 9002313.511
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73 | SUBFNUM() Q 9002313.5111
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74 | FLOCK() L +^BPS(9002313.511):300 Q $T
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75 | FUNLOCK L -^BPS(9002313.511) Q
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76 | FIELDIEN(FIELDNUM) ; ien of a 9002313.91 NCPDP Data Dictionary field
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77 | Q $$FIND1^DIC(9002313.91,,,FIELDNUM)
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78 | FIELDNAM(FIELDNUM) ; name of a 9002313.91 NCPDP Data Dictionary field
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79 | Q $$GET1^DIQ(9002313.91,$$FIELDIEN(FIELDNUM),.03)
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80 | ; given pointer to NCPDP Data Dictionary fields, return external #
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81 | FIELDNUM(IEN91) Q $P($G(^BPSF(9002313.91,IEN91,0)),U)
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82 | NEW() ;EP - create new entry in 9002313.511
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83 | F Q:$$FLOCK Q:'$$IMPOSS^BPSOSUE("L","RTI","interlock on new Override record creation",,"NEW",$T(+0))
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84 | N FLAGS,FDA,IEN,MSG,FN,X,NEWREC S FN=$$FILENUM
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85 | D NEW1
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86 | D FUNLOCK
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87 | Q NEWREC
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88 | NEW1 ;
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89 | S FDA(FN,"+1,",.01)=$O(^BPS(FN,"B",999999999999),-1)+1
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90 | D UPDATE^DIE(,"FDA","IEN","MSG")
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91 | I $D(MSG) D G NEW1:$$IMPOSS^BPSOSUE("FM","TRI","UPDATE^DIE failed",,"NEW1",$T(+0))
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92 | . D ZWRITE^BPSOS("FDA","IEN","MSG")
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93 | . K MSG
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94 | S NEWREC=IEN(1)
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95 | NEW2 ;
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96 | S FDA(FN,NEWREC_",",.02)="NOW"
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97 | D FILE^DIE("E","FDA","MSG")
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98 | Q:'$D(MSG) ; success
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99 | G NEW2:$$IMPOSS^BPSOSUE("FM","TRI","FILE^DIE failed",,"NEW2",$T(+0))
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100 | Q
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101 | HASVALUE(IEN,FIELDNUM) ; does the FIELDNUM have an override value?
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102 | ; returns IEN into the subfile
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103 | Q $$FIND1^DIC($$SUBFNUM,","_IEN_",",,FIELDNUM)
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104 | GETVALUE(IEN,FIELDNUM) ; return currently-set override value for given FIELDNUM
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105 | N X S X=$$HASVALUE(IEN,FIELDNUM) I 'X Q ""
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106 | Q $$GET1^DIQ($$SUBFNUM,X_","_IEN_",",.02)
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107 | SETVALUE(IEN,FIELDNUM,VALUE) ;
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108 | ; can DO or $$; $$ = ien in subfile for this FIELDNUM
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109 | ; Special case for the override file: if you're trying to set the
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110 | ; field's value to "@", don't just delete the field value,
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111 | ; which would leave the field defined with a null value.
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112 | ; Instead, delete the entire override for the field.
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113 | ; This prevents accidentally overriding a genuine value with null.
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114 | I "@"=VALUE D DELVALUE(IEN,FIELDNUM) Q ""
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115 | ; But the usual case is just storing a value:
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116 | N FDA,MSG,IENS,IENARRAY
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117 | ; Note: I tried the "+?1,ien," method but it always created a new
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118 | ; entry, even when it meant creating duplicates. So now we test to
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119 | ; see if there's already an entry for the fieldnum, and if not,
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120 | ; then we put in a "+1,"
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121 | N ENTRY S ENTRY=$$HASVALUE(IEN,FIELDNUM) ; do we already have FIELDNUM
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122 | I 'ENTRY S ENTRY="+1" ; if not, then create a new entry
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123 | S IENS=ENTRY_","_IEN_","
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124 | S FDA($$SUBFNUM,IENS,.01)=FIELDNUM
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125 | S FDA($$SUBFNUM,IENS,.02)=VALUE
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126 | D SETV1
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127 | I ENTRY="+1" S ENTRY=$G(IENARRAY(1))
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128 | Q ENTRY
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129 | SETV1 ;
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130 | D UPDATE^DIE("E","FDA","IENARRAY","MSG")
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131 | Q:'$D(MSG) ; success
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132 | K ^TMP("BPS",$J,"BPSOSO2",$J,"SETVALUE")
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133 | S ^TMP("BPS",$J,"BPSOSO2",$J,"SETVALUE")=$$ERRHDR
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134 | M ^TMP("BPS",$J,"BPSOSO2",$J,"SETVALUE","MSG")=MSG
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135 | I $D(IENARRAY) M ^TMP("BPS",$J,"BPSOSO2",$J,"SETVALUE","IENARRAY")=IENARRAY
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136 | D ZWRITE^BPSOS("FDA","IENARRAY","MSG")
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137 | G SETV1:$$IMPOSS^BPSOSUE("FM","TRI",,,"SETVALUE",$T(+0))
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138 | Q
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139 | DELVALUE(IEN,FIELDNUM) ;
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140 | N ENTRY S ENTRY=$$HASVALUE(IEN,FIELDNUM) Q:'ENTRY ; wasn't defined
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141 | N FDA,MSG
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142 | S FDA($$SUBFNUM,ENTRY_","_IEN_",",.01)="@"
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143 | DE5 D FILE^DIE("E","FDA","MSG")
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144 | Q:'$D(MSG) ; success
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145 | K ^TMP("BPS",$J,"BPSOSO2",$J,"DELVALUE")
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146 | S ^TMP("BPS",$J,"BPSOSO2",$J,"DELVALUE")=$$ERRHDR
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147 | D ZWRITE^BPSOS("IEN","FDA","MSG")
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148 | G DE5:$$IMPOSS^BPSOSUE("FM","TRI",,,"DELVALUE",$T(+0))
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149 | Q
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150 | ERRHDR() Q "ERROR AT $H="_$H_" FOR $J="_$J
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151 | SEE(IEN) N TMP M TMP=^BPS($$FILENUM,IEN) D ZWRITE^BPSOS("TMP") Q ; debugging
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152 | ;
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153 | PRIORA(IEN) ;IHS/SD/lwj 9/3/02 NCPDP 5.1 Changes - Prior Authorization
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154 | ; We are still processing 5.1 and 3.2 claims, so we have to be able
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155 | ; to populate fields 461, 462 and 416. 416 will be created based
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156 | ; on the input into fields 461, and 462.
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157 | ;
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158 | N FIELDNUM
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159 | ;
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160 | S FIELDNUM=461 ;Prior authorization type code
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161 | D EDIT(IEN,FIELDNUM)
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162 | ;
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163 | S FIELDNUM=462 ;Prior authorization number submitted
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164 | D EDIT(IEN,FIELDNUM)
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165 | ;
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166 | ;now we combine field 461 and 462 to creat field 416
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167 | ;
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168 | N VAL461,VAL462,VAL416,DA
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169 | S (VAL461,VAL462,VAL416)=""
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170 | ;
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171 | S VAL461=$$GETVALUE(IEN,461)
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172 | S VAL462=$$GETVALUE(IEN,462)
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173 | S VAL416=VAL461_VAL462
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174 | Q:VAL416=""
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175 | ;
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176 | S DA=$$SETVALUE(IEN,416,"")
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177 | S:$G(DA)'="" DA=$$SETVALUE(IEN,416,VAL416)
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178 | ;
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179 | ;
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180 | Q
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