1 | IBCECSA5 ;ALB/CXW - VIEW EOB SCREEN ;01-OCT-1999
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2 | ;;2.0;INTEGRATED BILLING;**137,135,263,280,155,349**;21-MAR-1994;Build 46
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3 | ;;Per VHA Directive 2004-038, this routine should not be modified.
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4 | ;
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5 | EN ; -- main entry point for VIEW EOB
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6 | N VALMCNT,VALMBG,VALMHDR
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7 | S VALMCNT=0,VALMBG=1
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8 | D EN^VALM("IBCEM VIEW EOB")
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9 | Q
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10 | ;
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11 | INIT ; -- init variables and list array
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12 | I '$G(IBIFN) S VALMQUIT="" G INITQ ; bill# is required
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13 | D HDR^IBCEOB2 ; build the VALMHDR array
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14 | K IBCNT,IBONE,^TMP("IBCECSD",$J) ; kill vars and scratch global
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15 | ;
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16 | ; 8/13/03 - If variable IBEOBIFN is set, then this is the 361.1 ien
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17 | ; that the user selected from a list. Build the detail.
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18 | I $G(IBEOBIFN) S IBCNT=IBEOBIFN,IBONE=1 D BLD^IBCECSA6 G INITQ
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19 | ;
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20 | D BLD^IBCEOB2 ; build ^TMP("IBCEOB",$J) containing MRA/EOB lister
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21 | S IBONE=0
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22 | M ^TMP("IBCECSD",$J)=^TMP("IBCEOB",$J)
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23 | ;
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24 | ; 4/7/03 - If only 1 EOB record found for this bill, then set the
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25 | ; IBCNT variable, the IBONE one-time flag, and build the
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26 | ; detail sections of this list.
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27 | I $G(VALMCNT)=1 S IBCNT=$P($G(^TMP("IBCECSD",$J,1)),U,2),IBONE=1 I IBCNT D BLD^IBCECSA6
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28 | ;
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29 | INITQ Q
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30 | ;
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31 | HELP ; -- help code
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32 | S X="?" D DISP^XQORM1 W !!
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33 | Q
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34 | ;
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35 | EXIT ; -- exit code
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36 | K ^TMP("IBCECSD",$J)
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37 | D CLEAR^VALM1,CLEAN^VALM10
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38 | Q
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39 | MIN ;
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40 | N IBREC1,IBRM1,IBRM2,IBRM3,IBRM4,IBRM5,IBRL,IBTYPE,IBT,IBTX,IBD
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41 | ; flag for inpatient mra
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42 | S IBTYPE=$S($G(IBSRC):1,$$INPAT^IBCEF(+IBREC):1,1:0)
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43 | ;
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44 | S IB=$$SETSTR^VALM1("MEDICARE INFORMATION:","",1,50)
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45 | D SET(IB)
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46 | I '$G(IBSRC) D
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47 | . D CNTRL^VALM10(VALMCNT,1,21,IORVON,IORVOFF)
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48 | . S ^TMP("IBCECSD",$J,"X",5)=VALMCNT
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49 | I $G(IBSRC),'$D(^IBM(361.1,IBCNT,4)) Q
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50 | I '$G(IBSRC),'$$INPAT^IBCEF(+IBREC) Q
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51 | D SET(" INPATIENT:")
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52 | S IBREC1=$G(^IBM(361.1,IBCNT,4)),(IB,IBRL)=""
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53 | ;
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54 | F IBT=2:1 S IBTX=$P($T(MINDAT+IBT),";",3) Q:IBTX="" D
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55 | . S IBD=$P(IBREC1,"^",+IBTX)
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56 | . I $L($P(IBTX,"^",4)) X $P(IBTX,"^",4) E N IBFULL S IBFULL=1
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57 | . I $S(IBFULL:1,1:IBD) D
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58 | .. I $L($P(IBTX,"^",4)) X $P(IBTX,"^",4) I Q
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59 | .. X "S IBD="_$S($L($P(IBTX,"^",3)):$P(IBTX,"^",3),1:"$$A10(IBD)")
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60 | .. S IB=$$SETSTR^VALM1($P(IBTX,"^",2)_IBD,IB,$S('IBRL:4,1:37),$S('IBRL:41,1:38))
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61 | .. S IBRL=$S(IBRL:0,1:1)
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62 | .. I 'IBRL D SET(IB,IBRL) S IB=""
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63 | ;
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64 | D:IBRL'="" SET(IB)
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65 | D REMARK
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66 | Q
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67 | ;
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68 | MINDAT ; data for MIN tag
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69 | ; format: piece^lable^special format code^special decision for disp
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70 | ;;1^Cov Days/Visit Ct : ^$$RJ(+IBD)^I $G(IBSRC)
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71 | ;;3^Claim DRG Amt :
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72 | ;;2^Lifetm Psych Dy Ct : ^$$RJ(IBD)
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73 | ;;5^Disprop Share Amt : ^^I IBTYPE
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74 | ;;4^Cap Exception Amt :
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75 | ;;7^PPS Capital Amt : ^^I IBTYPE
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76 | ;;6^MSP Pass Thru Amt :
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77 | ;;9^PPS Cap HSP-DRG Amt: ^^I IBTYPE
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78 | ;;8^PPS Cap FSP-DRG Amt: ^^I IBTYPE
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79 | ;;11^Old Capital Amt : ^^I IBTYPE
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80 | ;;10^PPS Cap DSH-DRG Amt: ^^I IBTYPE
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81 | ;;13^PPS Op Hos DRG Amt :
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82 | ;;12^PPS Capital IME Amt: ^^I IBTYPE
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83 | ;;15^PPS Op Fed DRG Amt : ^^I IBTYPE
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84 | ;;14^Cost Report Day Ct : ^$$RJ(IBD)^I IBTYPE
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85 | ;;17^Indirect Teach Amt : ^^I IBTYPE
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86 | ;;16^PPS Cap Outlier Amt: ^^I IBTYPE
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87 | ;;18^Non-Pay Prof Comp : ^$$RJ(IBD)
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88 | ;;19^Non-Covered Days Ct: ^$$RJ(+IBD)^I IBTYPE
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89 | ;;
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90 | ;
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91 | REMARK ; set up remarks and line level details
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92 | N IBREC1,IBP,IBT,IBX,RCODE,RDESC,REXIST
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93 | Q:$G(IBREM) S IBREM=1
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94 | D SET(" ")
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95 | D SET(" Claim Level Remark Information")
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96 | D SET(" Code Description")
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97 | I '$G(IBSRC) D
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98 | . D CNTRL^VALM10(VALMCNT,4,4,IOUON,IOUOFF)
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99 | . D CNTRL^VALM10(VALMCNT,13,11,IOUON,IOUOFF)
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100 | . Q
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101 | ;
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102 | S IBREC1=$P($G(^IBM(361.1,IBCNT,3)),U,3,7)
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103 | I $P(IBREC1,U,1)="" S IBREC1=$P($G(^IBM(361.1,IBCNT,5)),U,1,5)
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104 | S REXIST=0
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105 | ;
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106 | F IBP=1:1:5 D
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107 | . S RCODE=$P(IBREC1,U,IBP)
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108 | . S RDESC=$G(^IBM(361.1,IBCNT,"RM"_IBP))
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109 | . I RCODE="",RDESC="" Q
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110 | . S REXIST=1
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111 | . K IBT
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112 | . S IBT(IBP)=RDESC
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113 | . D TXT1(.IBT,0,60)
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114 | . D SET(" "_$$LJ^XLFSTR(RCODE,6)_"- "_$G(IBT(1)))
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115 | . S IBX=1
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116 | . F S IBX=$O(IBT(IBX)) Q:'IBX D SET($J("",12)_IBT(IBX))
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117 | . Q
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118 | ;
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119 | I 'REXIST D SET(" No claim level remarks on file")
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120 | D SET(" ")
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121 | Q:$G(IBSRC) ; MRA Only
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122 | ;
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123 | MRALLA S IB=$$SETSTR^VALM1("LINE LEVEL ADJUSTMENTS:","",1,50)
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124 | D SET(IB)
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125 | I '$G(IBSRC) D
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126 | . D CNTRL^VALM10(VALMCNT,1,23,IORVON,IORVOFF)
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127 | . S ^TMP("IBCECSD",$J,"X",7)=VALMCNT
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128 | I '$D(^IBM(361.1,IBCNT,15,0)) D SET("NONE") Q ; only if there is info
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129 | ;
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130 | ; look up all billed data
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131 | N IBZDATA,IBFORM,IBX2,IBX3,IBREC2,IBREC3,IBTX,IBT,IBRC,IBZ,IBTXL
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132 | S IBFORM=0 ; cms-1500
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133 | I $$FT^IBCEF(+IBREC)=3 S IBFORM=1 ; UB-04
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134 | D F^IBCEF("N-"_$S(IBFORM:"UB-04",1:"HCFA 1500")_" SERVICE LINE (EDI)","IBZDATA",,+IBREC)
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135 | ;
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136 | S IBX=0 F S IBX=$O(^IBM(361.1,IBCNT,15,IBX)) Q:IBX<1 S IBREC1=^IBM(361.1,IBCNT,15,IBX,0) D
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137 | . NEW RVL
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138 | . D SET(" # SV DT REVCD PROC MOD UNITS BILLED DEDUCT COINS ALLOW PYMT")
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139 | . S RVL=+$P(IBREC1,U,12) ; referenced Vista line#
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140 | . I 'RVL S RVL=IBX ; use the EOB line# if not there
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141 | . S IBT=$$RJ($P(IBREC1,"^"),3) ; line number
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142 | . S IBT=IBT_" "_$$DAT1^IBOUTL($P($P(IBREC1,"^",16),".")) ; service date
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143 | . S IBT=IBT_" "_$$RJ($$EXTERNAL^DILFD(361.115,.1,"",$P(IBREC1,"^",10)),6) ; revcd
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144 | . S IBT=IBT_" "_$$RJ($P(IBREC1,"^",4),5) ; procedure
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145 | . S IBT=IBT_" "_$$RJ($P($G(^IBM(361.1,IBCNT,15,IBX,2,1,0)),"^"),3)_$S($D(^IBM(361.1,IBCNT,15,IBX,2,2,0)):"+",1:" ") ; modifiers
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146 | . S IBT=IBT_" "_$$RJ($FN($P(IBREC1,"^",11),"",0),5) ; units
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147 | . S IBT=IBT_" "_$$RJ($FN($S(IBFORM:$P($G(IBZDATA(RVL)),"^",5),1:$P($G(IBZDATA(RVL)),"^",8)*$P($G(IBZDATA(RVL)),"^",9)),"",2),8) ; billed
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148 | . S IBT=IBT_" "_$$RJ($FN($P($G(^IBM(361.1,IBCNT,15,IBX,1,+$O(^IBM(361.1,IBCNT,15,IBX,1,"B","PR",0)),1,+$O(^IBM(361.1,IBCNT,15,IBX,1,+$O(^IBM(361.1,IBCNT,15,IBX,1,"B","PR",0)),1,"B",1,0)),0)),"^",2),"",2),7) ; deduct
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149 | . S IBT=IBT_" "_$$RJ($FN($P($G(^IBM(361.1,IBCNT,15,IBX,1,+$O(^IBM(361.1,IBCNT,15,IBX,1,"B","PR",0)),1,+$O(^IBM(361.1,IBCNT,15,IBX,1,+$O(^IBM(361.1,IBCNT,15,IBX,1,"B","PR",0)),1,"B",2,0)),0)),"^",2),"",2),6) ; coins
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150 | . S IBT=IBT_" "_$$RJ($FN($P(IBREC1,"^",13),"",2),8) ; allow
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151 | . S IBT=IBT_" "_$$RJ($FN($P(IBREC1,"^",3),"",2),8) ; payment
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152 | . D SET(IBT)
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153 | . S IBX2=0 F S IBX2=$O(^IBM(361.1,IBCNT,15,IBX,1,IBX2)) Q:IBX2<1 D
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154 | .. S IBREC2=^IBM(361.1,IBCNT,15,IBX,1,IBX2,0),IBX3=0
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155 | .. F S IBX3=$O(^IBM(361.1,IBCNT,15,IBX,1,IBX2,1,IBX3)) Q:IBX3<1 D
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156 | ... S IBREC3=^IBM(361.1,IBCNT,15,IBX,1,IBX2,1,IBX3,0)
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157 | ... ; line level adjustments; don't display kludges (esg 10/23/03)
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158 | ... I $P(IBREC2,U,1)="PR",$P(IBREC3,U,1)="AAA" Q
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159 | ... I $P(IBREC2,U,1)="OA",$P(IBREC3,U,1)="AB3" Q
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160 | ... I $P(IBREC2,U,1)="LQ" Q
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161 | ... S IBTX(1)="ADJ: "_$P(IBREC2,"^")_" "_$P(IBREC3,"^")_" "_$P(IBREC3,"^",4) D TXT1(.IBTX,0,79) S IBT=0 F S IBT=$O(IBTX(IBT)) Q:IBT<1 D SET(IBTX(IBT))
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162 | ... K IBTX
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163 | ... D SET("ADJ AMT: "_$FN($P(IBREC3,"^",2),"",2))
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164 | . S IBRC=0
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165 | . F S IBRC=$O(^IBM(361.1,IBCNT,15,IBX,4,IBRC)) Q:'IBRC S IBREC2=$G(^(IBRC,0)) I IBREC2 K IBTX,IBZ S IBTX(1)=" -REMARK CODE("_+IBREC2_"): ",IBTXL=$L(IBTX(1)) D
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166 | .. S IBTX(1)=IBTX(1)_$P(IBREC2,U,2)_" "_$P(IBREC2,U,3)
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167 | .. I $L(IBTX(1))>79 D
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168 | ... D TXT1(.IBTX,0,79) D SET(IBTX(1)) M IBZ=IBTX K IBTX S IBTX(1)="",IBT=1 F S IBT=$O(IBZ(IBT)) Q:'IBT S IBTX(1)=IBTX(1)_IBZ(IBT)_" "
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169 | .. E D
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170 | ... S IBTXL=0
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171 | .. D TXT1(.IBTX,IBTXL,79) S IBT=0 F S IBT=$O(IBTX(IBT)) Q:IBT<1 D SET(IBTX(IBT))
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172 | . D SET(" ")
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173 | D SET(" ")
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174 | Q
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175 | ;
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176 | TXT(IBRM,IBLN,IBXY) ;display text over 79 chars
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177 | ;IBRM - text, IBLN - length, IBXY - position
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178 | S IBRM=$E(IBRM,IBLN+1,999)
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179 | REP I $E(IBRM,1,IBLN)'="" S IB=$$SETSTR^VALM1($E(IBRM,1,IBLN),"",IBXY,IBLN) D SET(IB) S IBRM=$E(IBRM,IBLN+1,999) G REP
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180 | Q
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181 | ;
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182 | SET(IB,IBSAV) ;
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183 | I '$G(IBSAV) D SET^IBCECSA6($G(IBSRC),IB,CNT,IBCNT)
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184 | Q
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185 | ;
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186 | A10(X) ;
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187 | Q $$A10^IBCECSA6(X)
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188 | ;
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189 | A7(X) ; returns a dollar amount right justified to 7 characters
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190 | Q $$RJ($FN(X,"",2),7)
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191 | ;
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192 | TXT1(IBT,DIWL,DIWR) ; sets up text for over 79 chars
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193 | ; IBT - pass by ref, array of text to be formatted back in array
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194 | ; DIWL - left margin, DIWR = right margin
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195 | N IBX,X,DIWF,IBS K ^UTILITY($J,"W")
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196 | S DIWF="|I"_DIWL
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197 | S IBX=0 F S IBX=$O(IBT(IBX)) Q:IBX<1 S X=IBT(IBX) D ^DIWP
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198 | K IBT F S IBX=$O(^UTILITY($J,"W",DIWL,IBX)) Q:IBX<1 S IBT(IBX)=^UTILITY($J,"W",DIWL,IBX,0)
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199 | K ^UTILITY($J,"W")
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200 | Q
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201 | ;
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202 | RJ(X,Y) ; right just, default is 10
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203 | Q $$RJ^XLFSTR(X,$G(Y,10)," ")
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204 | ;
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