| 1 | IBCEF73A ;ALB/KJH - FORMATTER AND EXTRACTOR SPECIFIC (NPI) BILL FUNCTIONS ; 30 Aug 2006  10:38 AM | 
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| 2 | ;;2.0;INTEGRATED BILLING;**343,374,395**;21-MAR-94;Build 3 | 
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| 3 | ;; Per VHA Directive 10-93-142, this routine should not be modified. | 
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| 4 | ; | 
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| 5 | PROVNPI(IBIEN399,IBNONPI) ; | 
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| 6 | ;Retrieves NPIs from #200 or 355.93 | 
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| 7 | ; Input: | 
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| 8 | ;       IBIEN399 - IEN of record in BILL/CLAIMS file 399 | 
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| 9 | ;       IBNONPI - variable to pass info on missing NPI to calling routine.  Pass by reference | 
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| 10 | ; Output: | 
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| 11 | ;       NPI codes for all providers | 
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| 12 | ;       IBNONPI - U-delimited list of provider types with missing NPIs | 
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| 13 | N IBRETVAL,IBPTR,IBFT | 
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| 14 | S IBRETVAL="",IBNONPI="" | 
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| 15 | F IBFT=1:1:9 D | 
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| 16 | . S IBPTR=$$PROVPTR^IBCEF7(IBIEN399,IBFT) | 
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| 17 | . I IBPTR S $P(IBRETVAL,"^",IBFT)=$$GETNPI(IBPTR) | 
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| 18 | Q IBRETVAL | 
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| 19 | GETNPI(IBPTR) ;look for NPI in #200 or #355.93 | 
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| 20 | ;Input: IBPTR from 399.0222, field .02 | 
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| 21 | ;Output: NPI | 
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| 22 | ;if in file #200 | 
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| 23 | N NPI | 
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| 24 | S NPI="" | 
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| 25 | ;if in 200 then get it from 200 | 
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| 26 | I $P(IBPTR,";",2)="VA(200," S NPI=$P($$NPI^XUSNPI("Individual_ID",$P(IBPTR,";")),U) S:NPI=-1 NPI="" | 
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| 27 | ;if in 355.93 then use 355.93 | 
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| 28 | I $P(IBPTR,";",2)="IBA(355.93," S NPI=$$NPIGET^IBCEP81($P(IBPTR,";")) | 
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| 29 | I NPI="",$D(IBNONPI) S IBNONPI=$S(IBNONPI="":IBFT,1:IBNONPI_U_IBFT) | 
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| 30 | Q NPI | 
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| 31 | ; | 
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| 32 | SPECTAX(IBIEN399,IBNOSPEC) ; | 
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| 33 | ;Retrieves Specialty Codes from Current Taxonomy entries for a claim from #399 | 
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| 34 | ; Input: | 
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| 35 | ;       IBIEN399 - IEN of record in BILL/CLAIMS file 399 | 
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| 36 | ;       IBNOSPEC - variable to pass info on missing taxonomies to calling routine.  Pass by reference | 
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| 37 | ; Output: | 
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| 38 | ;       Taxonomy Specialty Codes for all providers | 
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| 39 | ;       IBNOSPEC - U-delimited list of provider types with missing Taxonomy Specialty codes | 
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| 40 | N IBRETVAL,IBN,IBFT,IBSPEC,SPEC | 
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| 41 | S IBRETVAL="",IBNOSPEC="" | 
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| 42 | I $G(IBIEN399)="" Q "" | 
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| 43 | F IBFT=1:1:9 D | 
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| 44 | . S IBN=$O(^DGCR(399,IBIEN399,"PRV","B",IBFT,0)) | 
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| 45 | . I +IBN=0 Q | 
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| 46 | . S IBSPEC=$P($G(^DGCR(399,IBIEN399,"PRV",+IBN,0)),"^",15) | 
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| 47 | . S SPEC=$$GET1^DIQ(8932.1,IBSPEC,"SPECIALTY CODE") | 
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| 48 | . S $P(IBRETVAL,"^",IBFT)=SPEC | 
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| 49 | . I SPEC="",$D(IBNOSPEC) S IBNOSPEC=$S(IBNOSPEC="":IBFT,1:IBNOSPEC_U_IBFT) | 
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| 50 | Q IBRETVAL | 
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| 51 | ; | 
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| 52 | PROVTAX(IBIEN399,IBNOTAX) ; | 
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| 53 | ;Retrieves Current Taxonomy entries for a claim from #399 | 
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| 54 | ; Input: | 
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| 55 | ;       IBIEN399 - IEN of record in BILL/CLAIMS file 399 | 
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| 56 | ;       IBNOTAX - variable to pass info on missing taxonomies to calling routine.  Pass by reference | 
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| 57 | ; Output: | 
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| 58 | ;       Taxonomy X12 codes for all providers | 
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| 59 | ;       IBNOTAX - U-delimited list of provider types with missing Taxonomy X12 codes | 
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| 60 | N IBRETVAL,IBN,IBFT,IBTAX,TAX | 
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| 61 | S IBRETVAL="",IBNOTAX="" | 
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| 62 | I $G(IBIEN399)="" Q "" | 
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| 63 | F IBFT=1:1:9 D | 
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| 64 | . S IBN=$O(^DGCR(399,IBIEN399,"PRV","B",IBFT,0)) | 
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| 65 | . I +IBN=0 Q | 
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| 66 | . S IBTAX=$P($G(^DGCR(399,IBIEN399,"PRV",+IBN,0)),"^",15) | 
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| 67 | . S TAX=$$GET1^DIQ(8932.1,IBTAX,"X12 CODE") | 
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| 68 | . S $P(IBRETVAL,"^",IBFT)=TAX | 
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| 69 | . I TAX="",$D(IBNOTAX) S IBNOTAX=$S(IBNOTAX="":IBFT,1:IBNOTAX_U_IBFT) | 
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| 70 | Q IBRETVAL | 
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| 71 | GETTAX(IBPTR) ;look for Taxonomy in #200 or #355.93 | 
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| 72 | ;Input: IBPTR from 399.0222, field .02 | 
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| 73 | ;Output: Taxonomy X12 code_"^"_IEN | 
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| 74 | N TAX | 
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| 75 | S TAX="^" | 
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| 76 | ;if in 200 then get it from 200 | 
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| 77 | I $P(IBPTR,";",2)="VA(200," S TAX=$$TAXIND^XUSTAX($P(IBPTR,";")) | 
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| 78 | ;if in 355.93 then use 355.93 | 
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| 79 | I $P(IBPTR,";",2)="IBA(355.93," S TAX=$$TAXGET^IBCEP81($P(IBPTR,";")) | 
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| 80 | Q TAX | 
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| 81 | ; | 
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| 82 | ORGNPI(IBIEN399,IBNONPI) ; Extract NPIs for organizations on this claim | 
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| 83 | ; Input | 
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| 84 | ;       IBIEN399 - Claim IEN in file 399 | 
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| 85 | ;       IBNONPI - Variable to pass info on missing NPI back to calling routine.  Pass by reference. | 
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| 86 | ; Output - NPI codes for facilities | 
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| 87 | ;        Piece 1) Division (Responsible Institution) NPI code | 
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| 88 | ;        Piece 2) Non-VA Service Facility NPI code | 
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| 89 | ;        Piece 3) Billing Provider NPI code (main VA division) | 
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| 90 | N IBRETVAL,IBORG,IBEVDT,IBDIV,NPI | 
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| 91 | S IBNONPI="" | 
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| 92 | I $G(IBIEN399)="" Q "" | 
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| 93 | S IBRETVAL="" | 
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| 94 | S IBEVDT=$$GET1^DIQ(399,IBIEN399_",",.03,"I") | 
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| 95 | I IBEVDT="" S IBEVDT=DT | 
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| 96 | S IBDIV=$$GET1^DIQ(399,IBIEN399_",",.22,"I") | 
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| 97 | I IBDIV="" S IBDIV=$$PRIM^VASITE(IBEVDT) | 
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| 98 | S IBORG=$P($$SITE^VASITE(IBEVDT,IBDIV),U),NPI="" | 
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| 99 | I IBORG S NPI=$P($$NPI^XUSNPI("Organization_ID",IBORG),U) S:NPI'=-1 $P(IBRETVAL,U)=NPI | 
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| 100 | I NPI<1,$D(IBNONPI) S IBNONPI=1 | 
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| 101 | S IBORG=$$GET1^DIQ(399,IBIEN399_",",232,"I") | 
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| 102 | I IBORG S NPI=$$NPIGET^IBCEP81(IBORG),$P(IBRETVAL,U,2)=NPI I 'NPI,$D(IBNONPI) S IBNONPI=$S(IBNONPI="":2,1:IBNONPI_U_2) | 
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| 103 | S IBORG=$P($$SITE^VASITE,U),NPI="" | 
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| 104 | I IBORG S NPI=$P($$NPI^XUSNPI("Organization_ID",IBORG),U) S:NPI'=-1 $P(IBRETVAL,U,3)=NPI | 
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| 105 | I NPI<1,$D(IBNONPI) S IBNONPI=$S(IBNONPI="":3,1:IBNONPI_U_3) | 
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| 106 | I $$ISRX^IBCEF1(IBIEN399) S IBORG=$$RXSITE(IBIEN399) I IBORG S NPI=$P($$NPI^XUSNPI("Organization_ID",IBORG),U) S:NPI'=-1 $P(IBRETVAL,U,3)=NPI | 
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| 107 | Q IBRETVAL | 
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| 108 | ; | 
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| 109 | ORGTAX(IBIEN399,IBNOTAX) ; Extract Taxonomies for organizations on this claim | 
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| 110 | ; Input | 
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| 111 | ;       IBIEN399 - Claim IEN in file 399 | 
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| 112 | ;       IBNOTAX - Variable to pass info on missing taxonomies back to calling routine.  Pass by reference. | 
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| 113 | ; Output - Taxonomy X12 codes for facilities | 
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| 114 | ;        Piece 1) Division (Responsible Institution) Taxonomy X12 code | 
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| 115 | ;        Piece 2) Non-VA Service Facility Taxonomy X12 code | 
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| 116 | ;        Piece 3) Billing Provider Taxonomy X12 code (main VA division) | 
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| 117 | N IBRETVAL,IBTAX,TAX | 
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| 118 | S IBTAX=$$GET1^DIQ(399,IBIEN399_",",243,"I") | 
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| 119 | S TAX=$$GET1^DIQ(8932.1,IBTAX,"X12 CODE") | 
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| 120 | S $P(IBRETVAL,U)=TAX | 
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| 121 | I '$L(TAX),$D(IBNOTAX) S IBNOTAX=1 | 
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| 122 | S IBTAX=$$GET1^DIQ(399,IBIEN399_",",244,"I") | 
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| 123 | S TAX=$$GET1^DIQ(8932.1,IBTAX,"X12 CODE") | 
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| 124 | S $P(IBRETVAL,U,2)=TAX | 
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| 125 | I '$L(TAX),$$GET1^DIQ(399,IBIEN399_",",232,"I"),$D(IBNOTAX) S IBNOTAX=$S(IBNOTAX="":2,1:IBNOTAX_U_2) | 
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| 126 | S IBORG=$P($$SITE^VASITE,U) | 
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| 127 | S TAX=$P($$TAXORG^XUSTAX(IBORG),U) | 
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| 128 | S $P(IBRETVAL,U,3)=TAX | 
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| 129 | I '$L(TAX),$D(IBNOTAX) S IBNOTAX=$S(IBNOTAX="":3,1:IBNOTAX_U_3) | 
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| 130 | Q IBRETVAL | 
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| 131 | ; | 
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| 132 | RXSITE(IBIEN399,IBLIST) ; returns prescription organization (file 4) pointer | 
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| 133 | ; for the given bill.  If IBLIST passed by reference, then a list of | 
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| 134 | ; the possible organizations are returned for a bill, since a bill may | 
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| 135 | ; have more than one prescription.  If more than one rx on the bill, the | 
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| 136 | ; $$ return is the pointer of the last prescription found. | 
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| 137 | ; IBLIST(rx ien,fill date)=ORGINATION (file 4 pointer) | 
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| 138 | ; | 
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| 139 | N IBX,IBDATA,IBORG,IBRX,IBDT,IBY,IBRXN,DFN | 
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| 140 | K ^TMP($J,"IBCEF73A") | 
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| 141 | S IBORG=0,DFN=$P($G(^DGCR(399,IBIEN399,0)),"^",2),IBLIST="IBCEF73A" | 
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| 142 | S IBRXN=0 F  S IBRXN=$O(^IBA(362.4,"AIFN"_IBIEN399,IBRXN)) Q:'IBRXN  S IBX=0 F  S IBX=$O(^IBA(362.4,"AIFN"_IBIEN399,IBRXN,IBX)) Q:'IBX  D | 
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| 143 | . S IBDATA=$G(^IBA(362.4,IBX,0)) | 
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| 144 | . S IBRX=$P(IBDATA,"^",5),IBDT=$P(IBDATA,"^",3) Q:'IBRX!('IBDT) | 
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| 145 | . D RX^PSO52API(DFN,IBLIST,IBRX,,"0,2,R") | 
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| 146 | . I IBDT=+$G(^TMP($J,"IBCEF73A",DFN,IBRX,22)) S (IBORG,IBLIST(IBRX,IBDT))=$$PSONPI(+$G(^TMP($J,"IBCEF73A",DFN,IBRX,20))) Q | 
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| 147 | . S IBY=0 F  S IBY=$O(^TMP($J,"IBCEF73A",DFN,IBRX,"RF",IBY)) Q:'IBY  I IBDT=+$G(^TMP($J,"IBCEF73A",DFN,IBRX,"RF",IBY,.01)) S (IBORG,IBLIST(IBRX,IBDT))=$$PSONPI(+$G(^TMP($J,"IBCEF73A",DFN,IBRX,"RF",IBY,8))) Q | 
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| 148 | K ^TMP($J,"IBCEF73A") | 
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| 149 | Q IBORG | 
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| 150 | ; | 
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| 151 | PSONPI(IB59IEN) ; returns institution ien for a file 59 ien | 
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| 152 | N IB4IEN | 
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| 153 | K ^TMP($J,"IBCEF59") | 
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| 154 | D PSS^PSO59(IB59IEN,,"IBCEF59") | 
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| 155 | S IB4IEN=+$G(^TMP($J,"IBCEF59",IB59IEN,101)) | 
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| 156 | K ^TMP($J,"IBCEF59") | 
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| 157 | Q IB4IEN | 
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