1 | IBCNRHLT ;DAOU/DMK - Receive HL7 e-Pharmacy MFN Message ;23-OCT-2003
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2 | ;;2.0;INTEGRATED BILLING;**251**;21-MAR-94
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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 | ; Description
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6 | ;
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7 | ; Receive HL7 e-Pharmacy MFN Message
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8 | ; Table Update
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9 | ;
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10 | ; Control processing of segments
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11 | ;
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12 | ; Required segments listed in order
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13 | ; MSH (Message Header Segment) (processed by IBCNEHLT)
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14 | ; MFI (Master File Identifier Segment) (processed by IBCNEHLT)
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15 | ; MFE (Master File Entry Segment)
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16 | ;
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17 | ; Optional segments listed by file
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18 | ; ZP0 (365.12 PAYER File Update Segment)
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19 | ;
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20 | ; ZPT (366.01 NCPDP PROCESSOR File Update Segment)
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21 | ; ZCM (366.012 NCPDP PROCESSOR CONTACT MEANS Subfile Update Segment)
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22 | ;
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23 | ; ZPB (366.02 PHARMACY BENEFITS MANAGER (PBM) File Update Segment)
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24 | ; ZCM (366.022 PHARMACY BENEFITS MANAGER (PBM) CONTACT MEANS Subfile
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25 | ; Update Segment)
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26 | ;
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27 | ; ZPL (366.03 PLAN File Update Segment)
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28 | ; ZCM (366.032 PLAN CONTACT MEANS Subfile Update Segment)
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29 | ;
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30 | ; ZRX (366.03 PLAN File (Pharmacy) Update Segment)
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31 | ; ZCM (366.0312 PLAN RX CONTACT MEANS Subfile Update Segment)
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32 | ;
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33 | ; Called by IBCNEHLT if all of the following are true
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34 | ; * File # (MFI Segment) = 365.12, 366.01, 366.02, or 366.03
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35 | ; * Primary Key Value (MFE Segment) does not contain "IIV"
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36 | ; * Segment ID (every segment) = MFE, ZCM, ZP0, ZPB, ZPL, ZPT, or ZRX
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37 | ;
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38 | ; Entry point
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39 | ;
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40 | 1000 ; Control processing
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41 | I $D(ERROR) Q
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42 | D @SEG
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43 | ;
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44 | ; Initialize MFK Message (Application Acknowledgement) variables
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45 | I $D(ERROR) D Q
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46 | . S DATAMFK("ERROR")=ERROR
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47 | . S DATAMFK("IEN")=IEN
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48 | ;
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49 | ; Quit if more segments
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50 | I $O(^TMP($J,"IBCNEHLI",HCT))]"" Q
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51 | ;
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52 | ; Update File?
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53 | I $D(DATA) D
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54 | . S FIELDNO="" F S FIELDNO=$O(DATA(FIELDNO)) Q:FIELDNO="" D
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55 | .. ;
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56 | .. ; Convert "" to "@" to delete field value if necessary
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57 | .. I IEN'=-1,DATA(FIELDNO)="" S DATA(FIELDNO)="@"
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58 | .. ;
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59 | .. ; Convert HL7 special characters if necessary
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60 | .. I DATA(FIELDNO)[$E(HLECH,3) S DATA(FIELDNO)=$$TRAN1^IBCNRHLU(DATA(FIELDNO))
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61 | . D FILE
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62 | ;
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63 | ; Update File?
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64 | I $D(DATABPS) D
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65 | . S FIELDNO="" F S FIELDNO=$O(DATABPS(FIELDNO)) Q:FIELDNO="" D
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66 | .. ;
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67 | .. ; Convert "" to "@" to delete field value if necessary
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68 | .. I IEN'=-1,DATABPS(FIELDNO)="" S DATABPS(FIELDNO)="@"
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69 | .. ;
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70 | .. ; Convert HL7 special characters if necessary
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71 | .. I DATABPS(FIELDNO)[$E(HLECH,3) S DATABPS(FIELDNO)=$$TRAN1^IBCNRHLU(DATABPS(FIELDNO))
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72 | . ;
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73 | . D FILEBPS
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74 | ;
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75 | ; Update APPLICATION Subfile?
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76 | I $D(DATAAP) D
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77 | . S FIELDNO="" F S FIELDNO=$O(DATAAP(FIELDNO)) Q:FIELDNO="" D
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78 | .. ;
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79 | .. ; Convert "" to "@" to delete field value if necessary
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80 | .. I APIEN'=-1,DATAAP(FIELDNO)="" S DATAAP(FIELDNO)="@"
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81 | .. ;
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82 | .. ; Convert HL7 special characters if necessary
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83 | .. I DATAAP(FIELDNO)[$E(HLECH,3) S DATAAP(FIELDNO)=$$TRAN1^IBCNRHLU(DATAAP(FIELDNO))
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84 | . S FIELDNO=$S(FILENO=365.12:1,1:3)
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85 | . D FILEAP
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86 | ;
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87 | ; Update CONTACT MEANS Subfile?
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88 | I $D(DATACM) D
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89 | . S FIELDNO="" F S FIELDNO=$O(DATACM(FIELDNO)) Q:FIELDNO="" D
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90 | .. ;
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91 | .. ; Convert "" to "@" to delete field value if necessary
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92 | .. I CMIEN'=-1,DATACM(FIELDNO)="" S DATACM(FIELDNO)="@"
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93 | .. ;
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94 | .. ; Convert HL7 special characters if necessary
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95 | .. I DATACM(FIELDNO)[$E(HLECH,3) S DATACM(FIELDNO)=$$TRAN1^IBCNRHLU(DATACM(FIELDNO))
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96 | . S FIELDNO=$S(FILE["Pharmacy"&FILENO=366.03:12,1:2)
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97 | . I IBCNACT="MDL" D DELETECM Q
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98 | . D FILECM
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99 | Q
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100 | ;
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101 | ADD ; Add File entry
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102 | ; 365.12 PAYER File
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103 | ; 366.01 NCPDP PROCESSOR File
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104 | ; 366.02 PHARMACY BENEFITS MANAGER (PBM) File
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105 | ; 366.03 PLAN File
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106 | ;
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107 | S IEN=$$ADD1^IBCNRFM1(FILENO,DATA(.01))
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108 | Q
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109 | ;
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110 | ADDAP ; Add APPLICATION Subfile entry
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111 | ; 365.121 PAYER APPLICATION Subfile
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112 | ; 366.013 NCPDP PROCESSOR APPLICATION File
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113 | ; 366.023 PHARMACY BENEFITS MANAGER (PBM) APPLICATION Subfile
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114 | ; 366.033 PLAN APPLICATION Subfile
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115 | ;
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116 | S APIEN=$$ADD2^IBCNRFM1(FILENO,IEN,FIELDNO,AIEN)
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117 | Q
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118 | ;
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119 | ADDCM ; Add CONTACT MEANS Subfile entry
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120 | ; 366.012 NCPDP PROCESSOR CONTACT MEANS Subfile
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121 | ; 366.022 PHARMACY BENEFITS MANAGER (PBM) CONTACT MEANS Subfile
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122 | ; 366.032 PLAN CONTACT MEANS Subfile
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123 | ; 366.0312 PLAN RX CONTACT MEANS Subfile
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124 | ;
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125 | S CMIEN=$$ADD2^IBCNRFM1(FILENO,IEN,FIELDNO,DATACM(.01))
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126 | Q
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127 | ;
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128 | DELETECM ; Delete CONTACT MEANS Subfile entry
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129 | ; 366.012 NCPDP PROCESSOR CONTACT MEANS Subfile
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130 | ; 366.022 PHARMACY BENEFITS MANAGER (PBM) CONTACT MEANS Subfile
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131 | ; 366.032 PLAN CONTACT MEANS Subfile
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132 | ; 366.0312 PLAN RX CONTACT MEANS Subfile
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133 | ;
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134 | D DELETE2^IBCNRFM1(FILENO,IEN,FIELDNO,CMIEN)
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135 | Q
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136 | ;
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137 | FILE ; File data
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138 | ; 365.12 PAYER File
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139 | ; 366.01 NCPDP PROCESSOR File
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140 | ; 366.02 PHARMACY BENEFITS MANAGER (PBM) File
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141 | ; 366.03 PLAN File
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142 | ;
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143 | ; Add?
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144 | I IEN=-1 D ADD
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145 | ;
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146 | ; Update
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147 | D FILE1^IBCNRFM1(FILENO,IEN,.DATA)
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148 | Q
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149 | ;
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150 | FILEAP ; File APPLICATION Subfile data
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151 | ; 365.121 PAYER APPLICATION Subfile
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152 | ; 366.013 NCPDP PROCESSOR APPLICATION Subfile
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153 | ; 366.023 PHARMACY BENEFITS MANAGER (PBM) APPLICATION Subfile
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154 | ; 366.033 PLAN APPLICATION Subfile
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155 | ;
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156 | ; Add?
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157 | I APIEN=-1 D ADDAP
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158 | ;
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159 | ; Update
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160 | D FILE2^IBCNRFM1(FILENO,IEN,FIELDNO,APIEN,.DATAAP)
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161 | Q
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162 | ;
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163 | FILEBPS ; File data
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164 | ; 90002312.92 BPS NCPDP FORMATS File
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165 | ;
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166 | N FILENO1
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167 | S FILENO1=9002313.92
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168 | ;
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169 | ; Update Billing Payer Sheet Entry?
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170 | S BPSIEN=DATA(10.07) I BPSIEN'="@" D
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171 | . D FILE1^IBCNRFM1(FILENO1,BPSIEN,.DATABPS)
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172 | ;
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173 | ; Update Rebill Payer Sheet Entry?
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174 | S BPSIEN=DATA(10.09) I BPSIEN'="@" D
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175 | . D FILE1^IBCNRFM1(FILENO1,BPSIEN,.DATABPS)
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176 | ;
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177 | ; Update Reversal Payer Sheet Entry?
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178 | S BPSIEN=DATA(10.08) I BPSIEN'="@" D
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179 | . ;
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180 | . ; 1.03 = Maximum RX's Per Claim
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181 | . S DATABPS(1.03)=1
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182 | . ;
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183 | . ; 1.07 = Is A Reversal Format
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184 | . S DATABPS(1.07)=1
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185 | . ;
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186 | . D FILE1^IBCNRFM1(FILENO1,BPSIEN,.DATABPS)
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187 | Q
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188 | ;
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189 | FILECM ; File CONTACT MEANS Subfile data
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190 | ; 366.012 NCPDP PROCESSOR CONTACT MEANS Subfile
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191 | ; 366.022 PHARMACY BENEFITS MANAGER (PBM) CONTACT MEANS Subfile
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192 | ; 366.032 PLAN CONTACT MEANS Subfile
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193 | ; 366.0312 PLAN RX CONTACT MEANS Subfile
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194 | ;
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195 | ; Add?
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196 | I CMIEN=-1 D ADDCM
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197 | ;
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198 | ; Update
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199 | D FILE2^IBCNRFM1(FILENO,IEN,FIELDNO,CMIEN,.DATACM)
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200 | Q
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201 | ;
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202 | MFE ; Process MFE Segment
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203 | D ^IBCNRMFE
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204 | Q
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205 | ;
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206 | ZP0 ; Process ZP0 Segment
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207 | D ^IBCNRZP0
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208 | Q
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209 | ;
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210 | ZCM ; Process ZCM Segment
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211 | D ^IBCNRZCM
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212 | Q
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213 | ;
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214 | ZPB ; Process ZPB Segment
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215 | D ^IBCNRZPB
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216 | Q
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217 | ;
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218 | ZPL ; Process ZPL Segment
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219 | D ^IBCNRZPL
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220 | Q
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221 | ;
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222 | ZPT ; Process ZPT Segment
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223 | D ^IBCNRZPT
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224 | Q
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225 | ;
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226 | ZRX ; Process ZRX Segment
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227 | D ^IBCNRZRX
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228 | Q
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