| 1 | IBCNRHLT ;DAOU/DMK - Receive HL7 e-Pharmacy MFN Message ;23-OCT-2003 | 
|---|
| 2 | ;;2.0;INTEGRATED BILLING;**251**;21-MAR-94 | 
|---|
| 3 | ;;Per VHA Directive 10-93-142, this routine should not be modified. | 
|---|
| 4 | ; | 
|---|
| 5 | ; Description | 
|---|
| 6 | ; | 
|---|
| 7 | ; Receive HL7 e-Pharmacy MFN Message | 
|---|
| 8 | ; Table Update | 
|---|
| 9 | ; | 
|---|
| 10 | ; Control processing of segments | 
|---|
| 11 | ; | 
|---|
| 12 | ; Required segments listed in order | 
|---|
| 13 | ; MSH (Message Header Segment) (processed by IBCNEHLT) | 
|---|
| 14 | ; MFI (Master File Identifier Segment) (processed by IBCNEHLT) | 
|---|
| 15 | ; MFE (Master File Entry Segment) | 
|---|
| 16 | ; | 
|---|
| 17 | ; Optional segments listed by file | 
|---|
| 18 | ; ZP0 (365.12 PAYER File Update Segment) | 
|---|
| 19 | ; | 
|---|
| 20 | ; ZPT (366.01 NCPDP PROCESSOR File Update Segment) | 
|---|
| 21 | ; ZCM (366.012 NCPDP PROCESSOR CONTACT MEANS Subfile Update Segment) | 
|---|
| 22 | ; | 
|---|
| 23 | ; ZPB (366.02 PHARMACY BENEFITS MANAGER (PBM) File Update Segment) | 
|---|
| 24 | ; ZCM (366.022 PHARMACY BENEFITS MANAGER (PBM) CONTACT MEANS Subfile | 
|---|
| 25 | ;      Update Segment) | 
|---|
| 26 | ; | 
|---|
| 27 | ; ZPL (366.03 PLAN File Update Segment) | 
|---|
| 28 | ; ZCM (366.032 PLAN CONTACT MEANS Subfile Update Segment) | 
|---|
| 29 | ; | 
|---|
| 30 | ; ZRX (366.03 PLAN File (Pharmacy) Update Segment) | 
|---|
| 31 | ; ZCM (366.0312 PLAN RX CONTACT MEANS Subfile Update Segment) | 
|---|
| 32 | ; | 
|---|
| 33 | ; Called by IBCNEHLT if all of the following are true | 
|---|
| 34 | ; * File # (MFI Segment) = 365.12, 366.01, 366.02, or 366.03 | 
|---|
| 35 | ; * Primary Key Value (MFE Segment) does not contain "IIV" | 
|---|
| 36 | ; * Segment ID (every segment) = MFE, ZCM, ZP0, ZPB, ZPL, ZPT, or ZRX | 
|---|
| 37 | ; | 
|---|
| 38 | ; Entry point | 
|---|
| 39 | ; | 
|---|
| 40 | 1000 ; Control processing | 
|---|
| 41 | I $D(ERROR) Q | 
|---|
| 42 | D @SEG | 
|---|
| 43 | ; | 
|---|
| 44 | ; Initialize MFK Message (Application Acknowledgement) variables | 
|---|
| 45 | I $D(ERROR) D  Q | 
|---|
| 46 | . S DATAMFK("ERROR")=ERROR | 
|---|
| 47 | . S DATAMFK("IEN")=IEN | 
|---|
| 48 | ; | 
|---|
| 49 | ; Quit if more segments | 
|---|
| 50 | I $O(^TMP($J,"IBCNEHLI",HCT))]"" Q | 
|---|
| 51 | ; | 
|---|
| 52 | ; Update File? | 
|---|
| 53 | I $D(DATA) D | 
|---|
| 54 | . S FIELDNO="" F  S FIELDNO=$O(DATA(FIELDNO)) Q:FIELDNO=""  D | 
|---|
| 55 | .. ; | 
|---|
| 56 | .. ; Convert "" to "@" to delete field value if necessary | 
|---|
| 57 | .. I IEN'=-1,DATA(FIELDNO)="" S DATA(FIELDNO)="@" | 
|---|
| 58 | .. ; | 
|---|
| 59 | .. ; Convert HL7 special characters if necessary | 
|---|
| 60 | .. I DATA(FIELDNO)[$E(HLECH,3) S DATA(FIELDNO)=$$TRAN1^IBCNRHLU(DATA(FIELDNO)) | 
|---|
| 61 | . D FILE | 
|---|
| 62 | ; | 
|---|
| 63 | ; Update File? | 
|---|
| 64 | I $D(DATABPS) D | 
|---|
| 65 | . S FIELDNO="" F  S FIELDNO=$O(DATABPS(FIELDNO)) Q:FIELDNO=""  D | 
|---|
| 66 | .. ; | 
|---|
| 67 | .. ; Convert "" to "@" to delete field value if necessary | 
|---|
| 68 | .. I IEN'=-1,DATABPS(FIELDNO)="" S DATABPS(FIELDNO)="@" | 
|---|
| 69 | .. ; | 
|---|
| 70 | .. ; Convert HL7 special characters if necessary | 
|---|
| 71 | .. I DATABPS(FIELDNO)[$E(HLECH,3) S DATABPS(FIELDNO)=$$TRAN1^IBCNRHLU(DATABPS(FIELDNO)) | 
|---|
| 72 | . ; | 
|---|
| 73 | . D FILEBPS | 
|---|
| 74 | ; | 
|---|
| 75 | ; Update APPLICATION Subfile? | 
|---|
| 76 | I $D(DATAAP) D | 
|---|
| 77 | . S FIELDNO="" F  S FIELDNO=$O(DATAAP(FIELDNO)) Q:FIELDNO=""  D | 
|---|
| 78 | .. ; | 
|---|
| 79 | .. ; Convert "" to "@" to delete field value if necessary | 
|---|
| 80 | .. I APIEN'=-1,DATAAP(FIELDNO)="" S DATAAP(FIELDNO)="@" | 
|---|
| 81 | .. ; | 
|---|
| 82 | .. ; Convert HL7 special characters if necessary | 
|---|
| 83 | .. I DATAAP(FIELDNO)[$E(HLECH,3) S DATAAP(FIELDNO)=$$TRAN1^IBCNRHLU(DATAAP(FIELDNO)) | 
|---|
| 84 | . S FIELDNO=$S(FILENO=365.12:1,1:3) | 
|---|
| 85 | . D FILEAP | 
|---|
| 86 | ; | 
|---|
| 87 | ; Update CONTACT MEANS Subfile? | 
|---|
| 88 | I $D(DATACM) D | 
|---|
| 89 | . S FIELDNO="" F  S FIELDNO=$O(DATACM(FIELDNO)) Q:FIELDNO=""  D | 
|---|
| 90 | .. ; | 
|---|
| 91 | .. ; Convert "" to "@" to delete field value if necessary | 
|---|
| 92 | .. I CMIEN'=-1,DATACM(FIELDNO)="" S DATACM(FIELDNO)="@" | 
|---|
| 93 | .. ; | 
|---|
| 94 | .. ; Convert HL7 special characters if necessary | 
|---|
| 95 | .. I DATACM(FIELDNO)[$E(HLECH,3) S DATACM(FIELDNO)=$$TRAN1^IBCNRHLU(DATACM(FIELDNO)) | 
|---|
| 96 | . S FIELDNO=$S(FILE["Pharmacy"&FILENO=366.03:12,1:2) | 
|---|
| 97 | . I IBCNACT="MDL" D DELETECM Q | 
|---|
| 98 | . D FILECM | 
|---|
| 99 | Q | 
|---|
| 100 | ; | 
|---|
| 101 | ADD ; Add File entry | 
|---|
| 102 | ; 365.12 PAYER File | 
|---|
| 103 | ; 366.01 NCPDP PROCESSOR File | 
|---|
| 104 | ; 366.02 PHARMACY BENEFITS MANAGER (PBM) File | 
|---|
| 105 | ; 366.03 PLAN File | 
|---|
| 106 | ; | 
|---|
| 107 | S IEN=$$ADD1^IBCNRFM1(FILENO,DATA(.01)) | 
|---|
| 108 | Q | 
|---|
| 109 | ; | 
|---|
| 110 | ADDAP ; Add APPLICATION Subfile entry | 
|---|
| 111 | ; 365.121 PAYER APPLICATION Subfile | 
|---|
| 112 | ; 366.013 NCPDP PROCESSOR APPLICATION File | 
|---|
| 113 | ; 366.023 PHARMACY BENEFITS MANAGER (PBM) APPLICATION Subfile | 
|---|
| 114 | ; 366.033 PLAN APPLICATION Subfile | 
|---|
| 115 | ; | 
|---|
| 116 | S APIEN=$$ADD2^IBCNRFM1(FILENO,IEN,FIELDNO,AIEN) | 
|---|
| 117 | Q | 
|---|
| 118 | ; | 
|---|
| 119 | ADDCM ; Add CONTACT MEANS Subfile entry | 
|---|
| 120 | ; 366.012  NCPDP PROCESSOR CONTACT MEANS Subfile | 
|---|
| 121 | ; 366.022  PHARMACY BENEFITS MANAGER (PBM) CONTACT MEANS Subfile | 
|---|
| 122 | ; 366.032  PLAN CONTACT MEANS Subfile | 
|---|
| 123 | ; 366.0312 PLAN RX CONTACT MEANS Subfile | 
|---|
| 124 | ; | 
|---|
| 125 | S CMIEN=$$ADD2^IBCNRFM1(FILENO,IEN,FIELDNO,DATACM(.01)) | 
|---|
| 126 | Q | 
|---|
| 127 | ; | 
|---|
| 128 | DELETECM ; Delete CONTACT MEANS Subfile entry | 
|---|
| 129 | ; 366.012  NCPDP PROCESSOR CONTACT MEANS Subfile | 
|---|
| 130 | ; 366.022  PHARMACY BENEFITS MANAGER (PBM) CONTACT MEANS Subfile | 
|---|
| 131 | ; 366.032  PLAN CONTACT MEANS Subfile | 
|---|
| 132 | ; 366.0312 PLAN RX CONTACT MEANS Subfile | 
|---|
| 133 | ; | 
|---|
| 134 | D DELETE2^IBCNRFM1(FILENO,IEN,FIELDNO,CMIEN) | 
|---|
| 135 | Q | 
|---|
| 136 | ; | 
|---|
| 137 | FILE ; File data | 
|---|
| 138 | ; 365.12 PAYER File | 
|---|
| 139 | ; 366.01 NCPDP PROCESSOR File | 
|---|
| 140 | ; 366.02 PHARMACY BENEFITS MANAGER (PBM) File | 
|---|
| 141 | ; 366.03 PLAN File | 
|---|
| 142 | ; | 
|---|
| 143 | ; Add? | 
|---|
| 144 | I IEN=-1 D ADD | 
|---|
| 145 | ; | 
|---|
| 146 | ; Update | 
|---|
| 147 | D FILE1^IBCNRFM1(FILENO,IEN,.DATA) | 
|---|
| 148 | Q | 
|---|
| 149 | ; | 
|---|
| 150 | FILEAP ; File APPLICATION Subfile data | 
|---|
| 151 | ; 365.121 PAYER APPLICATION Subfile | 
|---|
| 152 | ; 366.013 NCPDP PROCESSOR APPLICATION Subfile | 
|---|
| 153 | ; 366.023 PHARMACY BENEFITS MANAGER (PBM) APPLICATION Subfile | 
|---|
| 154 | ; 366.033 PLAN APPLICATION Subfile | 
|---|
| 155 | ; | 
|---|
| 156 | ; Add? | 
|---|
| 157 | I APIEN=-1 D ADDAP | 
|---|
| 158 | ; | 
|---|
| 159 | ; Update | 
|---|
| 160 | D FILE2^IBCNRFM1(FILENO,IEN,FIELDNO,APIEN,.DATAAP) | 
|---|
| 161 | Q | 
|---|
| 162 | ; | 
|---|
| 163 | FILEBPS ; File data | 
|---|
| 164 | ; 90002312.92 BPS NCPDP FORMATS File | 
|---|
| 165 | ; | 
|---|
| 166 | N FILENO1 | 
|---|
| 167 | S FILENO1=9002313.92 | 
|---|
| 168 | ; | 
|---|
| 169 | ; Update Billing Payer Sheet Entry? | 
|---|
| 170 | S BPSIEN=DATA(10.07) I BPSIEN'="@" D | 
|---|
| 171 | . D FILE1^IBCNRFM1(FILENO1,BPSIEN,.DATABPS) | 
|---|
| 172 | ; | 
|---|
| 173 | ; Update Rebill Payer Sheet Entry? | 
|---|
| 174 | S BPSIEN=DATA(10.09) I BPSIEN'="@" D | 
|---|
| 175 | . D FILE1^IBCNRFM1(FILENO1,BPSIEN,.DATABPS) | 
|---|
| 176 | ; | 
|---|
| 177 | ; Update Reversal Payer Sheet Entry? | 
|---|
| 178 | S BPSIEN=DATA(10.08) I BPSIEN'="@" D | 
|---|
| 179 | . ; | 
|---|
| 180 | . ; 1.03 = Maximum RX's Per Claim | 
|---|
| 181 | . S DATABPS(1.03)=1 | 
|---|
| 182 | . ; | 
|---|
| 183 | . ; 1.07 = Is A Reversal Format | 
|---|
| 184 | . S DATABPS(1.07)=1 | 
|---|
| 185 | . ; | 
|---|
| 186 | . D FILE1^IBCNRFM1(FILENO1,BPSIEN,.DATABPS) | 
|---|
| 187 | Q | 
|---|
| 188 | ; | 
|---|
| 189 | FILECM ; File CONTACT MEANS Subfile data | 
|---|
| 190 | ; 366.012  NCPDP PROCESSOR CONTACT MEANS Subfile | 
|---|
| 191 | ; 366.022  PHARMACY BENEFITS MANAGER (PBM) CONTACT MEANS Subfile | 
|---|
| 192 | ; 366.032  PLAN CONTACT MEANS Subfile | 
|---|
| 193 | ; 366.0312 PLAN RX CONTACT MEANS Subfile | 
|---|
| 194 | ; | 
|---|
| 195 | ; Add? | 
|---|
| 196 | I CMIEN=-1 D ADDCM | 
|---|
| 197 | ; | 
|---|
| 198 | ; Update | 
|---|
| 199 | D FILE2^IBCNRFM1(FILENO,IEN,FIELDNO,CMIEN,.DATACM) | 
|---|
| 200 | Q | 
|---|
| 201 | ; | 
|---|
| 202 | MFE ; Process MFE Segment | 
|---|
| 203 | D ^IBCNRMFE | 
|---|
| 204 | Q | 
|---|
| 205 | ; | 
|---|
| 206 | ZP0 ; Process ZP0 Segment | 
|---|
| 207 | D ^IBCNRZP0 | 
|---|
| 208 | Q | 
|---|
| 209 | ; | 
|---|
| 210 | ZCM ; Process ZCM Segment | 
|---|
| 211 | D ^IBCNRZCM | 
|---|
| 212 | Q | 
|---|
| 213 | ; | 
|---|
| 214 | ZPB ; Process ZPB Segment | 
|---|
| 215 | D ^IBCNRZPB | 
|---|
| 216 | Q | 
|---|
| 217 | ; | 
|---|
| 218 | ZPL ; Process ZPL Segment | 
|---|
| 219 | D ^IBCNRZPL | 
|---|
| 220 | Q | 
|---|
| 221 | ; | 
|---|
| 222 | ZPT ; Process ZPT Segment | 
|---|
| 223 | D ^IBCNRZPT | 
|---|
| 224 | Q | 
|---|
| 225 | ; | 
|---|
| 226 | ZRX ; Process ZRX Segment | 
|---|
| 227 | D ^IBCNRZRX | 
|---|
| 228 | Q | 
|---|