1 | IBCRER1 ;ALB/ARH - RATES: CM RC NATIONAL ENTER/EDIT OPTION (CONT) ; 13-FEB-2007
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2 | ;;2.0;INTEGRATED BILLING;**370**;21-MAR-94;Build 5
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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 | ;
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6 | CHGLN(IBEFF,IBTYP,IBLINE) ; get all user data for charge
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7 | ; Input: pass by reference to get/retain defaults: Effective Date, Inst/Prof
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8 | ; Output: IBLINE if passed by reference
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9 | ; IBLINE = 'cpt ifn^eff dt^mod ifn^type (I/P)^charge^incr type (PR/ML/HR/MN)^incr charge^inpt^snf^opt^free'
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10 | ; or null if no CPT, or -1 if invalid (exit)
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11 | N IBCPT,IBMOD,IBCHGU,IBINCR,IBCHGI,IBINP,IBSNF,IBOPT,IBFS S IBEFF=$G(IBEFF),IBTYP=$G(IBTYP),IBLINE=""
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12 | ;
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13 | S IBCPT=$$GETCPT(IBEFF) I IBCPT<1 S IBLINE=-1 Q ; active cpt code
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14 | S IBEFF=$$GETEFF(IBEFF) Q:IBEFF<1 ; charge effective date
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15 | S IBMOD=$$GETMOD() Q:IBMOD<0 ; modifier for procedure charge
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16 | S IBTYP=$$GETTYP(IBTYP) Q:IBTYP<0 ; charge type, inst/prof
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17 | S IBCHGU=$$GETCHGU() Q:IBCHGU<0 W ! ; unit charge
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18 | ;
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19 | S IBINCR=$$GETINCR() Q:IBINCR<0 ; type of incremental charge
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20 | S IBCHGI=$$GETCHGI(IBINCR) Q:IBCHGI<0 W ! ; incremental charge
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21 | ;
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22 | S IBINP=$$GETIINP() Q:IBINP<0 ; inpatient indicator
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23 | S IBSNF=$$GETISNF() Q:IBSNF<0 ; snf indicator
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24 | S IBOPT=$$GETIOPT() Q:IBOPT<0 ; outpatient indictor
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25 | S IBFS=$$GETIFS() Q:IBFS<0 ; freestanding indicator
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26 | ;
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27 | S IBLINE=+IBCPT_U_+IBEFF_U_IBMOD_U_IBTYP_U_IBCHGU_U_IBINCR_U_IBCHGI_U_IBINP_U_IBSNF_U_IBOPT_U_IBFS
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28 | Q
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29 | ;
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30 | GETCPT(EFFDT) ; Get CPT/HCPCS procedure associated with charge
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31 | ; Returns: IFN of CPT/HCPCS selected, -1 if invalid
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32 | N IBX,DIC,DIE,DA,DR,I,X,Y,DTOUT,DUOUT S IBX=-1
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33 | ;
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34 | S DIC("A")="Select PROCEDURE CPT/HCPCS: " I +$G(EFFDT) S DIC("S")="I $$CPTACT^IBACSV(+Y,EFFDT)"
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35 | S DIC="^ICPT(",DIC(0)="AEMNQ" D ^DIC K DIC I +Y>0 S IBX=+Y
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36 | I $D(DTOUT)!$D(DUOUT) S IBX=-1
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37 | Q IBX
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38 | ;
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39 | GETEFF(DEFAULT) ; Get Effective Date for charge, must be within date range of current version
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40 | ; returns valid effective date, -1 if invalid
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41 | N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y,IBY,IBI,IBZ,IBA,IBMIN S IBMIN="",IBA="",IBX=-1
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42 | S IBY=$$VERSALL^IBCRHBRV() F IBI=1:1 S IBZ=$P(IBY,U,IBI) Q:IBZ="" S IBMIN=IBZ
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43 | S DIR("?",1)="Charge Effective Date must be within the date range of the current RC"
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44 | S DIR("?",2)="version, v"_+IBMIN_". Date must be between "_$$DATE(+$P(IBMIN,";",2))_" and Today.",DIR("?",3)=""
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45 | S DIR("?")="Enter Effective Date of Charge."
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46 | ;
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47 | S DIR("A")="EFFECTIVE DATE" I +$G(DEFAULT)>0 S DIR("B")=$$DATE(DEFAULT),IBA="A",DIR("A")=DIR("A")_": "
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48 | S DIR(0)="D"_IBA_"^"_+$P(IBMIN,";",2)_":"_DT_":EX" D ^DIR K DIR I Y?7N S IBX=+Y
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49 | I $D(DTOUT)!$D(DUOUT) S IBX=-1
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50 | Q IBX
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51 | ;
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52 | GETMOD() ; Get Modifier associated with the procedure charge
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53 | ; Modifier not limited to valid CPTs since that list is often out of date
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54 | ; Returns: IFN of selected modifier, null if no modifier selected, -1 if invalid
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55 | N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=""
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56 | S DIR("?",1)="Modifier is optional. If a modifier is added then the charge will only"
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57 | S DIR("?",2)="be applied if the modifier is assigned to the procedure on the bill.",DIR("?",3)=""
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58 | S DIR("?")="Enter the Modifier associated with the procedure charge."
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59 | ;
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60 | S DIR("A")="MODIFIER"
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61 | S DIR(0)="PO^DIC(81.3,:AEMQ" D ^DIR K DIR I Y>0 S IBX=+Y
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62 | I $D(DUOUT)!$D(DTOUT) S IBX=-1
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63 | Q IBX
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64 | ;
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65 | GETTYP(DEFAULT) ; Get Charge Type: Institutional or Professional
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66 | ; Returns: I for Institutional, P for Professional, -1 if invalid
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67 | N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=-1
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68 | I $G(DEFAULT)'="" S DEFAULT=$S(DEFAULT="I":"Institutional",DEFAULT="P":"Professional",1:"")
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69 | S DIR("?")="Enter the type of charge, either Institutional or Professional."
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70 | ;
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71 | S DIR("A")="CHARGE TYPE" I $G(DEFAULT)'="" S DIR("B")=DEFAULT
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72 | S DIR(0)="SB^I:Institutional;P:Professional" D ^DIR S IBX=Y
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73 | I $D(DTOUT)!$D(DUOUT) S IBX=-1
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74 | Q IBX
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75 | ;
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76 | GETCHGU() ; get procedures unit charge
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77 | ; Returns: dollar amount (non-zero), -1 if invalid
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78 | N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=-1
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79 | S DIR("?",1)="The dollar amount to be added to a bill for each of this procedure on the bill."
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80 | S DIR("?",2)="Enter an amount greater than zero and less than 99999, 2 decimal digits."
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81 | S DIR("?")="Enter the unit charge for Procedure to be used at all sites."
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82 | ;
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83 | S DIR("A")="UNIT CHARGE: "
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84 | S DIR(0)="NA^.001:99999:2" D ^DIR K DIR I +Y>0 S IBX=Y
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85 | I $D(DTOUT)!$D(DUOUT) S IBX=-1
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86 | Q IBX
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87 | ;
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88 | GETINCR() ; get the type of charge, identifies Charge Method and incremental calculations
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89 | ; Returns: PR for standard, HR for observation, MN for anesthesia, ML for ambulance, -1 if invalid
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90 | N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=-1
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91 | S DIR("?",1)="Most charges are a standard charge per procedure. There are three types of"
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92 | S DIR("?",2)="charges that require special calculations that add charge based on an "
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93 | S DIR("?",3)="increment of units: Anesthesia, Observation, Ambulance."
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94 | S DIR("?")="Enter type of care that will identify the charge calculation."
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95 | ;
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96 | S DIR("A")="Standard, Observation, Anesthesia, or Ambulance",DIR("B")="Standard"
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97 | S DIR(0)="SB^PR:Standard;HR:Observation;MN:Anesthesia;ML:Ambulance" D ^DIR S IBX=Y
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98 | I $D(DTOUT)!$D(DUOUT) S IBX=-1
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99 | ;
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100 | Q IBX
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101 | ;
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102 | GETCHGI(TYPE) ; if a special charge then get the incremental charge amount, anesthesia and observation only
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103 | ; Returns: dollar amount if applicable (non-zero), null if not applicable, -1 if invalid
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104 | N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y,IBTYP S TYPE=$G(TYPE),IBX=-1
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105 | S IBTYP=$S(TYPE="MN":"Anesthesia",TYPE="HR":"Observation",1:"") I IBTYP="" S IBX=""
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106 | S DIR("?",1)="Anesthesia and Observation have a unit charge added to a base/incremental"
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107 | S DIR("?",2)="charge that is multiplied by the time associated with the procedure."
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108 | S DIR("?",3)="Enter an amount greater than zero and less than 99999, 2 decimal digits.",DIR("?",4)=""
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109 | S DIR("?")="Enter the base or incremental "_IBTYP_" charge for this procedure."
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110 | ;
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111 | S DIR("A")=IBTYP_" BASE CHARGE: "
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112 | I IBTYP'="" S DIR(0)="NA^.001:99999:2" D ^DIR K DIR I +Y>0 S IBX=Y
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113 | I $D(DTOUT)!$D(DUOUT) S IBX=-1
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114 | Q IBX
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115 | ;
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116 | GETIINP() ; Get Inpatient Indicator, is this charge billable for Inpatient care
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117 | ; Returns: 1 for Yes Billable for Inpatient care, 0 for not billable, -1 if invalid
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118 | N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=0
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119 | S DIR("?")="Enter Yes if this charge is billable for Inpatient care, No otherwise."
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120 | ;
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121 | S DIR(0)="Y",DIR("A")="INPATIENT",DIR("B")="No" D ^DIR I Y=1 S IBX=1
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122 | I $D(DTOUT)!$D(DUOUT) S IBX=-1
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123 | Q IBX
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124 | ;
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125 | GETISNF() ; Get SNF Indicator, is this charge billable for Skilled Nursing care
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126 | ; Returns: 1 for Yes Billable for SNF care, 0 for not billable, -1 if invalid
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127 | N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=0
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128 | S DIR("?")="Enter Yes if this charge is billable for SNF care, No otherwise."
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129 | ;
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130 | S DIR(0)="Y",DIR("A")="SKILLED NURSING",DIR("B")="Yes" D ^DIR I Y=1 S IBX=1
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131 | I $D(DTOUT)!$D(DUOUT) S IBX=-1
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132 | Q IBX
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133 | ;
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134 | GETIOPT() ; Get Outpatient Indicator, is this charge billable for Outpatient care
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135 | ; Returns: 1 for Yes Billable for outpatient care, 0 for not billable, -1 if invalid
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136 | N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=0
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137 | S DIR("?")="Enter Yes if this charge is billable for Outpatient care, No otherwise."
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138 | ;
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139 | S DIR(0)="Y",DIR("A")="OUTPATIENT",DIR("B")="Yes" D ^DIR I Y=1 S IBX=1
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140 | I $D(DTOUT)!$D(DUOUT) S IBX=-1
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141 | Q IBX
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142 | ;
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143 | GETIFS() ; Get Freestanding Indicator, is this charge billable at Freestanding Sites
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144 | ; Returns: 1 for Yes Billable at Non-Provider Based/Freestanding sites, 0 for not billable, -1 if invalid
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145 | N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=0
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146 | S DIR("?",1)="All charges for Freestanding sites will be stored as Professional charges."
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147 | S DIR("?")="Enter Yes if this charge is billable at Freestanding Sites, No otherwise."
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148 | ;
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149 | S DIR(0)="Y",DIR("A")="FREESTANDING",DIR("B")="Yes" D ^DIR I Y=1 S IBX=1
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150 | I $D(DTOUT)!$D(DUOUT) S IBX=-1
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151 | Q IBX
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152 | ;
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153 | DATE(X) ; returns VA date in external form
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154 | N Y S Y="" I $G(X)?7N.E S Y=$E(X,4,5)_"/"_$E(X,6,7)_"/"_$E(X,2,3)
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155 | Q Y
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