1 | IBCU1 ;ALB/MRL - BILLING UTILITY ROUTINE (CONTINUED) ;01 JUN 88 12:00
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2 | ;;2.0;INTEGRATED BILLING;**27,52,106,138,51,182,210,266,309,320,347**;21-MAR-94;Build 24
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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 | ;MAP TO DGCRU1
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6 | ;
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7 | ;procedure doesn't appear to be used (6/4/93), if it is used, what for??
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8 | ;where would multiple provider numbers comde from? ARH
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9 | ;BCH ;Blue Cross/Shield Help
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10 | W ! S IB01=$P($G(^IBE(350.9,1,1)),"^",6)
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11 | I IB01]"" W "CHOOSE FROM",!!?4,"1 - ",$P(IB01,"^",6) F IB00=2,3 I $P(IB01,"^",$S(IB00=2:14,1:15))]"" W !?4,IB00," - ",$P(IB01,"^",$S(IB00=2:14,1:15))
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12 | W:IB01']"" "NO BLUE CROSS/SHIELD PROVIDER NUMBERS IDENTIFIED TO SELECT FROM!" W ! W:IB01]"" !,"OR " W "ENTER BLUE CROSS/SHIELD PROVIDER # (BETWEEN 3-13 CHARACTERS)",! K IB00,IB01 Q
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13 | ;
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14 | RCD ;Revenue Code Display
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15 | Q:'$D(^DGCR(399,IBIFN,"RC"))
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16 | W @IOF,!,"Revenue Code Listing",?34,"Units",?45,"Charge" W:$$FT^IBCEF(IBIFN)=3 ?56,"Non-Cov"
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17 | S DGIFN=0 F IBI=0:0 S DGIFN=$O(^DGCR(399,IBIFN,"RC",DGIFN)) Q:'DGIFN I $D(^DGCR(399,IBIFN,"RC",DGIFN,0)) S Z=^(0) D DISRC
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18 | W !
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19 | I $D(DIC(0)) S DIC(0)=DIC(0)_"N"
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20 | Q
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21 | DISRC N Z0 W !?1,DGIFN,?4,$P(^DGCR(399.2,+Z,0),"^"),"-",$E($P(^DGCR(399.2,+Z,0),"^",2),1,19)
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22 | I +$P(Z,U,6) W ?28,$P($$CPT^ICPTCOD(+$P(Z,U,6)),U,2)
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23 | W ?36,$P(Z,"^",3),?40 S X=$P(Z,"^",2),X2="2$" D COMMA^%DTC W X
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24 | I $$FT^IBCEF(IBIFN)=3,$P(Z,U,9)'="" S X=$P(Z,U,9),X2="2$" D COMMA^%DTC W ?51,X
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25 | I $D(^DGCR(399.1,+$P(Z,"^",5),0)) W ?64,$E($P(^(0),"^"),1,15)
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26 | I $S($P(Z,U,15):1,1:$P(Z,U,10)=3) D
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27 | . W !,?5,"(Rx: ",$S($P(Z,U,11):$P($G(^IBA(362.4,$P(Z,U,11),0)),U),1:"Link Missing")," Procedure "_$S($P(Z,U,15):"#"_$P(Z,U,15)_" "_$$CPTNM^IBCRBH1(IBIFN,4,$P(Z,U,15)),1:"Link Missing"),")"
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28 | Q
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29 | ;
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30 | RVCPRC(IBIFN,IBD0) ; returns 1 if CHAMPVA rate type + 2 if CMS-1500, 0 otherwise
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31 | ; IBD0 - zero node of bill if available, not required
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32 | N X S X=0
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33 | I $G(IBD0)="" S IBD0=$G(^DGCR(399,+$G(IBIFN),0))
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34 | I $P($G(^DGCR(399.3,+$P(IBD0,U,7),0)),U,1)="CHAMPVA" S X=X+1
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35 | I $P(IBD0,U,19)=2 S X=X+2
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36 | Q X
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37 | ;
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38 | ORDNXT(IFN) ;CALLED BY TRIGGER ON (362.3,.02) THAT SETS DX PRINT ORDER (362.3,.03),
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39 | ;returns the highest print order used on the bill plus 3, returns 3 if no existing print order
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40 | ;used for the default print order so that dx's can be printed in order of entry without any input by the user,
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41 | ;3 is added to allow spaces for additions, changes, moves
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42 | N X,Y S X="" I $D(^DGCR(399,+$G(IFN),0)) S X=3,Y=0 F S Y=$O(^IBA(362.3,"AO",+IFN,Y)) Q:'Y S X=Y+3
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43 | Q X
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44 | ;
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45 | ORDDUP(ORD,DIFN) ;returns true if print order ORD is already defined for a bill (not same entry)
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46 | N IBX,IBY S IBY=0
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47 | I +$G(ORD) S IBX=$G(^IBA(362.3,+$G(DIFN),0)) I +IBX,+$P(IBX,U,3)'=ORD,$D(^IBA(362.3,"AO",+$P(IBX,U,2),+ORD)) S IBY=1
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48 | Q IBY
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49 | ;
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50 | DXDUP(DX,DIFN,IFN) ;returns true if DX is already defined for a bill (not same entry)
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51 | ;either DIFN or IFN can be passed, both are not needed, DIFN is needed during edit so can reenter the same dx
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52 | N IBX,IBY S IBY=0 I +$G(DX),'$G(IFN) S IBX=$G(^IBA(362.3,+$G(DIFN),0)),IFN=+$P(IBX,U,2)
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53 | I +$G(DX),$D(^IBA(362.3,"AIFN"_+IFN,+DX)),$O(^IBA(362.3,"AIFN"_+IFN,+DX,0))'=+$G(DIFN) S IBY=1
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54 | Q IBY
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55 | ;
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56 | DXBSTAT(DIFN,IFN) ;returns a diagnosis' bill status (either DIFN or IFN can be passed, both are not needed)
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57 | N IBX,IBY I '$G(IFN) S IBX=$G(^IBA(362.3,+$G(DIFN),0)),IFN=+$P(IBX,U,2)
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58 | S IBY=+$P($G(^DGCR(399,+IFN,0)),U,13)
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59 | Q IBY
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60 | ;
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61 | RXSTAT(DRUG,PIFN,FILLDT) ; returns status/definition of rx
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62 | ; returns: ORIGINAL ^ RELEASED/RETURNED TO STOCK ^ DRUG DEA
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63 | N IBX,IBY,IBZ,IBLN,IBNUM S IBLN="",DRUG=+$G(DRUG),PIFN=+$G(PIFN),FILLDT=+$G(FILLDT)
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64 | ;
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65 | S IBX=$$RXSEC^IBRXUTL($$FILE^IBRXUTL(PIFN,2),PIFN),IBZ="" I IBX'="",$P(IBX,U,2)=$G(FILLDT) D I IBZ'="" S $P(IBLN,U,2)=IBZ
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66 | . S IBLN="ORG"
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67 | . ;I +$G(^PS(59.7,1,49.99))<6 Q
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68 | . I '$P(IBX,U,13) S IBZ="NR"
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69 | . I +$P(IBX,U,15) S:IBZ'="" IBZ=IBZ_"-" S IBZ=IBZ_"RTS"
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70 | ;
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71 | I IBLN="" S IBNUM=$$RFLNUM^IBRXUTL(PIFN,FILLDT,1),IBX=$$ZEROSUB^IBRXUTL($$FILE^IBRXUTL(PIFN,2),PIFN,IBNUM),IBZ="" I IBX'="" D I IBZ'="" S $P(IBLN,U,2)=IBZ
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72 | . ;I +$G(^PS(59.7,1,49.99))<6 Q
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73 | . I '$P(IBX,U,18) S IBZ="NR"
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74 | . I +$P(IBX,U,16) S:IBZ'="" IBZ=IBZ_"-" S IBZ=IBZ_"RTS"
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75 | ;
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76 | D ZERO^IBRXUTL(DRUG)
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77 | S IBX=$G(^TMP($J,"IBDRUG",0)) I IBX'="" S IBY=$G(^TMP($J,"IBDRUG",DRUG,3)),IBZ="" D I IBZ'="" S $P(IBLN,U,3)=IBZ
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78 | . I IBY["9" S IBZ="OTC"
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79 | . I IBY["I" S:IBZ'="" IBZ=IBZ_"-" S IBZ=IBZ_"INV"
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80 | . I IBY["S" S:IBZ'="" IBZ=IBZ_"-" S IBZ=IBZ_"SUP"
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81 | K ^TMP($J,"IBDRUG")
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82 | Q IBLN
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83 | ;
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84 | PRVLIC(NPIFN,IBDT,ARR,STIFN) ; returns the Provider License data from the New Person file active on a date
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85 | ; Input: NPIFN = pointer to file 200, IBDT = date to check (if none passed then all returned)
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86 | ; ARR = array pass by reference (optional), STIFN = state to return as value of function (optional)
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87 | ; Output: ARR(X) = license state (ifn) ^ license ^ expiration date (200,541)
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88 | ; return value = license data of state requested or if no state passed in then count found
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89 | N IBX,IBY,IBLN,IBCNT S IBX=0,IBCNT=0 K ARR
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90 | I +$G(NPIFN) S IBY=0 F S IBY=$O(^VA(200,NPIFN,"PS1",IBY)) Q:'IBY D
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91 | . S IBLN=$G(^VA(200,NPIFN,"PS1",IBY,0))
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92 | . I +$G(IBDT),+$P(IBLN,U,3),$P(IBLN,U,3)<IBDT Q
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93 | . I +$G(STIFN),+STIFN=+IBLN S IBX=IBLN
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94 | . S IBCNT=IBCNT+1,ARR(IBCNT)=IBLN
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95 | S ARR=IBCNT I '$G(STIFN) S IBX=IBCNT
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96 | Q IBX
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97 | ;
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98 | DELPR(IB,IBX) ; Deletes the corresponding RX proc when the RX pointer is
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99 | ; deleted
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100 | ; IB = the ien of the bill in file 399
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101 | ; IBX = the ien of the entry in the procedure multiple to be deleted
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102 | ;
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103 | N DA,DIK,X,Y
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104 | S DA(1)=IB,DA=IBX
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105 | I $D(^DGCR(399,DA(1),"CP",DA,0)) S DIK="^DGCR(399,"_DA(1)_",""CP""," D ^DIK
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106 | Q
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107 | ;
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108 | MODHLP(DA) ; Executable modifier help 399.042 .14
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109 | ; DA = iens of the current entry DA(1) = file 399 ien
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110 | ; DA = file 399.042 ien
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111 | N Z,IBZ,DIC,IBDATE
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112 | S IBDATE=$$BDATE^IBACSV(+$G(DA(1))) ; The date of service
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113 | I $P($G(^DGCR(399,+$G(DA(1)),"RC",+$G(DA),0)),U,14)'="" S Z=$P(^(0),U,14) D
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114 | . N Q
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115 | . S Q=1
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116 | . S IBZ(1)="Current modifier"_$S($P(Z,";",2)'="":"s are:",1:"is:")
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117 | . I $P(Z,";")'="" S Q=Q+1,IBZ(Q)=" "_$P(Z,";")_" "_$P($$MOD^ICPTMOD($P(Z,";"),"E",IBDATE),U,3)
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118 | . I $P(Z,";",2)'="" S Q=Q+1,IBZ(Q)=" "_$P(Z,";",2)_" "_$P($$MOD^ICPTMOD($P(Z,";",2),"E",IBDATE),U,3)
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119 | . S Q=Q+1,IBZ(Q)=" "
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120 | . D EN^DDIOL(.IBZ)
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121 | ;
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122 | S DIC="^DIC(81.3,",DIC(0)="E"
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123 | S DIC("S")="I $$MODP^ICPTMOD($P($G(^DGCR(399,DA(1),""RC"",DA,0)),U,6),Y,""I"",IBDATE)>0"
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124 | S DIC("W")="W ?14,$P($$MOD^ICPTMOD(Y,""I"",IBDATE),U,3)"
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125 | D ^DIC
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126 | Q
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127 | ;
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128 | QMED(IBRTN,IBIFN) ; DSS QuadraMed Interface: DSS/QuadraMed Available
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129 | ; return 1 if QuadraMed Interface is On and available for the type of bill
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130 | ; - routine must exist on the system (interface is 'On')
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131 | ; Input: IBRTN = tag^routine, if it exists then Interface is 'On'
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132 | ; IBIFN = Bill IFN, bill to check if appropriate for sending to QuadraMed
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133 | ;
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134 | N IBON S IBON=0
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135 | I +$G(IBIFN),$G(IBRTN)'="",$T(@IBRTN)'="" S IBON=1
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136 | Q IBON
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137 | ;
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138 | ATTREND(IBIFN,IBIFN1,FIELD) ; This function is called from Mumps Cross References in the claim file 399 and
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139 | ; also the PROVIDER subfile 399.0222.
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140 | ;
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141 | ; IBIFN = IEN to claim file
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142 | ; IBIFN1 = IEN to provider sub-file in claim file
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143 | ; FIELD = Field in sub-file being modified (the triggering event). If field has no value, all 6 fields are
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144 | ; possibly updated
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145 | ;
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146 | ; The following fields are the "triggering" events
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147 | ; File 399
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148 | ; #19 FORM TYPE - This triggers all 6 fields (122, 123, 124, 128, 129, 130).
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149 | ;
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150 | ; Sub-File 399.0222
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151 | ; #.05 PRIMARY INS CO ID NUMBER triggers 122
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152 | ; #.06 SECONDARY INS CO ID NUMBER triggers 123
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153 | ; #.07 TERTIARY INS CO ID NUMBER triggers 124
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154 | ; #.12 PRIM INS PROVIDER ID TYPE triggers 128
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155 | ; #.13 SEC INS PROVIDER ID TYPE triggers 129
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156 | ; #.14 TERT INS PROVIDER ID TYPE triggers 130
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157 | ;
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158 | ; The following fields are the ones being "triggered"
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159 | ; #122 PRIMARY PROVIDER #
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160 | ; #123 SECONDARY PROVIDER #
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161 | ; #124 TERTIARY PROVIDER #
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162 | ; #128 PRIMARY ID QUALIFER
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163 | ; #129 SECONDARY ID QUALIFIER
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164 | ; #130 TERTIARY ID QUALIFIER
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165 | ;
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166 | Q:$G(IBPRCOB) ; this is set when creating an MRA scondary claim. Don't want to be changing the data on
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167 | ; a secondary claim
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168 | ;
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169 | N FT,DATA,I,PC,INS,IFUNC,ATTRENDD,IBDR
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170 | S FT=$$FT^IBCEF(IBIFN)
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171 | Q:'FT
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172 | ;
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173 | S IFUNC=$O(^DGCR(399,IBIFN,"PRV","B",$S(FT=3:4,1:3),""))
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174 | I $G(IBIFN1),$G(IFUNC)'=IBIFN1 Q ; if called from subfile, quits if att/rend provider was not the one being modified
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175 | S ATTRENDD=$S('$G(IFUNC):"",1:$G(^DGCR(399,IBIFN,"PRV",IFUNC,0)))
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176 | ;
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177 | S PC=$S(FT=2:6,FT=3:8,1:"") ; get the correct piece from the ins co dictionary
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178 | Q:'+PC
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179 | ;
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180 | F I="I1","I2","I3" D
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181 | . S INS=$P($G(^DGCR(399,IBIFN,I)),U)
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182 | . Q:'+INS
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183 | . Q:'$P($G(^DIC(36,INS,4)),U,PC)
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184 | . D:I="I1"
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185 | .. S:".05"[FIELD IBDR(399,IBIFN_",",122)=$S($P(ATTRENDD,U,5)]"":$P(ATTRENDD,U,5),1:"@")
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186 | .. S:".12"[FIELD IBDR(399,IBIFN_",",128)=$S($P(ATTRENDD,U,12)]"":$P(ATTRENDD,U,12),1:"@")
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187 | . D:I="I2"
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188 | .. S:".06"[FIELD IBDR(399,IBIFN_",",123)=$S($P(ATTRENDD,U,6)]"":$P(ATTRENDD,U,6),1:"@")
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189 | .. S:".13"[FIELD IBDR(399,IBIFN_",",129)=$S($P(ATTRENDD,U,13)]"":$P(ATTRENDD,U,13),1:"@")
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190 | . D:I="I3"
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191 | .. S:".07"[FIELD IBDR(399,IBIFN_",",124)=$S($P(ATTRENDD,U,7)]"":$P(ATTRENDD,U,7),1:"@")
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192 | .. S:".14"[FIELD IBDR(399,IBIFN_",",130)=$S($P(ATTRENDD,U,14)]"":$P(ATTRENDD,U,14),1:"@")
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193 | ;
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194 | I $O(IBDR(0)) D FILE^DIE("","IBDR")
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195 | Q
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