source: FOIAVistA/trunk/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBCU6.m@ 1397

Last change on this file since 1397 was 628, checked in by George Lilly, 15 years ago

initial load of FOIAVistA 6/30/08 version

File size: 4.2 KB
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1IBCU6 ;ALB/AAS - UTILITY ROUTINE TO SET BEDSECTIONS/REVENUE CODES FROM PTF DATA ;25 MAY 90
2 ;;2.0;INTEGRATED BILLING;**14,52,138,245,155**;21-MAR-94
3 ;;Per VHA Directive 10-93-142, this routine should not be modified.
4 ;
5 ;MAP TO DGCRU6
6 ;
7% ;setup variables - needs IBifn
8 ;K IBRSARR D BILL^IBCRBC(IBIFN,.IBRSARR)
9 I $P($G(^DGCR(399,IBIFN,0)),U,13)'=1 Q ; Do not calculate bill charges if bill not in Entered/Not Reviewed status
10 N X S X=$$PRCDIV^IBCU71(IBIFN) I '$D(ZTQUEUED),+X W !,$P(X,U,2) ; update bill default division
11 S X=$$DVTYP^IBCU71(IBIFN) I '$D(ZTQUEUED),$P(X,U,2)'="" W !,$P(X,U,2) ; update bill charge type
12 ;
13 D BILL^IBCRBC(IBIFN) ; calculate bill charges
14 ;
15 D CPTMOD26^IBCU73(IBIFN) ; add cpt modifier 26 to professional bill
16 Q
17 ;
18 Q:'$D(^DGCR(399,IBIFN,0)) N IBQUIT S IBQUIT=0 K ^UTILITY($J) D GVAR^IBCU61 Q:IBQUIT
19 I '$D(DFN) S DFN=$P(^DGCR(399,IBIFN,0),"^",2)
20 I IBIDS(.05)<3 S PTF=$P(^DGCR(399,IBIFN,0),"^",8) Q:PTF']"" Q:'$D(^DGPT(PTF,0)) I '$P(^DGPT(PTF,0),"^",6),'$P(^(0),"^",4),'$D(DGPTUPDT) D UPDT^DGPTUTL S DGPTUPDT=""
21 S DGADM=IBIDS(.03),DGPMCA=$O(^DGPM("AMV1",DGADM,DFN,0)) ;find corresponding admission
22 D:$O(^DGCR(399,IBIFN,"RC",0)) ALL^IBCU61
23 ;
24OPT ;I IBIDS(.05)>2 S DGBILLBS="OUTPATIENT VISIT",DGVISCNT=$S($D(^DGCR(399,IBIFN,"OP",0)):$P(^(0),U,4),1:""),^UTILITY($J,"IB-BS",DGBILLBS)=DGVISCNT G END:DGVISCNT<1 D G END:IBQUIT,3
25 ;.I $D(^DGCR(399,IBIFN,"CP","ASC",1)) D ^IBCU63
26 ;.;I $D(^UTILITY($J,"IB-ASC")) S IBQUIT=1
27 I IBIDS(.05)>2 D G END:(DGVISCNT<1)!IBQUIT,3
28 . S DGBILLBS="OUTPATIENT VISIT",DGVISCNT=$S($D(^DGCR(399,IBIFN,"OP",0)):$P(^(0),U,4),1:""),^UTILITY($J,"IB-BS",DGBILLBS)=DGVISCNT ; visit
29 . I DGVISCNT>0,$D(^DGCR(399,IBIFN,"CP","ASC",1)) D ^IBCU63 ; basc
30 . D SET^IBCSC5A(IBIFN,.IBX) S IBCNT=+$P(IBX,U,2) K IBX I +IBCNT D RX^IBCU63 ; rx refills
31 ;
321 ;build array of movement dates, billable bedsections
33 S DGMOVE=0 F DGII=0:0 S DGMOVE=$O(^DGPT(PTF,"M",DGMOVE)) Q:'DGMOVE D SETU
34 ;
352 ;build array of billable bedsections = los in bedsection
36 ;start with statement covers from date, end with statement covers to date
37 S (DGMVDT,DGMVDTP)=$S($D(IBIDS(151)):IBIDS(151),1:IBIDS(.03)),(DGBS,DGBS1)=""
38 ;
39 S DGMVDT=DGMVDT+.3,IBMVDTE=IBIDS(152)\1
40 I ",2,3,"'[IBIDS(.06) S IBMVDTE=IBMVDTE-.01 I IBIDS(151)=IBIDS(152) S DGMVDT=IBIDS(151)
41 I +DGPMCA S DGII=$$AD^IBCU64(DGPMCA) I ($P(DGII,U,1)\1)=($P(DGII,U,2)\1) S DGMVDT=IBIDS(151),IBMVDTE=IBIDS(152)
42 ;
43 S DGMVDT=DGMVDT-.01 F DGII=0:0 S DGMVDT=$O(^UTILITY($J,"IB-PTF",DGMVDT)) Q:'DGMVDT!(DGMVDTP\1>IBIDS(152)) D SETU1 S DGMVDTP=DGMVDT Q:(DGMVDTP\1)>IBMVDTE
44 ;
453 ;find revenue codes and set up in file.
46 S DGBS=0 I '$D(^DGCR(399,IBIFN,"RC",0)) S ^DGCR(399,IBIFN,"RC",0)="^399.042PA"
47 F DGII=0:0 S DGBS=$O(^UTILITY($J,"IB-BS",DGBS)) Q:DGBS']""!(IBQUIT) S DGBSLOS=^(DGBS),DGBSI=$O(^DGCR(399.1,"B",DGBS,0)) I DGBSI,$D(^DGCR(399.1,DGBSI,0)) D SETREV^IBCU62
48 G END
49 ;
50SETU ;utility array of all movements by date, billing bedsection
51 ;non-billable bs's must be added to array so their days will not be added to a billable bs
52 S X=^DGPT(PTF,"M",DGMOVE,0)
53 S DGBILLBS=$P($G(^DIC(42.4,+$P(X,U,2),0)),U,5) I DGBILLBS="" S DGBILLBS="UNKNOWN"
54 ;S DGBILLBS=$S('$P(X,U,2):"UNKNOWN",$D(^DIC(42.4,$P(X,U,2),0)):$P(^(0),U,5),1:"UNKNOWN") Q:DGBILLBS=""
55 S ^UTILITY($J,"IB-PTF",$S($P(X,U,10)]"":$P(X,U,10),1:DT),DGBILLBS)=($P(X,U,3)+$P(X,U,4))_"^"_$P(X,U,18)
56 Q
57 ;
58SETU1 ;determine los - set utility=los
59 S DGBS=$O(^UTILITY($J,"IB-PTF",DGMVDT,0)) Q:DGBS="UNKNOWN" S:DGBS1="" DGBS1=DGBS
60 S DGEDT=$S(DGMVDT<IBIDS(152):DGMVDT,1:IBIDS(152)),DGBDT=$S(IBIDS(151)>DGMVDTP:IBIDS(151),1:DGMVDTP)
61 S IBTF=$S(IBIDS(152)<(DGMVDT\1):IBIDS(.06),1:1)
62 S X=$$LOS^IBCU64(DGBDT,DGEDT,IBTF,DGPMCA) Q:'X
63 I $D(DGINPAR),$P(DGINPAR,"^")=0,(DGBS1'=DGBS) Q ;only one bedsection allowed by ins co
64 I IBIDS(.11)="c",(DGBS1'=DGBS) Q
65 I $P(^UTILITY($J,"IB-PTF",DGMVDT,DGBS),U,2)=1 Q ;treatment for sc condition
66 S ^UTILITY($J,"IB-BS",DGBS)=+$G(^UTILITY($J,"IB-BS",DGBS))+X
67 Q
68END I IBIDS(.11)="c" S IBIDS(.11)="p"
69 K ^UTILITY($J),DGMOVE,DGMVDT,DGMVDTP,DGBS,DGBSLOS,DGBSI,DGBILLBS,DGBR,DGREC,DGII,DGJJ,DGKK,DGREVHDR,DGAMNT,DGREV,DGBS1,X,X1,X2,Y,Z,DGINPAR,DR,DIK,DGVISCNT,DGBRN,DGFUNC,DGACTDT,DGRVRCAL,DA,IBIDS,DGREV00
70 K DGLL,DGFND,IBND0,IBNDU,DGPMCA,DGADM,DGEDT,DGBDT,DGMVTP,DGMVT,DGDC,DGNEXT,DGX,DGIFN,IBTF,IBCNT,IBCHK,IBMVDTE
71 Q
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