| 1 | IBTUTL ;ALB/AAS - CLAIMS TRACKING UTILITY ROUTINE ; 21-JUN-93 | 
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| 2 | ;;Version 2.0 ; INTEGRATED BILLING ;**23,62**; 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 | ADM(DGPMCA,VAINDT,RANDOM,IBVSIT) ; -- set up info for adding a current admission | 
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| 6 | ; -- Input DGPMCA   = pointer for an admission to patient movement file | 
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| 7 | ;          VAINDT   = optional date for admission (default is dt) | 
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| 8 | ;          RANDOM   = whether or not this is a random sample | 
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| 9 | ;          IBVSIT   = Pointer to visit file (optional) | 
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| 10 | ; | 
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| 11 | N DA,DIC,DIE,DR,X,VAIN,VA,IBSCHED,IBSCH | 
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| 12 | I '$G(VAINDT) K VAINDT | 
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| 13 | I '$G(DGPMCA) S VA200="" D INP^VADPT S DGPMCA=VAIN(1) | 
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| 14 | Q:DGPMCA="" | 
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| 15 | S RANDOM=$S($G(RANDOM):1,1:0) | 
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| 16 | S X=$O(^IBT(356,"ADM",DFN,DGPMCA,0)) I X S IBTRN=X G ADMQ | 
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| 17 | S IBADMDT=$P(^DGPM(DGPMCA,0),"^") | 
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| 18 | ;S IBETYP=+$O(^IBE(356.6,"B","INPATIENT ADMISSION",0)) | 
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| 19 | S IBETYP=+$O(^IBE(356.6,"AC",1,0)) | 
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| 20 | S (IBSCH,IBTRN)=$O(^IBT(356,"ASCH",+$$SCH^IBTRKR2(DGPMCA),0)) | 
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| 21 | D:'IBTRN ADDT | 
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| 22 | I IBTRN<1 G ADMQ | 
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| 23 | S DA=IBTRN,DIE="^IBT(356," | 
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| 24 | L +^IBT(356,+IBTRN):10 I '$T G ADMQ | 
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| 25 | S DR=$$ADMDR(IBADMDT,IBETYP,DGPMCA,RANDOM) | 
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| 26 | D ^DIE K DA,DR,DIE | 
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| 27 | I $P($G(^IBT(356,IBTRN,0)),"^",32) S DA=IBTRN,DR=".32///@",DIE="^IBT(356," D ^DIE K DA,DR,DIE | 
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| 28 | L -^IBT(356,+IBTRN) | 
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| 29 | ; | 
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| 30 | S IBSCHED=$S($P(^DGPM(DGPMCA,0),U,25):10,1:20) | 
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| 31 | ; | 
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| 32 | ; -- if random sample add hospital review | 
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| 33 | I $P(^IBT(356,IBTRN,0),U,25) D PRE^IBTUTL2(DT,IBTRN,IBSCHED) | 
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| 34 | ; | 
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| 35 | ; -- if scheduled admission entry converted to admission, don't add | 
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| 36 | ;    second insurance review | 
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| 37 | I $G(IBSCH) G ADMQ | 
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| 38 | ; | 
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| 39 | ; -- if insured add ins review | 
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| 40 | I $P(^IBT(356,IBTRN,0),U,24) D COM^IBTUTL3(DT,IBTRN,IBSCHED,$G(IBTRV)) | 
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| 41 | ; | 
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| 42 | ADMQ Q | 
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| 43 | ; | 
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| 44 | ADDT ; -- add new entry to tracking, ibt(356 | 
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| 45 | ; | 
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| 46 | N %DT,DD,DO,DIC,DR,DIE,DLAYGO,IBTR1,DINUM | 
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| 47 | L +^IBT(356,0):0 ;I '$T S Y="-1^IB085" G ADDTQ | 
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| 48 | ;I $G(^IBT(356,0))="" S Y="-1^IB086" G ADDTQ | 
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| 49 | S X=$P($G(^IBT(356,0)),"^",3)+1 L -^IBT(356,0) | 
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| 50 | S DIC="^IBT(356,",DIC(0)="L",DLAYGO=356 | 
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| 51 | F X=X:1 L:$D(IBTR1) -^IBT(356,IBTR1) I X>0,'$D(^IBT(356,X)) S IBTR1=X L +^IBT(356,IBTR1):1 I $T,'$D(^IBT(356,X)) S DINUM=X,X=($$IBSITE())_X D FILE^DICN I +Y>0 Q | 
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| 52 | L -^IBT(356,IBTR1) | 
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| 53 | I +Y<1  S Y="-1^IB087" | 
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| 54 | ADDTQ ;I +Y<0 D ^IBTERR | 
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| 55 | S IBTRN=+Y,IBNEW=1 | 
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| 56 | Q | 
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| 57 | ; | 
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| 58 | OTH(DFN,IBETYP,IBTDT) ; -- add miscellaneous entries, care may not be in data base | 
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| 59 | ; -- input   dfn  := patient pointer to 2 | 
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| 60 | ;          ibetyp := pointer to type entry in 356.6 | 
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| 61 | ;          ibtdt  := episode date | 
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| 62 | ; | 
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| 63 | N X,Y,DA,DR,DIE,DIC | 
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| 64 | S X=$O(^IBT(356,"APTY",DFN,IBETYP,IBTDT,0)) I X S IBTRN=X G OTHQ | 
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| 65 | D ADDT | 
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| 66 | I IBTRN<1 G OTHQ | 
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| 67 | S DA=IBTRN,DIE="^IBT(356," | 
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| 68 | S DR=".02////"_$G(DFN)_";.06////"_+$G(IBTDT)_";.18////"_IBETYP_";.2////1;.24////"_$$INSURED^IBCNS1(DFN)_";1.01///NOW;1.02////"_DUZ_";.17////"_$$EABD(IBETYP,IBTDT) | 
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| 69 | L +^IBT(356,+IBTRN):10 I '$T G OTHQ | 
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| 70 | D ^DIE K DA,DR,DIE | 
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| 71 | L -^IBT(356,+IBTRN) | 
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| 72 | OTHQ Q | 
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| 73 | ; | 
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| 74 | IBSITE() ; -- calculate site from site parameters | 
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| 75 | ; --  output ibsite = station number | 
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| 76 | ; | 
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| 77 | N IBFAC,IBSITE | 
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| 78 | D SITE^IBAUTL | 
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| 79 | Q IBSITE | 
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| 80 | ; | 
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| 81 | ADMDR(IBADMDT,IBETYP,DGPMCA,RANDOM) ; -- set up dr string for admissions | 
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| 82 | S DR="" | 
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| 83 | I '$G(IBETYP)!'$G(IBADMDT) G ADMDRQ | 
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| 84 | S DR=".02////"_$G(DFN)_";.03////"_$G(IBVSIT)_";.05////"_$G(DGPMCA)_";.06////"_+$G(IBADMDT)_";.18////"_$G(IBETYP)_";.2////1;.24////"_$$INSURED^IBCNS1(DFN)_";1.01///NOW;1.02////"_DUZ_";.17////"_$$EABD(IBETYP,$G(IBADMDT)) D | 
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| 85 | .I $G(DGPMCA),$G(RANDOM) S DR=DR_";.25////1" Q | 
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| 86 | ADMDRQ Q DR | 
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| 87 | ; | 
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| 88 | EABD(IBETYP,IBTDT) ; -- compute earliest auto bill date: date entered plus days delay for event type | 
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| 89 | ; -- input   IBETYPE = pointer to type of entry file | 
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| 90 | ;            IBTDT   = episode date, if not passed in uses DT | 
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| 91 | ; | 
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| 92 | N X,X1,X2,Y,IBETYPD S Y="" I '$G(IBETYP) G EABDQ | 
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| 93 | S IBETYPD=$G(^IBE(356.6,+IBETYP,0)) I '$G(IBTDT) S IBTDT=DT | 
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| 94 | I '$P(IBETYPD,"^",4) G EABDQ ; automated billing turned off | 
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| 95 | S X2=+$P(IBETYPD,"^",6) ;set earliest autobill date to entered date plus days delay | 
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| 96 | S X1=IBTDT D C^%DTC S Y=X\1 | 
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| 97 | EABDQ Q Y | 
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| 98 | ; | 
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| 99 | BILL(IBTRN) ;check if event is billable, return EABD if it is | 
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| 100 | N X,Y,Z,IBTRND S (X,Y)="" S IBTRND=$G(^IBT(356,+$G(IBTRN),0)) I IBTRND="" G BILLQ | 
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| 101 | ; | 
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| 102 | ; -- billed and bill not cancelled and not inpt interim first or continuous | 
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| 103 | I +$P(IBTRND,U,11) S Z=$$BILLED^IBCU8(IBTRN),Y=$P(Z,U,2) I +Z,'Y G BILLQ | 
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| 104 | ; | 
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| 105 | ; -- special type (not riem. ins), not billable, inactive | 
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| 106 | I +$P(IBTRND,U,12)!(+$P(IBTRND,U,19))!('$P(IBTRND,U,20)) G BILLQ | 
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| 107 | I 'Y S Y=+$G(^IBT(356,+$G(IBTRN),1)) I 'Y S Y=DT | 
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| 108 | S X=$$EABD(+$P(IBTRND,U,18),Y) | 
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| 109 | BILLQ Q X | 
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| 110 | ; | 
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| 111 | STOBIL Q | 
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| 112 | KTOBIL Q | 
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