| 1 | RMPRPFFS ;Hines OIFO/HNC - REMOTE PROCEDURE, LIST NPPD DATA ;9/8/03  07:23
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| 2 |  ;;3.0;PROSTHETICS;**96,60**;Feb 09, 1996;Build 18
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| 3 |  ;
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| 4 |  ;  patch 96 - HNC
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| 5 |  ;        -DBIA #4419 for INSUR^IBBAPI
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| 6 |  ;        -DBIA #3990 for ICDDX^ICDCODE
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| 7 |  ;        -DBIA #1997 for STATCHK^ICPTAPIU
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| 8 |  ;        -DBIA #3823 for read file 355.3, field .04
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| 9 |  ;RESULTS passed to broker in ^TMP($J,
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| 10 |  ;delimited by "^"
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| 11 |  ;piece 1 = ENTRY DATE
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| 12 |  ;piece 2 = PATIENT NAME
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| 13 |  ;piece 3 = PSAS HCPCS with * if hcpcs has Calculation Flag
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| 14 |  ;piece 4 = QTY
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| 15 |  ;piece 5 = Insurance with * if more insurance info available
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| 16 |  ;piece 6 = Insurance Effective Date
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| 17 |  ;piece 7 = TOTAL COST
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| 18 |  ;piece 8 = DESCRIPTION (ITEM, BRIEF DESCRIPTION WITH ~R~ FOR REPAIR)
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| 19 |  ;piece 9 = Coding Errors
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| 20 |  ;piece 10 = Insurance Holder
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| 21 |  ;piece 11 = STATION
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| 22 |  ;piece 12 = ICD9 Description
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| 23 |  ;piece 13 = Billing Group Number
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| 24 |  ;piece 14 = Subscriber ID
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| 25 |  ;piece 15 = SSN
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| 26 |  ;piece 16 = IEN TO FILE 660
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| 27 |  ;piece 17 = HCPCS SHORT DESCRIPTION
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| 28 |  ;piece 18 = ICD9 code
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| 29 |  ;piece 19 = Delivery Date
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| 30 |  ;piece 20 = Expiration Insurance Date
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| 31 |  ;piece 21 = Hcpcs-Icd9 Flag, this routine will set field 4.9 in file 660
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| 32 |  ;all records will have a 1
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| 33 |  ;ICD9, 2
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| 34 |  ;HCPCS, 3
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| 35 |  ;Not Billable 4
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| 36 |  ;
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| 37 |  ;No errors, number 1.
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| 38 |  ;PSAS HCPCS, Not Billable Item, number 14.
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| 39 |  ;ICD9 error, number 12.
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| 40 |  ;HCPCS error, number 13.
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| 41 |  ;Both ICD9 and HCPCS error, number 132.
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| 42 |  ;Both ICD9 error and Not Billable Item, number 142.
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| 43 |  Q
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| 44 |  ;
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| 45 | EN(RESULT,DATE1,DATE2) ;broker entry point
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| 46 |  ;
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| 47 |  K ^TMP($J)
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| 48 |  I '$D(DATE1)!('$D(DATE2)) G EXIT
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| 49 |  S DATE=DATE1-1
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| 50 |  F  S DATE=$O(^RMPR(660,"B",DATE)) Q:(DATE="")!($P(DATE,".",1)>DATE2)  D
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| 51 |  .S RMPRB=0
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| 52 |  .F  S RMPRB=$O(^RMPR(660,"B",DATE,RMPRB)) Q:RMPRB=""  D
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| 53 |  ..Q:$P(^RMPR(660,RMPRB,0),U,15)["*"
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| 54 |  ..Q:$P(^RMPR(660,RMPRB,0),U,14)'["C"
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| 55 |  ..;Q:$P(^RMPR(660,RMPRB,0),U,12)=""
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| 56 |  ..Q:$P($G(^RMPR(660,RMPRB,"AM")),U,3)<2
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| 57 |  ..;end of filter
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| 58 |  ..S PHCPCS=$P($G(^RMPR(660,RMPRB,1)),U,4)
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| 59 |  ..Q:PHCPCS=""
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| 60 |  ..Q:PHCPCS'>0
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| 61 |  ..S HDES=$P(^RMPR(661.1,PHCPCS,0),U,2)
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| 62 |  ..;code set versioning check
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| 63 |  ..S RICP=""
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| 64 |  ..S RICP=$P(^RMPR(661.1,PHCPCS,0),U,1)
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| 65 |  ..S RICPP="",CODERR="Alert",CODEFLG=1
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| 66 |  ..I RICP'="" D
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| 67 |  ...I $A($E(RICP,2,2))>64 S CODERR=" Non Billable Item",CODEFLG=CODEFLG_4 Q
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| 68 |  ...I $A($E(RICP,2,2))<65 S RICPP=$$STATCHK^ICPTAPIU(RICP,$P(^RMPR(660,RMPRB,0),U,1))
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| 69 |  ..I RICPP'="" D
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| 70 |  ...I $P(RICPP,U,1)=0 S CODERR=CODERR_" HCPCS Inactive",CODEFLG=CODEFLG_3
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| 71 |  ..S TYPE=$P($G(^RMPR(660,RMPRB,0)),U,4)
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| 72 |  ..I TYPE'="X" S LINE=$P(^RMPR(661.1,PHCPCS,0),U,7)
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| 73 |  ..I TYPE="X" S LINE=$P(^RMPR(661.1,PHCPCS,0),U,6)
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| 74 |  ..S CAL=$P(^RMPR(661.1,PHCPCS,0),U,8)
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| 75 |  ..I CAL'="" S CAL="*"
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| 76 |  ..S DFN=$P(^RMPR(660,RMPRB,0),U,2)
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| 77 |  ..D DEM^VADPT
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| 78 |  ..D SVC^VADPT
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| 79 |  ..S RMPROEOI=$S(VASV(11)>0:"<!>",VASV(12)>0:"<!>",VASV(13)>0:"<!>",1:0)
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| 80 |  ..S (RMI,HOLDER,SUBID,INSUR,INSURE,INSURG,INSURGG,INICD9D,INICD9E,RMPRDELD,RMPRIND,RMPRDEL)=""
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| 81 |  ..S RMPRDELD=$P(^RMPR(660,RMPRB,0),U,12)
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| 82 |  ..I RMPRDELD'="" S RMPRDEL=$E(RMPRDELD,4,5)_"/"_$E(RMPRDELD,6,7)_"/"_(($E(RMPRDELD,1,3))+1700)
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| 83 |  ..S X=$$INSUR^IBBAPI(DFN,,"RBA",.RMI,"*") I $D(RMI) D
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| 84 |  ...;format the RMI array
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| 85 |  ...;look for primary insurance
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| 86 |  ...;RMI("IBBAPI","INSUR",n,7)=1^PRIMARY
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| 87 |  ...S X="" F  S X=$O(RMI("IBBAPI","INSUR",X)) Q:'X  D
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| 88 |  ....;I $P(RMI("IBBAPI","INSUR",X,7),U,2)'="PRIMARY" Q
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| 89 |  ....S INSUR=$P(RMI("IBBAPI","INSUR",X,1),U,2)
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| 90 |  ....I X>1 S INSUR="*"_INSUR
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| 91 |  ....S SUBID=$P(RMI("IBBAPI","INSUR",X,14),U,1)
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| 92 |  ....S HOLDER=$P(RMI("IBBAPI","INSUR",X,12),U,2)
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| 93 |  ....S RMPRIND=$P(RMI("IBBAPI","INSUR",X,11),U,1)
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| 94 |  ....I RMPRIND'="" S RMPRIND=$E(RMPRIND,4,5)_"/"_$E(RMPRIND,6,7)_"/"_(($E(RMPRIND,1,3))+1700)
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| 95 |  ....S INSURE=$P(RMI("IBBAPI","INSUR",X,10),U,1)
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| 96 |  ....I INSURE'="" S INSURE=$E(INSURE,4,5)_"/"_$E(INSURE,6,7)_"/"_(($E(INSURE,1,3))+1700)
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| 97 |  ....S INSURG=$P(RMI("IBBAPI","INSUR",X,8),U,1)
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| 98 |  ....S INSURGG=$$GET1^DIQ(355.3,INSURG_",",.04)
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| 99 |  ..I '$D(RMI) D
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| 100 |  ...S INSUR="No Insurance Information"
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| 101 |  ...S SUBID=""
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| 102 |  ...S HOLDER=""
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| 103 |  ...S INSURE=""
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| 104 |  ...S INSURGG=""
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| 105 |  ...S RMPRIND=""
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| 106 |  ..;get icd9 data
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| 107 |  ..S INICD9I=$P($G(^RMPR(660,RMPRB,10)),U,8)
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| 108 |  ..I INICD9I'="" D
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| 109 |  ...S INICD9=$$ICDDX^ICDCODE(INICD9I,$P(^RMPR(660,RMPRB,0),U,1))
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| 110 |  ...I INICD9'="" S INICD9E=$P(INICD9,U,2),INICD9D=$P(INICD9,U,4)
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| 111 |  ...I $P(INICD9,U,10)=0 S CODERR=CODERR_" ICD9 Inactive",CODEFLG=CODEFLG_2
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| 112 |  ..D DATA
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| 113 |  S RESULT=$NA(^TMP($J))
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| 114 |  Q
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| 115 |  ;
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| 116 | DATA ;
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| 117 |  S B=RMPRB
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| 118 |  D GETS^DIQ(660,B,".01;.02;2;4.5;5;7;8;8.3;11;12;14;24;27;68","","RMXM")
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| 119 |  S $P(^TMP($J,B),U,1)=$G(RMXM(660,B_",",.01))
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| 120 |  ;Check for OEF/OIF
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| 121 |  I RMPROEOI="<!>" S RMXM(660,B_",",.02)="<!>"_RMXM(660,B_",",.02)
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| 122 |  S $P(^TMP($J,B),U,2)=$G(RMXM(660,B_",",.02))
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| 123 |  S $P(^TMP($J,B),U,3)=$G(RMXM(660,B_",",4.5))_CAL
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| 124 |  S $P(^TMP($J,B),U,4)=$G(RMXM(660,B_",",5))
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| 125 |  ;change to insurance
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| 126 |  I INSUR="" S INSUR="Incomplete Insurance Information"
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| 127 |  S $P(^TMP($J,B),U,5)=INSUR
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| 128 |  ;change to effective insurance date
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| 129 |  S $P(^TMP($J,B),U,6)=INSURE
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| 130 |  S $P(^TMP($J,B),U,7)=$G(RMXM(660,B_",",14))
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| 131 |  ;patch 77 remove the " for Excel CSV
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| 132 |  ;append ~R~ for repair items
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| 133 |  I $G(RMXM(660,B_",",2))="REPAIR" S RMXM(660,B_",",24)="~R~"_RMXM(660,B_",",24)
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| 134 |  S $P(^TMP($J,B),U,8)=$TR($G(RMXM(660,B_",",24)),"""","'")
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| 135 |  ;change to coding errors
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| 136 |  I CODERR="Alert" S CODERR=""
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| 137 |  S $P(^TMP($J,B),U,9)=CODERR
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| 138 |  ;change to holder
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| 139 |  S $P(^TMP($J,B),U,10)=HOLDER
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| 140 |  S $P(^TMP($J,B),U,11)=$G(RMXM(660,B_",",8))
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| 141 |  ;change to ICD9 description
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| 142 |  S $P(^TMP($J,B),U,12)=INICD9D
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| 143 |  ;change to Billing Group
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| 144 |  S $P(^TMP($J,B),U,13)=INSURGG
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| 145 |  ;change to subscriber ID
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| 146 |  S $P(^TMP($J,B),U,14)=SUBID
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| 147 |  S $P(^TMP($J,B),U,15)=$P(VADM(2),U,2)
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| 148 |  S $P(^TMP($J,B),U,16)=B
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| 149 |  S $P(^TMP($J,B),U,17)=HDES
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| 150 |  ;change to ICD9 code
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| 151 |  S $P(^TMP($J,B),U,18)=INICD9E
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| 152 |  ;add Delivery Date
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| 153 |  S $P(^TMP($J,B),U,20)=RMPRDEL
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| 154 |  ;add Insurance Expiration Date
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| 155 |  S $P(^TMP($J,B),U,19)=RMPRIND
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| 156 |  ;hcpcs-icd9 code flag
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| 157 |  S $P(^TMP($J,B),U,21)=CODEFLG
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| 158 |  S $P(^RMPR(660,RMPRB,1),U,11)=CODEFLG
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| 159 |  S $P(^RMPR(660,RMPRB,1),U,12)=DT
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| 160 |  K RMXM,VADM,CAL
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| 161 |  D KVAR^VADPT
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| 162 |  Q
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| 163 | EXIT ;common exit point
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| 164 |  N RESULTS D KILL^XUSCLEAN
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| 165 |  Q
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| 166 |  ;END
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