RMPRPFFS ;Hines OIFO/HNC - REMOTE PROCEDURE, LIST NPPD DATA ;9/8/03 07:23 ;;3.0;PROSTHETICS;**96,60**;Feb 09, 1996;Build 18 ; ; patch 96 - HNC ; -DBIA #4419 for INSUR^IBBAPI ; -DBIA #3990 for ICDDX^ICDCODE ; -DBIA #1997 for STATCHK^ICPTAPIU ; -DBIA #3823 for read file 355.3, field .04 ;RESULTS passed to broker in ^TMP($J, ;delimited by "^" ;piece 1 = ENTRY DATE ;piece 2 = PATIENT NAME ;piece 3 = PSAS HCPCS with * if hcpcs has Calculation Flag ;piece 4 = QTY ;piece 5 = Insurance with * if more insurance info available ;piece 6 = Insurance Effective Date ;piece 7 = TOTAL COST ;piece 8 = DESCRIPTION (ITEM, BRIEF DESCRIPTION WITH ~R~ FOR REPAIR) ;piece 9 = Coding Errors ;piece 10 = Insurance Holder ;piece 11 = STATION ;piece 12 = ICD9 Description ;piece 13 = Billing Group Number ;piece 14 = Subscriber ID ;piece 15 = SSN ;piece 16 = IEN TO FILE 660 ;piece 17 = HCPCS SHORT DESCRIPTION ;piece 18 = ICD9 code ;piece 19 = Delivery Date ;piece 20 = Expiration Insurance Date ;piece 21 = Hcpcs-Icd9 Flag, this routine will set field 4.9 in file 660 ;all records will have a 1 ;ICD9, 2 ;HCPCS, 3 ;Not Billable 4 ; ;No errors, number 1. ;PSAS HCPCS, Not Billable Item, number 14. ;ICD9 error, number 12. ;HCPCS error, number 13. ;Both ICD9 and HCPCS error, number 132. ;Both ICD9 error and Not Billable Item, number 142. Q ; EN(RESULT,DATE1,DATE2) ;broker entry point ; K ^TMP($J) I '$D(DATE1)!('$D(DATE2)) G EXIT S DATE=DATE1-1 F S DATE=$O(^RMPR(660,"B",DATE)) Q:(DATE="")!($P(DATE,".",1)>DATE2) D .S RMPRB=0 .F S RMPRB=$O(^RMPR(660,"B",DATE,RMPRB)) Q:RMPRB="" D ..Q:$P(^RMPR(660,RMPRB,0),U,15)["*" ..Q:$P(^RMPR(660,RMPRB,0),U,14)'["C" ..;Q:$P(^RMPR(660,RMPRB,0),U,12)="" ..Q:$P($G(^RMPR(660,RMPRB,"AM")),U,3)<2 ..;end of filter ..S PHCPCS=$P($G(^RMPR(660,RMPRB,1)),U,4) ..Q:PHCPCS="" ..Q:PHCPCS'>0 ..S HDES=$P(^RMPR(661.1,PHCPCS,0),U,2) ..;code set versioning check ..S RICP="" ..S RICP=$P(^RMPR(661.1,PHCPCS,0),U,1) ..S RICPP="",CODERR="Alert",CODEFLG=1 ..I RICP'="" D ...I $A($E(RICP,2,2))>64 S CODERR=" Non Billable Item",CODEFLG=CODEFLG_4 Q ...I $A($E(RICP,2,2))<65 S RICPP=$$STATCHK^ICPTAPIU(RICP,$P(^RMPR(660,RMPRB,0),U,1)) ..I RICPP'="" D ...I $P(RICPP,U,1)=0 S CODERR=CODERR_" HCPCS Inactive",CODEFLG=CODEFLG_3 ..S TYPE=$P($G(^RMPR(660,RMPRB,0)),U,4) ..I TYPE'="X" S LINE=$P(^RMPR(661.1,PHCPCS,0),U,7) ..I TYPE="X" S LINE=$P(^RMPR(661.1,PHCPCS,0),U,6) ..S CAL=$P(^RMPR(661.1,PHCPCS,0),U,8) ..I CAL'="" S CAL="*" ..S DFN=$P(^RMPR(660,RMPRB,0),U,2) ..D DEM^VADPT ..D SVC^VADPT ..S RMPROEOI=$S(VASV(11)>0:"",VASV(12)>0:"",VASV(13)>0:"",1:0) ..S (RMI,HOLDER,SUBID,INSUR,INSURE,INSURG,INSURGG,INICD9D,INICD9E,RMPRDELD,RMPRIND,RMPRDEL)="" ..S RMPRDELD=$P(^RMPR(660,RMPRB,0),U,12) ..I RMPRDELD'="" S RMPRDEL=$E(RMPRDELD,4,5)_"/"_$E(RMPRDELD,6,7)_"/"_(($E(RMPRDELD,1,3))+1700) ..S X=$$INSUR^IBBAPI(DFN,,"RBA",.RMI,"*") I $D(RMI) D ...;format the RMI array ...;look for primary insurance ...;RMI("IBBAPI","INSUR",n,7)=1^PRIMARY ...S X="" F S X=$O(RMI("IBBAPI","INSUR",X)) Q:'X D ....;I $P(RMI("IBBAPI","INSUR",X,7),U,2)'="PRIMARY" Q ....S INSUR=$P(RMI("IBBAPI","INSUR",X,1),U,2) ....I X>1 S INSUR="*"_INSUR ....S SUBID=$P(RMI("IBBAPI","INSUR",X,14),U,1) ....S HOLDER=$P(RMI("IBBAPI","INSUR",X,12),U,2) ....S RMPRIND=$P(RMI("IBBAPI","INSUR",X,11),U,1) ....I RMPRIND'="" S RMPRIND=$E(RMPRIND,4,5)_"/"_$E(RMPRIND,6,7)_"/"_(($E(RMPRIND,1,3))+1700) ....S INSURE=$P(RMI("IBBAPI","INSUR",X,10),U,1) ....I INSURE'="" S INSURE=$E(INSURE,4,5)_"/"_$E(INSURE,6,7)_"/"_(($E(INSURE,1,3))+1700) ....S INSURG=$P(RMI("IBBAPI","INSUR",X,8),U,1) ....S INSURGG=$$GET1^DIQ(355.3,INSURG_",",.04) ..I '$D(RMI) D ...S INSUR="No Insurance Information" ...S SUBID="" ...S HOLDER="" ...S INSURE="" ...S INSURGG="" ...S RMPRIND="" ..;get icd9 data ..S INICD9I=$P($G(^RMPR(660,RMPRB,10)),U,8) ..I INICD9I'="" D ...S INICD9=$$ICDDX^ICDCODE(INICD9I,$P(^RMPR(660,RMPRB,0),U,1)) ...I INICD9'="" S INICD9E=$P(INICD9,U,2),INICD9D=$P(INICD9,U,4) ...I $P(INICD9,U,10)=0 S CODERR=CODERR_" ICD9 Inactive",CODEFLG=CODEFLG_2 ..D DATA S RESULT=$NA(^TMP($J)) Q ; DATA ; S B=RMPRB D GETS^DIQ(660,B,".01;.02;2;4.5;5;7;8;8.3;11;12;14;24;27;68","","RMXM") S $P(^TMP($J,B),U,1)=$G(RMXM(660,B_",",.01)) ;Check for OEF/OIF I RMPROEOI="" S RMXM(660,B_",",.02)=""_RMXM(660,B_",",.02) S $P(^TMP($J,B),U,2)=$G(RMXM(660,B_",",.02)) S $P(^TMP($J,B),U,3)=$G(RMXM(660,B_",",4.5))_CAL S $P(^TMP($J,B),U,4)=$G(RMXM(660,B_",",5)) ;change to insurance I INSUR="" S INSUR="Incomplete Insurance Information" S $P(^TMP($J,B),U,5)=INSUR ;change to effective insurance date S $P(^TMP($J,B),U,6)=INSURE S $P(^TMP($J,B),U,7)=$G(RMXM(660,B_",",14)) ;patch 77 remove the " for Excel CSV ;append ~R~ for repair items I $G(RMXM(660,B_",",2))="REPAIR" S RMXM(660,B_",",24)="~R~"_RMXM(660,B_",",24) S $P(^TMP($J,B),U,8)=$TR($G(RMXM(660,B_",",24)),"""","'") ;change to coding errors I CODERR="Alert" S CODERR="" S $P(^TMP($J,B),U,9)=CODERR ;change to holder S $P(^TMP($J,B),U,10)=HOLDER S $P(^TMP($J,B),U,11)=$G(RMXM(660,B_",",8)) ;change to ICD9 description S $P(^TMP($J,B),U,12)=INICD9D ;change to Billing Group S $P(^TMP($J,B),U,13)=INSURGG ;change to subscriber ID S $P(^TMP($J,B),U,14)=SUBID S $P(^TMP($J,B),U,15)=$P(VADM(2),U,2) S $P(^TMP($J,B),U,16)=B S $P(^TMP($J,B),U,17)=HDES ;change to ICD9 code S $P(^TMP($J,B),U,18)=INICD9E ;add Delivery Date S $P(^TMP($J,B),U,20)=RMPRDEL ;add Insurance Expiration Date S $P(^TMP($J,B),U,19)=RMPRIND ;hcpcs-icd9 code flag S $P(^TMP($J,B),U,21)=CODEFLG S $P(^RMPR(660,RMPRB,1),U,11)=CODEFLG S $P(^RMPR(660,RMPRB,1),U,12)=DT K RMXM,VADM,CAL D KVAR^VADPT Q EXIT ;common exit point N RESULTS D KILL^XUSCLEAN Q ;END