| 1 | FBAAFSF ;WCIOFO/dmk,SAB-OUTPATIENT 75TH PERCENTILE FEE SCHEDULE ;5/18/1999
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| 2 | ;;3.5;FEE BASIS;**4**;JAN 30, 1995
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| 3 | ;
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| 4 | Q
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| 5 | ;
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| 6 | PRCTL(CPT,MODL,DOS) ; Calculate 75th Percentile Fee Schedule Amount
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| 7 | ; input
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| 8 | ; CPT - CPT/HCPCS code, external, required
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| 9 | ; MODL - list of optional CPT/HCPCS modifiers (external values)
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| 10 | ; delimited by commas
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| 11 | ; DOS - date of service, fileman format, required
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| 12 | ; returns $ amount or null if not on schedule
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| 13 | N FBAMT,FBERR
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| 14 | ;
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| 15 | ; initialize
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| 16 | S FBAMT=""
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| 17 | K FBERR
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| 18 | ;
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| 19 | ;validate parameters
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| 20 | S CPT=$G(CPT)
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| 21 | S DOS=$G(DOS)
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| 22 | I CPT="" D ERR^FBAAFS("Missing CPT")
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| 23 | I DOS'?7N D ERR^FBAAFS("Invalid Date of Service")
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| 24 | ;
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| 25 | I '$D(FBERR) D
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| 26 | . ; get data from 163.99 (stored in previous fiscal year)
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| 27 | . N FBDA,FBFY,FBI,FBMOD,FBMODA,FBMODLE,FBX
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| 28 | . S FBFY=$E(DOS,1,3)+1700+$E(DOS,4) ; fiscal year of service
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| 29 | . ;
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| 30 | . ; build a sorted list of the CPT modifiers
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| 31 | . F FBI=1:1 S FBMOD=$P(MODL,",",FBI) Q:FBMOD="" S FBMODA(FBMOD)=""
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| 32 | . S (FBMOD,FBMODLE)=""
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| 33 | . F S FBMOD=$O(FBMODA(FBMOD)) Q:FBMOD="" S FBMODLE=FBMODLE_","_FBMOD
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| 34 | . S:$E(FBMODLE)="," FBMODLE=$E(FBMODLE,2,999)
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| 35 | . ;
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| 36 | . ; build lookup value from CPT and sorted list of modifiers
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| 37 | . S FBX=CPT_$S(FBMODLE]"":"-"_FBMODLE,1:"")
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| 38 | . ; look in file
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| 39 | . S FBDA=$O(^FBAA(163.99,"B",FBX,0))
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| 40 | . I FBDA S FBAMT=$P($G(^FBAA(163.99,FBDA,"FY",FBFY-1,0)),U,5)
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| 41 | ;
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| 42 | ; return result
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| 43 | Q FBAMT
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| 44 | ;
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| 45 | ;FBAAFSF
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