[613] | 1 | FBAAV0 ;AISC/GRR-ELECTRONICALLY TRANSMIT FEE DATA ;11 Apr 2006 2:51 PM
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| 2 | ;;3.5;FEE BASIS;**3,4,55,89,98**;JAN 30, 1995;Build 54
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| 3 | ;;Per VHA Directive 10-93-142, this routine should not be modified.
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| 4 | K ^TMP($J,"FBAABATCH"),^TMP($J,"FBVADAT") D DT^DICRW
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| 5 | I '$D(^FBAA(161.7,"AC","S")),'$D(^FBAA(161.7,"AC","R")),'$D(^FBAA(161.25,"AE")),$S('$D(^FBAA(161.26,"AC","P")):1,$O(^FBAA(161.26,"AC","P",0))'>0:1,1:0) W !,*7,"There are no transactions requiring transmission",*7 Q
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| 6 | W !!,"This option will transmit all Batches and MRA's ready to be transmitted",!,"to Austin"
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| 7 | RD W !! S DIR(0)="Y",DIR("A")="Are you sure you want to continue",DIR("B")="No" D ^DIR K DIR G END:'Y
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| 8 | L +^FBAA(161.7,"AC"):0 G:'$T LOCK^FBAAUTL1
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| 9 | W !!,"The following Batches will be transmitted: " F FBSTAT="S","R" F J=0:0 S J=$O(^FBAA(161.7,"AC",FBSTAT,J)) Q:J'>0 S FBATCH=$G(^FBAA(161.7,J,0)) D
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| 10 | .Q:'+FBATCH
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| 11 | .I (FBSTAT="S"&($P(FBATCH,U,15)="Y"))!(+$P(FBATCH,U,9)) S ^TMP($J,"FBAABATCH",J)="" W !,+FBATCH
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| 12 | RTRAN ;Entry from Re-transmit MRA routine
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| 13 | D ADDRESS^FBAAV01 G END:VATERR K VAT
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| 14 | D WAIT^DICD,STATION^FBAAUTL,HD^FBAAUTL I $D(FB("ERROR")) G END
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| 15 | S TOTSTR=0,$P(PAD," ",200)=" "
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| 16 | D ^FBAAV1:$D(^FBAA(161.25,"AE"))
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| 17 | D ^FBAAV4:$D(^FBAA(161.26,"AC","P"))
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| 18 | F J=0:0 S J=$O(^TMP($J,"FBAABATCH",J)) Q:J'>0 I $D(^FBAA(161.7,J,0)) S Y(0)=^(0) D SET1,DET:FBAABT="B3",DETP^FBAAV2:FBAABT="B5",DETT^FBAAV3:FBAABT="B2",^FBAAV5:FBAABT="B9"
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| 19 | END L -^FBAA(161.7,"AC") D KILL^FBAAV1 Q
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| 20 | SET1 ; build the payment batch header string (used by all four formats)
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| 21 | S FBAABN=$P(Y(0),"^",1),FBAABN=$E("00000",$L(FBAABN)+1,5)_FBAABN
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| 22 | S FBAAON=$E($P(Y(0),"^",2),3,6)
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| 23 | S FBAACD=$$AUSDT^FBAAV3(DT)
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| 24 | S FBAACP=$E($P(Y(0),"^",2),1,2)
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| 25 | S FBAABT=$P(Y(0),"^",3)
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| 26 | S FBAAAP=$$AUSAMT^FBAAV3($P(Y(0),"^",9),10)
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| 27 | S FBSTAT=$P(^FBAA(161.7,J,"ST"),"^")
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| 28 | S FBCHB=$P(Y(0),"^",15)
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| 29 | S FBEXMPT=$P(Y(0),"^",18)
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| 30 | S X=$$SUB^FBAAUTL5(+$P(Y(0),U,8)_"-"_$P(Y(0),U,2))
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| 31 | S FBAASN=$$LJ^XLFSTR($S(X]"":X,1:FBAASN),6," ")
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| 32 | I FBSTAT="R"!(FBSTAT="S"&(FBCHB'["Y"))!(FBSTAT="S"&($G(FBEXMPT)="Y")) S FBSTR=FBHD_$S(FBAABT="B2":"BT",1:FBAABT)_FBAACD_FBAASN_FBAABN_" "_FBAAAP_FBAACP_" $"
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| 33 | Q
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| 34 | DET ;entry point to process B3 (outpatient/ancillary) batch
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| 35 | ; input (partial list)
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| 36 | ; J - Batch IEN in file 161.7
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| 37 | ; FBAAON - last 4 of obligation number
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| 38 | ; FBAASN - station number (formatted)
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| 39 | S FBTXT=0
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| 40 | D CKB3V^FBAAV01 I $G(FBERR) K FBERR Q
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| 41 | F K=0:0 S K=$O(^FBAAC("AC",J,K)) Q:K'>0 F L=0:0 S L=$O(^FBAAC("AC",J,K,L)) Q:L'>0 F M=0:0 S M=$O(^FBAAC("AC",J,K,L,M)) Q:M'>0 F N=0:0 S N=$O(^FBAAC("AC",J,K,L,M,N)) Q:N'>0 S Y(0)=$G(^FBAAC(K,1,L,1,M,1,N,0)) I Y(0)]"",+$P(Y(0),U,3) D
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| 42 | .N FBDTSR1,FBPICN
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| 43 | .S FBDTSR1=+$G(^FBAAC(K,1,L,1,M,0))
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| 44 | .S FBPICN=K_U_L_U_M_U_N
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| 45 | .S FBY=$G(^FBAAC(K,1,L,1,M,1,N,2))
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| 46 | .I 'FBTXT S FBTXT=1 D NEWMSG^FBAAV01,STORE^FBAAV01,UPD
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| 47 | .D GOT
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| 48 | ;
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| 49 | D:FBTXT XMIT^FBAAV01
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| 50 | Q
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| 51 | ;
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| 52 | GOT ; process a B3 line item
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| 53 | ;
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| 54 | N DFN,FBADJ,FBADJA1,FBADJA2,FBADJR1,FBADJR2,FBADMIT,FBAUTHF,FBIENS
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| 55 | N FBMOD1,FBMOD2,FBMOD3,FBMOD4,FBPNAMX,FBUNITS,FBX,FBNPI
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| 56 | ;
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| 57 | S FBIENS=N_","_M_","_L_","_K_","
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| 58 | ;
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| 59 | ; get CPT modifiers
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| 60 | D
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| 61 | . N FBMODA,FBMODL
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| 62 | . D MODDATA^FBAAUTL4(K,L,M,N)
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| 63 | . S FBMODL=$$MODL^FBAAUTL4("FBMODA","E")
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| 64 | . S FBMOD1=$$RJ^XLFSTR($P(FBMODL,",",1),5," ")
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| 65 | . S FBMOD2=$$RJ^XLFSTR($P(FBMODL,",",2),5," ")
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| 66 | . S FBMOD3=$$RJ^XLFSTR($P(FBMODL,",",3),5," ")
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| 67 | . S FBMOD4=$$RJ^XLFSTR($P(FBMODL,",",4),5," ")
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| 68 | ;
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| 69 | S FBPAYT=$P(Y(0),"^",20),FBPAYT=$S(FBPAYT]"":FBPAYT,1:"V")
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| 70 | ;
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| 71 | S FBVID=$P($G(^FBAAV(L,0)),U,2)
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| 72 | S FBVID=FBVID_$E(PAD,$L(FBVID)+1,11)
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| 73 | S:FBPAYT="R" FBVID=$E(PAD,1,11)
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| 74 | S FBNPI=$$EN^FBNPILK(L) ;SET THE NPI TO BE PASSED TO FBAAV01,FBAAV2,FBAAV5
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| 75 | ;
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| 76 | D POV^FBAAUTL2
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| 77 | S POV=$S(POV']"":"",POV="A":6,POV="B":7,POV="C":8,POV="D":9,POV="E":10,1:POV)
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| 78 | S POV=$S(POV']"":99,$D(^FBAA(161.82,POV,0)):$P(^(0),"^",3),1:99)
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| 79 | S FBPOV=POV
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| 80 | S FBTT=$S(FBTT]"":FBTT,1:1)
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| 81 | S FBCPT=$$CPT^FBAAUTL4($P(Y(0),"^")),FBCPT=$S($L(FBCPT)=5:FBCPT,1:" ")
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| 82 | S FBPSA=$$PSA^FBAAV5(+$P(Y(0),U,12),+FBAASN) I $L(+FBPSA)'=3 S FBPSA=999
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| 83 | S FBPATT=$P(Y(0),"^",17),FBPATT=$S(FBPATT]"":FBPATT,1:10)
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| 84 | S FBTD=$$AUSDT^FBAAV3(FBDTSR1) ; formatted treatment date
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| 85 | S FBSUSP=$P(Y(0),"^",5),FBSUSP=$S(FBSUSP]"":FBSUSP,1:" ")
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| 86 | S FBSUSP=$S(FBSUSP=" ":" ",$D(^FBAA(161.27,+FBSUSP,0)):$P(^(0),"^"),1:" ")
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| 87 | S FBAP=$$AUSAMT^FBAAV3($P(Y(0),"^",3),8) ; amount paid
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| 88 | S FBPOS=+$P(Y(0),"^",25),FBPOS=$S(FBPOS:$P(^IBE(353.1,FBPOS,0),"^"),1:" ")
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| 89 | S FBHCFA=+$P(Y(0),"^",26),FBHCFA=$S(FBHCFA:$P(^IBE(353.2,FBHCFA,0),"^"),1:""),FBHCFA=$E(PAD,$L(FBHCFA)+1,2)_FBHCFA
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| 90 | S FBVTOS=+$P(Y(0),"^",24),FBVTOS=$S(FBVTOS:$P(^FBAA(163.85,FBVTOS,0),"^",2),1:" ")
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| 91 | S FBPD=+$P(Y(0),"^",23),FBPD=$S(FBPD:$$ICD9^FBCSV1(FBPD,$G(FBDTSR1)),1:""),FBPD=$E(PAD,$L(FBPD)+1,7)_FBPD
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| 92 | S FBINVN=$P(Y(0),"^",16)
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| 93 | S FBINVN=$E("000000000",$L(FBINVN)+1,9)_FBINVN
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| 94 | S FBAUTHF=$S($P(Y(0),U,13)["FB583":"U",1:"A") ; auth/unauth flag
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| 95 | S FBDIN=$$AUSDT^FBAAV3($P(Y(0),"^",15)) ; invoice date rec'd
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| 96 | S FBADMIT=$$AUSDT^FBAAV3($$B3ADMIT(FBIENS)) ; formatted admission date
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| 97 | ;
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| 98 | S VAPA("P")=""
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| 99 | S DFN=K
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| 100 | ; Note - before this point Y(0) was the 0 node of subfile #162.03
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| 101 | ; - after this point Y(0) will be the 0 node of file #2
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| 102 | S Y(0)=$G(^DPT(+K,0)) Q:Y(0)']""
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| 103 | D PAT^FBAAUTL2
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| 104 | ; obtain date of birth, must follow call to PAT^FBAAUTL2 to overwrite
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| 105 | ; the value returned from it
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| 106 | S FBDOB=$$AUSDT^FBAAV3($P(Y(0),"^",3)) ; date of birth
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| 107 | D ADD^VADPT
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| 108 | S FBPNAMX=$$HL7NAME^FBAAV4(DFN) ; patient name
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| 109 | S FBUNITS=$P(FBY,U,14)
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| 110 | S:FBUNITS<1 FBUNITS=1
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| 111 | S FBUNITS=$$RJ^XLFSTR(FBUNITS,5,0) ; volume indicator (units paid)
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| 112 | ;
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| 113 | ; get and format adjustment reason codes and amounts (if any)
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| 114 | D LOADADJ^FBAAFA(FBIENS,.FBADJ)
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| 115 | S FBX=$$ADJL^FBUTL2(.FBADJ)
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| 116 | S FBADJR1=$$RJ^XLFSTR($P(FBX,U,1),5," ")
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| 117 | S FBADJA1=$$AUSAMT^FBAAV3($P(FBX,U,3),9,1)
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| 118 | S FBADJR2=$$RJ^XLFSTR($P(FBX,U,4),5," ")
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| 119 | S FBADJA2=$$AUSAMT^FBAAV3($P(FBX,U,6),9,1)
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| 120 | K FBADJ,FBX
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| 121 | ;
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| 122 | S FBST=$S($P(VAPA(5),"^")="":" ",$D(^DIC(5,$P(VAPA(5),"^"),0)):$P(^(0),"^",2),1:" ")
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| 123 | S:$L(FBST)'=2 FBST=$E(PAD,$L(FBST)+1,2)_FBST
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| 124 | S FBCTY=$S($P(VAPA(7),"^",1)="":" ",FBST=" ":" ",$D(^DIC(5,$P(VAPA(5),"^"),1,$P(VAPA(7),"^"),0)):$P(^(0),"^",3),1:" ")
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| 125 | I $L(FBCTY)'=3 S FBCTY=$E("000",$L(FBCTY)+1,3)_FBCTY
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| 126 | S FBZIP=$S('+$G(VAPA(11)):VAPA(6),+VAPA(11):$P(VAPA(11),U),1:VAPA(6)),FBZIP=$TR(FBZIP,"-","")_$E("000000000",$L(FBZIP)+1,9)
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| 127 | D STRING^FBAAV01
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| 128 | Q
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| 129 | ;
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| 130 | UPD ; update the batch file
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| 131 | N Y
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| 132 | S DA=J,(DIC,DIE)="^FBAA(161.7,"
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| 133 | S DR="11////^S X=""T"";12////^S X=DT"
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| 134 | D ^DIE
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| 135 | Q
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| 136 | ;
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| 137 | STORE D STORE^FBAAV01 Q
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| 138 | ;
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| 139 | B3ADMIT(FBIENS) ; Determine Admission Date for a B3 payment line item
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| 140 | ; input
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| 141 | ; FBIENS - IENS (FileMan format) for subfile 162.03 entry
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| 142 | ; returns admission date in internal FileMan format or null value
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| 143 | ;
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| 144 | N FB7078,FBRET
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| 145 | S FBRET=""
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| 146 | S FB7078=$$GET1^DIQ(162.03,FBIENS,27,"I") ; associated 7078/583
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| 147 | ; (the unauthorized ancillary claims will have the treatment date
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| 148 | ; instead of the inpatient admission date so nothing is sent to
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| 149 | ; Austin for them)
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| 150 | ;
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| 151 | ; if line items points to a 7078 authorization then return a date
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| 152 | I $P(FB7078,";",2)="FB7078(" D
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| 153 | . N FBY
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| 154 | . S FBY=$G(^FB7078(+FB7078,0))
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| 155 | . ; if fee program is civil hospital then return 7078 date of admission
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| 156 | . I $P(FBY,U,11)=6 S FBRET=$P(FBY,U,15)
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| 157 | . ; if fee program is CNH then return 7078 authorized from date
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| 158 | . I $P(FBY,U,11)=7 S FBRET=$P(FBY,U,4)
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| 159 | ;
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| 160 | Q FBRET
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