| 1 | IVMZ7CCD ;BAJ - HL7 Z07 CONSISTENCY CHECKER -- CATASTROPHIC DISABILITY SUBROUTINE ; 11/9/05 9:30am
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| 2 |  ;;2.0;INCOME VERIFICATION MATCH;**105**;JUL 8,1996;Build 2
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| 3 |  ;
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| 4 |  ; Catastrophic Disability Consistency Checks
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| 5 |  ; This routine checks the various elements of catastrophic disability information
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| 6 |  ; prior to building a Z07 record.  Any tests which fail consistency check will be
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| 7 |  ; saved to the ^DGIN(38.6 record for the patient.
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| 8 |  ;
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| 9 |  ;
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| 10 |  ; Must be called from entry point
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| 11 |  Q
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| 12 |  ;
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| 13 | EN(DFN) ; entry point.  Patient DFN is sent from calling routine.
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| 14 |  ; initialize working variables
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| 15 |  N RULE,Y,DGCDIS,PASS,FILERR
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| 16 |  ; patient array DGCDIS can be populated by a call to $$GET^DGENCDA(DFN,.DGCDIS) as follows:
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| 17 |  ;
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| 18 |  ; S PASS=$$GET^DGENCDA(DFN,.DGCDIS)
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| 19 |  ;
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| 20 |  ; and creates an array similar to this:
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| 21 |  ;       DGCDIS("BY")="DR. JOHN"
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| 22 |  ;       DGCDIS("COND",1)="48"
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| 23 |  ;       DGCDIS("DATE")="3050926"
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| 24 |  ;       DGCDIS("DIAG",1)="8"
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| 25 |  ;       DGCDIS("DTFACIRV")=""
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| 26 |  ;       DGCDIS("DTVETNOT")=""
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| 27 |  ;       DGCDIS("FACDET")="16660"
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| 28 |  ;       DGCDIS("METDET")="3"
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| 29 |  ;       DGCDIS("PERM",1)="1"
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| 30 |  ;       DGCDIS("REVDTE")="3050926"
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| 31 |  ;       DGCDIS("SCORE",1)="6"
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| 32 |  ;       DGCDIS("VCD")="Y"
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| 33 |  ;       DGCDIS("VETREQDT")=""
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| 34 |  ;
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| 35 |  ; if the patient has no CD data on file, the API will return the following:
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| 36 |  ;       DGCDIS=""
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| 37 |  ;       DGCDIS("BY")=""
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| 38 |  ;       DGCDIS("DATE")=""
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| 39 |  ;       DGCDIS("DTFACIRV")=""
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| 40 |  ;       DGCDIS("DTVETNOT")=""
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| 41 |  ;       DGCDIS("FACDET")=""
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| 42 |  ;       DGCDIS("METDET")=""
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| 43 |  ;       DGCDIS("REVDTE")=""
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| 44 |  ;       DGCDIS("VCD")=""
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| 45 |  ;       DGCDIS("VETREQDT")=""
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| 46 |  ;
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| 47 |  S PASS=$$GET^DGENCDA(DFN,.DGCDIS)
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| 48 |  ;
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| 49 |  ; In cases where patient is not listed as catastrophically disabled, routine should check to see if patient could potentially
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| 50 |  ; qualify for CD.  If patient qualifies and is not listed as CD, an inconsistency should be filed.  Otherwise continue.
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| 51 |  ; If patient is not listed as CD, regardless of potential, further checks are not necessary as the rest depend on CD="YES"
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| 52 |  ;
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| 53 |  I '$$CD(DGCDIS("VCD")="Y") D  Q
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| 54 |  . I $D(FILERR) D FILE
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| 55 |  ;
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| 56 |  ; loop through rules in INCONSISTENT DATA ELEMENTS file.
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| 57 |  ; execute only the rules where CHECK/DON'T CHECK and INCLUDE IN Z07 CHECKS fields are turned ON.
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| 58 |  ; 
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| 59 |  ; ***NOTE loop boundary (701-726) must be changed if rule numbers are added ***
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| 60 |  F RULE=701:1:726 I $D(^DGIN(38.6,RULE)) D
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| 61 |  . S Y=^DGIN(38.6,RULE,0)
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| 62 |  . I '$P(Y,"^",5),$P(Y,"^",6) D @RULE
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| 63 |  I $D(FILERR) D FILE
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| 64 |  Q
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| 65 |  ;
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| 66 | CD(VCD) ; Is Patient Catastrophically disabled?  If not, we need to examine patient's record to see if qualified for CD
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| 67 |  ; Whether qualified or not, if patient is listed as NOT CD, the rest of the rules should not be checked.  Therefore,
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| 68 |  ; if DGCDIS("VCD") does not = "Y" system will exit after this rule without checking any further.
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| 69 |  I VCD Q 1
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| 70 |  I $$ISCD^DGENCDA1(.DGCDIS) S FILERR(720)=""
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| 71 |  Q 0
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| 72 |  ;
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| 73 | 701 ;Catastrophic Disability 'Decided By' Cannot be 'HINQ'
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| 74 |  I $G(DGCDIS("BY"))="HINQ" S FILERR(RULE)=""
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| 75 |  Q
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| 76 |  ;
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| 77 | 702 ;Catastrophic Disability 'Decided By' not valid
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| 78 |  I ($L(DGCDIS("BY"))<3)!($L(DGCDIS("BY"))>35) S FILERR(RULE)=""
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| 79 |  Q
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| 80 | 703 ;"Catastrophic Disability 'Decided By' required"
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| 81 |  I $G(DGCDIS("BY"))="" S FILERR(RULE)=""
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| 82 |  Q
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| 83 |  ;
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| 84 | 704 ;"Catastrophic Disability Review Date Required"
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| 85 |  I $G(DGCDIS("REVDTE"))="" S FILERR(RULE)=""
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| 86 |  Q
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| 87 |  ;
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| 88 | 705 ;"Catastrophic Disability Review Date Invalid"
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| 89 |  N RESULT
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| 90 |  D CHK^DIE(2,.394,,DGCDIS("REVDTE"),.RESULT)
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| 91 |  I RESULT="^" S FILERR(RULE)=""
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| 92 |  Q
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| 93 |  ;
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| 94 | 706 ;"CD Condition Score not valid"
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| 95 |  N ITEM,ERR
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| 96 |  S ITEM="",ERR=0
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| 97 |  F  S ITEM=$O(DGCDIS("COND",ITEM)) Q:ITEM=""  D
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| 98 |  . I '$$VALID^DGENA5(DGCDIS("COND",ITEM),$G(DGCDIS("SCORE",ITEM))) S ERR=1
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| 99 |  I ERR S FILERR(RULE)=""
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| 100 |  Q
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| 101 |  ;
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| 102 | 707 ;"CD Review Date greater than CD Date of Determination"
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| 103 |  I $G(DGCDIS("REVDTE"))>$G(DGCDIS("DATE")) S FILERR(RULE)=""
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| 104 |  Q
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| 105 |  ;
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| 106 | 708 ;"CD Status Affected Extremity' Invalid"
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| 107 |  N ITEM,EIEN,ERR
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| 108 |  S ITEM="",ERR=0
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| 109 |  F  S ITEM=$O(DGCDIS("PROC",ITEM)) Q:ITEM=""  D
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| 110 |  . S EIEN="" F  S EIEN=$O(DGCDIS("EXT",ITEM,EIEN)) Q:EIEN=""  D
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| 111 |  . . I '$$LIMBOK^DGENA5(DGCDIS("PROC",ITEM),DGCDIS("EXT",ITEM,EIEN)) S ERR=1
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| 112 |  I ERR S FILERR(RULE)=""
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| 113 |  Q
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| 114 |  ;
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| 115 | 709 ;"CD Status Diagnoses' Not Valid"
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| 116 |  ; .396 CD STATUS DIAGNOSES field (multiple):
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| 117 |  N ITEM,ERR
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| 118 |  S ITEM="",ERR=0
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| 119 |  F  S ITEM=$O(DGCDIS("DIAG",ITEM)) Q:ITEM=""  D
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| 120 |  . I $$TYPE^DGENA5(DGCDIS("DIAG",ITEM))'="D" S ERR=1
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| 121 |  I ERR S FILERR(RULE)=""
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| 122 |  Q
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| 123 |  ;
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| 124 | 710 ;"'CD Status Procedure' Not Valid"
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| 125 |  ; .397 CD STATUS PROCEDURES field (multiple):
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| 126 |  N ITEM,ERR
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| 127 |  S ITEM="",ERR=0
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| 128 |  F  S ITEM=$O(DGCDIS("PROC",ITEM)) Q:ITEM=""  D
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| 129 |  . I $$TYPE^DGENA5(DGCDIS("PROC",ITEM))'="P" S ERR=1
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| 130 |  I ERR S FILERR(RULE)=""
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| 131 |  Q
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| 132 |  ;
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| 133 | 711 ;"'CD Status Reason' Not Present"
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| 134 |  I '($D(DGCDIS("DIAG"))!$D(DGCDIS("PROC"))!$D(DGCDIS("COND"))) S FILERR(RULE)=""
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| 135 |  Q
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| 136 |  ;
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| 137 | 712 ;"'Date Of Catastophic Disability Decision' Not Valid"
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| 138 |  N RESULT,OK,EXTERNAL
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| 139 |  S OK=0
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| 140 |  I $G(DGCDIS("DATE"))'="" S OK=1 D
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| 141 |  . S EXTERNAL=$$EXTERNAL^DILFD(2,.392,"",DGCDIS("DATE"))
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| 142 |  . I EXTERNAL="" S OK=0 Q
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| 143 |  . D CHK^DIE(2,.392,,EXTERNAL,.RESULT) I RESULT="^" S OK=0
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| 144 |  I 'OK S FILERR(RULE)=""
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| 145 |  Q
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| 146 |  ;
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| 147 | 713 ;"'Date Of Catastophic Disability Decision' Required"
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| 148 |  I $G(DGCDIS("DATE"))="" S FILERR(RULE)=""
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| 149 |  Q
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| 150 |  ;
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| 151 | 714 ;"'Facility Making Catastrophic Disability Determination' Not Valid"
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| 152 |  I DGCDIS("VCD")'=""!(DGCDIS("FACDET")'=""),$$EXTERNAL^DILFD(2,.393,"",$G(DGCDIS("FACDET")))="" S FILERR(RULE)=""
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| 153 |  Q
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| 154 |  ;
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| 155 | 715 ;"'Method Of Determination' Is A Required Value"
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| 156 |  I $G(DGCDIS("METDET"))="" S FILERR(RULE)=""
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| 157 |  Q
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| 158 |  ;
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| 159 | 716 ;"'Method Of Determination' Not Valid"
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| 160 |  I ".2.3."'[("."_$G(DGCDIS("METDET"))_".") S FILERR(RULE)=""
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| 161 |  Q
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| 162 |  ;
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| 163 | 717 ;"Not Enough Diagnoses/Procedures/Conditions To Qualify For CD Status"
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| 164 |  I '$$ISCD^DGENCDA1(.DGCDIS) S FILERR(RULE)=""
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| 165 |  Q
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| 166 |  ;
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| 167 | 718 ;"Permanent Status Indicator' Not Valid"
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| 168 |  N ITEM
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| 169 |  S ITEM="" F  S ITEM=$O(DGCDIS("COND",ITEM)) Q:ITEM=""  D
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| 170 |  . I ".1.2.3."'[("."_DGCDIS("PERM",ITEM)_".") S FILERR(RULE)=""
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| 171 |  Q
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| 172 |  ;
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| 173 | 719 ;"'Veteran Catastrophically Disabled?' Field Must Have A Response"
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| 174 |  ; .39 VETERAN CATASTROPHICALLY DISABLED? field.
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| 175 |  I DGCDIS("VCD")="" S FILERR(RULE)=""
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| 176 |  Q
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| 177 |  ;
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| 178 | 720 ;"Veteran Has Enough Diagnoses/Procedures/Conditions To Qualify For CD Status"
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| 179 |  ; We check this rule at the beginning of the routine.  No need to check it here,
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| 180 |  ; but we need the label as a place holder.
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| 181 |  Q
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| 182 |  ;
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| 183 | 723 ;"Catastrophic Disability Review date must be a precise date"
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| 184 |  N RESULT
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| 185 |  D CHK^DIE(2,.394,,DGCDIS("REVDTE"),.RESULT)
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| 186 |  I RESULT="^" S FILERR(RULE)=""
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| 187 |  Q
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| 188 |  ;
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| 189 | 724 ;"Catastrophic Disability Date of Decision must be a precise date"
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| 190 |  N RESULT
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| 191 |  D CHK^DIE(2,.392,,DGCDIS("DATE"),.RESULT)
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| 192 |  I RESULT="^" S FILERR(RULE)=""
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| 193 |  Q
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| 194 |  ;
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| 195 | 725 ;"Catastrophic Disability Procedure code must be accompanied with an Affected Extremity field"
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| 196 |  ; Procedure list = DGCDIS("PROC",ITEM)
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| 197 |  ; Affected Extremity list = DGCDIS("EXT",ITEM)
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| 198 |  ; This tag makes sure that there is at least one Affected Extremity for each procedure code.
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| 199 |  N ITEM,ERR
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| 200 |  S ERR=0,ITEM=""
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| 201 |  F  S ITEM=$O(DGCDIS("PROC",ITEM)) Q:ITEM=""  D
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| 202 |  . I '$D(DGCDIS("EXT",ITEM)) S ERR=1 Q
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| 203 |  . I $G(DGCDIS("EXT",ITEM))="" S ERR=1
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| 204 |  I ERR S FILERR(RULE)=""
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| 205 |  Q
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| 206 |  ;
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| 207 | 726 ;"Catastrophic Disablity condition code requires a Score field"
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| 208 |  ; Condition list = DGCDIS("COND",ITEM)
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| 209 |  ; Score list = DGCDIS("SCORE",ITEM)
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| 210 |  N ITEM,ERR
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| 211 |  S ERR=0,ITEM=""
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| 212 |  F  S ITEM=$O(DGCDIS("COND",ITEM)) Q:ITEM=""  D
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| 213 |  . I '$D(DGCDIS("SCORE",ITEM)) S ERR=1 Q
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| 214 |  . I $G(DGCDIS("SCORE",ITEM))="" S ERR=1
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| 215 |  I ERR S FILERR(RULE)=""
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| 216 |  Q
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| 217 |  ; 
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| 218 | FILE ;file the inconsistencies in a temp global
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| 219 |  M ^TMP($J,DFN)=FILERR
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| 220 |  Q
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| 221 |  ;
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