| 1 | IBAECI ;ALB/BGA-LONG TERM CARE INPATIENT TRACKER ; 09-OCT-01
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| 2 | ;;2.0;INTEGRATED BILLING;**164,171,176,198,188**;21-MAR-94
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| 3 | ;; Per VHA Directive 10-93-142, this routine should not be modified
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| 4 | ;
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| 5 | ; This routine is called from ^IBAMTD and tracks all patient movements
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| 6 | ; that are related to Long Term Care (LTC). If the Episode of care is
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| 7 | ; related to LTC the episode of care is stored in ^IBA(351.8 and will
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| 8 | ; be further screen when the Monthly Job is run and than Priced.
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| 9 | ;
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| 10 | ;
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| 11 | EN ; Main Entry Point
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| 12 | ;
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| 13 | ; === When IBALTC=0 episode not LTC billable so passed to MTC Module
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| 14 | ; IBALTC=1 episode is LTC Billable do NOT passed to MTC Module
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| 15 | ;
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| 16 | S IBALTC=0
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| 17 | I $G(DGPMA)="",$G(DGPMP)="" Q
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| 18 | I DT<$$STDATE^IBAECU1() Q ;quit if today<effective date
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| 19 | N IBCL,IBDT,IBDTA,IBLTCST,IBT,IBTS,IBX,IBY,IBZ,IBM,IBV,IBE
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| 20 | ;
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| 21 | S IBV=$S($L($G(DGPMP)):"DGPMP",1:"DGPMA") D:+$G(@IBV)>0
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| 22 | . N IBDT S IBDT=+$G(@IBV)\1
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| 23 | . N VAIP S VAIP("D")=IBDT_.2359 D IN5^VADPT I $P($$TREATSP^IBAECU2($P($G(^DIC(45.7,+VAIP(8),0)),U,2)),"^",1)="L" D BACKBIL Q
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| 24 | . I +$G(VAIP(1))>0 S VAIP(1)=$$ORIGADM^IBAECN1(VAIP(1)) I $$ISLTC4DT^IBAECN1(DFN,+$G(VAIP(1)),IBDT_.2359)=1 D BACKBIL
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| 25 | ; is this related to LTC
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| 26 | S IBX=0 F S IBX=$O(^UTILITY("DGPM",$J,6,IBX)) Q:IBX<1 F IBY="A","P" S IBTS=$P($G(^UTILITY("DGPM",$J,6,IBX,IBY)),"^",9) I IBTS,$$LTCSPEC^IBAECU(+$$FACSPEC^IBAECU(IBTS)) S IBALTC=1
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| 27 | I IBALTC=0 I $D(^UTILITY("DGPM",$J,3)) D
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| 28 | . N VAIN,VAINDT S VAINDT=+$G(@IBV)\1 D INP^VADPT I $P($$TREATSP^IBAECU2($P($G(^DIC(45.7,+VAIN(3),0)),U,2)),"^",1)="L" S IBALTC=1
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| 29 | I 'IBALTC Q
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| 30 | ;
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| 31 | ; get the earliest date of care for this movement
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| 32 | S IBDT=+DGPMA
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| 33 | I DGPMP,(DGPMP<DGPMA!('IBDT)) S IBDT=+DGPMP S IBT=0 F S IBT=$O(^UTILITY($J,IBT)) Q:IBT<1 S IBX=DGPMDA-1 F S IBX=$O(^UTILITY($J,IBT,IBX)) Q:IBX<1 F IBZ="A","P" S IBDTA=+$G(^UTILITY($J,IBT,IBX,IBZ)) I IBDTA<IBDT S IBDT=IBDTA
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| 34 | ;
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| 35 | ; look up this patient's LTC status
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| 36 | S IBLTCST=+$$LTCST^IBAECU(DFN,IBDT\1,1)
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| 37 | ;
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| 38 | ; are they exempt from LTC care?
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| 39 | I IBLTCST=1 S IBALTC=1 Q
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| 40 | ;
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| 41 | ; no 1010EC send message and quit
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| 42 | I IBLTCST=0 D D XMNOEC^IBAECU(DFN,IBDT,.IBE) Q
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| 43 | . S IBV=$S($L($G(DGPMP)):"DGPMP",1:"DGPMA")
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| 44 | . S IBE(1)="",IBE(2)=" Event Type: Inpatient Movement "_$S(IBV="DGPMP"&($G(DGPMA)):"Edited",IBV="DGPMP":"Deleted",1:"Added")
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| 45 | . S IBE(3)="",IBE(4)="Event Action: "_$S($P(@IBV,"^",2)=1:"Admission",$P(@IBV,"^",2)=2:"Transfer",$P(@IBV,"^",2)=3:"Discharge",$P(@IBV,"^",2)=6:"Specialty Change",1:"")
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| 46 | . S IBE(5)="",IBE(6)=" Location: " D
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| 47 | . . I $P(@IBV,"^",6) S IBE(6)=IBE(6)_$P($G(^DIC(42,+$P(@IBV,"^",6),0)),"^") Q
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| 48 | . . I $P(@IBV,"^",14),$P($G(^UTILITY("DGPM",$J,1,$P(@IBV,"^",14),"A")),"^",6) S IBE(6)=IBE(6)_$P($G(^DIC(42,+$P(^("A"),"^",6),0)),"^") Q
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| 49 | . . I $P(@IBV,"^",14),$P($G(^UTILITY("DGPM",$J,1,$P(@IBV,"^",14),"P")),"^",6) S IBE(6)=IBE(6)_$P($G(^DIC(42,+$P(^("P"),"^",6),0)),"^")
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| 50 | . . I $P(@IBV,"^",14),$P($G(^DGPM(+$P(@IBV,"^",14),0)),"^",6) S IBE(6)=IBE(6)_$P($G(^DIC(42,+$P(^(0),"^",6),0)),"^") Q
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| 51 | . . S IBE(6)=IBE(6)_"Unknown"
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| 52 | ;
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| 53 | D BACKBIL
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| 54 | ;
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| 55 | ; flag LTC for current events
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| 56 | S IBCL=$$CLOCK^IBAECU(DFN,$S(IBDT<$$STDATE^IBAECU1:$$STDATE^IBAECU1,1:IBDT\1))
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| 57 | ;
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| 58 | Q
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| 59 | ;
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| 60 | BACKBIL ;called from EN
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| 61 | ; back billing issue? send message and quit
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| 62 | S IBV=$S($L($G(DGPMP)):"DGPMP",1:"DGPMA")
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| 63 | I $$LASTMJ^IBAECU()>0,$E(IBDT,1,5)<$E($$LASTMJ^IBAECU(),1,5) D D XMBACK^IBAECU(DFN,.IBM) Q
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| 64 | . S IBM(1)="A(n) Added." I $D(IBV),$D(@IBV) D
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| 65 | . . S IBM(1)="A(n) "_$S($P(@IBV,"^",2)=1:"Admission",$P(@IBV,"^",2)=2:"Transfer",$P(@IBV,"^",2)=3:"Discharge",$P(@IBV,"^",2)=6:"Specialty Change",1:"")_" was "_$S(IBV="DGPMP"&($G(DGPMA)):"Edited",IBV="DGPMP":"Deleted",1:"Added")_"."
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| 66 | . S IBM(2)=" ",IBM(3)="This may result in a Back Billing issue for LTC. You should review the"
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| 67 | . S IBM(4)="patient's records for "_$$FMTE^XLFDT(IBDT)_" to ensure correct billing."
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| 68 | . S IBM(5)="LTC Billing Clock and LTC charges may have to be manually adjusted."
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| 69 | Q
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| 70 | ;
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| 71 | CALC ; tag for completion of manual adding of inpt charges
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| 72 | ; requires DFN, IBCHG, IBEVDA, IBTO
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| 73 | ;
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| 74 | N IBT,IBTYP,IBLOS,IBZ
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| 75 | ;
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| 76 | ; get the LOS
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| 77 | S IBZ=^IB(+IBEVDA,0),IBLOS=$$LOS^IBCU64($S($$BILDATE^IBAECN1>$P(IBZ,"^",17):$$BILDATE^IBAECN1,1:$P(IBZ,"^",17)),$$LASTDT^IBAECU(IBTO),2,$P($P(IBZ,"^",4),":",2))
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| 78 | ;
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| 79 | ; update the status
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| 80 | S IBLTCST=$$LTCST^IBAECU(DFN,IBTO,IBLOS) I IBLTCST<2 W !!," This patient is not LTC billable on the date." S IBY=-1 Q
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| 81 | ;
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| 82 | ; find the total amount already billed for mo
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| 83 | D TOT^IBAECU
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| 84 | ;
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| 85 | W !!," Calculated Monthly Copay Cap Type to be used: INPATIENT ",$S(IBLOS<181:"< 181",1:"> 180")," days."
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| 86 | W !," Calculated Monthly Copay Cap is: $ ",$FN($P(IBLTCST,"^",$S(IBLOS<181:3,1:4)),",",2)
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| 87 | W !," Total previously billed: $ ",$FN(IBT,",",2)
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| 88 | ;
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| 89 | I IBCHG+IBT>$P(IBLTCST,"^",$S(IBLOS<181:3,1:4)) S IBCHG=$P(IBLTCST,"^",$S(IBLOS<181:3,1:4))-IBT
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| 90 | ;
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| 91 | ; check for negative $ amount cap
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| 92 | I $P(IBLTCST,"^",$S(IBLOS<181:3,1:4))<0 S IBCHG=0
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| 93 | ;
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| 94 | Q
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