| 1 | IBARXEU0 ;AAS/ALB - RX EXEMPTION UTILITY ROUTINE ; 2-NOV-92
 | 
|---|
| 2 |  ;;2.0;INTEGRATED BILLING;**139**; 21-MAR-94
 | 
|---|
| 3 |  ;;Per VHA Directive 10-93-142, this routine should not be modified.
 | 
|---|
| 4 |  ;
 | 
|---|
| 5 |  ;
 | 
|---|
| 6 | RXEXMT(DFN,IBDT) ; -- Check income exemption status of patient
 | 
|---|
| 7 |  ; -- Warning, this function may cause new entries to be created
 | 
|---|
| 8 |  ;    when no data exists of new entry for current caledar year exists.
 | 
|---|
| 9 |  ;
 | 
|---|
| 10 |  ;  input = :  dfn  = patient file pointer
 | 
|---|
| 11 |  ;             ibdt = date to check for
 | 
|---|
| 12 |  ;  returns :
 | 
|---|
| 13 |  ;              0 if not exempt
 | 
|---|
| 14 |  ;              1 if exempt^text^reason code^reason^date of test
 | 
|---|
| 15 |  ;
 | 
|---|
| 16 |  ;*** START RT CLOCK
 | 
|---|
| 17 |  ;S XRTN="ADD EXEMPTION",XRTL=$ZU(0) D T0^%ZOSV
 | 
|---|
| 18 |  ;
 | 
|---|
| 19 |  N X,Y,IBON,IBX,IBJOB,IBEXERR,IBWHER,DA,DR,DIC,DIE
 | 
|---|
| 20 |  ;
 | 
|---|
| 21 |  S IBON=$$ON I IBON<1 Q IBON
 | 
|---|
| 22 |  ;
 | 
|---|
| 23 |  S IBX="",IBJOB=14,IBEXERR=""
 | 
|---|
| 24 |  I '$G(IBDT) S IBDT=DT
 | 
|---|
| 25 |  I IBDT>DT S IBDT=DT ; no future dates
 | 
|---|
| 26 |  ;
 | 
|---|
| 27 |  ; -- date before legislation
 | 
|---|
| 28 |  I IBDT<$$STDATE^IBARXEU S IBX="0^NON-EXEMPT^^Date is prior to legislation^" G RXEXMTQ
 | 
|---|
| 29 |  ;
 | 
|---|
| 30 |  S X=$G(^IBA(354,DFN,0))
 | 
|---|
| 31 |  ;
 | 
|---|
| 32 |  ; -- if current patient, current request, get data and quit
 | 
|---|
| 33 |  I IBDT'<$P(X,"^",3),IBDT'>$$PLUS($P(X,"^",3)),$P(X,"^",4)'="" S IBX=$$IBX(DFN,IBDT) G RXEXMTQ
 | 
|---|
| 34 |  ;
 | 
|---|
| 35 |  ; -- if no patient add one
 | 
|---|
| 36 |  I '+X D ADDP^IBAUTL6 S X=$G(^IBA(354,DFN,0)) G:$G(IBEXERR) RXEXMTQ D AEX(DFN,IBDT) S IBX=$$IBX(DFN,IBDT) G RXEXMTQ
 | 
|---|
| 37 |  ;
 | 
|---|
| 38 |  ; -- if current exemption older than 365 days add new one
 | 
|---|
| 39 |  I IBDT'<$P(X,"^",3),IBDT>$$PLUS($P(X,"^",3)) D AEX(DFN,IBDT) S IBX=$$IBX(DFN,IBDT) G RXEXMTQ
 | 
|---|
| 40 |  ;
 | 
|---|
| 41 |  ; -- if ibdt less than current date need old exemption data
 | 
|---|
| 42 |  I IBDT<$P(X,"^",3) D
 | 
|---|
| 43 |  .;
 | 
|---|
| 44 |  .;find status of prior year
 | 
|---|
| 45 |  .S Y=$G(^IBA(354.1,+$O(^(+$O(^IBA(354.1,"AIVDT",1,DFN,-(IBDT+.0001))),0)),0))
 | 
|---|
| 46 |  .; -- no data
 | 
|---|
| 47 |  .I Y="" D AEX(DFN,IBDT)
 | 
|---|
| 48 |  .;
 | 
|---|
| 49 |  .; -- old data too old need to insert exemption
 | 
|---|
| 50 |  .I IBDT>$$PLUS(+Y) D AEX(DFN,IBDT)
 | 
|---|
| 51 |  .;
 | 
|---|
| 52 |  .; -- if old exemption is current for this copay date
 | 
|---|
| 53 |  .S IBX=$$IBXOLD(DFN,IBDT)
 | 
|---|
| 54 |  .Q
 | 
|---|
| 55 |  ;
 | 
|---|
| 56 |  ;*** STOP RT CLOCK
 | 
|---|
| 57 | RXEXMTQ ;I $D(XRT0),$D(XRTN) D T1^%ZOSV
 | 
|---|
| 58 |  ;
 | 
|---|
| 59 |  Q IBX
 | 
|---|
| 60 |  ;
 | 
|---|
| 61 |  ;
 | 
|---|
| 62 | AEX(DFN,IBDT) ; -- add exemption
 | 
|---|
| 63 |  ; set exemption effective date to means test dates
 | 
|---|
| 64 |  ;
 | 
|---|
| 65 |  N X
 | 
|---|
| 66 |  S X=$$STATUS^IBARXEU1(DFN,IBDT)
 | 
|---|
| 67 |  D ADDEX^IBAUTL6(+X,$P(X,"^",2))
 | 
|---|
| 68 |  Q
 | 
|---|
| 69 |  ;
 | 
|---|
| 70 | IBX(DFN,IBDT) ; -- format output from current status
 | 
|---|
| 71 |  N X,Y
 | 
|---|
| 72 |  S X=$G(^IBA(354,DFN,0)),Y=$$LST(DFN,IBDT)
 | 
|---|
| 73 |  Q +$P(X,"^",4)_"^"_$$TEXT(+$P(X,"^",4))_"^"_$$ACODE(Y)_"^"_$$REASON(Y)_"^"_+Y
 | 
|---|
| 74 |  ;
 | 
|---|
| 75 | IBXOLD(DFN,IBDT) ; -- format output from old exemption
 | 
|---|
| 76 |  N X,Y
 | 
|---|
| 77 |  S Y=$$LST(DFN,IBDT)
 | 
|---|
| 78 |  S X=$G(^IBE(354.2,+$P(Y,"^",5),0)) ; exemption reason node
 | 
|---|
| 79 |  Q +$P(X,"^",4)_"^"_$$TEXT(+$P(X,"^",4))_"^"_$$ACODE(Y)_"^"_$$REASON(Y)_"^"_+Y
 | 
|---|
| 80 |  ;
 | 
|---|
| 81 |  ;
 | 
|---|
| 82 | ON() ; -- is copay exemption testing on
 | 
|---|
| 83 |  ;    output 1 = exemption testing is active
 | 
|---|
| 84 |  ;           0 = exemption testing is inactive (everybody non-exempt)
 | 
|---|
| 85 |  ;          -1 = copay is off (everybody exempt)
 | 
|---|
| 86 |  Q 1
 | 
|---|
| 87 |  ;Q "0^NON-EXEMPT^0^Medication Copay Exemption Testing turned off^"_DT
 | 
|---|
| 88 |  ;Q "-1^EXEMPT^0^Medication Copayment has been turned off^"_DT
 | 
|---|
| 89 |  ;
 | 
|---|
| 90 | PLUS(X1) ; -- computes plus 1 year (into future)
 | 
|---|
| 91 |  ; if x1=2920930 + 1 year = +10000 = 2930930
 | 
|---|
| 92 |  I $E(X1,4,7)="0229" Q X1+10072  ;makes the anniversary date March 1
 | 
|---|
| 93 |  Q X1+10000
 | 
|---|
| 94 |  ;
 | 
|---|
| 95 | MINUS(X1) ; -- computes minus 1 year (into past)
 | 
|---|
| 96 |  Q X1-10000
 | 
|---|
| 97 |  ;
 | 
|---|
| 98 | ACODE(Y) ; -- return lookup code of reason, input zeroth node of exemption
 | 
|---|
| 99 |  Q $P($G(^IBE(354.2,+$P($G(Y),"^",5),0)),"^",5)
 | 
|---|
| 100 |  ;
 | 
|---|
| 101 | REASON(Y) ; -- return reason description, input zeroth node of exemption
 | 
|---|
| 102 |  Q $P($G(^IBE(354.2,+$P($G(Y),"^",5),0)),"^",2)
 | 
|---|
| 103 |  ;
 | 
|---|
| 104 | TEXT(X) ; -- convert 0 or 1 to text
 | 
|---|
| 105 |  Q $S(X=1:"EXEMPT",X=0:"NON-EXEMPT",1:"UNKNOWN")
 | 
|---|
| 106 |  ;
 | 
|---|
| 107 | LST(DFN,IBDT) ; -- returns last exemption entry before date x
 | 
|---|
| 108 |  ;
 | 
|---|
| 109 |  ; -- returns zeroth node of last test before date
 | 
|---|
| 110 |  ;
 | 
|---|
| 111 |  I '$G(IBDT) S IBDT=DT
 | 
|---|
| 112 |  Q $G(^IBA(354.1,+$O(^(+$O(^IBA(354.1,"AIVDT",1,DFN,-(IBDT+.00001))),0)),0))
 | 
|---|
| 113 |  ;
 | 
|---|
| 114 | LSTAC(DFN) ; -- computes last reason code and date for a patient
 | 
|---|
| 115 |  ; -- returns exemption reason ^ exemption date
 | 
|---|
| 116 |  N X1
 | 
|---|
| 117 |  S X1=$G(^IBA(354.1,+$O(^(+$O(^IBA(354.1,"AIVDT",1,DFN,-(DT+.00001))),0)),0))
 | 
|---|
| 118 |  Q $P($G(^IBE(354.2,+$P(X1,"^",5),0)),"^",5)_"^"_+X1
 | 
|---|