| 1 | IBCBB11 ;ALB/AAS - CONTINUATION OF EDIT CHECK ROUTINE ;12 Jun 2006 3:45 PM
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| 2 | ;;2.0;INTEGRATED BILLING;**51,343,363,371,395,392,401**;21-MAR-94;Build 5
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| 3 | ;;Per VHA Directive 2004-038, this routine should not be modified.
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| 4 | ;
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| 5 | WARN(IBDISP) ; Set warning in global
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| 6 | ; DISP = warning text to display
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| 7 | ;
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| 8 | N Z
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| 9 | S Z=+$O(^TMP($J,"BILL-WARN",""),-1)
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| 10 | I Z=0 S ^TMP($J,"BILL-WARN",1)=$J("",5)_"**Warnings**:",Z=1
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| 11 | S Z=Z+1,^TMP($J,"BILL-WARN",Z)=$J("",5)_IBDISP
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| 12 | Q
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| 13 | ;
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| 14 | MULTDIV(IBIFN,IBND0) ; Check for multiple divisions on a bill ien IBIFN
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| 15 | ; IBND0 = 0-node of bill
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| 16 | ;
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| 17 | ; Function returns 1 if more than 1 division found on bill
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| 18 | N Z,Z0,Z1,MULT
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| 19 | S MULT=0,Z1=$P(IBND0,U,22)
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| 20 | I Z1 D
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| 21 | . S Z=0 F S Z=$O(^DGCR(399,IBIFN,"RC",Z)) Q:'Z S Z0=$P(^(Z,0),U,7) I Z0,Z0'=Z1 S MULT=1 Q
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| 22 | . S Z=0 F S Z=$O(^DGCR(399,IBIFN,"CP",Z)) Q:'Z S Z0=$P(^(Z,0),U,6) I Z0,Z0'=Z1 S MULT=2 Q
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| 23 | I 'Z1 S MULT=3
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| 24 | Q MULT
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| 25 | ;
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| 26 | ;; PREGNANCY DX CODES: V22**-V24**, V27**-V28**, 630**-677**
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| 27 | ;; FLU SHOTS PROCEDURE CODES: 90724, G0008, 90732, G0009
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| 28 | ;
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| 29 | ; Check for required NPIs
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| 30 | NPICHK ;
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| 31 | N IBNPIS,IBNONPI,IBNPIREQ,Z
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| 32 | S IBNPIREQ=$$NPIREQ^IBCEP81(DT) ; Check if NPI is required
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| 33 | ; Check providers
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| 34 | S IBNPIS=$$PROVNPI^IBCEF73A(IBIFN,.IBNONPI)
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| 35 | I $L(IBNONPI) F Z=1:1:$L(IBNONPI,U) D
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| 36 | . I IBNPIREQ S IBER=IBER_"IB"_(140+$P(IBNONPI,U,Z))_";" Q ; If required, set error
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| 37 | . D WARN("NPI for the "_$P("referring^operating^rendering^attending^supervising^^^^other",U,$P(IBNONPI,U,Z))_" provider has no value") ; Else, set warning
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| 38 | ; Check organizations
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| 39 | S IBNONPI=""
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| 40 | S IBNPIS=$$ORGNPI^IBCEF73A(IBIFN,.IBNONPI)
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| 41 | I $L(IBNONPI) F Z=1:1:$L(IBNONPI,U) D
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| 42 | . ; Turn IB161, IB162 to a warning
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| 43 | . I IBNPIREQ,$P(IBNONPI,U,Z)=3 S IBER=IBER_"IB163;" Q
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| 44 | . ; PRXM/KJH - Changed descriptions.
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| 45 | . D WARN("NPI for the "_$P("Division^Non-VA Service Facility^Billing Provider",U,$P(IBNONPI,U,Z))_" has no value") ; Else, set warning
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| 46 | Q
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| 47 | ;
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| 48 | ; Check for required taxonomies
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| 49 | TAXCHK ;
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| 50 | N IBTAXS,IBNOTAX,IBTAXREQ,Z
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| 51 | S IBTAXREQ=$$TAXREQ^IBCEP81(DT) ; Check if taxonomy is required
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| 52 | ; Check providers
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| 53 | S IBTAXS=$$PROVTAX^IBCEF73A(IBIFN,.IBNOTAX)
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| 54 | I $L(IBNOTAX) F Z=1:1:$L(IBNOTAX,U) D
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| 55 | . ; Only Referring, Rendering and Attending are currently sent to the payer
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| 56 | . I IBTAXREQ,"134"[$P(IBNOTAX,U,Z) S IBER=IBER_"IB"_(250+$P(IBNOTAX,U,Z))_";" Q ; If required, set error
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| 57 | . D WARN("Taxonomy for the "_$P("referring^operating^rendering^attending^supervising^^^^other",U,$P(IBNOTAX,U,Z))_" provider has no value") ; Else, set warning
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| 58 | ; Check organizations
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| 59 | S IBNOTAX=""
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| 60 | S IBTAXS=$$ORGTAX^IBCEF73A(IBIFN,.IBNOTAX)
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| 61 | I $L(IBNOTAX) F Z=1:1:$L(IBNOTAX,U) D
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| 62 | . ; Turn IB165, IB166 to a warning
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| 63 | . I IBTAXREQ,$P(IBNOTAX,U,Z)=3 S IBER=IBER_"IB167;" Q
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| 64 | . ; PRXM/KJH - Changed descriptions.
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| 65 | . D WARN("Taxonomy for the "_$P("Division^Non-VA Service Facility^Billing Provider",U,$P(IBNOTAX,U,Z))_" has no value") ; Else, set warning
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| 66 | Q
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| 67 | ;
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| 68 | VALNDC(IBIFN,IBDFN) ; IB*2*363 - validate NDC# between PRESCRIPTION file (#52)
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| 69 | ; and IB BILL/CLAIMS PRESCRIPTION REFILL file (#362.4)
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| 70 | ; input - IBIFN = internal entry number of the billing record in the BILL/CLAIMS file (#399)
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| 71 | ; IBDFN = internal entry number of patient record in the PATIENT file (#2)
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| 72 | N IBX,IBRXCOL
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| 73 | ; call program that determines if NDC differences exist
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| 74 | D VALNDC^IBEFUNC3(IBIFN,IBDFN,.IBRXCOL)
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| 75 | Q:'$D(IBRXCOL)
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| 76 | ; at least one RX on the IB record has an NDC discrepancy
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| 77 | S IBX=0 F S IBX=$O(IBRXCOL(IBX)) Q:'IBX D WARN("NDC# on Bill does not equal the NDC# on Rx "_IBRXCOL(IBX))
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| 78 | Q
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| 79 | ;
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| 80 | PRIIDCHK ; Check for required Pimarary ID (SSN/EIN)
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| 81 | ; If the provider is on the claim, he must have one
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| 82 | ;
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| 83 | N IBI,IBZ
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| 84 | I $$TXMT^IBCEF4(IBIFN) D
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| 85 | . D F^IBCEF("N-ALL ATT/REND PROV SSN/EI","IBZ",,IBIFN)
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| 86 | . S IBI="" F S IBI=$O(^DGCR(399,IBIFN,"PRV","B",IBI)) Q:IBI="" D
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| 87 | .. I $P(IBZ,U,IBI)="" S IBER=IBER_$S(IBI=1:"IB151;",IBI=2:"IB152;",IBI=3!(IBI=4):"IB321;",IBI=5:"IB153;",IBI=9:"IB154;",1:"")
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| 88 | Q
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| 89 | ;
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| 90 | RXNPI(IBIFN) ; check for multiple pharmacy npi's on the same bill
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| 91 | N IBORG,IBRXNPI,IBX,IBY
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| 92 | S IBORG=$$RXSITE^IBCEF73A(IBIFN,.IBORG)
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| 93 | S IBX=0 F S IBX=$O(IBORG(IBX)) Q:'IBX S IBY=0 F S IBY=$O(IBORG(IBX,IBY)) Q:'IBY S IBRXNPI(+IBORG(IBX,IBY))=""
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| 94 | S (IBX,IBY)=0 F S IBX=$O(IBRXNPI(IBX)) Q:'IBX S IBY=IBY+1
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| 95 | I IBY>1 D WARN("Bill has prescriptions resulting from "_IBY_" different NPI locations")
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| 96 | Q
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