| [613] | 1 | IBCBB21 ;ALB/AAS - CONTINUATION OF EDIT CHECK ROUTINE FOR UB-04 ;2-NOV-89
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| 2 | ;;2.0;INTEGRATED BILLING;**51,137,210,232,155,291,348,349**;21-MAR-94;Build 46
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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 | EN(IBZPRC92) ;
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| 6 | ;
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| 7 | N ECODE,IBTXMT,IBXDATA,IBLPRT,IBI,Z,Z0,Z1,IBREQMRA
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| 8 | I '$D(IBZPRC92) D ALLPROC^IBCVA1(IBIFN,.IBZPRC92)
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| 9 | S IBREQMRA=$$REQMRA^IBEFUNC(IBIFN) ; MRA?
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| 10 | K IBQUIT S IBQUIT=0
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| 11 | S (Z,Z0,Z1)=0
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| 12 | F S Z=$O(IBZPRC92(Z)) Q:'Z S:IBZPRC92(Z)["CPT" Z0=Z0+1 S:IBZPRC92(Z)["ICD" Z1=Z1+1
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| 13 | S IBTXMT=$$TXMT^IBCEF4(IBIFN)
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| 14 | S IBZPRC92=Z0_U_Z1 ;Save # of CPT's and ICD9's
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| 15 | ; More than 50 procedures on a bill - must print locally
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| 16 | I IBTXMT,(+IBZPRC92>50!(+$P(IBZPRC92,U,2)>50)) D Q:IBQUIT
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| 17 | . I 'IBREQMRA S IBQUIT=$$IBER^IBCBB3(.IBER,308) Q
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| 18 | . I '$P(IBNDTX,U,9) S IBQUIT=$$IBER^IBCBB3(.IBER,325)
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| 19 | ; If ICD9 procedures with dates and charges, bill 11x or 83x needs operating physician
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| 20 | I IBTOB12="11",$P(IBZPRC92,U,2),'$$CKPROV^IBCEU(IBIFN,2) S IBER=IBER_"IB304;"
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| 21 | I IBTOB12="83",$P(IBZPRC92,U,2),'$$CKPROV^IBCEU(IBIFN,2) S IBER=IBER_"IB312;"
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| 22 | ;
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| 23 | ; If any CPT procedures have more than 2 modifiers, warn
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| 24 | S Z=0 F S Z=$O(IBZPRC92(Z)) Q:'Z I $P(IBZPRC92(Z),U)["ICPT(",$L($P(IBZPRC92(Z),U,15),",")>2 S Z0="Proc "_$$PRCD^IBCEF1($P(IBZPRC92(Z),U))_" has > 2 modifiers - only first 2 will be used" D WARN^IBCBB11(Z0)
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| 25 | ;
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| 26 | I $$WNRBILL^IBEFUNC(IBIFN),$$MRATYPE^IBEFUNC(IBIFN)'="A" S IBER=IBER_"IB086;"
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| 27 | ;
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| 28 | ; UB-04 Diagnosis Codes
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| 29 | K IBXDATA D F^IBCEF("N-DIAGNOSES",,,IBIFN)
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| 30 | ;
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| 31 | ; Only 9 dx's allowed per claim plus 1 E-code
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| 32 | S (Z,ECODE,IBI)=0 F S Z=$O(IBXDATA(Z)) Q:'Z D Q:IBER["309;"
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| 33 | . S IBI=IBI+1
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| 34 | . I $E($$ICD9^IBACSV(+$P(IBXDATA(Z),U)))="E" S:ECODE IBQUIT=$$IBER^IBCBB3(.IBER,301) S:'ECODE IBI=IBI-1,ECODE=1
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| 35 | . ; max DX check does not apply to MRAs
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| 36 | . I IBTXMT,IBI>9 D
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| 37 | .. I 'IBREQMRA Q:$P(IBNDTX,U,8) S IBER=IBER_"IB309;" Q
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| 38 | .. I '$P(IBNDTX,U,9) S IBER=IBER_"IB326;"
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| 39 | ;
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| 40 | I 'IBI S IBER=IBER_"IB071;" ;Require Diag code NOIS:OKL-0304-72495
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| 41 | I IBI,$$INPAT^IBCEF(IBIFN,1),$E($$ICD9^IBACSV(+$P(IBXDATA(1),U)))="V" S Z="Principal Dx V-code may not be valid" D WARN^IBCBB11(Z)
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| 42 | I '$$OCC10^IBCBB2(IBIFN,.IBXDATA,3) S IBER=IBER_"IB093;"
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| 43 | ;
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| 44 | K ^TMP($J,"IBC-RC")
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| 45 | D F^IBCEF("N-UB-04 SERVICE LINE (PRINT)",,,IBIFN)
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| 46 | S (Z0,IBI)=0 F S IBI=$O(^TMP($J,"IBC-RC",IBI)) Q:'IBI S Z=$G(^(IBI)) Q:+$P(Z,U,2)=1 I $P(Z,U,2),$P(Z,U,1)=1 D
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| 47 | . I IBER'["IB090;",$P(Z,U,2)>1,($P(Z,U,7)>99999.99!($P(Z,U,8)>99999.99)) S IBER=IBER_"IB090;"
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| 48 | . Q:$P(Z,U,2)'<180&($P(Z,U,2)'>189) ;Pass days (LOA) don't matter
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| 49 | . I '$P(Z,U,7),'$P(Z,U,8),'Z0,$$COBN^IBCEF(IBIFN)'>1 S Z0="Rev Code(s) having a 0-charge will not be transmitted for the bill" D WARN^IBCBB11(Z0) S Z0=1
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| 50 | K ^TMP($J,"IBC-RC")
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| 51 | Q
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| 52 | ;
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