IBCEF71 ;WOIFO/SS - FORMATTER AND EXTRACTOR SPECIFIC BILL FUNCTIONS ;31-JUL-03 ;;2.0;INTEGRATED BILLING;**232,155,288,320,349**;21-MAR-94;Build 46 ;;Per VHA Directive 2004-038, this routine should not be modified. ; ;--------- ;OTHPAYC - from FORMAT code for OP1,OP2 ... ;Input: ;IBXIEN - ien #399 ;IBSAVE - "in" array (i.e. IBXSAVE) ;IBDATA - "out" array (i.e. IBXDATA) ;IBFUNC - FUNCTION from #399 (1-refering,2-operating,etc) ;IBVAL - output value ;Output: ; IBDATA with formatted output OTHPAYC(IBXIEN,IBSAVE,IBDATA,IBFUNC,IBVAL) ; N IB1,IB2,IBINS,IBFL S IBFL=$S(IBFUNC=3!(IBFUNC=4):1,1:0) F IB1=1,2 D . Q:'$$ISINSUR($G(IBSAVE("PROVINF",IBXIEN,"O",IB1)),IBXIEN) ;don't create anything if no such insurance . I IBFL S IBFUNC=$S($O(IBSAVE("PROVINF",IBXIEN,"O",IB1,3,0)):3,1:4) . S:$O(IBSAVE("PROVINF",IBXIEN,"O",IB1,IBFUNC,0)) IBDATA(IB1)=IBVAL Q ;---- ;OTHPAYV - called from FORMAT code for OP1,OP2 ... ;Input: ;IBXIEN - ien #399 ;IBSAVE - "in" array (i.e. IBXSAVE) ;IBDATA - "out" array (i.e. IBXDATA) ;IBFUNC - FUNCTION from #399 (1-refering, 2-operating, etc) ;IBSEQN - seq # of ID/QUAL ;IBFLDTYP ; "I" - ID "Q" - ID QUAL ;Output: ; IBDATA with formatted output OTHPAYV(IBXIEN,IBSAVE,IBDATA,IBFUNC,IBFLDTYP,IBSEQN) ; N IB1,IB2,IBPIECE,IBINS,IBFL S IBFL=$S(IBFUNC=3!(IBFUNC=4):1,1:0) S IBPIECE=$S(IBFLDTYP="I":4,IBFLDTYP="Q":3,1:3) F IB1=1,2 D . Q:'$$ISINSUR($G(IBSAVE("PROVINF",IBXIEN,"O",IB1)),IBXIEN) ;don't create anything if there is no such insurance . I IBFL S IBFUNC=$S($O(IBSAVE("PROVINF",IBXIEN,"O",IB1,3,0)):3,1:4),IBFL=0 . S IBDATA(IB1)=$P($G(IBSAVE("PROVINF",IBXIEN,"O",IB1,IBFUNC,IBSEQN)),"^",IBPIECE) Q ; ;chk for ins ;Input: ; IBINS = "P","S","T" ; IBXIEN - ien file #399 ;Output: ; returns 1-exists , 0-doesn't ISINSUR(IBINS,IBXIEN) ; N IBINSNOD S IBINSNOD=$S(IBINS="P":"I1",IBINS="S":"I2",IBINS="T":"I3",1:"") I IBINSNOD="" Q 0 Q $D(^DGCR(399,IBXIEN,IBINSNOD)) ; ;---PRACT---- ;Get list of all 355.9 or 355.93 records for prov ;Input: ;IB399INS - ins co for bill to match PRACTIONER from 355.9 ;IB399FRM - form type (0=unknwn/both,1=UB,2=1500) to ; match PRACTIONER from 355.9 ;IB399CAR - BILL CARE (0=unknwn or both inp/outp,1=inpatient, ; 2=outpatient/3=Rx) to match PROV from 355.9 ; OR - DIVISION PTR to file 40.8 for entries in file 355.92 ;IBPROV - VARIABLE PTR VA prov ;IBARR - array by reference for result ;IBPROVTP- function (2-operating, 3-RENDERING,etc 0-facility) ;IBINSTP - "C" -current ins , "O"-other ;IBFILE - 355.92 for facility ids or 355.9 (default) for provider ids ;IBINS - 1 if to include ids for the ins co for all provs ;Ouput: ;IBARR - array by ref for result ; prov var ptr^ins ptr^X12 id cd^ID^form typ^care typ or division ptr^st ptr^id rec ptr^id type ptr PRACT(IB399INS,IB399FRM,IB399CAR,IBPROV,IBARR,IBPROVTP,IBINSTP,IBFILE,IBINS) ; N IB1,IB2,IBDAT,IBF,IBFX,IB3559,IBINSCO,IBFRMTYP,IBIDTYP,IBID,IBIDT,IBDIV,IBQ,IBS1,IBS2,IBARRX,Z,Z1,Z2,IBCARE I $G(IBFILE)="" S IBFILE=355.9 S IBINS=$G(IBINS) S (IBARR,IB3559,IB1)=0 F IBF="",1 Q:IBF=1&$S(IBFILE'=355.9:1,1:'IBINS) S IBFX=IBFILE_IBF F IB2=1:1 S IB3559=$O(^IBA(IBFX,"B",$S(IBFILE=355.9&(IBF=""):IBPROV,1:IB399INS),IB3559)) Q:IB3559="" D . S IBINSCO=$P($G(^IBA(IBFX,IB3559,0)),"^",$S(IBFILE=355.9&(IBF=""):2,1:1)) ;ins co. ptr . I IBINSCO'="" I IBINSCO'=IB399INS Q ;exclude if different ins . S:IBINSCO="" IBINSCO="NONE" ;NONE will be included in the array . S IBFRMTYP=+$P($G(^IBA(IBFX,IB3559,0)),"^",4) ;form type (0=both,1=UB,2=1500) . I '(IBFRMTYP=0!(IB399FRM=0)) Q:IBFRMTYP'=IB399FRM ;exclude if not "both" and different . S IBCARE=+$P($G(^IBA(IBFX,IB3559,0)),"^",5) ;0=both(inp and outp),1=inp,2=outp,3=prescr -- OR -- division ptr . I $S(IBFILE=355.92:0,1:IBCARE=3) I IB399CAR'=3 Q ; Id is only for Rx . I $S(IBFILE=355.92:0,1:IBCARE=1!(IBCARE=2)) I IB399CAR=1!(IB399CAR=2) Q:IBCARE'=IB399CAR ;both is OK . I IBFILE=355.92,IBCARE Q:IB399CAR'=IBCARE ; Division doesn't match . S IBIDTYP=+$P($G(^IBA(IBFX,IB3559,0)),"^",6) ;prov ID type . I IBFILE=355.9,IBIDTYP=$$TAXID^IBCEP8(),$S(IBPROV["VA(200":1,1:$P($G(^IBA(355.93,+IBPROV,0)),U,2)=2) Q ; Don't extract tax id # id for indiv prov . S IBIDT=IBIDTYP . S IBIDTYP=$P($G(^IBE(355.97,IBIDTYP,0)),"^",3) . Q:$P($G(^IBE(355.97,+IBIDT,1)),U,9) . Q:IBFILE=355.9&(IBIDTYP="X4") ;exclude CLIA # . S IBID=$P($G(^IBA(IBFX,IB3559,0)),"^",7) ;prov ID value . I $G(IBPROVTP)'="",$G(IBINSTP)'="",IBPROVTP'=0 I '$$CHCKSEC^IBCEF73(IB399FRM,IBPROVTP,IBINSTP,IBIDTYP) Q ; No qualifier chk for fac . I IBID'="" S IBDAT=IBPROV_"^"_IBINSCO_"^"_IBIDTYP_"^"_IBID_"^"_IBFRMTYP_"^"_IBCARE_"^"_"^"_IB3559_U_IBIDT,IBS2=$S(IBFX'=355.91:"",1:"INS DEF^")_IB3559 . I IBFILE'=355.92,IBID'="",IB399CAR=3 S IBQ=0 D Q:IBQ .. I $G(IBARRX(IBIDT))!(IBCARE=1) S IBQ=1 Q .. I IBCARE=3&(IB399CAR=3) S IBARRX(IBIDT)=1 Q ; Rx match .. I IBCARE=0!(IBCARE=2) S IBARRX(IBIDT,IBINSCO,IBS2)=IBDAT,IBQ=1 Q . I IBID'="" S IBARR(IBINSCO,IBS2)=IBDAT ; I IB399CAR=3 S Z=0 F S Z=$O(IBARRX(Z)) Q:'Z I '$G(IBARRX(Z)) D . S Z1="" F S Z1=$O(IBARRX(Z,Z1)) Q:Z1="" S Z2="" F S Z2=$O(IBARRX(Z,Z1,Z2)) Q:Z2="" S IBARR(Z1,Z2)=IBARRX(Z,Z1,Z2) ; I IBPROV["VA(200," D ; Get lic #s from file 2 for VA providers . N Z,IBLIC . S IBLIC=+IBPROV,IBLIC=$$GETLIC^IBCEP5D(.IBLIC) . S IBIDTYP=$P($G(^IBE(355.97,+$$STLIC^IBCEP8(),0)),U,3) . S Z=0 F S Z=$O(IBLIC(Z)) Q:'Z S:$$CHCKSEC^IBCEF73(IB399FRM,IBPROVTP,IBINSTP,IBIDTYP) IBARR("NONE","LIC"_Z_"^"_IBPROV)=IBPROV_U_"NONE"_U_IBIDTYP_U_IBLIC(Z)_U_"0"_U_"0"_U_Z_U_U_+$$STLIC^IBCEP8() I IBPROV["IBA(355.93" D . Q:$P($G(^IBA(355.93,+IBPROV,0)),U,12)="" . S IBIDTYP=$P($G(^IBE(355.97,+$$STLIC^IBCEP8(),0)),U,3) . I $$CHCKSEC^IBCEF73(IB399FRM,IBPROVTP,IBINSTP,IBIDTYP) D . . S IBARR("NONE","LIC"_$P($G(^DIC(5,+$P(^IBA(355.93,+IBPROV,0),U,7),0)),U,2)_"^"_IBPROV)=IBPROV_U_"NONE"_U_IBIDTYP_U_$P(^IBA(355.93,+IBPROV,0),U,12)_U_"0"_U_"0"_U_$P(^IBA(355.93,+IBPROV,0),U,7)_U_U_+IBPROV Q ; ALLPRFAC(IBXIEN,IBXSAVE) ; Return all non-VA/outside facility prov ids ; and all VA alternate prov ids ; IBXIEN = ien file 399 ; IBXSAVE = subscripted array returned N IBPROV,IBFRMTYP,IBCARE,IBRETARR,IBRET1,IBCOBN,Z,Z0,Z1,ZZ K IBXSAVE("PROVINF_FAC",IBXIEN) ; Always rebuild this S IBCOBN=+$$COBN^IBCEF(IBXIEN) S IBFRMTYP=$$FT^IBCEF(IBXIEN),IBFRMTYP=$S(IBFRMTYP=2:2,IBFRMTYP=3:1,1:0) S IBPROV=$P($G(^DGCR(399,IBXIEN,"U2")),U,10) ; IB patch 320 - Build IBPROV variable better when a non-VA facility exists I IBPROV S IBPROV=IBPROV_";IBA(355.93," I 'IBPROV S IBCARE=$P($G(^DGCR(399,IBXIEN,0)),U,22) I IBPROV D . S IBCARE=$S($$ISRX^IBCEF1(IBXIEN):3,1:0) ;if Rx refill bill . S:IBCARE=0 IBCARE=$$INPAT^IBCEF(IBXIEN,1) S:'IBCARE IBCARE=2 ;1-inp, 2-out F Z=1:1:3 K IBRETARR I $G(^DGCR(399,IBXIEN,"I"_Z)) D . D PRACT(+^DGCR(399,IBXIEN,"I"_Z),IBFRMTYP,IBCARE,IBPROV,.IBRETARR,0,$S(Z=IBCOBN:"C",1:"O"),$S('IBPROV:355.92,1:355.9)) . K IBRET1 . S Z0="" F S Z0=$O(IBRETARR(Z0)) Q:Z0="" S Z1="" F S Z1=$O(IBRETARR(Z0,Z1)) Q:Z1="" D .. ; Sort by div/id type .. S IBRET1($S(IBPROV:0,1:+$P(IBRETARR(Z0,Z1),U,6)),+$P(IBRETARR(Z0,Z1),U,9))=IBRETARR(Z0,Z1) .. Q . ; . S Z0=$O(IBRET1(""),-1) Q:Z0="" D .. ; IB patch 320 - loop thru all ID's .. S Z1="" F S Z1=$O(IBRET1(Z0,Z1)) Q:Z1="" D ... I Z=IBCOBN S IBXSAVE("PROVINF_FAC",IBXIEN,"C",1,0,$O(IBXSAVE("PROVINF_FAC",IBXIEN,"C",1,0," "),-1)+1)=IBRET1(Z0,Z1) Q ... S ZZ=$S(Z=1:1,Z=2:(IBCOBN=3)+1,1:2) ... S IBXSAVE("PROVINF_FAC",IBXIEN,"O",ZZ,0,$O(IBXSAVE("PROVINF_FAC",IBXIEN,"O",ZZ,0," "),-1)+1)=IBRET1(Z0,Z1),IBXSAVE("PROVINF_FAC",IBXIEN,"O",ZZ)=$E("PST",Z) ... Q .. Q . Q ; S IBXSAVE("PROVINF_FAC",IBXIEN)=IBXIEN,IBXSAVE("PROVINF_FAC",IBXIEN,"C",1)=$E("PST",IBCOBN) Q ; OTHID(IBXSAVE,IBXDATA,IBXIEN,PRIDSEQ,PRTYP,IBQ,IBFAC) ; From data in IBXSAVE, ; determine id or qualifier to output in the 837 records OP* ; Returns IBXDATA array IBXDATA(n)=data ; IBXIEN = ien of the bill-file 399 ; PRIDSEQ = sequence of the payer id needed ; PRTYP = provider type to check for data ; IBQ = 1 if qualifier needed, 0/null if id needed ; IBFAC = 1 if facility id, 0 for individual provider id ; N Z,Z0,Z1 S Z0="PROVINF"_$S('$G(IBFAC):"",1:"_FAC"),Z1=$S($G(IBQ):3,1:4) S Z=0 F S Z=$O(IBXSAVE("OSQ",Z)) Q:'Z D . I $P($G(IBXSAVE(Z0,IBXIEN,"O",Z,+$G(PRTYP),+$G(PRIDSEQ))),U,4)'="" S IBXDATA(IBXSAVE("OSQ",Z))=$P(IBXSAVE(Z0,IBXIEN,"O",Z,+$G(PRTYP),+$G(PRIDSEQ)),U,Z1) Q ; SETSEQ(IBXIEN,IBXSAVE,IBXDATA,PRTYP,IBFAC,IBOP) ; Sets up IBXSAVE("OSQ") ; array for other id seq in 837 records OP* ; Returns IBXDATA(n)=cob seq indicator for ids ; IBXIEN = ien of bill-399 ; PRTYP = the provider type to check for data for indiv provider ; IBFAC = 1 if facility id, 0 for individual provider id ; IBOP = segement # in OP being output N C,Z,Z0,Z1,OK S C=0,Z0="PROVINF"_$S('$G(IBFAC):"",1:"_FAC") S:$G(IBFAC) PRTYP=0 S Z=0 F S Z=$O(IBXSAVE(Z0,IBXIEN,"O",Z)) Q:'Z S OK=0 D . N Z1 F Z1=1:1 Q:'$D(IBXSAVE(Z0,IBXIEN,"O",Z,+$G(PRTYP),Z1)) I $P(IBXSAVE(Z0,IBXIEN,"O",Z,+$G(PRTYP),Z1),U,4)'="""" S OK=1 Q . I OK S C=C+1,IBXSAVE("OSQ",Z)=C S Z=0 F S Z=$O(IBXSAVE("OSQ",Z)) Q:'Z S IBXDATA(IBXSAVE("OSQ",Z))=$G(IBXSAVE(Z0,IBXIEN,"O",Z)) D:IBXSAVE("OSQ",Z)>1 ID^IBCEF2(IBXSAVE("OSQ",Z),"OP"_$G(IBOP)_" ") Q ; PSPRV(IBIFN) ; Q $$PSPRV^IBCEF7(IBIFN) ; Moved ;