1 | IBCEP2A ;ALB/TMP - EDI UTILITIES for provider ID ;25-APR-01
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2 | ;;2.0;INTEGRATED BILLING;**137,232,320,348,349**;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 | ALT(IBPERF,IBSRC,IBALT,IBINS4,IBPTYP) ; set source level to next higher level
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6 | ; or set the alternate type and source if performing provider id
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7 | ; alternate type and source exist
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8 | ; IBPERF = 1 if performing provider id is requested
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9 | ; IBINS4 = '4' node of insurance co (file 36)
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10 | ; Pass IBPTYP by reference to get alternate provider id type
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11 | ; Pass IBALT by reference. Set to 1 if alternate id is to be used next
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12 | ;
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13 | I '$G(IBPERF)!($P(IBINS4,U,3)=1) S IBSRC=IBSRC-1 G ALTQ
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14 | S IBSRC=""
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15 | I '$G(IBALT),$P(IBINS4,U,3)=2,$P(IBINS4,U,10),$P(IBINS4,U,11) S IBALT=1,IBSRC=$P(IBINS4,U,11),IBPTYP=$P(IBINS4,U,10) S:IBPTYP="" IBPTYP=$P(IBINS4,U)
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16 | ;
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17 | ALTQ Q IBSRC
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18 | ;
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19 | IDSET(IBPTYP,IBINS4,IBPERF,IBSPEC,IBSRC,IBUP) ; set variables for provider id type search
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20 | N Z
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21 | S IBSPEC=$G(^IBE(355.97,+IBPTYP,1))
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22 | S Z=$S($G(IBPERF):2,$P(IBSPEC,U,5):6,$P(IBSPEC,U,6):4,1:2)
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23 | S IBSRC=$P(IBINS4,U,Z),IBUP=$P(IBINS4,U,$S(IBSRC:Z+1,1:0))
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24 | Q
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25 | ;
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26 | CAREST(IBIFN) ; Return state file ien of state where care was performed
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27 | ; IBIFN = ien of bill in file 399
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28 | ; Get it from rendering facility or if none, the billing facility
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29 | N Z,IBXDATA,STATE
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30 | S STATE=""
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31 | D F^IBCEF("N-RENDERING INSTITUTION",,,IBIFN)
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32 | I IBXDATA D
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33 | . I '$P(IBXDATA,U,2) S STATE=+$P($G(^DIC(4,+IBXDATA,0)),U,2) Q
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34 | . S STATE=+$P($G(^IBA(355.93,+IBXDATA,0)),U,7)
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35 | E D
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36 | . D F^IBCEF("N-AGENT CASHIER STATE",,,IBIFN)
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37 | . S STATE=IBXDATA
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38 | Q STATE
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39 | ;
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40 | RECALCA(IBIFN) ; Recalculate all performing provider id's on bill IBIFN
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41 | ; IBIFN = ien of bill entry (file 399)
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42 | N IBZ,IBZ0,IBX,IBP,IBSEQ,DA,DIE,DR,DIR,X,Y
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43 | ;
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44 | D EN^DDIOL("THIS FUNCTION HAS BEEN DISABLED",,"!") Q
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45 | ;
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46 | S DA(1)=IBIFN
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47 | I '$D(^XUSEC("IB SUPERVISOR",DUZ)) D EN^DDIOL("YOU ARE NOT AUTHORIZED TO PERFORM THIS FUNCTION",,"!")
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48 | S IBZ=0 F S IBZ=$O(^DGCR(399,IBIFN,"PRV",IBZ)) Q:'IBZ S IBP=$G(^(IBZ,0)) I $P(IBP,U,2)'="" D
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49 | . S DA=IBZ
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50 | . F IBZ0=5:1:7 Q:'$G(^DGCR(399,IBIFN,"I"_(IBZ0-4))) D
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51 | .. S IBSEQ=$$EXPAND^IBTRE(399.0222,.01,+IBP)_" "_$P("PRIMARY^SECONDARY^TERTIARY",U,IBZ0-4)_" PROVIDER ID "
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52 | .. S IBX=$$RECALC(.DA,IBZ0-4,$P(IBP,U,IBZ0),1)
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53 | .. I IBX'="",IBX=$P(IBP,U,IBZ0) D EN^DDIOL(IBSEQ_"NO CHANGE NEEDED",,"!") Q
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54 | .. I IBX'="",IBX'=$P(IBP,U,IBZ0) D Q
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55 | ... S DR=(IBZ0/100)_"////"_IBX,DIE="^DGCR(399,"_DA(1)_",""PRV""," D ^DIE
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56 | ... D EN^DDIOL(IBSEQ_"CHANGED TO "_IBX,,"!")
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57 | .. D EN^DDIOL(IBSEQ_"NOT FOUND",,"!")
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58 | Q
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59 | ;
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60 | RECALC(IBDA,IBSEQ,IBX,IBD) ; Recalculate id #, if possible - called
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61 | ; from input transforms in subfile 399.0222, fields .05-.07
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62 | ; IBDA = DA array of the provider entry (file 399.0222)
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63 | ; IBSEQ = the numeric COB sequence of the provider id (1-3)
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64 | ; IBX = the current value of the id in the subfile
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65 | ; IBD = flag that if set to 1 will suppress the display text
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66 | ;
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67 | N IBPN,IBZ
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68 | S IBPN=$P($G(^DGCR(399,IBDA(1),"PRV",IBDA,0)),U,2)
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69 | I IBPN="" D:'$G(IBD) EN^DDIOL(" CAN'T CALCULATE WITHOUT A PROVIDER NAME","","?0") G RECALCQ
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70 | S IBZ=$$GETID^IBCEP2(IBDA(1),2,IBPN,IBSEQ)
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71 | I IBZ="" D:'$G(IBD) EN^DDIOL(" ID COULD NOT BE DETERMINED","","?0") G RECALCQ
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72 | D:'$G(IBD) EN^DDIOL(" "_IBZ_$S(IBZ'=IBX:"",1:" (no change)"),"","?0")
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73 | S IBX=IBZ
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74 | ;
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75 | RECALCQ Q IBX
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76 | ;
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77 | PERFPRV(IBIFN) ; Returns the variable pointer of the 'performing provider'
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78 | ; (attending or rendering) for a bill IBIFN
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79 | N IBP,IBPT,IBQ,Z
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80 | S Z=$$FT^IBCEF(IBIFN),IBPT=$S(Z=2:3,Z=3:4,1:0)
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81 | D GETPRV^IBCEU(IBIFN,IBPT,.IBP)
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82 | Q $P($G(IBP(IBPT,1)),U,3)
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83 | ;
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84 | INSPAR(IBIFN,SEQ) ;
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85 | N Z,Z4,Z0
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86 | Q:$G(X)'="??"
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87 | S:'$G(SEQ) SEQ=$$COBN^IBCEF(IBIFN)
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88 | S Z=+$G(^DGCR(399,IBIFN,"I"_SEQ)),Z4=$G(^DIC(36,Z,4))
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89 | I Z D
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90 | . D EN^DDIOL(">"_$J("",20)_"-- PERFORMING PROVIDER ID PARAMETERS --",,"!")
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91 | . S Z0=$P(" PRIMARY^SECONDARY^ TERTIARY",U,SEQ)_" INSURANCE: "_$P($G(^DIC(36,Z,0)),U)
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92 | . D EN^DDIOL(">"_$J("",(80-$L(Z0))\2)_Z0,,"!")
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93 | . D EN^DDIOL("> Secondary Perf Prov ID Type (1500): "_$$EXPAND^IBTRE(36,4.01,+Z4),,"!")
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94 | . D EN^DDIOL("> Secondary Perf Prov ID Type (UB04): "_$$EXPAND^IBTRE(36,4.02,$P(Z4,U,2)),,"!")
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95 | . D EN^DDIOL("> Secondary Perf Prov IDs Required: "_$$EXPAND^IBTRE(36,4.03,$P(Z4,U,3)),,"!")
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96 | . D EN^DDIOL(" ",,"!")
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97 | Q
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98 | ;
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99 | GETTYP(IBXIEN,IBCOBN,IBFUNC) ; Function returns provider id type for insurance co
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100 | ; with COB of IBCOBN on claim ien IBXIEN in first ^ pc and 1 in second
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101 | ; ^ piece if the id is required
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102 | ;
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103 | ; IBFUNC=1:REFERRING;2:OPERATING;3:RENDERING;4:ATTENDING;5:SUPERVISING;9:OTHER
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104 | ;
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105 | N A,R,Z,Z0
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106 | S A="",R=0
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107 | S:'$G(IBCOBN)!(IBCOBN>3) IBCOBN=$$COBN^IBCEF(IBXIEN)
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108 | S Z=+$G(^DGCR(399,IBXIEN,"I"_+IBCOBN))
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109 | I Z D
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110 | . S Z0=$$FT^IBCEF(IBXIEN)
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111 | . S A=+$P($G(^DIC(36,Z,4)),U,$S(Z0=2&($G(IBFUNC)=1):4,Z0=2:1,1:2))
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112 | . I A,$G(IBFUNC)'=1 S R=$P($G(^DIC(36,Z,4)),U,3),R=$S('R:0,R=3:1,R=1:Z0=2,R=2:Z0=3,1:0)
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113 | . I A,$G(IBFUNC)=1 S R=+$P($G(^DIC(36,Z,4)),U,5),R=$S('R:0,Z0'=2:0,1:1)
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114 | Q A_U_R
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115 | ;
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116 | UNIQ1(IBIFN,IBINS,IBPTYP,IBPROV,IBUNIT,IBCU,IBT) ; Match most-least specific
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117 | ; *** SEE PARAMETER DEFINITIONS IN IBCEP3 ***
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118 | ;
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119 | ; Start in file 355.9 (Specific Provider)
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120 | ; IBPROV = (variable pointer syntax) provider on bill IBIFN
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121 | ;
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122 | N Q,Z0,Z1,Z2,IBID,IBX
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123 | S IBID=""
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124 | S IBX=$P($G(^IBA(355.9,+IBCU,0)),U,3) S:"0"[IBX IBX="*N/A*"
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125 | S Z0=$$FT^IBCEF(IBIFN),Z0=$S(Z0=2:2,Z0=3:1,1:0),Z1=$$INPAT^IBCEF(IBIFN,1) S:'Z1 Z1=2 S Z2=$$ISRX^IBCEF1(IBIFN)
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126 | ;
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127 | ; Match all elements
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128 | F Q=$S(Z2:3,1:Z1),$S(Z2:Z1,1:"") I Q'="",$D(^IBA(355.9,"AUNIQ",IBPROV,IBINS,IBX,Z0,Q,IBPTYP,IBCU)) S IBID=$P($G(^IBA(355.9,IBCU,0)),U,7),$P(IBT,U,2,3)=(IBCU_U_355.9) Q
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129 | G:IBID'="" UNIQ1Q
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130 | ;
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131 | ; Match both form types,specific I/O element
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132 | F Q=$S(Z2:3,1:Z1),$S(Z2:Z1,1:"") I Q'="",$D(^IBA(355.9,"AUNIQ",IBPROV,IBINS,IBX,0,Q,IBPTYP,IBCU)) S IBID=$P($G(^IBA(355.9,IBCU,0)),U,7),$P(IBT,U,2,3)=(IBCU_U_355.9) Q
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133 | G:IBID'="" UNIQ1Q
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134 | ;
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135 | ; Match specific form type, both I/O element or Rx
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136 | F Q=$S(Z2:3,1:0),$S(Z2:0,1:"") I Q'="",$D(^IBA(355.9,"AUNIQ",IBPROV,IBINS,IBX,Z0,Q,IBPTYP,IBCU)) S IBID=$P($G(^IBA(355.9,IBCU,0)),U,7),$P(IBT,U,2,3)=(IBCU_U_355.9) Q
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137 | G:IBID'="" UNIQ1Q
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138 | ;
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139 | ; Match both form types, both I/O element or Rx
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140 | F Q=$S(Z2:3,1:0),$S(Z2:0,1:"") I Q'="",$D(^IBA(355.9,"AUNIQ",IBPROV,IBINS,IBX,0,Q,IBPTYP,IBCU)) S IBID=$P($G(^IBA(355.9,IBCU,0)),U,7),$P(IBT,U,2,3)=(IBCU_U_355.9) Q
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141 | ;
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142 | UNIQ1Q Q IBID
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143 | ;
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144 | UNIQ2(IBIFN,IBINS,IBPTYP,IBUNIT,IBCU,IBT) ; Match on most-least specific
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145 | ; *** SEE PARAMETER DEFINITIONS IN IBCEP3 ***
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146 | ;
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147 | ; Start in file 355.91 (Specific Insurance)
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148 | ;
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149 | N Q,Z0,Z1,Z2,IBID,IBX
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150 | S IBID="" S:"0"[$G(IBUNIT) IBUNIT="*N/A*"
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151 | S Z0=$$FT^IBCEF(IBIFN),Z0=$S(Z0=2:2,Z0=3:1,1:0),Z1=$$INPAT^IBCEF(IBIFN,1) S:'Z1 Z1=2 S Z2=$$ISRX^IBCEF1(IBIFN)
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152 | ;
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153 | ; Match all elements
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154 | F Q=$S(Z2:3,1:Z1),$S(Z2:Z1,1:"") I Q'="",$D(^IBA(355.91,"AUNIQ",IBINS,IBUNIT,Z0,Q,IBPTYP,IBCU)) S IBID=$P($G(^IBA(355.91,IBCU,0)),U,7),$P(IBT,U,2,3)=(IBCU_U_355.91) Q
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155 | G:IBID'="" UNIQ2Q
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156 | ;
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157 | ; Match both form types,specific I/O element
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158 | F Q=$S(Z2:3,1:Z1),$S(Z2:Z1,1:"") I Q'="",$D(^IBA(355.91,"AUNIQ",IBINS,IBUNIT,0,Q,IBPTYP,IBCU)) S IBID=$P($G(^IBA(355.91,IBCU,0)),U,7),$P(IBT,U,2,3)=(IBCU_U_355.91) Q
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159 | G:IBID'="" UNIQ2Q
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160 | ;
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161 | ; Match specific form type, both I/O element or Rx
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162 | F Q=$S(Z2:3,1:0),$S(Z2:0,1:"") I Q'="",$D(^IBA(355.91,"AUNIQ",IBINS,IBUNIT,Z0,Q,IBPTYP,IBCU)) S IBID=$P($G(^IBA(355.91,IBCU,0)),U,7),$P(IBT,U,2,3)=(IBCU_U_355.91) Q
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163 | G:IBID'="" UNIQ2Q
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164 | ;
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165 | ; Match both form types, both I/O elements or Rx
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166 | F Q=$S(Z2:3,1:0),$S(Z2:0,1:"") I Q'="",$D(^IBA(355.91,"AUNIQ",IBINS,IBUNIT,0,Q,IBPTYP,IBCU)) S IBID=$P($G(^IBA(355.91,IBCU,0)),U,7),$P(IBT,U,2,3)=(IBCU_U_355.91) Q
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167 | ;
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168 | UNIQ2Q Q IBID
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169 | ;
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