| 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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