| [613] | 1 | IBCNRHLT ;DAOU/DMK - Receive HL7 e-Pharmacy MFN Message ;23-OCT-2003
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 | 2 |  ;;2.0;INTEGRATED BILLING;**251**;21-MAR-94
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 | 3 |  ;;Per VHA Directive 10-93-142, this routine should not be modified.
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 | 4 |  ;
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 | 5 |  ; Description
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 | 6 |  ;
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 | 7 |  ; Receive HL7 e-Pharmacy MFN Message
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 | 8 |  ; Table Update
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 | 9 |  ;
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 | 10 |  ; Control processing of segments
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 | 11 |  ;
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 | 12 |  ; Required segments listed in order
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 | 13 |  ; MSH (Message Header Segment) (processed by IBCNEHLT)
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 | 14 |  ; MFI (Master File Identifier Segment) (processed by IBCNEHLT)
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 | 15 |  ; MFE (Master File Entry Segment)
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 | 16 |  ;
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 | 17 |  ; Optional segments listed by file
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 | 18 |  ; ZP0 (365.12 PAYER File Update Segment)
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 | 19 |  ;
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 | 20 |  ; ZPT (366.01 NCPDP PROCESSOR File Update Segment)
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 | 21 |  ; ZCM (366.012 NCPDP PROCESSOR CONTACT MEANS Subfile Update Segment)
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 | 22 |  ;
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 | 23 |  ; ZPB (366.02 PHARMACY BENEFITS MANAGER (PBM) File Update Segment)
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 | 24 |  ; ZCM (366.022 PHARMACY BENEFITS MANAGER (PBM) CONTACT MEANS Subfile
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 | 25 |  ;      Update Segment)
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 | 26 |  ;
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 | 27 |  ; ZPL (366.03 PLAN File Update Segment)
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 | 28 |  ; ZCM (366.032 PLAN CONTACT MEANS Subfile Update Segment)
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 | 29 |  ;
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 | 30 |  ; ZRX (366.03 PLAN File (Pharmacy) Update Segment)
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 | 31 |  ; ZCM (366.0312 PLAN RX CONTACT MEANS Subfile Update Segment)
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 | 32 |  ;
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 | 33 |  ; Called by IBCNEHLT if all of the following are true
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 | 34 |  ; * File # (MFI Segment) = 365.12, 366.01, 366.02, or 366.03
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 | 35 |  ; * Primary Key Value (MFE Segment) does not contain "IIV"
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 | 36 |  ; * Segment ID (every segment) = MFE, ZCM, ZP0, ZPB, ZPL, ZPT, or ZRX
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 | 37 |  ;
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 | 38 |  ; Entry point
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 | 39 |  ;
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 | 40 | 1000 ; Control processing
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 | 41 |  I $D(ERROR) Q
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 | 42 |  D @SEG
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 | 43 |  ;
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 | 44 |  ; Initialize MFK Message (Application Acknowledgement) variables
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 | 45 |  I $D(ERROR) D  Q
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 | 46 |  . S DATAMFK("ERROR")=ERROR
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 | 47 |  . S DATAMFK("IEN")=IEN
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 | 48 |  ;
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 | 49 |  ; Quit if more segments
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 | 50 |  I $O(^TMP($J,"IBCNEHLI",HCT))]"" Q
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 | 51 |  ;
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 | 52 |  ; Update File?
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 | 53 |  I $D(DATA) D
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 | 54 |  . S FIELDNO="" F  S FIELDNO=$O(DATA(FIELDNO)) Q:FIELDNO=""  D
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 | 55 |  .. ;
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 | 56 |  .. ; Convert "" to "@" to delete field value if necessary
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 | 57 |  .. I IEN'=-1,DATA(FIELDNO)="" S DATA(FIELDNO)="@"
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 | 58 |  .. ;
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 | 59 |  .. ; Convert HL7 special characters if necessary
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 | 60 |  .. I DATA(FIELDNO)[$E(HLECH,3) S DATA(FIELDNO)=$$TRAN1^IBCNRHLU(DATA(FIELDNO))
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 | 61 |  . D FILE
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 | 62 |  ;
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 | 63 |  ; Update File?
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 | 64 |  I $D(DATABPS) D
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 | 65 |  . S FIELDNO="" F  S FIELDNO=$O(DATABPS(FIELDNO)) Q:FIELDNO=""  D
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 | 66 |  .. ;
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 | 67 |  .. ; Convert "" to "@" to delete field value if necessary
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 | 68 |  .. I IEN'=-1,DATABPS(FIELDNO)="" S DATABPS(FIELDNO)="@"
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 | 69 |  .. ;
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 | 70 |  .. ; Convert HL7 special characters if necessary
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 | 71 |  .. I DATABPS(FIELDNO)[$E(HLECH,3) S DATABPS(FIELDNO)=$$TRAN1^IBCNRHLU(DATABPS(FIELDNO))
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 | 72 |  . ;
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 | 73 |  . D FILEBPS
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 | 74 |  ;
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 | 75 |  ; Update APPLICATION Subfile?
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 | 76 |  I $D(DATAAP) D
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 | 77 |  . S FIELDNO="" F  S FIELDNO=$O(DATAAP(FIELDNO)) Q:FIELDNO=""  D
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 | 78 |  .. ;
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 | 79 |  .. ; Convert "" to "@" to delete field value if necessary
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 | 80 |  .. I APIEN'=-1,DATAAP(FIELDNO)="" S DATAAP(FIELDNO)="@"
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 | 81 |  .. ;
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 | 82 |  .. ; Convert HL7 special characters if necessary
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 | 83 |  .. I DATAAP(FIELDNO)[$E(HLECH,3) S DATAAP(FIELDNO)=$$TRAN1^IBCNRHLU(DATAAP(FIELDNO))
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 | 84 |  . S FIELDNO=$S(FILENO=365.12:1,1:3)
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 | 85 |  . D FILEAP
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 | 86 |  ;
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 | 87 |  ; Update CONTACT MEANS Subfile?
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 | 88 |  I $D(DATACM) D
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 | 89 |  . S FIELDNO="" F  S FIELDNO=$O(DATACM(FIELDNO)) Q:FIELDNO=""  D
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 | 90 |  .. ;
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 | 91 |  .. ; Convert "" to "@" to delete field value if necessary
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 | 92 |  .. I CMIEN'=-1,DATACM(FIELDNO)="" S DATACM(FIELDNO)="@"
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 | 93 |  .. ;
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 | 94 |  .. ; Convert HL7 special characters if necessary
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 | 95 |  .. I DATACM(FIELDNO)[$E(HLECH,3) S DATACM(FIELDNO)=$$TRAN1^IBCNRHLU(DATACM(FIELDNO))
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 | 96 |  . S FIELDNO=$S(FILE["Pharmacy"&FILENO=366.03:12,1:2)
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 | 97 |  . I IBCNACT="MDL" D DELETECM Q
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 | 98 |  . D FILECM
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 | 99 |  Q
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 | 100 |  ;
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 | 101 | ADD ; Add File entry
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 | 102 |  ; 365.12 PAYER File
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 | 103 |  ; 366.01 NCPDP PROCESSOR File
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 | 104 |  ; 366.02 PHARMACY BENEFITS MANAGER (PBM) File
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 | 105 |  ; 366.03 PLAN File
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 | 106 |  ;
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 | 107 |  S IEN=$$ADD1^IBCNRFM1(FILENO,DATA(.01))
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 | 108 |  Q
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 | 109 |  ;
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 | 110 | ADDAP ; Add APPLICATION Subfile entry
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 | 111 |  ; 365.121 PAYER APPLICATION Subfile
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 | 112 |  ; 366.013 NCPDP PROCESSOR APPLICATION File
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 | 113 |  ; 366.023 PHARMACY BENEFITS MANAGER (PBM) APPLICATION Subfile
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 | 114 |  ; 366.033 PLAN APPLICATION Subfile
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 | 115 |  ;
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 | 116 |  S APIEN=$$ADD2^IBCNRFM1(FILENO,IEN,FIELDNO,AIEN)
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 | 117 |  Q
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 | 118 |  ;
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 | 119 | ADDCM ; Add CONTACT MEANS Subfile entry
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 | 120 |  ; 366.012  NCPDP PROCESSOR CONTACT MEANS Subfile
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 | 121 |  ; 366.022  PHARMACY BENEFITS MANAGER (PBM) CONTACT MEANS Subfile
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 | 122 |  ; 366.032  PLAN CONTACT MEANS Subfile
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 | 123 |  ; 366.0312 PLAN RX CONTACT MEANS Subfile
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 | 124 |  ;
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 | 125 |  S CMIEN=$$ADD2^IBCNRFM1(FILENO,IEN,FIELDNO,DATACM(.01))
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 | 126 |  Q
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 | 127 |  ;
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 | 128 | DELETECM ; Delete CONTACT MEANS Subfile entry
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 | 129 |  ; 366.012  NCPDP PROCESSOR CONTACT MEANS Subfile
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 | 130 |  ; 366.022  PHARMACY BENEFITS MANAGER (PBM) CONTACT MEANS Subfile
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 | 131 |  ; 366.032  PLAN CONTACT MEANS Subfile
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 | 132 |  ; 366.0312 PLAN RX CONTACT MEANS Subfile
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 | 133 |  ;
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 | 134 |  D DELETE2^IBCNRFM1(FILENO,IEN,FIELDNO,CMIEN)
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 | 135 |  Q
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 | 136 |  ;
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 | 137 | FILE ; File data
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 | 138 |  ; 365.12 PAYER File
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 | 139 |  ; 366.01 NCPDP PROCESSOR File
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 | 140 |  ; 366.02 PHARMACY BENEFITS MANAGER (PBM) File
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 | 141 |  ; 366.03 PLAN File
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 | 142 |  ;
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 | 143 |  ; Add?
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 | 144 |  I IEN=-1 D ADD
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 | 145 |  ;
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 | 146 |  ; Update
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 | 147 |  D FILE1^IBCNRFM1(FILENO,IEN,.DATA)
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 | 148 |  Q
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 | 149 |  ;
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 | 150 | FILEAP ; File APPLICATION Subfile data
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 | 151 |  ; 365.121 PAYER APPLICATION Subfile
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 | 152 |  ; 366.013 NCPDP PROCESSOR APPLICATION Subfile
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 | 153 |  ; 366.023 PHARMACY BENEFITS MANAGER (PBM) APPLICATION Subfile
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 | 154 |  ; 366.033 PLAN APPLICATION Subfile
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 | 155 |  ;
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 | 156 |  ; Add?
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 | 157 |  I APIEN=-1 D ADDAP
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 | 158 |  ;
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 | 159 |  ; Update
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 | 160 |  D FILE2^IBCNRFM1(FILENO,IEN,FIELDNO,APIEN,.DATAAP)
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 | 161 |  Q
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 | 162 |  ;
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 | 163 | FILEBPS ; File data
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 | 164 |  ; 90002312.92 BPS NCPDP FORMATS File
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 | 165 |  ;
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 | 166 |  N FILENO1
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 | 167 |  S FILENO1=9002313.92
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 | 168 |  ;
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 | 169 |  ; Update Billing Payer Sheet Entry?
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 | 170 |  S BPSIEN=DATA(10.07) I BPSIEN'="@" D
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 | 171 |  . D FILE1^IBCNRFM1(FILENO1,BPSIEN,.DATABPS)
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 | 172 |  ;
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 | 173 |  ; Update Rebill Payer Sheet Entry?
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 | 174 |  S BPSIEN=DATA(10.09) I BPSIEN'="@" D
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 | 175 |  . D FILE1^IBCNRFM1(FILENO1,BPSIEN,.DATABPS)
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 | 176 |  ;
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 | 177 |  ; Update Reversal Payer Sheet Entry?
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 | 178 |  S BPSIEN=DATA(10.08) I BPSIEN'="@" D
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 | 179 |  . ;
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 | 180 |  . ; 1.03 = Maximum RX's Per Claim
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 | 181 |  . S DATABPS(1.03)=1
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 | 182 |  . ;
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 | 183 |  . ; 1.07 = Is A Reversal Format
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 | 184 |  . S DATABPS(1.07)=1
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 | 185 |  . ;
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 | 186 |  . D FILE1^IBCNRFM1(FILENO1,BPSIEN,.DATABPS)
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 | 187 |  Q
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 | 188 |  ;
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 | 189 | FILECM ; File CONTACT MEANS Subfile data
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 | 190 |  ; 366.012  NCPDP PROCESSOR CONTACT MEANS Subfile
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 | 191 |  ; 366.022  PHARMACY BENEFITS MANAGER (PBM) CONTACT MEANS Subfile
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 | 192 |  ; 366.032  PLAN CONTACT MEANS Subfile
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 | 193 |  ; 366.0312 PLAN RX CONTACT MEANS Subfile
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 | 194 |  ;
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 | 195 |  ; Add?
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 | 196 |  I CMIEN=-1 D ADDCM
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 | 197 |  ;
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 | 198 |  ; Update
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 | 199 |  D FILE2^IBCNRFM1(FILENO,IEN,FIELDNO,CMIEN,.DATACM)
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 | 200 |  Q
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 | 201 |  ;
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 | 202 | MFE ; Process MFE Segment
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 | 203 |  D ^IBCNRMFE
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 | 204 |  Q
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 | 205 |  ;
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 | 206 | ZP0 ; Process ZP0 Segment
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 | 207 |  D ^IBCNRZP0
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 | 208 |  Q
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 | 209 |  ;
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 | 210 | ZCM ; Process ZCM Segment
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 | 211 |  D ^IBCNRZCM
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 | 212 |  Q
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 | 213 |  ;
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 | 214 | ZPB ; Process ZPB Segment
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 | 215 |  D ^IBCNRZPB
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 | 216 |  Q
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 | 217 |  ;
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 | 218 | ZPL ; Process ZPL Segment
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 | 219 |  D ^IBCNRZPL
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 | 220 |  Q
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 | 221 |  ;
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 | 222 | ZPT ; Process ZPT Segment
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 | 223 |  D ^IBCNRZPT
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 | 224 |  Q
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 | 225 |  ;
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 | 226 | ZRX ; Process ZRX Segment
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 | 227 |  D ^IBCNRZRX
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 | 228 |  Q
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