| 1 | IBCRCC ;ALB/ARH - RATES: CALCULATION OF ITEM CHARGE ;22-MAY-1996
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| 2 |  ;;2.0;INTEGRATED BILLING;**52,80,106,138,245,223,309,347**;21-MAR-94;Build 24
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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 |  ; ITMCHG and RATECHG are basic item/set/rate charge functions, IBCRCI contains more standard callable functions
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| 6 |  ;
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| 7 | ITMCHG(CS,ITEM,EVDT,MOD,ARR) ; get the base unit charges for a specific item, given a charge set, item and date
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| 8 |  ; this is the primary function to get an item charge and works for all Charge Methods, given an Item
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| 9 |  ; returns ARR = count of items in array ^ total charge for item ^ total base charge
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| 10 |  ;         ARR(x) = charge item IFN (if any) ^ rev code (if any) ^ $ charge ^ $ base charge
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| 11 |  ; checks Item effective and inactive dates, modifier match, and only sets array if the charge is non-zero
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| 12 |  ; each item will be passed back separately in the array, no combination of charges
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| 13 |  ;
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| 14 |  N IBCSBR,IBEVDT,IBEFDT,IBXREF,IBITEM,IBDA,IBLN,IBCHRG,IBITMFND K ARR S ARR=0
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| 15 |  S CS=+$G(CS),IBEVDT=$S(+$G(EVDT):+EVDT,1:DT),IBITEM=+$G(ITEM),MOD=$G(MOD) I 'CS!'IBITEM Q
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| 16 |  S IBCSBR=$$CSBR^IBCRU3(CS)
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| 17 |  ;
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| 18 |  ; va cost
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| 19 |  I $P(IBCSBR,U,5)=2 D  Q  ; va cost
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| 20 |  . I $P(IBCSBR,U,1)["PROSTHETICS" S IBCHRG=$$PICOST(IBITEM)  I +IBCHRG D SETARR(0,0,+IBCHRG,.ARR) Q
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| 21 |  . I $P(IBCSBR,U,1)["PRESCRIPTION" S IBCHRG=$$RXCOST(IBITEM) I +IBCHRG D SETARR(0,0,+IBCHRG,.ARR) Q
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| 22 |  ;
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| 23 |  ; all others - have Charge Item entries
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| 24 |  ;
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| 25 |  ; find most recent Charge Item for the item, search until modifiers match (only BI=CPT should have mods defined)
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| 26 |  S IBXREF="AIVDTS"_CS,IBITMFND=0
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| 27 |  S IBEFDT=-(IBEVDT+.01) F  S IBEFDT=$O(^IBA(363.2,IBXREF,IBITEM,IBEFDT)) Q:'IBEFDT  D  Q:IBITMFND
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| 28 |  . S IBDA=0 F  S IBDA=$O(^IBA(363.2,IBXREF,IBITEM,IBEFDT,IBDA)) Q:'IBDA  D
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| 29 |  .. S IBLN=$G(^IBA(363.2,IBDA,0))
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| 30 |  .. I +$P(IBLN,U,7)'=+MOD Q  ; charge item modifier does not match modifier passed in
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| 31 |  .. S IBITMFND=1 ; item found
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| 32 |  .. I +$P(IBLN,U,4),+$P(IBLN,U,4)<IBEVDT Q  ; charge is inactive on event date
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| 33 |  .. I +$P(IBLN,U,5) D SETARR(IBDA,+$P(IBLN,U,6),+$P(IBLN,U,5),.ARR,$P(IBLN,U,8))
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| 34 |  Q
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| 35 |  ;
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| 36 | SETARR(CI,RVCD,CHRG,ARR,CHRGB) ; set charges into an array, does not allow zero charge, a new entry is created each time,
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| 37 |  ; no attempt to combine like items, the new item charge is added to any that may already be in the array 
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| 38 |  ; returns ARR = count of items in array ^ total charge for item
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| 39 |  ;         ARR(x) = charge item IFN (if any) ^ item rev code (if any) ^ $ charge
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| 40 |  ;
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| 41 |  N CNT,TCHRG,TCHRGB
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| 42 |  S CNT=+$G(ARR)+1,TCHRG=$P($G(ARR),U,2)+$G(CHRG) I +$G(CHRGB) S TCHRGB=+$P($G(ARR),U,3)+CHRGB
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| 43 |  I +$G(CHRG) S ARR=CNT_U_+TCHRG_U_$G(TCHRGB),ARR(CNT)=$G(CI)_U_+$G(RVCD)_U_+CHRG_U_$G(TCHRGB)
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| 44 |  Q
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| 45 |  ;
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| 46 | PICOST(PI) ; returns (PI=ptr 362.5): total VA cost of an item (660,14) ^ quantity (660,5) from prosthetics ^ bill IFN
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| 47 |  ;
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| 48 |  N IBPIP,IBLN,IBX,IBIFN S (IBPIP,IBX)=0
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| 49 |  I +$G(PI) S IBLN=$G(^IBA(362.5,+PI,0)),IBPIP=$P(IBLN,U,4),IBIFN=$P(IBLN,U,2)
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| 50 |  I +IBPIP S IBLN=$G(^RMPR(660,+IBPIP,0)) I IBLN'="" S IBX=$P(IBLN,U,16)_U_$P(IBLN,U,7)_U_IBIFN
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| 51 |  Q IBX
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| 52 |  ;
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| 53 | RATECHG(RS,CHG,EVDT,FEE) ; returns modifed item charge based on rate schedule:  check effective dates, apply adjustment
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| 54 |  ; adjusted amount ^ comment (if there is an adjustment)
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| 55 |  ; if FEE passed by reference, returns disp fee^admin fee
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| 56 |  ;
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| 57 |  N IBX,IBRS0,IBRS10,IBEFDT,IBINADT,IBRTY,X S IBRTY=""
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| 58 |  S IBX=+$G(CHG),IBRS0=$G(^IBE(363,+$G(RS),0)),IBRS10=$G(^IBE(363,+$G(RS),10))
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| 59 |  S EVDT=$S(+$G(EVDT):EVDT,1:DT),IBEFDT=$P(IBRS0,U,5),IBINADT=$P(IBRS0,U,6)
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| 60 |  I +IBEFDT>EVDT!(+IBINADT&(IBINADT<EVDT)) S IBX=0
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| 61 |  I +IBX,IBRS10'="" S X=IBX X IBRS10 S IBX=X,IBRTY="^Rate Schedule Adjustment ("_$J(CHG,"",2)_")"
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| 62 |  S FEE=$P($G(^IBE(363,+$G(RS),1)),"^",1,2)
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| 63 |  Q IBX_IBRTY
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| 64 |  ;
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| 65 | RXCOST(RX) ; returns (RX=ptr 362.4): VA Cost of an Rx - Per Unit Cost ^ bill IFN
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| 66 |  ; w/ Per Unit Cost = RX (Unit Price of Drug - 52,17) or Drug (Price Per Dispense Unit 50,16) cost
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| 67 |  ;
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| 68 |  N IBRXP,IBDGP,IBLN,IBX,IBIFN S (IBRXP,IBX)=0
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| 69 |  I +$G(RX) S IBLN=$G(^IBA(362.4,+RX,0)),IBRXP=$P(IBLN,U,5),IBDGP=$P(IBLN,U,4),IBIFN=$P(IBLN,U,2)
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| 70 |  I +IBRXP S IBX=$$FILE^IBRXUTL(IBRXP,17)_U_IBIFN
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| 71 |  I 'IBRXP,+IBDGP D DATA^IBRXUTL(+IBDGP) S IBLN=$G(^TMP($J,"IBDRUG",0)) I IBLN'="" S IBX=$G(^TMP($J,"IBDRUG",+IBDGP,16))_U_IBIFN
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| 72 |  K ^TMP($J,"IBDRUG")
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| 73 |  Q IBX
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| 74 |  ;
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| 75 | PRVCHG(CS,CHG,PRV,EVDT,ITEM) ; return discounted amount, based on total charge for a the care, the provider and Charge Set (BR)
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| 76 |  ; if no discount record found for the Charge Set or the provider then returns original amount
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| 77 |  ; no provider discount for Lab charges (80000-89999)
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| 78 |  ;   discounted amount ^ comment (if discounted) ^ percent discount
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| 79 |  ;
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| 80 |  N IBPC,IBSGFN,IBSG,IBPDFN,IBPD0,IBPDTY,IBI,IBX,IBY S IBX=+$G(CHG),(IBSGFN,IBPDTY)="" I '$G(EVDT) S EVDT=DT
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| 81 |  I +$G(ITEM),ITEM>79999,ITEM<90000 S (CS,PRV)=""
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| 82 |  I +$G(CS) S IBSGFN=+$$CSSG^IBCRU6(+CS,"",2,.IBSG)
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| 83 |  I +$G(PRV),+IBSGFN S IBPC=$$GET^XUA4A72(PRV,EVDT)
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| 84 |  ;
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| 85 |  S IBI=0 F  S IBI=$O(IBSG(IBI)) Q:'IBI  S IBSGFN=+IBSG(IBI) I +IBSGFN D
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| 86 |  . S IBPDFN=0 F  S IBPDFN=$O(^IBE(363.34,"C",+IBSGFN,IBPDFN)) Q:'IBPDFN  D  Q:IBPDTY'=""
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| 87 |  .. I '$O(^IBE(363.34,+IBPDFN,11,"B",+IBPC,0)) Q
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| 88 |  .. S IBPD0=$G(^IBE(363.34,+IBPDFN,0)),IBY=$P(IBPD0,U,3) Q:IBY=""
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| 89 |  .. S IBY=+IBY/100,IBX=IBY*IBX
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| 90 |  .. S IBPDTY=U_$P($G(^VA(200,+PRV,0)),U,1)_" - "_$P(IBPD0,U,1)_" "_$P(IBPD0,U,3)_"% of "_$J(CHG,0,2)_U_+IBY
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| 91 |  Q IBX_IBPDTY
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| 92 |  ;
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| 93 | HRUNIT(HRS) ; returns Hour Units based on the Hours passed in
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| 94 |  ; Hour Units are the hours rounded to the nearest whole hour (less than 30 minutes is 0 units)
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| 95 |  N IBX S IBX=0 I +$G(HRS) S IBX=$J(HRS,0,0)
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| 96 |  Q IBX
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| 97 |  ;
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| 98 | MLUNIT(MLS) ; returns Miles Units based on the Miles passed in
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| 99 |  ; Mile Units are the miles rounded to the nearest whole mile
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| 100 |  N IBX S IBX=0 I +$G(MLS) S IBX=$J(MLS,0,0) I 'IBX S IBX=1
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| 101 |  Q IBX
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| 102 |  ;
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| 103 | MNUNIT(MNS) ; return Minute Units based on the Minutes passed in
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| 104 |  ; Minute Units are 15 minute intervals, rounded down for less than 5 minutes
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| 105 |  N IBX S IBX=0 I +$G(MNS) S IBX=(MNS\15) S:(MNS#15)>4 IBX=IBX+1 I 'IBX S IBX=1
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| 106 |  Q IBX
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