[613] | 1 | IBCRHBS6 ;ALB/ARH - RATES: UPLOAD (RC 2+) CALCULATIONS SETUP ; 10-OCT-03
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| 2 | ;;2.0;INTEGRATED BILLING;**245**;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 | INPT(IBSITE,IBXRF1) ; Create Charge Sets for Inpatient and SNF Charges
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| 6 | N IBRG,IBDIVN,IBEVNT,IBBS,TYPE
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| 7 | W !,$P(IBSITE,U,2)," ",$P(IBSITE,U,3)," - Inpatient and SNF Charges"
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| 8 | ;
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| 9 | ; set billing region
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| 10 | S IBRG=$$RG^IBCRHU2("RC "_$P(IBSITE,U,2)_" - "_$P(IBSITE,U,3),$P(IBSITE,U,2),$P(IBSITE,U,4),$P(IBSITE,U,5))
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| 11 | S IBRG=$P(IBRG,U,2),IBDIVN=$P(IBSITE,U,2)
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| 12 | ;
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| 13 | S TYPE=$P(IBSITE,U,5) Q:TYPE'=1
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| 14 | ;
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| 15 | ;
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| 16 | ; Inpatient Facility Per Diem Charges from Table A (DRG Based)
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| 17 | S IBEVNT="INPATIENT DRG",IBBS="GENERAL MEDICAL CARE" ; Inpatient Standard DRG Charges
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| 18 | D SETUP(IBXRF1,"Inpt PD R&B","RC-INPT R&B","RC INPATIENT FACILITY",IBDIVN,4,IBEVNT,IBRG,"INST",101,IBBS)
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| 19 | D SETUP(IBXRF1,"Inpt PD Anc","RC-INPT ANC","RC INPATIENT FACILITY",IBDIVN,4,IBEVNT,IBRG,"INST",240,IBBS)
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| 20 | ;
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| 21 | S IBEVNT="INPATIENT DRG",IBBS="ICU" ; Inpatient ICU DRG Charges
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| 22 | D SETUP(IBXRF1,"Inpt PD R&B ICU","RC-INPT R&B ICU","RC INPATIENT FACILITY",IBDIVN,4,IBEVNT,IBRG,"INST",200,IBBS)
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| 23 | D SETUP(IBXRF1,"Inpt PD Anc ICU","RC-INPT ANC ICU","RC INPATIENT FACILITY",IBDIVN,4,IBEVNT,IBRG,"INST",240,IBBS)
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| 24 | ;
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| 25 | S IBEVNT="INPATIENT BEDSECTION STAY",IBBS="SKILLED NURSING/SUB-ACUTE CARE" ; Inpatient SNF Charges
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| 26 | D SETUP(IBXRF1,"SNF PD INC","RC-SNF INC","RC FACILITY PER DIEM",IBDIVN,1,IBEVNT,IBRG,"INST",101,IBBS)
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| 27 | ;
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| 28 | ;
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| 29 | ; Inpatient Facility Charges from Table B (CPT Based)
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| 30 | S IBEVNT="PROCEDURE",IBBS="GENERAL MEDICAL CARE" ; Inpatient Facility Charges
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| 31 | D SETUP(IBXRF1,"Inpt Fac 1","RC-INPT FAC PR","RC FACILITY PR",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS)
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| 32 | D SETUP(IBXRF1,"Inpt Fac 2","RC-INPT FAC HR","RC FACILITY HR",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS)
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| 33 | D SETUP(IBXRF1,"Inpt Fac 4","RC-INPT FAC ML","RC FACILITY ML",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS)
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| 34 | ;
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| 35 | S IBEVNT="PROCEDURE",IBBS="SKILLED NURSING/SUB-ACUTE CARE" ; SNF Facility Charges
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| 36 | D SETUP(IBXRF1,"SNF Fac 1","RC-SNF FAC PR","RC FACILITY PR",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS)
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| 37 | D SETUP(IBXRF1,"SNF Fac 2","RC-SNF FAC HR","RC FACILITY HR",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS)
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| 38 | D SETUP(IBXRF1,"SNF Fac 4","RC-SNF FAC ML","RC FACILITY ML",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS)
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| 39 | ;
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| 40 | ;
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| 41 | ; Inpatient Facility Charges from Table C (CPT Based)
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| 42 | S IBEVNT="PROCEDURE",IBBS="GENERAL MEDICAL CARE" ; Inpatient Facility CPT Charges
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| 43 | D SETUP(IBXRF1,"Inpt Fac/Phys 1","RC-INPT FAC PR","RC FACILITY PR",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS)
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| 44 | ;
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| 45 | S IBEVNT="PROCEDURE",IBBS="SKILLED NURSING/SUB-ACUTE CARE" ; SNF Facility CPT Charges
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| 46 | D SETUP(IBXRF1,"SNF Fac/Phys 1","RC-SNF FAC PR","RC FACILITY PR",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS)
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| 47 | ;
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| 48 | ;
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| 49 | ; Inpatient Physician Charges from Table C (CPT Based)
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| 50 | S IBEVNT="PROCEDURE",IBBS="GENERAL MEDICAL CARE" ; Inpatient Professional CPT Charges
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| 51 | D SETUP(IBXRF1,"Inpt Phys 1","RC-PHYSICIAN INPT PR","RC PHYSICIAN PR",IBDIVN,2,IBEVNT,IBRG,"PROF",960,IBBS)
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| 52 | D SETUP(IBXRF1,"Inpt Phys 3","RC-PHYSICIAN INPT MN","RC PHYSICIAN MN",IBDIVN,2,IBEVNT,IBRG,"PROF",960,IBBS)
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| 53 | ;
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| 54 | S IBEVNT="PROCEDURE",IBBS="SKILLED NURSING/SUB-ACUTE CARE" ; SNF Professional CPT Charges
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| 55 | D SETUP(IBXRF1,"SNF Phys 1","RC-PHYSICIAN SNF PR","RC PHYSICIAN PR",IBDIVN,2,IBEVNT,IBRG,"PROF",960,IBBS)
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| 56 | D SETUP(IBXRF1,"SNF Phys 3","RC-PHYSICIAN SNF MN","RC PHYSICIAN MN",IBDIVN,2,IBEVNT,IBRG,"PROF",960,IBBS)
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| 57 | ;
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| 58 | Q
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| 59 | ;
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| 60 | ;
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| 61 | OPT(IBSITE,IBXRF1) ; Create Charge Sets for Outpatient Facilities (CPT based and Partial Hospitalization)
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| 62 | N IBRG,IBDIVN,IBEVNT,IBBS,TYPE
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| 63 | W !,$P(IBSITE,U,2)," ",$P(IBSITE,U,3)," - Outpatient Charges"
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| 64 | ;
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| 65 | ; set billing region
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| 66 | S IBRG=$$RG^IBCRHU2("RC "_$P(IBSITE,U,2)_" - "_$P(IBSITE,U,3),$P(IBSITE,U,2),$P(IBSITE,U,4),$P(IBSITE,U,5))
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| 67 | S IBRG=$P(IBRG,U,2),IBDIVN=$P(IBSITE,U,2)
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| 68 | ;
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| 69 | S TYPE=$P(IBSITE,U,5) Q:TYPE'<3
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| 70 | ;
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| 71 | ;
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| 72 | ; Outpatient Facility Charges from Table B (CPT Based)
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| 73 | S IBEVNT="PROCEDURE",IBBS="OUTPATIENT VISIT" ; Outpatient Facility CPT Charges
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| 74 | D SETUP(IBXRF1,"Opt Fac 1","RC-OPT FAC PR","RC FACILITY PR",IBDIVN,2,IBEVNT,IBRG,"INST",510,IBBS)
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| 75 | D SETUP(IBXRF1,"Opt Fac 2","RC-OPT FAC HR","RC FACILITY HR",IBDIVN,2,IBEVNT,IBRG,"INST",510,IBBS)
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| 76 | D SETUP(IBXRF1,"Opt Fac 4","RC-OPT FAC ML","RC FACILITY ML",IBDIVN,2,IBEVNT,IBRG,"INST",510,IBBS)
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| 77 | ;
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| 78 | S IBEVNT="UNASSOCIATED",IBBS="PARTIAL HOSPITALIZATION" ; Partial Hospitalization Facility Per Diem Charge
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| 79 | D SETUP(IBXRF1,"Opt PD PHosp","RC-OPT MISC","RC MISCELLANEOUS",IBDIVN,9,IBEVNT,IBRG,"INST",912,IBBS)
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| 80 | ;
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| 81 | ;
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| 82 | ; Outpatient Facility Charges from Table C (CPT Based)
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| 83 | S IBEVNT="PROCEDURE",IBBS="OUTPATIENT VISIT" ; Outpatient Facility CPT Charges
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| 84 | D SETUP(IBXRF1,"Opt Fac/Phys 1","RC-OPT FAC PR","RC FACILITY PR",IBDIVN,2,IBEVNT,IBRG,"INST",510,IBBS)
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| 85 | ;
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| 86 | ;
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| 87 | ; Outpatient Physician Charges from Table C (CPT Based)
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| 88 | S IBEVNT="PROCEDURE",IBBS="OUTPATIENT VISIT" ; Outpatient Professional CPT Charges
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| 89 | D SETUP(IBXRF1,"Opt Phys 1","RC-PHYSICIAN OPT PR","RC PHYSICIAN PR",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS)
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| 90 | D SETUP(IBXRF1,"Opt Phys 3","RC-PHYSICIAN OPT MN","RC PHYSICIAN MN",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS)
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| 91 | ;
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| 92 | Q
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| 93 | ;
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| 94 | ;
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| 95 | FREE(IBSITE,IBXRF1) ; Create Charge Sets for Freestanding Facilities
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| 96 | N IBRG,IBDIVN,IBEVNT,IBBS,TYPE
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| 97 | W !,$P(IBSITE,U,2)," ",$P(IBSITE,U,3)," - Freestanding Charges"
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| 98 | ;
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| 99 | ; set billing region
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| 100 | S IBRG=$$RG^IBCRHU2("RC "_$P(IBSITE,U,2)_" - "_$P(IBSITE,U,3),$P(IBSITE,U,2),$P(IBSITE,U,4),$P(IBSITE,U,5))
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| 101 | S IBRG=$P(IBRG,U,2),IBDIVN=$P(IBSITE,U,2)
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| 102 | ;
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| 103 | S TYPE=$P(IBSITE,U,5) Q:TYPE'=3
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| 104 | ;
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| 105 | ;
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| 106 | ; Freestanding Physician Charges from Table C (CPT Based)
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| 107 | S IBEVNT="PROCEDURE",IBBS="OUTPATIENT VISIT" ; Freestanding Professional CPT Charges
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| 108 | D SETUP(IBXRF1,"FS Phys 1","RC-PHYSICIAN FS PR","RC PHYSICIAN PR",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS)
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| 109 | D SETUP(IBXRF1,"FS Phys 3","RC-PHYSICIAN FS MN","RC PHYSICIAN MN",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS)
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| 110 | ;
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| 111 | ;
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| 112 | ; Freestanding Physician Charges from Table B (CPT Based)
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| 113 | S IBEVNT="PROCEDURE",IBBS="OUTPATIENT VISIT" ; Freestanding Professional CPT Charges
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| 114 | D SETUP(IBXRF1,"FS Phys/Opt 1","RC-PHYSICIAN FS PR","RC PHYSICIAN PR",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS)
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| 115 | D SETUP(IBXRF1,"FS Phys/Opt 4","RC-PHYSICIAN FS ML","RC PHYSICIAN ML",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS)
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| 116 | D SETUP(IBXRF1,"FS Phys/Opt TC 1","RC-PHYSICIAN FS PR","RC PHYSICIAN PR",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS)
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| 117 | ;
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| 118 | ;
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| 119 | ; Freestanding Physician Global Charges from Table C (CPT Based, sum of TC and 26)
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| 120 | S IBEVNT="PROCEDURE",IBBS="OUTPATIENT VISIT" ; Freestanding Professional CPT Charges
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| 121 | D SETUP(IBXRF1,"FS Phys/Add 00 1","RC-PHYSICIAN FS PR","RC PHYSICIAN PR",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS)
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| 122 | ;
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| 123 | Q
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| 124 | ;
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| 125 | ;
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| 126 | SETUP(IBXRF1,IBXRF2,CSNM,BRATE,DIVN,BITEM,EVNT,RG,CHGTYP,RVCD,BS) ; Set up XTMP array and Charge Set for Charges
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| 127 | N IBCS
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| 128 | ;
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| 129 | S IBCS=$$CS^IBCRHU2(CSNM_" "_DIVN,BRATE,EVNT,RG,CHGTYP,RVCD,BS)
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| 130 | ;
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| 131 | D SETHDR(IBXRF1,IBXRF2,IBCS,BITEM)
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| 132 | ;
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| 133 | Q
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| 134 | ;
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| 135 | SETHDR(IBXRF1,IBXRF2,CS,BITYPE) ; set up header for XTMP file
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| 136 | N IBX
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| 137 | S IBX="IB Upload RC v"_$$VERSION^IBCRHBRV_" "_$P(IBXRF1,"UPLOAD RC ",2)_", "_$P($$HTE^XLFDT($H,2),":",1,2)_" by "_$P($G(^VA(200,+$G(DUZ),0)),U,1)
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| 138 | S ^XTMP(IBXRF1,0)=$$FMADD^XLFDT(DT,2)_U_DT_U_IBX
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| 139 | ;
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| 140 | S ^XTMP(IBXRF1,IBXRF2)=0_U_$G(BITYPE)_U_$G(CS)
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| 141 | Q
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