| [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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