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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