[613] | 1 | IBEMTSCU ;ALB/RFJ-print billable types for visit copay ;23 Nov 01
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| 2 | ;;2.0;INTEGRATED BILLING;**167,177,187**;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 | Q
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| 5 | ;
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| 6 | EFFDT() ;effect date Visit Copay 2
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| 7 | Q 3021001 ;OCT 1,2002
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| 8 | ;
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| 9 | ADD(IBSTOPCD,IBEFFDT,IBBILTYP,IBDESC,IBOVER) ; add a stop code to file 352.5
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| 10 | ; ibstopcd = 3 or 6 digit stop code to add
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| 11 | ; ibeffdt = effective date, internal fileman form (ex:3011206)
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| 12 | ; if effective date is not passed, it uses today (dt)
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| 13 | ; ibbiltyp = billable type (B=basic, S=specialty, N=non-billable)
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| 14 | ; default is non-billable if a B or S is not passed
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| 15 | ; ibdesc = description of stop code
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| 16 | ; ibover = if the code belongs to Override table
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| 17 | ; returns 1 if added, -#^error if not added
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| 18 | ;
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| 19 | N D,D0,DA,DI,DIC,DIE,DLAYGO,DQ,DR,IBDA,X,Y,IBZ
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| 20 | ;
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| 21 | ; check length of stop code
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| 22 | I '(($L(IBSTOPCD)=3)!($L(IBSTOPCD)=6)) Q "-1^STOP CODE "_IBSTOPCD_" NOT 3 OR 6 CHARACTERS IN LENGTH."
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| 23 | ;
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| 24 | ; change billable type code to match set of codes in file 352.5
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| 25 | S IBBILTYP=$S(IBBILTYP="B":1,IBBILTYP="S":2,1:0)
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| 26 | ;
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| 27 | S (DIC,DIE)="^IBE(352.5,",DIC(0)="L",DLAYGO=352.5
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| 28 | ;
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| 29 | ; check to see if entry is in the file
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| 30 | S IBDA=$O(^IBE(352.5,"AEFFDT",IBSTOPCD,-IBEFFDT,0))
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| 31 | I IBDA S IBZ=$G(^IBE(352.5,IBDA,0)) D Q 1
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| 32 | . S DR=""
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| 33 | . ; check to see if the correct billable type is set correctly
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| 34 | . I $P(IBZ,"^",3)'=IBBILTYP S DR=".03////"_IBBILTYP_";"
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| 35 | . ; check description
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| 36 | . I $P(IBZ,"^",4)'=$E(IBDESC,1,30) S DR=DR_".04////"_$E(IBDESC,1,30)
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| 37 | . ; if not, change it
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| 38 | . I $L(DR) S DA=IBDA D ^DIE
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| 39 | ;
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| 40 | ; add entry to file 352.5
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| 41 | S X=IBSTOPCD
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| 42 | S DIC("DR")=".02////"_IBEFFDT_";.03////"_IBBILTYP_";.04////"_$E(IBDESC,1,30)_";"
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| 43 | S:$G(IBOVER)=1 DIC("DR")=DIC("DR")_".05////1;"
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| 44 | D FILE^DICN
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| 45 | Q 1
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| 46 | ;
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| 47 | ;
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| 48 | DIQ407(DA,DR) ; diq call to retrieve data for dr fields in file 40.7
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| 49 | N D0,DIC,DIQ,DIQ2,YY
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| 50 | K IBSCDATA(40.7,DA)
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| 51 | I $G(DR)="" S DR=".01:4;"
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| 52 | S DIQ(0)="IE",DIC="^DIC(40.7,",DIQ="IBSCDATA" D EN^DIQ1
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| 53 | Q
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| 54 | ;
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| 55 | ;0 - active
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| 56 | ISINACT(IBCODE) ;
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| 57 | Q:$L(IBCODE)=6 $$INACTIVE($E(IBCODE,1,3))+$$INACTIVE($E(IBCODE,4,6))
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| 58 | Q $$INACTIVE(IBCODE)
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| 59 | ;
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| 60 | INACTIVE(IBSTCODE) ; return 1 if inactive in file 40.7
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| 61 | ; also, return ibscdata(da for stop code entries in 40.7)
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| 62 | N DA,IBSCDATA,RESULT
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| 63 | ;
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| 64 | ; default is inactive
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| 65 | S RESULT=1
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| 66 | ;
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| 67 | S DA=0 F S DA=$O(^DIC(40.7,"C",IBSTCODE,DA)) Q:'DA D
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| 68 | . D DIQ407(DA,2)
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| 69 | . I 'IBSCDATA(40.7,DA,2,"I") S RESULT=0
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| 70 | ;
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| 71 | Q RESULT
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| 72 | ;
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| 73 | ;
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| 74 | ASK() ; ask if the user wants to enter a stop code or select a clinic
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| 75 | ; return will be what entry point to use
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| 76 | N DIR,X,Y,DTOUT,DUOUT,DIRUT,DIROUT
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| 77 | S DIR(0)="S^C:Clinic;S:Stop Code" D ^DIR
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| 78 | Q $S(Y="C":"C",Y="S":"S",1:"")
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| 79 | ;
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| 80 | ASKSCODE(IBPROMPT) ; ask and return selected stop code from file 352.5
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| 81 | ; ibprompt = optional prompt to display
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| 82 | ;
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| 83 | N DIC,DILN,I,X,Y,DTOUT,DUOUT,DIRUT,DIROUT
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| 84 | S DIC="^IBE(352.5,",DIC(0)="QEAM"
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| 85 | S DIC("A")="Select OUTPATIENT VISIT STOP CODE: "
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| 86 | I $G(IBPROMPT)'="" S DIC("A")=IBPROMPT
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| 87 | S DIC("S")="I $$STOPSCRN^IBEMTSCU(Y)"
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| 88 | ;
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| 89 | W ! D ^DIC
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| 90 | I Y<1 Q -1
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| 91 | Q +Y
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| 92 | ;
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| 93 | ;
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| 94 | STOPSCRN(IBX) ; screens out so only active and current ones are selectable
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| 95 | ;
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| 96 | ; if we have no from date, all are selectable
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| 97 | I '$G(IBFR) Q 1
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| 98 | ;
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| 99 | N IBZ,IBAX,IBS,IBEFFDT
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| 100 | S IBZ=$G(^IBE(352.5,IBX,0)),IBS=$P(IBZ,"^")
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| 101 | ;
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| 102 | ; is the effective date for this entry in the future?
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| 103 | I $P(IBZ,"^",2)>IBFR Q 0
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| 104 | ;
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| 105 | ; get the effective date for stop code and visit date
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| 106 | S IBEFFDT=$O(^IBE(352.5,"AEFFDT",IBS,-(IBFR+.1)))
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| 107 | I 'IBEFFDT Q 0
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| 108 | ;
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| 109 | ; get the billable entry to compare
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| 110 | S IBAX=$O(^IBE(352.5,"AEFFDT",IBS,IBEFFDT,0))
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| 111 | ;
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| 112 | Q $S(IBX=IBAX:1,1:0)
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| 113 | ;
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| 114 | ASKSC(IBVISTDT) ; ask for a clinic to look up the stop code
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| 115 | ; it will prompt for a clinic selection, and return the stop
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| 116 | ; code number in 352.5 associated with the clinic
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| 117 | N DIC,X,Y,IB407,IBEFDT,IBCLIN
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| 118 | S DIC="^SC(",DIC(0)="AEMQZ",DIC("A")="Select CLINIC: ",DIC("S")="I $P(^(0),U,3)=""C""" D ^DIC Q:Y<1 -1
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| 119 | S IBCLIN=+Y
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| 120 | ;primary
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| 121 | S IB407=$P(Y(0),"^",7)
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| 122 | S IBCODE1=$$GETCODE(IB407)
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| 123 | ; if < eff date
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| 124 | Q:IBVISTDT<$$EFFDT() $$GET3525(+IBCODE1,0,IBVISTDT)
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| 125 | ;secondary
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| 126 | ; get the secondary stop code value
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| 127 | S IBCODE2=$$GETCRED(IBCLIN)
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| 128 | ;return proper IEN of #352.5
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| 129 | Q +$$GET3525(IBCODE1,IBCODE2,IBVISTDT)
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| 130 | ;
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| 131 | ;
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| 132 | GETTYPE(IBSTOPCD,IBVISTDT) ; lookup billable type
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| 133 | ; input ibstopcd = stop code (.01 field entry in file 352.5)
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| 134 | ; ibvistdt = visit date in fileman format
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| 135 | ;
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| 136 | ; returns -1 = stop code/effective date not found or defined
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| 137 | ; 0 = non-billable
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| 138 | ; 1 = basic rate
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| 139 | ; 2 = specialty rate
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| 140 | ;
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| 141 | N DA,IBEFFDT,RESULT
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| 142 | ;
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| 143 | ; get the effective date for stop code and visit date
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| 144 | S IBEFFDT=$O(^IBE(352.5,"AEFFDT",IBSTOPCD,-(IBVISTDT+.1)))
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| 145 | I 'IBEFFDT Q -1
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| 146 | ;
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| 147 | ; get the billable type
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| 148 | S DA=$O(^IBE(352.5,"AEFFDT",IBSTOPCD,IBEFFDT,0))
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| 149 | I 'DA Q -1
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| 150 | ;
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| 151 | ; get the billable type
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| 152 | S RESULT=+$P($G(^IBE(352.5,DA,0)),"^",3)
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| 153 | Q RESULT
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| 154 | ;
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| 155 | ;
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| 156 | GETSC(IBSL,IBVISTDT) ; return the ien of the entry in file 352.5.
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| 157 | ; ibsl is the clinic stop code in 409.68. find the matching
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| 158 | ; entry in file 352.5. the 352.5 entry is populated in the 350 field
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| 159 | ; for reference using the ibstopda variable
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| 160 | ; input ibsl = 409.68:ien
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| 161 | N IB407,IBCLIN,IBCODE1,IBCODE2
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| 162 | I $P(IBSL,":")'=409.68 Q ""
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| 163 | ;primary
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| 164 | ;this is the ien for file 40.7 (dbia402)
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| 165 | S IB407=+$P($G(^SCE(+$P(IBSL,":",2),0)),"^",3)
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| 166 | ;get the primary stop code value
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| 167 | S IBCODE1=+$$GETCODE(IB407)
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| 168 | ;if < eff date
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| 169 | Q:IBVISTDT<$$EFFDT() $$GET3525(+IBCODE1,0,IBVISTDT)
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| 170 | ;secondary
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| 171 | ;get clinic(#44) pointer from #409.68
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| 172 | S IBCLIN=+$P($G(^SCE(+$P(IBSL,":",2),0)),"^",4)
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| 173 | ;get the secondary stop code value
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| 174 | S IBCODE2=+$$GETCRED(IBCLIN)
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| 175 | ;return proper IEN of #352.5
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| 176 | Q $$GET3525(+IBCODE1,+IBCODE2,IBVISTDT)
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| 177 | ;
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| 178 | ;apply business rules, select appropr. code in #352.5 and return its IEN
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| 179 | ;if not found then return ""
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| 180 | GET3525(IBCODE1,IBCODE2,IBVISTDT) ;
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| 181 | Q:+IBCODE1=0 "" ;must be defined as a required field in #44
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| 182 | Q:$L(+IBCODE1)'=3!(IBCODE1<0) ""
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| 183 | I $L(+IBCODE2)'=3!(IBCODE2<0) S IBCODE2=0
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| 184 | N IB6DIG
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| 185 | N IBEFDT1,IBIEN1,IBOVER1,IBTYPE1
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| 186 | N IBEFDT2,IBIEN2,IBOVER2,IBTYPE2
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| 187 | S (IBIEN1,IBIEN2,IBOVER1,IBOVER2)=0
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| 188 | ;------ find appropriate ien in file #352.5
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| 189 | S IB6DIG=$S(IBCODE2>0:IBCODE1_IBCODE2,1:IBCODE1)
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| 190 | ;in the #352.5 with appropriate eff date?
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| 191 | S IBEFDT1=+$O(^IBE(352.5,"AEFFDT",IB6DIG,-(IBVISTDT+.1)))
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| 192 | ;
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| 193 | ;A) if found and it is 6 or 3 digit code
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| 194 | I IBEFDT1 D Q:IBIEN1>0 IBIEN1
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| 195 | . ;get the entry in 352.5
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| 196 | . S IBIEN1=+$O(^IBE(352.5,"AEFFDT",IB6DIG,IBEFDT1,0))
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| 197 | ;
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| 198 | ;B) if not found and it is 3 digit - return nothing, BASIC applies
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| 199 | I +IBCODE2=0 Q ""
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| 200 | ;
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| 201 | ;C) if not found and it is 6 digit - try each separately
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| 202 | ;-- primary code
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| 203 | ;in the #352.5 "override" tables with appropriate eff date?
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| 204 | S IBEFDT1=+$O(^IBE(352.5,"AEFFDT",IBCODE1,-(IBVISTDT+.1)))
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| 205 | I IBEFDT1 D
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| 206 | . ;get the entry in 352.5
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| 207 | . S IBIEN1=+$O(^IBE(352.5,"AEFFDT",IBCODE1,IBEFDT1,0))
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| 208 | . Q:IBIEN1=0
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| 209 | . S IBOVER1=+$P($G(^IBE(352.5,IBIEN1,0)),"^",5)
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| 210 | . S IBTYPE1=+$P($G(^IBE(352.5,IBIEN1,0)),"^",3)
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| 211 | ;-- secondary code
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| 212 | ;in the #352.5 "override" tables with appropriate eff date?
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| 213 | S IBEFDT2=+$O(^IBE(352.5,"AEFFDT",IBCODE2,-(IBVISTDT+.1)))
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| 214 | I IBEFDT2 D
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| 215 | . ;get the entry in 352.5
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| 216 | . S IBIEN2=+$O(^IBE(352.5,"AEFFDT",IBCODE2,IBEFDT2,0))
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| 217 | . Q:IBIEN2=0
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| 218 | . S IBOVER2=+$P($G(^IBE(352.5,IBIEN2,0)),"^",5)
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| 219 | . S IBTYPE2=+$P($G(^IBE(352.5,IBIEN2,0)),"^",3)
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| 220 | ;
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| 221 | ; If not found in override tables
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| 222 | ; - AND primary is not in #352.5 then return nothing, BASIC applies
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| 223 | ; - AND primary is in #352.5 then return IBIEN1
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| 224 | I IBOVER1=0,IBOVER2=0 Q $S(IBIEN1>0:IBIEN1,1:"")
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| 225 | ;
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| 226 | I IBOVER1=0,IBOVER2'=0 Q +IBIEN2
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| 227 | ;
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| 228 | I IBOVER1'=0,IBOVER2=0 Q +IBIEN1
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| 229 | ;
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| 230 | ; If IBOVER1'=0,IBOVER2'=0
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| 231 | I IBTYPE1=0 Q +IBIEN1 ;NON
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| 232 | I IBTYPE2=0 Q +IBIEN2 ;NON
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| 233 | I IBTYPE1=2 Q +IBIEN1 ;SPEC
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| 234 | I IBTYPE2=2 Q +IBIEN2 ;SPEC
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| 235 | Q +IBIEN1 ;BASIC
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| 236 | ;
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| 237 | ;
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| 238 | OPT ; perform outpatient copay edits for visits after 11/29/01
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| 239 | ; called from IBECEA3
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| 240 | ;
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| 241 | ; return IBSTOPDA (if selected) to be stored in file 350
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| 242 | K IBSTOPDA,IBANS
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| 243 | ;
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| 244 | ; ask selection by clinic or stop code
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| 245 | S IBANS=$$ASK I '$L(IBANS) W !!,"Charge NOT added." S IBY=-1 Q
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| 246 | ;
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| 247 | ; ask clinic stop to calc charges
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| 248 | S IBSTOPDA=+$S(IBANS="S":$$ASKSCODE,1:$$ASKSC(IBFR))
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| 249 | I IBSTOPDA<0 S IBY=-1 W !!,"Charge NOT added." K IBSTOPDA Q
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| 250 | ;
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| 251 | ; user selected a non-billable clinic stop
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| 252 | I IBSTOPDA>0,'$P($G(^IBE(352.5,IBSTOPDA,0)),"^",3) W !?5,"********** This is a NON-BILLABLE Clinic Stop **********",!?5,"Select an active billable clinic stop or press RETURN to exit." G OPT
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| 253 | ; user selected an inactive stop code
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| 254 | I IBSTOPDA>0,$$ISINACT($P($G(^IBE(352.5,IBSTOPDA,0)),"^")) W !?5,"********** This is a INACTIVE Clinic Stop in file #40.7 **********",!?5,"Select an active billable clinic stop or press RETURN to exit." G OPT
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| 255 | ;
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| 256 | ; *** get the charge ***
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| 257 | ; return IBTO, IBUNIT, IBEVDA, IBCHG for processing in IBECEAU3
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| 258 | N IBDT,IBTYPE,IBX
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| 259 | S (IBDT,IBTO)=IBFR ;visit date
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| 260 | S IBX="O" ;O for outpatient
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| 261 | S IBUNIT=1,IBEVDA="*"
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| 262 | S IBTYPE=1 ;BASIC by default
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| 263 | S:IBSTOPDA>0 IBTYPE=$P(^IBE(352.5,IBSTOPDA,0),"^",3) ;type of charge, basic or specialty
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| 264 | D TYPE^IBAUTL2
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| 265 | I IBY<0 Q
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| 266 | ;
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| 267 | W !!,"Charge to be billed under the ",$$TYPE^IBEMTSCR($P($G(^IBE(352.5,IBSTOPDA,0)),"^",3))," Rate --> $",$J(IBCHG,0,2)
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| 268 | Q
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| 269 | ;
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| 270 | ;Get credit pair (secondary code) from #44
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| 271 | GETCRED(IBCLIN) ;
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| 272 | N IB407
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| 273 | ; get credit pair (secondary stop code pointer) from #44
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| 274 | S IB407=+$P($G(^SC(IBCLIN,0)),"^",18)
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| 275 | ; if IB407 is defined, get the stop code in IBSCDATA(40.7,IB407,1,"E")
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| 276 | Q $$GETCODE(IB407)
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| 277 | ;
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| 278 | GETCODE(IB407) ;
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| 279 | ; get the stop code in IBSCDATA(40.7,IB407,1,"E")
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| 280 | N IBCODE,IBSCDATA
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| 281 | S IBCODE=0
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| 282 | I IB407'=0 D DIQ407(IB407,1) D
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| 283 | . I $G(IBSCDATA(40.7,IB407,1,"E"))="" Q
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| 284 | . S IBCODE=+$G(IBSCDATA(40.7,IB407,1,"E"))
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| 285 | . S:$L(+IBCODE)'=3!(IBCODE<0) IBCODE=0
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| 286 | Q IBCODE
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| 287 | ;
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