source: WorldVistAEHR/trunk/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBRFN3.m@ 1096

Last change on this file since 1096 was 623, checked in by George Lilly, 15 years ago

revised back to 6/30/08 version
File size: 6.7 KB
Line 
1IBRFN3 ;ALB/ARH - PASS BILL/CLAIM TO AR ;3/18/96
2 ;;2.0;INTEGRATED BILLING;**61,133,210,309**;21-MAR-94
3 ;;Per VHA Directive 10-93-142, this routine should not be modified.
4 ;
5 ; Returns information on the bill passed in, all data returned in external format, for AR's RC project
6 ;
7 ; If the bill can not be found then returns ARRAY=0 (should be called with ARRAY passed by reference)
8 ; Otherwise ARRAY=1 and the following array elements may be defined
9 ; these array elements will only be defined is there is data to return
10 ; those elements that have multiple entries will be in the form ARRAY("SUB",X) where X=1:1:...
11 ;
12 ; ARRAY("BN") = BILL NUMBER
13 ; ARRAY("SR") = SENSITIVE RECORD? (Y or N)
14 ; ARRAY("STF") = STATEMENT COVERS FROM DATE - first date covered by bill
15 ; ARRAY("STT") = STATEMENT COVERS TO DATE - last date covered by bill
16 ; ARRAY("TCG") = TOTAL CHARGES^OFFSET AMT (PRIOR PAYMENTS)^OFFSET DESC
17 ; ARRAY("TOC") = BILL TYPE (INPATIENT OR OUTPATIENT)
18 ; ARRAY("TCF") = BILL FORM TYPE
19 ; ARRAY("DFP") = DATE FIRST PRINTED
20 ; ARRAY("TAX") = FEDERAL TAX NUMBER - for facility, a site parameter
21 ;
22 ; ARRAY("PIN") = DEBTOR INSURANCE NAME ^ HOSPITAL PROVIDER NUMBER ^ GROUP NAME ^ GROUP NUMBER ^
23 ; NAME OF INSURED ^ SUBSCRIBER ID ^ RELATIONSHIP TO INSURED
24 ;
25 ; ARRAY("PIN","MMA") = DEBTOR MAILING STREET ADDRESS [LINE 1] ^
26 ; MAILING STREET ADDRESS [LINE 2] ^ MAILING STREET ADDRESS [LINE 3] ^ CITY ^
27 ; STATE (ABBREVIATED) ^ ZIP ^ PHONE NUMBER
28 ;
29 ; ARRAY("RVC") = NUMBER OF REVENUE CODES ON BILL
30 ; ARRAY("RVC",X) = REVENUE CODE ^ REVENUE CODE DESCRIPTION ^ CHARGE (PER UNIT) ^ UNITS ^
31 ; TOTAL CHARGE FOR REV CODE
32 ;
33 ; ARRAY("OPV") = NUMBER OF OUTPATIENT VISIT DATES ON BILL
34 ; ARRAY("OPV",X) = OUTPATIENT VISIT DATE
35 ;
36 ; ARRAY("PRC") = NUMBER OF PROCEDURES ON BILL
37 ; ARRAY("PRC",X) = PROCEDURE CODE ^ PROCEDURE DESCRIPTION ^ PROCEDURE DATE ^
38 ; PLACE OF SERVICE CODE ^ PLACE OF SERVICE ^ TYPE OF SERVICE CODE ^ TYPE OF SERVICE
39 ;
40 ; ARRAY("DXS") = NUMBER OF DIAGNOSIS ON BILL
41 ; ARRAY("DXS,X) = DIAGNOSIS CODE ^ DIAGNOSIS
42 ;
43 ; ARRAY("RXF") = NUMBER OF PRESCRIPTION REFILLS ON BILL
44 ; ARRAY("RXF",X) = PRESCRIPTION # ^ REFILL DATE ^ DRUG NAME ^ DAYS SUPPLY ^ QUANTITY ^ NDC #
45 ;
46 ; ARRAY("PRD") = NUMBER OF PROSTHETIC ITEMS ON BILL
47 ; ARRAY("PRD",X) = PROSTHETIC DEVICE ^ DELIVERY DATE
48 ;
49 ; IF CONDITION RELATED TO EMPLOYMENT: ARRAY("CRE") = "EMPLOYMENT"
50 ; IF CONDITION RELATED TO AN AUTO ACCIDENT: ARRAY("CRA") = "AUTO ACCIDENT" ^ STATE (ABBREVIATION)
51 ; IF CONDITION RELATED TO AN OTHER ACCIDENT: ARRAY("CRO") = "OTHER ACCIDENT"
52 ;
53BILL(IBIFN,ARRAY) ; returns array of information on a specific bill, based on RC requirements
54 ;
55 N IBI,IBJ,IBK,IBX,IBY,IBTMP,IBD0,IBDU,IBDU1,IBDI1,IBDS,IBDATE
56 K ARRAY S ARRAY=1 I '$G(IBIFN)!($G(^DGCR(399,+$G(IBIFN),0))="") S ARRAY=0 Q
57 F IBI=0,"U","U1","S" S @("IBD"_IBI)=$G(^DGCR(399,IBIFN,IBI))
58 S IBX=$P(IBD0,U,21),IBX=$S(IBX="P":"I1",IBX="S":"I2",IBX="T":"I3",1:" ")
59 S IBDI1=$G(^DGCR(399,IBIFN,IBX))
60 ;
61 S ARRAY("TCG")=$P(IBDU1,U,1,3)
62 S ARRAY("BN")=$P(IBD0,U,1)
63 S ARRAY("SR")=$S($P(IBDU,U,5)=1:"Y",1:"N")
64 S ARRAY("STF")=$P(IBDU,U,1)
65 S ARRAY("STT")=$P(IBDU,U,2)
66 S ARRAY("TOC")=$S($P(IBD0,U,5)<3:"INPATIENT",1:"OUTPATIENT")
67 S ARRAY("TCF")=$$FTN^IBCU3($$FT^IBCU3(IBIFN))
68 S ARRAY("DFP")=$P(IBDS,U,12)
69 S ARRAY("TAX")=$P($G(^IBE(350.9,1,1)),U,5)
70 ;
71INS ; insurance information
72 S IBX=$G(^DGCR(399,+IBIFN,"M"))
73 S ARRAY("PIN")=$P(IBX,U,4)_U_$P($G(^DIC(36,+IBDI1,0)),U,11)_U_$P(IBDI1,U,15)_U_$P(IBDI1,U,3)_U_$P(IBDI1,U,17)_U_$P(IBDI1,U,2)_U_$$RTI($P(IBDI1,U,16))
74 S ARRAY("PIN","MMA")=$P(IBX,U,5)_U_$P(IBX,U,6)_U_$P($G(^DGCR(399,+IBIFN,"M1")),U,1)_U_$P(IBX,U,7)_U_$$STATE($P(IBX,U,8))
75 S ARRAY("PIN","MMA")=ARRAY("PIN","MMA")_U_$$ZIP($P(IBX,U,9))_U_$P($G(^DIC(36,+IBDI1,.13)),U,1)
76 ;
77RC ; revenue codes
78 S (IBI,IBJ)=0,ARRAY("RVC")=IBJ F S IBI=$O(^DGCR(399,IBIFN,"RC",IBI)) Q:'IBI D
79 . S IBX=$G(^DGCR(399,IBIFN,"RC",IBI,0)) Q:IBX="" S IBY=$G(^DGCR(399.2,+IBX,0))
80 . S IBJ=IBJ+1,ARRAY("RVC")=IBJ
81 . S ARRAY("RVC",IBJ)=$P(IBY,U,1)_U_$P(IBY,U,2)_U_$P(IBX,U,2)_U_$P(IBX,U,3)_U_$P(IBX,U,4)
82 ;
83OPV ; outpatient visit dates
84 S (IBI,IBJ)=0,ARRAY("OPV")=IBJ F S IBI=$O(^DGCR(399,IBIFN,"OP",IBI)) Q:'IBI D
85 . S IBX=$G(^DGCR(399,IBIFN,"OP",IBI,0)) Q:'IBX
86 . S IBJ=IBJ+1,ARRAY("OPV")=IBJ
87 . S ARRAY("OPV",IBJ)=+IBX
88 ;
89PRC ; procedure codes
90 S (IBI,IBJ)=0,ARRAY("PRC")=IBJ F S IBI=$O(^DGCR(399,IBIFN,"CP",IBI)) Q:'IBI D
91 . S IBX=$G(^DGCR(399,IBIFN,"CP",IBI,0)),IBY=""
92 . S IBDATE=$P(IBX,U,2) I 'IBDATE S IBDATE=$$BDATE^IBACSV(IBIFN)
93 . S IBY=$P($$PRCD^IBCEF1($P(IBX,U),1,IBDATE),U,2,3)
94 . Q:$P(IBY,U)=""
95 . S IBJ=IBJ+1,ARRAY("PRC")=IBJ
96 . S ARRAY("PRC",IBJ)=IBY_U_$P(IBX,U,2)
97 . S IBY=$G(^IBE(353.1,+$P(IBX,U,9),0)),ARRAY("PRC",IBJ)=ARRAY("PRC",IBJ)_U_$P(IBY,U)_U_$P(IBY,U,3)
98 . S IBY=$G(^IBE(353.2,+$P(IBX,U,10),0)),ARRAY("PRC",IBJ)=ARRAY("PRC",IBJ)_U_$P(IBY,U)_U_$P(IBY,U,3)
99 ;
100DX ; diagnosis codes
101 K IBTMP D SET^IBCSC4D(IBIFN,"",.IBTMP)
102 S IBDATE=$$BDATE^IBACSV(IBIFN)
103 S (IBI,IBJ)=0,ARRAY("DXS")=IBJ F S IBI=$O(IBTMP(IBI)) Q:'IBI D
104 . S IBX=IBTMP(IBI),IBY=$$ICD9^IBACSV(+IBX,IBDATE) Q:IBY=""
105 . S IBJ=IBJ+1,ARRAY("DXS")=IBJ
106 . S ARRAY("DXS",IBJ)=$P(IBY,U)_U_$P(IBY,U,3)
107 ;
108RX ; prescription refills
109 K IBTMP D SET^IBCSC5A(IBIFN,.IBTMP)
110 S (IBI,IBJ)=0,ARRAY("RXF")=IBJ F S IBI=$O(IBTMP(IBI)) Q:'IBI D
111 . S IBK=0 F S IBK=$O(IBTMP(IBI,IBK)) Q:'IBK D
112 .. S IBX=IBTMP(IBI,IBK) D ZERO^IBRXUTL(+$P(IBX,U,2)) S IBY=$G(^TMP($J,"IBDRUG",+$P(IBX,U,2),.01))
113 .. S IBJ=IBJ+1,ARRAY("RXF")=IBJ
114 .. S ARRAY("RXF",IBJ)=IBI_U_IBK_U_IBY_U_$P(IBX,U,3)_U_$P(IBX,U,4)_U_$P(IBX,U,5)
115 .. K ^TMP($J,"IBDRUG")
116 .. Q
117 ;
118PD ; prosthetic items
119 K IBTMP D SET^IBCSC5B(IBIFN,.IBTMP)
120 S (IBI,IBJ)=0,ARRAY("PRD")=IBJ F S IBI=$O(IBTMP(IBI)) Q:'IBI D
121 . S IBK=0 F S IBK=$O(IBTMP(IBI,IBK)) Q:'IBK D
122 .. S IBX=IBTMP(IBI,IBK)
123 .. S IBJ=IBJ+1,ARRAY("PRD")=IBJ
124 .. S ARRAY("PRD",IBJ)=$P($$PIN^IBCSC5B(IBK),U,2)_U_IBI
125 ;
126CC ; condition related to employment, auto accident (place), other accident
127 S IBI=0 F S IBI=$O(^DGCR(399,IBIFN,"CC",IBI)) Q:'IBI I $G(^(IBI,0))="02" S ARRAY("CRE")="EMPLOYMENT"
128 S IBI=0 F S IBI=$O(^DGCR(399,IBIFN,"OC",IBI)) Q:'IBI S IBX=$G(^(IBI,0)) I +IBX D
129 . S IBY=$G(^DGCR(399.1,+IBX,0)) Q:IBY=""
130 . I $P(IBY,U,9)=1 S ARRAY("CRE")="EMPLOYMENT"
131 . I $P(IBY,U,9)=2 S ARRAY("CRA")="AUTO ACCIDENT"_U_$$STATE($P(IBX,U,3))
132 . I $P(IBY,U,9)=3 S ARRAY("CRO")="OTHER ACCIDENT"
133 Q
134 ;
135STATE(X) ; returns 2 letter abbreviation for state
136 Q $P($G(^DIC(5,+X,0)),U,2)
137ZIP(X) ; returns zip in external form
138 S X=$E(X,1,5)_$S($E(X,6,9)]"":"-"_$E(X,6,9),1:"")
139 Q X
140RTI(X) ; returns external form of relationship to insured
141 I X'="" S X=$S(X="01":"PATIENT",X="02":"SPOUSE",X="03":"NATURAL CHILD",X="08":"EMPLOYEE",X="09":"UNKNOWN",X="11":"ORGAN DONOR",X="15":"INJURED PLANTIFF",X="18":"PARENT",1:"")
142 Q X
143 ;IBRFN3
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