| [613] | 1 | IBYPSA1 ;ALB/ARH - IB*2.0*245 POST INIT: REASONABLE CHARGES V2.0 CONT; 10-OCT-2003 | 
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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 | ; | 
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|  | 6 | Q | 
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|  | 7 | ; | 
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|  | 8 | ADDRB ; Add Billable Service (399.1, .2=1) | 
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|  | 9 | N IBA,IBCNT,IBI,IBLN,IBFN,IBX,DD,DO,DLAYGO,DIC,DIE,DA,DR,X,Y S IBCNT=0 | 
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|  | 10 | ; | 
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|  | 11 | F IBI=1:1 S IBLN=$P($T(RBF+IBI),";;",2) Q:+IBLN!(IBLN="")  I $E(IBLN)?1A D | 
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|  | 12 | . ; | 
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|  | 13 | . I +$$MCCRUTL($P(IBLN,U,1),13) Q | 
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|  | 14 | . ; | 
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|  | 15 | . K DD,DO S DLAYGO=399.1,DIC="^DGCR(399.1,",DIC(0)="L",X=$P(IBLN,U,1) D FILE^DICN K DIC I Y<1 K X,Y Q | 
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|  | 16 | . S IBFN=+Y,IBCNT=IBCNT+1 | 
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|  | 17 | . ; | 
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|  | 18 | . S DR=".03////"_$P(IBLN,U,2)_";.2////"_1 | 
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|  | 19 | . S DIE="^DGCR(399.1,",DA=+IBFN D ^DIE K DIE,DA,DR,X,Y | 
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|  | 20 | . ; | 
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|  | 21 | . S IBA(IBCNT+1)="             "_$P(IBLN,U,1) | 
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|  | 22 | ; | 
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|  | 23 | RBQ S IBA(1)="      >> "_IBCNT_" Billable Services added (399.1)..." | 
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|  | 24 | D MES^XPDUTL(.IBA) | 
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|  | 25 | Q | 
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|  | 26 | ; | 
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|  | 27 | ADDBS ; Add Bedsection (399.1, .12=1) | 
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|  | 28 | N IBA,IBCNT,IBI,IBLN,IBRB,IBFN,DD,DO,DLAYGO,DIC,DIE,DA,DR,X,Y S IBCNT=0 | 
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|  | 29 | ; | 
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|  | 30 | F IBI=1:1 S IBLN=$P($T(BSF+IBI),";;",2) Q:+IBLN!(IBLN="")  I $E(IBLN)?1A D | 
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|  | 31 | . ; | 
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|  | 32 | . I +$$MCCRUTL($P(IBLN,U,1),5) Q | 
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|  | 33 | . ; | 
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|  | 34 | . S IBRB=$P(IBLN,U,3) I IBRB'="" S IBRB=$$MCCRUTL(IBRB,13) D  Q:'IBRB | 
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|  | 35 | .. I 'IBRB D MSG("         *** Billable Service "_$P(IBLN,U,3)_" not defined, BS "_$P(IBLN,U,1)_" not created") | 
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|  | 36 | . ; | 
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|  | 37 | . K DD,DO S DLAYGO=399.1,DIC="^DGCR(399.1,",DIC(0)="L",X=$P(IBLN,U,1) D FILE^DICN K DIC I Y<1 K X,Y Q | 
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|  | 38 | . S IBFN=+Y,IBCNT=IBCNT+1 | 
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|  | 39 | . ; | 
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|  | 40 | . S DR=".03////"_$P(IBLN,U,2)_";.12////"_1 I +IBRB S DR=DR_";.25////"_IBRB | 
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|  | 41 | . S DIE="^DGCR(399.1,",DA=+IBFN D ^DIE K DIE,DA,DR,X,Y | 
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|  | 42 | . ; | 
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|  | 43 | . S IBA(IBCNT+1)="             "_$P(IBLN,U,1) | 
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|  | 44 | ; | 
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|  | 45 | BSQ S IBA(1)="      >> "_IBCNT_" Bedsection added (399.1)..." | 
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|  | 46 | D MES^XPDUTL(.IBA) | 
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|  | 47 | Q | 
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|  | 48 | ; | 
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|  | 49 | ADDBI ; Add Billing Items (363.21) | 
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|  | 50 | N IBA,IBCNT,IBI,IBLN,IBFN,IBX,DD,DO,DLAYGO,DIC,DIE,DA,DR,X,Y S IBCNT=0 | 
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|  | 51 | ; | 
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|  | 52 | F IBI=1:1 S IBLN=$P($T(BIF+IBI),";;",2) Q:+IBLN!(IBLN="")  I $E(IBLN)?1A D | 
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|  | 53 | . ; | 
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|  | 54 | . S IBX=$O(^IBA(363.21,"B",$P(IBLN,U,1),0)) I +IBX,$P($G(^IBA(363.21,IBX,0)),U,2)=$P(IBLN,U,2) Q | 
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|  | 55 | . ; | 
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|  | 56 | . S DIC("DR")=".02////"_$P(IBLN,U,2) | 
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|  | 57 | . K DD,DO S DLAYGO=363.21,DIC="^IBA(363.21,",DIC(0)="L",X=$P(IBLN,U,1) D FILE^DICN K DIC,DLAYGO I Y<1 K X,Y Q | 
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|  | 58 | . S IBFN=+Y,IBCNT=IBCNT+1 | 
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|  | 59 | . ; | 
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|  | 60 | . S IBA(IBCNT+1)="             "_$P(IBLN,U,1) | 
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|  | 61 | ; | 
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|  | 62 | BIQ S IBA(1)="      >> "_IBCNT_" Billing Items added (363.21)..." | 
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|  | 63 | D MES^XPDUTL(.IBA) | 
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|  | 64 | Q | 
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|  | 65 | ADDBR ; Add Billing Rates (363.3) | 
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|  | 66 | N IBA,IBCNT,IBI,IBJ,IBBR,IBLN,IBFN,DD,DO,DINUM,DLAYGO,DIC,DIE,DA,DR,X,Y S IBCNT=0 | 
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|  | 67 | ; | 
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|  | 68 | F IBI=1:1 S IBLN=$P($T(BRF+IBI),";;",2) Q:+IBLN!(IBLN="")  I $E(IBLN)?1A D | 
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|  | 69 | . ; | 
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|  | 70 | . I $O(^IBE(363.3,"B",$P(IBLN,U,1),0)) Q | 
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|  | 71 | . ; | 
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|  | 72 | . F IBJ=1:1 S IBBR=$G(^IBE(363.3,IBJ,0)) I IBBR="" S DINUM=IBJ Q | 
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|  | 73 | . ; | 
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|  | 74 | . K DD,DO S DLAYGO=363.3,DIC="^IBE(363.3,",DIC(0)="L",X=$P(IBLN,U,1) D FILE^DICN K DIC I Y<1 K X,Y Q | 
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|  | 75 | . S IBFN=+Y,IBCNT=IBCNT+1 | 
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|  | 76 | . ; | 
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|  | 77 | . S DR=".02////"_$P(IBLN,U,2)_";.03////"_$P(IBLN,U,3)_";.04////"_$P(IBLN,U,4)_";.05////"_$P(IBLN,U,5)_";.06////"_$P(IBLN,U,6) | 
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|  | 78 | . S DIE="^IBE(363.3,",DA=+IBFN D ^DIE K DIE,DA,DR,X,Y | 
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|  | 79 | . ; | 
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|  | 80 | . S IBA(IBCNT+1)="             "_$P(IBLN,U,1) | 
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|  | 81 | ; | 
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|  | 82 | BRQ S IBA(1)="      >> "_IBCNT_" Billing Rates added (363.3)..." | 
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|  | 83 | D MES^XPDUTL(.IBA) | 
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|  | 84 | Q | 
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|  | 85 | ; | 
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|  | 86 | ADDRS ; add Rate Schedules (363) for Reasonable Charges, if this is the first time the patch is installed | 
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|  | 87 | ; (charge sets will be added when rates are uploaded) | 
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|  | 88 | N IBA,IBCNT,IBI,IBLN,IBFN,IBRT,IBBS,IBJ,IBLNCS,IBCS,IBCSFN,IBSTDT,IBRS,DINUM,DD,DO,DLAYGO,DIC,DIE,DA,DR,X,Y S IBSTDT="",IBCNT=0 | 
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|  | 89 | ; | 
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|  | 90 | I $O(^IBE(363.3,"B","RC PHYSICIAN MN",0)) G RSQ | 
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|  | 91 | ; | 
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|  | 92 | S IBSTDT=$$VERSDT^IBCRHBRV(2) ;I '$$PROD^IBCORC S IBSTDT=2981001 | 
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|  | 93 | ; | 
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|  | 94 | F IBI=1:1 S IBLN=$P($T(RSF+IBI),";;",2) Q:+IBLN!(IBLN="")  I $E(IBLN)?1A D | 
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|  | 95 | . ; | 
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|  | 96 | . S IBBS=$P(IBLN,U,4) I IBBS'="" S IBBS=$$MCCRUTL(IBBS,13) D  Q:'IBBS | 
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|  | 97 | .. I 'IBBS D MSG("         *** Billable Service "_$P(IBLN,U,4)_" not defined, RS "_$P(IBLN,U,1)_" not created") | 
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|  | 98 | . ; | 
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|  | 99 | . S IBRT=$P(IBLN,U,2),IBRT=$O(^DGCR(399.3,"B",IBRT,0)) D  Q:'IBRT | 
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|  | 100 | .. I 'IBRT D MSG("         *** Rate Type "_$P(IBLN,U,2)_" not defined, RS "_$P(IBLN,U,1)_" not created") | 
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|  | 101 | .. I +$P($G(^DGCR(399.3,+IBRT,0)),U,3) S IBRT=0 D MSG("         *** Rate Type "_$P(IBLN,U,2)_" not Active, RS "_$P(IBLN,U,1)_" not created") | 
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|  | 102 | . ; | 
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|  | 103 | . F IBJ=1:1 S IBRS=$G(^IBE(363,IBJ,0)) I IBRS="" S DINUM=IBJ Q | 
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|  | 104 | . ; | 
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|  | 105 | . K DD,DO S DLAYGO=363,DIC="^IBE(363,",DIC(0)="L",X=$P(IBLN,U,1) D FILE^DICN K DIC,DINUM,DLAYGO I Y<1 K X,Y Q | 
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|  | 106 | . S IBFN=+Y,IBCNT=IBCNT+1 | 
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|  | 107 | . ; | 
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|  | 108 | . S DR=".02////"_IBRT_";.03////"_$P(IBLN,U,3) S:+IBBS DR=DR_";.04////"_IBBS S DR=DR_";.05////"_IBSTDT | 
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|  | 109 | . S DIE="^IBE(363,",DA=+Y D ^DIE K DIE,DA,DR,X,Y | 
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|  | 110 | . ; | 
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|  | 111 | . ; charge sets (multiple) | 
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|  | 112 | . S IBLNCS=$P(IBLN,":",2,999) I IBLNCS'="" F IBJ=1:1 S IBCS=$P(IBLNCS,":",IBJ) Q:IBCS=""  D | 
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|  | 113 | .. S IBCSFN=$O(^IBE(363.1,"B",IBCS,0)) Q:'IBCSFN | 
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|  | 114 | .. ; | 
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|  | 115 | .. S DLAYGO=363,DA(1)=+IBFN,DIC="^IBE(363,"_DA(1)_",11,",DIC(0)="L",X=IBCS,DIC("DR")=".02////"_1,DIC("P")="363.0011P" D ^DIC K DIC,DIE | 
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|  | 116 | ; | 
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|  | 117 | RSQ S IBA(1)="      >> "_IBCNT_" Rate Schedules added, active on "_$E(IBSTDT,4,5)_"/"_$E(IBSTDT,6,7)_"/"_$E(IBSTDT,2,3)_" (363)..." | 
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|  | 118 | D MES^XPDUTL(.IBA) | 
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|  | 119 | Q | 
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|  | 120 | ; | 
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|  | 121 | MCCRUTL(X,P) ; returns IFN of item in 399.1 if Name is found and piece P is true | 
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|  | 122 | N IBX,IBY S IBY="" | 
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|  | 123 | I $G(X)'="" S IBX=0 F  S IBX=$O(^DGCR(399.1,"B",X,IBX)) Q:'IBX  I $P($G(^DGCR(399.1,IBX,0)),U,+$G(P)) S IBY=IBX | 
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|  | 124 | Q IBY | 
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|  | 125 | ; | 
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|  | 126 | MSG(X) ; | 
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|  | 127 | N IBX S IBX=$O(IBA(999999),-1) S:'IBX IBX=1 S IBX=IBX+1 | 
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|  | 128 | S IBA(IBX)=$G(X) | 
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|  | 129 | Q | 
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|  | 130 | ; | 
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|  | 131 | ; | 
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|  | 132 | RBF ; billable services (399.1,.2) | 
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|  | 133 | ;; name ^ abbreviation | 
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|  | 134 | ;; | 
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|  | 135 | ;;SKILLED NURSING^SNF | 
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|  | 136 | ;; | 
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|  | 137 | ; | 
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|  | 138 | BSF ;  Bedsections (399.1,.12) | 
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|  | 139 | ;; name ^ abbreviation ^ other care | 
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|  | 140 | ;; | 
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|  | 141 | ;;ICU^ICU | 
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|  | 142 | ;;PARTIAL HOSPITALIZATION^PARTIAL HOSP | 
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|  | 143 | ;;SKILLED NURSING CARE^SNF^SKILLED NURSING | 
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|  | 144 | ;;SUB-ACUTE CARE^SUBACUTE^SKILLED NURSING | 
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|  | 145 | ;; | 
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|  | 146 | ; | 
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|  | 147 | BIF ;  Billing Items (363.21) | 
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|  | 148 | ;; name ^ type | 
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|  | 149 | ;; | 
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|  | 150 | ;;PARTIAL HOSPITALIZATION^9 | 
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|  | 151 | ;; | 
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|  | 152 | BRF ;  Billing Rates File (363.3) | 
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|  | 153 | ;; name ^ abbreviation ^ distribution ^ billable item ^ charge method ^ base allowed | 
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|  | 154 | ;; | 
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|  | 155 | ;;RC FACILITY PER DIEM^RC F/PD^1^1^1 | 
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|  | 156 | ;; | 
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|  | 157 | ;;RC FACILITY HR^RC F/HR^1^2^6^1 | 
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|  | 158 | ;;RC FACILITY ML^RC F/ML^1^2^4 | 
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|  | 159 | ;; | 
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|  | 160 | ;;RC MISCELLANEOUS^RC MISC^1^9^1 | 
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|  | 161 | ;; | 
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|  | 162 | ;;RC PHYSICIAN MN^RC P/MN^1^2^5^1 | 
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|  | 163 | ;;RC PHYSICIAN ML^RC P/ML^1^2^4 | 
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|  | 164 | ;; | 
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|  | 165 | RSF ;  Rate Schedules (363) | 
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|  | 166 | ;; rs name ^ rate type ^ bill type ^ billable service ^ effective date ^^ charge sets | 
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|  | 167 | ;; | 
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|  | 168 | ;;RI-INPT^REIMBURSABLE INS.^1^^ | 
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|  | 169 | ;;RI-SNF^REIMBURSABLE INS.^1^SKILLED NURSING^ | 
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|  | 170 | ;;RI-OPT^REIMBURSABLE INS.^3^^ | 
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|  | 171 | ;;RI-RX^REIMBURSABLE INS.^3^^^^:TL-RX FILL | 
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|  | 172 | ;; | 
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|  | 173 | ;;NF-INPT^NO FAULT INS.^1^^ | 
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|  | 174 | ;;NF-SNF^NO FAULT INS.^1^SKILLED NURSING^ | 
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|  | 175 | ;;NF-OPT^NO FAULT INS.^3^^ | 
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|  | 176 | ;;NF-RX^NO FAULT INS.^3^^^^:TL-RX FILL | 
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|  | 177 | ;; | 
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|  | 178 | ;;WC-INPT^WORKERS' COMP.^1^^ | 
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|  | 179 | ;;WC-SNF^WORKERS' COMP.^1^SKILLED NURSING^ | 
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|  | 180 | ;;WC-OPT^WORKERS' COMP.^3^^ | 
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|  | 181 | ;;WC-RX^WORKERS' COMP.^3^^^^:TL-RX FILL | 
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|  | 182 | ;; | 
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