| 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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