Changeset 623 for WorldVistAEHR/trunk/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBCBB9.m

Timestamp:

Dec 4, 2009, 12:11:15 AM (14 years ago)

Author:

George Lilly

Message:

revised back to 6/30/08 version

File:

• WorldVistAEHR/trunk/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBCBB9.m (modified) (1 diff)

WorldVistAEHR/trunk/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBCBB9.m

@@ -1 @@
-IBCBB9  ;ALB/BGA MEDICARE PART B EDIT CHECKS ;10/15/98
-        ;;2.0;INTEGRATED BILLING;**51,137,155,349,371**;21-MAR-94;Build 57
-        ;;Per VHA Directive 2004-038, this routine should not be modified.
-        ;
-PARTB   ; MEDICARE specific edit checks for PART B claims (CMS-1500)
-        ;
-        N IBXDATA,IBXERR,IBXIEN,IBXSAVE,IBPR,IBDTFLG
-        ;
-        I $$NEEDMRA^IBEFUNC(IBIFN) D
-        . K IBXDATA
-        . D F^IBCEF("N-HCFA 1500 SERVICE LINE (EDI)",,,IBIFN)
-        . S IBI=0
-        . F  S IBI=$O(IBXDATA(IBI)) Q:'IBI  D
-        .. S IBJ=$P(IBXDATA(IBI),U,5)
-        .. I IBJ'="","^CJ^HC^"[(U_$P(IBXDATA(IBI),U,6)_U) S IBPR(IBJ)=""
-        . I $$REQMRA^IBEFUNC(IBIFN),$O(IBXDATA(""),-1)>12 D WARN^IBCBB11("This claim will be split into multiple EOB'S since there are more than 12"),WARN^IBCBB11("service lines being submitted on the claim.")
-        . I $$REQMRA^IBEFUNC(IBIFN),$E(IBFDT,1,3)'=$E(IBTDT,1,3) D WARN^IBCBB11("This claim will be split into multiple EOB'S due to the service dates"),WARN^IBCBB11("spanning different calendar years.")
-        . D NONMCR^IBCBB3(.IBPR,.IBLABS) ; Oxygen, labs, influenza shots
-        . S Z="80000" F  S Z=$O(IBPR(Z)) Q:Z'?1"8"4N  S IBLABS=1
-        . I $G(IBLABS) D WARN^IBCBB11("The only possible billable procedures on this bill are labs -"),WARN^IBCBB11(" Please verify that MEDICARE does not reimburse these labs at 100%") Q
-        . I $O(IBPR(""))="" S IBQUIT=$$IBER^IBCBB3(.IBER,"098")
-        ;
-        ; First char of the pat's first and last name must be present and
-        ; must be an alpha
-        K IBXDATA D F^IBCEF("N-PATIENT NAME",,,IBIFN)
-        S IBXDATA=$$NAME^IBCEFG1(IBXDATA)
-        I $S($G(IBXDATA)="":1,$E($P(IBXDATA,U))=" "!($E($P(IBXDATA,U))'?1A):1,$E($P(IBXDATA,U,2))=" "!($E($P(IBXDATA,U,2))'?1A):1,1:0) S IBQUIT=$$IBER^IBCBB3(.IBER,300) Q:IBQUIT
-        ;
-        ; Must be a valid HIC #
-        I '$$VALID^IBCBB8(IBIFN) S IBQUIT=$$IBER^IBCBB3(.IBER,215) Q:IBQUIT
-        ;
-        ; Specialty code 99 is not valid for Medicare MRA request claims
-        I $$REQMRA^IBEFUNC(IBIFN),$$BILLSPEC^IBCEU3(IBIFN)=99 S IBQUIT=$$IBER^IBCBB3(.IBER,122) Q:IBQUIT
-        ;
-        Q
-        ;
+IBCBB9 ;ALB/BGA MEDICARE PART B EDIT CHECKS ;10/15/98
+ ;;2.0;INTEGRATED BILLING;**51,137,155,349**;21-MAR-94;Build 46
+ ;;Per VHA Directive 2004-038, this routine should not be modified.
+ ;
+PARTB ; MEDICARE specific edit checks for PART B claims (CMS-1500)
+ ;
+ N IBXDATA,IBXERR,IBXIEN,IBXSAVE,IBPR,IBDTFLG
+ ;
+ I $$NEEDMRA^IBEFUNC(IBIFN) D
+ . K IBXDATA
+ . D F^IBCEF("N-HCFA 1500 SERVICE LINE (EDI)",,,IBIFN)
+ . S IBI=0
+ . F  S IBI=$O(IBXDATA(IBI)) Q:'IBI  D
+ .. S IBJ=$P(IBXDATA(IBI),U,5)
+ .. I IBJ'="","^CJ^HC^"[(U_$P(IBXDATA(IBI),U,6)_U) S IBPR(IBJ)=""
+ . I $$REQMRA^IBEFUNC(IBIFN),$O(IBXDATA(""),-1)>12 D WARN^IBCBB11("This claim will be split into multiple EOB'S since there are more than 12"),WARN^IBCBB11("service lines being submitted on the claim.")
+ . I $$REQMRA^IBEFUNC(IBIFN),$E(IBFDT,1,3)'=$E(IBTDT,1,3) D WARN^IBCBB11("This claim will be split into multiple EOB'S due to the service dates"),WARN^IBCBB11("spanning different calendar years.")
+ . D NONMCR^IBCBB3(.IBPR,.IBLABS) ; Oxygen, labs, influenza shots
+ . S Z="80000" F  S Z=$O(IBPR(Z)) Q:Z'?1"8"4N  S IBLABS=1
+ . I $G(IBLABS) D WARN^IBCBB11("The only possible billable procedures on this bill are labs -"),WARN^IBCBB11(" Please verify that MEDICARE does not reimburse these labs at 100%") Q
+ . I $O(IBPR(""))="" S IBQUIT=$$IBER^IBCBB3(.IBER,"098")
+ ;
+ ; First char of the pat's first and last name must be present and
+ ; must be an alpha
+ K IBXDATA D F^IBCEF("N-PATIENT NAME",,,IBIFN)
+ S IBXDATA=$$NAME^IBCEFG1(IBXDATA)
+ I $S($G(IBXDATA)="":1,$E($P(IBXDATA,U))=" "!($E($P(IBXDATA,U))'?1A):1,$E($P(IBXDATA,U,2))=" "!($E($P(IBXDATA,U,2))'?1A):1,1:0) S IBQUIT=$$IBER^IBCBB3(.IBER,300) Q:IBQUIT
+ ;
+ ; First char of the pat's address and city must not be a space
+ K IBXDATA D F^IBCEF("N-PATIENT STREET ADDRESS LN 1",,,IBIFN)
+ I $G(IBXDATA)=""!($E($G(IBXDATA))=" ") S IBQUIT=$$IBER^IBCBB3(.IBER,302) Q:IBQUIT
+ ;
+ K IBXDATA D F^IBCEF("N-PATIENT CITY",,,IBIFN)
+ I $G(IBXDATA)=""!($E($G(IBXDATA))=" ") S IBQUIT=$$IBER^IBCBB3(.IBER,302) Q:IBQUIT
+ ;
+ ; Must be a valid HIC #
+ I '$$VALID^IBCBB8(IBIFN) S IBQUIT=$$IBER^IBCBB3(.IBER,215) Q:IBQUIT
+ ;
+ ; Specialty code 99 is not valid for Medicare MRA request claims
+ I $$REQMRA^IBEFUNC(IBIFN),$$BILLSPEC^IBCEU3(IBIFN)=99 S IBQUIT=$$IBER^IBCBB3(.IBER,122) Q:IBQUIT
+ ;
+ Q
+ ;