Changeset 636 for FOIAVistA/tag/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBCBB3.m

Timestamp:

Dec 4, 2009, 8:26:01 PM (14 years ago)

Author:

George Lilly

Message:

WorldVistAEHR overlayed on FOIAVistA

Location:

FOIAVistA/tag/r

Files:

• . (copied) (copied from FOIAVistA/trunk/r )
• INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBCBB3.m (modified) (9 diffs)

FOIAVistA/tag/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBCBB3.m

@@ -1 +1 @@
 IBCBB3 ;ALB/TMP - CONTINUATION OF EDIT CHECKS ROUTINE (MEDICARE) ;06/23/98
- ;;2.0;INTEGRATED BILLING;**51,137,155,349,371,377**;21-MAR-94;Build 23
+ ;;2.0;INTEGRATED BILLING;**51,137,155,349**;21-MAR-94;Build 46
  ;;Per VHA Directive 2004-038, this routine should not be modified.
  ;
@@ -21 +21 @@
  I $G(IBXDATA)="",IBFT=3 D  Q:IBQUIT
  . N Z
- . I "^11^18^"[(U_IBTOB12_U) S IBQUIT=$$IBER(.IBER,231) Q
+ . I "^11^18^"[(U_IBTOB12_U) S IBQUIT=$$IBER^IBCBB3(.IBER,231) Q
  . I $$INPAT^IBCEF(IBIFN,1) S Z="Admitting Diagnosis may be required by payer, please verify" D WARN^IBCBB11(Z)
  ;
@@ -27 +27 @@
  S IBOK=1,Z=0,IBZP=U F  S Z=$O(Z(Z)) Q:'Z  S:$S($P($G(Z(Z,1)),U,3)["VA(200":1,1:0) IBZP=IBZP_+$P(Z(Z,1),U,3)_U
  D ALLPROC^IBCVA1(IBIFN,.IBZP1)
- S Z=0 F  S Z=$O(IBZP1(Z)) Q:'Z  I $P(IBZP1(Z),U,18),IBZP'[(U_$P(IBZP1(Z),U,18)_U) S IBOK=0 Q
+ S Z=0 F  S Z=$O(IBZP1(Z)) Q:'Z  I $P(IBZP1(Z),U,18),(U_$P(IBZP1(Z),U,18)_U)'[IBZP S IBOK=0 Q
  I 'IBOK D WARN^IBCBB11("At least one provider on a procedure does not match your "_$S(IBFT=2:"render",1:"attend")_"ing or operating provider")
  I IBFT=2 D EN^IBCBB2
@@ -37 +37 @@
 PARTA ; MEDICARE specific edit checks for PART A claims (UB-04 formats)
  ;
- N IBI,IBJ,IBX,IBCTYP,VADM,VAPA,IBSTOP,IBDXC,IBDXARY,IBPR,IBLABS,REQMRA
+ N IBI,IBJ,IBX,IBCTYP,VADM,VAPA,IBSTOP,IBDXC,IBDXARY,IBPR,IBLABS
  N IBS,IBTUNIT,IBCAGE,IBREV1,IBOCCS,IBOCSDT,IBVALCD,IBOCCD,IBNOPR
  N IBCCARY1,IBPATST,IBZADMIT,IBZDISCH,IBXIEN,IBXERR,IBXDATA,IBOCSP
@@ -89 +89 @@
  ;              procedure
  ;
- S REQMRA=$$REQMRA^IBEFUNC(IBIFN)
  S (IBNOPR,IBI)=0
  F  S IBI=$O(IBXDATA(IBI)) Q:'IBI  D
- . I REQMRA D GYMODCHK(IBXDATA(IBI))      ; IB*2*377 GY modifier check
  . S IBJ=$P(IBXDATA(IBI),U),IBECAT=""
  . I 'IBNOPR D
@@ -119 +117 @@
  . ;    to be sent to MEDICARE for an MRA
  . D NONMCR(.IBPR,.IBLABS) ; Remove Oxygen, labs, influenza shots
+ . ;I $O(IBPR(""))="" D
  . 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(""))="" D
@@ -138 +137 @@
  D DEM^VADPT
  I $P(VADM(5),U)'="M",$P(VADM(5),U)'="F" S IBQUIT=$$IBER(.IBER,124) Q:IBQUIT
- ;
- ; esg - 10/17/07 - patch 371
- ; For Part A replacement MRA request claims, make sure
- ; the Medicare ICN/DCN number is present and also text in FL-80.
- I $$REQMRA^IBEFUNC(IBIFN),$F(".137.138.117.118.","."_IBTOB_".") D  Q:IBQUIT
- . N IBZ,FL80TXT
- . D F^IBCEF("N-CURR INS FORM LOC 64","IBZ",,IBIFN)  ; see CI3-11
- . I IBZ="" S IBQUIT=$$IBER(.IBER,205) Q:IBQUIT      ; missing ICN/DCN
- . S FL80TXT=$P($G(^DGCR(399,IBIFN,"UF2")),U,3)
- . I FL80TXT="" S IBQUIT=$$IBER(.IBER,206) Q:IBQUIT  ; missing FL80 text
- . Q
  ;
  D ^IBCBB4
@@ -172 +160 @@
  F Z=77:1:85 S Z0="E13"_Z K IBPR(Z0)
  ; Labs
+ ;S Z="80000" F  S Z=$O(IBPR(Z)) Q:Z'?1"8"4N  K IBPR(Z) S IBLABS=1
  S Z="80000" F  S Z=$O(IBPR(Z)) Q:Z'?1"8"4N  S IBLABS=1
  ; Flu shots
@@ -195 +184 @@
  Q IB
  ;
-GYMODCHK(Z) ; GY modifier check procedure.  IB*2*377 - 2/4/08
- ; Z is the IBXDATA(IBI) service line EDI
- N MODS
- I IBER["IB123" Q     ; error already found
- S MODS=$P(Z,U,9)     ; list of modifiers separated by commas
- I MODS'["GY" Q       ; GY modifier not here on this line item
- I $P(Z,U,6) Q        ; non-covered charges exist on this line item
- S IBQUIT=$$IBER(.IBER,123)
-GYMODX ;
- Q
- ;