FBAAFSR ;WCIOFO/TCK,SS,DMK,SAB - RBRVS FEE SCHEDULE ;1/14/11 11:07am
Source file <FBAAFSR.m>
| action | A | extended action | Ea | event driver | Ed | subscriber | Su | protocol | O | limited protocol | LP | run routine | RR | broker | B | edit | E | server | Se | P | screenman | SM | inquire | I |
| Name | Comments | DBIA/ICR reference |
|---|---|---|
| RBRVS(CPT,MODL,DOS,ZIP,FAC,TIME) | ; calculate RBRVS Fee Schedule amount
; Input ; CPT = CPT/HCPCS code (external value) ; MODL = list of CPT/HCPCS modifiers (external values) ; delimited by commas (e.g. "26,51") ; DOS = date of service (fileman format e.g. 2980101) ; ZIP = ZIP code of service (external 5 digit value) ; FAC = facility flag =1 if site of service is facility setting ; TIME = time in minutes, only passed on anesthesia CPT codes ; Returns string ; dollar amount^sched year OR null value if not on RBRVS schedule ; Output ; FBERR( array of error messages OR undefined if none |
|
| PROC(CPT,MODL,FBCY,FBNONPBL) | ; get procedure data for RBRVS schedule
; Input ; CPT = CPT/HCPCS code (external value) ; MODL = list of CPT/HCPCS modifiers (external value) ; delimited by commas ; FBCY = calendar year (4 digit) ; FBNONPBL ( optional): ; if $G(FBNONPBL)=0 then will make search among payable records only in #162.97 ; ignoring those non-payable ones with field #.08 NONPAYABLE = 1 ; if $G(FBNONPBL)=1 then will make search among all items in #162.97 ; ; Output ; FBCPT0 = zero node from file 162.97 OR "" if not covered ; FBCPTY0 = zero node from subfile 162.971 or "" if not covered |
|
| PROC1(CPTM,FBCY,FBNONPBL) | ; get procedure data for CPT-Modifier
; input ; CPTM - CPT Code - Modifier (e.g. 57335-TC or 57335) ; FBCY - 4 digit calendar year ; FBNONPBL ( optional): ; if $G(FBNONPBL)=0 then will make search among payable records only in #162.97 ; ignoring those non-payable ones with field #.08 NONPAYABLE = 1 ; if $G(FBNONPBL)=1 then will make search among all items in #162.97 ; output ; FBCPT0 = zero node from file 162.97 OR "" if not covered ; FBCPTY0 = zero node from subfile 162.971 or "" if not covered |
|
| ZIP(FBCY,ZIP) | ; get GPCIs
; Input ; FBCY = calendar year (4 digit) ; ZIP = zip code (5 digit external value) ; Output ; FBGPCIY0 = zero node from file 162.96 or "" if not found |
|
| CF(FBCY,FBDA) | ; get conversion factor
; Input ; FBCY = calendar year ; FBDA = optional conversion category (internal) ; Returns ; conversion factor from file 162.99 |
|
| CALC(FBCY,FAC,FBCPTY0,FBGPCIY0,FBCF) | ;
; Input ; FBCY = calendar year (4 digit) ; FAC = facility flag (0 or 1) ; FBCPTY0 = zero node from file 162.71 ; FBGPCI0 = zero node from file 162.61 ; FBCF = conversion factor (number) ; Returns $ amount |
|
| MULT(FBCY,MODL,FBCPT0,FBCPTY0) | ;returns multiplier based on table type
; Input ; FBCY = calendar year (4 digit) ; MODL = list of CPT/HCPCS modifiers (external values) ; delimited by commas ; FBCPT0 = zero node of file 162.7 for procedure ; FBCPTY0 = zero node of subfile 162.71 for year ; Returns ; multiplier value OR 1 if none |
|
| LASTCY() | ; Determine last calendar year of RBRVS FEE schedule data
; based on last year for Medicine conversion factor |
|
| ADJ(CPT,DOS) | ;Apply Adjustments to Fee Amount
|
| Name | Line Occurrences (* Changed, ! Killed) |
|---|---|
| ^FB(162.96 - [#162.96] | ZIP+9, ZIP+10, ZIP+11 |
| ^FB(162.97 - [#162.97] | PROC1+13, PROC1+14, PROC1+17, PROC1+27 |
| ^FB(162.98 - [#162.98] | MULT+14, MULT+20, MULT+22 |
| ^FB(162.99 - [#162.99] | CF+8, CF+9, LASTCY+3 |
| Name | Line Occurrences |
|---|---|
| $$ADJ | RBRVS+68 |
| $$CF | RBRVS+60 |
| $$LASTCY | RBRVS+38 |
| $$MULT | RBRVS+70 |
| CALC | RBRVS+64 |
| PROC | RBRVS+41 |
| PROC1 | PROC+22, PROC+25 |
| ZIP | RBRVS+56 |
| >> | Not killed explicitly |
| * | Changed |
| ! | Killed |
| ~ | Newed |
| Name | Field # of Occurrence |
|---|---|
| ADJ | ADJ+3~, ADJ+4*, ADJ+5*, ADJ+6*, ADJ+7 |
| CPT | RBRVS~, RBRVS+21, RBRVS+41, RBRVS+48, RBRVS+68, PROC~, PROC+16, PROC+21, PROC+25, ADJ~ , ADJ+5, ADJ+6 |
| CPTM | PROC+14~, PROC+21*, PROC+22, PROC1~, PROC1+13, PROC1+22, PROC1+23 |
| DOS | RBRVS~, RBRVS+22, RBRVS+26, RBRVS+32, RBRVS+35, RBRVS+68, CALC+12, CALC+14, CALC+19, CALC+25 , ADJ~, ADJ+5, ADJ+6 |
| FAC | RBRVS~, RBRVS+52, RBRVS+64, CALC~, CALC+27, CALC+35 |
| FBAMT | RBRVS+14~, RBRVS+17*, RBRVS+23, RBRVS+26, RBRVS+29, RBRVS+67*, RBRVS+68*, RBRVS+70*, RBRVS+73, CALC+10* , CALC+30*, CALC+35* |
| FBCF | RBRVS+14~, RBRVS+60*, RBRVS+61, RBRVS+64, CF+6~, CF+9*, CF+10, CALC~, CALC+30 |
| FBCPT0 | RBRVS+14~, RBRVS+60, RBRVS+70, PROC+15*, PROC1+12*, PROC1+27*, MULT~, MULT+18 |
| FBCPTY0 | RBRVS+14~, RBRVS+48, RBRVS+64, RBRVS+70, PROC+15*, PROC+20, PROC+25, PROC1+12*, PROC1+26*, CALC~ , CALC+13, CALC+17, CALC+22, CALC+26, CALC+27, CALC+28, MULT~, MULT+11 |
| FBCY | RBRVS+14~, RBRVS+32*, RBRVS+35*, RBRVS+38*, RBRVS+41, RBRVS+56, RBRVS+60, RBRVS+64, RBRVS+70, RBRVS+73 , PROC~, PROC+16, PROC+22, PROC+25, PROC1~, PROC1+14, ZIP~, ZIP+7, ZIP+10, CF~ , CF+8, CALC~, MULT~, MULT+12, MULT+13 |
| FBDA | PROC1+11~, PROC1+13*, PROC1+14, PROC1+15, PROC1+17, PROC1+27, ZIP+8~, ZIP+9*, ZIP+10, ZIP+11 , CF~, CF+7*, CF+8, CF+9, MULT+9~, MULT+14*, MULT+15, MULT+20, MULT+22 |
| FBDA1 | PROC1+11~, PROC1+14*, PROC1+15, PROC1+17, ZIP+8~, ZIP+10*, ZIP+11, CF+6~, CF+8*, CF+9 , MULT+9~, MULT+20*, MULT+21, MULT+22 |
| FBERR | RBRVS+14~, RBRVS+18!, RBRVS+23, RBRVS+53 |
| FBGPCIY0 | RBRVS+14~, RBRVS+57, RBRVS+64, ZIP+6*, ZIP+11*, CALC~, CALC+29 |
| FBI | PROC+14~, PROC+20*, PROC1+16~, PROC1+24*, CALC+9~, CALC+29*, MULT+9~, MULT+17* |
| FBML | MULT+9~, MULT+11*, MULT+12, MULT+13 |
| FBNONPBL | PROC~, PROC+22, PROC+25, PROC1~, PROC1+20, PROC1+22, PROC1+23 |
| FBPD | MULT+9~, MULT+22*, MULT+23 |
| FBRET | MULT+9~, MULT+10*, MULT+23*, MULT+24 |
| FBSUM | PROC1+16~, PROC1+23, PROC1+24* |
| FBTBL | MULT+9~, MULT+13*, MULT+14 |
| FBY | PROC1+16~, PROC1+17*, PROC1+20, PROC1+22, PROC1+24, PROC1+26 |
| GPCI | CALC+9~ |
| GPCI( | CALC+29* |
| GPCI(1 | CALC+30 |
| GPCI(2 | CALC+30 |
| GPCI(3 | CALC+30 |
| MOD | PROC+14~, PROC+20*, PROC+21, MULT+9~, MULT+17*, MULT+18, MULT+20 |
| MODL | RBRVS~, RBRVS+29, RBRVS+41, RBRVS+70, PROC~, PROC+19, PROC+20, MULT~, MULT+12, MULT+17 |
| RVU | CALC+9~ |
| RVU(1 | CALC+13*, CALC+18*, CALC+23*, CALC+26*, CALC+30 |
| RVU(2 | CALC+27*, CALC+30, CALC+35 |
| RVU(3 | CALC+28*, CALC+30 |
| TIME | RBRVS~ |
| TMP | CALC+9~, CALC+17*, CALC+22* |
| TMPRVU | CALC+9~, CALC+17*, CALC+18, CALC+22*, CALC+23 |
| U | RBRVS+60, RBRVS+73, PROC1+20, PROC1+22, PROC1+24, CF+9, CALC+13, CALC+17, CALC+22, CALC+26 , CALC+27, CALC+28, CALC+29, MULT+11, MULT+18, MULT+22 |
| YEAR | LASTCY+2~, LASTCY+3*, LASTCY+4 |
| ZIP | RBRVS~, RBRVS+51, RBRVS+56, ZIP~, ZIP+7, ZIP+9 |
