IB20P619 ;ALB/CXW - REMOVE TC MODIFIER FOR MEDICARE ;02/08/2018
;;2.0;INTEGRATED BILLING;**619**;21-MAR-94;Build 34
;;Per VA Directive 6402, this routine should not be modified.
Q
POST ;
N IBZ,U S U="^"
D MSG(" IB*2.0*619 Post-Install starts .....")
D MSG(""),RMTC,MSG("")
D MSG(" IB*2.0*619 Post-Install is complete.")
Q
;
RMTC ; Remove TC modifier for Medicare in file (#399)
N IBA,IBBCT,IBBCPT,IBCHG,IBCNT,IBEDT,IBFND,IBIFN,IBLN,IBMCR,IBMODS,IBTC,IBVDT,IB26
; effective date 01/11/18 of TC modifier auto added to institutional claims
S IBCNT=0,IBEDT=3180110
S IBTC=+$$MOD^ICPTMOD("TC","E") I IBTC<1 D MSG("TC Modifier not defined, the BILL/CLAIMS (#399) file not updated") Q
S IB26=+$$MOD^ICPTMOD("26","E") I IB26<1 D MSG("26 Modifier not defined, the BILL/CLAIMS (#399) file not updated") Q
F S IBEDT=$O(^DGCR(399,"D",IBEDT)) Q:'IBEDT S IBIFN=0 D
. F S IBIFN=$O(^DGCR(399,"D",IBEDT,IBIFN)) Q:'IBIFN S IBFND=0 D
.. S IBA=$G(^DGCR(399,IBIFN,0)) Q:IBA=""
.. S IBBCT=$P(IBA,U,27) Q:'IBBCT
.. ; Medicare claim or quit
.. S IBMCR=$$MCRB(IBIFN) Q:'IBMCR
.. S IBBCPT=0 F S IBBCPT=$O(^DGCR(399,IBIFN,"CP",IBBCPT)) Q:'IBBCPT D
... S IBLN=$G(^DGCR(399,IBIFN,"CP",IBBCPT,0)) Q:IBLN'[";ICPT("
... S IBVDT=$P(IBLN,U,2)
... S IBCHG=$$CHGMOD^IBCRCU1(IBIFN,+IBLN,IBVDT,2)
... I (+IBCHG'=1)!(+$P(IBCHG,":",3)'=IB26) Q
... S IBMODS=","_$$GETMOD^IBEFUNC(IBIFN,IBBCPT)_","
... ; institutional charge type, tc modifier
... I IBBCT=1,$F(IBMODS,","_IBTC_",") D DELMOD^IBCU73(IBIFN,IBBCPT,IBTC) S IBFND=1
.. S:IBFND IBCNT=IBCNT+1
D MSG("TC modifier removed for Medicare on total "_IBCNT_" bill"_$S(IBCNT'=1:"s",1:"")_" of the BILL/CLAIMS (#399) file")
Q
MSG(IBZ) ;
D MES^XPDUTL(IBZ)
Q
;
MCRB(IBIFN) ; No TC modifier for Medicare
; input-IBIFN, output-1 if payer sequence is primary and 1st or 2nd payer is Medicare, otherwise 0
N IBMCR,IBCOB S IBMCR=0
S IBCOB=$$COBN^IBCEF(IBIFN)
I IBCOB=1 I ($$WNRBILL^IBEFUNC(IBIFN,1))!($$WNRBILL^IBEFUNC(IBIFN,2)) S IBMCR=1
Q IBMCR
;
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HIB20P619 2048 printed Apr 09, 2024@21:23:52 Page 2
IB20P619 ;ALB/CXW - REMOVE TC MODIFIER FOR MEDICARE ;02/08/2018
+1 ;;2.0;INTEGRATED BILLING;**619**;21-MAR-94;Build 34
+2 ;;Per VA Directive 6402, this routine should not be modified.
+3 QUIT
POST ;
+1 NEW IBZ,U
SET U="^"
+2 DO MSG(" IB*2.0*619 Post-Install starts .....")
+3 DO MSG("")
DO RMTC
DO MSG("")
+4 DO MSG(" IB*2.0*619 Post-Install is complete.")
+5 QUIT
+6 ;
RMTC ; Remove TC modifier for Medicare in file (#399)
+1 NEW IBA,IBBCT,IBBCPT,IBCHG,IBCNT,IBEDT,IBFND,IBIFN,IBLN,IBMCR,IBMODS,IBTC,IBVDT,IB26
+2 ; effective date 01/11/18 of TC modifier auto added to institutional claims
+3 SET IBCNT=0
SET IBEDT=3180110
+4 SET IBTC=+$$MOD^ICPTMOD("TC","E")
IF IBTC<1
DO MSG("TC Modifier not defined, the BILL/CLAIMS (#399) file not updated")
QUIT
+5 SET IB26=+$$MOD^ICPTMOD("26","E")
IF IB26<1
DO MSG("26 Modifier not defined, the BILL/CLAIMS (#399) file not updated")
QUIT
+6 FOR
SET IBEDT=$ORDER(^DGCR(399,"D",IBEDT))
if 'IBEDT
QUIT
SET IBIFN=0
Begin DoDot:1
+7 FOR
SET IBIFN=$ORDER(^DGCR(399,"D",IBEDT,IBIFN))
if 'IBIFN
QUIT
SET IBFND=0
Begin DoDot:2
+8 SET IBA=$GET(^DGCR(399,IBIFN,0))
if IBA=""
QUIT
+9 SET IBBCT=$PIECE(IBA,U,27)
if 'IBBCT
QUIT
+10 ; Medicare claim or quit
+11 SET IBMCR=$$MCRB(IBIFN)
if 'IBMCR
QUIT
+12 SET IBBCPT=0
FOR
SET IBBCPT=$ORDER(^DGCR(399,IBIFN,"CP",IBBCPT))
if 'IBBCPT
QUIT
Begin DoDot:3
+13 SET IBLN=$GET(^DGCR(399,IBIFN,"CP",IBBCPT,0))
if IBLN'[";ICPT("
QUIT
+14 SET IBVDT=$PIECE(IBLN,U,2)
+15 SET IBCHG=$$CHGMOD^IBCRCU1(IBIFN,+IBLN,IBVDT,2)
+16 IF (+IBCHG'=1)!(+$PIECE(IBCHG,":",3)'=IB26)
QUIT
+17 SET IBMODS=","_$$GETMOD^IBEFUNC(IBIFN,IBBCPT)_","
+18 ; institutional charge type, tc modifier
+19 IF IBBCT=1
IF $FIND(IBMODS,","_IBTC_",")
DO DELMOD^IBCU73(IBIFN,IBBCPT,IBTC)
SET IBFND=1
End DoDot:3
+20 if IBFND
SET IBCNT=IBCNT+1
End DoDot:2
End DoDot:1
+21 DO MSG("TC modifier removed for Medicare on total "_IBCNT_" bill"_$SELECT(IBCNT'=1:"s",1:"")_" of the BILL/CLAIMS (#399) file")
+22 QUIT
MSG(IBZ) ;
+1 DO MES^XPDUTL(IBZ)
+2 QUIT
+3 ;
MCRB(IBIFN) ; No TC modifier for Medicare
+1 ; input-IBIFN, output-1 if payer sequence is primary and 1st or 2nd payer is Medicare, otherwise 0
+2 NEW IBMCR,IBCOB
SET IBMCR=0
+3 SET IBCOB=$$COBN^IBCEF(IBIFN)
+4 IF IBCOB=1
IF ($$WNRBILL^IBEFUNC(IBIFN,1))!($$WNRBILL^IBEFUNC(IBIFN,2))
SET IBMCR=1
+5 QUIT IBMCR
+6 ;
