- 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 23, 2025@18:18:36 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 ;
