IBAECI ;ALB/BGA-LONG TERM CARE INPATIENT TRACKER ; 09-OCT-01
;;2.0;INTEGRATED BILLING;**164,171,176,198,188**;21-MAR-94
;; Per VHA Directive 10-93-142, this routine should not be modified
;
; This routine is called from ^IBAMTD and tracks all patient movements
; that are related to Long Term Care (LTC). If the Episode of care is
; related to LTC the episode of care is stored in ^IBA(351.8 and will
; be further screen when the Monthly Job is run and than Priced.
;
;
EN ; Main Entry Point
;
; === When IBALTC=0 episode not LTC billable so passed to MTC Module
; IBALTC=1 episode is LTC Billable do NOT passed to MTC Module
;
S IBALTC=0
I $G(DGPMA)="",$G(DGPMP)="" Q
I DT<$$STDATE^IBAECU1() Q ;quit if today<effective date
N IBCL,IBDT,IBDTA,IBLTCST,IBT,IBTS,IBX,IBY,IBZ,IBM,IBV,IBE
;
S IBV=$S($L($G(DGPMP)):"DGPMP",1:"DGPMA") D:+$G(@IBV)>0
. N IBDT S IBDT=+$G(@IBV)\1
. N VAIP S VAIP("D")=IBDT_.2359 D IN5^VADPT I $P($$TREATSP^IBAECU2($P($G(^DIC(45.7,+VAIP(8),0)),U,2)),"^",1)="L" D BACKBIL Q
. I +$G(VAIP(1))>0 S VAIP(1)=$$ORIGADM^IBAECN1(VAIP(1)) I $$ISLTC4DT^IBAECN1(DFN,+$G(VAIP(1)),IBDT_.2359)=1 D BACKBIL
; is this related to LTC
S IBX=0 F S IBX=$O(^UTILITY("DGPM",$J,6,IBX)) Q:IBX<1 F IBY="A","P" S IBTS=$P($G(^UTILITY("DGPM",$J,6,IBX,IBY)),"^",9) I IBTS,$$LTCSPEC^IBAECU(+$$FACSPEC^IBAECU(IBTS)) S IBALTC=1
I IBALTC=0 I $D(^UTILITY("DGPM",$J,3)) D
. N VAIN,VAINDT S VAINDT=+$G(@IBV)\1 D INP^VADPT I $P($$TREATSP^IBAECU2($P($G(^DIC(45.7,+VAIN(3),0)),U,2)),"^",1)="L" S IBALTC=1
I 'IBALTC Q
;
; get the earliest date of care for this movement
S IBDT=+DGPMA
I DGPMP,(DGPMP<DGPMA!('IBDT)) S IBDT=+DGPMP S IBT=0 F S IBT=$O(^UTILITY($J,IBT)) Q:IBT<1 S IBX=DGPMDA-1 F S IBX=$O(^UTILITY($J,IBT,IBX)) Q:IBX<1 F IBZ="A","P" S IBDTA=+$G(^UTILITY($J,IBT,IBX,IBZ)) I IBDTA<IBDT S IBDT=IBDTA
;
; look up this patient's LTC status
S IBLTCST=+$$LTCST^IBAECU(DFN,IBDT\1,1)
;
; are they exempt from LTC care?
I IBLTCST=1 S IBALTC=1 Q
;
; no 1010EC send message and quit
I IBLTCST=0 D D XMNOEC^IBAECU(DFN,IBDT,.IBE) Q
. S IBV=$S($L($G(DGPMP)):"DGPMP",1:"DGPMA")
. S IBE(1)="",IBE(2)=" Event Type: Inpatient Movement "_$S(IBV="DGPMP"&($G(DGPMA)):"Edited",IBV="DGPMP":"Deleted",1:"Added")
. S IBE(3)="",IBE(4)="Event Action: "_$S($P(@IBV,"^",2)=1:"Admission",$P(@IBV,"^",2)=2:"Transfer",$P(@IBV,"^",2)=3:"Discharge",$P(@IBV,"^",2)=6:"Specialty Change",1:"")
. S IBE(5)="",IBE(6)=" Location: " D
. . I $P(@IBV,"^",6) S IBE(6)=IBE(6)_$P($G(^DIC(42,+$P(@IBV,"^",6),0)),"^") Q
. . I $P(@IBV,"^",14),$P($G(^UTILITY("DGPM",$J,1,$P(@IBV,"^",14),"A")),"^",6) S IBE(6)=IBE(6)_$P($G(^DIC(42,+$P(^("A"),"^",6),0)),"^") Q
. . I $P(@IBV,"^",14),$P($G(^UTILITY("DGPM",$J,1,$P(@IBV,"^",14),"P")),"^",6) S IBE(6)=IBE(6)_$P($G(^DIC(42,+$P(^("P"),"^",6),0)),"^")
. . I $P(@IBV,"^",14),$P($G(^DGPM(+$P(@IBV,"^",14),0)),"^",6) S IBE(6)=IBE(6)_$P($G(^DIC(42,+$P(^(0),"^",6),0)),"^") Q
. . S IBE(6)=IBE(6)_"Unknown"
;
D BACKBIL
;
; flag LTC for current events
S IBCL=$$CLOCK^IBAECU(DFN,$S(IBDT<$$STDATE^IBAECU1:$$STDATE^IBAECU1,1:IBDT\1))
;
Q
;
BACKBIL ;called from EN
; back billing issue? send message and quit
S IBV=$S($L($G(DGPMP)):"DGPMP",1:"DGPMA")
I $$LASTMJ^IBAECU()>0,$E(IBDT,1,5)<$E($$LASTMJ^IBAECU(),1,5) D D XMBACK^IBAECU(DFN,.IBM) Q
. S IBM(1)="A(n) Added." I $D(IBV),$D(@IBV) D
. . S IBM(1)="A(n) "_$S($P(@IBV,"^",2)=1:"Admission",$P(@IBV,"^",2)=2:"Transfer",$P(@IBV,"^",2)=3:"Discharge",$P(@IBV,"^",2)=6:"Specialty Change",1:"")_" was "_$S(IBV="DGPMP"&($G(DGPMA)):"Edited",IBV="DGPMP":"Deleted",1:"Added")_"."
. S IBM(2)=" ",IBM(3)="This may result in a Back Billing issue for LTC. You should review the"
. S IBM(4)="patient's records for "_$$FMTE^XLFDT(IBDT)_" to ensure correct billing."
. S IBM(5)="LTC Billing Clock and LTC charges may have to be manually adjusted."
Q
;
CALC ; tag for completion of manual adding of inpt charges
; requires DFN, IBCHG, IBEVDA, IBTO
;
N IBT,IBTYP,IBLOS,IBZ
;
; get the LOS
S IBZ=^IB(+IBEVDA,0),IBLOS=$$LOS^IBCU64($S($$BILDATE^IBAECN1>$P(IBZ,"^",17):$$BILDATE^IBAECN1,1:$P(IBZ,"^",17)),$$LASTDT^IBAECU(IBTO),2,$P($P(IBZ,"^",4),":",2))
;
; update the status
S IBLTCST=$$LTCST^IBAECU(DFN,IBTO,IBLOS) I IBLTCST<2 W !!," This patient is not LTC billable on the date." S IBY=-1 Q
;
; find the total amount already billed for mo
D TOT^IBAECU
;
W !!," Calculated Monthly Copay Cap Type to be used: INPATIENT ",$S(IBLOS<181:"< 181",1:"> 180")," days."
W !," Calculated Monthly Copay Cap is: $ ",$FN($P(IBLTCST,"^",$S(IBLOS<181:3,1:4)),",",2)
W !," Total previously billed: $ ",$FN(IBT,",",2)
;
I IBCHG+IBT>$P(IBLTCST,"^",$S(IBLOS<181:3,1:4)) S IBCHG=$P(IBLTCST,"^",$S(IBLOS<181:3,1:4))-IBT
;
; check for negative $ amount cap
I $P(IBLTCST,"^",$S(IBLOS<181:3,1:4))<0 S IBCHG=0
;
Q
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HIBAECI 4934 printed Sep 23, 2025@19:42:13 Page 2
IBAECI ;ALB/BGA-LONG TERM CARE INPATIENT TRACKER ; 09-OCT-01
+1 ;;2.0;INTEGRATED BILLING;**164,171,176,198,188**;21-MAR-94
+2 ;; Per VHA Directive 10-93-142, this routine should not be modified
+3 ;
+4 ; This routine is called from ^IBAMTD and tracks all patient movements
+5 ; that are related to Long Term Care (LTC). If the Episode of care is
+6 ; related to LTC the episode of care is stored in ^IBA(351.8 and will
+7 ; be further screen when the Monthly Job is run and than Priced.
+8 ;
+9 ;
EN ; Main Entry Point
+1 ;
+2 ; === When IBALTC=0 episode not LTC billable so passed to MTC Module
+3 ; IBALTC=1 episode is LTC Billable do NOT passed to MTC Module
+4 ;
+5 SET IBALTC=0
+6 IF $GET(DGPMA)=""
IF $GET(DGPMP)=""
QUIT
+7 ;quit if today<effective date
IF DT<$$STDATE^IBAECU1()
QUIT
+8 NEW IBCL,IBDT,IBDTA,IBLTCST,IBT,IBTS,IBX,IBY,IBZ,IBM,IBV,IBE
+9 ;
+10 SET IBV=$SELECT($LENGTH($GET(DGPMP)):"DGPMP",1:"DGPMA")
if +$GET(@IBV)>0
Begin DoDot:1
+11 NEW IBDT
SET IBDT=+$GET(@IBV)\1
+12 NEW VAIP
SET VAIP("D")=IBDT_.2359
DO IN5^VADPT
IF $PIECE($$TREATSP^IBAECU2($PIECE($GET(^DIC(45.7,+VAIP(8),0)),U,2)),"^",1)="L"
DO BACKBIL
QUIT
+13 IF +$GET(VAIP(1))>0
SET VAIP(1)=$$ORIGADM^IBAECN1(VAIP(1))
IF $$ISLTC4DT^IBAECN1(DFN,+$GET(VAIP(1)),IBDT_.2359)=1
DO BACKBIL
End DoDot:1
+14 ; is this related to LTC
+15 SET IBX=0
FOR
SET IBX=$ORDER(^UTILITY("DGPM",$JOB,6,IBX))
if IBX<1
QUIT
FOR IBY="A","P"
SET IBTS=$PIECE($GET(^UTILITY("DGPM",$JOB,6,IBX,IBY)),"^",9)
IF IBTS
IF $$LTCSPEC^IBAECU(+$$FACSPEC^IBAECU(IBTS))
SET IBALTC=1
+16 IF IBALTC=0
IF $DATA(^UTILITY("DGPM",$JOB,3))
Begin DoDot:1
+17 NEW VAIN,VAINDT
SET VAINDT=+$GET(@IBV)\1
DO INP^VADPT
IF $PIECE($$TREATSP^IBAECU2($PIECE($GET(^DIC(45.7,+VAIN(3),0)),U,2)),"^",1)="L"
SET IBALTC=1
End DoDot:1
+18 IF 'IBALTC
QUIT
+19 ;
+20 ; get the earliest date of care for this movement
+21 SET IBDT=+DGPMA
+22 IF DGPMP
IF (DGPMP<DGPMA!('IBDT))
SET IBDT=+DGPMP
SET IBT=0
FOR
SET IBT=$ORDER(^UTILITY($JOB,IBT))
if IBT<1
QUIT
SET IBX=DGPMDA-1
FOR
SET IBX=$ORDER(^UTILITY($JOB,IBT,IBX))
if IBX<1
QUIT
FOR IBZ="A","P"
SET IBDTA=+$GET(^UTILITY($JOB,IBT,IBX,IBZ))
IF IBDTA<IBDT
SET IBDT=IBDTA
+23 ;
+24 ; look up this patient's LTC status
+25 SET IBLTCST=+$$LTCST^IBAECU(DFN,IBDT\1,1)
+26 ;
+27 ; are they exempt from LTC care?
+28 IF IBLTCST=1
SET IBALTC=1
QUIT
+29 ;
+30 ; no 1010EC send message and quit
+31 IF IBLTCST=0
Begin DoDot:1
+32 SET IBV=$SELECT($LENGTH($GET(DGPMP)):"DGPMP",1:"DGPMA")
+33 SET IBE(1)=""
SET IBE(2)=" Event Type: Inpatient Movement "_$SELECT(IBV="DGPMP"&($GET(DGPMA)):"Edited",IBV="DGPMP":"Deleted",1:"Added")
+34 SET IBE(3)=""
SET IBE(4)="Event Action: "_$SELECT($PIECE(@IBV,"^",2)=1:"Admission",$PIECE(@IBV,"^",2)=2:"Transfer",$PIECE(@IBV,"^",2)=3:"Discharge",$PIECE(@IBV,"^",2)=6:"Specialty Change",1:"")
+35 SET IBE(5)=""
SET IBE(6)=" Location: "
Begin DoDot:2
+36 IF $PIECE(@IBV,"^",6)
SET IBE(6)=IBE(6)_$PIECE($GET(^DIC(42,+$PIECE(@IBV,"^",6),0)),"^")
QUIT
+37 IF $PIECE(@IBV,"^",14)
IF $PIECE($GET(^UTILITY("DGPM",$JOB,1,$PIECE(@IBV,"^",14),"A")),"^",6)
SET IBE(6)=IBE(6)_$PIECE($GET(^DIC(42,+$PIECE(^("A"),"^",6),0)),"^")
QUIT
+38 IF $PIECE(@IBV,"^",14)
IF $PIECE($GET(^UTILITY("DGPM",$JOB,1,$PIECE(@IBV,"^",14),"P")),"^",6)
SET IBE(6)=IBE(6)_$PIECE($GET(^DIC(42,+$PIECE(^("P"),"^",6),0)),"^")
+39 IF $PIECE(@IBV,"^",14)
IF $PIECE($GET(^DGPM(+$PIECE(@IBV,"^",14),0)),"^",6)
SET IBE(6)=IBE(6)_$PIECE($GET(^DIC(42,+$PIECE(^(0),"^",6),0)),"^")
QUIT
+40 SET IBE(6)=IBE(6)_"Unknown"
End DoDot:2
End DoDot:1
DO XMNOEC^IBAECU(DFN,IBDT,.IBE)
QUIT
+41 ;
+42 DO BACKBIL
+43 ;
+44 ; flag LTC for current events
+45 SET IBCL=$$CLOCK^IBAECU(DFN,$SELECT(IBDT<$$STDATE^IBAECU1:$$STDATE^IBAECU1,1:IBDT\1))
+46 ;
+47 QUIT
+48 ;
BACKBIL ;called from EN
+1 ; back billing issue? send message and quit
+2 SET IBV=$SELECT($LENGTH($GET(DGPMP)):"DGPMP",1:"DGPMA")
+3 IF $$LASTMJ^IBAECU()>0
IF $EXTRACT(IBDT,1,5)<$EXTRACT($$LASTMJ^IBAECU(),1,5)
Begin DoDot:1
+4 SET IBM(1)="A(n) Added."
IF $DATA(IBV)
IF $DATA(@IBV)
Begin DoDot:2
+5 SET IBM(1)="A(n) "_$SELECT($PIECE(@IBV,"^",2)=1:"Admission",$PIECE(@IBV,"^",2)=2:"Transfer",$PIECE(@IBV,"^",2)=3:"Discharge",$PIECE(@IBV,"^",2)=6:"Specialty Change",1:"")_" was "_...
... $SELECT(IBV="DGPMP"&($GET(DGPMA)):"Edited",IBV="DGPMP":"Deleted",1:"Added")_"."
End DoDot:2
+6 SET IBM(2)=" "
SET IBM(3)="This may result in a Back Billing issue for LTC. You should review the"
+7 SET IBM(4)="patient's records for "_$$FMTE^XLFDT(IBDT)_" to ensure correct billing."
+8 SET IBM(5)="LTC Billing Clock and LTC charges may have to be manually adjusted."
End DoDot:1
DO XMBACK^IBAECU(DFN,.IBM)
QUIT
+9 QUIT
+10 ;
CALC ; tag for completion of manual adding of inpt charges
+1 ; requires DFN, IBCHG, IBEVDA, IBTO
+2 ;
+3 NEW IBT,IBTYP,IBLOS,IBZ
+4 ;
+5 ; get the LOS
+6 SET IBZ=^IB(+IBEVDA,0)
SET IBLOS=$$LOS^IBCU64($SELECT($$BILDATE^IBAECN1>$P(IBZ,"^",17):$$BILDATE^IBAECN1,1:$PIECE(IBZ,"^",17)),$$LASTDT^IBAECU(IBTO),2,$PIECE($PIECE(IBZ,"^",4),":",2))
+7 ;
+8 ; update the status
+9 SET IBLTCST=$$LTCST^IBAECU(DFN,IBTO,IBLOS)
IF IBLTCST<2
WRITE !!," This patient is not LTC billable on the date."
SET IBY=-1
QUIT
+10 ;
+11 ; find the total amount already billed for mo
+12 DO TOT^IBAECU
+13 ;
+14 WRITE !!," Calculated Monthly Copay Cap Type to be used: INPATIENT ",$SELECT(IBLOS<181:"< 181",1:"> 180")," days."
+15 WRITE !," Calculated Monthly Copay Cap is: $ ",$FNUMBER($PIECE(IBLTCST,"^",$SELECT(IBLOS<181:3,1:4)),",",2)
+16 WRITE !," Total previously billed: $ ",$FNUMBER(IBT,",",2)
+17 ;
+18 IF IBCHG+IBT>$PIECE(IBLTCST,"^",$SELECT(IBLOS<181:3,1:4))
SET IBCHG=$PIECE(IBLTCST,"^",$SELECT(IBLOS<181:3,1:4))-IBT
+19 ;
+20 ; check for negative $ amount cap
+21 IF $PIECE(IBLTCST,"^",$SELECT(IBLOS<181:3,1:4))<0
SET IBCHG=0
+22 ;
+23 QUIT
