IBAUTL ;ALB/AAS - INTEGRATED BILLING APPLICATION UTILITIES ; 14-FEB-91
;;2.0;INTEGRATED BILLING;**93,156,347,429,563**;21-MAR-94;Build 12
;;Per VA Directive 6402, this routine should not be modified.
;
;
COST ; - find charges for transaction type, when only one
N IBD,IBN,IB K X1
S IBD=-($G(IBEFDT,DT)+.9)
F S IBD=$O(^IBE(350.2,"AIVDT",DA,IBD)) Q:'IBD S IBN=0 F S IBN=$O(^IBE(350.2,"AIVDT",DA,IBD,IBN)) Q:'IBN S IB=$G(^IBE(350.2,IBN,0)) I IB]"",$$TIEROK^IBAUTL(IB),'$P(IB,"^",5)!($P(IB,"^",5)>$G(IBEFDT,DT)) S X1=$P(IB,"^",4) G COSTQ
COSTQ S X1=+$G(X1)
I 'X1,$G(IBTIER),$D(^IBE(350.2,"AC",DA,2)) S IBTIER=2 G COST ;default foced tier
I 'IBN S Y="-1^IB029" Q
I $L($G(^IBE(350.2,IBN,20))) X ^(20) I S X1=X1+$P($G(^IBE(350.2,IBN,0)),"^",6)
Q
TIEROK(IB) ; - if there is a tier present, make sure it matches
; if not present it's OK
; IB = zero node of 350.2 from COST above
I '$D(IBTIER) Q 1
I $P(IB,"^",7)=IBTIER Q 1
Q 0
;
FY I $D(X) S IBAFY=$$FY^IBOUTL(X)
Q
;
PTL ; - parent trace logic
; - input in x resulting from field from file 350
; - output in y=1 if found, -1^error message if not found
; - y(0) = zeroth node of top level
; - y(1) = zeroth node of second level
; - y(n) = zeroth node of nth level
;
K Y
S Y=1 I '+X!'($D(^DIC(+X,0,"GL"))) S Y="-1^IB004" G PTLQ
I +X=52 G PHAPI
S IBAGL=^DIC(+X,0,"GL")
I '$D(@(IBAGL_$P($P(X,";",1),":",2)_",0)")) S Y="-1^IB005" G PTLQ
;
; This naked reference should be set to the original data source that
; is causing this charge to be created. The data source will be one of
; many different data sources that will generate patient charges.
S Y(0)=^(0)
;
F IBJJ=2:1 S IBII=$P(X,";",IBJJ) Q:IBII="" D PTL1
PTLQ K IBAGL,IBII,IBJJ,IBMIN
Q
;
PTL1 ; - find y(n) of sublevels
; Call in here with a FOR loop to go each level deeper. This will
; setup the subsripts in Y for all the data elements that go into
; causing this charge to be created. It looks in the original data
; source file as approprite to obtain the information. The naked
; reference should be the last data level in the data source appropriate
; data source file last looked up.
;
S IBMIN=$P(IBII,":") I IBMIN="" S Y="-1^IB006" Q
I '$D(^(IBMIN,$P(IBII,":",2),0)) S Y="-1^IB006" Q
;I '$D(^(+IBII,$P(IBII,":",2),0)) S Y="-1^IB006" Q
S Y(IBJJ-1)=^(0)
Q
;
CHKX ; - check input x
; - piece 1 = service and exists
; - peice 2 = patient and exists
; - piece 3 = action type
; - piece 4 = user duz
S DFN=$P(X,"^",2),IBSERV=+IBSAVX
I $S('DFN:1,'$D(^DPT(DFN,0)):1,1:0) S Y="-1^IB002" G CHKXQ ;patient pointer bad
I $S('IBSERV:1,'$D(^DIC(49,IBSERV,0)):1,1:0) S Y="-1^IB003" G CHKXQ ;service pointer bad
I IBTAG=1 G CHKXQ
S IBDUZ=$P(IBSAVX,"^",4) I $S('IBDUZ:1,'$D(^VA(200,IBDUZ,0)):1,1:0) S Y="-1^IB007" G CHKXQ
I IBTAG=3 G CHKXQ
S IBATYP=$P(IBSAVX,"^",3) I $S('IBATYP:1,'$D(^IBE(350.1,IBATYP,0)):1,1:0) S Y="-1^IB008"
CHKXQ Q
;
SITE ; - calculate site from site parameters
; - output ibsite = station number
; = ibfac = pointer to institution file
I '$D(^IBE(350.9,1,0)) S Y="-1^IB016" Q
S IBFAC=$P(^IBE(350.9,1,0),"^",2),IBSITE=$S('$D(^DIC(4,IBFAC,99)):"",1:+^(99)) I IBSITE<1 S Y="-1^IB009"
Q
;
ADD ; - add new entry to ^ib
;
N %DT,IBYCHK
L +^IB(0):10 I '$T S Y="-1^IB014" G ADDQ
S X=$P($S($D(^IB(0)):^(0),1:"^^-1"),"^",3)+1 L -^IB(0) I 'X S Y="-1^IB015" G ADDQ
K DD,DO,DIC,DR S DIC="^IB(",DIC(0)="L",DLAYGO=350
F X=X:1 L:$D(IBN1) -^IB(IBN1) I X>0,'$D(^IB(X)) S IBN1=X L +^IB(IBN1):1 I $T,'$D(^IB(X)) S DINUM=X,X=+IBSITE_X D FILE^DICN I +Y>0 Q
S IBN=+Y,DIE="^IB(",DA=IBN,DR=".02////"_$S($D(DFN):DFN,1:"")_";.03////"_$S($D(IBATYP):IBATYP,1:"")_";.05////1;12///NOW" D
. N Y D ^DIE K DA,DR,DIE I $D(Y) S IBYCHK=Y
L -^IB(IBN1)
S Y=$S('$D(IBYCHK):1,1:"-1^IB028")
;
ADDQ K DO,DD,DINUM,DIC,IBN1 Q
;
ARPARM N X S X=DT
D SITE,FY,NOW^%DTC S IBNOW=%
Q
BILLNO ; -get open bill number
I '$G(IBTOTL) S (IBIL,IBTRAN)="" G BILLQ
S IBARTYP=$S($D(^IBE(350.1,+IBATYP,0)):$P(^(0),"^",3),1:"")
S X=IBSITE_"^"_IBSERV_"^"_IBARTYP_"^"_DFN_";DPT("_"^"_IBAFY_"^"_$S($D(IBTOTL):IBTOTL,1:0)_"^"_$S($D(IBDUZ):IBDUZ,$D(DUZ):DUZ,1:0)_"^"_$P(IBNOW,".",1) D ^PRCASER I +Y<1 G BILLQ
S IBIL=$P(Y,"^",2),IBTRAN=$P(Y,"^",3) I IBIL="" S Y="-1^IB011" G BILLQ
S IBTRAN=$S(IBTRAN>0:IBTRAN,1:"")
BILLQ Q
;
PHAPI ;
;This is alternate code for Parent Trace Logic
; to deal with the Pharmacy Encapsulation of Prescription File (#52)
;
N IBRFL,IBXX,IBPT,IBRX,IBY
S IBXX=X,IBY=1
S IBRX=$P($P(IBXX,";"),":",2)
S IBPT=$$FILE^IBRXUTL(IBRX,2),IBY(0)=$$RXZERO^IBRXUTL(IBPT,IBRX) I IBY(0)="" S IBY="-1^IB005" G PHAPIQ
I $P(IBXX,";",2)="" G PHAPIQ ; original fill being billed
S IBRFL=$P($P(IBXX,";",2),":",2),IBY(1)=$$ZEROSUB^IBRXUTL(IBPT,IBRX,IBRFL)
I IBY(1)="" S IBY="-1^IB006" G PHAPIQ
;
PHAPIQ ;
S:$G(IBY)]"" Y=IBY
S:$G(IBY(0))]"" Y(0)=IBY(0)
S:$G(IBY(1))]"" Y(1)=IBY(1)
Q
;
RXTIER(DFN,IBRX,IBEFDT) ; - look up the tier of the prescription
; returns the tier level of the specified prescription
; the existence of the IBTIER variable means it is already determined elsewhere and we'll just use that value
; default tier is always 2
;
N IBR
I $D(IBTIER) Q IBTIER
I '$G(IBRX) Q 2
I $T(CPTIER^PSNAPIS)="" Q 2
S IBR=$$RXZERO^IBRXUTL(DFN,IBRX)
S IBR=$S($P(IBR,"^",6):$$DRUGF^IBRXUTL1($P(IBR,"^",6),22),1:0)
S IBR=$S(IBR:$$CPTIER^PSNAPIS(+IBR,IBEFDT),1:2)
I IBR="" S IBR=2
Q +IBR
;
ARCOST(DFN,DA,IBX) ; api for AR to look up the charge of a med
; input: DFN = patient pointer
; DA = 350.1 pointer
; IBX = Rx IEN
; output: returns the single 30 day supply charge amount
; assumption, since AR is all about today, DT is used for the date
;
N IBEFDT,X1,IBTIER
S IBTIER=$$RXTIER(DFN,IBX,DT)
S IBX=":"_IBX
D COST
Q X1
;
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HIBAUTL 5932 printed Apr 09, 2024@21:14:16 Page 2
IBAUTL ;ALB/AAS - INTEGRATED BILLING APPLICATION UTILITIES ; 14-FEB-91
+1 ;;2.0;INTEGRATED BILLING;**93,156,347,429,563**;21-MAR-94;Build 12
+2 ;;Per VA Directive 6402, this routine should not be modified.
+3 ;
+4 ;
COST ; - find charges for transaction type, when only one
+1 NEW IBD,IBN,IB
KILL X1
+2 SET IBD=-($GET(IBEFDT,DT)+.9)
+3 FOR
SET IBD=$ORDER(^IBE(350.2,"AIVDT",DA,IBD))
if 'IBD
QUIT
SET IBN=0
FOR
SET IBN=$ORDER(^IBE(350.2,"AIVDT",DA,IBD,IBN))
if 'IBN
QUIT
SET IB=$GET(^IBE(350.2,IBN,0))
IF IB]""
IF $$TIEROK^IBAUTL(IB)
IF '$PIECE(IB,"^",5)!($PIECE(IB,"^",5)>$GET(IBEFDT,DT))
SET X1=$PIECE(IB,"^",4)
GOTO COSTQ
COSTQ SET X1=+$GET(X1)
+1 ;default foced tier
IF 'X1
IF $GET(IBTIER)
IF $DATA(^IBE(350.2,"AC",DA,2))
SET IBTIER=2
GOTO COST
+2 IF 'IBN
SET Y="-1^IB029"
QUIT
+3 IF $LENGTH($GET(^IBE(350.2,IBN,20)))
XECUTE ^(20)
IF $TEST
SET X1=X1+$PIECE($GET(^IBE(350.2,IBN,0)),"^",6)
+4 QUIT
TIEROK(IB) ; - if there is a tier present, make sure it matches
+1 ; if not present it's OK
+2 ; IB = zero node of 350.2 from COST above
+3 IF '$DATA(IBTIER)
QUIT 1
+4 IF $PIECE(IB,"^",7)=IBTIER
QUIT 1
+5 QUIT 0
+6 ;
FY IF $DATA(X)
SET IBAFY=$$FY^IBOUTL(X)
+1 QUIT
+2 ;
PTL ; - parent trace logic
+1 ; - input in x resulting from field from file 350
+2 ; - output in y=1 if found, -1^error message if not found
+3 ; - y(0) = zeroth node of top level
+4 ; - y(1) = zeroth node of second level
+5 ; - y(n) = zeroth node of nth level
+6 ;
+7 KILL Y
+8 SET Y=1
IF '+X!'($DATA(^DIC(+X,0,"GL")))
SET Y="-1^IB004"
GOTO PTLQ
+9 IF +X=52
GOTO PHAPI
+10 SET IBAGL=^DIC(+X,0,"GL")
+11 IF '$DATA(@(IBAGL_$PIECE($PIECE(X,";",1),":",2)_",0)"))
SET Y="-1^IB005"
GOTO PTLQ
+12 ;
+13 ; This naked reference should be set to the original data source that
+14 ; is causing this charge to be created. The data source will be one of
+15 ; many different data sources that will generate patient charges.
+16 SET Y(0)=^(0)
+17 ;
+18 FOR IBJJ=2:1
SET IBII=$PIECE(X,";",IBJJ)
if IBII=""
QUIT
DO PTL1
PTLQ KILL IBAGL,IBII,IBJJ,IBMIN
+1 QUIT
+2 ;
PTL1 ; - find y(n) of sublevels
+1 ; Call in here with a FOR loop to go each level deeper. This will
+2 ; setup the subsripts in Y for all the data elements that go into
+3 ; causing this charge to be created. It looks in the original data
+4 ; source file as approprite to obtain the information. The naked
+5 ; reference should be the last data level in the data source appropriate
+6 ; data source file last looked up.
+7 ;
+8 SET IBMIN=$PIECE(IBII,":")
IF IBMIN=""
SET Y="-1^IB006"
QUIT
+9 IF '$DATA(^(IBMIN,$PIECE(IBII,":",2),0))
SET Y="-1^IB006"
QUIT
+10 ;I '$D(^(+IBII,$P(IBII,":",2),0)) S Y="-1^IB006" Q
+11 SET Y(IBJJ-1)=^(0)
+12 QUIT
+13 ;
CHKX ; - check input x
+1 ; - piece 1 = service and exists
+2 ; - peice 2 = patient and exists
+3 ; - piece 3 = action type
+4 ; - piece 4 = user duz
+5 SET DFN=$PIECE(X,"^",2)
SET IBSERV=+IBSAVX
+6 ;patient pointer bad
IF $SELECT('DFN:1,'$DATA(^DPT(DFN,0)):1,1:0)
SET Y="-1^IB002"
GOTO CHKXQ
+7 ;service pointer bad
IF $SELECT('IBSERV:1,'$DATA(^DIC(49,IBSERV,0)):1,1:0)
SET Y="-1^IB003"
GOTO CHKXQ
+8 IF IBTAG=1
GOTO CHKXQ
+9 SET IBDUZ=$PIECE(IBSAVX,"^",4)
IF $SELECT('IBDUZ:1,'$DATA(^VA(200,IBDUZ,0)):1,1:0)
SET Y="-1^IB007"
GOTO CHKXQ
+10 IF IBTAG=3
GOTO CHKXQ
+11 SET IBATYP=$PIECE(IBSAVX,"^",3)
IF $SELECT('IBATYP:1,'$DATA(^IBE(350.1,IBATYP,0)):1,1:0)
SET Y="-1^IB008"
CHKXQ QUIT
+1 ;
SITE ; - calculate site from site parameters
+1 ; - output ibsite = station number
+2 ; = ibfac = pointer to institution file
+3 IF '$DATA(^IBE(350.9,1,0))
SET Y="-1^IB016"
QUIT
+4 SET IBFAC=$PIECE(^IBE(350.9,1,0),"^",2)
SET IBSITE=$SELECT('$DATA(^DIC(4,IBFAC,99)):"",1:+^(99))
IF IBSITE<1
SET Y="-1^IB009"
+5 QUIT
+6 ;
ADD ; - add new entry to ^ib
+1 ;
+2 NEW %DT,IBYCHK
+3 LOCK +^IB(0):10
IF '$TEST
SET Y="-1^IB014"
GOTO ADDQ
+4 SET X=$PIECE($SELECT($DATA(^IB(0)):^(0),1:"^^-1"),"^",3)+1
LOCK -^IB(0)
IF 'X
SET Y="-1^IB015"
GOTO ADDQ
+5 KILL DD,DO,DIC,DR
SET DIC="^IB("
SET DIC(0)="L"
SET DLAYGO=350
+6 FOR X=X:1
if $DATA(IBN1)
LOCK -^IB(IBN1)
IF X>0
IF '$DATA(^IB(X))
SET IBN1=X
LOCK +^IB(IBN1):1
IF $TEST
IF '$DATA(^IB(X))
SET DINUM=X
SET X=+IBSITE_X
DO FILE^DICN
IF +Y>0
QUIT
+7 SET IBN=+Y
SET DIE="^IB("
SET DA=IBN
SET DR=".02////"_$SELECT($DATA(DFN):DFN,1:"")_";.03////"_$SELECT($DATA(IBATYP):IBATYP,1:"")_";.05////1;12///NOW"
Begin DoDot:1
+8 NEW Y
DO ^DIE
KILL DA,DR,DIE
IF $DATA(Y)
SET IBYCHK=Y
End DoDot:1
+9 LOCK -^IB(IBN1)
+10 SET Y=$SELECT('$DATA(IBYCHK):1,1:"-1^IB028")
+11 ;
ADDQ KILL DO,DD,DINUM,DIC,IBN1
QUIT
+1 ;
ARPARM NEW X
SET X=DT
+1 DO SITE
DO FY
DO NOW^%DTC
SET IBNOW=%
+2 QUIT
BILLNO ; -get open bill number
+1 IF '$GET(IBTOTL)
SET (IBIL,IBTRAN)=""
GOTO BILLQ
+2 SET IBARTYP=$SELECT($DATA(^IBE(350.1,+IBATYP,0)):$PIECE(^(0),"^",3),1:"")
+3 SET X=IBSITE_"^"_IBSERV_"^"_IBARTYP_"^"_DFN_";DPT("_"^"_IBAFY_"^"_$SELECT($DATA(IBTOTL):IBTOTL,1:0)_"^"_$SELECT($DATA(IBDUZ):IBDUZ,$DATA(DUZ):DUZ,1:0)_"^"_$PIECE(IBNOW,".",1)
DO ^PRCASER
IF +Y<1
GOTO BILLQ
+4 SET IBIL=$PIECE(Y,"^",2)
SET IBTRAN=$PIECE(Y,"^",3)
IF IBIL=""
SET Y="-1^IB011"
GOTO BILLQ
+5 SET IBTRAN=$SELECT(IBTRAN>0:IBTRAN,1:"")
BILLQ QUIT
+1 ;
PHAPI ;
+1 ;This is alternate code for Parent Trace Logic
+2 ; to deal with the Pharmacy Encapsulation of Prescription File (#52)
+3 ;
+4 NEW IBRFL,IBXX,IBPT,IBRX,IBY
+5 SET IBXX=X
SET IBY=1
+6 SET IBRX=$PIECE($PIECE(IBXX,";"),":",2)
+7 SET IBPT=$$FILE^IBRXUTL(IBRX,2)
SET IBY(0)=$$RXZERO^IBRXUTL(IBPT,IBRX)
IF IBY(0)=""
SET IBY="-1^IB005"
GOTO PHAPIQ
+8 ; original fill being billed
IF $PIECE(IBXX,";",2)=""
GOTO PHAPIQ
+9 SET IBRFL=$PIECE($PIECE(IBXX,";",2),":",2)
SET IBY(1)=$$ZEROSUB^IBRXUTL(IBPT,IBRX,IBRFL)
+10 IF IBY(1)=""
SET IBY="-1^IB006"
GOTO PHAPIQ
+11 ;
PHAPIQ ;
+1 if $GET(IBY)]""
SET Y=IBY
+2 if $GET(IBY(0))]""
SET Y(0)=IBY(0)
+3 if $GET(IBY(1))]""
SET Y(1)=IBY(1)
+4 QUIT
+5 ;
RXTIER(DFN,IBRX,IBEFDT) ; - look up the tier of the prescription
+1 ; returns the tier level of the specified prescription
+2 ; the existence of the IBTIER variable means it is already determined elsewhere and we'll just use that value
+3 ; default tier is always 2
+4 ;
+5 NEW IBR
+6 IF $DATA(IBTIER)
QUIT IBTIER
+7 IF '$GET(IBRX)
QUIT 2
+8 IF $TEXT(CPTIER^PSNAPIS)=""
QUIT 2
+9 SET IBR=$$RXZERO^IBRXUTL(DFN,IBRX)
+10 SET IBR=$SELECT($PIECE(IBR,"^",6):$$DRUGF^IBRXUTL1($PIECE(IBR,"^",6),22),1:0)
+11 SET IBR=$SELECT(IBR:$$CPTIER^PSNAPIS(+IBR,IBEFDT),1:2)
+12 IF IBR=""
SET IBR=2
+13 QUIT +IBR
+14 ;
ARCOST(DFN,DA,IBX) ; api for AR to look up the charge of a med
+1 ; input: DFN = patient pointer
+2 ; DA = 350.1 pointer
+3 ; IBX = Rx IEN
+4 ; output: returns the single 30 day supply charge amount
+5 ; assumption, since AR is all about today, DT is used for the date
+6 ;
+7 NEW IBEFDT,X1,IBTIER
+8 SET IBTIER=$$RXTIER(DFN,IBX,DT)
+9 SET IBX=":"_IBX
+10 DO COST
+11 QUIT X1
+12 ;
