- IBCBB8 ;ALB/BGA - CON'T MEDICARE EDIT CHECKS ;08/12/98
- ;;2.0;INTEGRATED BILLING;**51,137,210,349,373**;21-MAR-94;Build 6
- ;;Per VHA Directive 2004-038, this routine should not be modified.
- ;
- ; UB-04 CLAIM CERTIFICATE ID NUMBER
- I '$$VALID(IBIFN) S IBQUIT=$$IBER^IBCBB3(.IBER,215) Q:IBQUIT
- ;
- ; Req. on Primary Payor when Medicare is secondary and value 12-15,43
- I $$COBN^IBCEF(IBIFN)=2 D Q:IBQUIT
- . I $O(IBVALCD(16),-1)'<12!$D(IBVALCD(43)) D
- . . K IBXDATA D F^IBCEF("N-ALL INSURED EMPLOYER INFO",,,IBIFN)
- . . ; employer name^city^state abbreviation^state ien
- . . ;I '$O(IBXDATA(0)) S IBQUIT=$$IBER^IBCBB3(.IBER,222) Q
- . . ; Employer name missing
- . . ;I $P($G(IBXDATA(1)),U)="" S IBQUIT=$$IBER^IBCBB3(.IBER,222)
- . . ; Employer address missing
- . . ;I $TR($P($G(IBXDATA(1)),U,2,4),U)="" S IBQUIT=$$IBER^IBCBB3(.IBER,223)
- . ;
- . ; Insured's Group Number
- . ; if Medicare is secondary, need insurance group number for primary
- . K IBXDATA D F^IBCEF("N-ALL INSURANCE GROUP NUMBER",,,IBIFN)
- . I $P($G(IBXDATA(1)),U)="" S IBQUIT=$$IBER^IBCBB3(.IBER,225)
- ;
- ; UB-04 Diagnosis Codes
- K IBXDATA D F^IBCEF("N-DIAGNOSES",,,IBIFN)
- ;
- S IBI=0
- F S IBI=$O(IBXDATA(IBI)) Q:'IBI D Q:IBQUIT
- . S IBDXC=$P($$ICD9^IBACSV(+$P(IBXDATA(IBI),U)),U)
- . ; no duplicate dx
- . I IBDXC'="",$D(IBDXARY(IBDXC)) S IBQUIT=$$IBER^IBCBB3(.IBER,227)
- . I IBDXC'="",'$D(IBDXARY(IBDXC)) S IBDXARY(IBDXC)=IBXDATA(IBI)
- Q:IBQUIT
- ;
- Q
- ;
- VALID(IBIFN) ; Verify HIC # is valid
- N VAL,IBXDATA
- S VAL=1
- G:'$$MCRWNR^IBEFUNC(+$$CURR^IBCEF2(IBIFN)) VALQ
- ;
- K IBXDATA D F^IBCEF("N-CURR INSURED ID",,,IBIFN)
- ;
- I $G(IBXDATA)="" S VAL=0 G VALQ
- ;
- S IBXDATA=$TR(IBXDATA,"-")
- ; HIC # must pass standard MEDICARE edits
- I '$$VALHIC^IBCNSMM(IBXDATA) S VAL=0
- ;
- VALQ Q VAL
- ;
- --- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HIBCBB8 1800 printed Feb 18, 2025@23:35:23 Page 2
- IBCBB8 ;ALB/BGA - CON'T MEDICARE EDIT CHECKS ;08/12/98
- +1 ;;2.0;INTEGRATED BILLING;**51,137,210,349,373**;21-MAR-94;Build 6
- +2 ;;Per VHA Directive 2004-038, this routine should not be modified.
- +3 ;
- +4 ; UB-04 CLAIM CERTIFICATE ID NUMBER
- +5 IF '$$VALID(IBIFN)
- SET IBQUIT=$$IBER^IBCBB3(.IBER,215)
- if IBQUIT
- QUIT
- +6 ;
- +7 ; Req. on Primary Payor when Medicare is secondary and value 12-15,43
- +8 IF $$COBN^IBCEF(IBIFN)=2
- Begin DoDot:1
- +9 IF $ORDER(IBVALCD(16),-1)'<12!$DATA(IBVALCD(43))
- Begin DoDot:2
- +10 KILL IBXDATA
- DO F^IBCEF("N-ALL INSURED EMPLOYER INFO",,,IBIFN)
- +11 ; employer name^city^state abbreviation^state ien
- +12 ;I '$O(IBXDATA(0)) S IBQUIT=$$IBER^IBCBB3(.IBER,222) Q
- +13 ; Employer name missing
- +14 ;I $P($G(IBXDATA(1)),U)="" S IBQUIT=$$IBER^IBCBB3(.IBER,222)
- +15 ; Employer address missing
- +16 ;I $TR($P($G(IBXDATA(1)),U,2,4),U)="" S IBQUIT=$$IBER^IBCBB3(.IBER,223)
- End DoDot:2
- +17 ;
- +18 ; Insured's Group Number
- +19 ; if Medicare is secondary, need insurance group number for primary
- +20 KILL IBXDATA
- DO F^IBCEF("N-ALL INSURANCE GROUP NUMBER",,,IBIFN)
- +21 IF $PIECE($GET(IBXDATA(1)),U)=""
- SET IBQUIT=$$IBER^IBCBB3(.IBER,225)
- End DoDot:1
- if IBQUIT
- QUIT
- +22 ;
- +23 ; UB-04 Diagnosis Codes
- +24 KILL IBXDATA
- DO F^IBCEF("N-DIAGNOSES",,,IBIFN)
- +25 ;
- +26 SET IBI=0
- +27 FOR
- SET IBI=$ORDER(IBXDATA(IBI))
- if 'IBI
- QUIT
- Begin DoDot:1
- +28 SET IBDXC=$PIECE($$ICD9^IBACSV(+$PIECE(IBXDATA(IBI),U)),U)
- +29 ; no duplicate dx
- +30 IF IBDXC'=""
- IF $DATA(IBDXARY(IBDXC))
- SET IBQUIT=$$IBER^IBCBB3(.IBER,227)
- +31 IF IBDXC'=""
- IF '$DATA(IBDXARY(IBDXC))
- SET IBDXARY(IBDXC)=IBXDATA(IBI)
- End DoDot:1
- if IBQUIT
- QUIT
- +32 if IBQUIT
- QUIT
- +33 ;
- +34 QUIT
- +35 ;
- VALID(IBIFN) ; Verify HIC # is valid
- +1 NEW VAL,IBXDATA
- +2 SET VAL=1
- +3 if '$$MCRWNR^IBEFUNC(+$$CURR^IBCEF2(IBIFN))
- GOTO VALQ
- +4 ;
- +5 KILL IBXDATA
- DO F^IBCEF("N-CURR INSURED ID",,,IBIFN)
- +6 ;
- +7 IF $GET(IBXDATA)=""
- SET VAL=0
- GOTO VALQ
- +8 ;
- +9 SET IBXDATA=$TRANSLATE(IBXDATA,"-")
- +10 ; HIC # must pass standard MEDICARE edits
- +11 IF '$$VALHIC^IBCNSMM(IBXDATA)
- SET VAL=0
- +12 ;
- VALQ QUIT VAL
- +1 ;