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Routine: IBCEF1

Package: Integrated Billing

Routine: IBCEF1


Information

IBCEF1 ;ALB/TMP - FORMATTER SPECIFIC BILL FUNCTIONS - CONT ;30-JAN-96

Source Information

Source file <IBCEF1.m>

Call Graph

Call Graph

Call Graph Total: 12

Package Total Call Graph
Integrated Billing 8 $$ICD0^IBACSV  ($$COBN,$$FT,$$INPAT,F)^IBCEF  ($$BATCH,OUTPT)^IBCEF11  B24^IBCEF3  $$STATE^IBCEFG1  $$MCRPAY^IBCEU0  OCC^IBCF32  $$MCRWNR^IBEFUNC  
CPT HCPCS Codes 2 $$CPT^ICPTCOD  $$MOD^ICPTMOD  
Accounts Receivable 1 $$TPR^PRCAFN  
Registration 1 $$SITE^VASITE  

Caller Graph

Caller Graph Total: 38

Package Total Caller Graph
Integrated Billing 37 IBCBB1  IBCBB2  IBCBB21  IBCECOB5  IBCEDC  IBCEF12  IBCEF2  IBCEF4  
IBCEF71  IBCEF74  IBCEF75  IBCEF76  IBCEF79  IBCEF80  IBCEFP  IBCEOB1  
IBCEP1  IBCEP2  IBCEP2A  IBCEP3  IBCEP4  IBCEPTR  IBCF23A  IBCF31  
IBCF33  IBCIADD1  IBCICME1  IBCIWK  IBCSC4  IBCSC5  IBCSCH1  IBJTBA  
IBJTBC  IBJTRX  IBOCNC2  IBRFN3  IBTOBI4  
Accounts Receivable 1 RCDPEWL2  

Entry Points

Name Comments DBIA/ICR reference
OCC(IBIFN,REL,TEXT) ;Sets up an arrays of occurrence codes for various cks
OCCQ
OCC1(ARR,OCC,REL,TEXT) ; Search thru local array for parameters met
; ARR = null to search OCC subscript, "S" to search OCCS subscript
RX(IBIFN) ; Format billable prescription data for refills for 837
RXQ
OTHPAY(IBIFN,SEQ) ; Return the other insurance payment amount for bill
; IBIFN and payer sequence SEQ (1-3)
OUTPT(IBIFN,IBPRINT) ; Moved for space
OCC92 ;Reformats IBXSAVE("OCC") and IBXSAVE("OCCS") to fit blocks on UB-04
; Set up IBXSAVE(32-36) arrays
BATCH() ; Moved for space IB*2*349
PROC(T,TYPE) ; Find procedure code, strip '.' Function returns result
; T = Procedure internal entry #;file reference
; TYPE = "CPT" for only CPT/HCPCS valid
; "ICD" for only ICD9 valid or null for either
FACILITY(IBIFN) ;return the Facility (Institution pointer-#4) for a bill
; the institution of the Bill Division (399,.22) if defined, otherwise the Facility Name (350.9,.02)
ISRX(IBIFN) ; Function to determine if bill is a prescription refill bill
; Returns 0 if no Rx on bill or 1 if there is.
ISPROS(IBIFN) ; Function to determine if bill is a prosthetics bill
; Returns 0 if no Prosthetics on bill or 1 if there is.
FINDINS(IBIFN,IBSEQ) ; Returns the internal entry number of the insurance
; company for bill ien IBIFN for payer sequence IBSEQ (or current if
; IBSEQ is null)
TOB(IBIFN) ; Returns UB-04 type of bill from data in the output formatter
PRCD(PRIEN,ALL,EDT) ; Function returns the code that corresponds to the variable
; pointer data in PRIEN (ien;file)
; ALL = if ALL=1, returns the entire $$CPT^ICPTCOD for CPT or
; ^code^name format for ICD result
; or null if lookup fails
; EDT = Effective date to check (not used if +$G(ALL)=0)
PRCDQ
NFT(FT,IBIFN) ; Returns 1 if bill IBIFN is not of form type FT (internal)
; so the data element should not be required
REQ(FT,INP,IBIFN) ; Determine if bill IBIFN is of form type FT and
; Inpatient (I) or Outpatient (O) status INP [or either if (null)]
SET1(IBIFN,A,IBZ,IBXDATA,IBXNOREQ) ; Utility to set variables for output
; formatter for professional EDI
; Returns values of A, IBXDATA, IBZ, IBXNOREQ
CIADDR(IBXDATA,IBXSAVE,LINE,FORM) ; Format current ins co address line LINE for FORM
; FORM = 1 for CMS-1500, 2 for UB-04
; Called from output formatter - both IBXDATA, IBXSAVE parameters are
; passed by reference
HHLTH(IBIFN,OUT) ; determine if claim is hospice/home health and needs episode of care date **574**
; per NUBC, date the episode of care began is needed for all outpatient CMS-1500 Home Health and Hospice claims and
; UB-04: 012x,022x,032x,034x,081x & 082x claims
; this string is zero + the Bill Type field from screens 6&7 of enter/edit Bill: 0_field#.24(LOC OF CARE)_.25(BILL CLASS)_.26(TIMEFRAME)
; required - IBIFN = internal claim#
; optional - OUT = optional flag to pass to INPAT^IBCEF
; returns a 1 if date should be included on bill and a 0 if it should NOT be included on bill

External References

Name Field # of Occurrence
$$ICD0^IBACSV PROC+10, PRCD+10
$$COBN^IBCEF FINDINS+3
$$FT^IBCEF NFT+2, SET1+14
$$INPAT^IBCEF REQ+14, HHLTH+11
F^IBCEF TOB+2, TOB+3, TOB+4, CIADDR+22
$$BATCH^IBCEF11 BATCH+1
OUTPT^IBCEF11 OUTPT+1
B24^IBCEF3 RX+2
$$STATE^IBCEFG1 CIADDR+35, CIADDR+45
$$MCRPAY^IBCEU0 OTHPAY+8
OCC^IBCF32 OCC92+7
$$MCRWNR^IBEFUNC OTHPAY+8
$$CPT^ICPTCOD PRCD+9
$$MOD^ICPTMOD PROC+8
$$TPR^PRCAFN OTHPAY+9
$$SITE^VASITE FACILITY+4

Global Variables Directly Accessed

Name Line Occurrences  (* Changed,  ! Killed)
^DGCR(399 - [#399] OCC+11, OTHPAY+3, OTHPAY+8, OTHPAY+13, FACILITY+4, FINDINS+3, HHLTH+12
^DGCR(399.1 - [#399.1] OCC+12, HHLTH+17
^IBA(362.4 - [#362.4] ISRX+4
^IBA(362.5 - [#362.5] ISPROS+4
^IBE(350.9 - [#350.9] FACILITY+5, CIADDR+17, CIADDR+41

Label References

Name Line Occurrences
$$NFT REQ+12
$$PRCD PROC+7, PROC+9
$$REQ SET1+14
OCC1 OCC+24
OCCQ OCC+16
PRCDQ PRCD+9, PRCD+10

Naked Globals

Name Field # of Occurrence
^( OCC+11

Local Variables

Legend:

>> Not killed explicitly
* Changed
! Killed
~ Newed

Name Field # of Occurrence
A SET1~, SET1+4*
ADDR CIADDR+16~, CIADDR+20*, CIADDR+27, CIADDR+29, CIADDR+31, CIADDR+35
ALL PRCD~, PRCD+9, PRCD+10
AMT OTHPAY+2~, OTHPAY+8*, OTHPAY+9*, OTHPAY+13*, OTHPAY+14
ARR OCC+8~, OCC+20*, OCC+22*, OCC1~, OCC1+3*, OCC1+4, OCC1+5, OCC1+6
CODE OCC+8~, OCC+20*, OCC+22*, PRCD+6~, PRCD+7*, PRCD+9*, PRCD+10*, PRCDQ
CT OCC+8~, OCC+22*, RX+1~, RX+3*, RX+4*, RXQ, SET1+3~, SET1+5*, SET1+10*, CIADDR+40~
, CIADDR+42*, CIADDR+43*, CIADDR+44*, CIADDR+45*
CT1 OCC+10~*, OCC+15*
CT2 OCC+10~*, OCC+14*
DATA OCC+8~, OCC+20*
EDT PRCD~, PRCD+9, PRCD+10
FORM CIADDR~, CIADDR+6, CIADDR+39
FT NFT~, NFT+2*, NFT+3, REQ~, REQ+12
IB0 FACILITY+3~, FACILITY+4*, HHLTH+8~, HHLTH+12*, HHLTH+17
IB32 OCC92+2~, OCC92+5*, OCC92+6*
IB32("" OCC92+6
IB33 OCC92+2~
IB34 OCC92+2~
IB35 OCC92+2~
IB36 OCC92+2~, OCC92+5*, OCC92+6*
IB36("" OCC92+6
IBC HHLTH+8~, HHLTH+17*, HHLTH+19, HHLTH+20, HHLTH+21
IBFL OCC92+2~
IBFL( OCC92+4!*, OCC92+8
IBI OCC+10~*, OCC+11*
IBIFN OCC~, OCC+11, RX~, RX+2, OTHPAY~, OTHPAY+3, OTHPAY+8, OTHPAY+13, OUTPT~, OUTPT+1
, FACILITY~, FACILITY+4, ISRX~, ISRX+4, ISPROS~, ISPROS+4, FINDINS~, FINDINS+3, TOB~, TOB+2
, TOB+3, TOB+4, NFT~, NFT+2, REQ~, REQ+12, REQ+14, SET1~, SET1+14, HHLTH~
, HHLTH+9, HHLTH+11, HHLTH+12
IBIFN1 OTHPAY+2~, OTHPAY+3*, OTHPAY+4, OTHPAY+8, OTHPAY+9
IBIN FACILITY+3~*, FACILITY+4*, FACILITY+5*, FACILITY+6
IBL HHLTH+8~, HHLTH+12*, HHLTH+14, HHLTH+16, HHLTH+21
IBPG OCC92+2~, OCC92+3*
IBPRINT OUTPT~, OUTPT+1
IBPROS ISPROS+3~, ISPROS+4*, ISPROS+5
IBPSTAT CIADDR+16~, CIADDR+24
IBRX ISRX+3~, ISRX+4*, ISRX+5
IBSEQ FINDINS~, FINDINS+3
IBT HHLTH+8~, HHLTH+21*, HHLTH+23
IBTOB TOB+1~, TOB+5*, TOB+6
IBX PRCD+6~, PRCD+9*, PRCD+10*
IBXDATA RX+1~, SET1~, SET1+12!, CIADDR~, CIADDR+5!
IBXDATA( RX+4*, SET1+6, SET1+10, CIADDR+26*, CIADDR+28*, CIADDR+30*, CIADDR+32*, CIADDR+35*, CIADDR+43*, CIADDR+44*
, CIADDR+45*
IBXDATA(1 CIADDR+24*
>> IBXIEN SET1+14, CIADDR+22
IBXNOREQ SET1~, SET1+14*
IBXSAVE RX+2, CIADDR~
IBXSAVE( OCC+20, OCC+22!*, OCC1+4, OCC1+5, OCC1+6
IBXSAVE("BOX24" RX+2, RX+4
IBXSAVE("CADR" CIADDR+20, CIADDR+36!, CIADDR+43, CIADDR+44, CIADDR+45
IBXSAVE("CADR_NAME" CIADDR+26, CIADDR+36!
IBXSAVE("INDENT" CIADDR+41*, CIADDR+43, CIADDR+44, CIADDR+45
IBXSAVE("OC92" OCC92+8*
IBXSAVE("OCC" OCC+9, OCC+15*, OCC+16*, OCC92+5
IBXSAVE("OCCS" OCC+9, OCC+14*, OCC+16, OCC92+5
IBZ SET1~
IBZ( SET1+10*
IBZ1 TOB+1~, TOB+5
IBZ2 TOB+1~, TOB+5
IBZ3 TOB+1~, TOB+5
INP REQ~, REQ+13, REQ+14*, REQ+15
LINE CIADDR~
LM CIADDR+16~, CIADDR+17*, CIADDR+19
N OCC+8~, OCC+20*, OCC+22*
OCC OCC+8~, OCC+24, OCCQ, OCC1~, OCC1+5*, OCC1+6*
OUT HHLTH~, HHLTH+11
PG OCC92+2~, OCC92+6*
PRIEN PRCD~, PRCD+9, PRCD+10
PRP OTHPAY+2~, OTHPAY+3*, OTHPAY+8*, OTHPAY+9*, OTHPAY+13
Q PROC+4~, PROC+5*, PROC+7*, PROC+8*, PROC+9*, PROC+10*, PROC+11, CIADDR+16~, CIADDR+24*, CIADDR+25*
, CIADDR+26, CIADDR+28*, CIADDR+30*, CIADDR+32, CIADDR+34*, CIADDR+35
REL OCC~, OCC+24, OCC1~, OCC1+5
S PROC+4~, PROC+5*, PROC+7, PROC+9
SEQ OTHPAY~, OTHPAY+3, OTHPAY+8, OTHPAY+13
SORT OCC+8~
SORT( OCC+20*, OCC+22
T PROC~, PROC+5, PROC+7, PROC+8, PROC+9, PROC+10
TEXT OCC~, OCC+24, OCC1~, OCC1+6
TYPE PROC~, PROC+6, PROC+9, PROC+10
U OCC+13, OCC+14, OCC+15, OCC+20, OCC1+5, OCC1+6, OTHPAY+3, OTHPAY+13, OCC92+8, PROC+7
, PROC+8, PROC+10, FACILITY+4, FACILITY+5, FINDINS+3, PRCD+9, PRCD+10, SET1+10, CIADDR+17, CIADDR+27
, CIADDR+29, CIADDR+31, CIADDR+35, CIADDR+41, CIADDR+43, CIADDR+44, CIADDR+45, HHLTH+12, HHLTH+17
X CIADDR+16~, CIADDR+27*, CIADDR+28, CIADDR+29*, CIADDR+30, CIADDR+31*, CIADDR+32, CIADDR+40~, CIADDR+43*, CIADDR+44*
Z OCC+10~, OCC+11*, OCC+12, OCC+14, OCC+15, OCC1+2~, OCC1+3*, OCC1+4*, OCC1+5, OCC1+6
, RX+1~, RX+3*, RX+4*, OCC92+2~, OCC92+4*, OCC92+8*, REQ+10~, REQ+11*, REQ+12*, REQ+13
, REQ+15*, REQ+16, SET1+3~, SET1+5*, SET1+6*, SET1+10, CIADDR+16~, CIADDR+18*, CIADDR+19*, CIADDR+23
, CIADDR+26, CIADDR+28, CIADDR+30, CIADDR+35, CIADDR+40~, CIADDR+41*
Z0 OCC+10~, OCC+12*, OCC+13, OCC+14, OCC+15, OCC92+2~, OCC92+8*, REQ+14*, REQ+15
Z1 CIADDR+16~, CIADDR+23*, CIADDR+24
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