IBCEU2 ;ALB/TMP - EDI UTILITIES FOR AUTO ADD OF CODES ON BILL ;20-OCT-99
;;2.0;INTEGRATED BILLING;**51,137,155,349**;21-MAR-94;Build 46
;;Per VHA Directive 2004-038, this routine should not be modified.
;
AUTOCK(IBIFN,IBQUIET) ; Auto add any codes necessary based on data
; existing on bill, if needed.
; IBQUIET - optional parameter - equals 1 to suppress screen display
;
N IBCOBN,IBFL,DIE,DA,DR
S DR="",IBCOBN=$$COBN^IBCEF(IBIFN)
;
;Look for prior payments value codes A1, A2 and occur code 24, if needed
;I IBCOBN>1 D PRPAY(IBIFN,IBCOBN,$G(IBQUIET))
;
;Look for occur codes A1,B1,C1 for subscriber date of birth, if needed
D SUBDOB(IBIFN,IBCOBN,$G(IBQUIET))
;
; If outpatient bill and no discharge status, add code 01 as default
I '$$INPAT^IBCEF(IBIFN,1),$$FT^IBCEF(IBIFN)=3 D
. ;Default discharge status for outpt UB to '01'
. D F^IBCEF("N-PATIENT STATUS","IBZ",,IBIFN)
. I IBZ="" D
.. N Z S Z=0 F S Z=$O(^DGCR(399.1,"C","01",Z)) Q:'Z I $P($G(^DGCR(399.1,Z,0)),U,6) Q
.. I Z S DR=DR_$S(DR'="":";",1:"")_"162////"_Z
. ; Default admit source to 2
. D F^IBCEF("N-SOURCE OF ADMISSION","IBZ",,IBIFN)
. I IBZ="" S DR=DR_$S(DR'="":";",1:"")_"159///2"
;
; If inpatient bill and no 01 or 02 value code, add 01 value code with
; the highest value of all 101 entries
I $$INPAT^IBCEF(IBIFN,1) D
. N IBTOB,IBND0,IBFL,IBOK,Z,Z0,IBAMT,DIC,DR,DIE,DA,DO,DD,DLAYGO,X,Y
. S IBND0=$G(^DGCR(399,IBIFN,0)),IBTOB=$P(IBND0,U,24)_$P($G(^DGCR(399.1,+$P(IBND0,U,25),0)),U,2)
. I IBTOB'="11",IBTOB'="18",IBTOB'="21" Q
. S IBOK=0
. D F^IBCEF("N-VALUE CODES",,,IBIFN)
. S Z=0 F S Z=$O(IBFL(39,Z)) Q:'Z I $P(IBFL(39,Z),U)="01"!($P(IBFL(39,Z),U)="02") S IBOK=1 Q
. Q:IBOK
. S Z=0,IBAMT=0
. F S Z=$O(^DGCR(399,IBIFN,"RC",Z)) Q:'Z S Z0=$P($G(^DGCR(399.2,+$G(^DGCR(399,IBIFN,"RC",Z,0)),0)),U) I Z0=101,IBAMT<$P($G(^DGCR(399,IBIFN,"RC",Z,0)),U,2) S IBAMT=$P(^(0),U,2)
. I IBAMT D
.. S DA(1)=IBIFN,DLAYGO=399.047,DIC(0)="L",DIC="^DGCR(399,"_DA(1)_",""CV"",",DIC("DR")=".02////"_IBAMT
.. S X=0 F S X=$O(^DGCR(399.1,"C","01",X)) Q:'X I $P($G(^DGCR(399.1,X,0)),U,11) Q
.. I X D FILE^DICN
.. K DIC,DO,DD,DLAYGO
I DR'="" S DA=IBIFN,DIE="^DGCR(399," D ^DIE
Q
;
PRPAY(IBIFN,IBCOBN,IBQUIET) ; Output value cd A1 or A2 for prior payments, if needed
; IBIFN = ien of bill in file 399
; IBCOBN = the COB sequence number for bill (2=secondary, 3=tertiary)
; IBQUIET = 1 to suppress screen display
;
N IBNEED,IBNEED24,IB24,IBV,IBVN,DIC,DA,DLAYGO,DD,DO,Z,Z0
S (IBCT,IBNEED)=0,IBNEED24=1,(IB24(24),IB24("A1"),IB24("A2"))=0
S Z=0 F S Z=$O(^DGCR(399.1,"C1",24,Z)) Q:'Z I $P($G(^DGCR(399.1,Z,0)),U,4) S IB24(24)=Z Q ;Occurrence code 24
F Z0="A1","A2" S Z=0 F S Z=$O(^DGCR(399.1,"C1",Z0,Z)) Q:'Z I $P($G(^DGCR(399.1,Z,0)),U,11) S IB24(Z0)=Z Q ;Value codes A1 and A2
F Z="A1","A2" I $D(^DGCR(399,IBIFN,"I"_$P(Z,"A",2)+1)),IB24(Z) D
. I '$D(^DGCR(399,IBIFN,"CV","B",+IB24(Z))) S IBNEED(Z)="",IBNEED=IBNEED+1 Q
. S Z0=0 F S Z0=$O(^DGCR(399,IBIFN,"CV","B",+IB24(Z),Z0)) Q:'Z0 S IBV(Z)=$G(^DGCR(399,IBIFN,"CV",Z0,0)) I Z="A1" S IBNEED24=$S($P(IBV(Z),U,2):0,1:1)
;
I $D(^DGCR(399,IBIFN,"OC","B",+IB24(24))) S IBNEED24=0
I 'IBNEED24,'IBNEED Q
I IBNEED D
. N IBZ,IBXDATA
. D F^IBCEF("N-OTH INSURANCE PRIOR PAYMENT","IBZ",,IBIFN) Q:'$O(IBZ(0)) ;No prior payment data found
. F Z="A1","A2" I $D(IBNEED(Z)) S Z0=$TR(Z,"A"),IBNEED(Z)=$G(IBZ(Z0)) S:IBNEED(Z) IBCT=IBCT+1,IBVN(Z)="" I Z="A1",$P(IBNEED(Z),U,2) S IBNEED24=0
;
I IBNEED24 D
. N Z1,IBZ,IBXDATA
. ; Get primary's EOB data if possible - find EOB reject date
. D F^IBCEF("N-EOB ENTRIES","IBZ",,IBIFN)
. Q:'$O(IBZ(1,0)) ;EOB entry not found for primary insurance
. S (IB24,Z)=""
. F S Z=$O(IBZ(1,Z),-1) Q:'Z S Z0=$G(^IBM(361.1,+IBZ(1,Z),0)),Z1=+$G(^(1)) I 'Z1 S IB24=$P(Z0,U,6)\1 Q:IB24
. Q:'IB24
. W:'$G(IBQUIET) !,"Adding occurrence code 24 and primary insurance rejection date to bill"
. S DA(1)=IBIFN,DIC="^DGCR(399,"_IBIFN_",""OC"",",X=IB24(24),DLAYGO=399.041
. S DIC("P")=$$GETSPEC^IBEFUNC(399,41),DIC(0)="L",DIC("DR")=".02////"_IB24
. D FILE^DICN K DO,DD,DIC,DLAYGO
;
I IBNEED D
. W:'$G(IBQUIET) !!,"Adding value code",$S(IBCT=2:"s A1 and A2",1:$O(IBVN("")))," for reporting of bill's prior payments"
. ; Adding codes to bill
. F Z="A1","A2" I $D(IBVN(Z)) D
.. S DA(1)=IBIFN,DIC="^DGCR(399,"_IBIFN_",""VC"",",X=IB24(Z),DLAYGO=399.047
.. S DIC("P")=$$GETSPEC^IBEFUNC(399,47),DIC(0)="L",DIC("DR")=".02////"_+$P(IBNEED(Z),U,2)
.. D FILE^DICN K DO,DD,DIC,DLAYGO
;
Q
;
SUBDOB(IBIFN,IBCOBN,IBQUIET) ; Add occurrence codes A1,B1,C1 as needed for subscriber DOB
; IBIFN = ien of bill in file 399
; IBQUIET = 1 to suppress screen display
;
N IBZ,Z,Z0,IBVOC,DR
S (IBVOC("A1"),IBVOC("B1"),IBVOC("C1"))=0
F Z0="A1","B1","C1" S Z=0 F S Z=$O(^DGCR(399.1,"C1",Z0,Z)) Q:'Z I $P($G(^DGCR(399.1,Z,0)),U,4) S IBVOC(Z0)=Z Q ;Occurrence codes A1, B1, C1
F Z=1,2,3 I $D(^DGCR(399,IBIFN,"I"_Z)) D
. N IBZ1,IBZ2,IBOC,DIC,DA,DLAYGO,DO,DD,X,Y
. S IBOC=$E("ABC",Z)_"1"
. Q:'IBVOC(IBOC)
. Q:$D(^DGCR(399,IBIFN,"OC","B",IBVOC(IBOC))) ;Already there
. I '$D(IBZ) D
.. D F^IBCEF("N-CURR INSURED DEMOGRAPHICS","IBZ1",,IBIFN)
.. D F^IBCEF("N-OTH INSURED DEMOGRAPHICS","IBZ2",,IBIFN)
.. I IBCOBN=1 S IBZ(1)=+$G(IBZ1),IBZ(2)=+$G(IBZ2(1)),IBZ(3)=+$G(IBZ2(2)) Q
.. I IBCOBN=2 S IBZ(1)=+$G(IBZ2(1)),IBZ(2)=+$G(IBZ1),IBZ(3)=+$G(IBZ2(2)) Q
.. I IBCOBN=3 S IBZ(1)=+$G(IBZ2(1)),IBZ(2)=+$G(IBZ2(2)),IBZ(3)=+$G(IBZ1)
. Q:'$G(IBZ(Z))!$D(^DGCR(399,IBIFN,"OC","B",IBOC(IBOC)))
. W:'$G(IBQUIET) !,"Adding occurrence code '"_IBOC_"' for "_$P("primary^secondary^tertiary",U,Z)_" insurance subscriber's date of birth"
. S DIC="^DGCR(399,"_IBIFN_",""OC"",",DA(1)=IBIFN,DLAYGO=399.041,DIC(0)="L",DIC("P")=$$GETSPEC^IBEFUNC(399,41),X=IBVOC(IBOC),DIC("DR")=".02////"_IBZ(Z)
. D FILE^DICN K DO,DD
Q
;
COMBO(IBXDATA,IBXTRA,IBINST) ; Determine the bundled/unbundled codes - add
; line items where needed to line item array IBXDATA(line #)
; Update referenced line in COB entries returned in IBXDATA
; IBXTR = array input with bundled/unbundled procedures
; ("ALL",original line~original procedure~service date,
; new procedure)=COB seq #^sequence # of adjustment in
; IBXDATA(n,"COB",COB seq #,adj#)
; IBINST = 1 if institutional claim, 0 if professional
N Z,Z0,Z1
S Z="" F S Z=$O(IBXTRA("ALL",Z)) Q:Z="" S Z0=$O(IBXTRA("ALL",Z,"")) D
. ; Unbundled procs will have multiple entries for the combination of
. ; line~original procedure~service date - one for every new procedure
. ; Bundled ones will have multiple entries for the same original
. ; procedure~service date combination
. ;
. I $O(IBXTRA("ALL",Z,Z0))'="" S Z0="" F S Z0=$O(IBXTRA("ALL",Z,Z0)) Q:Z0="" S IBXTRA("U",Z,Z0)=IBXTRA("ALL",Z,Z0) Q
. ; Must be bundled
. S IBXTRA("B",Z0_"~"_$P(Z,"~",3),$P(Z,"~",1,2))=IBXTRA("ALL",Z,Z0)
K IBXTRA("ALL")
;
; UNBUNDLED
I $D(IBXTRA("U")) D ; Add a new entry to IBXDATA for each new proc
. S Z="" F S Z=$O(IBXTRA("U",Z)) Q:Z="" S Z0="" F S Z0=$O(IBXTRA("U",Z,Z0)) Q:Z0="" D
.. ; Z0 = the new procedure, +Z = the original line to reference
.. S Z1=+$O(IBXDATA(""),-1)+1,IBXDATA(Z1)=IBXDATA(+Z)
.. I '$G(IBINST) S $P(IBXDATA(Z1),U,8)=0,$P(IBXDATA(Z1),U,5)=Z0,$P(IBXDATA(+Z,"COB",+IBXTRA("U",Z,Z0),$P(IBXTRA("U",Z,Z0),U,2)),U)=Z1
.. I $G(IBINST) S $P(IBXDATA(Z1),U,3)=0,$P(IBXDATA(Z1),U,5,6)="0^0",$P(IBXDATA(Z1),U,2)=Z0
;
; BUNDLED
I $D(IBXTRA("B")) D ; Add a new entry to IBXDATA for the new proc
. N PROC1
. S Z0="" F S Z0=$O(IBXTRA("B",Z0)) Q:Z0="" S PROC1="",Z=$O(IBXTRA("B",Z0,"")) Q:Z="" D
.. ; $P(Z0,"~",1) = the new procedure, +Z = the original line to reference
.. I 'PROC1 N ZP S PROC1=1,Z1=+$O(IBXDATA(""),-1)+1,IBXDATA(Z1)=IBXDATA(+Z),ZP=$P(Z0,"~") D
... I '$G(IBINST) S $P(IBXDATA(Z1),U,8)=0,$P(IBXDATA(Z1),U,5)=ZP,$P(IBXDATA(+Z,"COB",+IBXTRA("U",Z,Z0),$P(IBXTRA("U",Z,Z0),U,2)),U)=Z1
.. I $G(IBINST) S $P(IBXDATA(Z1),U,3)=0,$P(IBXDATA(Z1),U,5,6)="0^0",$P(IBXDATA(Z1),U,2)=ZP
.. S $P(IBXDATA(+Z,"COB",+IBXTRA("U",Z,Z0),$P(IBXTRA("U",Z,Z0),U,2)),U)=Z1 ;Update original line with reference to the new procedure line
;
Q
;
MCRPT(DFN,IBDT) ; Determine if patient has MCRWNR insurance or if they
; are at least 65 yrs old, so should be MCR eligible as of IBDT (or DT)
; DFN = ien of patient
N MCR,DOB,Z
I '$G(IBDT) S IBDT=DT
S (MCR,Z)=0
F S Z=$O(^DPT(2,DFN,2.312,Z)) Q:'Z I $$MCRWNR^IBEFUNC(+$P($G(^(Z,0)),U)) S MCR=1 Q
I 'MCR S DOB=+$P($G(^DPT(DFN,0)),U,3) I DOB,$E(DT,1,3)-$E(DOB,1,3)-($E(DT,4,7)<$E(DOB,4,7)) S MCR=1
Q MCR
;
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HIBCEU2 8662 printed Dec 13, 2024@02:12:33 Page 2
IBCEU2 ;ALB/TMP - EDI UTILITIES FOR AUTO ADD OF CODES ON BILL ;20-OCT-99
+1 ;;2.0;INTEGRATED BILLING;**51,137,155,349**;21-MAR-94;Build 46
+2 ;;Per VHA Directive 2004-038, this routine should not be modified.
+3 ;
AUTOCK(IBIFN,IBQUIET) ; Auto add any codes necessary based on data
+1 ; existing on bill, if needed.
+2 ; IBQUIET - optional parameter - equals 1 to suppress screen display
+3 ;
+4 NEW IBCOBN,IBFL,DIE,DA,DR
+5 SET DR=""
SET IBCOBN=$$COBN^IBCEF(IBIFN)
+6 ;
+7 ;Look for prior payments value codes A1, A2 and occur code 24, if needed
+8 ;I IBCOBN>1 D PRPAY(IBIFN,IBCOBN,$G(IBQUIET))
+9 ;
+10 ;Look for occur codes A1,B1,C1 for subscriber date of birth, if needed
+11 DO SUBDOB(IBIFN,IBCOBN,$GET(IBQUIET))
+12 ;
+13 ; If outpatient bill and no discharge status, add code 01 as default
+14 IF '$$INPAT^IBCEF(IBIFN,1)
IF $$FT^IBCEF(IBIFN)=3
Begin DoDot:1
+15 ;Default discharge status for outpt UB to '01'
+16 DO F^IBCEF("N-PATIENT STATUS","IBZ",,IBIFN)
+17 IF IBZ=""
Begin DoDot:2
+18 NEW Z
SET Z=0
FOR
SET Z=$ORDER(^DGCR(399.1,"C","01",Z))
if 'Z
QUIT
IF $PIECE($GET(^DGCR(399.1,Z,0)),U,6)
QUIT
+19 IF Z
SET DR=DR_$SELECT(DR'="":";",1:"")_"162////"_Z
End DoDot:2
+20 ; Default admit source to 2
+21 DO F^IBCEF("N-SOURCE OF ADMISSION","IBZ",,IBIFN)
+22 IF IBZ=""
SET DR=DR_$SELECT(DR'="":";",1:"")_"159///2"
End DoDot:1
+23 ;
+24 ; If inpatient bill and no 01 or 02 value code, add 01 value code with
+25 ; the highest value of all 101 entries
+26 IF $$INPAT^IBCEF(IBIFN,1)
Begin DoDot:1
+27 NEW IBTOB,IBND0,IBFL,IBOK,Z,Z0,IBAMT,DIC,DR,DIE,DA,DO,DD,DLAYGO,X,Y
+28 SET IBND0=$GET(^DGCR(399,IBIFN,0))
SET IBTOB=$PIECE(IBND0,U,24)_$PIECE($GET(^DGCR(399.1,+$PIECE(IBND0,U,25),0)),U,2)
+29 IF IBTOB'="11"
IF IBTOB'="18"
IF IBTOB'="21"
QUIT
+30 SET IBOK=0
+31 DO F^IBCEF("N-VALUE CODES",,,IBIFN)
+32 SET Z=0
FOR
SET Z=$ORDER(IBFL(39,Z))
if 'Z
QUIT
IF $PIECE(IBFL(39,Z),U)="01"!($PIECE(IBFL(39,Z),U)="02")
SET IBOK=1
QUIT
+33 if IBOK
QUIT
+34 SET Z=0
SET IBAMT=0
+35 FOR
SET Z=$ORDER(^DGCR(399,IBIFN,"RC",Z))
if 'Z
QUIT
SET Z0=$PIECE($GET(^DGCR(399.2,+$GET(^DGCR(399,IBIFN,"RC",Z,0)),0)),U)
IF Z0=101
IF IBAMT<$PIECE($GET(^DGCR(399,IBIFN,"RC",Z,0)),U,2)
SET IBAMT=$PIECE(^(0),U,2)
+36 IF IBAMT
Begin DoDot:2
+37 SET DA(1)=IBIFN
SET DLAYGO=399.047
SET DIC(0)="L"
SET DIC="^DGCR(399,"_DA(1)_",""CV"","
SET DIC("DR")=".02////"_IBAMT
+38 SET X=0
FOR
SET X=$ORDER(^DGCR(399.1,"C","01",X))
if 'X
QUIT
IF $PIECE($GET(^DGCR(399.1,X,0)),U,11)
QUIT
+39 IF X
DO FILE^DICN
+40 KILL DIC,DO,DD,DLAYGO
End DoDot:2
End DoDot:1
+41 IF DR'=""
SET DA=IBIFN
SET DIE="^DGCR(399,"
DO ^DIE
+42 QUIT
+43 ;
PRPAY(IBIFN,IBCOBN,IBQUIET) ; Output value cd A1 or A2 for prior payments, if needed
+1 ; IBIFN = ien of bill in file 399
+2 ; IBCOBN = the COB sequence number for bill (2=secondary, 3=tertiary)
+3 ; IBQUIET = 1 to suppress screen display
+4 ;
+5 NEW IBNEED,IBNEED24,IB24,IBV,IBVN,DIC,DA,DLAYGO,DD,DO,Z,Z0
+6 SET (IBCT,IBNEED)=0
SET IBNEED24=1
SET (IB24(24),IB24("A1"),IB24("A2"))=0
+7 ;Occurrence code 24
SET Z=0
FOR
SET Z=$ORDER(^DGCR(399.1,"C1",24,Z))
if 'Z
QUIT
IF $PIECE($GET(^DGCR(399.1,Z,0)),U,4)
SET IB24(24)=Z
QUIT
+8 ;Value codes A1 and A2
FOR Z0="A1","A2"
SET Z=0
FOR
SET Z=$ORDER(^DGCR(399.1,"C1",Z0,Z))
if 'Z
QUIT
IF $PIECE($GET(^DGCR(399.1,Z,0)),U,11)
SET IB24(Z0)=Z
QUIT
+9 FOR Z="A1","A2"
IF $DATA(^DGCR(399,IBIFN,"I"_$PIECE(Z,"A",2)+1))
IF IB24(Z)
Begin DoDot:1
+10 IF '$DATA(^DGCR(399,IBIFN,"CV","B",+IB24(Z)))
SET IBNEED(Z)=""
SET IBNEED=IBNEED+1
QUIT
+11 SET Z0=0
FOR
SET Z0=$ORDER(^DGCR(399,IBIFN,"CV","B",+IB24(Z),Z0))
if 'Z0
QUIT
SET IBV(Z)=$GET(^DGCR(399,IBIFN,"CV",Z0,0))
IF Z="A1"
SET IBNEED24=$SELECT($PIECE(IBV(Z),U,2):0,1:1)
End DoDot:1
+12 ;
+13 IF $DATA(^DGCR(399,IBIFN,"OC","B",+IB24(24)))
SET IBNEED24=0
+14 IF 'IBNEED24
IF 'IBNEED
QUIT
+15 IF IBNEED
Begin DoDot:1
+16 NEW IBZ,IBXDATA
+17 ;No prior payment data found
DO F^IBCEF("N-OTH INSURANCE PRIOR PAYMENT","IBZ",,IBIFN)
if '$ORDER(IBZ(0))
QUIT
+18 FOR Z="A1","A2"
IF $DATA(IBNEED(Z))
SET Z0=$TRANSLATE(Z,"A")
SET IBNEED(Z)=$GET(IBZ(Z0))
if IBNEED(Z)
SET IBCT=IBCT+1
SET IBVN(Z)=""
IF Z="A1"
IF $PIECE(IBNEED(Z),U,2)
SET IBNEED24=0
End DoDot:1
+19 ;
+20 IF IBNEED24
Begin DoDot:1
+21 NEW Z1,IBZ,IBXDATA
+22 ; Get primary's EOB data if possible - find EOB reject date
+23 DO F^IBCEF("N-EOB ENTRIES","IBZ",,IBIFN)
+24 ;EOB entry not found for primary insurance
if '$ORDER(IBZ(1,0))
QUIT
+25 SET (IB24,Z)=""
+26 FOR
SET Z=$ORDER(IBZ(1,Z),-1)
if 'Z
QUIT
SET Z0=$GET(^IBM(361.1,+IBZ(1,Z),0))
SET Z1=+$GET(^(1))
IF 'Z1
SET IB24=$PIECE(Z0,U,6)\1
if IB24
QUIT
+27 if 'IB24
QUIT
+28 if '$GET(IBQUIET)
WRITE !,"Adding occurrence code 24 and primary insurance rejection date to bill"
+29 SET DA(1)=IBIFN
SET DIC="^DGCR(399,"_IBIFN_",""OC"","
SET X=IB24(24)
SET DLAYGO=399.041
+30 SET DIC("P")=$$GETSPEC^IBEFUNC(399,41)
SET DIC(0)="L"
SET DIC("DR")=".02////"_IB24
+31 DO FILE^DICN
KILL DO,DD,DIC,DLAYGO
End DoDot:1
+32 ;
+33 IF IBNEED
Begin DoDot:1
+34 if '$GET(IBQUIET)
WRITE !!,"Adding value code",$SELECT(IBCT=2:"s A1 and A2",1:$ORDER(IBVN("")))," for reporting of bill's prior payments"
+35 ; Adding codes to bill
+36 FOR Z="A1","A2"
IF $DATA(IBVN(Z))
Begin DoDot:2
+37 SET DA(1)=IBIFN
SET DIC="^DGCR(399,"_IBIFN_",""VC"","
SET X=IB24(Z)
SET DLAYGO=399.047
+38 SET DIC("P")=$$GETSPEC^IBEFUNC(399,47)
SET DIC(0)="L"
SET DIC("DR")=".02////"_+$PIECE(IBNEED(Z),U,2)
+39 DO FILE^DICN
KILL DO,DD,DIC,DLAYGO
End DoDot:2
End DoDot:1
+40 ;
+41 QUIT
+42 ;
SUBDOB(IBIFN,IBCOBN,IBQUIET) ; Add occurrence codes A1,B1,C1 as needed for subscriber DOB
+1 ; IBIFN = ien of bill in file 399
+2 ; IBQUIET = 1 to suppress screen display
+3 ;
+4 NEW IBZ,Z,Z0,IBVOC,DR
+5 SET (IBVOC("A1"),IBVOC("B1"),IBVOC("C1"))=0
+6 ;Occurrence codes A1, B1, C1
FOR Z0="A1","B1","C1"
SET Z=0
FOR
SET Z=$ORDER(^DGCR(399.1,"C1",Z0,Z))
if 'Z
QUIT
IF $PIECE($GET(^DGCR(399.1,Z,0)),U,4)
SET IBVOC(Z0)=Z
QUIT
+7 FOR Z=1,2,3
IF $DATA(^DGCR(399,IBIFN,"I"_Z))
Begin DoDot:1
+8 NEW IBZ1,IBZ2,IBOC,DIC,DA,DLAYGO,DO,DD,X,Y
+9 SET IBOC=$EXTRACT("ABC",Z)_"1"
+10 if 'IBVOC(IBOC)
QUIT
+11 ;Already there
if $DATA(^DGCR(399,IBIFN,"OC","B",IBVOC(IBOC)))
QUIT
+12 IF '$DATA(IBZ)
Begin DoDot:2
+13 DO F^IBCEF("N-CURR INSURED DEMOGRAPHICS","IBZ1",,IBIFN)
+14 DO F^IBCEF("N-OTH INSURED DEMOGRAPHICS","IBZ2",,IBIFN)
+15 IF IBCOBN=1
SET IBZ(1)=+$GET(IBZ1)
SET IBZ(2)=+$GET(IBZ2(1))
SET IBZ(3)=+$GET(IBZ2(2))
QUIT
+16 IF IBCOBN=2
SET IBZ(1)=+$GET(IBZ2(1))
SET IBZ(2)=+$GET(IBZ1)
SET IBZ(3)=+$GET(IBZ2(2))
QUIT
+17 IF IBCOBN=3
SET IBZ(1)=+$GET(IBZ2(1))
SET IBZ(2)=+$GET(IBZ2(2))
SET IBZ(3)=+$GET(IBZ1)
End DoDot:2
+18 if '$GET(IBZ(Z))!$DATA(^DGCR(399,IBIFN,"OC","B",IBOC(IBOC)))
QUIT
+19 if '$GET(IBQUIET)
WRITE !,"Adding occurrence code '"_IBOC_"' for "_$PIECE("primary^secondary^tertiary",U,Z)_" insurance subscriber's date of birth"
+20 SET DIC="^DGCR(399,"_IBIFN_",""OC"","
SET DA(1)=IBIFN
SET DLAYGO=399.041
SET DIC(0)="L"
SET DIC("P")=$$GETSPEC^IBEFUNC(399,41)
SET X=IBVOC(IBOC)
SET DIC("DR")=".02////"_IBZ(Z)
+21 DO FILE^DICN
KILL DO,DD
End DoDot:1
+22 QUIT
+23 ;
COMBO(IBXDATA,IBXTRA,IBINST) ; Determine the bundled/unbundled codes - add
+1 ; line items where needed to line item array IBXDATA(line #)
+2 ; Update referenced line in COB entries returned in IBXDATA
+3 ; IBXTR = array input with bundled/unbundled procedures
+4 ; ("ALL",original line~original procedure~service date,
+5 ; new procedure)=COB seq #^sequence # of adjustment in
+6 ; IBXDATA(n,"COB",COB seq #,adj#)
+7 ; IBINST = 1 if institutional claim, 0 if professional
+8 NEW Z,Z0,Z1
+9 SET Z=""
FOR
SET Z=$ORDER(IBXTRA("ALL",Z))
if Z=""
QUIT
SET Z0=$ORDER(IBXTRA("ALL",Z,""))
Begin DoDot:1
+10 ; Unbundled procs will have multiple entries for the combination of
+11 ; line~original procedure~service date - one for every new procedure
+12 ; Bundled ones will have multiple entries for the same original
+13 ; procedure~service date combination
+14 ;
+15 IF $ORDER(IBXTRA("ALL",Z,Z0))'=""
SET Z0=""
FOR
SET Z0=$ORDER(IBXTRA("ALL",Z,Z0))
if Z0=""
QUIT
SET IBXTRA("U",Z,Z0)=IBXTRA("ALL",Z,Z0)
QUIT
+16 ; Must be bundled
+17 SET IBXTRA("B",Z0_"~"_$PIECE(Z,"~",3),$PIECE(Z,"~",1,2))=IBXTRA("ALL",Z,Z0)
End DoDot:1
+18 KILL IBXTRA("ALL")
+19 ;
+20 ; UNBUNDLED
+21 ; Add a new entry to IBXDATA for each new proc
IF $DATA(IBXTRA("U"))
Begin DoDot:1
+22 SET Z=""
FOR
SET Z=$ORDER(IBXTRA("U",Z))
if Z=""
QUIT
SET Z0=""
FOR
SET Z0=$ORDER(IBXTRA("U",Z,Z0))
if Z0=""
QUIT
Begin DoDot:2
+23 ; Z0 = the new procedure, +Z = the original line to reference
+24 SET Z1=+$ORDER(IBXDATA(""),-1)+1
SET IBXDATA(Z1)=IBXDATA(+Z)
+25 IF '$GET(IBINST)
SET $PIECE(IBXDATA(Z1),U,8)=0
SET $PIECE(IBXDATA(Z1),U,5)=Z0
SET $PIECE(IBXDATA(+Z,"COB",+IBXTRA("U",Z,Z0),$PIECE(IBXTRA("U",Z,Z0),U,2)),U)=Z1
+26 IF $GET(IBINST)
SET $PIECE(IBXDATA(Z1),U,3)=0
SET $PIECE(IBXDATA(Z1),U,5,6)="0^0"
SET $PIECE(IBXDATA(Z1),U,2)=Z0
End DoDot:2
End DoDot:1
+27 ;
+28 ; BUNDLED
+29 ; Add a new entry to IBXDATA for the new proc
IF $DATA(IBXTRA("B"))
Begin DoDot:1
+30 NEW PROC1
+31 SET Z0=""
FOR
SET Z0=$ORDER(IBXTRA("B",Z0))
if Z0=""
QUIT
SET PROC1=""
SET Z=$ORDER(IBXTRA("B",Z0,""))
if Z=""
QUIT
Begin DoDot:2
+32 ; $P(Z0,"~",1) = the new procedure, +Z = the original line to reference
+33 IF 'PROC1
NEW ZP
SET PROC1=1
SET Z1=+$ORDER(IBXDATA(""),-1)+1
SET IBXDATA(Z1)=IBXDATA(+Z)
SET ZP=$PIECE(Z0,"~")
Begin DoDot:3
+34 IF '$GET(IBINST)
SET $PIECE(IBXDATA(Z1),U,8)=0
SET $PIECE(IBXDATA(Z1),U,5)=ZP
SET $PIECE(IBXDATA(+Z,"COB",+IBXTRA("U",Z,Z0),$PIECE(IBXTRA("U",Z,Z0),U,2)),U)=Z1
End DoDot:3
+35 IF $GET(IBINST)
SET $PIECE(IBXDATA(Z1),U,3)=0
SET $PIECE(IBXDATA(Z1),U,5,6)="0^0"
SET $PIECE(IBXDATA(Z1),U,2)=ZP
+36 ;Update original line with reference to the new procedure line
SET $PIECE(IBXDATA(+Z,"COB",+IBXTRA("U",Z,Z0),$PIECE(IBXTRA("U",Z,Z0),U,2)),U)=Z1
End DoDot:2
End DoDot:1
+37 ;
+38 QUIT
+39 ;
MCRPT(DFN,IBDT) ; Determine if patient has MCRWNR insurance or if they
+1 ; are at least 65 yrs old, so should be MCR eligible as of IBDT (or DT)
+2 ; DFN = ien of patient
+3 NEW MCR,DOB,Z
+4 IF '$GET(IBDT)
SET IBDT=DT
+5 SET (MCR,Z)=0
+6 FOR
SET Z=$ORDER(^DPT(2,DFN,2.312,Z))
if 'Z
QUIT
IF $$MCRWNR^IBEFUNC(+$PIECE($GET(^(Z,0)),U))
SET MCR=1
QUIT
+7 IF 'MCR
SET DOB=+$PIECE($GET(^DPT(DFN,0)),U,3)
IF DOB
IF $EXTRACT(DT,1,3)-$EXTRACT(DOB,1,3)-($EXTRACT(DT,4,7)<$EXTRACT(DOB,4,7))
SET MCR=1
+8 QUIT MCR
+9 ;
