Home   Package List   Routine Alphabetical List   Global Alphabetical List   FileMan Files List   FileMan Sub-Files List   Package Component Lists   Package-Namespace Mapping  
Info |  Source |  Entry Points
Print Page as PDF
Routine: IBCRBC1

Package: Integrated Billing

Routine: IBCRBC1


Information

IBCRBC1 ;ALB/ARH - RATES: BILL CALCULATION BILLABLE EVENTS ; 22 MAY 96

Source Information

Source file <IBCRBC1.m>

Entry Points

Name Comments DBIA/ICR reference
INPTBS(IBIFN,RS,CS) ; Determine charges for INPATIENT BEDSECTION STAY billable events
; - the billable events are billable bedsections based on the patient movement treating specialties,
; these are pulled from the PTF record each time the charges are calculated (INPTPTF^IBCRCG)
; - each day of billable care is calculated separately in case a rate becomes inactive
OPTVST(IBIFN,RS,CS) ; Determine charges for OUTPATIENT VISIT DATE billable events
; - the billable event is the outpatient visit date(s) on the bill (399,43)
RX(IBIFN,RS,CS) ; Determine charges for PRESCRIPTION billable events
; - the billable event is an rx that has been added to the bill (362.4)
; - the insurance company Prescription Refill Rev Code (36,.15) is passed to the calculator to be used as
; the rev code for all Rx charges, all types, this overrides the rev codes for the set or item
; - on HCFA 1500, the site parameter Default Rx Refill CPT (350.9,1.3) is added as the CPT to all Rx RC entries
CPT(IBIFN,RS,CS) ; Determine charges for PROCEDURE billable events
; - the billable event is a CPT procedure from the bill (399,304)
; - the item to be billed is a CPT, this may include Modifier
; - for each CPT found on the bill that has a modifier, will first check to see if that CPT-modifier
; combination is billable (ie. is defined as a charge item for the Billing Rate, does not have to be active)
; if it does not then assumes the charge should be the CPT charge
; - if the charge set is limited by region then either the CPT's division or if no CPT division then the bill's
; Default Division must be contained in the sets region
; - the billable CPT is added as the CPT of the charge entry, Division is also added if defined for the CPT
; - the procedures provider may affect the charges due to a provider discount
; - if an inpatient bill then the bedsection on date of procedure will be used as the default bedsection
; - different sets of charges apply to SNF and Inpatient care although the bill is defined as inpatient
; - the Default Rx CPT should not be billed the CPT charge, instead the Rx is charged
PI(IBIFN,RS,CS) ; Determine charges for PROSTHETICS billable events
; - the billable event is a prosthetic item that has been added to the bill (362.5)
Info |  Source |  Entry Points