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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>

Call Graph

Call Graph

Call Graph Total: 11

Package Total Call Graph
Integrated Billing 10 $$CURR^IBCEF2  ($$CHGOTH,$$CPTUNITS,ALLBEDS,BITMCHG)^IBCRBC2  INPTPTF^IBCRBG  (CPT,OPTVD)^IBCRBG1  $$CPTMOD^IBCRCU1  ($$CSBR,$$CSDV)^IBCRU3  SET^IBCSC5A  SET^IBCSC5B  
$$FT^IBCU3  $$MCRWNR^IBEFUNC  
CPT HCPCS Codes 1 $$CPT^ICPTCOD  

Caller Graph

Legends:

Legend of Colors

Package Component Superscript legend

action A extended action Ea event driver Ed subscriber Su protocol O limited protocol LP run routine RR broker B edit E server Se print P screenman SM inquire I

Caller Graph

Caller Graph Total: 2

Package Total Caller Graph
Integrated Billing 2 IBCRBC  IBCRBH1  

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)

External References

Name Field # of Occurrence
$$CURR^IBCEF2 INPTBS+11, OPTVST+9, RX+13, CPT+21, PI+9
$$CHGOTH^IBCRBC2 CPT+34
$$CPTUNITS^IBCRBC2 CPT+37
ALLBEDS^IBCRBC2 OPTVST+16, RX+23, PI+16
BITMCHG^IBCRBC2 INPTBS+23, RX+31, RX+38, CPT+47, PI+23
INPTPTF^IBCRBG INPTBS+7, CPT+26
CPT^IBCRBG1 CPT+17
OPTVD^IBCRBG1 OPTVST+5
$$CPTMOD^IBCRCU1 CPT+44
$$CSBR^IBCRU3 INPTBS+9, OPTVST+7, RX+11, CPT+19, PI+7
$$CSDV^IBCRU3 INPTBS+20, CPT+43
SET^IBCSC5A RX+9
SET^IBCSC5B PI+5
$$FT^IBCU3 RX+16
$$MCRWNR^IBEFUNC INPTBS+11, OPTVST+9, RX+13, CPT+21, PI+9
$$CPT^ICPTCOD CPT+42

Global Variables Directly Accessed

Name Line Occurrences  (* Changed,  ! Killed)
^DGCR(399 - [#399] INPTBS+10, INPTBS+14, OPTVST+8, RX+12, CPT+20, CPT+25, PI+8
^DIC(36 - [#36] INPTBS+12, OPTVST+10, RX+14, CPT+22, PI+10
^IBA(362.4 - [#362.4] CPT+23
^IBA(363.21 - [#363.21] RX+29
^IBE(350.9 - [#350.9] RX+16, CPT+23
^IBE(363.1 - [#363.1] INPTBS+9, OPTVST+7, RX+11, CPT+19, PI+7
^TMP($J INPTBS+17, INPTBS+18, INPTBS+24!, CPT+39, CPT+40, CPT+48!

Local Variables

Legend:

>> Not killed explicitly
* Changed
! Killed
~ Newed

Name Field # of Occurrence
CS INPTBS~, INPTBS+5, INPTBS+7, INPTBS+9, INPTBS+20, INPTBS+23, OPTVST~, OPTVST+3, OPTVST+7, OPTVST+16
, RX~, RX+7, RX+11, RX+23, RX+31, RX+38, CPT~, CPT+15, CPT+19, CPT+26
, CPT+37, CPT+43, CPT+44, CPT+47, PI~, PI+3, PI+7, PI+16, PI+23
IBBDIV INPTBS+5~, INPTBS+14*, INPTBS+20, CPT+14~, CPT+25*, CPT+43
IBBLITEM INPTBS+5~, INPTBS+9*, INPTBS+16, OPTVST+3~, OPTVST+7*, OPTVST+12, RX+6~, RX+11*, RX+18, RX+25
, CPT+14~, CPT+19*, CPT+28, PI+3~, PI+7*, PI+12
IBBR CPT+14~, CPT+23*
IBBS CPT+15~, CPT+39*, CPT+40*, CPT+46
IBCHGMTH INPTBS+5~, INPTBS+9*, INPTBS+16, OPTVST+3~, OPTVST+7*, OPTVST+12, RX+6~, RX+11*, RX+18, RX+25
, RX+33, CPT+14~, CPT+19*, CPT+37, PI+3~, PI+7*, PI+12, PI+18
IBCLIN CPT+15~, CPT+32*, CPT+46
IBCMPNT INPTBS+5~, INPTBS+9*, INPTBS+22, OPTVST+3~, OPTVST+7*, OPTVST+15, RX+6~, RX+11*, RX+22, RX+30
, RX+37, CPT+14~, CPT+19*, CPT+46, PI+3~, PI+7*, PI+15, PI+22
IBCPT CPT+14~, CPT+29*, CPT+30, CPT+31, CPT+35, CPT+42, CPT+44, CPT+46, CPT+47
IBCPTARR CPT+14~, CPT+17
IBCPTARR( CPT+29, CPT+30, CPT+31
IBCPTFN CPT+14~, CPT+30*, CPT+31, CPT+46
IBCPTRX CPT+15~, CPT+23*, CPT+35
IBDIV INPTBS+5~, INPTBS+18*, INPTBS+20, INPTBS+22, CPT+14~, CPT+32*, CPT+43, CPT+46
IBEVDT INPTBS+5~, INPTBS+17*, INPTBS+18, INPTBS+23, OPTVST+3~, OPTVST+14*, OPTVST+16, RX+6~, RX+20*, RX+22
, RX+23, RX+27*, RX+28, RX+31, RX+35*, RX+36, RX+38, CPT+14~, CPT+31*, CPT+34
, CPT+39, CPT+40, CPT+42, CPT+44, CPT+47, PI+3~, PI+13*, PI+14, PI+16, PI+19*
, PI+20, PI+21, PI+23
IBI OPTVST+3~, OPTVST+13*, OPTVST+14
IBIDRC INPTBS+5~, INPTBS+10*, INPTBS+11*, INPTBS+12*, INPTBS+23, OPTVST+3~, OPTVST+8*, OPTVST+9*, OPTVST+10*, OPTVST+16
, RX+6~, RX+12*, RX+13*, RX+14*, RX+23, RX+31, RX+38, CPT+14~, CPT+20*, CPT+21*
, CPT+22*, CPT+47, PI+3~, PI+8*, PI+9*, PI+10*, PI+16, PI+23
IBIFN INPTBS~, INPTBS+5, INPTBS+7, INPTBS+10, INPTBS+11, INPTBS+14, OPTVST~, OPTVST+3, OPTVST+5, OPTVST+8
, OPTVST+9, RX~, RX+7, RX+9, RX+12, RX+13, RX+16, CPT~, CPT+15, CPT+17
, CPT+20, CPT+21, CPT+23, CPT+25, CPT+26, CPT+34, PI~, PI+3, PI+5, PI+8
, PI+9
IBIRC RX+6~, RX+14*, RX+23, RX+31, RX+38
IBITM INPTBS+5~, INPTBS+18*, INPTBS+23, RX+6~, RX+28*, RX+30, RX+36*, RX+37, RX+38, PI+3~
, PI+21*, PI+22, PI+23
IBMOD CPT+14~, CPT+31*, CPT+44*, CPT+47
IBMODS CPT+15~, CPT+31*, CPT+46
IBNDC RX+6~, RX+28*, RX+29*, RX+31
IBOE CPT+15~, CPT+32*, CPT+35, CPT+46
IBOPVARR OPTVST+3~, OPTVST+5
IBOPVARR( OPTVST+13, OPTVST+14
IBPI PI+3~, PI+14*, PI+20*, PI+21
IBPIARR PI+3~, PI+5
IBPIARR( PI+13, PI+14, PI+19, PI+20, PI+21
IBPPRV CPT+15~, CPT+32*, CPT+46
IBRX RX+6~, RX+19*, RX+20, RX+22, RX+26*, RX+27, RX+28, RX+34*, RX+35, RX+36
IBRXARR RX+6~, RX+9
IBRXARR( RX+19, RX+20, RX+22, RX+26, RX+27, RX+28, RX+34, RX+35, RX+36
IBRXCPT RX+6~, RX+16*, RX+22, RX+30, RX+37
IBSAVE INPTBS+5~, INPTBS+22*, INPTBS+23, OPTVST+3~, OPTVST+15*, OPTVST+16, RX+6~, RX+22*, RX+23, RX+30*
, RX+31, RX+37*, RX+38, CPT+15~, CPT+46*, CPT+47, PI+3~, PI+15*, PI+16, PI+22*
, PI+23
IBTYPE INPTBS+5~, INPTBS+9*, INPTBS+22, OPTVST+3~, OPTVST+7*, OPTVST+15, RX+6~, RX+11*, RX+22, RX+30
, RX+37, CPT+14~, CPT+19*, CPT+46, PI+3~, PI+7*, PI+15, PI+22
IBUNIT RX+6~, RX+28*, RX+31, RX+36*, RX+38, CPT+15~, CPT+37*, CPT+47
IBX INPTBS+5~, INPTBS+9*, INPTBS+18*, OPTVST+3~, OPTVST+7*, RX+6~, RX+11*, RX+28*, RX+36*, CPT+14~
, CPT+19*, CPT+23, CPT+31*, CPT+32, CPT+37, CPT+40*, PI+3~, PI+7*
RS INPTBS~, INPTBS+23, OPTVST~, OPTVST+16, RX~, RX+23, RX+31, RX+38, CPT~, CPT+34
, CPT+47, PI~, PI+16, PI+23
U INPTBS+9, INPTBS+12, INPTBS+14, INPTBS+18, OPTVST+7, OPTVST+10, RX+9, RX+11, RX+14, RX+16
, RX+28, RX+36, CPT+19, CPT+22, CPT+23, CPT+25, CPT+31, CPT+32, CPT+39, CPT+40
, CPT+42, CPT+46, PI+5, PI+7, PI+10
Info |  Source |  Call Graph |  Caller Graph |  Entry Points |  External References |  Global Variables Directly Accessed |  Local Variables  | All