IBCRBC1 ;ALB/ARH - RATES: BILL CALCULATION BILLABLE EVENTS ; 22 MAY 96
;;2.0;INTEGRATED BILLING;**52,80,106,138,51,148,245,270,370**;21-MAR-94;Build 5
;;Per VHA Directive 2004-038, this routine should not be modified.
;
; For each type of Billable Event, search for items on the bill and calculate the charges
; 1) search the bill for items of the billable event type
; 2) determine how the charges should be calculated, based on Billable Item and Charge Method of the Set's Rate
; 3) calculate charges
; For per diem Billing Rates, no item pointers are passed since all items have a standard charge
; The Insurance Company Different Revenue Codes to Use (36,.07) is passed so standard rev codes can be replaced
; The Charge Type (363.1,.04) is passed so it can be added to the charge on the bill if it is defined for a Set
; Output: ^TMP($J,"IBCRCC")= ..., (created in IBCRBC2 based on charge items found here)
;
INPTBS(IBIFN,RS,CS) ; Determine charges for INPATIENT BEDSECTION STAY billable events
; - the billable events are billable bedsections based on the patient movement treating specialties,
; these are pulled from the PTF record each time the charges are calculated (INPTPTF^IBCRCG)
; - each day of billable care is calculated separately in case a rate becomes inactive
;
N IBX,IBBLITEM,IBCHGMTH,IBEVDT,IBIDRC,IBBDIV,IBITM,IBDIV,IBTYPE,IBCMPNT,IBSAVE I '$G(IBIFN)!'$G(CS) Q
;
D INPTPTF^IBCRBG(IBIFN,CS)
;
S IBTYPE=1,IBCMPNT=$P($G(^IBE(363.1,+CS,0)),U,4),IBX=$$CSBR^IBCRU3(CS),IBBLITEM=$P(IBX,U,4),IBCHGMTH=$P(IBX,U,5)
S IBIDRC=+$G(^DGCR(399,+IBIFN,"MP"))
I 'IBIDRC,$$MCRWNR^IBEFUNC($$CURR^IBCEF2(IBIFN)) S IBIDRC=$$CURR^IBCEF2(IBIFN)
S IBIDRC=$G(^DIC(36,+IBIDRC,0)),IBIDRC=$P(IBIDRC,U,7)
;
S IBBDIV=$P($G(^DGCR(399,+IBIFN,0)),U,22) ; bill's default division
;
I IBBLITEM=1,IBCHGMTH=1 D ; inpt/bedsection/per diem
. S IBEVDT="" F S IBEVDT=$O(^TMP($J,"IBCRC-INDT",IBEVDT)) Q:'IBEVDT D
.. S IBX=$G(^TMP($J,"IBCRC-INDT",IBEVDT)),IBITM=+$P(IBX,U,2),IBDIV=$P(IBX,U,5)
.. ;
.. I $$CSDV^IBCRU3(CS,IBDIV,IBBDIV)<0 Q ; check division
.. ;
.. S IBSAVE="1^^"_IBDIV_"^"_IBTYPE_"^^"_IBCMPNT
.. D BITMCHG^IBCRBC2(RS,CS,IBITM,IBEVDT,1,"","",IBIDRC,IBSAVE)
K ^TMP($J,"IBCRC-INDT")
Q
;
OPTVST(IBIFN,RS,CS) ; Determine charges for OUTPATIENT VISIT DATE billable events
; - the billable event is the outpatient visit date(s) on the bill (399,43)
;
N IBX,IBBLITEM,IBCHGMTH,IBIDRC,IBOPVARR,IBI,IBEVDT,IBTYPE,IBCMPNT,IBSAVE I '$G(IBIFN)!'$G(CS) Q
;
D OPTVD^IBCRBG1(IBIFN,.IBOPVARR) Q:'IBOPVARR
;
S IBTYPE=2,IBCMPNT=$P($G(^IBE(363.1,+CS,0)),U,4),IBX=$$CSBR^IBCRU3(CS),IBBLITEM=$P(IBX,U,4),IBCHGMTH=$P(IBX,U,5)
S IBIDRC=+$G(^DGCR(399,+IBIFN,"MP"))
I 'IBIDRC,$$MCRWNR^IBEFUNC($$CURR^IBCEF2(IBIFN)) S IBIDRC=$$CURR^IBCEF2(IBIFN)
S IBIDRC=$G(^DIC(36,+IBIDRC,0)),IBIDRC=$P(IBIDRC,U,7)
;
I IBBLITEM=1,IBCHGMTH=1 D ; opt vst/bedsection/per diem
. S IBI="" F S IBI=$O(IBOPVARR(IBI)) Q:IBI="" D
.. S IBEVDT=IBOPVARR(IBI)
.. S IBSAVE="1^^^"_IBTYPE_"^^"_IBCMPNT
.. D ALLBEDS^IBCRBC2(RS,CS,IBEVDT,"",IBIDRC,IBSAVE)
Q
;
RX(IBIFN,RS,CS) ; Determine charges for PRESCRIPTION billable events
; - the billable event is an rx that has been added to the bill (362.4)
; - the insurance company Prescription Refill Rev Code (36,.15) is passed to the calculator to be used as
; the rev code for all Rx charges, all types, this overrides the rev codes for the set or item
; - on HCFA 1500, the site parameter Default Rx Refill CPT (350.9,1.3) is added as the CPT to all Rx RC entries
;
N IBX,IBBLITEM,IBCHGMTH,IBRXCPT,IBIDRC,IBIRC,IBRXARR,IBRX,IBEVDT,IBUNIT,IBITM,IBNDC,IBTYPE,IBCMPNT,IBSAVE
I '$G(IBIFN)!'$G(CS) Q
;
D SET^IBCSC5A(IBIFN,.IBRXARR) Q:'$P(IBRXARR,U,2)
;
S IBTYPE=3,IBCMPNT=$P($G(^IBE(363.1,+CS,0)),U,4),IBX=$$CSBR^IBCRU3(CS),IBBLITEM=$P(IBX,U,4),IBCHGMTH=$P(IBX,U,5)
S IBIDRC=+$G(^DGCR(399,+IBIFN,"MP"))
I 'IBIDRC,$$MCRWNR^IBEFUNC($$CURR^IBCEF2(IBIFN)) S IBIDRC=$$CURR^IBCEF2(IBIFN)
S IBIDRC=$G(^DIC(36,+IBIDRC,0)),IBIRC=$P(IBIDRC,U,15),IBIDRC=$P(IBIDRC,U,7)
;
S IBRXCPT="" I $$FT^IBCU3(IBIFN)=2 S IBRXCPT=$P($G(^IBE(350.9,1,1)),U,30)
;
I IBBLITEM=1,IBCHGMTH=1 D ; rx refill/bedsection/per diem
. S IBRX="" F S IBRX=$O(IBRXARR(IBRX)) Q:IBRX="" D
.. S IBEVDT=0 F S IBEVDT=$O(IBRXARR(IBRX,IBEVDT)) Q:'IBEVDT D
... ;
... S IBSAVE="1^"_IBRXCPT_"^^"_IBTYPE_"^"_+IBRXARR(IBRX,IBEVDT)_"^"_IBCMPNT
... D ALLBEDS^IBCRBC2(RS,CS,IBEVDT,IBIRC,IBIDRC,IBSAVE)
;
I IBBLITEM=3,IBCHGMTH=3 D ; ndc/quantity
. S IBRX="" F S IBRX=$O(IBRXARR(IBRX)) Q:IBRX="" D
.. S IBEVDT=0 F S IBEVDT=$O(IBRXARR(IBRX,IBEVDT)) Q:'IBEVDT D
... S IBX=IBRXARR(IBRX,IBEVDT),IBITM=+IBX,IBUNIT=$P(IBX,U,4),IBNDC=$P(IBX,U,5) Q:IBNDC=""
... S IBNDC=$O(^IBA(363.21,"B",IBNDC,0)) Q:'IBNDC
... S IBSAVE="1^"_IBRXCPT_"^^"_IBTYPE_"^"_IBITM_"^"_IBCMPNT
... D BITMCHG^IBCRBC2(RS,CS,IBNDC,IBEVDT,IBUNIT,"",IBIRC,IBIDRC,IBSAVE)
;
I IBCHGMTH=2 D ; va cost
. S IBRX="" F S IBRX=$O(IBRXARR(IBRX)) Q:IBRX="" D
.. S IBEVDT=0 F S IBEVDT=$O(IBRXARR(IBRX,IBEVDT)) Q:'IBEVDT D
... S IBX=IBRXARR(IBRX,IBEVDT),IBITM=+IBX,IBUNIT=$P(IBX,U,4) Q:'IBITM
... S IBSAVE="1^"_IBRXCPT_"^^"_IBTYPE_"^"_IBITM_"^"_IBCMPNT
... D BITMCHG^IBCRBC2(RS,CS,IBITM,IBEVDT,IBUNIT,"",IBIRC,IBIDRC,IBSAVE)
;
Q
;
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
;
N IBX,IBBLITEM,IBCHGMTH,IBBR,IBBDIV,IBIDRC,IBCPTARR,IBCPT,IBCPTFN,IBEVDT,IBMOD,IBDIV,IBTYPE,IBCMPNT
N IBPPRV,IBBS,IBCLIN,IBOE,IBSAVE,IBUNIT,IBCPTRX,IBMODS I '$G(IBIFN)!'$G(CS) Q
;
D CPT^IBCRBG1(IBIFN,.IBCPTARR) Q:'IBCPTARR
;
S IBTYPE=4,IBCMPNT=$P($G(^IBE(363.1,+CS,0)),U,4),IBX=$$CSBR^IBCRU3(CS),IBBLITEM=$P(IBX,U,4),IBCHGMTH=$P(IBX,U,5)
S IBIDRC=+$G(^DGCR(399,+IBIFN,"MP"))
I 'IBIDRC,$$MCRWNR^IBEFUNC($$CURR^IBCEF2(IBIFN)) S IBIDRC=$$CURR^IBCEF2(IBIFN)
S IBIDRC=$G(^DIC(36,+IBIDRC,0)),IBIDRC=$P(IBIDRC,U,7)
S IBBR=$P(IBX,U,3) S IBCPTRX="" I $O(^IBA(362.4,"C",IBIFN,0)) S IBCPTRX=+$P($G(^IBE(350.9,1,1)),U,30)
;
S IBBDIV=$P($G(^DGCR(399,+IBIFN,0)),U,22) ; bill's default division
D INPTPTF^IBCRBG(IBIFN,CS) ; get inpatient bedsections
;
I IBBLITEM=2 D ; cpt/count/minutes/miles/hours
. S IBCPT=0 F S IBCPT=$O(IBCPTARR(IBCPT)) Q:'IBCPT D
.. S IBCPTFN=0 F S IBCPTFN=$O(IBCPTARR(IBCPT,IBCPTFN)) Q:'IBCPTFN D
... S IBX=IBCPTARR(IBCPT,IBCPTFN),IBEVDT=$P(IBX,U,1),(IBMOD,IBMODS)=$P(IBX,U,2)
... S IBDIV=$P(IBX,U,3),IBPPRV=$P(IBX,U,4),IBCLIN=$P(IBX,U,5),IBOE=$P(IBX,U,6)
... ;
... I '$$CHGOTH^IBCRBC2(IBIFN,RS,IBEVDT) Q
... I +IBCPTRX,'IBOE,IBCPT=IBCPTRX Q ; site parameter rx procedure
... ;
... S IBUNIT=$$CPTUNITS^IBCRBC2(CS,IBCHGMTH,IBX) Q:'IBUNIT
... ;
... S IBBS=$P($G(^TMP($J,"IBCRC-INDT",IBEVDT)),U,2) ; get inpatient bedsection
... I 'IBBS S IBX=$O(^TMP($J,"IBCRC-INDT",IBEVDT),-1) I +IBX S IBBS=$P($G(^TMP($J,"IBCRC-INDT",IBX)),U,2)
... ;
... I '$P($$CPT^ICPTCOD(+IBCPT,+IBEVDT),U,7) Q ; check is a valid active CPT
... I $$CSDV^IBCRU3(CS,IBDIV,IBBDIV)<0 Q ; check division
... I +IBMOD S IBMOD=$P($$CPTMOD^IBCRCU1(CS,IBCPT,IBMOD,IBEVDT),",",1) ; check CPT-MODs for billable combination
... ;
... S IBSAVE="1^"_IBCPT_U_IBDIV_U_IBTYPE_U_IBCPTFN_U_IBCMPNT_U_IBBS_U_IBPPRV_U_IBCLIN_U_IBOE_U_IBMODS
... D BITMCHG^IBCRBC2(RS,CS,IBCPT,IBEVDT,IBUNIT,IBMOD,"",IBIDRC,IBSAVE)
K ^TMP($J,"IBCRC-INDT")
Q
;
PI(IBIFN,RS,CS) ; Determine charges for PROSTHETICS billable events
; - the billable event is a prosthetic item that has been added to the bill (362.5)
;
N IBX,IBBLITEM,IBCHGMTH,IBPIARR,IBIDRC,IBEVDT,IBPI,IBITM,IBTYPE,IBCMPNT,IBSAVE I '$G(IBIFN)!'$G(CS) Q
;
D SET^IBCSC5B(IBIFN,.IBPIARR) Q:'$P(IBPIARR,U,2)
;
S IBTYPE=5,IBCMPNT=$P($G(^IBE(363.1,+CS,0)),U,4),IBX=$$CSBR^IBCRU3(CS),IBBLITEM=$P(IBX,U,4),IBCHGMTH=$P(IBX,U,5)
S IBIDRC=+$G(^DGCR(399,+IBIFN,"MP"))
I 'IBIDRC,$$MCRWNR^IBEFUNC($$CURR^IBCEF2(IBIFN)) S IBIDRC=$$CURR^IBCEF2(IBIFN)
S IBIDRC=$G(^DIC(36,+IBIDRC,0)),IBIDRC=$P(IBIDRC,U,7)
;
I IBBLITEM=1,IBCHGMTH=1 D ; pros/bedsection/per diem
. S IBEVDT="" F S IBEVDT=$O(IBPIARR(IBEVDT)) Q:'IBEVDT D
.. S IBPI=0 F S IBPI=$O(IBPIARR(IBEVDT,IBPI)) Q:'IBPI D
... S IBSAVE="1^^^"_IBTYPE_"^^"_IBCMPNT
... D ALLBEDS^IBCRBC2(RS,CS,IBEVDT,"",IBIDRC,IBSAVE)
;
I IBCHGMTH=2 D ; va cost
. S IBEVDT="" F S IBEVDT=$O(IBPIARR(IBEVDT)) Q:'IBEVDT D
.. S IBPI=0 F S IBPI=$O(IBPIARR(IBEVDT,IBPI)) Q:'IBPI D
... S IBITM=IBPIARR(IBEVDT,IBPI) Q:'IBITM
... S IBSAVE="1^^^"_IBTYPE_"^"_+IBITM_"^"_IBCMPNT
... D BITMCHG^IBCRBC2(RS,CS,+IBITM,IBEVDT,1,"","",IBIDRC,IBSAVE)
;
Q
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HIBCRBC1 9678 printed Oct 16, 2024@18:19:24 Page 2
IBCRBC1 ;ALB/ARH - RATES: BILL CALCULATION BILLABLE EVENTS ; 22 MAY 96
+1 ;;2.0;INTEGRATED BILLING;**52,80,106,138,51,148,245,270,370**;21-MAR-94;Build 5
+2 ;;Per VHA Directive 2004-038, this routine should not be modified.
+3 ;
+4 ; For each type of Billable Event, search for items on the bill and calculate the charges
+5 ; 1) search the bill for items of the billable event type
+6 ; 2) determine how the charges should be calculated, based on Billable Item and Charge Method of the Set's Rate
+7 ; 3) calculate charges
+8 ; For per diem Billing Rates, no item pointers are passed since all items have a standard charge
+9 ; The Insurance Company Different Revenue Codes to Use (36,.07) is passed so standard rev codes can be replaced
+10 ; The Charge Type (363.1,.04) is passed so it can be added to the charge on the bill if it is defined for a Set
+11 ; Output: ^TMP($J,"IBCRCC")= ..., (created in IBCRBC2 based on charge items found here)
+12 ;
INPTBS(IBIFN,RS,CS) ; Determine charges for INPATIENT BEDSECTION STAY billable events
+1 ; - the billable events are billable bedsections based on the patient movement treating specialties,
+2 ; these are pulled from the PTF record each time the charges are calculated (INPTPTF^IBCRCG)
+3 ; - each day of billable care is calculated separately in case a rate becomes inactive
+4 ;
+5 NEW IBX,IBBLITEM,IBCHGMTH,IBEVDT,IBIDRC,IBBDIV,IBITM,IBDIV,IBTYPE,IBCMPNT,IBSAVE
IF '$GET(IBIFN)!'$GET(CS)
QUIT
+6 ;
+7 DO INPTPTF^IBCRBG(IBIFN,CS)
+8 ;
+9 SET IBTYPE=1
SET IBCMPNT=$PIECE($GET(^IBE(363.1,+CS,0)),U,4)
SET IBX=$$CSBR^IBCRU3(CS)
SET IBBLITEM=$PIECE(IBX,U,4)
SET IBCHGMTH=$PIECE(IBX,U,5)
+10 SET IBIDRC=+$GET(^DGCR(399,+IBIFN,"MP"))
+11 IF 'IBIDRC
IF $$MCRWNR^IBEFUNC($$CURR^IBCEF2(IBIFN))
SET IBIDRC=$$CURR^IBCEF2(IBIFN)
+12 SET IBIDRC=$GET(^DIC(36,+IBIDRC,0))
SET IBIDRC=$PIECE(IBIDRC,U,7)
+13 ;
+14 ; bill's default division
SET IBBDIV=$PIECE($GET(^DGCR(399,+IBIFN,0)),U,22)
+15 ;
+16 ; inpt/bedsection/per diem
IF IBBLITEM=1
IF IBCHGMTH=1
Begin DoDot:1
+17 SET IBEVDT=""
FOR
SET IBEVDT=$ORDER(^TMP($JOB,"IBCRC-INDT",IBEVDT))
if 'IBEVDT
QUIT
Begin DoDot:2
+18 SET IBX=$GET(^TMP($JOB,"IBCRC-INDT",IBEVDT))
SET IBITM=+$PIECE(IBX,U,2)
SET IBDIV=$PIECE(IBX,U,5)
+19 ;
+20 ; check division
IF $$CSDV^IBCRU3(CS,IBDIV,IBBDIV)<0
QUIT
+21 ;
+22 SET IBSAVE="1^^"_IBDIV_"^"_IBTYPE_"^^"_IBCMPNT
+23 DO BITMCHG^IBCRBC2(RS,CS,IBITM,IBEVDT,1,"","",IBIDRC,IBSAVE)
End DoDot:2
End DoDot:1
+24 KILL ^TMP($JOB,"IBCRC-INDT")
+25 QUIT
+26 ;
OPTVST(IBIFN,RS,CS) ; Determine charges for OUTPATIENT VISIT DATE billable events
+1 ; - the billable event is the outpatient visit date(s) on the bill (399,43)
+2 ;
+3 NEW IBX,IBBLITEM,IBCHGMTH,IBIDRC,IBOPVARR,IBI,IBEVDT,IBTYPE,IBCMPNT,IBSAVE
IF '$GET(IBIFN)!'$GET(CS)
QUIT
+4 ;
+5 DO OPTVD^IBCRBG1(IBIFN,.IBOPVARR)
if 'IBOPVARR
QUIT
+6 ;
+7 SET IBTYPE=2
SET IBCMPNT=$PIECE($GET(^IBE(363.1,+CS,0)),U,4)
SET IBX=$$CSBR^IBCRU3(CS)
SET IBBLITEM=$PIECE(IBX,U,4)
SET IBCHGMTH=$PIECE(IBX,U,5)
+8 SET IBIDRC=+$GET(^DGCR(399,+IBIFN,"MP"))
+9 IF 'IBIDRC
IF $$MCRWNR^IBEFUNC($$CURR^IBCEF2(IBIFN))
SET IBIDRC=$$CURR^IBCEF2(IBIFN)
+10 SET IBIDRC=$GET(^DIC(36,+IBIDRC,0))
SET IBIDRC=$PIECE(IBIDRC,U,7)
+11 ;
+12 ; opt vst/bedsection/per diem
IF IBBLITEM=1
IF IBCHGMTH=1
Begin DoDot:1
+13 SET IBI=""
FOR
SET IBI=$ORDER(IBOPVARR(IBI))
if IBI=""
QUIT
Begin DoDot:2
+14 SET IBEVDT=IBOPVARR(IBI)
+15 SET IBSAVE="1^^^"_IBTYPE_"^^"_IBCMPNT
+16 DO ALLBEDS^IBCRBC2(RS,CS,IBEVDT,"",IBIDRC,IBSAVE)
End DoDot:2
End DoDot:1
+17 QUIT
+18 ;
RX(IBIFN,RS,CS) ; Determine charges for PRESCRIPTION billable events
+1 ; - the billable event is an rx that has been added to the bill (362.4)
+2 ; - the insurance company Prescription Refill Rev Code (36,.15) is passed to the calculator to be used as
+3 ; the rev code for all Rx charges, all types, this overrides the rev codes for the set or item
+4 ; - on HCFA 1500, the site parameter Default Rx Refill CPT (350.9,1.3) is added as the CPT to all Rx RC entries
+5 ;
+6 NEW IBX,IBBLITEM,IBCHGMTH,IBRXCPT,IBIDRC,IBIRC,IBRXARR,IBRX,IBEVDT,IBUNIT,IBITM,IBNDC,IBTYPE,IBCMPNT,IBSAVE
+7 IF '$GET(IBIFN)!'$GET(CS)
QUIT
+8 ;
+9 DO SET^IBCSC5A(IBIFN,.IBRXARR)
if '$PIECE(IBRXARR,U,2)
QUIT
+10 ;
+11 SET IBTYPE=3
SET IBCMPNT=$PIECE($GET(^IBE(363.1,+CS,0)),U,4)
SET IBX=$$CSBR^IBCRU3(CS)
SET IBBLITEM=$PIECE(IBX,U,4)
SET IBCHGMTH=$PIECE(IBX,U,5)
+12 SET IBIDRC=+$GET(^DGCR(399,+IBIFN,"MP"))
+13 IF 'IBIDRC
IF $$MCRWNR^IBEFUNC($$CURR^IBCEF2(IBIFN))
SET IBIDRC=$$CURR^IBCEF2(IBIFN)
+14 SET IBIDRC=$GET(^DIC(36,+IBIDRC,0))
SET IBIRC=$PIECE(IBIDRC,U,15)
SET IBIDRC=$PIECE(IBIDRC,U,7)
+15 ;
+16 SET IBRXCPT=""
IF $$FT^IBCU3(IBIFN)=2
SET IBRXCPT=$PIECE($GET(^IBE(350.9,1,1)),U,30)
+17 ;
+18 ; rx refill/bedsection/per diem
IF IBBLITEM=1
IF IBCHGMTH=1
Begin DoDot:1
+19 SET IBRX=""
FOR
SET IBRX=$ORDER(IBRXARR(IBRX))
if IBRX=""
QUIT
Begin DoDot:2
+20 SET IBEVDT=0
FOR
SET IBEVDT=$ORDER(IBRXARR(IBRX,IBEVDT))
if 'IBEVDT
QUIT
Begin DoDot:3
+21 ;
+22 SET IBSAVE="1^"_IBRXCPT_"^^"_IBTYPE_"^"_+IBRXARR(IBRX,IBEVDT)_"^"_IBCMPNT
+23 DO ALLBEDS^IBCRBC2(RS,CS,IBEVDT,IBIRC,IBIDRC,IBSAVE)
End DoDot:3
End DoDot:2
End DoDot:1
+24 ;
+25 ; ndc/quantity
IF IBBLITEM=3
IF IBCHGMTH=3
Begin DoDot:1
+26 SET IBRX=""
FOR
SET IBRX=$ORDER(IBRXARR(IBRX))
if IBRX=""
QUIT
Begin DoDot:2
+27 SET IBEVDT=0
FOR
SET IBEVDT=$ORDER(IBRXARR(IBRX,IBEVDT))
if 'IBEVDT
QUIT
Begin DoDot:3
+28 SET IBX=IBRXARR(IBRX,IBEVDT)
SET IBITM=+IBX
SET IBUNIT=$PIECE(IBX,U,4)
SET IBNDC=$PIECE(IBX,U,5)
if IBNDC=""
QUIT
+29 SET IBNDC=$ORDER(^IBA(363.21,"B",IBNDC,0))
if 'IBNDC
QUIT
+30 SET IBSAVE="1^"_IBRXCPT_"^^"_IBTYPE_"^"_IBITM_"^"_IBCMPNT
+31 DO BITMCHG^IBCRBC2(RS,CS,IBNDC,IBEVDT,IBUNIT,"",IBIRC,IBIDRC,IBSAVE)
End DoDot:3
End DoDot:2
End DoDot:1
+32 ;
+33 ; va cost
IF IBCHGMTH=2
Begin DoDot:1
+34 SET IBRX=""
FOR
SET IBRX=$ORDER(IBRXARR(IBRX))
if IBRX=""
QUIT
Begin DoDot:2
+35 SET IBEVDT=0
FOR
SET IBEVDT=$ORDER(IBRXARR(IBRX,IBEVDT))
if 'IBEVDT
QUIT
Begin DoDot:3
+36 SET IBX=IBRXARR(IBRX,IBEVDT)
SET IBITM=+IBX
SET IBUNIT=$PIECE(IBX,U,4)
if 'IBITM
QUIT
+37 SET IBSAVE="1^"_IBRXCPT_"^^"_IBTYPE_"^"_IBITM_"^"_IBCMPNT
+38 DO BITMCHG^IBCRBC2(RS,CS,IBITM,IBEVDT,IBUNIT,"",IBIRC,IBIDRC,IBSAVE)
End DoDot:3
End DoDot:2
End DoDot:1
+39 ;
+40 QUIT
+41 ;
CPT(IBIFN,RS,CS) ; Determine charges for PROCEDURE billable events
+1 ; - the billable event is a CPT procedure from the bill (399,304)
+2 ; - the item to be billed is a CPT, this may include Modifier
+3 ; - for each CPT found on the bill that has a modifier, will first check to see if that CPT-modifier
+4 ; combination is billable (ie. is defined as a charge item for the Billing Rate, does not have to be active)
+5 ; if it does not then assumes the charge should be the CPT charge
+6 ; - if the charge set is limited by region then either the CPT's division or if no CPT division then the bill's
+7 ; Default Division must be contained in the sets region
+8 ; - the billable CPT is added as the CPT of the charge entry, Division is also added if defined for the CPT
+9 ; - the procedures provider may affect the charges due to a provider discount
+10 ; - if an inpatient bill then the bedsection on date of procedure will be used as the default bedsection
+11 ; - different sets of charges apply to SNF and Inpatient care although the bill is defined as inpatient
+12 ; - the Default Rx CPT should not be billed the CPT charge, instead the Rx is charged
+13 ;
+14 NEW IBX,IBBLITEM,IBCHGMTH,IBBR,IBBDIV,IBIDRC,IBCPTARR,IBCPT,IBCPTFN,IBEVDT,IBMOD,IBDIV,IBTYPE,IBCMPNT
+15 NEW IBPPRV,IBBS,IBCLIN,IBOE,IBSAVE,IBUNIT,IBCPTRX,IBMODS
IF '$GET(IBIFN)!'$GET(CS)
QUIT
+16 ;
+17 DO CPT^IBCRBG1(IBIFN,.IBCPTARR)
if 'IBCPTARR
QUIT
+18 ;
+19 SET IBTYPE=4
SET IBCMPNT=$PIECE($GET(^IBE(363.1,+CS,0)),U,4)
SET IBX=$$CSBR^IBCRU3(CS)
SET IBBLITEM=$PIECE(IBX,U,4)
SET IBCHGMTH=$PIECE(IBX,U,5)
+20 SET IBIDRC=+$GET(^DGCR(399,+IBIFN,"MP"))
+21 IF 'IBIDRC
IF $$MCRWNR^IBEFUNC($$CURR^IBCEF2(IBIFN))
SET IBIDRC=$$CURR^IBCEF2(IBIFN)
+22 SET IBIDRC=$GET(^DIC(36,+IBIDRC,0))
SET IBIDRC=$PIECE(IBIDRC,U,7)
+23 SET IBBR=$PIECE(IBX,U,3)
SET IBCPTRX=""
IF $ORDER(^IBA(362.4,"C",IBIFN,0))
SET IBCPTRX=+$PIECE($GET(^IBE(350.9,1,1)),U,30)
+24 ;
+25 ; bill's default division
SET IBBDIV=$PIECE($GET(^DGCR(399,+IBIFN,0)),U,22)
+26 ; get inpatient bedsections
DO INPTPTF^IBCRBG(IBIFN,CS)
+27 ;
+28 ; cpt/count/minutes/miles/hours
IF IBBLITEM=2
Begin DoDot:1
+29 SET IBCPT=0
FOR
SET IBCPT=$ORDER(IBCPTARR(IBCPT))
if 'IBCPT
QUIT
Begin DoDot:2
+30 SET IBCPTFN=0
FOR
SET IBCPTFN=$ORDER(IBCPTARR(IBCPT,IBCPTFN))
if 'IBCPTFN
QUIT
Begin DoDot:3
+31 SET IBX=IBCPTARR(IBCPT,IBCPTFN)
SET IBEVDT=$PIECE(IBX,U,1)
SET (IBMOD,IBMODS)=$PIECE(IBX,U,2)
+32 SET IBDIV=$PIECE(IBX,U,3)
SET IBPPRV=$PIECE(IBX,U,4)
SET IBCLIN=$PIECE(IBX,U,5)
SET IBOE=$PIECE(IBX,U,6)
+33 ;
+34 IF '$$CHGOTH^IBCRBC2(IBIFN,RS,IBEVDT)
QUIT
+35 ; site parameter rx procedure
IF +IBCPTRX
IF 'IBOE
IF IBCPT=IBCPTRX
QUIT
+36 ;
+37 SET IBUNIT=$$CPTUNITS^IBCRBC2(CS,IBCHGMTH,IBX)
if 'IBUNIT
QUIT
+38 ;
+39 ; get inpatient bedsection
SET IBBS=$PIECE($GET(^TMP($JOB,"IBCRC-INDT",IBEVDT)),U,2)
+40 IF 'IBBS
SET IBX=$ORDER(^TMP($JOB,"IBCRC-INDT",IBEVDT),-1)
IF +IBX
SET IBBS=$PIECE($GET(^TMP($JOB,"IBCRC-INDT",IBX)),U,2)
+41 ;
+42 ; check is a valid active CPT
IF '$PIECE($$CPT^ICPTCOD(+IBCPT,+IBEVDT),U,7)
QUIT
+43 ; check division
IF $$CSDV^IBCRU3(CS,IBDIV,IBBDIV)<0
QUIT
+44 ; check CPT-MODs for billable combination
IF +IBMOD
SET IBMOD=$PIECE($$CPTMOD^IBCRCU1(CS,IBCPT,IBMOD,IBEVDT),",",1)
+45 ;
+46 SET IBSAVE="1^"_IBCPT_U_IBDIV_U_IBTYPE_U_IBCPTFN_U_IBCMPNT_U_IBBS_U_IBPPRV_U_IBCLIN_U_IBOE_U_IBMODS
+47 DO BITMCHG^IBCRBC2(RS,CS,IBCPT,IBEVDT,IBUNIT,IBMOD,"",IBIDRC,IBSAVE)
End DoDot:3
End DoDot:2
End DoDot:1
+48 KILL ^TMP($JOB,"IBCRC-INDT")
+49 QUIT
+50 ;
PI(IBIFN,RS,CS) ; Determine charges for PROSTHETICS billable events
+1 ; - the billable event is a prosthetic item that has been added to the bill (362.5)
+2 ;
+3 NEW IBX,IBBLITEM,IBCHGMTH,IBPIARR,IBIDRC,IBEVDT,IBPI,IBITM,IBTYPE,IBCMPNT,IBSAVE
IF '$GET(IBIFN)!'$GET(CS)
QUIT
+4 ;
+5 DO SET^IBCSC5B(IBIFN,.IBPIARR)
if '$PIECE(IBPIARR,U,2)
QUIT
+6 ;
+7 SET IBTYPE=5
SET IBCMPNT=$PIECE($GET(^IBE(363.1,+CS,0)),U,4)
SET IBX=$$CSBR^IBCRU3(CS)
SET IBBLITEM=$PIECE(IBX,U,4)
SET IBCHGMTH=$PIECE(IBX,U,5)
+8 SET IBIDRC=+$GET(^DGCR(399,+IBIFN,"MP"))
+9 IF 'IBIDRC
IF $$MCRWNR^IBEFUNC($$CURR^IBCEF2(IBIFN))
SET IBIDRC=$$CURR^IBCEF2(IBIFN)
+10 SET IBIDRC=$GET(^DIC(36,+IBIDRC,0))
SET IBIDRC=$PIECE(IBIDRC,U,7)
+11 ;
+12 ; pros/bedsection/per diem
IF IBBLITEM=1
IF IBCHGMTH=1
Begin DoDot:1
+13 SET IBEVDT=""
FOR
SET IBEVDT=$ORDER(IBPIARR(IBEVDT))
if 'IBEVDT
QUIT
Begin DoDot:2
+14 SET IBPI=0
FOR
SET IBPI=$ORDER(IBPIARR(IBEVDT,IBPI))
if 'IBPI
QUIT
Begin DoDot:3
+15 SET IBSAVE="1^^^"_IBTYPE_"^^"_IBCMPNT
+16 DO ALLBEDS^IBCRBC2(RS,CS,IBEVDT,"",IBIDRC,IBSAVE)
End DoDot:3
End DoDot:2
End DoDot:1
+17 ;
+18 ; va cost
IF IBCHGMTH=2
Begin DoDot:1
+19 SET IBEVDT=""
FOR
SET IBEVDT=$ORDER(IBPIARR(IBEVDT))
if 'IBEVDT
QUIT
Begin DoDot:2
+20 SET IBPI=0
FOR
SET IBPI=$ORDER(IBPIARR(IBEVDT,IBPI))
if 'IBPI
QUIT
Begin DoDot:3
+21 SET IBITM=IBPIARR(IBEVDT,IBPI)
if 'IBITM
QUIT
+22 SET IBSAVE="1^^^"_IBTYPE_"^"_+IBITM_"^"_IBCMPNT
+23 DO BITMCHG^IBCRBC2(RS,CS,+IBITM,IBEVDT,1,"","",IBIDRC,IBSAVE)
End DoDot:3
End DoDot:2
End DoDot:1
+24 ;
+25 QUIT
