IBCRER1 ;ALB/ARH - RATES: CM RC NATIONAL ENTER/EDIT OPTION (CONT) ; 13-FEB-2007
;;2.0;INTEGRATED BILLING;**370**;21-MAR-94;Build 5
;;Per VHA Directive 2004-038, this routine should not be modified.
;
;
CHGLN(IBEFF,IBTYP,IBLINE) ; get all user data for charge
; Input: pass by reference to get/retain defaults: Effective Date, Inst/Prof
; Output: IBLINE if passed by reference
; IBLINE = 'cpt ifn^eff dt^mod ifn^type (I/P)^charge^incr type (PR/ML/HR/MN)^incr charge^inpt^snf^opt^free'
; or null if no CPT, or -1 if invalid (exit)
N IBCPT,IBMOD,IBCHGU,IBINCR,IBCHGI,IBINP,IBSNF,IBOPT,IBFS S IBEFF=$G(IBEFF),IBTYP=$G(IBTYP),IBLINE=""
;
S IBCPT=$$GETCPT(IBEFF) I IBCPT<1 S IBLINE=-1 Q ; active cpt code
S IBEFF=$$GETEFF(IBEFF) Q:IBEFF<1 ; charge effective date
S IBMOD=$$GETMOD() Q:IBMOD<0 ; modifier for procedure charge
S IBTYP=$$GETTYP(IBTYP) Q:IBTYP<0 ; charge type, inst/prof
S IBCHGU=$$GETCHGU() Q:IBCHGU<0 W ! ; unit charge
;
S IBINCR=$$GETINCR() Q:IBINCR<0 ; type of incremental charge
S IBCHGI=$$GETCHGI(IBINCR) Q:IBCHGI<0 W ! ; incremental charge
;
S IBINP=$$GETIINP() Q:IBINP<0 ; inpatient indicator
S IBSNF=$$GETISNF() Q:IBSNF<0 ; snf indicator
S IBOPT=$$GETIOPT() Q:IBOPT<0 ; outpatient indictor
S IBFS=$$GETIFS() Q:IBFS<0 ; freestanding indicator
;
S IBLINE=+IBCPT_U_+IBEFF_U_IBMOD_U_IBTYP_U_IBCHGU_U_IBINCR_U_IBCHGI_U_IBINP_U_IBSNF_U_IBOPT_U_IBFS
Q
;
GETCPT(EFFDT) ; Get CPT/HCPCS procedure associated with charge
; Returns: IFN of CPT/HCPCS selected, -1 if invalid
N IBX,DIC,DIE,DA,DR,I,X,Y,DTOUT,DUOUT S IBX=-1
;
S DIC("A")="Select PROCEDURE CPT/HCPCS: " I +$G(EFFDT) S DIC("S")="I $$CPTACT^IBACSV(+Y,EFFDT)"
S DIC="^ICPT(",DIC(0)="AEMNQ" D ^DIC K DIC I +Y>0 S IBX=+Y
I $D(DTOUT)!$D(DUOUT) S IBX=-1
Q IBX
;
GETEFF(DEFAULT) ; Get Effective Date for charge, must be within date range of current version
; returns valid effective date, -1 if invalid
N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y,IBY,IBI,IBZ,IBA,IBMIN S IBMIN="",IBA="",IBX=-1
S IBY=$$VERSALL^IBCRHBRV() F IBI=1:1 S IBZ=$P(IBY,U,IBI) Q:IBZ="" S IBMIN=IBZ
S DIR("?",1)="Charge Effective Date must be within the date range of the current RC"
S DIR("?",2)="version, v"_+IBMIN_". Date must be between "_$$DATE(+$P(IBMIN,";",2))_" and Today.",DIR("?",3)=""
S DIR("?")="Enter Effective Date of Charge."
;
S DIR("A")="EFFECTIVE DATE" I +$G(DEFAULT)>0 S DIR("B")=$$DATE(DEFAULT),IBA="A",DIR("A")=DIR("A")_": "
S DIR(0)="D"_IBA_"^"_+$P(IBMIN,";",2)_":"_DT_":EX" D ^DIR K DIR I Y?7N S IBX=+Y
I $D(DTOUT)!$D(DUOUT) S IBX=-1
Q IBX
;
GETMOD() ; Get Modifier associated with the procedure charge
; Modifier not limited to valid CPTs since that list is often out of date
; Returns: IFN of selected modifier, null if no modifier selected, -1 if invalid
N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=""
S DIR("?",1)="Modifier is optional. If a modifier is added then the charge will only"
S DIR("?",2)="be applied if the modifier is assigned to the procedure on the bill.",DIR("?",3)=""
S DIR("?")="Enter the Modifier associated with the procedure charge."
;
S DIR("A")="MODIFIER"
S DIR(0)="PO^DIC(81.3,:AEMQ" D ^DIR K DIR I Y>0 S IBX=+Y
I $D(DUOUT)!$D(DTOUT) S IBX=-1
Q IBX
;
GETTYP(DEFAULT) ; Get Charge Type: Institutional or Professional
; Returns: I for Institutional, P for Professional, -1 if invalid
N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=-1
I $G(DEFAULT)'="" S DEFAULT=$S(DEFAULT="I":"Institutional",DEFAULT="P":"Professional",1:"")
S DIR("?")="Enter the type of charge, either Institutional or Professional."
;
S DIR("A")="CHARGE TYPE" I $G(DEFAULT)'="" S DIR("B")=DEFAULT
S DIR(0)="SB^I:Institutional;P:Professional" D ^DIR S IBX=Y
I $D(DTOUT)!$D(DUOUT) S IBX=-1
Q IBX
;
GETCHGU() ; get procedures unit charge
; Returns: dollar amount (non-zero), -1 if invalid
N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=-1
S DIR("?",1)="The dollar amount to be added to a bill for each of this procedure on the bill."
S DIR("?",2)="Enter an amount greater than zero and less than 99999, 2 decimal digits."
S DIR("?")="Enter the unit charge for Procedure to be used at all sites."
;
S DIR("A")="UNIT CHARGE: "
S DIR(0)="NA^.001:99999:2" D ^DIR K DIR I +Y>0 S IBX=Y
I $D(DTOUT)!$D(DUOUT) S IBX=-1
Q IBX
;
GETINCR() ; get the type of charge, identifies Charge Method and incremental calculations
; Returns: PR for standard, HR for observation, MN for anesthesia, ML for ambulance, -1 if invalid
N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=-1
S DIR("?",1)="Most charges are a standard charge per procedure. There are three types of"
S DIR("?",2)="charges that require special calculations that add charge based on an "
S DIR("?",3)="increment of units: Anesthesia, Observation, Ambulance."
S DIR("?")="Enter type of care that will identify the charge calculation."
;
S DIR("A")="Standard, Observation, Anesthesia, or Ambulance",DIR("B")="Standard"
S DIR(0)="SB^PR:Standard;HR:Observation;MN:Anesthesia;ML:Ambulance" D ^DIR S IBX=Y
I $D(DTOUT)!$D(DUOUT) S IBX=-1
;
Q IBX
;
GETCHGI(TYPE) ; if a special charge then get the incremental charge amount, anesthesia and observation only
; Returns: dollar amount if applicable (non-zero), null if not applicable, -1 if invalid
N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y,IBTYP S TYPE=$G(TYPE),IBX=-1
S IBTYP=$S(TYPE="MN":"Anesthesia",TYPE="HR":"Observation",1:"") I IBTYP="" S IBX=""
S DIR("?",1)="Anesthesia and Observation have a unit charge added to a base/incremental"
S DIR("?",2)="charge that is multiplied by the time associated with the procedure."
S DIR("?",3)="Enter an amount greater than zero and less than 99999, 2 decimal digits.",DIR("?",4)=""
S DIR("?")="Enter the base or incremental "_IBTYP_" charge for this procedure."
;
S DIR("A")=IBTYP_" BASE CHARGE: "
I IBTYP'="" S DIR(0)="NA^.001:99999:2" D ^DIR K DIR I +Y>0 S IBX=Y
I $D(DTOUT)!$D(DUOUT) S IBX=-1
Q IBX
;
GETIINP() ; Get Inpatient Indicator, is this charge billable for Inpatient care
; Returns: 1 for Yes Billable for Inpatient care, 0 for not billable, -1 if invalid
N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=0
S DIR("?")="Enter Yes if this charge is billable for Inpatient care, No otherwise."
;
S DIR(0)="Y",DIR("A")="INPATIENT",DIR("B")="No" D ^DIR I Y=1 S IBX=1
I $D(DTOUT)!$D(DUOUT) S IBX=-1
Q IBX
;
GETISNF() ; Get SNF Indicator, is this charge billable for Skilled Nursing care
; Returns: 1 for Yes Billable for SNF care, 0 for not billable, -1 if invalid
N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=0
S DIR("?")="Enter Yes if this charge is billable for SNF care, No otherwise."
;
S DIR(0)="Y",DIR("A")="SKILLED NURSING",DIR("B")="Yes" D ^DIR I Y=1 S IBX=1
I $D(DTOUT)!$D(DUOUT) S IBX=-1
Q IBX
;
GETIOPT() ; Get Outpatient Indicator, is this charge billable for Outpatient care
; Returns: 1 for Yes Billable for outpatient care, 0 for not billable, -1 if invalid
N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=0
S DIR("?")="Enter Yes if this charge is billable for Outpatient care, No otherwise."
;
S DIR(0)="Y",DIR("A")="OUTPATIENT",DIR("B")="Yes" D ^DIR I Y=1 S IBX=1
I $D(DTOUT)!$D(DUOUT) S IBX=-1
Q IBX
;
GETIFS() ; Get Freestanding Indicator, is this charge billable at Freestanding Sites
; Returns: 1 for Yes Billable at Non-Provider Based/Freestanding sites, 0 for not billable, -1 if invalid
N IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y S IBX=0
S DIR("?",1)="All charges for Freestanding sites will be stored as Professional charges."
S DIR("?")="Enter Yes if this charge is billable at Freestanding Sites, No otherwise."
;
S DIR(0)="Y",DIR("A")="FREESTANDING",DIR("B")="Yes" D ^DIR I Y=1 S IBX=1
I $D(DTOUT)!$D(DUOUT) S IBX=-1
Q IBX
;
DATE(X) ; returns VA date in external form
N Y S Y="" I $G(X)?7N.E S Y=$E(X,4,5)_"/"_$E(X,6,7)_"/"_$E(X,2,3)
Q Y
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HIBCRER1 7879 printed Oct 16, 2024@18:19:46 Page 2
IBCRER1 ;ALB/ARH - RATES: CM RC NATIONAL ENTER/EDIT OPTION (CONT) ; 13-FEB-2007
+1 ;;2.0;INTEGRATED BILLING;**370**;21-MAR-94;Build 5
+2 ;;Per VHA Directive 2004-038, this routine should not be modified.
+3 ;
+4 ;
CHGLN(IBEFF,IBTYP,IBLINE) ; get all user data for charge
+1 ; Input: pass by reference to get/retain defaults: Effective Date, Inst/Prof
+2 ; Output: IBLINE if passed by reference
+3 ; IBLINE = 'cpt ifn^eff dt^mod ifn^type (I/P)^charge^incr type (PR/ML/HR/MN)^incr charge^inpt^snf^opt^free'
+4 ; or null if no CPT, or -1 if invalid (exit)
+5 NEW IBCPT,IBMOD,IBCHGU,IBINCR,IBCHGI,IBINP,IBSNF,IBOPT,IBFS
SET IBEFF=$GET(IBEFF)
SET IBTYP=$GET(IBTYP)
SET IBLINE=""
+6 ;
+7 ; active cpt code
SET IBCPT=$$GETCPT(IBEFF)
IF IBCPT<1
SET IBLINE=-1
QUIT
+8 ; charge effective date
SET IBEFF=$$GETEFF(IBEFF)
if IBEFF<1
QUIT
+9 ; modifier for procedure charge
SET IBMOD=$$GETMOD()
if IBMOD<0
QUIT
+10 ; charge type, inst/prof
SET IBTYP=$$GETTYP(IBTYP)
if IBTYP<0
QUIT
+11 ; unit charge
SET IBCHGU=$$GETCHGU()
if IBCHGU<0
QUIT
WRITE !
+12 ;
+13 ; type of incremental charge
SET IBINCR=$$GETINCR()
if IBINCR<0
QUIT
+14 ; incremental charge
SET IBCHGI=$$GETCHGI(IBINCR)
if IBCHGI<0
QUIT
WRITE !
+15 ;
+16 ; inpatient indicator
SET IBINP=$$GETIINP()
if IBINP<0
QUIT
+17 ; snf indicator
SET IBSNF=$$GETISNF()
if IBSNF<0
QUIT
+18 ; outpatient indictor
SET IBOPT=$$GETIOPT()
if IBOPT<0
QUIT
+19 ; freestanding indicator
SET IBFS=$$GETIFS()
if IBFS<0
QUIT
+20 ;
+21 SET IBLINE=+IBCPT_U_+IBEFF_U_IBMOD_U_IBTYP_U_IBCHGU_U_IBINCR_U_IBCHGI_U_IBINP_U_IBSNF_U_IBOPT_U_IBFS
+22 QUIT
+23 ;
GETCPT(EFFDT) ; Get CPT/HCPCS procedure associated with charge
+1 ; Returns: IFN of CPT/HCPCS selected, -1 if invalid
+2 NEW IBX,DIC,DIE,DA,DR,I,X,Y,DTOUT,DUOUT
SET IBX=-1
+3 ;
+4 SET DIC("A")="Select PROCEDURE CPT/HCPCS: "
IF +$GET(EFFDT)
SET DIC("S")="I $$CPTACT^IBACSV(+Y,EFFDT)"
+5 SET DIC="^ICPT("
SET DIC(0)="AEMNQ"
DO ^DIC
KILL DIC
IF +Y>0
SET IBX=+Y
+6 IF $DATA(DTOUT)!$DATA(DUOUT)
SET IBX=-1
+7 QUIT IBX
+8 ;
GETEFF(DEFAULT) ; Get Effective Date for charge, must be within date range of current version
+1 ; returns valid effective date, -1 if invalid
+2 NEW IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y,IBY,IBI,IBZ,IBA,IBMIN
SET IBMIN=""
SET IBA=""
SET IBX=-1
+3 SET IBY=$$VERSALL^IBCRHBRV()
FOR IBI=1:1
SET IBZ=$PIECE(IBY,U,IBI)
if IBZ=""
QUIT
SET IBMIN=IBZ
+4 SET DIR("?",1)="Charge Effective Date must be within the date range of the current RC"
+5 SET DIR("?",2)="version, v"_+IBMIN_". Date must be between "_$$DATE(+$PIECE(IBMIN,";",2))_" and Today."
SET DIR("?",3)=""
+6 SET DIR("?")="Enter Effective Date of Charge."
+7 ;
+8 SET DIR("A")="EFFECTIVE DATE"
IF +$GET(DEFAULT)>0
SET DIR("B")=$$DATE(DEFAULT)
SET IBA="A"
SET DIR("A")=DIR("A")_": "
+9 SET DIR(0)="D"_IBA_"^"_+$PIECE(IBMIN,";",2)_":"_DT_":EX"
DO ^DIR
KILL DIR
IF Y?7N
SET IBX=+Y
+10 IF $DATA(DTOUT)!$DATA(DUOUT)
SET IBX=-1
+11 QUIT IBX
+12 ;
GETMOD() ; Get Modifier associated with the procedure charge
+1 ; Modifier not limited to valid CPTs since that list is often out of date
+2 ; Returns: IFN of selected modifier, null if no modifier selected, -1 if invalid
+3 NEW IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y
SET IBX=""
+4 SET DIR("?",1)="Modifier is optional. If a modifier is added then the charge will only"
+5 SET DIR("?",2)="be applied if the modifier is assigned to the procedure on the bill."
SET DIR("?",3)=""
+6 SET DIR("?")="Enter the Modifier associated with the procedure charge."
+7 ;
+8 SET DIR("A")="MODIFIER"
+9 SET DIR(0)="PO^DIC(81.3,:AEMQ"
DO ^DIR
KILL DIR
IF Y>0
SET IBX=+Y
+10 IF $DATA(DUOUT)!$DATA(DTOUT)
SET IBX=-1
+11 QUIT IBX
+12 ;
GETTYP(DEFAULT) ; Get Charge Type: Institutional or Professional
+1 ; Returns: I for Institutional, P for Professional, -1 if invalid
+2 NEW IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y
SET IBX=-1
+3 IF $GET(DEFAULT)'=""
SET DEFAULT=$SELECT(DEFAULT="I":"Institutional",DEFAULT="P":"Professional",1:"")
+4 SET DIR("?")="Enter the type of charge, either Institutional or Professional."
+5 ;
+6 SET DIR("A")="CHARGE TYPE"
IF $GET(DEFAULT)'=""
SET DIR("B")=DEFAULT
+7 SET DIR(0)="SB^I:Institutional;P:Professional"
DO ^DIR
SET IBX=Y
+8 IF $DATA(DTOUT)!$DATA(DUOUT)
SET IBX=-1
+9 QUIT IBX
+10 ;
GETCHGU() ; get procedures unit charge
+1 ; Returns: dollar amount (non-zero), -1 if invalid
+2 NEW IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y
SET IBX=-1
+3 SET DIR("?",1)="The dollar amount to be added to a bill for each of this procedure on the bill."
+4 SET DIR("?",2)="Enter an amount greater than zero and less than 99999, 2 decimal digits."
+5 SET DIR("?")="Enter the unit charge for Procedure to be used at all sites."
+6 ;
+7 SET DIR("A")="UNIT CHARGE: "
+8 SET DIR(0)="NA^.001:99999:2"
DO ^DIR
KILL DIR
IF +Y>0
SET IBX=Y
+9 IF $DATA(DTOUT)!$DATA(DUOUT)
SET IBX=-1
+10 QUIT IBX
+11 ;
GETINCR() ; get the type of charge, identifies Charge Method and incremental calculations
+1 ; Returns: PR for standard, HR for observation, MN for anesthesia, ML for ambulance, -1 if invalid
+2 NEW IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y
SET IBX=-1
+3 SET DIR("?",1)="Most charges are a standard charge per procedure. There are three types of"
+4 SET DIR("?",2)="charges that require special calculations that add charge based on an "
+5 SET DIR("?",3)="increment of units: Anesthesia, Observation, Ambulance."
+6 SET DIR("?")="Enter type of care that will identify the charge calculation."
+7 ;
+8 SET DIR("A")="Standard, Observation, Anesthesia, or Ambulance"
SET DIR("B")="Standard"
+9 SET DIR(0)="SB^PR:Standard;HR:Observation;MN:Anesthesia;ML:Ambulance"
DO ^DIR
SET IBX=Y
+10 IF $DATA(DTOUT)!$DATA(DUOUT)
SET IBX=-1
+11 ;
+12 QUIT IBX
+13 ;
GETCHGI(TYPE) ; if a special charge then get the incremental charge amount, anesthesia and observation only
+1 ; Returns: dollar amount if applicable (non-zero), null if not applicable, -1 if invalid
+2 NEW IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y,IBTYP
SET TYPE=$GET(TYPE)
SET IBX=-1
+3 SET IBTYP=$SELECT(TYPE="MN":"Anesthesia",TYPE="HR":"Observation",1:"")
IF IBTYP=""
SET IBX=""
+4 SET DIR("?",1)="Anesthesia and Observation have a unit charge added to a base/incremental"
+5 SET DIR("?",2)="charge that is multiplied by the time associated with the procedure."
+6 SET DIR("?",3)="Enter an amount greater than zero and less than 99999, 2 decimal digits."
SET DIR("?",4)=""
+7 SET DIR("?")="Enter the base or incremental "_IBTYP_" charge for this procedure."
+8 ;
+9 SET DIR("A")=IBTYP_" BASE CHARGE: "
+10 IF IBTYP'=""
SET DIR(0)="NA^.001:99999:2"
DO ^DIR
KILL DIR
IF +Y>0
SET IBX=Y
+11 IF $DATA(DTOUT)!$DATA(DUOUT)
SET IBX=-1
+12 QUIT IBX
+13 ;
GETIINP() ; Get Inpatient Indicator, is this charge billable for Inpatient care
+1 ; Returns: 1 for Yes Billable for Inpatient care, 0 for not billable, -1 if invalid
+2 NEW IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y
SET IBX=0
+3 SET DIR("?")="Enter Yes if this charge is billable for Inpatient care, No otherwise."
+4 ;
+5 SET DIR(0)="Y"
SET DIR("A")="INPATIENT"
SET DIR("B")="No"
DO ^DIR
IF Y=1
SET IBX=1
+6 IF $DATA(DTOUT)!$DATA(DUOUT)
SET IBX=-1
+7 QUIT IBX
+8 ;
GETISNF() ; Get SNF Indicator, is this charge billable for Skilled Nursing care
+1 ; Returns: 1 for Yes Billable for SNF care, 0 for not billable, -1 if invalid
+2 NEW IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y
SET IBX=0
+3 SET DIR("?")="Enter Yes if this charge is billable for SNF care, No otherwise."
+4 ;
+5 SET DIR(0)="Y"
SET DIR("A")="SKILLED NURSING"
SET DIR("B")="Yes"
DO ^DIR
IF Y=1
SET IBX=1
+6 IF $DATA(DTOUT)!$DATA(DUOUT)
SET IBX=-1
+7 QUIT IBX
+8 ;
GETIOPT() ; Get Outpatient Indicator, is this charge billable for Outpatient care
+1 ; Returns: 1 for Yes Billable for outpatient care, 0 for not billable, -1 if invalid
+2 NEW IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y
SET IBX=0
+3 SET DIR("?")="Enter Yes if this charge is billable for Outpatient care, No otherwise."
+4 ;
+5 SET DIR(0)="Y"
SET DIR("A")="OUTPATIENT"
SET DIR("B")="Yes"
DO ^DIR
IF Y=1
SET IBX=1
+6 IF $DATA(DTOUT)!$DATA(DUOUT)
SET IBX=-1
+7 QUIT IBX
+8 ;
GETIFS() ; Get Freestanding Indicator, is this charge billable at Freestanding Sites
+1 ; Returns: 1 for Yes Billable at Non-Provider Based/Freestanding sites, 0 for not billable, -1 if invalid
+2 NEW IBX,DIR,DUOUT,DTOUT,DIRUT,X,Y
SET IBX=0
+3 SET DIR("?",1)="All charges for Freestanding sites will be stored as Professional charges."
+4 SET DIR("?")="Enter Yes if this charge is billable at Freestanding Sites, No otherwise."
+5 ;
+6 SET DIR(0)="Y"
SET DIR("A")="FREESTANDING"
SET DIR("B")="Yes"
DO ^DIR
IF Y=1
SET IBX=1
+7 IF $DATA(DTOUT)!$DATA(DUOUT)
SET IBX=-1
+8 QUIT IBX
+9 ;
DATE(X) ; returns VA date in external form
+1 NEW Y
SET Y=""
IF $GET(X)?7N.E
SET Y=$EXTRACT(X,4,5)_"/"_$EXTRACT(X,6,7)_"/"_$EXTRACT(X,2,3)
+2 QUIT Y
