IBCU3 ;ALB/AAS - BILLING UTILITY ROUTINE (CONTINUED) ; 4/4/03 8:49am
;;2.0;INTEGRATED BILLING;**52,80,91,106,51,137,211,245,348,399,400,592**;21-MAR-94;Build 58
;;Per VA Directive 6402, this routine should not be modified.
;
;MAP TO DGCRU3
SC(DFN) ; returns 1 if service connection indicated, 0 otherwise (based on VAEL(3))
N X,VAEL,VAERR S X=0
I +$G(DFN) D ELIG^VADPT S X=+$G(VAEL(3))
Q X
;
APPT(DATE,DFN,DISP) ;Check date to see if patient has any visit data
;input: DATE - required, date to check for appointments
; DFN - required, patient to check for appointments on date
; DISP - if true then error message will be printed before exit, if any
;returns: 1 - if appt visit found
; 2 - if unscheduled add/edit clinic stop entry found
; 3 - if only disposition found
; "0^error message" if no valid visit data/disposition found
;
N Y,X,X1,X2 S DATE=$P(DATE,".",1),Y="0^* Patient has no Visits for this date..."
I 'DATE!'$D(^DPT(DFN,0)) S Y="0^Unable to check for appointments on this date!" G APPTE
N IBVAL,IBCBK,IBVTYP
S IBVAL("DFN")=DFN,IBVAL("BDT")=DATE,IBVAL("EDT")=DATE+.9
S IBCBK="I '$P(Y0,U,6) S IBVTYP=+$P(Y0,U,8) I $S(IBVTYP=2:1,IBVTYP=1:$$APPTCT^IBEFUNC(Y0),IBVTYP=3:$$DISCT^IBEFUNC(Y,Y0),1:0) S IBVTYP(IBVTYP)="""" S:$D(IBVTYP(1)) SDSTOP=1"
D SCAN^IBSDU("PATIENT/DATE",.IBVAL,"",IBCBK,1) K ^TMP("DIERR",$J)
S IBVTYP=$O(IBVTYP(0))
S:IBVTYP Y=IBVTYP
;
APPTE I +$G(DISP),'Y W !,?10,*7,$P(Y,U,2)
Q Y
;
BDT(DFN,DATE) ; returns primary bill defined for an event date, "" if none
N X,Y S X="" I '$O(^DGCR(399,"C",+$G(DFN),0))!'$G(DATE) G BDTE
S Y="",DATE=9999999-DATE F S Y=$O(^DGCR(399,"APDT",+DFN,Y)) Q:'Y D
. I $O(^DGCR(399,"APDT",+DFN,Y,0))=DATE,'$P($G(^DGCR(399,Y,"S")),U,16) S X=$P($G(^DGCR(399,Y,0)),U,17) Q
BDTE Q X
;
BILLED(PTF) ;returns bill "IFN^^rate group" if PTF record is already associated with an uncancelled final bill
;returns "bill IFN ^ bill date (stm to) ^ bill rate group" if inpatients interim with no final bill, 0 otherwise
N IFN,Y,X S Y=0 I '$D(^DGCR(399,"APTF",+$G(PTF))) G BILLEDQ
S IFN=0 F S IFN=$O(^DGCR(399,"APTF",PTF,IFN)) Q:'IFN D I +Y,'$P(Y,U,2) Q
. S X=$G(^DGCR(399,IFN,0)) I $P(X,U,13)=7 Q ; bill cancelled
. S Y=IFN_"^^"_$P(X,U,7) I $P(X,U,6)=2!($P(X,U,6)=3) S Y=IFN_"^"_$P($G(^DGCR(399,IFN,"U")),U,2)_"^"_$P(X,U,7)
BILLEDQ Q Y
;
FTN(FT) ;returns name of the form type passed in, "" if not defined
N X S X=$P($G(^IBE(353,+$G(FT),0)),U,1)
Q X
;
FT(IFN,IBRESET) ;return the correct form type for a bill (trigger code in 399 to set .19)
; if IBRESET is not a positive value ('IBRESET), returns the bills current form type (if defined)
; if IBRESET is a positive value (+IBRESET), interpret form type according to following rules (for triggers):
; first use if bill is inst (UB) or prof (1500) (399,.27), then current (399,.19), then UB
N X,Y,FTC,FTT
S X="",IFN=+$G(IFN),Y=$G(^DGCR(399,IFN,0))
S FTC=$P(Y,U,19) I FTC=1 S FTC=3
I '$G(IBRESET),+FTC S X=FTC G FTQ
S FTT=$S($P(Y,U,27)=1:3,$P(Y,U,27)=2:2,1:"")
;JWS;IB*2.0*592;Dental form 7
I FTC=7,FTT=2 Q 7
S X=$S(+FTT:FTT,+FTC:FTC,1:3)
FTQ Q X
;
FNT(FTN) ;returns the ifn of the form type name passed in, must be exact match, 0 if none found
N X,Y S X=0 I $G(FTN)'="" S X=$O(^IBE(353,"B",FTN,0))
Q X
;
BILLDEV(IFN,PRT) ;returns the default device for a bill's form type, if PRT is passed as true then returns the AR follow up device, otherwise the billing device
N X,Y S X=0 I $D(^DGCR(399,+$G(IFN),0)) S PRT=$S(+$G(PRT):3,1:2),Y=$$FT(IFN),X=$P($G(^IBE(353,+Y,0)),U,PRT)
Q X
;
RXDUP(RX,DATE,IFN,DISP,DFN,RTG) ;returns bill ifn if rx # exists on another bill
;input: rx # - required, rx # to check for
; date - required, date of refill
;ifn, dfn, rtg are optional - if not passed then not used to specify rx
;(if ifn not passed then returns true if on any bill same or dfn and rtgetc.)
;if ifn passed the dfn and rtg do not need to be
N X,LN,RIFN,BIFN,RLN,BLN S (RIFN,X)=0,DATE=$G(DATE),RX=$G(RX),IFN=$G(IFN) I RX=""!('DATE) G RXDUPE
S LN=$G(^DGCR(399,+IFN,0)),DFN=$S(+$G(DFN):DFN,1:+$P(LN,U,2)),RTG=$S(+$G(RTG):RTG,1:+$P(LN,U,7))
F S RIFN=$O(^IBA(362.4,"B",RX,RIFN)) Q:'RIFN S RLN=$G(^IBA(362.4,+RIFN,0)) I +DATE=+$P(RLN,U,3) D Q:+X
. S BIFN=+$P(RLN,U,2),BLN=$G(^DGCR(399,BIFN,0)) Q:(BLN="")!(BIFN=+$G(IFN))
. I $P(BLN,U,13)=7 Q ; bill cancelled
. I +DFN,$P(BLN,U,2)'=DFN Q ; different patient
. I +RTG,+RTG'=$P(BLN,U,7) Q ; different rate group
. S X=BIFN_"^A "_$P($G(^DGCR(399.3,+$P(BLN,U,7),0)),U,1)_" bill ("_$P(BLN,U,1)_") exists for Rx # "_RX_" and refill date "_$$DAT1^IBOUTL(DATE)_"."
RXDUPE I +$G(DISP),+X W !,?10,$P(X,U,2)
Q X
;
BCOB(IBIFN,IBCOB) ; returns an array of all bills related COB to the bill passed in
; includes prior bills defined on this bill then checks the Primary, Secondary and Tertiary Bills and adds
; all the prior bills defined on them
; ARR(BILL SEQUENCE (1,2,3), INSURANCE CO, BILL #)=""
;
N IBM1,IBI,IBIFN1,IBM,IBM11,IBSEQ,IBSEQN,IBJ K IBCOB
S IBM1=$G(^DGCR(399,IBIFN,"M1"))
F IBI=IBIFN,+$P(IBM1,U,5),+$P(IBM1,U,6),+$P(IBM1,U,7) I +IBI S IBIFN1=+IBI D
. ;
. S IBM=$G(^DGCR(399,IBIFN1,"M")),IBM11=$G(^DGCR(399,IBIFN1,"M1")) I IBIFN=IBIFN1,'$P(IBM,U,2),'$P(IBM,U,3) Q
. S IBSEQ=$P($G(^DGCR(399,IBIFN1,0)),U,21),IBSEQN=$S(IBSEQ="P":1,IBSEQ="S":2,IBSEQ="T":3,1:"") Q:'IBSEQN
. ;
. F IBJ=1:1:3 I +$P(IBM,U,IBJ) S IBCOB(IBJ,+$P(IBM,U,IBJ),+$P(IBM11,U,(IBJ+4)))=""
. I +$P(IBM,U,IBSEQN) S IBCOB(IBSEQN,$P(IBM,U,IBSEQN),+IBIFN1)=""
;
S IBI=0 F S IBI=$O(IBCOB(IBI)) Q:'IBI S IBJ=0 F S IBJ=$O(IBCOB(IBI,IBJ)) Q:'IBJ I +$O(IBCOB(IBI,IBJ,0)) K IBCOB(IBI,IBJ,0)
Q
;
BINS(IBIFN) ; return list of billable insurance carriers on a bill (COB)
; output: sequence:carrier:policy ^ sequence:carrier:policy ^ sequence:carrier:policy
N IBM0,IBI,IBS,IBC,IBP,IBX S IBI=0,IBX="",IBM0=$G(^DGCR(399,+$G(IBIFN),"M"))
F IBS="P","S","T" S IBI=IBI+1,IBC=+$P(IBM0,U,IBI) I +IBC D
. S IBP=+$P(IBM0,U,(11+IBI)) I $P($G(^DIC(36,+IBC,0)),U,2)'="N" S IBX=IBX_IBS_":"_IBC_":"_IBP_U
Q IBX
;
BOTHER(IBIFN,IBDT) ; return Bedsection of Type of Care if date is Other Type of care, based on "OT" multiple
; Other care is not inpatient or outpatient, SNF and Sub-Acute became distinct with RC v2.0
; as with all other bedsection movements, the last date is not included since that is the date they left
N IBX,IBY,IBFND S IBFND=0,IBDT=$G(IBDT)\1
I +$G(IBIFN),+IBDT S IBX=0 F S IBX=$O(^DGCR(399,IBIFN,"OT",IBX)) Q:'IBX D
. S IBY=$G(^DGCR(399,IBIFN,"OT",IBX,0)) Q:'IBY
. I IBDT'<$P(IBY,U,2),IBDT<$P(IBY,U,3) S IBFND=+IBY
. I IBDT=($P(IBY,U,2)\1),IBDT=($P(IBY,U,3)\1) S IBFND=+IBY ; 1 day SNF stay
Q IBFND
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HIBCU3 6779 printed Dec 13, 2024@02:20:38 Page 2
IBCU3 ;ALB/AAS - BILLING UTILITY ROUTINE (CONTINUED) ; 4/4/03 8:49am
+1 ;;2.0;INTEGRATED BILLING;**52,80,91,106,51,137,211,245,348,399,400,592**;21-MAR-94;Build 58
+2 ;;Per VA Directive 6402, this routine should not be modified.
+3 ;
+4 ;MAP TO DGCRU3
SC(DFN) ; returns 1 if service connection indicated, 0 otherwise (based on VAEL(3))
+1 NEW X,VAEL,VAERR
SET X=0
+2 IF +$GET(DFN)
DO ELIG^VADPT
SET X=+$GET(VAEL(3))
+3 QUIT X
+4 ;
APPT(DATE,DFN,DISP) ;Check date to see if patient has any visit data
+1 ;input: DATE - required, date to check for appointments
+2 ; DFN - required, patient to check for appointments on date
+3 ; DISP - if true then error message will be printed before exit, if any
+4 ;returns: 1 - if appt visit found
+5 ; 2 - if unscheduled add/edit clinic stop entry found
+6 ; 3 - if only disposition found
+7 ; "0^error message" if no valid visit data/disposition found
+8 ;
+9 NEW Y,X,X1,X2
SET DATE=$PIECE(DATE,".",1)
SET Y="0^* Patient has no Visits for this date..."
+10 IF 'DATE!'$DATA(^DPT(DFN,0))
SET Y="0^Unable to check for appointments on this date!"
GOTO APPTE
+11 NEW IBVAL,IBCBK,IBVTYP
+12 SET IBVAL("DFN")=DFN
SET IBVAL("BDT")=DATE
SET IBVAL("EDT")=DATE+.9
+13 SET IBCBK="I '$P(Y0,U,6) S IBVTYP=+$P(Y0,U,8) I $S(IBVTYP=2:1,IBVTYP=1:$$APPTCT^IBEFUNC(Y0),IBVTYP=3:$$DISCT^IBEFUNC(Y,Y0),1:0) S IBVTYP(IBVTYP)="""" S:$D(IBVTYP(1)) SDSTOP=1"
+14 DO SCAN^IBSDU("PATIENT/DATE",.IBVAL,"",IBCBK,1)
KILL ^TMP("DIERR",$JOB)
+15 SET IBVTYP=$ORDER(IBVTYP(0))
+16 if IBVTYP
SET Y=IBVTYP
+17 ;
APPTE IF +$GET(DISP)
IF 'Y
WRITE !,?10,*7,$PIECE(Y,U,2)
+1 QUIT Y
+2 ;
BDT(DFN,DATE) ; returns primary bill defined for an event date, "" if none
+1 NEW X,Y
SET X=""
IF '$ORDER(^DGCR(399,"C",+$GET(DFN),0))!'$GET(DATE)
GOTO BDTE
+2 SET Y=""
SET DATE=9999999-DATE
FOR
SET Y=$ORDER(^DGCR(399,"APDT",+DFN,Y))
if 'Y
QUIT
Begin DoDot:1
+3 IF $ORDER(^DGCR(399,"APDT",+DFN,Y,0))=DATE
IF '$PIECE($GET(^DGCR(399,Y,"S")),U,16)
SET X=$PIECE($GET(^DGCR(399,Y,0)),U,17)
QUIT
End DoDot:1
BDTE QUIT X
+1 ;
BILLED(PTF) ;returns bill "IFN^^rate group" if PTF record is already associated with an uncancelled final bill
+1 ;returns "bill IFN ^ bill date (stm to) ^ bill rate group" if inpatients interim with no final bill, 0 otherwise
+2 NEW IFN,Y,X
SET Y=0
IF '$DATA(^DGCR(399,"APTF",+$GET(PTF)))
GOTO BILLEDQ
+3 SET IFN=0
FOR
SET IFN=$ORDER(^DGCR(399,"APTF",PTF,IFN))
if 'IFN
QUIT
Begin DoDot:1
+4 ; bill cancelled
SET X=$GET(^DGCR(399,IFN,0))
IF $PIECE(X,U,13)=7
QUIT
+5 SET Y=IFN_"^^"_$PIECE(X,U,7)
IF $PIECE(X,U,6)=2!($PIECE(X,U,6)=3)
SET Y=IFN_"^"_$PIECE($GET(^DGCR(399,IFN,"U")),U,2)_"^"_$PIECE(X,U,7)
End DoDot:1
IF +Y
IF '$PIECE(Y,U,2)
QUIT
BILLEDQ QUIT Y
+1 ;
FTN(FT) ;returns name of the form type passed in, "" if not defined
+1 NEW X
SET X=$PIECE($GET(^IBE(353,+$GET(FT),0)),U,1)
+2 QUIT X
+3 ;
FT(IFN,IBRESET) ;return the correct form type for a bill (trigger code in 399 to set .19)
+1 ; if IBRESET is not a positive value ('IBRESET), returns the bills current form type (if defined)
+2 ; if IBRESET is a positive value (+IBRESET), interpret form type according to following rules (for triggers):
+3 ; first use if bill is inst (UB) or prof (1500) (399,.27), then current (399,.19), then UB
+4 NEW X,Y,FTC,FTT
+5 SET X=""
SET IFN=+$GET(IFN)
SET Y=$GET(^DGCR(399,IFN,0))
+6 SET FTC=$PIECE(Y,U,19)
IF FTC=1
SET FTC=3
+7 IF '$GET(IBRESET)
IF +FTC
SET X=FTC
GOTO FTQ
+8 SET FTT=$SELECT($PIECE(Y,U,27)=1:3,$PIECE(Y,U,27)=2:2,1:"")
+9 ;JWS;IB*2.0*592;Dental form 7
+10 IF FTC=7
IF FTT=2
QUIT 7
+11 SET X=$SELECT(+FTT:FTT,+FTC:FTC,1:3)
FTQ QUIT X
+1 ;
FNT(FTN) ;returns the ifn of the form type name passed in, must be exact match, 0 if none found
+1 NEW X,Y
SET X=0
IF $GET(FTN)'=""
SET X=$ORDER(^IBE(353,"B",FTN,0))
+2 QUIT X
+3 ;
BILLDEV(IFN,PRT) ;returns the default device for a bill's form type, if PRT is passed as true then returns the AR follow up device, otherwise the billing device
+1 NEW X,Y
SET X=0
IF $DATA(^DGCR(399,+$GET(IFN),0))
SET PRT=$SELECT(+$GET(PRT):3,1:2)
SET Y=$$FT(IFN)
SET X=$PIECE($GET(^IBE(353,+Y,0)),U,PRT)
+2 QUIT X
+3 ;
RXDUP(RX,DATE,IFN,DISP,DFN,RTG) ;returns bill ifn if rx # exists on another bill
+1 ;input: rx # - required, rx # to check for
+2 ; date - required, date of refill
+3 ;ifn, dfn, rtg are optional - if not passed then not used to specify rx
+4 ;(if ifn not passed then returns true if on any bill same or dfn and rtgetc.)
+5 ;if ifn passed the dfn and rtg do not need to be
+6 NEW X,LN,RIFN,BIFN,RLN,BLN
SET (RIFN,X)=0
SET DATE=$GET(DATE)
SET RX=$GET(RX)
SET IFN=$GET(IFN)
IF RX=""!('DATE)
GOTO RXDUPE
+7 SET LN=$GET(^DGCR(399,+IFN,0))
SET DFN=$SELECT(+$GET(DFN):DFN,1:+$PIECE(LN,U,2))
SET RTG=$SELECT(+$GET(RTG):RTG,1:+$PIECE(LN,U,7))
+8 FOR
SET RIFN=$ORDER(^IBA(362.4,"B",RX,RIFN))
if 'RIFN
QUIT
SET RLN=$GET(^IBA(362.4,+RIFN,0))
IF +DATE=+$PIECE(RLN,U,3)
Begin DoDot:1
+9 SET BIFN=+$PIECE(RLN,U,2)
SET BLN=$GET(^DGCR(399,BIFN,0))
if (BLN="")!(BIFN=+$GET(IFN))
QUIT
+10 ; bill cancelled
IF $PIECE(BLN,U,13)=7
QUIT
+11 ; different patient
IF +DFN
IF $PIECE(BLN,U,2)'=DFN
QUIT
+12 ; different rate group
IF +RTG
IF +RTG'=$PIECE(BLN,U,7)
QUIT
+13 SET X=BIFN_"^A "_$PIECE($GET(^DGCR(399.3,+$PIECE(BLN,U,7),0)),U,1)_" bill ("_$PIECE(BLN,U,1)_") exists for Rx # "_RX_" and refill date "_$$DAT1^IBOUTL(DATE)_"."
End DoDot:1
if +X
QUIT
RXDUPE IF +$GET(DISP)
IF +X
WRITE !,?10,$PIECE(X,U,2)
+1 QUIT X
+2 ;
BCOB(IBIFN,IBCOB) ; returns an array of all bills related COB to the bill passed in
+1 ; includes prior bills defined on this bill then checks the Primary, Secondary and Tertiary Bills and adds
+2 ; all the prior bills defined on them
+3 ; ARR(BILL SEQUENCE (1,2,3), INSURANCE CO, BILL #)=""
+4 ;
+5 NEW IBM1,IBI,IBIFN1,IBM,IBM11,IBSEQ,IBSEQN,IBJ
KILL IBCOB
+6 SET IBM1=$GET(^DGCR(399,IBIFN,"M1"))
+7 FOR IBI=IBIFN,+$PIECE(IBM1,U,5),+$PIECE(IBM1,U,6),+$PIECE(IBM1,U,7)
IF +IBI
SET IBIFN1=+IBI
Begin DoDot:1
+8 ;
+9 SET IBM=$GET(^DGCR(399,IBIFN1,"M"))
SET IBM11=$GET(^DGCR(399,IBIFN1,"M1"))
IF IBIFN=IBIFN1
IF '$PIECE(IBM,U,2)
IF '$PIECE(IBM,U,3)
QUIT
+10 SET IBSEQ=$PIECE($GET(^DGCR(399,IBIFN1,0)),U,21)
SET IBSEQN=$SELECT(IBSEQ="P":1,IBSEQ="S":2,IBSEQ="T":3,1:"")
if 'IBSEQN
QUIT
+11 ;
+12 FOR IBJ=1:1:3
IF +$PIECE(IBM,U,IBJ)
SET IBCOB(IBJ,+$PIECE(IBM,U,IBJ),+$PIECE(IBM11,U,(IBJ+4)))=""
+13 IF +$PIECE(IBM,U,IBSEQN)
SET IBCOB(IBSEQN,$PIECE(IBM,U,IBSEQN),+IBIFN1)=""
End DoDot:1
+14 ;
+15 SET IBI=0
FOR
SET IBI=$ORDER(IBCOB(IBI))
if 'IBI
QUIT
SET IBJ=0
FOR
SET IBJ=$ORDER(IBCOB(IBI,IBJ))
if 'IBJ
QUIT
IF +$ORDER(IBCOB(IBI,IBJ,0))
KILL IBCOB(IBI,IBJ,0)
+16 QUIT
+17 ;
BINS(IBIFN) ; return list of billable insurance carriers on a bill (COB)
+1 ; output: sequence:carrier:policy ^ sequence:carrier:policy ^ sequence:carrier:policy
+2 NEW IBM0,IBI,IBS,IBC,IBP,IBX
SET IBI=0
SET IBX=""
SET IBM0=$GET(^DGCR(399,+$GET(IBIFN),"M"))
+3 FOR IBS="P","S","T"
SET IBI=IBI+1
SET IBC=+$PIECE(IBM0,U,IBI)
IF +IBC
Begin DoDot:1
+4 SET IBP=+$PIECE(IBM0,U,(11+IBI))
IF $PIECE($GET(^DIC(36,+IBC,0)),U,2)'="N"
SET IBX=IBX_IBS_":"_IBC_":"_IBP_U
End DoDot:1
+5 QUIT IBX
+6 ;
BOTHER(IBIFN,IBDT) ; return Bedsection of Type of Care if date is Other Type of care, based on "OT" multiple
+1 ; Other care is not inpatient or outpatient, SNF and Sub-Acute became distinct with RC v2.0
+2 ; as with all other bedsection movements, the last date is not included since that is the date they left
+3 NEW IBX,IBY,IBFND
SET IBFND=0
SET IBDT=$GET(IBDT)\1
+4 IF +$GET(IBIFN)
IF +IBDT
SET IBX=0
FOR
SET IBX=$ORDER(^DGCR(399,IBIFN,"OT",IBX))
if 'IBX
QUIT
Begin DoDot:1
+5 SET IBY=$GET(^DGCR(399,IBIFN,"OT",IBX,0))
if 'IBY
QUIT
+6 IF IBDT'<$PIECE(IBY,U,2)
IF IBDT<$PIECE(IBY,U,3)
SET IBFND=+IBY
+7 ; 1 day SNF stay
IF IBDT=($PIECE(IBY,U,2)\1)
IF IBDT=($PIECE(IBY,U,3)\1)
SET IBFND=+IBY
End DoDot:1
+8 QUIT IBFND
