VistA-FOIAVistA/r/FEE_BASIS-FB/FBAAUTL4.m

177 lines
6.2 KiB
Mathematica

FBAAUTL4 ;AISC/CMR,dmk,WCIOFO/SAB-UTILITY ROUTINE ;7/11/2001
;;3.5;FEE BASIS;**4,32,77,81**;JAN 30, 1995
;;Per VHA Directive 10-93-142, this routine should not be modified.
;
CPT(X,Y,FBSRVDT) ;return external format of CPT code
;INPUT X = ien of CPT
;optional Y I Y return description, I 'Y return external format of CPT
;optional FBSRVDT - date of service
;OUTPUT external format of CPT code or description of CPT code
I '$G(X) Q ""
N Z
S Z=$$CPT^ICPTCOD(X,$S($G(FBSRVDT)>0:+$G(FBSRVDT),1:""),1)
Q $S('$G(Y):$P(Z,U,2),1:$P(Z,U,3))
;
MOD(X,Y,FBSRVDT) ;return external format of modifier
;INPUT X = ien of modifier
;optional Y I Y return description, I 'Y return external format of mod
;optional FBSRVDT - date of service
;OUTPUT external format of modifier or description of CPT code
I '$G(X) Q ""
N Z
S Z=$$MOD^ICPTMOD(X,"I",$S($G(FBSRVDT)>0:+$G(FBSRVDT),1:""),1)
Q $S('$G(Y):$P(Z,U,2),1:$P(Z,U,3))
;
CPTDATA(W,X,Y,Z) ;get internal value of CPT
; input
; W = IEN of PATIENT in file 162
; X = IEN of VENDOR multiple in file 162
; Y = IEN of INITIAL TREATMENT DATE multiple in file 162
; Z = IEN of SERVICE PROVIDED multiple in file 162
; returns
; value of SERVICE PROVIDED (internal)
;
I '$G(W)!('$G(X))!('$G(Y))!('$G(Z)) Q ""
Q $P($G(^FBAAC(W,1,X,1,Y,1,Z,0)),U)
;
MODDATA(W,X,Y,Z) ;get internal values of CPT Modifier
; input
; W = IEN of PATIENT in file 162
; X = IEN of VENDOR multiple in file 162
; Y = IEN of INITIAL TREATMENT DATE multiple in file 162
; Z = IEN of SERVICE PROVIDED multiple in file 162
; output
; FBMODA( array of CPT MODIFIERs
; FBMODA(#)=CPT MODIFIER (internal value)
; where # is the IEN for an entry in the CPT MODIFIER multiple
K FBMODA
I '$G(W)!('$G(X))!('$G(Y))!('$G(Z)) Q
N FBI,FBMOD
S FBI=0 F S FBI=$O(^FBAAC(W,1,X,1,Y,1,Z,"M",FBI)) Q:'FBI D
. S FBMOD=$P($G(^FBAAC(W,1,X,1,Y,1,Z,"M",FBI,0)),U)
. Q:FBMOD=""
. S FBMODA(FBI)=FBMOD
Q
;
APS(FBJ,FBK,FBL,FBM) ; amount paid symbol
; input
; FBJ = IEN of PATIENT in file 162
; FBK = IEN of VENDOR multiple in file 162
; FBL = IEN of INITIAL TREATMENT DATE multiple in file 162
; FBM = IEN of SERVICE PROVIDED multiple in file 162
; returns symbol
; where value is M (Mill Bill emergency care - 38 U.S.C. 1725)
; R (RBRVS fee schedule amount)
; F (VA fee schedule amount)
; C (contracted service amount)
; U (usual & customary - claimed)
; null if no amount paid
N FBAP,FBRET,FBY0,FBY2
S FBRET=""
S FBY0=$G(^FBAAC(FBJ,1,FBK,1,FBL,1,FBM,0))
S FBY2=$G(^FBAAC(FBJ,1,FBK,1,FBL,1,FBM,2))
S FBAP=$P(FBY0,U,3)
I FBAP>0 D
. ; use fee schedule info for payment (if any)
. I +FBAP=+$P(FBY2,U,12) S FBRET=$P(FBY2,U,13) Q:FBRET]""
. ; if no fee schedule info then calc 75th percentile and check
. I $P(FBY2,U,12)="" D Q:FBRET]""
. . S FBCPT=$$CPT($P(FBY0,U))
. . S FBMODL=$$MODL("^FBAAC("_FBJ_",1,"_FBK_",1,"_FBL_",1,"_FBM_",""M"")","E")
. . S FBDOS=$P($G(^FBAAC(FBJ,1,FBK,1,FBL,0)),U)
. . I +FBAP=+$$PRCTL^FBAAFSF(FBCPT,FBMODL,FBDOS) S FBRET="F"
. ; since not paid by a fee schedule, check prompt pay type
. I $P(FBY2,U,2) S FBRET="C" Q
. ; since not fee schedule or contract check POV code to identify
. ; Mill Bill payments
. S:"^39^52^"[(U_$P($G(^FBAA(161.82,+$P(FBY0,U,18),0)),U,3)_U) FBRET="M"
. Q:FBRET]""
. ; all other payments considered u&c
. S FBRET="U"
Q FBRET
;
CHKBI(X,Y) ;called to determine if batch number or invoice number
;already exists
;X= next batch/invoice number
;Y=1 if Batch
;Y undefined if invoice number passed
;returns a truth if X is ok for next batch/invoice #
;
I 'X Q ""
I $G(Y) Q $S($D(^FBAA(161.7,"B",X)):"",1:1)
I '$G(Y) Q $S($D(^FBAA(162.1,"B",X)):"",$D(^FBAAI("B",X)):"",$D(^FBAAC("C",X)):"",1:1)
;
MODL(FBAN,FBFLAG) ;return sorted list given array of modifiers
; Input
; FBAN - closed root of array containing modifiers
; the data must be in nodes descendent from this root.
; The subscripts of the nodes below FBAN must be
; positive numbers. The CPT MODIFIER internal value
; must be the first piece in these nodes or in the
; 0-node descendent from these nodes.
; i.e.
; ARRAY(number)=CPT MODIFIER (internal value)
; OR
; ARRAY(number,0)=CPT MODIFIER (internal value)
; FBFLAG - (optional) flag, E or I, default I
; I to return internal values of modifiers
; E to return external values of modifiers
; Returns string of sorted modifiers (e.g. "1,3,7")
;
N FBI,FBRET,FBSORT,FBX,FBZERO
S FBRET=""
S FBFLAG=$G(FBFLAG,"I")
;
; if any descendent data then determine if it is 0-node descendent
S FBZERO=0 I $O(@FBAN@(0)),$D(@FBAN@($O(@FBAN@(0)),0))#2 S FBZERO=1
;
; loop thru input array and place modifiers in a sort array
S FBI=0 F S FBI=$O(@FBAN@(FBI)) Q:'FBI D
. ; get the cpt modifier
. I FBZERO S FBX=$P(@FBAN@(FBI,0),U)
. E S FBX=$P(@FBAN@(FBI),U)
. I FBFLAG="E" D
. . ; convert to external value
. . S FBX=$$MOD^ICPTMOD(FBX,"I")
. . I FBX>0 S FBX=$P(FBX,U,2)
. . E S FBX=""
. I FBX]"" S FBSORT(FBX)=""
;
; loop thru sorted array and add the modifiers to return value
S FBX="" F S FBX=$O(FBSORT(FBX)) Q:FBX="" S FBRET=FBRET_","_FBX
;
; strip leading comma (if any)
I $E(FBRET)="," S FBRET=$E(FBRET,2,999)
;
; return value
Q FBRET
;
REPMOD(FBJ,FBK,FBL,FBM) ; Replace CPT Modifier(s) in payment
; input
; FBJ = IEN of PATIENT in file 162
; FBK = IEN of VENDOR multiple in file 162
; FBL = IEN of INITIAL TREATMENT DATE multiple in file 162
; FBM = IEN of SERVICE PROVIDED multiple in file 162
; FBMODA( array of modifiers
; where FBMODA(number)=CPT Modifier (internal)
;
N FBI,FBIENS,FBFDA
S FBIENS=FBM_","_FBL_","_FBK_","_FBJ_","
;
; delete any existing CPT MODIFIER entries from global
I $O(^FBAAC(FBJ,1,FBK,1,FBL,1,FBM,"M",0)) D
. K FBFDA S FBI=0
. F S FBI=$O(^FBAAC(FBJ,1,FBK,1,FBL,1,FBM,"M",FBI)) Q:'FBI D
. . S FBFDA(162.06,FBI_","_FBIENS,.01)="@"
. D FILE^DIE("","FBFDA") D MSG^DIALOG()
;
; create CPT MODIFIER entries from data in array FBMODA
I $O(FBMODA(0)) D
. K FBFDA S FBI=0 F S FBI=$O(FBMODA(FBI)) Q:'FBI D
. . S FBFDA(162.06,"+"_FBI_","_FBIENS,.01)=FBMODA(FBI)
. D UPDATE^DIE("","FBFDA") D MSG^DIALOG()
;
Q
;
;FBAAUTL4