VistA-FOIAVistA/r/INTEGRATED_BILLING-IB-PRQ--.../IBCU65.m

140 lines
6.1 KiB
Mathematica

IBCU65 ;ALB/ARH - BILL CHARGE UTILITY: COMBINE E&M ; 12/01/04
;;2.0;INTEGRATED BILLING;**287**;21-MAR-94
;;Per VHA Directive 10-93-142, this routine should not be modified.
;
; Combine (E&M) Charges on one bill:
; 90801-90815, 90845-90899, 99201-99215, 99241-99245, 99271-99288, 99385-99387, 99395-99429, 99499
; For each of the procedures update the first line item to include both the professional and facility charge
; If there is another line item for the procedure then delete it (no bill CT)
;
ASKCMB(IBIFN) ; if the user requests, combine (E&M) charges on the bill
N DIR,DIRUT,DTOUT,DUOUT,X,Y S IBIFN=+$G(IBIFN) Q:'IBIFN
;
I '$$CHKBILL(IBIFN) Q ; provider based bill with combinable procedures
;
W !! S DIR("?")="Enter Yes to add both Institutional and Professional charge for E&M codes"
S DIR("?",1)="The Professional and Facility charges of certain E&M codes may be combined onto"
S DIR("?",2)="one line item on this bill.",DIR("?",3)=" "
S DIR("B")="NO",DIR("A")="Combine Institutional and Professional Charges for E&M Procedures"
S DIR(0)="Y" D ^DIR Q:$D(DIRUT) Q:'Y
;
I Y=1 D CHGCMB(IBIFN)
Q
;
CHGCMB(IBIFN) ; combine certain E&M codes on the bill
N IBRC,IBRC0,IBCPT,IBRCCT,IBMATCH,IBCHGS,IBTCHG,IBDONE,IBX K ^TMP($J,"IBCU65 CMB") Q:'$G(IBIFN)
;
D BILLCHG(IBIFN) I '$D(^TMP($J,"IBCU65 CMB")) Q
;
S IBRC=0 F S IBRC=$O(^DGCR(399,IBIFN,"RC",IBRC)) Q:'IBRC D
. S IBRC0=$G(^DGCR(399,IBIFN,"RC",IBRC,0))
. ;
. S IBCPT=$P(IBRC0,U,6) Q:'IBCPT I '$$CHKCODE(IBCPT) Q ; charge must be for a combinable cpt
. S IBRCCT=$P(IBRC0,U,12) I IBRCCT'=1,IBRCCT'=2 Q ; must be a component charge
. I '$P(IBRC0,U,8) Q ; charge must be auto created
. ;
. S IBMATCH=$P(IBRC0,U,3)_U_IBCPT_U_$P(IBRC0,U,7)_U_$P(IBRC0,U,10)_U_$P(IBRC0,U,11)
. ;
. S IBCHGS=$G(^TMP($J,"IBCU65 CMB",IBMATCH)) Q:IBCHGS="" ; find match
. ;
. I +$G(IBDONE(IBMATCH)) I $$RVDEL(IBIFN,IBRC) D Q ; if already combined delete line item
.. S IBX(IBCPT_" "_IBRC)=$S(IBRCCT=1:"Facility",1:"Professional")_" Charge for "_IBCPT_" deleted "_$P(IBRC0,U,2)
. ;
. S IBTCHG=$P(IBCHGS,U,3) Q:'IBTCHG
. ;
. I $$RVCHG(IBIFN,IBRC,IBTCHG) S IBDONE(IBMATCH)=1 D ; match found, combine charges
.. S IBX(IBCPT_" "_IBRC)="Charge for "_IBCPT_" combined: "_$P(IBCHGS,U,1)_"+"_$P(IBCHGS,U,2)_"="_IBTCHG
;
I '$D(ZTQUEUED),'$G(IBAUTO) S IBX="" F S IBX=$O(IBX(IBX)) Q:IBX="" W !,IBX(IBX)
K ^TMP($J,"IBCU65 CMB")
Q
;
;
;
RVDEL(IBIFN,RCIFN) ; delete charge line item, Output: 0/1
; Input: IBIFN = Bill Number, RCIFN = Charge Line Item in RC multiple
N IBX,DIK,DIC,X,Y,Z,Z1,DA,D0,D1,DG,DICR,DIG,DIH,DIW,DGXRF1 S IBX=0
I $D(^DGCR(399,+$G(IBIFN),"RC",+$G(RCIFN),0)) D S IBX=1
. S DA(1)=+IBIFN,DA=+RCIFN,DIK="^DGCR(399,"_DA(1)_",""RC""," D ^DIK K DIK
Q IBX
;
RVCHG(IBIFN,RCIFN,CHG) ; update line item charge and remove component, Output: 0/1
; Input: IBIFN = Bill Number, RCIFN = Charge Line Item in RC multiple, CHG = New Charge Amount
N IBX,DA,DIE,DIC,DR,X,Y,Z,Z1,D,D0,D1,DI,DQ,DGXRF1 S IBX=0
I $D(^DGCR(399,+$G(IBIFN),"RC",+$G(RCIFN),0)) D S IBX=1
. S DA(1)=+IBIFN,DIE="^DGCR(399,"_DA(1)_",""RC"",",DR=".12///@;.02////"_+$G(CHG),DA=+RCIFN D ^DIE
Q IBX
;
;
CHKCODE(CPT) ; return true if CPT code combinable
N IBOUT S CPT=+$G(CPT) S IBOUT=0
I (CPT<90800)!(CPT>99500) S IBOUT=0 G CHKCODQ
;
I CPT>90800,CPT<90816 S IBOUT=1 G CHKCODQ
I CPT>90844,CPT<90900 S IBOUT=1 G CHKCODQ
I CPT>99200,CPT<99216 S IBOUT=1 G CHKCODQ
I CPT>99240,CPT<99246 S IBOUT=1 G CHKCODQ
I CPT>99270,CPT<99289 S IBOUT=1 G CHKCODQ
I CPT>99384,CPT<99388 S IBOUT=1 G CHKCODQ
I CPT>99394,CPT<99430 S IBOUT=1 G CHKCODQ
I CPT=99499 S IBOUT=1
;
CHKCODQ Q IBOUT
;
CHKBILL(IBIFN) ; return true if combining charges is applicable or available for bill
; bill must be Provider Based and have at least one combinable procedure
N IBOUT,IBX,IBY S IBOUT=0 S IBIFN=+$G(IBIFN) I 'IBIFN G CHKBILQ
;
S IBX=$P($G(^DGCR(399,+IBIFN,0)),U,22) S IBY=$P($$RCDV^IBCRU8(IBX),U,3) I IBY'=1,IBY'=2 S IBOUT=0 G CHKBILQ
;
S IBX="90800;" F S IBX=$O(^DGCR(399,IBIFN,"CP","B",IBX)) Q:('IBX)!(+IBX>99499) I +$$CHKCODE(+IBX) S IBOUT=1 Q
;
CHKBILQ Q IBOUT
;
;
BILLCHG(IBIFN) ; get all possible charges for bill with discounts applied
; output array of charges for combinable procedures
; Output: ^TMP($J,"IBCU65 CMB", "units ^ cpt ^ div ^ itm type ^ itm ptr") = inst chg ^ prof chg ^ total chg
;
N IBX,IB0,IBU,IBBRT,IBBTYPE,IBCBARR,IBLN,IBCPT,IBCMP,IBSBCR,IBCHGI,IBCHGP
K ^TMP($J,"IBCRCC"),^TMP($J,"IBCRCSX"),^TMP($J,"IBCRCSXR"),^TMP($J,"IBCRCSXN")
K ^TMP($J,"IBCU65 TMP"),^TMP($J,"IBCU65 CMB") Q:'$G(IBIFN)
I '$O(^DGCR(399,+IBIFN,"RC",0)) Q
;
S IB0=$G(^DGCR(399,+IBIFN,0)) Q:IB0="" S IBU=$G(^DGCR(399,+IBIFN,"U")) Q:'IBU
S IBBRT=+$P(IB0,U,7),IBBTYPE=$S($P(IB0,U,5)<3:1,1:3)
;
; get standard set of charge sets available for bill, including all Instutional and Professional charge sets
D RT^IBCRU3(IBBRT,IBBTYPE,$P(IBU,U,1,2),.IBCBARR,"PROCEDURE") I 'IBCBARR Q
;
; get all possible charges and sort as they would be added to the bill, including all discounts applied
D BILL^IBCRBH1(IBIFN,1,.IBCBARR),SORTCI^IBCRBH1(IBIFN)
;
;
; compile like charges for procedures that are combinable
S IBX=0 F S IBX=$O(^TMP($J,"IBCRCSX",IBX)) Q:'IBX D
. S IBLN=$G(^TMP($J,"IBCRCSX",IBX))
. ;
. S IBCPT=$P(IBLN,U,5) Q:'IBCPT I '$$CHKCODE(IBCPT) Q ; CPT must be defined and combinable
. S IBCMP=+$P(IBLN,U,9) Q:'IBCMP ; must be a component charge
. I '$P(IBLN,U,8) Q ; item pointer must be defined
. I $P(IBLN,U,7)'=4 Q ; item type must be cpt
. ;
. S IBSBCR=$P(IBLN,U,4,8)
. S ^TMP($J,"IBCU65 TMP",IBSBCR)=+$G(^TMP($J,"IBCU65 TMP",IBSBCR))+1
. S ^TMP($J,"IBCU65 TMP",IBSBCR,IBCMP)=IBLN
;
;
; compile array of combinable charges by procedure, must be combinable cpt and have both charges available
S IBSBCR="" F S IBSBCR=$O(^TMP($J,"IBCU65 TMP",IBSBCR)) Q:IBSBCR="" D
. I +$G(^TMP($J,"IBCU65 TMP",IBSBCR))'=2 Q
. ;
. S IBCHGI=$P($G(^TMP($J,"IBCU65 TMP",IBSBCR,1)),U,3) Q:'IBCHGI
. S IBCHGP=$P($G(^TMP($J,"IBCU65 TMP",IBSBCR,2)),U,3) Q:'IBCHGP
. ;
. S ^TMP($J,"IBCU65 CMB",IBSBCR)=IBCHGI_U_IBCHGP_U_(IBCHGI+IBCHGP)
;
;
K ^TMP($J,"IBCRCC"),^TMP($J,"IBCRCSX"),^TMP($J,"IBCRCSXR"),^TMP($J,"IBCRCSXN"),^TMP($J,"IBCU65 TMP")
Q