VistA-FOIAVistA/r/E_CLAIMS_MGMT_ENGINE-BPS/BPSOSO2.m

181 lines
6.6 KiB
Mathematica

BPSOSO2 ;BHAM ISC/FCS/DRS/DLF - NCPDP Override-Fman utils ;06/01/2004
;;1.0;E CLAIMS MGMT ENGINE;**1,3,5**;JUN 2004;Build 45
;;Per VHA Directive 2004-038, this routine should not be modified.
Q
; EDIT,EDITGEN are called from the menus in BPSOSO1,
; typically reached from the pharmacy package's call
; to OVERRIDE^BPSOSO
; GET511 is called from BPSOSCD during claim construction
;
;IHS/SD/lwj 8/01/02 NCPDP 5.1 changes to GET511 subroutine
; Routine was changed to look at an exceptions list, if the
; field being processed is in the exceptions list it will
; create a "claim header" and "claim rx" entry. The reason
; for this is that several 300 range fields were moved to the
; claim rx area within the 5.1 segments creating duplicate flds.
; (i.e. the <402 and >402 rule is no longer valid)
;
; New routine (PRIORA) added to handle the input of the prior
; authorization information at prescription creation time.
;
EDIT(IEN,FIELDNUM) ;
I '$D(FIELDNUM) D EDITGEN(IEN) Q
; Editing one field
N DIE,DA,DR,DIDEL,DTOUT,FIELDNAM
S DA=$$HASVALUE(IEN,FIELDNUM)
; Make sure the entry exists in the subfile.
; Create an empty one if necessary.
I 'DA S DA=$$SETVALUE(IEN,FIELDNUM,"")
; edit the value field in the subfile
S DIE="^BPS(9002313.511,"_IEN_",1,",DA(1)=IEN
S DR=.02_$TR($$FIELDNAM(FIELDNUM),""";~","")
D ^DIE
; If the value is null, then delete the entire FIELDNUM entry
I $$GETVALUE(IEN,FIELDNUM)="" D DELVALUE(IEN,FIELDNUM)
Q
EDITGEN(IEN) ; general edit
; First pass: quick & dirty Fileman ^DIE call
; Future: Screenman interface
N DIE,DA,DR,DIDEL,DTOUT
S DA=IEN,DIE=$$FILENUM,DR=1 D ^DIE
; And we need to delete any entries with null values
N A S A=0 F S A=$O(^BPS(9002313.511,IEN,1,A)) Q:'A D
. N X S X=^BPS(9002313.511,IEN,1,A,0)
. I $P(X,U,2)="" D
. . N FIELDNUM S FIELDNUM=$P(^BPSF(9002313.91,$P(X,U),0),U)
. . D DELVALUE(IEN,FIELDNUM)
Q
GET511(IEN,ARR101,ARR402) ;EP - from BPSOSCD - load arrays with data from IEN
;
N A,C S A=0,C=0
N X,F,HDRLST,MULTLST,TFLD,BPFLDNUM
;
; Build the exception lists
S HDRLST=",524,",MULTLST=",308,315,316,317,318,319,320,327,"
;
F S A=$O(^BPS(9002313.511,IEN,1,A)) Q:'A D
. S X=^BPS(9002313.511,IEN,1,A,0)
. S F=$P(X,U) ; Field IEN, points to 9002313.91
. ; Store in either claim header or claim detail, based on field #
. ; Note that logic below will put 401 field in both header and detail
. S BPFLDNUM=+$$FIELDNUM(F)
. S TFLD=","_BPFLDNUM_","
. I BPFLDNUM<402!(HDRLST[TFLD) S @ARR101@(F)=$P(X,U,2)
. I BPFLDNUM>400!(MULTLST[TFLD) S @ARR402@(F)=$P(X,U,2)
. ;
. S C=C+1
Q C
;
; Generalized utilities - good for everything, not just auth #
LOCK() L +^BPS(9002313.511,IEN):300 Q $T
UNLOCK L -^BPS(9002313.511,IEN) Q
FILENUM() Q 9002313.511
SUBFNUM() Q 9002313.5111
FLOCK() L +^BPS(9002313.511):300 Q $T
FUNLOCK L -^BPS(9002313.511) Q
FIELDIEN(FIELDNUM) ; ien of a 9002313.91 NCPDP Data Dictionary field
Q $$FIND1^DIC(9002313.91,,,FIELDNUM)
FIELDNAM(FIELDNUM) ; name of a 9002313.91 NCPDP Data Dictionary field
Q $$GET1^DIQ(9002313.91,$$FIELDIEN(FIELDNUM),.03)
; given pointer to NCPDP Data Dictionary fields, return external #
FIELDNUM(IEN91) Q $P($G(^BPSF(9002313.91,IEN91,0)),U)
NEW() ;EP - create new entry in 9002313.511
F Q:$$FLOCK Q:'$$IMPOSS^BPSOSUE("L","RTI","interlock on new Override record creation",,"NEW",$T(+0))
N FLAGS,FDA,IEN,MSG,FN,X,NEWREC S FN=$$FILENUM
D NEW1
D FUNLOCK
Q NEWREC
NEW1 ;
S FDA(FN,"+1,",.01)=$O(^BPS(FN,"B",999999999999),-1)+1
D UPDATE^DIE(,"FDA","IEN","MSG")
I $D(MSG) D G NEW1:$$IMPOSS^BPSOSUE("FM","TRI","UPDATE^DIE failed",,"NEW1",$T(+0))
. D ZWRITE^BPSOS("FDA","IEN","MSG")
. K MSG
S NEWREC=IEN(1)
NEW2 ;
S FDA(FN,NEWREC_",",.02)="NOW"
D FILE^DIE("E","FDA","MSG")
Q:'$D(MSG) ; success
G NEW2:$$IMPOSS^BPSOSUE("FM","TRI","FILE^DIE failed",,"NEW2",$T(+0))
Q
HASVALUE(IEN,FIELDNUM) ; does the FIELDNUM have an override value?
; returns IEN into the subfile
Q $$FIND1^DIC($$SUBFNUM,","_IEN_",",,FIELDNUM)
GETVALUE(IEN,FIELDNUM) ; return currently-set override value for given FIELDNUM
N X S X=$$HASVALUE(IEN,FIELDNUM) I 'X Q ""
Q $$GET1^DIQ($$SUBFNUM,X_","_IEN_",",.02)
SETVALUE(IEN,FIELDNUM,VALUE) ;
; can DO or $$; $$ = ien in subfile for this FIELDNUM
; Special case for the override file: if you're trying to set the
; field's value to "@", don't just delete the field value,
; which would leave the field defined with a null value.
; Instead, delete the entire override for the field.
; This prevents accidentally overriding a genuine value with null.
I "@"=VALUE D DELVALUE(IEN,FIELDNUM) Q ""
; But the usual case is just storing a value:
N FDA,MSG,IENS,IENARRAY
; Note: I tried the "+?1,ien," method but it always created a new
; entry, even when it meant creating duplicates. So now we test to
; see if there's already an entry for the fieldnum, and if not,
; then we put in a "+1,"
N ENTRY S ENTRY=$$HASVALUE(IEN,FIELDNUM) ; do we already have FIELDNUM
I 'ENTRY S ENTRY="+1" ; if not, then create a new entry
S IENS=ENTRY_","_IEN_","
S FDA($$SUBFNUM,IENS,.01)=FIELDNUM
S FDA($$SUBFNUM,IENS,.02)=VALUE
D SETV1
I ENTRY="+1" S ENTRY=$G(IENARRAY(1))
Q ENTRY
SETV1 ;
D UPDATE^DIE("E","FDA","IENARRAY","MSG")
Q:'$D(MSG) ; success
K ^TMP("BPS",$J,"BPSOSO2",$J,"SETVALUE")
S ^TMP("BPS",$J,"BPSOSO2",$J,"SETVALUE")=$$ERRHDR
M ^TMP("BPS",$J,"BPSOSO2",$J,"SETVALUE","MSG")=MSG
I $D(IENARRAY) M ^TMP("BPS",$J,"BPSOSO2",$J,"SETVALUE","IENARRAY")=IENARRAY
D ZWRITE^BPSOS("FDA","IENARRAY","MSG")
G SETV1:$$IMPOSS^BPSOSUE("FM","TRI",,,"SETVALUE",$T(+0))
Q
DELVALUE(IEN,FIELDNUM) ;
N ENTRY S ENTRY=$$HASVALUE(IEN,FIELDNUM) Q:'ENTRY ; wasn't defined
N FDA,MSG
S FDA($$SUBFNUM,ENTRY_","_IEN_",",.01)="@"
DE5 D FILE^DIE("E","FDA","MSG")
Q:'$D(MSG) ; success
K ^TMP("BPS",$J,"BPSOSO2",$J,"DELVALUE")
S ^TMP("BPS",$J,"BPSOSO2",$J,"DELVALUE")=$$ERRHDR
D ZWRITE^BPSOS("IEN","FDA","MSG")
G DE5:$$IMPOSS^BPSOSUE("FM","TRI",,,"DELVALUE",$T(+0))
Q
ERRHDR() Q "ERROR AT $H="_$H_" FOR $J="_$J
SEE(IEN) N TMP M TMP=^BPS($$FILENUM,IEN) D ZWRITE^BPSOS("TMP") Q ; debugging
;
PRIORA(IEN) ;IHS/SD/lwj 9/3/02 NCPDP 5.1 Changes - Prior Authorization
; We are still processing 5.1 and 3.2 claims, so we have to be able
; to populate fields 461, 462 and 416. 416 will be created based
; on the input into fields 461, and 462.
;
N FIELDNUM
;
S FIELDNUM=461 ;Prior authorization type code
D EDIT(IEN,FIELDNUM)
;
S FIELDNUM=462 ;Prior authorization number submitted
D EDIT(IEN,FIELDNUM)
;
;now we combine field 461 and 462 to creat field 416
;
N VAL461,VAL462,VAL416,DA
S (VAL461,VAL462,VAL416)=""
;
S VAL461=$$GETVALUE(IEN,461)
S VAL462=$$GETVALUE(IEN,462)
S VAL416=VAL461_VAL462
Q:VAL416=""
;
S DA=$$SETVALUE(IEN,416,"")
S:$G(DA)'="" DA=$$SETVALUE(IEN,416,VAL416)
;
;
Q