268 lines
8.4 KiB
Mathematica
268 lines
8.4 KiB
Mathematica
IBCEF73 ;WOIFO/SS - FORMATTER AND EXTRACTOR SPECIFIC BILL FUNCTIONS ;8/6/03 10:56am
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;;2.0;INTEGRATED BILLING;**232,320,358,349**;21-MAR-94;Build 46
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;;Per VHA Directive 2004-038, this routine should not be modified.
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;
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;check qualifier
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;IBFRM 0-both, 1=UB,2=1500
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;IBPROV - function in #399 (1-referring, 2-operating,etc)
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;IBTYPE - "C"-current insurance, "O"-other insurance
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;IBVAL - value to check
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CHCKSEC(IBFRM,IBPROV,IBTYPE,IBVAL) ;
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I IBFRM=0 Q:$$CHSEC(1,IBPROV,IBTYPE,IBVAL) 1 Q $$CHSEC(2,IBPROV,IBTYPE,IBVAL)
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Q $$CHSEC(IBFRM,IBPROV,IBTYPE,IBVAL)
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;
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CHSEC(IBFRM,IBPROV,IBTYPE,IBVAL) ;
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N IBSTR S IBSTR=""
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;referring
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I IBPROV=1 S IBSTR=$S(IBTYPE="C":$$OPR5(IBFRM),IBTYPE="O":$$OP4(IBFRM),1:"")
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;operating
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I IBPROV=2 S IBSTR=$S(IBTYPE="C":$$OPR3(IBFRM),IBTYPE="O":$$OP2(IBFRM),1:"")
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;rendering
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I IBPROV=3 S IBSTR=$S(IBTYPE="C":$$OPR2(IBFRM),IBTYPE="O":$$OP1(IBFRM),1:"")
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;attending
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I IBPROV=4 S IBSTR=$S(IBTYPE="C":$$OPR2(IBFRM),IBTYPE="O":$$OP1(IBFRM),1:"")
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;supervising
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I IBPROV=5 S IBSTR=$S(IBTYPE="C":$$OPR8(IBFRM),IBTYPE="O":$$OP8(IBFRM),1:"")
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;other
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I IBPROV=9 S IBSTR=$S(IBTYPE="C":$$OPR4(IBFRM),IBTYPE="O":$$OP9(IBFRM),1:"")
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Q:IBPROV=0!(IBSTR="") 1 ;if "" or facility id always return 1
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Q IBSTR[("^"_IBVAL_"^")
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;
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;Filter invalid qualifier entries for records SUB1,SUB2,OP6,OP7,OP3
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; Rebuild the IBXSAVE("PROVINF" or IBXSAVE("PROVINF_FAC" array with
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; only ids that have valid qualifiers
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;IBFRM 0-both, 1=UB,2=1500
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;IBREC record ID whose ids are being filtered (SUB1,SUB2,etc)
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;IBFAC - 1 if facility check, 0 if attending/rendering check
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;IBTYPE - "C"-current insurance, "O"-other insurance
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;IBXSAVE - the array of provider ids extracted, returned filtered -
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; passed by reference
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CHCKSUB(IBFRM,IBREC,IBFAC,IBTYPE,IBXSAVE) ;
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N Z,Z0,Z1,Z2,CT,IBSAVE
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S Z="PROVINF"_$P("^_FAC",U,$G(IBFAC)+1)
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I '$G(IBXSAVE(Z,IBXIEN)) D
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. D F^IBCEF("N-ALL "_$S($G(IBFAC):"OUTSIDE FAC PROVIDER INF",1:"CUR/OTH PROVIDER INFO"))
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M IBSAVE(Z,IBXIEN,IBTYPE)=IBXSAVE(Z,IBXIEN,IBTYPE) K IBXSAVE(Z,IBXIEN,IBTYPE)
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S Z0=0 F S Z0=$O(IBSAVE(Z,IBXIEN,IBTYPE,Z0)) Q:'Z0 S Z1="" F S Z1=$O(IBSAVE(Z,IBXIEN,IBTYPE,Z0,Z1)) Q:Z1="" S (Z2,CT)=0 F S Z2=$O(IBSAVE(Z,IBXIEN,IBTYPE,Z0,Z1,Z2)) Q:'Z2 D
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. N IBVAL
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. S IBVAL=$P(IBSAVE(Z,IBXIEN,IBTYPE,Z0,Z1,Z2),U,3)
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. I IBFRM=0 D Q
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.. I $S($$CHSUB(1,IBREC,IBVAL):1,1:$$CHSUB(2,IBPROV,IBTYPE,IBVAL)) D
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... S CT=CT+1,IBXSAVE(Z,IBXIEN,IBTYPE,Z0,Z1,CT)=IBSAVE(Z,IBXIEN,IBTYPE,Z0,Z1,Z2)
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... I $G(IBXSAVE(Z,IBXIEN,IBTYPE,Z0))="",$G(IBSAVE(Z,IBXIEN,IBTYPE,Z0))'="" S IBXSAVE(Z,IBXIEN,IBTYPE,Z0)=IBSAVE(Z,IBXIEN,IBTYPE,Z0)
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. I $$CHSUB(IBFRM,IBREC,IBVAL) D
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.. S CT=CT+1,IBXSAVE(Z,IBXIEN,IBTYPE,Z0,Z1,CT)=IBSAVE(Z,IBXIEN,IBTYPE,Z0,Z1,Z2)
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.. I $G(IBXSAVE(Z,IBXIEN,IBTYPE,Z0))="",$G(IBSAVE(Z,IBXIEN,IBTYPE,Z0))'="" S IBXSAVE(Z,IBXIEN,IBTYPE,Z0)=IBSAVE(Z,IBXIEN,IBTYPE,Z0)
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Q
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;
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; Check if valid qualifier
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;IBFRM 0-both, 1=UB,2=1500
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;IBREC record ID whose ids are being filtered (SUB1,SUB2,etc)
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;IBVAL - value to check
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CHSUB(IBFRM,IBREC,IBVAL) ;
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N IBSTR
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I IBREC="SUB1" S IBSTR=$$SUB1(IBFRM)
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I IBREC="SUB2" S IBSTR=$$SUB2(IBFRM)
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I IBREC="OP7" S IBSTR=$$OP7(IBFRM)
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I IBREC="OP3" S IBSTR=$$OP3(IBFRM)
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I IBREC="OP6" S IBSTR=$$OP6(IBFRM)
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Q:$G(IBSTR)="" 1 ;if "" always return 1
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Q IBSTR[("^"_IBVAL_"^")
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;
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;IBFRM 0-both, 1=UB,2=1500
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OPR2(IBFRM) ;
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Q:IBFRM=1 "^0B^1A^1B^1C^1D^1G^1H^EI^G2^LU^N5^SY^X5^"
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Q:IBFRM=2 "^0B^1B^1C^1D^1G^1H^EI^G2^LU^N5^SY^X5^"
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Q ""
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;
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;IBFRM 0-both, 1=UB,2=1500
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OP1(IBFRM) ;
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Q:IBFRM=1 "^1A^1B^1C^1D^1G^1H^EI^G2^LU^N5^"
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Q:IBFRM=2 "^1B^1C^1D^EI^G2^LU^N5^"
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Q ""
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;
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;IBFRM 0-both, 1=UB,2=1500
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OPR3(IBFRM) ;
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Q:IBFRM=1 "^0B^1A^1B^1C^1D^1G^1H^EI^G2^LU^N5^SY^X5^"
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Q ""
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;
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;IBFRM 0-both, 1=UB,2=1500
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OP2(IBFRM) ;
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Q:IBFRM=1 "^1A^1B^1C^1D^1G^1H^EI^G2^LU^N5^"
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Q ""
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;
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;IBFRM 0-both, 1=UB,2=1500
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SUB1(IBFRM) ;
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Q:IBFRM=1 "^0B^1A^1B^1C^1D^1G^1H^EI^G2^LU^N5^SY^X5^"
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Q:IBFRM=2 "^0B^1A^1B^1C^1D^1G^1H^EI^G2^LU^N5^U3^SY^X5^"
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Q ""
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;
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;IBFRM 0-both, 1=UB,2=1500
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OPR4(IBFRM) ;
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Q:IBFRM=1 "^0B^1A^1B^1C^1D^1G^1H^EI^G2^LU^N5^SY^X5^"
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Q ""
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;
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;IBFRM 0-both, 1=UB,2=1500
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OP9(IBFRM) ;
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Q:IBFRM=1 "^1A^1B^1C^1D^1G^1H^EI^G2^LU^N5^"
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Q ""
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;
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;IBFRM 0-both, 1=UB,2=1500
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SUB2(IBFRM) ;
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Q:IBFRM=1 "^0B^1A^1B^1C^1G^1H^1J^EI^FH^G2^G5^LU^N5^X5^TJ^B3^BQ^SY^U3^"
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Q:IBFRM=2 "^0B^X4^1A^1B^1C^1G^1H^G2^LU^X5^TJ^B3^BQ^SY^U3^"
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Q ""
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;
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;IBFRM 0-both, 1=UB,2=1500
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OP3(IBFRM) ;
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Q:IBFRM=1 "^1B^1C^EI^G2^LU^N5^"
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Q ""
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;
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;IBFRM 0-both, 1=UB,2=1500
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OPR5(IBFRM) ;
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Q:IBFRM=2 "^0B^1B^1C^1D^1G^1H^EI^G2^LU^N5^SY^X5^"
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Q ""
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;
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;IBFRM 0-both, 1=UB,2=1500
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OPR8(IBFRM) ;
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Q:IBFRM=2 "^0B^1B^1C^1D^1G^1H^EI^G2^LU^N5^SY^X5^"
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Q ""
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;
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;IBFRM 0-both, 1=UB,2=1500
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OP4(IBFRM) ;
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Q:IBFRM=2 "^1B^1C^1D^EI^G2^LU^N5^"
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Q ""
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;
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;IBFRM 0-both, 1=UB,2=1500
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OP8(IBFRM) ;
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Q:IBFRM=2 "^1B^1C^1D^EI^G2^N5^"
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Q ""
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;
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;IBFRM 0-both, 1=UB,2=1500
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OP6(IBFRM) ;
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Q:IBFRM=2 "^1A^1B^1C^G2^LU^N5^"
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Q ""
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;
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;IBFRM 0-both, 1=UB,2=1500
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OP7(IBFRM) ;
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Q:IBFRM=2 "^1A^1B^1C^G2^LU^N5^"
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Q ""
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;
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;check qualifier for PRV1
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;IBFRM 0-both, 1=UB,2=1500
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;IBVAL - value to check
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CHCKPRV1(IBFRM,IBVAL) ;
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I IBFRM=0 Q:$$CHPRV1(1,IBVAL) 1 Q $$CHPRV1(2,IBVAL)
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Q $$CHPRV1(IBFRM,IBVAL)
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;IBFRM 0-both, 1=UB,2=1500
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CHPRV1(IBFRM,IBVAL) ;
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N IBSTR S IBSTR=""
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S IBSTR=$$PRV1(IBFRM)
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Q:IBSTR="" 1
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Q IBSTR[("^"_IBVAL_"^")
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;
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PRV1(IBFRM) ;
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Q:IBFRM=1 "^1A^1C^1D^1G^1H^1J^B3^BQ^EI^FH^G2^G5^LU^SY^X5^"
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Q:IBFRM=2 "^1B^1C^1D^1G^1H^1J^B3^BQ^EI^FH^G2^G5^LU^U3^SY^X5^"
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Q ""
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;
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PTSELF ;This tag is for the CI2 segment. If the IBXSAVE("IADR") is empty
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;check to see if the relationship to pt is 18 (self) if so pull info
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;from PT1 calls
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;See if relationship to insured is 18 if not or if "" quit
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N IBZ
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D F^IBCEF("N-ALL INSURED PT RELATION","IBZ",,IBXIEN)
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S IBZ=$G(IBZ(+$$COBN^IBCEF(IBXIEN)))
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S IBZ=$$RELATION^IBCEFG1(IBZ)
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I IBZ'="18" S IBXDATA="" Q
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N IBZ D F^IBCEF("N-PATIENT STREET ADDRESS 1-3","IBZ",,IBXIEN)
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S IBXDATA="18"
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Q
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;
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NOPUNCT(X,SPACE,EXC) ; Strip punctuation from data in X
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; SPACE = flag if 1 strip SPACES
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; EXC = list of punct not to strip
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;
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N PUNCT,Z
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S PUNCT=".,-+(){}[]\/><:;?|=_*&%$#@!~`^'"""
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I $G(SPACE) S PUNCT=PUNCT_" "
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I $G(EXC)'="" S PUNCT=$TR(PUNCT,EXC)
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N L S L=""
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F S L=$O(X(L)) Q:L="" D
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. S X(L)=$TR(X(L),PUNCT)
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I $G(X)'="" D
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. S X=$TR(X,PUNCT)
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Q
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;
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PROVID(IBXIEN) ;This modified version of prov id call is to acquire the SSN
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;first, if the ssn is not available then we need to get the tax id.
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;we also need to provide the modifier for which value it is
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Q:+$G(IBXIEN)=0 ""
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S IBXSAVE("ID")=""
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S IBXSAVE=""
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S IBXSAVE=$$PROVSSN^IBCEF7(IBXIEN)
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N I
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F I=1:1:9 D
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. I $P(IBXSAVE,"^",I)]"" S $P(IBXSAVE("ID"),U,I)="34"
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;If no ibxdata go look in 355.97 for 24
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N IBRETVAL S IBRETVAL=""
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N IBPTR,IBFT
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F IBFT=1:1:9 D
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. Q:$P(IBXSAVE,U,IBFT)]""
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. S IBPTR=$$PROVPTR^IBCEF7(IBXIEN,IBFT)
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. S $P(IBRETVAL,"^",IBFT)=$$TAX3559(IBPTR)
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. I $P(IBRETVAL,U,IBFT)]"" D
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. . S $P(IBXSAVE,U,IBFT)=$P(IBRETVAL,U,IBFT)
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. . S $P(IBXSAVE("ID"),U,IBFT)="24"
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Q IBXSAVE
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;
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TAX3559(IBPROV) ;
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I $P(IBPROV,";",2)'["IBA(355.9" Q ""
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N IB2,IB3559,IBIDTYP,IBID,IBQFL
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S (IB3559,IBQFL)=0
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S IBID=""
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Q:+$G(IBPROV)=0 ""
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F IB2=1:1 S IB3559=$O(^IBA(355.9,"B",IBPROV,IB3559)) Q:IB3559=""!IBQFL D
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. S IBIDTYP=+$P($G(^IBA(355.9,IB3559,0)),"^",6) ;provider ID type, ptr to #355.97
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. S IBIDTYP=$P($G(^IBE(355.97,IBIDTYP,0)),"^",3)
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. S:IBIDTYP="EI" IBID=$P($G(^IBA(355.9,IB3559,0)),"^",7),IBQFL=1
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Q $$NOPUNCT^IBCEF(IBID)
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;
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;IBFULL-full name
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;IBEL - Name element : "FAMILY","GIVEN","MIDDLE","SUFFIX"
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;
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SSN200(IBPTR) ;
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I $P(IBPTR,";",2)'="VA(200," Q ""
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Q $$NOPUNCT^IBCEF($$GET1^DIQ(200,+$P(IBPTR,";")_",",9))
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;
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;Input:
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; IBIEN399 - ien in #399
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;Output:
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; returns a string with "^" delimiters that contains SSNs (if any)
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; in the position that equal to FUNCTION number
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; i.e. if RENDERING function # is 3 then SSN will be
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; in $P(return value,"^",3), etc.
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;
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SSN3559(IBPROV) ;
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N IB2,IB3559,IBIDTYP,IBID,IBQFL
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S (IB3559,IBQFL)=0
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S IBID=""
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Q:+$G(IBPROV)=0 ""
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F IB2=1:1 S IB3559=$O(^IBA(355.9,"B",IBPROV,IB3559)) Q:IB3559=""!IBQFL D
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. S IBIDTYP=+$P($G(^IBA(355.9,IB3559,0)),"^",6)
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. S IBIDTYP=$P($G(^IBE(355.97,IBIDTYP,0)),"^",3)
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. S:IBIDTYP="SY" IBID=$P($G(^IBA(355.9,IB3559,0)),"^",7),IBQFL=1
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Q $$NOPUNCT^IBCEF(IBID)
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;
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;IBIDTYP-provider ID type, ptr to #355.97
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;IBFULL-full name
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;IBEL - Name element : "FAMILY","GIVEN","MIDDLE","SUFFIX"
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;
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PRV1FMT(P) ;FORMAT CODE FOR PRV1 SEGMENT THAT WON'T FIT ON LINE
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K IBXDATA
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S:'$D(IBXSAVE("BIL-PROV-SEC")) IBXSAVE("BIL-PROV-SEC")=$$PRV1^IBCEF7(IBXIEN)
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S IBXDATA=$P($G(IBXSAVE("BIL-PROV-SEC")),"^",P)
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I $G(IBXDATA)'="" S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)
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Q
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;
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