VistA-WorldVistAEHR/r/INTEGRATED_BILLING-IB-PRQ--.../IBCU7A1.m

122 lines
5.8 KiB
Mathematica

IBCU7A1 ;ALB/ARH - BILL PROCEDURE MANIPULATIONS (BUNDLED) ; 10-OCT-03
;;2.0;INTEGRATED BILLING;**245,270**;21-MAR-94
;;Per VHA Directive 10-93-142, this routine should not be modified.
;
;
BNDL(IBIFN) ; manipulate a bill's CPT codes, replace bundled codes
; on facility and profesional bills global codes should be billed using their components
; on freestanding bills component codes should be billed as global
; - on facility bill, if a global code is found in the clinical data and on the bill then
; replace it on the bill with the institutional components
; - on professional bill, if the global code is found in the clinical data and the institutional components
; are found on the bill then replace the institutional components with the professional components
; - on a freestanding bill if all institutional and professional components are found then
; replace them with the global code
; maximum of 10 is insurance against infinite loops
N IB0,IBCT,IBDVTY,IBTYPE,IBI,IBJ,IBLN,IBGLB,IBNLN,IBNEW,IBDEL,IBRPL,IBX,IBMSG,IBCHANGE S IBCHANGE=0
S IB0=$G(^DGCR(399,+$G(IBIFN),0)) Q:IB0=""
S IBCT=$P(IB0,U,27) Q:'IBCT S IBDVTY=$P($$RCDV^IBCRU8($P(IB0,U,22)),U,3)
S IBTYPE=$S(IBDVTY=3:3,1:+IBCT)
;
I +$O(^DGCR(399,+$G(IBIFN),"CP","B","94017;ICPT("),-1)<93000 Q ; none of the bundled codes on bill
;
I IBDVTY'=3 D GETSD^IBCU7U(IBIFN) ; for provider based sites global charge should be in clincal data
;
; loop through list of bundled procedures and find any on bill
F IBI=1:1 S IBLN=$P($T(IPBI+IBI),";;",2) Q:IBLN="" D
. S IBGLB=$P(IBLN,":",1),IBCHANGE=0
. ;
. S IBNLN=$$IPB(IBLN,IBTYPE) Q:'IBNLN S IBNEW=$P(IBNLN,":",2),IBDEL=$P(IBNLN,":",1)
. ;
. I IBDVTY'=3,'$D(^UTILITY($J,"CPT-CLN",+IBGLB)) Q
. ;
. ; search the bill for the list of procedures to be replaced
. F IBJ=1:1 S IBRPL=$$FND(IBIFN,IBDEL) Q:'IBRPL D Q:IBJ>10
.. ;
.. I IBDVTY'=3,'$D(^UTILITY($J,"CPT-CLN",+IBGLB,+IBRPL)) Q
.. S IBRPL=$P(IBRPL,U,2,999) I $L(IBRPL,U)'=$L(IBDEL,U) Q
.. ;
.. I +$$RPL(IBIFN,IBNEW,IBRPL) S IBCHANGE=1 ; replace procedures
. ;
. I +IBCHANGE S IBMSG(IBI)=$TR(IBDEL,"^",",")_" replaced by "_$TR(IBNEW,"^",",")
;
I '$D(ZTQUEUED),'$G(IBAUTO),+$O(IBMSG(0)) S IBI=0 F S IBI=$O(IBMSG(IBI)) Q:'IBI W !,IBMSG(IBI)
Q
;
RPL(IBIFN,NEWCPTS,OLDLIST) ; replace procedures on the bill
; Input: NEWCPTS - list of CPT codes to add to the bill
; OLDLIST - list of procedure ifn's on the bill to be replaced
; Output: returns true if changes made
; the list of new and replaced may not be the same length
; - if more CPT's to be added than exist then the first existing procedure is copied for the new CPT
; - if fewer CPT's to be added than exist then the extra entries on the bill are deleted
N IBJ,IBFFN,IBRFN,IBNCPT,IBFND S IBFND=0
;
S NEWCPTS=$G(NEWCPTS),OLDLIST=$G(OLDLIST),IBFFN=+OLDLIST
;
F IBJ=1:1 S IBRFN=$P(OLDLIST,U,IBJ),IBNCPT=$P(NEWCPTS,U,IBJ) Q:('IBRFN)&('IBNCPT) D Q:'IBFND
. I +IBRFN,'IBNCPT S IBFND=$$DELCPT^IBCU7U(IBIFN,IBRFN) Q
. I 'IBRFN,+IBNCPT S IBFND=$$COPYCPT^IBCU7U(IBIFN,IBFFN,IBNCPT) Q
. I +IBRFN,+IBNCPT S IBFND=$$EDITCPT^IBCU7U(IBIFN,IBRFN,IBNCPT)
;
Q IBFND
;
FND(IBIFN,LIST) ; find first set of the procedures on the bill to be replaced
; if all found then returns procedure date followed by 'CP' ifn list
; Input: list of CPT's to be replaced separated by '^', internal format
; Output: procedure date ^ ifn of procedures in bill CP multiple
N IBJ,IBC1,IBC1N,IBC1D,IBC2,IBC2N,IBC2D,IBFND,IBNLIST S (IBFND,IBNLIST)=0 I '$G(LIST) G FNDQ
;
; start with the first procedure to be replaced if it is on the bill then search for the rest on same date
S IBC1=$P(LIST,U,1)
S IBC1N=0 F S IBC1N=$O(^DGCR(399,+$G(IBIFN),"CP","B",IBC1_";ICPT(",IBC1N)) Q:'IBC1N D Q:IBFND
. S IBC1D=$P($G(^DGCR(399,IBIFN,"CP",IBC1N,0)),U,2)
. S IBFND=1,IBNLIST=IBC1D_U_IBC1N
. ;
. ; find other procedures to be replaced for same date
. F IBJ=2:1 S IBC2=$P(LIST,U,IBJ) Q:'IBC2 S IBFND=0 D Q:'IBFND
.. S IBC2N=0 F S IBC2N=$O(^DGCR(399,IBIFN,"CP","B",IBC2_";ICPT(",IBC2N)) Q:'IBC2N D Q:IBFND
... S IBC2D=$P($G(^DGCR(399,IBIFN,"CP",IBC2N,0)),U,2) I IBC1D'=IBC2D S IBFND=0 Q
... S IBFND=1,IBNLIST=IBNLIST_U_IBC2N
. ;
. I 'IBFND S IBNLIST=0
;
FNDQ Q IBNLIST
;
CHKIPB(CPT,TYPE) ; return procedures that may replace procedure passed in
; Input: TYPE - 1 for institutional, 2 for professional, 3 for Non-Provider Based
; Output: Procedures to be replaced ':' Procedures they are replaced with
N IBX,IBI,IBLN,IBRPL S IBX="",CPT=$G(CPT),TYPE=+$G(TYPE)
I +TYPE,CPT>92999,CPT<94017 F IBI=1:1 S IBLN=$P($T(IPBI+IBI),";;",2) Q:IBLN="" D Q:+IBX
. S IBRPL=$$IPB(IBLN,TYPE) I $P(IBRPL,":",1)[CPT S IBX=IBRPL
Q IBX
;
;
IPB(LINE,TYPE) ; return procedures to be replaced and those they are replaced by for the type of bill
; Input: LINE - line of bundled procedures from IPBI
; TYPE - 1 for institutional, 2 for professional, 3 for Non-Provider Based
; Output: Procedures to be replaced ':' Procedures they are replaced with
; - institutional type the global is replaced by the technical componentes
; - professional type: the institutional components are replaced by the professional components
; - non-provider based: the institutional and professional components are preplaced by the global
;
N IBNEW,IBDEL,IBX S (IBX,IBDEL,IBNEW)="",TYPE=$G(TYPE),LINE=$G(LINE)
I TYPE=1 S IBNEW=$P(LINE,":",2),IBDEL=$P(LINE,":",1)
I TYPE=2 S IBNEW=$P(LINE,":",3),IBDEL=$P(LINE,":",2)
I TYPE=3 S IBNEW=$P(LINE,":",1),IBDEL=$P(LINE,":",2)_U_$P(LINE,":",3)
S IBX=IBDEL_":"_IBNEW
Q IBX
;
IPBI ; Facility Provider Based Replace Global by Technical Component: global:technical:professional
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