VistA-WorldVistAEHR/r/SCHEDULING-SD-SC/SDSCAPI.m

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Mathematica

SDSCAPI ;ALB/JDS/JAM/RBS - Automated Service Connection Designation Review ; 4/16/07 10:39am
;;5.3;Scheduling;**495**;Aug 13, 1993;Build 50
;;MODIFIED FOR NATIONAL RELEASE from a Class III software product
;;known as Service Connected Automated Monitoring (SCAM).
;
; Routine should be called at specified tags only.
Q
SC(SDFN,SDXS,SDENC,SDVST) ; Determine if SC based on DXS codes
; Input:
; SDFN = Patient ien, file #2 [Required, if SDENC or SDVST undefined]
; SDXS = Diagnosis code array [Optional, if SDENC defined]
; SDENC = Encounter ien, file #409.68 [Optional]
; SDVST = Visit ien, field #9000010 [Optional]
;
; Output:
; $$SDFILEOK = (4 piece data string ^ delimited)
; (SC flag^SC description^VBA/ICD9 match^ASCD Review)
; SC flag: 1-SC, 0-NSC, ""-could not be determined
; SC description: SC or NSC
; VBA/ICD9 match: 1-yes, 0-no
; ASCD: 1-send to review, 0-don't send to review
;
N SDOE0,SDFILEOK,SDOEDAT,SDKILL
S SDENC=+$G(SDENC),SDFILEOK=""
I 'SDENC S SDENC=+$O(^SCE("AVSIT",+$G(SDVST),0))
I SDENC S SDOE0=$$GETOE^SDOE(SDENC)
S SDOEDAT=$S(SDENC:+SDOE0,+$G(SDVST):+$G(^AUPNVSIT(SDVST,0)),1:DT)
; Get patient. If no patient, quit.
I '$G(SDFN) S SDFN=$S(SDENC:$P(SDOE0,U,2),+$G(SDVST):$P($G(^AUPNVSIT(SDVST,0)),U,5),1:"")
I '$G(SDFN) Q SDFILEOK
; diagnosis codes present
I $O(SDXS(0)) D OPT3 Q SDFILEOK
I 'SDENC Q SDFILEOK
D OPT2 I $D(SDKILL) K SDXS
Q SDFILEOK
;
OPT2 ; enter with no DXS defined; get ICD9 for visit/encounter
N SCDXS
K SDXS
I '+$G(SDENC) Q
D GETDX^SDOE(SDENC,"SCDXS")
S SDXS=0 F S SDXS=$O(SCDXS(SDXS)) Q:'SDXS S SDXS(+SCDXS(SDXS))=""
I $O(SDXS(0))="" Q
S SDKILL=1
OPT3 ; enter with DXS defined
N I,SDRD,SDRDIEN,SD31,ICDMCH,SDMCH,FL,SDARR
; Patient has no rated disabilities
D RDIS^DGRPDB(SDFN,.SDARR)
I '$D(SDARR) S SDFILEOK="1^SC^0^1" Q
; Patient has rated disabilities
S (SDRD,FL)=0
F S SDRD=$O(SDARR(SDRD)) Q:'SDRD D
.S SDRDIEN=$P(SDARR(SDRD),U) Q:SDRDIEN=""
.; Get code from eligibility file.
.S I=0,SD31=$G(^DIC(31,SDRDIEN,0)) Q:SD31=""
.; Get partial or true match on ICD9 code
.F S I=$O(SDXS(I)) Q:'I D
..S SDMCH=$$MATCH(SDRDIEN,I,SDOEDAT,SDENC),ICDMCH(SDMCH)=""
; locate entry in the following priority order -
F I="1^SC^1^0","1^SC^1^1","0^NSC^0^1","1^SC^0^1" I $D(ICDMCH(I)) S SDFILEOK=I Q
Q
;
STORE ; Save the information for this encounter.
N SDSC,SDIEN,SDERR
S SDIEN(1)=SDENC
S SDSC(409.48,"+1,",.01)=SDENC
S SDSC(409.48,"+1,",.04)=DT
S SDSC(409.48,"+1,",.07)=+SDOE0
S SDSC(409.48,"+1,",.08)=SDPRV
S SDSC(409.48,"+1,",.09)=$P(SDFILEOK,U,3)
S SDSC(409.48,"+1,",.11)=$P(SDOE0,U,2)
S SDSC(409.48,"+1,",.12)=$P(SDOE0,U,11)
S SDSC(409.48,"+1,",.05)="N"
S SDSC(409.48,"+1,",.13)=SDOSC
D UPDATE^DIE("","SDSC","SDIEN","SDERR")
I $D(SDERR) S ERR=1
Q
ST(SDENC,SDXS) ;Reviews the diagnosis codes for an encounter and then
;determines whether or not to file, or delete the record from the
;ASCD file, SDSC SERVICE CONNECTED CHANGES (#409.48).
;
; Input: SDENC = Encounter ien, file (#409.68) [Required]
; SDXS = Diagnosis code array [Optional]
;
; Output: $$ST value
; 0 = not filed for additional review
; 1 = filed for additional review
; 2 = deleted from (#409.48) file
;
N SDLIST,SDOE0,SDEL,SDOEDAT,SDPRV,SDFN,SDFILEOK,ERR,SCVAL,SDCLIN,SDSTP
N SDPAT,SDCST,SDKILL,SDV0,SDOSC,SDOEDT
I '$G(SDENC) Q 0
S SDOE0=$$GETOE^SDOE(SDENC) I SDOE0="" Q 0
;quit if child encounter
I $P(SDOE0,U,6) Q 0
S SDV0=$P(SDOE0,U,5),SDOSC=$$GET1^DIQ(9000010,SDV0_",",80001,"I")
S SDPRV=$$PRIMVPRV^PXUTL1(SDV0),SDEL=$P(SDOE0,U,13),SCVAL=0
S (SDOEDAT,SDOEDT)=+SDOE0,(SDFILEOK,ERR)=0,SDCLIN=$P(SDOE0,U,4)
S SDCST=$P(SDOE0,U,3),(SDFN,SDPAT)=$P(SDOE0,U,2)
;no patient
I 'SDPAT Q 0
;no clinic
I 'SDCLIN Q 0
;no stop code
I 'SDCST Q 0
;no visit SC value
I SDOSC="" Q 0
;not checked-out
I $P(SDOE0,U,12)'=2 Q 0
;check for non-count
I $$NCTCL^SDSCUTL(SDCLIN) Q 0
;no eligibility
I SDEL="" Q 0
;If eligibility is not service connected, quit.
D ELIG I '$D(SDLIST(SDEL)) Q 0
;if non-billable for first and third party, quit
I $$NBFP^SDSCUTL(SDENC),$$NBTP^SDSCUTL(SDENC) Q 0
D
.I $O(SDXS(0)) D OPT3 Q
.D OPT2 I $D(SDKILL) K SDXS
I SDFILEOK="" Q 0
;File encounter in ASCD if it does not exist
I $P(SDFILEOK,U,4),'$D(^SDSC(409.48,SDENC,0)) D STORE Q 'ERR
I '$P(SDFILEOK,U,4) D Q SCVAL
.;Set for review if Visit SC is different from ASCD
.I SDOSC'=$P(SDFILEOK,U) Q:$D(^SDSC(409.48,SDENC,0)) D STORE S SCVAL='ERR Q
.;Remove encounter from ASCD if no review needed
.N DA,DIK
.I $D(^SDSC(409.48,SDENC,0)) S DA=SDENC,DIK="^SDSC(409.48," D ^DIK S SCVAL=2
Q 0
ELIG ;Compile list of service connected eligibility codes
N I,J
F I=1,3 S J=0 F S J=$O(^DIC(8,"D",I,J)) Q:'J S SDLIST(J)=""
Q
MATCH(SDIEN31,SDXIEN,SDATE,SDENC) ;ICD9 matching code
; - api should be changed to lexicon in next version
; Input:
; SDIEN31 = File #31 [Required]
; SDXIEN = Diagnosis code ien, file #80 [Required]
; SDATE = Encounter date, [Optional] [Required for lexicon]
; SDENC = Encounter ien, file #409.68 [Required]
;
; Output:
; $$SDFILEOK = (4 piece data string ^ delimited)
; (SC flag^SC description^VBA/ICD9 match^ASCD Review)
; SC flag: 1-SC, 0-NSC, ""-could not be determined
; SC description: SC or NSC
; VBA/ICD9 match: 1-yes, 0-no
; ASCD: 1-send to review, 0-don't send to review
;
N SDMCH,SDXIEN1,SDXLVL,SDPDX
I '$D(^DIC(31,SDIEN31,"ICD")) Q "1^SC^0^1"
I '$D(^DIC(31,SDIEN31,"ICD","B",SDXIEN)) Q "0^NSC^0^1"
S SDXIEN1=$O(^DIC(31,SDIEN31,"ICD","B",SDXIEN,0))
S SDXLVL=$G(^DIC(31,SDIEN31,"ICD",+SDXIEN1,0)),SDMCH=+$P(SDXLVL,U,2)
I ('SDXIEN1)!(SDXLVL="") Q "0^NSC^0^1"
D GETPDX^SDOERPC(.SDPDX,SDENC)
Q $S(SDMCH&(SDPDX=SDXIEN):"1^SC^1^0",1:"1^SC^1^1")