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Routine: AZAXBILL

AZAXBILL.m

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  1. AZAXBILL ;IHS/PHXAO/AEF - FIND 3P BILLS AND CHANGE FROM HCFA-1500 TO UB-92
  1.  ;;1.0;ANNE'S SPECIAL ROUTINES;;MAR 2, 2004
  1.  ;
  1. DESC ;ROUTINE DESCRIPTION
  1.  ;;
  1.  ;;This routine finds all Arizona Medicaid bills that have been 
  1.  ;;transmitted during the 1/1/04 to 3/31/04 date range and changes 
  1.  ;;the CPT code from 00099 to 99211, the Mode of Export from 
  1.  ;;HCFA-1500-E to UB-92-E V4 and the Bill Type to 131.
  1.  ;;
  1.  ;;$$END
  1.  ;;
  1. EN ;EP -- MAIN ENTRY POINT
  1.  ;      LOOPS THROUGH THE 3P TX STATUS FILE TO FIND THE EXPORTS
  1.  ;      DURING THE TIME FRAME AND THEN FINDS ALL THE BILLS UNDER
  1.  ;      THAT EXPORT
  1.  ;
  1.  N BCNT,DATE,DIR,EXPIEN,FAC,NOW,TCNT,X,Y
  1.  ;
  1.  D ^XBKVAR
  1.  D HOME^%ZIS
  1.  ;
  1.  D TXT
  1.  ;
  1.  S DIR(0)="E"
  1.  D ^DIR
  1.  Q:'Y
  1.  ;
  1.  S NOW=$$NOW
  1.  ;D ADDREC(NOW)
  1.  ;
  1.  S TCNT=0
  1.  S FAC=0
  1.  F  S FAC=$O(^ABMDTXST(FAC)) Q:'FAC  D
  1.  . S DATE=3031231.9999
  1.  . F  S DATE=$O(^ABMDTXST(FAC,"B",DATE)) Q:'DATE  Q:DATE>3040331  D
  1.  . . S EXPIEN=0
  1.  . . F  S EXPIEN=$O(^ABMDTXST(FAC,"B",DATE,EXPIEN))  Q:'EXPIEN  D
  1.  . . . S BCNT=0
  1.  . . . D 1BAT(FAC,EXPIEN,.BCNT,NOW)
  1.  . . . S TCNT=TCNT+BCNT
  1.  ;
  1.  W !!?5,"TOTAL BILLS PROCESSED:  "_TCNT
  1.  ;
  1.  Q
  1. 1BAT(FAC,EXPIEN,BCNT,NOW) ;
  1.  ;----- PROCESS ONE BATCH
  1.  ;
  1.  N BILLIEN,DATA
  1.  ;
  1.  Q:'FAC
  1.  Q:'EXPIEN
  1.  Q:'NOW
  1.  ;
  1.  ;I '$D(^AZAXBILL("B",NOW)) D ADDREC(NOW)
  1.  ;
  1.  S DATA=$G(^ABMDTXST(FAC,EXPIEN,0))
  1.  Q:$$MODE($P(DATA,U,2))[837   ;DO ALL BATCHES EXCEPT FOR 837 BATCHES
  1.  Q:$$INSURER($P(DATA,U,4))'="ARIZONA MEDICAID"
  1.  ;
  1.  W !!?5,"PROCESSING BATCH #"_FAC_"-"_EXPIEN_"  "_$$DATE($P(DATA,U)) 
  1.  ;
  1.  D CHMOD(FAC,EXPIEN)
  1.  ;
  1.  S BILLIEN=0
  1.  F  S BILLIEN=$O(^ABMDTXST(FAC,EXPIEN,2,BILLIEN)) Q:'BILLIEN  D
  1.  . D 1BILL(FAC,BILLIEN,.BCNT,NOW)
  1.  W !?5,"NUMBER OF BILLS PROCESSED: "_BCNT
  1.  Q
  1. 1BILL(FAC,BILLIEN,BCNT,NOW) ;
  1.  ;----- PROCESS ONE BILL
  1.  ;      EDITS THE EXPORT MODE AND CPT CODES FOR ONE BILL
  1.  ;
  1.  N CODE,CODEIEN,DA,DATA,DIE,DR,MODE,X,Y
  1.  ;
  1.  Q:'FAC
  1.  Q:'BILLIEN
  1.  Q:'NOW
  1.  ;
  1.  ;I '$D(^AZAXBILL("B",NOW)) D ADDREC(NOW)
  1.  ;
  1.  Q:'$D(^ABMDBILL(FAC,BILLIEN,0))
  1.  S DATA=$G(^ABMDBILL(FAC,BILLIEN,0))
  1.  ;Q:$P(DATA,U,2)'=131   ;BILL TYPE MUST BE 131 ; DO ALL BILLS
  1.  ;Q:$P(DATA,U,4)'="B"   ;BILL STATUS MUST BE "BILLED"
  1.  Q:$$MODE($P(DATA,U,6))[837   ;DO ALL BILLS EXCEPT 837s
  1.  Q:$$INSURER($P(DATA,U,8))'="ARIZONA MEDICAID"
  1.  ;
  1.  D EXP(FAC,BILLIEN)
  1.  D CPT(FAC,BILLIEN)
  1.  ;D ADDBIL(NOW,FAC,BILLIEN)
  1.  ;
  1.  S BCNT=$G(BCNT)+1
  1.  Q
  1. CHMOD(FAC,EXPIEN) ;
  1.  ;----- CHANGE EXPORT MODE IN BATCH
  1.  ;
  1.  N DA,DIE,DR,MODE,X,Y
  1.  ;
  1.  S MODE="UB-92-E V4"
  1.  S DA=EXPIEN
  1.  S DIE="^ABMDTXST("_FAC_","
  1.  S DR=".02///^S X=MODE"
  1.  D ^DIE
  1.  Q
  1. EXP(FAC,BILLIEN) ;
  1.  ;----- CHANGE EXPORT MODE AND BILL TYPE IN BILL
  1.  ;
  1.  N DA,DIE,DR,MODE,TYPE,X,Y
  1.  ;
  1.  S TYPE=131
  1.  S MODE="UB-92-E V4"
  1.  S DA=BILLIEN
  1.  S DIE="^ABMDBILL("_FAC_","
  1.  S DR=".02///^S X=TYPE;.06///^S X=MODE"
  1.  D ^DIE   ;*** TESTING - AEF *** COMMENT OUT FOR TESTING
  1.  Q
  1. CPT(FAC,BILLIEN) ;
  1.  ;----- NOW FIND ALL THE 00099 CPT CODES UNDER THE Medical Procedures
  1.  ;      MULTIPLE AND CHANGE THEM TO 99211 AND STUFF REVENUE CODE 510
  1.  ;
  1.  N DA,DIE,DR,CODE,CODEIEN,REVCOD,X,Y
  1.  ;
  1.  S REVCODE=510
  1.  S CODEIEN=0
  1.  F  S CODEIEN=$O(^ABMDBILL(FAC,BILLIEN,27,CODEIEN)) Q:'CODEIEN  D
  1.  . S CODE=$P($G(^ABMDBILL(FAC,BILLIEN,27,CODEIEN,0)),U)
  1.  . Q:+CODE'=99
  1.  . S DA(1)=BILLIEN
  1.  . S DA=CODEIEN
  1.  . S DIE="^ABMDBILL("_FAC_","_DA(1)_",27,"
  1.  . S DR=".01///^S X=99211;.02///^S X=REVCOD"
  1.  . D ^DIE   ;*** TESTING - AEF *** COMMENT OUT FOR TESTING
  1.  Q
  1. ADDREC(X) ;
  1.  ;----- ADD RECORD TO THE AZAX BILL FILE
  1.  ;
  1.  ;      X  =  NOW
  1.  ; 
  1.  Q     
  1.  N DA,DD,DIC,DINUM,DO,Y
  1.  ;
  1.  S DINUM=X
  1.  S DIC="^AZAXBILL("
  1.  S DIC(0)=""
  1.  D FILE^DICN
  1.  Q
  1. ADDBIL(NOW,FAC,BIL) ;
  1.  ;----- ADD BILL TO THE AZAX BILL FILE
  1.  ;
  1.  Q
  1.  N DA,DD,DIADD,DIC,DO,X,Y
  1.  ;
  1.  S X=FAC_"-"_BIL
  1.  S DA(1)=NOW
  1.  S DIC="^AZAXBILL("_DA(1)_",1,"
  1.  S DIC(0)=""
  1.  S DIC("P")=$P(^DD(1991226,1,0),U,2)
  1.  S DIADD=1
  1.  D FILE^DICN
  1.  Q
  1. TXT ;----- PRINT OPTION TEXT
  1.  ;
  1.  N I,X
  1.  F I=1:1 S X=$P($T(DESC+I),";",3) Q:X["$$END"  W !,X
  1.  Q
  1. MODE(X)
  1.  ;----- RESOLVE EXPORT MODE POINTER
  1.  ;
  1.  N Y
  1.  S Y=""
  1.  I X S Y=$P($G(^ABMDEXP(X,0)),U)
  1.  Q Y
  1. INSURER(X)
  1.  ;----- RESOLVE INSURER POINTER
  1.  ;
  1.  N Y
  1.  S Y=""
  1.  I X S Y=$P($G(^AUTNINS(X,0)),U)
  1.  Q Y
  1. DATE(X) ;
  1.  ;----- DATE CONVERSION TO EXTERNAL DATE
  1.  ;
  1.  ;      X  =  DATE IN INTERNAL FM FORMAT
  1.  ;      
  1.  N Y
  1.  S Y=""
  1.  I X D
  1.  . S Y=X
  1.  . D DD^%DT
  1.  Q Y
  1. NOW() ;
  1.  ;----- RETURNS CURRENT DATE/TIME
  1.  ;
  1.  N %,%H,%I,X
  1.  D NOW^%DTC
  1.  Q %