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Routine: ABME5L7

ABME5L7.m

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  1. ABME5L7 ; IHS/ASDST/DMJ - Header 
  1.  ;;2.6;IHS 3P BILLING SYSTEM;**6,8,9,10,21**;NOV 12, 2009;Build 379
  1.  ;Header Segments
  1.  ;IHS/SD/SDR - 2.6*21 - HEAT70826 - Modified to remove 2310B loop based on SGTM entry
  1.  ;
  1. EP ;START HERE
  1.  N ABM
  1.  D GETPRV^ABMEEPRV             ; Build Claim Level Provider array
  1.  S ABMPAYER=ABMP("INS")
  1.  ;
  1.  ; Loop 2310A - Attending Physician Name
  1.  S ABMLOOP="2310A"
  1.  I $D(ABMP("PRV","A")) D
  1.  .Q:$G(ABMP("CLIN"))="A3"
  1.  .S ABM("PRV")=$O(ABMP("PRV","A",0))
  1.  .D EP^ABME5NM1("71")
  1.  .D WR^ABMUTL8("NM1")
  1.  .D EP^ABME5PRV("AT",ABM("PRV")) ;5010 837P
  1.  .D WR^ABMUTL8("PRV") ;5010 837P
  1.  .I ABMNPIU="N" D
  1.  ..;Q:(ABMNPIU="N")&(ABMP("EXP")=21)&(($P($G(^AUTNINS(ABMP("INS"),0)),U)="OKLAHOMA MEDICAID")!($P($G(^AUTNINS(ABMP("INS"),0)),U)["OK MEDICAID"))  ;Remove REF, OK Medicaid only  ;abm*2.6*8 5010
  1.  ..Q:(ABMNPIU="N")&(ABMP("EXP")=31)&(($P($G(^AUTNINS(ABMP("INS"),0)),U)="OKLAHOMA MEDICAID")!($P($G(^AUTNINS(ABMP("INS"),0)),U)["OK MEDICAID"))  ;Remove REF, OK Medicaid only  ;abm*2.6*8 5010
  1.  ..Q:((ABMRCID="99999")!(ABMRCID="AHCCCS866004791"))  ;AZ Medicaid
  1.  ..;D EP^ABME5REF("EI",9999999.06,DUZ(2))
  1.  ..;D WR^ABMUTL8("REF")
  1.  .I ABMNPIU'="N" D
  1.  ..I ABMRCID="FHC&AFFILIATES"!($P($G(^AUTNINS(ABMP("INS"),0)),U)="NORTH DAKOTA MEDICAID") D
  1.  ...;D EP^ABME5REF("LU",9999999.06,ABMP("LDFN"))  ;abm*2.6*10 IHS/SD/AML 3/30/12 Change for ND MCD NOHEAT
  1.  ...D EP^ABME5REF("G2",9999999.06,ABMP("LDFN"))  ;abm*2.6*10 IHS/SD/AML 3/30/12 Change for ND MCD NOHEAT
  1.  ...D WR^ABMUTL8("REF")
  1.  ..E  D EP^ABME5REF(ABMP("RTYPE"),200,ABM("PRV")),WR^ABMUTL8("REF")
  1.  K ABMLOOP
  1.  ;
  1.  ; Loop 2310B - Operating Physician Name
  1.  S ABMLOOP="2310B"
  1.  I $D(ABMP("PRV","O")) D
  1.  .Q:$$RCID^ABMUTLP(ABMP("INS"))=731476619
  1.  .;start new abm*2.6*21 IHS/SD/SDR HEAT70826
  1.  .S ABMOFLG=0
  1.  .I $D(^ABMNINS(ABMP("LDFN"),ABMP("INS"),2.5,"ASEND",ABMP("EXP"),"2310B","00","0","N"))>0 D
  1.  ..S ABMO=0
  1.  ..F  S ABMO=$O(^ABMNINS(ABMP("LDFN"),ABMP("INS"),2.5,"ASEND",ABMP("EXP"),"2310B","00","0","N",ABMO)) Q:'ABMO  D
  1.  ...I $P($G(^ABMNINS(ABMP("LDFN"),ABMP("INS"),2.5,ABMO,0)),U,6)=""!($P($G(^ABMNINS(ABMP("LDFN"),ABMP("INS"),2.5,ABMO,0)),U,6)=ABMP("VTYP")) S ABMOFLG=1
  1.  .Q:ABMOFLG=1
  1.  .;end new abm*2.6*21 IHS/SD/SDR HEAT70826
  1.  .S ABM("PRV")=$O(ABMP("PRV","O",0))
  1.  .D EP^ABME5NM1("72")
  1.  .D WR^ABMUTL8("NM1")
  1.  .;start old code abm*2.6*10 IHS/SD/AML NOHEAT remove EI if NPI ONLY
  1.  .;I ABMNPIU="N" D 
  1.  .;.;D EP^ABME5REF("EI",9999999.06,DUZ(2))  ;abm*2.6*9 HEAT57488 IHS/SD/AML - Removed "EI" qualifier as not allowed in 5010 
  1.  .;.;Q:(ABMNPIU="N")&(ABMP("EXP")=21)&(($P($G(^AUTNINS(ABMP("INS"),0)),U)="OKLAHOMA MEDICAID")!($P($G(^AUTNINS(ABMP("INS"),0)),U)["OK MEDICAID"))  ;Remove REF, OK Medicaid only  ;abm*2.6*8 5010
  1.  .;.Q:(ABMNPIU="N")&(ABMP("EXP")=31)&(($P($G(^AUTNINS(ABMP("INS"),0)),U)="OKLAHOMA MEDICAID")!($P($G(^AUTNINS(ABMP("INS"),0)),U)["OK MEDICAID"))  ;Remove REF, OK Medicaid only  ;abm*2.6*8 5010
  1.  .;.Q:((ABMRCID="99999")!(ABMRCID="AHCCCS866004791"))  ;AZ Medicaid
  1.  .;.;D WR^ABMUTL8("REF")  ;abm*2.6*9 HEAT57488 IHS/SD/AML 1/20/2012
  1.  .;end old code abm*2.6*10 NO HEAT
  1.  .I ABMNPIU'="N" D
  1.  ..I ABMRCID="FHC&AFFILIATES" D
  1.  ...D EP^ABME5REF("LU",9999999.06,ABMP("LDFN"))
  1.  ...D WR^ABMUTL8("REF")
  1.  ..E  D EP^ABME5REF(ABMP("RTYPE"),200,ABM("PRV")),WR^ABMUTL8("REF")
  1.  ;
  1.  ; Loop 2310C - Other Operating Physician
  1.  S ABMLOOP="2310C"
  1.  ;
  1.  ; Loop 2310D - Rendering Provider Name
  1.  S ABMLOOP="2310D"
  1.  I $D(ABMP("PRV","R")) D
  1.  .S ABM("PRV")=$O(ABMP("PRV","R",0))
  1.  .I $O(ABMP("PRV","R",0))=$O(ABMP("PRV","A",0)) Q  ;don't write if Attending=Rendering
  1.  .D EP^ABME5NM1("82")
  1.  .D WR^ABMUTL8("NM1")
  1.  .I ABMNPIU'="N" D
  1.  ..I ABMRCID="FHC&AFFILIATES"!($P($G(^AUTNINS(ABMP("INS"),0)),U)="NORTH DAKOTA MEDICAID") D
  1.  ...D EP^ABME5REF("LU",9999999.06,ABMP("LDFN"))
  1.  ...D WR^ABMUTL8("REF")
  1.  ..E  D EP^ABME5REF(ABMP("RTYPE"),200,ABM("PRV")),WR^ABMUTL8("REF")
  1.  ;
  1.  ; Loop 2310E - Service Facility Name
  1.  S ABMLOOP="2310E"
  1.  ;I ABMP("LDFN")'=DUZ(2) D  ;abm*2.6*9 HEAT57746
  1.  S ABMSLOC=$P($G(^ABMNINS(ABMP("LDFN"),ABMP("INS"),1,ABMP("VTYP"),1)),U,17)  ;abm*2.6*9 HEAT57746
  1.  I ((ABMSLOC="S")!((ABMSLOC="D")!(ABMSLOC="")&($P($G(^DIC(4,DUZ(2),0)),U)'=$P($G(^DIC(4,ABMP("LDFN"),0)),U)))) D  ;abm*2.6*8  ;abm*2.6*9 HEAT57746
  1.  .D EP^ABME5NM1("77")
  1.  .D WR^ABMUTL8("NM1")
  1.  .D EP^ABME5N3(4,ABMP("LDFN"))
  1.  .D WR^ABMUTL8("N3")
  1.  .D EP^ABME5N4(4,ABMP("LDFN"))
  1.  .D WR^ABMUTL8("N4")
  1.  .I ABMNPIU'="N" D
  1.  ..I ABMP("ITYPE")="R" D
  1.  ...D EP^ABME5REF("1C",9999999.06,ABMP("LDFN"))
  1.  ...D WR^ABMUTL8("REF")
  1.  ..I ABMP("ITYPE")="D"!(ABMP("ITYPE")="K") D
  1.  ...D EP^ABME5REF("1D",9999999.06,ABMP("LDFN"))
  1.  ...D WR^ABMUTL8("REF")
  1.  ;
  1.  ; Loop 2310F - Referrring Provider Name
  1.  S ABMLOOP="2310F"
  1.  I $D(ABMP("PRV","F")) D
  1.  .S ABM("PRV")=$O(ABMP("PRV","F",0))
  1.  .I $O(ABMP("PRV","A",0))=$O(ABMP("PRV","F",0)) Q  ;don't write if Attending=Referring (from page 3)
  1.  .;don't write if attending NPI equals NPI entered on page 3 for referring
  1.  .I (+$O(ABMP("PRV","A",0))'=0),(+$O(ABMP("PRV","F",0))=0)&($D(ABMP("PRV","F"))),$P($$NPI^XUSNPI("Individual_ID",$O(ABMP("PRV","A",0))),U)=$P(ABMP("PRV","F",$O(ABMP("PRV","F",""))),U,3) Q  ;abm*2.6*10 HEAT67469
  1.  .D EP^ABME5NM1("DN")
  1.  .D WR^ABMUTL8("NM1")
  1.  .I ABMNPIU'="N" D
  1.  ..I ABMRCID="FHC&AFFILIATES"!($P($G(^AUTNINS(ABMP("INS"),0)),U)="NORTH DAKOTA MEDICAID") D
  1.  ...D EP^ABME5REF("LU",9999999.06,ABMP("LDFN"))
  1.  ...D WR^ABMUTL8("REF")
  1.  ..E  D EP^ABME5REF(ABMP("RTYPE"),200,ABM("PRV")),WR^ABMUTL8("REF")
  1.  Q