- ABME8L7 ; IHS/ASDST/DMJ - Header
- ;;2.6;IHS 3P BILLING SYSTEM;**3**;NOV 12, 2009
- ;Header Segments
- ;
- ; IHS/SD/SDR - v2.5 p8 - task 6 - Don't send attending if ambulance
- ; IHS/SD/SDR - v2.5 p11 - NPI
- ; IHS/SD/SDR - v2.5 p12 - IM24975 - Changes for Value Options
- ; IHS/SD/SDR - v2.5 p12 - IM25247 - Add missing REF segment for TIN if NPI ONLY
- ; IHS/SD/SDR - abm*2.6*3 - HEAT8933 - do REF*LU for ND Medicaid
- ;
- EP ;START HERE
- N ABM
- D GETPRV^ABMEEPRV ; Build Claim Level Provider array
- S ABMPAYER=ABMP("INS")
- ;
- ; Loop 2310A - Attending Physician Name
- S ABMLOOP="2310A"
- I $D(ABMP("PRV","A")) D
- .Q:$G(ABMP("CLIN"))="A3"
- .S ABM("PRV")=$O(ABMP("PRV","A",0))
- .D EP^ABME8NM1("71")
- .D WR^ABMUTL8("NM1")
- .D EP^ABME8PRV("AT",ABM("PRV"))
- .D WR^ABMUTL8("PRV")
- .I ABMNPIU="N" D
- ..Q:(ABMNPIU="N")&(ABMP("EXP")=21)&(($P($G(^AUTNINS(ABMP("INS"),0)),U)="OKLAHOMA MEDICAID")!($P($G(^AUTNINS(ABMP("INS"),0)),U)["OK MEDICAID")) ;Remove REF, OK Medicaid only
- ..Q:((ABMRCID="99999")!(ABMRCID="AHCCCS866004791")) ;AZ Medicaid
- ..D EP^ABME8REF("EI",9999999.06,DUZ(2))
- ..D WR^ABMUTL8("REF")
- .I ABMNPIU'="N" D
- ..;I ABMRCID="FHC&AFFILIATES" D ;abm*2.6*3 HEAT8933
- ..I ABMRCID="FHC&AFFILIATES"!($P($G(^AUTNINS(ABMP("INS"),0)),U)="NORTH DAKOTA MEDICAID") D ;abm*2.6*3 HEAT8933
- ...D EP^ABME8REF("LU",9999999.06,ABMP("LDFN"))
- ...D WR^ABMUTL8("REF")
- ..E D EP^ABME8REF(ABMP("RTYPE"),200,ABM("PRV")),WR^ABMUTL8("REF")
- K ABMLOOP
- ;
- ; Loop 2310B - Operating Physician Name
- I $D(ABMP("PRV","O")) D
- .Q:$$RCID^ABMUTLP(ABMP("INS"))=731476619
- .S ABM("PRV")=$O(ABMP("PRV","O",0))
- .D EP^ABME8NM1("72")
- .D WR^ABMUTL8("NM1")
- .I ABMNPIU="N" D
- ..D EP^ABME8REF("EI",9999999.06,DUZ(2))
- ..Q:(ABMNPIU="N")&(ABMP("EXP")=21)&(($P($G(^AUTNINS(ABMP("INS"),0)),U)="OKLAHOMA MEDICAID")!($P($G(^AUTNINS(ABMP("INS"),0)),U)["OK MEDICAID")) ;Remove REF, OK Medicaid only
- ..Q:((ABMRCID="99999")!(ABMRCID="AHCCCS866004791")) ;AZ Medicaid
- ..D WR^ABMUTL8("REF")
- .I ABMNPIU'="N" D
- ..I ABMRCID="FHC&AFFILIATES" D
- ...D EP^ABME8REF("LU",9999999.06,ABMP("LDFN"))
- ...D WR^ABMUTL8("REF")
- ..E D EP^ABME8REF(ABMP("RTYPE"),200,ABM("PRV")),WR^ABMUTL8("REF")
- ;
- ; Loop 2310C - Other Physician Name
- I $D(ABMP("PRV","T")) D
- .Q:$$RCID^ABMUTLP(ABMP("INS"))=731476619
- .S ABM("PRV")=$O(ABMP("PRV","T",0))
- .D EP^ABME8NM1("73")
- .D WR^ABMUTL8("NM1")
- .I ABMNPIU="N" D
- ..D EP^ABME8REF("EI",9999999.06,DUZ(2))
- ..D WR^ABMUTL8("REF")
- .I ABMNPIU'="N" D
- ..I ABMRCID="FHC&AFFILIATES" D
- ...D EP^ABME8REF("LU",9999999.06,ABMP("LDFN"))
- ...D WR^ABMUTL8("REF")
- ..E D EP^ABME8REF(ABMP("RTYPE"),200,ABM("PRV")),WR^ABMUTL8("REF")
- ;
- ; Loop 2310E - Service Facility Name
- I ABMP("LDFN")'=DUZ(2) D
- .D EP^ABME8NM1("FA")
- .D WR^ABMUTL8("NM1")
- .D EP^ABME8N3(4,ABMP("LDFN"))
- .D WR^ABMUTL8("N3")
- .D EP^ABME8N4(4,ABMP("LDFN"))
- .D WR^ABMUTL8("N4")
- .I ABMNPIU'="N" D
- ..I ABMP("ITYPE")="R" D
- ...D EP^ABME8REF("1C",9999999.06,ABMP("LDFN"))
- ...D WR^ABMUTL8("REF")
- ..I ABMP("ITYPE")="D"!(ABMP("ITYPE")="K") D
- ...D EP^ABME8REF("1D",9999999.06,ABMP("LDFN"))
- ...D WR^ABMUTL8("REF")
- Q
- ABME8L7 ; IHS/ASDST/DMJ - Header
- +1 ;;2.6;IHS 3P BILLING SYSTEM;**3**;NOV 12, 2009
- +2 ;Header Segments
- +3 ;
- +4 ; IHS/SD/SDR - v2.5 p8 - task 6 - Don't send attending if ambulance
- +5 ; IHS/SD/SDR - v2.5 p11 - NPI
- +6 ; IHS/SD/SDR - v2.5 p12 - IM24975 - Changes for Value Options
- +7 ; IHS/SD/SDR - v2.5 p12 - IM25247 - Add missing REF segment for TIN if NPI ONLY
- +8 ; IHS/SD/SDR - abm*2.6*3 - HEAT8933 - do REF*LU for ND Medicaid
- +9 ;
- EP ;START HERE
- +1 NEW ABM
- +2 ; Build Claim Level Provider array
- DO GETPRV^ABMEEPRV
- +3 SET ABMPAYER=ABMP("INS")
- +4 ;
- +5 ; Loop 2310A - Attending Physician Name
- +6 SET ABMLOOP="2310A"
- +7 IF $DATA(ABMP("PRV","A"))
- Begin DoDot:1
- +8 IF $GET(ABMP("CLIN"))="A3"
- QUIT
- +9 SET ABM("PRV")=$ORDER(ABMP("PRV","A",0))
- +10 DO EP^ABME8NM1("71")
- +11 DO WR^ABMUTL8("NM1")
- +12 DO EP^ABME8PRV("AT",ABM("PRV"))
- +13 DO WR^ABMUTL8("PRV")
- +14 IF ABMNPIU="N"
- Begin DoDot:2
- +15 ;Remove REF, OK Medicaid only
- IF (ABMNPIU="N")&(ABMP("EXP")=21)&(($PIECE($GET(^AUTNINS(ABMP("INS"),0)),U)="OKLAHOMA MEDICAID")!($PIECE($GET(^AUTNINS(ABMP("INS"),0)),U)["OK MEDICAID"))
- QUIT
- +16 ;AZ Medicaid
- IF ((ABMRCID="99999")!(ABMRCID="AHCCCS866004791"))
- QUIT
- +17 DO EP^ABME8REF("EI",9999999.06,DUZ(2))
- +18 DO WR^ABMUTL8("REF")
- End DoDot:2
- +19 IF ABMNPIU'="N"
- Begin DoDot:2
- +20 ;I ABMRCID="FHC&AFFILIATES" D ;abm*2.6*3 HEAT8933
- +21 ;abm*2.6*3 HEAT8933
- IF ABMRCID="FHC&AFFILIATES"!($PIECE($GET(^AUTNINS(ABMP("INS"),0)),U)="NORTH DAKOTA MEDICAID")
- Begin DoDot:3
- +22 DO EP^ABME8REF("LU",9999999.06,ABMP("LDFN"))
- +23 DO WR^ABMUTL8("REF")
- End DoDot:3
- +24 IF '$TEST
- DO EP^ABME8REF(ABMP("RTYPE"),200,ABM("PRV"))
- DO WR^ABMUTL8("REF")
- End DoDot:2
- End DoDot:1
- +25 KILL ABMLOOP
- +26 ;
- +27 ; Loop 2310B - Operating Physician Name
- +28 IF $DATA(ABMP("PRV","O"))
- Begin DoDot:1
- +29 IF $$RCID^ABMUTLP(ABMP("INS"))=731476619
- QUIT
- +30 SET ABM("PRV")=$ORDER(ABMP("PRV","O",0))
- +31 DO EP^ABME8NM1("72")
- +32 DO WR^ABMUTL8("NM1")
- +33 IF ABMNPIU="N"
- Begin DoDot:2
- +34 DO EP^ABME8REF("EI",9999999.06,DUZ(2))
- +35 ;Remove REF, OK Medicaid only
- IF (ABMNPIU="N")&(ABMP("EXP")=21)&(($PIECE($GET(^AUTNINS(ABMP("INS"),0)),U)="OKLAHOMA MEDICAID")!($PIECE($GET(^AUTNINS(ABMP("INS"),0)),U)["OK MEDICAID"))
- QUIT
- +36 ;AZ Medicaid
- IF ((ABMRCID="99999")!(ABMRCID="AHCCCS866004791"))
- QUIT
- +37 DO WR^ABMUTL8("REF")
- End DoDot:2
- +38 IF ABMNPIU'="N"
- Begin DoDot:2
- +39 IF ABMRCID="FHC&AFFILIATES"
- Begin DoDot:3
- +40 DO EP^ABME8REF("LU",9999999.06,ABMP("LDFN"))
- +41 DO WR^ABMUTL8("REF")
- End DoDot:3
- +42 IF '$TEST
- DO EP^ABME8REF(ABMP("RTYPE"),200,ABM("PRV"))
- DO WR^ABMUTL8("REF")
- End DoDot:2
- End DoDot:1
- +43 ;
- +44 ; Loop 2310C - Other Physician Name
- +45 IF $DATA(ABMP("PRV","T"))
- Begin DoDot:1
- +46 IF $$RCID^ABMUTLP(ABMP("INS"))=731476619
- QUIT
- +47 SET ABM("PRV")=$ORDER(ABMP("PRV","T",0))
- +48 DO EP^ABME8NM1("73")
- +49 DO WR^ABMUTL8("NM1")
- +50 IF ABMNPIU="N"
- Begin DoDot:2
- +51 DO EP^ABME8REF("EI",9999999.06,DUZ(2))
- +52 DO WR^ABMUTL8("REF")
- End DoDot:2
- +53 IF ABMNPIU'="N"
- Begin DoDot:2
- +54 IF ABMRCID="FHC&AFFILIATES"
- Begin DoDot:3
- +55 DO EP^ABME8REF("LU",9999999.06,ABMP("LDFN"))
- +56 DO WR^ABMUTL8("REF")
- End DoDot:3
- +57 IF '$TEST
- DO EP^ABME8REF(ABMP("RTYPE"),200,ABM("PRV"))
- DO WR^ABMUTL8("REF")
- End DoDot:2
- End DoDot:1
- +58 ;
- +59 ; Loop 2310E - Service Facility Name
- +60 IF ABMP("LDFN")'=DUZ(2)
- Begin DoDot:1
- +61 DO EP^ABME8NM1("FA")
- +62 DO WR^ABMUTL8("NM1")
- +63 DO EP^ABME8N3(4,ABMP("LDFN"))
- +64 DO WR^ABMUTL8("N3")
- +65 DO EP^ABME8N4(4,ABMP("LDFN"))
- +66 DO WR^ABMUTL8("N4")
- +67 IF ABMNPIU'="N"
- Begin DoDot:2
- +68 IF ABMP("ITYPE")="R"
- Begin DoDot:3
- +69 DO EP^ABME8REF("1C",9999999.06,ABMP("LDFN"))
- +70 DO WR^ABMUTL8("REF")
- End DoDot:3
- +71 IF ABMP("ITYPE")="D"!(ABMP("ITYPE")="K")
- Begin DoDot:3
- +72 DO EP^ABME8REF("1D",9999999.06,ABMP("LDFN"))
- +73 DO WR^ABMUTL8("REF")
- End DoDot:3
- End DoDot:2
- End DoDot:1
- +74 QUIT
