- ABME8L9 ; IHS/ASDST/DMJ - Header
- ;;2.6;IHS 3P BILLING SYSTEM;**9**;NOV 12, 2009
- ;Header Segments
- ;
- ; IHS/SD/SDR - v2.5 p8 - IM14722
- ; Added code to check for FL override for FL32
- ;
- ; IHS/SD/SDR - V2.5 P8 - IM12418/IM14732/IM16264/IM16363/IM16618
- ; Treat rendering/attending the same
- ;
- ; IHS/SD/SDR - v2.5 p8 - task 6
- ; Don't send rendering if ambulance; send 77 for ambulance
- ;
- ; IHS/SD/SDR - v2.5 p9 - IM19291
- ; UPIN for Supervising Provider
- ;
- ; IHS/SD/SDR - v2.5 p9 - IM16962
- ; Removed check for Medicare Part B
- ;
- ; IHS/SD/SDR - v2.5 p10 - IM20111
- ; Added quit if POS=12
- ;
- ; IHS/SD/SDR - v2.5 p11 - NPI
- ;
- ; IHS/SD/SDR - v2.5 p11 - IM24200
- ;
- ; IHS/SD/SDR - v2.5 p12 - IM24898
- ; Change qualifier for supervising provider to 1G
- ;
- ; IHS/SD/SDR - v2.5 p12 - IM25247
- ; Add missing REF segment for TIN if NPI ONLY
- ;
- EP ;START HERE
- N ABM
- K ABMP("PRV") ;reset provider array
- D GETPRV^ABMEEPRV ; Build Claim Level Provider array
- S ABMPAYER=ABMP("INS")
- ;
- ; Loop 2310A - Referring Physician Name
- I $D(ABMP("PRV","F")) D
- .S ABM("PRV")=$O(ABMP("PRV","F",0))
- .S ABMLOOP="2310A"
- .D EP^ABME8NM1("DN")
- .D WR^ABMUTL8("NM1")
- .I $$PTAX^ABMEEPRV(ABM("PRV"))'="" D
- ..D EP^ABME8PRV("RF",ABM("PRV"))
- ..D WR^ABMUTL8("PRV")
- .I ABMNPIU="N" D
- ..D EP^ABME8REF("EI",9999999.06,DUZ(2))
- ..D WR^ABMUTL8("REF")
- .I ABMNPIU'="N" D
- ..D EP^ABME8REF($S($P($G(ABMB8),U,18)'="":$P(ABMB8,U,18),1:ABMP("RTYPE")),200,ABM("PRV"))
- ..D WR^ABMUTL8("REF")
- ;
- ; Loop 2310B - Rendering Physician Name
- I $D(ABMP("PRV","R"))!($D(ABMP("PRV","A"))) D
- .Q:$G(ABMP("VTYP"))=831 ;don't write provider info for ASC
- .Q:$G(ABMP("CLIN"))="A3"
- .S ABM("PRV")=$S($D(ABMP("PRV","R")):$O(ABMP("PRV","R",0)),1:$O(ABMP("PRV","A",0)))
- .S ABMLOOP="2310B"
- .D EP^ABME8NM1("82")
- .D WR^ABMUTL8("NM1")
- .D EP^ABME8PRV("PE",ABM("PRV"))
- .D WR^ABMUTL8("PRV")
- .Q:$P($G(^AUTNINS(ABMP("INS"),0)),U)["OKLAHOMA MEDICAID"
- .I ABMNPIU="N" D
- ..D EP^ABME8REF("EI",9999999.06,DUZ(2))
- ..Q:((ABMRCID="99999")!(ABMRCID="AHCCCS866004791")) ;AZ Medicaid
- ..D WR^ABMUTL8("REF")
- .I ABMNPIU'="N" D
- ..D EP^ABME8REF(ABMP("RTYPE"),200,ABM("PRV"))
- ..D WR^ABMUTL8("REF")
- .K ABMLOOP
- ;
- ; Loop 2310C - Purchased Service Physician Name
- I $D(ABMP("PRV","P")) D
- .S ABM("PRV")=$O(ABMP("PRV","P",0))
- .D EP^ABME8NM1("QB")
- .D WR^ABMUTL8("NM1")
- .I ABMNPIU="N" D
- ..D EP^ABME8REF("EI",9999999.06,DUZ(2))
- ..D WR^ABMUTL8("REF")
- .I ABMNPIU'="N" D
- ..D EP^ABME8REF(ABMP("RTYPE"),200,ABM("PRV"))
- ..D WR^ABMUTL8("REF")
- ;
- ;
- ; Loop 2310D - Service Facility Name
- S ABMLOOP="2310D"
- S ABMTRUE=(ABMP("LDFN")'=DUZ(2))
- S:$G(ABMTRUE)="" ABMTRUE=(ABMP("CLIN"))="A3"
- I 'ABMTRUE D
- .Q:$$POS^ABMERUTL<12
- .Q:$$POS^ABMERUTL=12
- .S ABMTRUE=1
- I ABMTRUE D
- .D EP^ABME8NM1($S($G(ABMP("CLIN"))="A3":77,1:"FA"))
- .D OVER^ABMUTLP(51)
- .D WR^ABMUTL8("NM1")
- .I $G(ABMP("CLIN"))="A3" S ABMFILE=9002274.4,ABMIEN=ABMP("BDFN")
- .E S ABMFILE=4,ABMIEN=ABMP("LDFN")
- .D EP^ABME8N3(ABMFILE,ABMIEN)
- .D OVER^ABMUTLP(52)
- .D WR^ABMUTL8("N3")
- .I $G(ABMP("CLIN"))="A3" S ABMFILE=9002274.4,ABMIEN=ABMP("BDFN")
- .E S ABMFILE=4,ABMIEN=ABMP("LDFN")
- .D EP^ABME8N4(ABMFILE,ABMIEN)
- .D OVER^ABMUTLP(53)
- .D WR^ABMUTL8("N4")
- .Q:$G(ABMP("CLIN"))="A3"
- .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")
- ;
- ; Loop 2310E - Supervising Physician Name
- I $D(ABMP("PRV","S")) D
- .S ABM("PRV")=$O(ABMP("PRV","S",0))
- .D EP^ABME8NM1("DQ")
- .D WR^ABMUTL8("NM1")
- .I ABMNPIU="N" D
- ..D EP^ABME8REF("EI",9999999.06,DUZ(2))
- ..D WR^ABMUTL8("REF")
- .I ABMNPIU'="N" D
- ..D EP^ABME8REF("1G",200,ABM("PRV"))
- ..D WR^ABMUTL8("REF")
- Q
- ABME8L9 ; IHS/ASDST/DMJ - Header
- +1 ;;2.6;IHS 3P BILLING SYSTEM;**9**;NOV 12, 2009
- +2 ;Header Segments
- +3 ;
- +4 ; IHS/SD/SDR - v2.5 p8 - IM14722
- +5 ; Added code to check for FL override for FL32
- +6 ;
- +7 ; IHS/SD/SDR - V2.5 P8 - IM12418/IM14732/IM16264/IM16363/IM16618
- +8 ; Treat rendering/attending the same
- +9 ;
- +10 ; IHS/SD/SDR - v2.5 p8 - task 6
- +11 ; Don't send rendering if ambulance; send 77 for ambulance
- +12 ;
- +13 ; IHS/SD/SDR - v2.5 p9 - IM19291
- +14 ; UPIN for Supervising Provider
- +15 ;
- +16 ; IHS/SD/SDR - v2.5 p9 - IM16962
- +17 ; Removed check for Medicare Part B
- +18 ;
- +19 ; IHS/SD/SDR - v2.5 p10 - IM20111
- +20 ; Added quit if POS=12
- +21 ;
- +22 ; IHS/SD/SDR - v2.5 p11 - NPI
- +23 ;
- +24 ; IHS/SD/SDR - v2.5 p11 - IM24200
- +25 ;
- +26 ; IHS/SD/SDR - v2.5 p12 - IM24898
- +27 ; Change qualifier for supervising provider to 1G
- +28 ;
- +29 ; IHS/SD/SDR - v2.5 p12 - IM25247
- +30 ; Add missing REF segment for TIN if NPI ONLY
- +31 ;
- EP ;START HERE
- +1 NEW ABM
- +2 ;reset provider array
- KILL ABMP("PRV")
- +3 ; Build Claim Level Provider array
- DO GETPRV^ABMEEPRV
- +4 SET ABMPAYER=ABMP("INS")
- +5 ;
- +6 ; Loop 2310A - Referring Physician Name
- +7 IF $DATA(ABMP("PRV","F"))
- Begin DoDot:1
- +8 SET ABM("PRV")=$ORDER(ABMP("PRV","F",0))
- +9 SET ABMLOOP="2310A"
- +10 DO EP^ABME8NM1("DN")
- +11 DO WR^ABMUTL8("NM1")
- +12 IF $$PTAX^ABMEEPRV(ABM("PRV"))'=""
- Begin DoDot:2
- +13 DO EP^ABME8PRV("RF",ABM("PRV"))
- +14 DO WR^ABMUTL8("PRV")
- End DoDot:2
- +15 IF ABMNPIU="N"
- Begin DoDot:2
- +16 DO EP^ABME8REF("EI",9999999.06,DUZ(2))
- +17 DO WR^ABMUTL8("REF")
- End DoDot:2
- +18 IF ABMNPIU'="N"
- Begin DoDot:2
- +19 DO EP^ABME8REF($SELECT($PIECE($GET(ABMB8),U,18)'="":$PIECE(ABMB8,U,18),1:ABMP("RTYPE")),200,ABM("PRV"))
- +20 DO WR^ABMUTL8("REF")
- End DoDot:2
- End DoDot:1
- +21 ;
- +22 ; Loop 2310B - Rendering Physician Name
- +23 IF $DATA(ABMP("PRV","R"))!($DATA(ABMP("PRV","A")))
- Begin DoDot:1
- +24 ;don't write provider info for ASC
- IF $GET(ABMP("VTYP"))=831
- QUIT
- +25 IF $GET(ABMP("CLIN"))="A3"
- QUIT
- +26 SET ABM("PRV")=$SELECT($DATA(ABMP("PRV","R")):$ORDER(ABMP("PRV","R",0)),1:$ORDER(ABMP("PRV","A",0)))
- +27 SET ABMLOOP="2310B"
- +28 DO EP^ABME8NM1("82")
- +29 DO WR^ABMUTL8("NM1")
- +30 DO EP^ABME8PRV("PE",ABM("PRV"))
- +31 DO WR^ABMUTL8("PRV")
- +32 IF $PIECE($GET(^AUTNINS(ABMP("INS"),0)),U)["OKLAHOMA MEDICAID"
- QUIT
- +33 IF ABMNPIU="N"
- Begin DoDot:2
- +34 DO EP^ABME8REF("EI",9999999.06,DUZ(2))
- +35 ;AZ Medicaid
- IF ((ABMRCID="99999")!(ABMRCID="AHCCCS866004791"))
- QUIT
- +36 DO WR^ABMUTL8("REF")
- End DoDot:2
- +37 IF ABMNPIU'="N"
- Begin DoDot:2
- +38 DO EP^ABME8REF(ABMP("RTYPE"),200,ABM("PRV"))
- +39 DO WR^ABMUTL8("REF")
- End DoDot:2
- +40 KILL ABMLOOP
- End DoDot:1
- +41 ;
- +42 ; Loop 2310C - Purchased Service Physician Name
- +43 IF $DATA(ABMP("PRV","P"))
- Begin DoDot:1
- +44 SET ABM("PRV")=$ORDER(ABMP("PRV","P",0))
- +45 DO EP^ABME8NM1("QB")
- +46 DO WR^ABMUTL8("NM1")
- +47 IF ABMNPIU="N"
- Begin DoDot:2
- +48 DO EP^ABME8REF("EI",9999999.06,DUZ(2))
- +49 DO WR^ABMUTL8("REF")
- End DoDot:2
- +50 IF ABMNPIU'="N"
- Begin DoDot:2
- +51 DO EP^ABME8REF(ABMP("RTYPE"),200,ABM("PRV"))
- +52 DO WR^ABMUTL8("REF")
- End DoDot:2
- End DoDot:1
- +53 ;
- +54 ;
- +55 ; Loop 2310D - Service Facility Name
- +56 SET ABMLOOP="2310D"
- +57 SET ABMTRUE=(ABMP("LDFN")'=DUZ(2))
- +58 IF $GET(ABMTRUE)=""
- SET ABMTRUE=(ABMP("CLIN"))="A3"
- +59 IF 'ABMTRUE
- Begin DoDot:1
- +60 IF $$POS^ABMERUTL<12
- QUIT
- +61 IF $$POS^ABMERUTL=12
- QUIT
- +62 SET ABMTRUE=1
- End DoDot:1
- +63 IF ABMTRUE
- Begin DoDot:1
- +64 DO EP^ABME8NM1($SELECT($GET(ABMP("CLIN"))="A3":77,1:"FA"))
- +65 DO OVER^ABMUTLP(51)
- +66 DO WR^ABMUTL8("NM1")
- +67 IF $GET(ABMP("CLIN"))="A3"
- SET ABMFILE=9002274.4
- SET ABMIEN=ABMP("BDFN")
- +68 IF '$TEST
- SET ABMFILE=4
- SET ABMIEN=ABMP("LDFN")
- +69 DO EP^ABME8N3(ABMFILE,ABMIEN)
- +70 DO OVER^ABMUTLP(52)
- +71 DO WR^ABMUTL8("N3")
- +72 IF $GET(ABMP("CLIN"))="A3"
- SET ABMFILE=9002274.4
- SET ABMIEN=ABMP("BDFN")
- +73 IF '$TEST
- SET ABMFILE=4
- SET ABMIEN=ABMP("LDFN")
- +74 DO EP^ABME8N4(ABMFILE,ABMIEN)
- +75 DO OVER^ABMUTLP(53)
- +76 DO WR^ABMUTL8("N4")
- +77 IF $GET(ABMP("CLIN"))="A3"
- QUIT
- +78 IF ABMNPIU'="N"
- Begin DoDot:2
- +79 IF ABMP("ITYPE")="R"
- Begin DoDot:3
- +80 DO EP^ABME8REF("1C",9999999.06,ABMP("LDFN"))
- +81 DO WR^ABMUTL8("REF")
- End DoDot:3
- +82 IF ABMP("ITYPE")="D"!(ABMP("ITYPE")="K")
- Begin DoDot:3
- +83 DO EP^ABME8REF("1D",9999999.06,ABMP("LDFN"))
- +84 DO WR^ABMUTL8("REF")
- End DoDot:3
- End DoDot:2
- End DoDot:1
- +85 ;
- +86 ; Loop 2310E - Supervising Physician Name
- +87 IF $DATA(ABMP("PRV","S"))
- Begin DoDot:1
- +88 SET ABM("PRV")=$ORDER(ABMP("PRV","S",0))
- +89 DO EP^ABME8NM1("DQ")
- +90 DO WR^ABMUTL8("NM1")
- +91 IF ABMNPIU="N"
- Begin DoDot:2
- +92 DO EP^ABME8REF("EI",9999999.06,DUZ(2))
- +93 DO WR^ABMUTL8("REF")
- End DoDot:2
- +94 IF ABMNPIU'="N"
- Begin DoDot:2
- +95 DO EP^ABME8REF("1G",200,ABM("PRV"))
- +96 DO WR^ABMUTL8("REF")
- End DoDot:2
- End DoDot:1
- +97 QUIT
