ABMP2511 ; IHS/SD/SDR - 3P BILLING 2.5 Patch 11 PRE/POST INIT ;
;;2.6;IHS 3P BILLING SYSTEM;;NOV 12, 2009
;
;
Q
PREINST ;
Q
EN ; EP
;WHAT ABOUT PATCH 10 INSTALL CHECK?
I $G(^DD(9002274.3021,.18,0))="" D EN^ABMPT259 ;if patch 9 not loaded do p9 post install
D EXPMODES ;add new export modes 27,28,29 (NPI formats)
D ERRCODES ;new 3P Error codes
D REINDEX^ABMPT259 ;re-index 3p provider taxonomy file
D PAGE3QS ;change some page 3 questions to use new display routine ABMDE301
D UPDT3PCD ;Update 3P Codes entries
D TURNON^DIAUTL(9002274.4,.02,"y") ;turn on audit for 3P BILL field .02
D TURNON^DIAUTL(9002274.4,.49,"y") ;turn on audit for 3P BILL field .49
D TURNON^DIAUTL(9002274.4,411,"y") ;turn on audit for 3P BILL field 411
Q
EXPMODES ;
K DIC,DR,DINUM,DLAYGO,DIE
S DIC="^ABMDEXP("
S DIC(0)="LM"
S DLAYGO=9002274
S X="CMS-1500 (08/05)",DINUM=27
K DD,DO
D ^DIC
Q:Y<0
S DA=+Y
S DIE="^ABMDEXP("
S DR=".04////ABMDF27;.05////ABMDF27X;.06///0;.07///OMB No. 0938-0999;.08///1,2,3,4B,5,7,9,10,12B,13,15,22,34,35,19,25;.11////ABMDES3;.15///H"
D ^DIE
;
K DIC,DR,DINUM,DLAYGO,DIE
S DIC="^ABMDEXP("
S DIC(0)="LM"
S DLAYGO=9002274
S X="UB-04",DINUM=28
K DD,DO
D ^DIC
Q:Y<0
S DA=+Y
S DIE="^ABMDEXP("
S DR=".04////ABMDF28;.05////ABMDF28X;.06///0;.07///OMB No. 0938-0997;.08///1,2,3,4,5,6,8,13,19,21,22,23,24;.11////ABMDES1;.15///H"
D ^DIE
;
K DIC,DR,DINUM,DLAYGO,DIE
S DIC="^ABMDEXP("
S DIC(0)="LM"
S DLAYGO=9002274
S X="ADA-2006",DINUM=29
K DD,DO
D ^DIC
Q:Y<0
S DA=+Y
S DIE="^ABMDEXP("
S DR=".04////ABMDF29;.05////ABMDF29X;.06///C;.07///ADA-2006 Dental Claim Form;.08///1,2,3,4,9,16,17,18,34,35;.11////ABMDES4;.15///H"
D ^DIE
Q
ERRCODES ;
;220 - E FOR NPI UNSPECIFIED IN NEW PERSON FILE FOR PROVIDER
K DIC,X
S DIC="^ABMDERR("
S DIC(0)="LM"
S DINUM=220
S X="NPI UNSPECIFIED IN NEW PERSON FILE FOR PROVIDER"
S DIC("DR")=".02///Use TM\PETM option to add NPI"
S DIC("DR")=DIC("DR")_";.03///E"
K DD,DO
D FILE^DICN
D SITE(220)
;221 - W FOR NPI UNSPECIFIED IN NEW PERSON FILE FOR PROVIDER
K DIC,X
S DIC="^ABMDERR("
S DIC(0)="LM"
S DINUM=221
S X="NPI UNSPECIFIED IN NEW PERSON FILE FOR PROVIDER"
S DIC("DR")=".02///Use TM\PETM option to add NPI"
S DIC("DR")=DIC("DR")_";.03///W"
K DD,DO
D FILE^DICN
D SITE(221)
;222 - E FOR EXPORT MODE DOESN'T SUPPORT NPI
K DIC,X
S DIC="^ABMDERR("
S DIC(0)="LM"
S DINUM=222
S X="NPI USAGE SAYS NPI BUT EXPORT MODE DOESN'T SUPPORT IT"
S DIC("DR")=".02///Change export mode to NPI format"
S DIC("DR")=DIC("DR")_";.03///E"
K DD,DO
D FILE^DICN
D SITE(222)
;223 - NPI UNSPECIFIED FOR REFERRING PROVIDER
K DIC,X
S DIC="^ABMDERR("
S DIC(0)="LM"
S DINUM=223
S X="NPI UNSPECIFIED FOR REFERRING PROVIDER"
S DIC("DR")=".02///Add NPI for referring provider on page 3"
S DIC("DR")=DIC("DR")_";.03///E"
K DD,DO
D FILE^DICN
D SITE(223)
;224 - NPI UNSPECIFIED FOR SUPERVISING PROVIDER
K DIC,X
S DIC="^ABMDERR("
S DIC(0)="LM"
S DINUM=224
S X="NPI UNSPECIFIED FOR SUPERVISING PROVIDER"
S DIC("DR")=".02///Add NPI for supervising provider on page 3"
S DIC("DR")=DIC("DR")_";.03///E"
K DD,DO
D FILE^DICN
D SITE(224)
Q
SITE(ABMX) ;Add SITE multiple
S DUZHOLD=DUZ(2)
S DUZ(2)=0
F S DUZ(2)=$O(^ABMDCLM(DUZ(2))) Q:'+DUZ(2) D
.S DIC(0)="LX"
.S DA(1)=ABMX
.S DIC="^ABMDERR("_DA(1)_",31,"
.S DIC("P")=$P(^DD(9002274.04,31,0),U,2)
.S DINUM=DUZ(2)
.S X=$P($G(^DIC(4,DUZ(2),0)),U)
.S DIC("DR")=".03////"_$S(DA(1)=221:"W",1:"E")
.D ^DIC
.K DA,DIC,DINUM
S DUZ(2)=DUZHOLD
K DUZHOLD,DLAYGO,ABMX
Q
PAGE3QS ;
K DIC,DIE,X,Y,DA
F DA=30:1:35 D
.S DIE="^ABMQUES("
.S DR=".03////ABMDE301"
.D ^DIE
;
K DIC,DIE,X,Y,DA
S DIK="^ABMQUES("
S DA=15
D ^DIK
K DIC,DIE,X,Y,DA
S DIC="^ABMQUES("
S DIC(0)="LM"
S DINUM=15
S X="RESUBMISSION (CONTROL) NUMBER"
S DIC("DR")=".02////W15;.03////ABMDE30;.04////15;1////ABMDE3C"
D ^DIC
Q
UPDT3PCD ; Use below tags to update 3P Codes
F ABMI=1:1 S ABMLN=$P($T(CODES+ABMI),";;",2) Q:ABMLN="END" D
.S ABMCTYP=$P(ABMLN,U)
.S ABMCD=$P(ABMLN,U,2)
.S ABMDESC=$P(ABMLN,U,3)
.S ABMIFLG=$P(ABMLN,U,4)
.S DA=+$O(^ABMDCODE("AC",ABMCTYP,ABMCD,0))
.Q:DA=0 ;no entry found; may need to replace with DIC to add the entry
.S DIE="^ABMDCODE("
.S DR=".03////"_ABMDESC
.I ABMIFLG'="" S DR=DR_";.04////1"
.D ^DIE
Q
CODES ;
A ;;A^A^Transfer from a Critical Access Hospital
C ;;C^17^PATIENT IS HOMELESS
;;C^A0^TRICARE EXTERNAL PARTNERSHIP PROGRAM
;;C^A6^VACCINES/MEDICARE 100%
;;C^D2^CHANGES IN REVENUE CODES/HCPCS/HIPPS RATE CODES
;;C^D4^CHANGE IN CLINICAL CODES (ISD) FOR DIAGNOSIS AND/OR PROCEDURE
;;C^D5^CANCEL TO CORRECT INSURED'S ID OR PROVIDER ID
;;C^69^IME/DGME/N&AH Payment only
;;C^70^Self Administered Anemia Management Drug
O ;;O^1^ACCIDENT/MEDICAL COVERAGE
;;O^2^NO FAULT INSURANCE INVOLVED-INCLUDES AUTO ACCIDENT/OTHER
;;O^4^ACCIDENT/EMPLOYMENT RELATED
;;O^5^ACCIDENT/NO MEDICAL OR LIABILITY COVERAGE
;;O^20^DATE GUARANTEE OF PAYMENT BEGAN
;;O^21^DATE UR NOTICE RECEIVED
;;O^23^PAYER CODE
;;O^12^Date of Onset for a Chronically Dependent Individual
;;O^27^Date of Hospice Certification or Re-Certification
;;O^30^Date Outpatient Speech Pathology Plan Established or Reviewed
;;O^A3^Benefits Exhausted-Payer A
;;O^E1^Birthdate-Insured D^I
;;O^E2^Effective Date-Insured D Policy^I
;;O^E3^Benefits Exhausted^I
;;O^F1^Birthdate - Insured E^I
;;O^F2^Effective Date - Insured E Policy^I
;;O^F3^Benefits Exhausted^I
;;O^G1^Birthdate - Insured F^I
;;O^G2^Effective Date - Insured F Policy^I
;;O^G3^Benefits Exhausted^I
S ;;S^74^NON-COVERED LEVEL OF CARE/LEAVE OF ABSENCE DATES
;;S^M0^QIO/UR APPROVED STAY DATES
V ;;V^4^PROFESSIONAL COMPONENT CHARGES WHICH ARE COMBINED
;;V^23^RECURRING MONTHLY INCOME
;;V^40^NEW COVERAGE NOT IMPLEMENTED BY HMO
;;V^E1^Deductible Payer D^I
;;V^E2^Coinsurance Payer D^I
;;V^E3^Estimated Responsibility Payer D^I
;;V^F1^Deductible Payer E^I
;;V^F2^Coinsurance Payer E^I
;;V^F3^Estimated Responsibility Payer E^I
;;V^G1^Deductible Payer F^I
;;V^G2^Coinsurance Payer F^I
;;V^G3^Estimated Responsibility Payer F^I
;;END
Q
ABMP2511 ; IHS/SD/SDR - 3P BILLING 2.5 Patch 11 PRE/POST INIT ;
+1 ;;2.6;IHS 3P BILLING SYSTEM;;NOV 12, 2009
+2 ;
+3 ;
+4 QUIT
PREINST ;
+1 QUIT
EN ; EP
+1 ;WHAT ABOUT PATCH 10 INSTALL CHECK?
+2 ;if patch 9 not loaded do p9 post install
IF $GET(^DD(9002274.3021,.18,0))=""
DO EN^ABMPT259
+3 ;add new export modes 27,28,29 (NPI formats)
DO EXPMODES
+4 ;new 3P Error codes
DO ERRCODES
+5 ;re-index 3p provider taxonomy file
DO REINDEX^ABMPT259
+6 ;change some page 3 questions to use new display routine ABMDE301
DO PAGE3QS
+7 ;Update 3P Codes entries
DO UPDT3PCD
+8 ;turn on audit for 3P BILL field .02
DO TURNON^DIAUTL(9002274.4,.02,"y")
+9 ;turn on audit for 3P BILL field .49
DO TURNON^DIAUTL(9002274.4,.49,"y")
+10 ;turn on audit for 3P BILL field 411
DO TURNON^DIAUTL(9002274.4,411,"y")
+11 QUIT
EXPMODES ;
+1 KILL DIC,DR,DINUM,DLAYGO,DIE
+2 SET DIC="^ABMDEXP("
+3 SET DIC(0)="LM"
+4 SET DLAYGO=9002274
+5 SET X="CMS-1500 (08/05)"
SET DINUM=27
+6 KILL DD,DO
+7 DO ^DIC
+8 IF Y<0
QUIT
+9 SET DA=+Y
+10 SET DIE="^ABMDEXP("
+11 SET DR=".04////ABMDF27;.05////ABMDF27X;.06///0;.07///OMB No. 0938-0999;.08///1,2,3,4B,5,7,9,10,12B,13,15,22,34,35,19,25;.11////ABMDES3;.15///H"
+12 DO ^DIE
+13 ;
+14 KILL DIC,DR,DINUM,DLAYGO,DIE
+15 SET DIC="^ABMDEXP("
+16 SET DIC(0)="LM"
+17 SET DLAYGO=9002274
+18 SET X="UB-04"
SET DINUM=28
+19 KILL DD,DO
+20 DO ^DIC
+21 IF Y<0
QUIT
+22 SET DA=+Y
+23 SET DIE="^ABMDEXP("
+24 SET DR=".04////ABMDF28;.05////ABMDF28X;.06///0;.07///OMB No. 0938-0997;.08///1,2,3,4,5,6,8,13,19,21,22,23,24;.11////ABMDES1;.15///H"
+25 DO ^DIE
+26 ;
+27 KILL DIC,DR,DINUM,DLAYGO,DIE
+28 SET DIC="^ABMDEXP("
+29 SET DIC(0)="LM"
+30 SET DLAYGO=9002274
+31 SET X="ADA-2006"
SET DINUM=29
+32 KILL DD,DO
+33 DO ^DIC
+34 IF Y<0
QUIT
+35 SET DA=+Y
+36 SET DIE="^ABMDEXP("
+37 SET DR=".04////ABMDF29;.05////ABMDF29X;.06///C;.07///ADA-2006 Dental Claim Form;.08///1,2,3,4,9,16,17,18,34,35;.11////ABMDES4;.15///H"
+38 DO ^DIE
+39 QUIT
ERRCODES ;
+1 ;220 - E FOR NPI UNSPECIFIED IN NEW PERSON FILE FOR PROVIDER
+2 KILL DIC,X
+3 SET DIC="^ABMDERR("
+4 SET DIC(0)="LM"
+5 SET DINUM=220
+6 SET X="NPI UNSPECIFIED IN NEW PERSON FILE FOR PROVIDER"
+7 SET DIC("DR")=".02///Use TM\PETM option to add NPI"
+8 SET DIC("DR")=DIC("DR")_";.03///E"
+9 KILL DD,DO
+10 DO FILE^DICN
+11 DO SITE(220)
+12 ;221 - W FOR NPI UNSPECIFIED IN NEW PERSON FILE FOR PROVIDER
+13 KILL DIC,X
+14 SET DIC="^ABMDERR("
+15 SET DIC(0)="LM"
+16 SET DINUM=221
+17 SET X="NPI UNSPECIFIED IN NEW PERSON FILE FOR PROVIDER"
+18 SET DIC("DR")=".02///Use TM\PETM option to add NPI"
+19 SET DIC("DR")=DIC("DR")_";.03///W"
+20 KILL DD,DO
+21 DO FILE^DICN
+22 DO SITE(221)
+23 ;222 - E FOR EXPORT MODE DOESN'T SUPPORT NPI
+24 KILL DIC,X
+25 SET DIC="^ABMDERR("
+26 SET DIC(0)="LM"
+27 SET DINUM=222
+28 SET X="NPI USAGE SAYS NPI BUT EXPORT MODE DOESN'T SUPPORT IT"
+29 SET DIC("DR")=".02///Change export mode to NPI format"
+30 SET DIC("DR")=DIC("DR")_";.03///E"
+31 KILL DD,DO
+32 DO FILE^DICN
+33 DO SITE(222)
+34 ;223 - NPI UNSPECIFIED FOR REFERRING PROVIDER
+35 KILL DIC,X
+36 SET DIC="^ABMDERR("
+37 SET DIC(0)="LM"
+38 SET DINUM=223
+39 SET X="NPI UNSPECIFIED FOR REFERRING PROVIDER"
+40 SET DIC("DR")=".02///Add NPI for referring provider on page 3"
+41 SET DIC("DR")=DIC("DR")_";.03///E"
+42 KILL DD,DO
+43 DO FILE^DICN
+44 DO SITE(223)
+45 ;224 - NPI UNSPECIFIED FOR SUPERVISING PROVIDER
+46 KILL DIC,X
+47 SET DIC="^ABMDERR("
+48 SET DIC(0)="LM"
+49 SET DINUM=224
+50 SET X="NPI UNSPECIFIED FOR SUPERVISING PROVIDER"
+51 SET DIC("DR")=".02///Add NPI for supervising provider on page 3"
+52 SET DIC("DR")=DIC("DR")_";.03///E"
+53 KILL DD,DO
+54 DO FILE^DICN
+55 DO SITE(224)
+56 QUIT
SITE(ABMX) ;Add SITE multiple
+1 SET DUZHOLD=DUZ(2)
+2 SET DUZ(2)=0
+3 FOR
SET DUZ(2)=$ORDER(^ABMDCLM(DUZ(2)))
IF '+DUZ(2)
QUIT
Begin DoDot:1
+4 SET DIC(0)="LX"
+5 SET DA(1)=ABMX
+6 SET DIC="^ABMDERR("_DA(1)_",31,"
+7 SET DIC("P")=$PIECE(^DD(9002274.04,31,0),U,2)
+8 SET DINUM=DUZ(2)
+9 SET X=$PIECE($GET(^DIC(4,DUZ(2),0)),U)
+10 SET DIC("DR")=".03////"_$SELECT(DA(1)=221:"W",1:"E")
+11 DO ^DIC
+12 KILL DA,DIC,DINUM
End DoDot:1
+13 SET DUZ(2)=DUZHOLD
+14 KILL DUZHOLD,DLAYGO,ABMX
+15 QUIT
PAGE3QS ;
+1 KILL DIC,DIE,X,Y,DA
+2 FOR DA=30:1:35
Begin DoDot:1
+3 SET DIE="^ABMQUES("
+4 SET DR=".03////ABMDE301"
+5 DO ^DIE
End DoDot:1
+6 ;
+7 KILL DIC,DIE,X,Y,DA
+8 SET DIK="^ABMQUES("
+9 SET DA=15
+10 DO ^DIK
+11 KILL DIC,DIE,X,Y,DA
+12 SET DIC="^ABMQUES("
+13 SET DIC(0)="LM"
+14 SET DINUM=15
+15 SET X="RESUBMISSION (CONTROL) NUMBER"
+16 SET DIC("DR")=".02////W15;.03////ABMDE30;.04////15;1////ABMDE3C"
+17 DO ^DIC
+18 QUIT
UPDT3PCD ; Use below tags to update 3P Codes
+1 FOR ABMI=1:1
SET ABMLN=$PIECE($TEXT(CODES+ABMI),";;",2)
IF ABMLN="END"
QUIT
Begin DoDot:1
+2 SET ABMCTYP=$PIECE(ABMLN,U)
+3 SET ABMCD=$PIECE(ABMLN,U,2)
+4 SET ABMDESC=$PIECE(ABMLN,U,3)
+5 SET ABMIFLG=$PIECE(ABMLN,U,4)
+6 SET DA=+$ORDER(^ABMDCODE("AC",ABMCTYP,ABMCD,0))
+7 ;no entry found; may need to replace with DIC to add the entry
IF DA=0
QUIT
+8 SET DIE="^ABMDCODE("
+9 SET DR=".03////"_ABMDESC
+10 IF ABMIFLG'=""
SET DR=DR_";.04////1"
+11 DO ^DIE
End DoDot:1
+12 QUIT
CODES ;
A ;;A^A^Transfer from a Critical Access Hospital
C ;;C^17^PATIENT IS HOMELESS
+1 ;;C^A0^TRICARE EXTERNAL PARTNERSHIP PROGRAM
+2 ;;C^A6^VACCINES/MEDICARE 100%
+3 ;;C^D2^CHANGES IN REVENUE CODES/HCPCS/HIPPS RATE CODES
+4 ;;C^D4^CHANGE IN CLINICAL CODES (ISD) FOR DIAGNOSIS AND/OR PROCEDURE
+5 ;;C^D5^CANCEL TO CORRECT INSURED'S ID OR PROVIDER ID
+6 ;;C^69^IME/DGME/N&AH Payment only
+7 ;;C^70^Self Administered Anemia Management Drug
O ;;O^1^ACCIDENT/MEDICAL COVERAGE
+1 ;;O^2^NO FAULT INSURANCE INVOLVED-INCLUDES AUTO ACCIDENT/OTHER
+2 ;;O^4^ACCIDENT/EMPLOYMENT RELATED
+3 ;;O^5^ACCIDENT/NO MEDICAL OR LIABILITY COVERAGE
+4 ;;O^20^DATE GUARANTEE OF PAYMENT BEGAN
+5 ;;O^21^DATE UR NOTICE RECEIVED
+6 ;;O^23^PAYER CODE
+7 ;;O^12^Date of Onset for a Chronically Dependent Individual
+8 ;;O^27^Date of Hospice Certification or Re-Certification
+9 ;;O^30^Date Outpatient Speech Pathology Plan Established or Reviewed
+10 ;;O^A3^Benefits Exhausted-Payer A
+11 ;;O^E1^Birthdate-Insured D^I
+12 ;;O^E2^Effective Date-Insured D Policy^I
+13 ;;O^E3^Benefits Exhausted^I
+14 ;;O^F1^Birthdate - Insured E^I
+15 ;;O^F2^Effective Date - Insured E Policy^I
+16 ;;O^F3^Benefits Exhausted^I
+17 ;;O^G1^Birthdate - Insured F^I
+18 ;;O^G2^Effective Date - Insured F Policy^I
+19 ;;O^G3^Benefits Exhausted^I
S ;;S^74^NON-COVERED LEVEL OF CARE/LEAVE OF ABSENCE DATES
+1 ;;S^M0^QIO/UR APPROVED STAY DATES
V ;;V^4^PROFESSIONAL COMPONENT CHARGES WHICH ARE COMBINED
+1 ;;V^23^RECURRING MONTHLY INCOME
+2 ;;V^40^NEW COVERAGE NOT IMPLEMENTED BY HMO
+3 ;;V^E1^Deductible Payer D^I
+4 ;;V^E2^Coinsurance Payer D^I
+5 ;;V^E3^Estimated Responsibility Payer D^I
+6 ;;V^F1^Deductible Payer E^I
+7 ;;V^F2^Coinsurance Payer E^I
+8 ;;V^F3^Estimated Responsibility Payer E^I
+9 ;;V^G1^Deductible Payer F^I
+10 ;;V^G2^Coinsurance Payer F^I
+11 ;;V^G3^Estimated Responsibility Payer F^I
+12 ;;END
+13 QUIT
