ABSP5B1C ; IHS/OIT/CASSevern/Pieran ran 1/19/2011 - Handling of outgoing NCPDP Billing "B1" Claims for 5.1 (COB and WORKERS COMP Segments)
;;1.0;PHARMACY POINT OF SALE;**42**;JUN 21, 2001;Build 38
COB ;EP CALLED FROM ABSP5B1 to set up PRICING SEGMENT -- Segment not yet implemented We'll probably have to do something very similar to DURR and CLINIC segments
Q:$D(SUPRESSG("COB"))
N FIELD
S RECORD=$G(RECORD)
F FIELD="111",337,338,339,340,443,993,341,342,431,471,472 D
. Q:$D(SUPRESF(FIELD))
. I (ACTION["CLAIM"),(FIELD'=111) D
. . D @(FIELD_"GET")
. . D @(FIELD_"FMT")
. . D @(FIELD_"SET")
. ELSE D APPEND(FIELD)
Q
;Segment identifier
111GET S ABSP("X")="05"
Q
111FMT S ABSP("X")=$$ANFF^ABSPECFM(ABSP("X"),2)
Q
111SET ;This isn't used for the 111 Field
Q
;Other Payments Count
337GET I '$D(SPECIAL(337)) S ABSP("X")=""
ELSE X SPECIAL(337)
Q
337FMT S:ABSP("X")'="" ABSP("X")="4C"_$$NFF^ABSPECFM($G(ABSP("X")),2)
Q
337SET ;Not Yet Implemented **
Q
;Other Payer Coverage Type
338GET I '$D(SPECIAL(338)) S ABSP("X")=""
ELSE X SPECIAL(338)
Q
338FMT S:ABSP("X")'="" ABSP("X")="5C"_$$ANFF^ABSPECFM($G(ABSP("X")),2)
Q
338SET ;Not Yet Implemented **
Q
;Other Payer ID Qualifer
339GET I '$D(SPECIAL(339)) S ABSP("X")=""
ELSE X SPECIAL(339)
Q
339FMT S:ABSP("X")'="" ABSP("X")="6C"_$$ANFF^ABSPECFM($G(ABSP("X")),2)
Q
339SET ;Not Yet Implemented **
Q
;Other Payer ID
340GET I '$D(SPECIAL(340)) S ABSP("X")=""
ELSE X SPECIAL(340)
Q
340FMT S:ABSP("X")'="" ABSP("X")="7C"_$$ANFF^ABSPECFM($G(ABSP("X")),10)
Q
340SET ;Not Yet Implemented **
Q
;Other Payer Date
443GET I '$D(SPECIAL(443)) S ABSP("X")=""
ELSE X SPECIAL(443)
Q
443FMT S:ABSP("X")'="" ABSP("X")="E8"_$$ANFF^ABSPECFM($G(ABSP("X")),8)
Q
443SET ;Not Yet Implemented **
Q
;Internal Control Number
993GET I '$D(SPECIAL(993)) S ABSP("X")=""
ELSE X SPECIAL(993)
Q
993FMT S:ABSP("X")'="" ABSP("X")="A7"_$$ANFF^ABSPECFM($G(ABSP("X")),30)
Q
993SET ;Not Yet Implemented **
Q
;Other Payer Amount Paid Count
341GET I '$D(SPECIAL(341)) S ABSP("X")=""
ELSE X SPECIAL(341)
Q
341FMT S:ABSP("X")'="" ABSP("X")="HB"_$$ANFF^ABSPECFM($G(ABSP("X")),2)
Q
341SET ;Not Yet Implemented **
Q
;Other Payer Amount Paid Qualifier
342GET I '$D(SPECIAL(342)) S ABSP("X")=""
ELSE X SPECIAL(342)
Q
342FMT S:ABSP("X")'="" ABSP("X")="HC"_$$ANFF^ABSPECFM($G(ABSP("X")),2)
Q
342SET ;Not Yet Implemented **
Q
;Other Payer Amount Paid
431GET I '$D(SPECIAL(431)) S ABSP("X")=""
ELSE X SPECIAL(431)
Q
431FMT S:ABSP("X")'="" ABSP("X")="DV"_$$ANFF^ABSPECFM($G(ABSP("X")),6)
Q
431SET ;Not Yet Implemented **
Q
;Other Payer Reject Count
471GET I '$D(SPECIAL(471)) S ABSP("X")=""
ELSE X SPECIAL(471)
Q
471FMT S:ABSP("X")'="" ABSP("X")="5E"_$$ANFF^ABSPECFM($G(ABSP("X")),2)
Q
471SET ;Not Yet Implemented **
Q
;Other Payer Reject Code
472GET I '$D(SPECIAL(472)) S ABSP("X")=""
ELSE X SPECIAL(472)
Q
472FMT S:ABSP("X")'="" ABSP("X")="6E"_$$ANFF^ABSPECFM($G(ABSP("X")),3)
Q
472SET ;Not Yet Implemented **
Q
WORKCOMP ;EP CALLED FROM ABSP5B1 to set up WORKERS COMP SEGMENT -- Entire segment not implemented yet
Q:$D(SUPRESSG("Workers Comp"))
N FIELD
S RECORD=$G(RECORD)
F FIELD="111A",434,315,316,317,318,319,320,321,327,435 D
. Q:$D(SUPRESF(FIELD))
. I (ACTION["CLAIM"),(FIELD'=111) D
. . D @(FIELD_"GET")
. . D @(FIELD_"FMT")
. . D @(FIELD_"SET")
. ELSE D APPEND(FIELD)
Q
;Segment identifier
111AGET S ABSP("X")="06"
Q
111AFMT S ABSP("X")=$$ANFF^ABSPECFM(ABSP("X"),2)
Q
111ASET ;This isn't used for the 111 Field
Q
;Date of Injury
434GET I '$D(SPECIAL(434)) S ABSP("X")=""
ELSE X SPECIAL(434)
Q
434FMT S:ABSP("X")'="" ABSP("X")="DY"_$$ANFF^ABSPECFM($G(ABSP("X")),8)
Q
434SET ;Not Yet Implemented
Q
;Employer Name
315GET I '$D(SPECIAL(315)) S ABSP("X")=""
ELSE X SPECIAL(315)
Q
315FMT S:ABSP("X")'="" ABSP("X")="CF"_$$ANFF^ABSPECFM($G(ABSP("X")),30)
Q
315SET ;Not Yet Implemented
Q
;Employer Street Address
316GET I '$D(SPECIAL(316)) S ABSP("X")=""
ELSE X SPECIAL(316)
Q
316FMT S:ABSP("X")'="" ABSP("X")="CG"_$$ANFF^ABSPECFM($G(ABSP("X")),30)
Q
316SET ;Not Yet Implemented
Q
;Employer City Address
317GET I '$D(SPECIAL(317)) S ABSP("X")=""
ELSE X SPECIAL(317)
Q
317FMT S:ABSP("X")'="" ABSP("X")="CH"_$$ANFF^ABSPECFM($G(ABSP("X")),20)
Q
317SET ;Not Yet Implemented
Q
;Employer State/Province Address
318GET I '$D(SPECIAL(318)) S ABSP("X")=""
ELSE X SPECIAL(318)
Q
318FMT S:ABSP("X")'="" ABSP("X")="CI"_$$ANFF^ABSPECFM($G(ABSP("X")),2)
Q
318SET ;Not Yet Implemented
Q
;Employer Zip
319GET I '$D(SPECIAL(319)) S ABSP("X")=""
ELSE X SPECIAL(319)
Q
319FMT S:ABSP("X")'="" ABSP("X")="CJ"_$$ANFF^ABSPECFM($G(ABSP("X")),15)
Q
319SET ;Not Yet Implemented
Q
;Employer Phone Number
320GET I '$D(SPECIAL(320)) S ABSP("X")=""
ELSE X SPECIAL(320)
Q
320FMT S:ABSP("X")'="" ABSP("X")="CK"_$$ANFF^ABSPECFM($G(ABSP("X")),10)
Q
320SET ;Not Yet Implemented
Q
;Employer Contact Name
321GET I '$D(SPECIAL(321)) S ABSP("X")=""
ELSE X SPECIAL(321)
Q
321FMT S:ABSP("X")'="" ABSP("X")="CL"_$$ANFF^ABSPECFM($G(ABSP("X")),30)
Q
321SET ;Not Yet Implemented
Q
;Carrier ID
327GET I '$D(SPECIAL(327)) S ABSP("X")=""
ELSE X SPECIAL(327)
Q
327FMT S:ABSP("X")'="" ABSP("X")="CR"_$$ANFF^ABSPECFM($G(ABSP("X")),10)
Q
327SET ;Not Yet Implemented
Q
;Claim/Reference ID
435GET I '$D(SPECIAL(435)) S ABSP("X")=""
ELSE X SPECIAL(435)
Q
435FMT S:ABSP("X")'="" ABSP("X")="DZ"_$$ANFF^ABSPECFM($G(ABSP("X")),30)
Q
435SET ;Not Yet Implemented
Q
APPEND(FIELD) ;This is where outgoing record is built field by field
I FIELD["111" D
. D @(FIELD_"GET")
. D @(FIELD_"FMT")
. S RECORD=RECORD_$C(30,28)_"AM"_ABSP("X")
ELSE D
. I $G(ABSP(9002313.0201,IEN(9002313.01),FIELD,"I"))'="" S RECORD=RECORD_$C(28)_$G(ABSP(9002313.0201,IEN(9002313.01),FIELD,"I"))
. ELSE I $D(SPECIAL(FIELD)) D
. . X SPECIAL(FIELD)
. . D @(FIELD_"FMT")
. . S RECORD=RECORD_$C(28)_ABSP("X")
Q
ABSP5B1C ; IHS/OIT/CASSevern/Pieran ran 1/19/2011 - Handling of outgoing NCPDP Billing "B1" Claims for 5.1 (COB and WORKERS COMP Segments)
+1 ;;1.0;PHARMACY POINT OF SALE;**42**;JUN 21, 2001;Build 38
COB ;EP CALLED FROM ABSP5B1 to set up PRICING SEGMENT -- Segment not yet implemented We'll probably have to do something very similar to DURR and CLINIC segments
+1 IF $DATA(SUPRESSG("COB"))
QUIT
+2 NEW FIELD
+3 SET RECORD=$GET(RECORD)
+4 FOR FIELD="111",337,338,339,340,443,993,341,342,431,471,472
Begin DoDot:1
+5 IF $DATA(SUPRESF(FIELD))
QUIT
+6 IF (ACTION["CLAIM")
IF (FIELD'=111)
Begin DoDot:2
+7 DO @(FIELD_"GET")
+8 DO @(FIELD_"FMT")
+9 DO @(FIELD_"SET")
End DoDot:2
+10 IF '$TEST
DO APPEND(FIELD)
End DoDot:1
+11 QUIT
+12 ;Segment identifier
111GET SET ABSP("X")="05"
+1 QUIT
111FMT SET ABSP("X")=$$ANFF^ABSPECFM(ABSP("X"),2)
+1 QUIT
111SET ;This isn't used for the 111 Field
+1 QUIT
+2 ;Other Payments Count
337GET IF '$DATA(SPECIAL(337))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(337)
+2 QUIT
337FMT IF ABSP("X")'=""
SET ABSP("X")="4C"_$$NFF^ABSPECFM($GET(ABSP("X")),2)
+1 QUIT
337SET ;Not Yet Implemented **
+1 QUIT
+2 ;Other Payer Coverage Type
338GET IF '$DATA(SPECIAL(338))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(338)
+2 QUIT
338FMT IF ABSP("X")'=""
SET ABSP("X")="5C"_$$ANFF^ABSPECFM($GET(ABSP("X")),2)
+1 QUIT
338SET ;Not Yet Implemented **
+1 QUIT
+2 ;Other Payer ID Qualifer
339GET IF '$DATA(SPECIAL(339))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(339)
+2 QUIT
339FMT IF ABSP("X")'=""
SET ABSP("X")="6C"_$$ANFF^ABSPECFM($GET(ABSP("X")),2)
+1 QUIT
339SET ;Not Yet Implemented **
+1 QUIT
+2 ;Other Payer ID
340GET IF '$DATA(SPECIAL(340))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(340)
+2 QUIT
340FMT IF ABSP("X")'=""
SET ABSP("X")="7C"_$$ANFF^ABSPECFM($GET(ABSP("X")),10)
+1 QUIT
340SET ;Not Yet Implemented **
+1 QUIT
+2 ;Other Payer Date
443GET IF '$DATA(SPECIAL(443))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(443)
+2 QUIT
443FMT IF ABSP("X")'=""
SET ABSP("X")="E8"_$$ANFF^ABSPECFM($GET(ABSP("X")),8)
+1 QUIT
443SET ;Not Yet Implemented **
+1 QUIT
+2 ;Internal Control Number
993GET IF '$DATA(SPECIAL(993))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(993)
+2 QUIT
993FMT IF ABSP("X")'=""
SET ABSP("X")="A7"_$$ANFF^ABSPECFM($GET(ABSP("X")),30)
+1 QUIT
993SET ;Not Yet Implemented **
+1 QUIT
+2 ;Other Payer Amount Paid Count
341GET IF '$DATA(SPECIAL(341))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(341)
+2 QUIT
341FMT IF ABSP("X")'=""
SET ABSP("X")="HB"_$$ANFF^ABSPECFM($GET(ABSP("X")),2)
+1 QUIT
341SET ;Not Yet Implemented **
+1 QUIT
+2 ;Other Payer Amount Paid Qualifier
342GET IF '$DATA(SPECIAL(342))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(342)
+2 QUIT
342FMT IF ABSP("X")'=""
SET ABSP("X")="HC"_$$ANFF^ABSPECFM($GET(ABSP("X")),2)
+1 QUIT
342SET ;Not Yet Implemented **
+1 QUIT
+2 ;Other Payer Amount Paid
431GET IF '$DATA(SPECIAL(431))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(431)
+2 QUIT
431FMT IF ABSP("X")'=""
SET ABSP("X")="DV"_$$ANFF^ABSPECFM($GET(ABSP("X")),6)
+1 QUIT
431SET ;Not Yet Implemented **
+1 QUIT
+2 ;Other Payer Reject Count
471GET IF '$DATA(SPECIAL(471))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(471)
+2 QUIT
471FMT IF ABSP("X")'=""
SET ABSP("X")="5E"_$$ANFF^ABSPECFM($GET(ABSP("X")),2)
+1 QUIT
471SET ;Not Yet Implemented **
+1 QUIT
+2 ;Other Payer Reject Code
472GET IF '$DATA(SPECIAL(472))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(472)
+2 QUIT
472FMT IF ABSP("X")'=""
SET ABSP("X")="6E"_$$ANFF^ABSPECFM($GET(ABSP("X")),3)
+1 QUIT
472SET ;Not Yet Implemented **
+1 QUIT
WORKCOMP ;EP CALLED FROM ABSP5B1 to set up WORKERS COMP SEGMENT -- Entire segment not implemented yet
+1 IF $DATA(SUPRESSG("Workers Comp"))
QUIT
+2 NEW FIELD
+3 SET RECORD=$GET(RECORD)
+4 FOR FIELD="111A",434,315,316,317,318,319,320,321,327,435
Begin DoDot:1
+5 IF $DATA(SUPRESF(FIELD))
QUIT
+6 IF (ACTION["CLAIM")
IF (FIELD'=111)
Begin DoDot:2
+7 DO @(FIELD_"GET")
+8 DO @(FIELD_"FMT")
+9 DO @(FIELD_"SET")
End DoDot:2
+10 IF '$TEST
DO APPEND(FIELD)
End DoDot:1
+11 QUIT
+12 ;Segment identifier
111AGET SET ABSP("X")="06"
+1 QUIT
111AFMT SET ABSP("X")=$$ANFF^ABSPECFM(ABSP("X"),2)
+1 QUIT
111ASET ;This isn't used for the 111 Field
+1 QUIT
+2 ;Date of Injury
434GET IF '$DATA(SPECIAL(434))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(434)
+2 QUIT
434FMT IF ABSP("X")'=""
SET ABSP("X")="DY"_$$ANFF^ABSPECFM($GET(ABSP("X")),8)
+1 QUIT
434SET ;Not Yet Implemented
+1 QUIT
+2 ;Employer Name
315GET IF '$DATA(SPECIAL(315))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(315)
+2 QUIT
315FMT IF ABSP("X")'=""
SET ABSP("X")="CF"_$$ANFF^ABSPECFM($GET(ABSP("X")),30)
+1 QUIT
315SET ;Not Yet Implemented
+1 QUIT
+2 ;Employer Street Address
316GET IF '$DATA(SPECIAL(316))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(316)
+2 QUIT
316FMT IF ABSP("X")'=""
SET ABSP("X")="CG"_$$ANFF^ABSPECFM($GET(ABSP("X")),30)
+1 QUIT
316SET ;Not Yet Implemented
+1 QUIT
+2 ;Employer City Address
317GET IF '$DATA(SPECIAL(317))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(317)
+2 QUIT
317FMT IF ABSP("X")'=""
SET ABSP("X")="CH"_$$ANFF^ABSPECFM($GET(ABSP("X")),20)
+1 QUIT
317SET ;Not Yet Implemented
+1 QUIT
+2 ;Employer State/Province Address
318GET IF '$DATA(SPECIAL(318))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(318)
+2 QUIT
318FMT IF ABSP("X")'=""
SET ABSP("X")="CI"_$$ANFF^ABSPECFM($GET(ABSP("X")),2)
+1 QUIT
318SET ;Not Yet Implemented
+1 QUIT
+2 ;Employer Zip
319GET IF '$DATA(SPECIAL(319))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(319)
+2 QUIT
319FMT IF ABSP("X")'=""
SET ABSP("X")="CJ"_$$ANFF^ABSPECFM($GET(ABSP("X")),15)
+1 QUIT
319SET ;Not Yet Implemented
+1 QUIT
+2 ;Employer Phone Number
320GET IF '$DATA(SPECIAL(320))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(320)
+2 QUIT
320FMT IF ABSP("X")'=""
SET ABSP("X")="CK"_$$ANFF^ABSPECFM($GET(ABSP("X")),10)
+1 QUIT
320SET ;Not Yet Implemented
+1 QUIT
+2 ;Employer Contact Name
321GET IF '$DATA(SPECIAL(321))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(321)
+2 QUIT
321FMT IF ABSP("X")'=""
SET ABSP("X")="CL"_$$ANFF^ABSPECFM($GET(ABSP("X")),30)
+1 QUIT
321SET ;Not Yet Implemented
+1 QUIT
+2 ;Carrier ID
327GET IF '$DATA(SPECIAL(327))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(327)
+2 QUIT
327FMT IF ABSP("X")'=""
SET ABSP("X")="CR"_$$ANFF^ABSPECFM($GET(ABSP("X")),10)
+1 QUIT
327SET ;Not Yet Implemented
+1 QUIT
+2 ;Claim/Reference ID
435GET IF '$DATA(SPECIAL(435))
SET ABSP("X")=""
+1 IF '$TEST
XECUTE SPECIAL(435)
+2 QUIT
435FMT IF ABSP("X")'=""
SET ABSP("X")="DZ"_$$ANFF^ABSPECFM($GET(ABSP("X")),30)
+1 QUIT
435SET ;Not Yet Implemented
+1 QUIT
APPEND(FIELD) ;This is where outgoing record is built field by field
+1 IF FIELD["111"
Begin DoDot:1
+2 DO @(FIELD_"GET")
+3 DO @(FIELD_"FMT")
+4 SET RECORD=RECORD_$CHAR(30,28)_"AM"_ABSP("X")
End DoDot:1
+5 IF '$TEST
Begin DoDot:1
+6 IF $GET(ABSP(9002313.0201,IEN(9002313.01),FIELD,"I"))'=""
SET RECORD=RECORD_$CHAR(28)_$GET(ABSP(9002313.0201,IEN(9002313.01),FIELD,"I"))
+7 IF '$TEST
IF $DATA(SPECIAL(FIELD))
Begin DoDot:2
+8 XECUTE SPECIAL(FIELD)
+9 DO @(FIELD_"FMT")
+10 SET RECORD=RECORD_$CHAR(28)_ABSP("X")
End DoDot:2
End DoDot:1
+11 QUIT
