IBINI066 ; ; 21-MAR-1994
;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94
Q:'DIFQ(356.2) F I=1:2 S X=$T(Q+I) Q:X="" S Y=$E($T(Q+I+1),4,999),X=$E(X,4,999) S:$A(Y)=126 I=I+1,Y=$E(Y,2,999)_$E($T(Q+I+1),5,99) S:$A(Y)=61 Y=$E(Y,2,999) X NO E S @X=Y
Q Q
;;^DD(356.2,.19,1,0)
;;=^.1
;;^DD(356.2,.19,1,1,0)
;;=356.2^AE
;;^DD(356.2,.19,1,1,1)
;;=S ^IBT(356.2,"AE",$E(X,1,30),DA)=""
;;^DD(356.2,.19,1,1,2)
;;=K ^IBT(356.2,"AE",$E(X,1,30),DA)
;;^DD(356.2,.19,1,1,"DT")
;;=2940207
;;^DD(356.2,.19,1,2,0)
;;=^^TRIGGER^356.2^.24
;;^DD(356.2,.19,1,2,1)
;;=K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X I $P(^IBT(356.2,DA,0),U,19)'=10 I X S X=DIV S Y(1)=$S($D(^IBT(356.2,D0,0)):^(0),1:"") S X=$P(Y(1),U,24),X=X S DIU=X K Y S X=DIV S X=DT X ^DD(356.2,.19,1,2,1.4)
;;^DD(356.2,.19,1,2,1.4)
;;=S DIH=$S($D(^IBT(356.2,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,24)=DIV,DIH=356.2,DIG=.24 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
;;^DD(356.2,.19,1,2,2)
;;=K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X I $P(^IBT(356.2,DA,0),U,19)=10 I X S X=DIV S Y(1)=$S($D(^IBT(356.2,D0,0)):^(0),1:"") S X=$P(Y(1),U,24),X=X S DIU=X K Y S X="" X ^DD(356.2,.19,1,2,2.4)
;;^DD(356.2,.19,1,2,2.4)
;;=S DIH=$S($D(^IBT(356.2,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,24)=DIV,DIH=356.2,DIG=.24 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
;;^DD(356.2,.19,1,2,"%D",0)
;;=^^1^1^2940207^
;;^DD(356.2,.19,1,2,"%D",1,0)
;;=This trigger deletes the NEXT REVIEW DATE when completing a review.
;;^DD(356.2,.19,1,2,"CREATE CONDITION")
;;=I $P(^IBT(356.2,DA,0),U,19)'=10
;;^DD(356.2,.19,1,2,"CREATE VALUE")
;;=S X=DT
;;^DD(356.2,.19,1,2,"DELETE CONDITION")
;;=I $P(^IBT(356.2,DA,0),U,19)=10
;;^DD(356.2,.19,1,2,"DELETE VALUE")
;;=@
;;^DD(356.2,.19,1,2,"DT")
;;=2940207
;;^DD(356.2,.19,1,2,"FIELD")
;;=#.24
;;^DD(356.2,.19,3)
;;=
;;^DD(356.2,.19,5,1,0)
;;=356.2^.11^4
;;^DD(356.2,.19,21,0)
;;=^^2^2^2930907^^^
;;^DD(356.2,.19,21,1,0)
;;=Enter whether or not this entry is active or not. Inactivating an
;;^DD(356.2,.19,21,2,0)
;;=entry has the same effect as deleting the entry.
;;^DD(356.2,.19,"DT")
;;=2940207
;;^DD(356.2,.2,0)
;;=CASE PENDING^S^1:UR/CLINICAL INFORMATION;2:PENDING MEDICAL REVIEW;3:OTHER;^0;20^Q
;;^DD(356.2,.2,21,0)
;;=^^4^4^2930806^
;;^DD(356.2,.2,21,1,0)
;;=If the action by the insurance company on this contact is pending, then
;;^DD(356.2,.2,21,2,0)
;;=this is what the case is pending for. Generally cases are pending
;;^DD(356.2,.2,21,3,0)
;;=further UR/Clinical information from the site or Medical Review at
;;^DD(356.2,.2,21,4,0)
;;=the insurance company.
;;^DD(356.2,.2,"DT")
;;=2930610
;;^DD(356.2,.21,0)
;;=NO COVERAGE^S^1:PATIENT NOT ELIGIBLE;2:SERVICE NOT PROGRAM BENEFIT;3:COVERAGE CANCELED BEFORE TREATMENT;4:OTHER;^0;21^Q
;;^DD(356.2,.21,21,0)
;;=^^3^3^2930806^
;;^DD(356.2,.21,21,1,0)
;;=If the action by the insurance company on this contact was that
;;^DD(356.2,.21,21,2,0)
;;=the patient was not covered by this carrier for this care then
;;^DD(356.2,.21,21,3,0)
;;=this is the reason that they claim no coverge.
;;^DD(356.2,.21,"DT")
;;=2930610
;;^DD(356.2,.22,0)
;;=FOLLOW-UP WITH APPEAL^S^1:YES;0:NO;^0;22^Q
;;^DD(356.2,.22,21,0)
;;=^^3^3^2930806^
;;^DD(356.2,.22,21,1,0)
;;=If the action by the insurance company on this contact was a denial,
;;^DD(356.2,.22,21,2,0)
;;=then enter whether you wish to follow up with an appeal. If you
;;^DD(356.2,.22,21,3,0)
;;=answer 'YES' then this will be included on your Pending Work.
;;^DD(356.2,.22,"DT")
;;=2930610
;;^DD(356.2,.23,0)
;;=TYPE OF APPEAL^S^1:CLINICAL;2:ADMINISTRATIVE;^0;23^Q
;;^DD(356.2,.23,21,0)
;;=^^2^2^2930806^
;;^DD(356.2,.23,21,1,0)
;;=If you are appealing the decision of an insurance company enter whether
;;^DD(356.2,.23,21,2,0)
;;=this is a clinical or administrative appeal.
IBINI066 ; ; 21-MAR-1994
+1 ;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94
+2 IF 'DIFQ(356.2)
QUIT
FOR I=1:2
SET X=$TEXT(Q+I)
IF X=""
QUIT
SET Y=$EXTRACT($TEXT(Q+I+1),4,999)
SET X=$EXTRACT(X,4,999)
IF $ASCII(Y)=126
SET I=I+1
SET Y=$EXTRACT(Y,2,999)_$EXTRACT($TEXT(Q+I+1),5,99)
IF $ASCII(Y)=61
SET Y=$EXTRACT(Y,2,999)
XECUTE NO
IF '$TEST
SET @X=Y
Q QUIT
+1 ;;^DD(356.2,.19,1,0)
+2 ;;=^.1
+3 ;;^DD(356.2,.19,1,1,0)
+4 ;;=356.2^AE
+5 ;;^DD(356.2,.19,1,1,1)
+6 ;;=S ^IBT(356.2,"AE",$E(X,1,30),DA)=""
+7 ;;^DD(356.2,.19,1,1,2)
+8 ;;=K ^IBT(356.2,"AE",$E(X,1,30),DA)
+9 ;;^DD(356.2,.19,1,1,"DT")
+10 ;;=2940207
+11 ;;^DD(356.2,.19,1,2,0)
+12 ;;=^^TRIGGER^356.2^.24
+13 ;;^DD(356.2,.19,1,2,1)
+14 ;;=K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X I $P(^IBT(356.2,DA,0),U,19)'=10 I X S X=DIV S Y(1)=$S($D(^IBT(356.2,D0,0)):^(0),1:"") S X=$P(Y(1),U,24),X=X S DIU=X K Y S X=DIV S X=DT X ^DD(356.2,.19,1,2,1.4)
+15 ;;^DD(356.2,.19,1,2,1.4)
+16 ;;=S DIH=$S($D(^IBT(356.2,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,24)=DIV,DIH=356.2,DIG=.24 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
+17 ;;^DD(356.2,.19,1,2,2)
+18 ;;=K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X I $P(^IBT(356.2,DA,0),U,19)=10 I X S X=DIV S Y(1)=$S($D(^IBT(356.2,D0,0)):^(0),1:"") S X=$P(Y(1),U,24),X=X S DIU=X K Y S X="" X ^DD(356.2,.19,1,2,2.4)
+19 ;;^DD(356.2,.19,1,2,2.4)
+20 ;;=S DIH=$S($D(^IBT(356.2,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,24)=DIV,DIH=356.2,DIG=.24 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
+21 ;;^DD(356.2,.19,1,2,"%D",0)
+22 ;;=^^1^1^2940207^
+23 ;;^DD(356.2,.19,1,2,"%D",1,0)
+24 ;;=This trigger deletes the NEXT REVIEW DATE when completing a review.
+25 ;;^DD(356.2,.19,1,2,"CREATE CONDITION")
+26 ;;=I $P(^IBT(356.2,DA,0),U,19)'=10
+27 ;;^DD(356.2,.19,1,2,"CREATE VALUE")
+28 ;;=S X=DT
+29 ;;^DD(356.2,.19,1,2,"DELETE CONDITION")
+30 ;;=I $P(^IBT(356.2,DA,0),U,19)=10
+31 ;;^DD(356.2,.19,1,2,"DELETE VALUE")
+32 ;;=@
+33 ;;^DD(356.2,.19,1,2,"DT")
+34 ;;=2940207
+35 ;;^DD(356.2,.19,1,2,"FIELD")
+36 ;;=#.24
+37 ;;^DD(356.2,.19,3)
+38 ;;=
+39 ;;^DD(356.2,.19,5,1,0)
+40 ;;=356.2^.11^4
+41 ;;^DD(356.2,.19,21,0)
+42 ;;=^^2^2^2930907^^^
+43 ;;^DD(356.2,.19,21,1,0)
+44 ;;=Enter whether or not this entry is active or not. Inactivating an
+45 ;;^DD(356.2,.19,21,2,0)
+46 ;;=entry has the same effect as deleting the entry.
+47 ;;^DD(356.2,.19,"DT")
+48 ;;=2940207
+49 ;;^DD(356.2,.2,0)
+50 ;;=CASE PENDING^S^1:UR/CLINICAL INFORMATION;2:PENDING MEDICAL REVIEW;3:OTHER;^0;20^Q
+51 ;;^DD(356.2,.2,21,0)
+52 ;;=^^4^4^2930806^
+53 ;;^DD(356.2,.2,21,1,0)
+54 ;;=If the action by the insurance company on this contact is pending, then
+55 ;;^DD(356.2,.2,21,2,0)
+56 ;;=this is what the case is pending for. Generally cases are pending
+57 ;;^DD(356.2,.2,21,3,0)
+58 ;;=further UR/Clinical information from the site or Medical Review at
+59 ;;^DD(356.2,.2,21,4,0)
+60 ;;=the insurance company.
+61 ;;^DD(356.2,.2,"DT")
+62 ;;=2930610
+63 ;;^DD(356.2,.21,0)
+64 ;;=NO COVERAGE^S^1:PATIENT NOT ELIGIBLE;2:SERVICE NOT PROGRAM BENEFIT;3:COVERAGE CANCELED BEFORE TREATMENT;4:OTHER;^0;21^Q
+65 ;;^DD(356.2,.21,21,0)
+66 ;;=^^3^3^2930806^
+67 ;;^DD(356.2,.21,21,1,0)
+68 ;;=If the action by the insurance company on this contact was that
+69 ;;^DD(356.2,.21,21,2,0)
+70 ;;=the patient was not covered by this carrier for this care then
+71 ;;^DD(356.2,.21,21,3,0)
+72 ;;=this is the reason that they claim no coverge.
+73 ;;^DD(356.2,.21,"DT")
+74 ;;=2930610
+75 ;;^DD(356.2,.22,0)
+76 ;;=FOLLOW-UP WITH APPEAL^S^1:YES;0:NO;^0;22^Q
+77 ;;^DD(356.2,.22,21,0)
+78 ;;=^^3^3^2930806^
+79 ;;^DD(356.2,.22,21,1,0)
+80 ;;=If the action by the insurance company on this contact was a denial,
+81 ;;^DD(356.2,.22,21,2,0)
+82 ;;=then enter whether you wish to follow up with an appeal. If you
+83 ;;^DD(356.2,.22,21,3,0)
+84 ;;=answer 'YES' then this will be included on your Pending Work.
+85 ;;^DD(356.2,.22,"DT")
+86 ;;=2930610
+87 ;;^DD(356.2,.23,0)
+88 ;;=TYPE OF APPEAL^S^1:CLINICAL;2:ADMINISTRATIVE;^0;23^Q
+89 ;;^DD(356.2,.23,21,0)
+90 ;;=^^2^2^2930806^
+91 ;;^DD(356.2,.23,21,1,0)
+92 ;;=If you are appealing the decision of an insurance company enter whether
+93 ;;^DD(356.2,.23,21,2,0)
+94 ;;=this is a clinical or administrative appeal.
