- 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.
