HCFA 1500 MENTIONS
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IB20PT5
FT ; Update called routine for form type HCFA 1500
FT+2 S IBFT="HCFA 1500" S IBFTI=$O(^IBE(353,"B",IBFT,0)) I +IBFTI S DIE="
^IBE(353,",DA=IBFTI,DR="1.01////EN^IBCF2" D ^DIE K DIE,DR,DA
IBCBB2
IBCBB2 ;ALB/ARH - CONTINUATION OF EDIT CHECKS ROUTINE (HCFA 1500) ;04/14/92
EN+11 D F^IBCEF("N-HCFA 1500 MODIFIERS",,,IBIFN) ;Get modifiers
EN+29 ; HCFA 1500: dxs associated with procs must be defined dxs for the b
ill
EN+42 D F^IBCEF("N-HCFA 1500 SERVICES (PRINT)",,,IBIFN) ;Get charge lines
IBCBB9
PARTB ; MEDICARE specific edit checks for PART B claims (HCFA 1500)
PARTB+6 . D F^IBCEF("N-HCFA 1500 SERVICE LINE (EDI)",,,IBIFN)
IBCE837
FIND ; Find/sort by HCFA 1500/UB92, test/live, ins ID # & div
IBCECOB4
SCR+11 S X=$$SETFLD^VALM1(" "_$$TYPE^IBJTLA1($P(IBCMT,U,5))_"/"_$P("UB-82^
HCFA 1500^UB-92",U,+$P(IBCMT,U,6)),X,"BTYPE")
IBCECSA5
MRALLA+11 D F^IBCEF("N-"_$S(IBFORM:"UB92",1:"HCFA 1500")_" SERVICE LINE (EDI)"
,"IBZDATA",,+IBREC)
IBCEF
SERVDT+6 G:$$INPAT^IBCEF(IBIFN,1)!($$FT^IBCEF(IBIFN)'=3) SERVDTQ ;Inpatient c
laim or billed on a HCFA 1500
IBCEF1
REQ+6 ; HCFA 1500/inpatient the data would be requ
ired
REQ+8 ; HCFA 1500/inpatient, the data would not b
e
CIADDR+1 ; FORM = 1 for HCFA 1500, 2 for UB-92
IBCEF11
BOX24D(A,IB) ; Returns the lines for boxes 19-24 of the HCFA 1500 display
OUTPT+1 ; HCFA 1500 box 24. Output is in IBXDATA(n)
IBCEF2
ALLPAYID+21 . ; RPRNT = HCFA 1500 Rx bills
ALLPAYID+30 . ; Rx bills on HCFA 1500
IBCEF3
MPG+1 ; for either HCFA 1500 or UB92
MPG+7 ; HCFA 1500: LINES 1-5,7-43,57 from col 1 to 49, 58-63
NONSERV+1 ; 24 of HCFA 1500
PG(VAL,LNCT) ;Set next pg for HCFA 1500 lines
B24+8 I IBIFN D F^IBCEF("N-HCFA 1500 SERVICE"_$S(IBSUB["24":"S (PRINT",1:"
LINE (EDI")_")",,,IBIFN)
IBCEF7
GETNMEL+24 ; FORMTYP: Form type 1=UB92,2=HCFA 1500
PSPRV+8 ; 4th digit: 0 if HCFA 1500 bill
IBCEF71
ISINSUR+10 ;IB399FRM - form type (0=unknwn/both,1=UB92,2=HCFA 1500) to
PRACT+9 . S IBFRMTYP=+$P($G(^IBA(IBFX,IB3559,0)),"^",4) ;form type (0=both,1
=UB92,2=HCFA 1500)
IBCEF72
IBCEF72+7 ;IBFRMTYP 0=unknwn/both,1=UB92,2=HCFA 1500
IBCEF73
IBCEF73+5 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
CHSEC+20 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
CHCKSUB+19 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
CHSUB+10 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
OPR2+5 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
OP1+5 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
OPR3+4 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
OP2+4 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
SUB1+5 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
OPR4+4 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
OP9+4 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
SUB2+5 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
OP3+4 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
OPR5+4 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
OPR8+4 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
OP4+4 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
OP8+4 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
OP6+4 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
OP7+5 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
CHCKPRV1+3 ;IBFRM 0-both, 1=UB92,2=HCFA 1500
IBCEF74
PROVINF+25 . I $G(IBINSTP)="O","34"[$G(IBPRTYP),"ST"[$G(IBCURR),$G(IBFRMTYP)=2,
$$MCRONBIL^IBEFUNC(IB399) S IB355OV=$$MCR24K^IBCEU3(IB399)_"^12" ;Ca
lculate MEDICARE (WNR) specific provider qualifier and ID for HCFA 1
500 secondary claims
PROVINF+30 . I IBFRMTYP=2,$P($G(^DIC(36,IBINSCO,3)),U,11),$P(IBALLSSN,U,IBPRTYP
)'="",IBSSNIEN D ; Force SSN as secondary id for HCFA 1500
IBCEM03
SUB1+18 . S DIR("A",1)=" YOU HAVE SELECTED BILL #: "_$P(IB399,U)_" ("_
$S($$INPAT^IBCEF(IBIFN):"INPATIENT",1:"OUTPATIENT")_"/"_$S($$FT^IBCE
F(IBIFN)=3:"UB92",1:"HCFA 1500")_" FORMAT)"
IBCEMRAA
PROC+9 ; based on the Bill's Form Type 3=UB92 ; 2=HCFA 1500
PROC+11 . I FRMTYP=2 D F^IBCEF("N-HCFA 1500 SERVICE LINE (EDI)","IBZDATA",,I
BIFN) Q
PRNTMRA+3 ; Print Part B - HCFA 1500
IBCEMRAB
IBCEMRAB+6 ; This routine prints MRA Report for HCFA 1500 (Part B) Form Type
HDR+53 ; On HCFA 1500 Form Type reports, If Medicare WNR is Primary or Seco
ndary, then set Performing Provider ID
IBCEMSR1
DETAILS+7 D CHKP Q:IBQ W !?7,"Primary UB92 MRA Requests",?67,"Primary HCFA 15
00 MRA Requests"
SUMMARY+6 D CHKP Q:IBQ W !?7,"Primary UB92 MRA Requests",?67,"Primary HCFA 15
00 MRA Requests"
SECONDRY+1 D CHKP Q:IBQ W !?7,"Secondary UB92 claims",?67,"Secondary HCFA 1500
claims"
IBCEMU2
MRACALC+15 S FRMTYP=$$FT^IBCEF(IBIFN) ;Form Type 2=HCFA 1500; 3=UB92
MRACALC+28 ; Handle HCFA 1500 Form Type Next:
IBCEOB1
FINDLN+76 ; At this point, we can assume the claim is HCFA 1500 format
FINDLN+77 I '$D(IBZDATA) D F^IBCEF("N-HCFA 1500 SERVICE LINE (EDI)","IBZDATA",
,IBIFN)
IBCEP4
BLD+11 .. S IBQ=IBQ_" "_$E($P("Both form types^UB92 Only^HCFA 1500 Only",U
,$P(IB0,U,4)+1)_$J("",15),1,15)_" "_$E($P("Inpt/Outpt^Inpt Only^Out
pt Only^RX Only",U,+$P(IB0,U,5)+1)_$J("",10),1,10)
IBCEP5C
COMBOK+27 .. S IBSPEC=$S($G(IBSPEC)'="":IBSPEC_" ",1:"")_$P($S(IBD=4:"UB92^HC
FA 1500",1:"INPT^OUTPT"),U,X0)_" ONLY"
COMBOK+28 . I $D(X1(0)) S IBSPEC=$S($G(IBSPEC)'="":IBSPEC_" ",1:"")_$S(IBD=4:
"BOTH UB92 and HCFA 1500 form type AND BOTH INPT and OUTPT care ty
pe",1:"BOTH INPT and OUTPT care type AND BOTH UB92 and HCFA 1500 f
orm type")
COMBOK+40 . S X0=$S($D(IBD(4)):"UB-92^HCFA 1500",1:"INPT^OUTPT")
IBCEP7
FACFLDS+17 S DIR("A")="FORM TYPE APPLIED TO: ",DIR(0)=$S($P(IBPARAM,U,3)'=1:"35
5.92,.04A",1:"SA^1:UB92;2:HCFA 1500")
FACFLDS+18 S:$P(IBPARAM,U,3)=1&$G(IBDA) DIR("B")=$P("UB92^HCFA 1500",U,+$P($G(^
IBA(355.92,IBDA,0)),U,4))
IBCEP9
5+3 S DIR(0)="355.9,.04r",DIR("B")="BOTH UB92 AND HCFA 1500 FORMS"
IBCEPTC
EN+3 ; IBFORM = form type to limit selection to U=UB92,H=HCFA 1500,B=BOTH
Q2 S DIR(0)="SA^H:HCFA 1500;U:UB92;B:Both",DIR("B")="Both"
IBCEQ1A
RPTOUT+24 ... D WRT(1," "_$E($P("BOTH^UB92^HCFA 1500",U,$P(IBX,U,4)+1)_$J(""
,9),1,9)_" "_$E($P(IBX,U,15)_$J("",23),1,23)_" "_$E(IBPNM_$J("",28)
,1,28)_" "_$E(IBPNUM,1,11))
HDR1+37 .. S Z0="*"_$J("",13)_"APPLIED TO A HCFA 1500 FORM TYPE." D WRT(1,Z0
_$J("",78-$L(Z0))_"*",IBCONT)
IBCEU
PRVOK+10 ; OUTPATIENT/HCFA 1500 : RENDERING(3), SUPERVISING(5)
PRVOK+11 ; INPATIENT/HCFA 1500 : RENDERING(3), SUPERVISING(5)
PRVOK+18 S IBUB92=($$FT^IBCEF(IBIFN)=3) ; 1 if UB-92 ; 0 if HCFA 1500
NEEDPRV+19 . ; if a HCFA 1500 bill, rendering is required
PSRV+3 D F^IBCEF("N-HCFA 1500 PROCEDURES",,,IBIFN)
IBCEU0
PREOBTOT+6 ; Form Type 2=HCFA 1500; 3=UB92
PREOBTOT+9 ; For bills w/HCFA 1500 Form Type, total up Pt Resp amount from top
IBCEU3
IBCEU3 ;ALB/TMP - EDI UTILITIES FOR HCFA 1500 ;30-NOV-99
BOX19(IBIFN) ; Returns the text that should print in box 19 of the HCFA 1500
NPRT K IBXDATA D F^IBCEF("N-HCFA 1500 BOX 19 RAW DATA",,,IBIFN)
ASK19(IBIFN) ; Ask to display HCFA 1500 box 19 data for current IBIFN
ASK19+2 S DIR(0)="YA",DIR("B")="NO",DIR("A")="DISPLAY THE FULL HCFA 1500 BOX
19?: "
MCR24K(IBIFN) ;Function returns MEDICARE id# for professional (HCFA 1500) box 24
k for bill IBIFN if appropriate
IBCEU4
BOX82NM+12 . I Z=4,$$FT^IBCEF(IBIFN)=2 S Z=3 ; Find rendering for HCFA 1500
IBCEU5
IBCEU5 ;ALB/TMP - EDI UTILITIES (continued) FOR HCFA 1500 ;13-DEC-99
FTPRV(IBIFN,NOASK) ; If form type changes from UB92 to HCFA 1500 or vice
FTPRV+2 ; form type (ATTENDING = UB92, RENDERING = HCFA 1500)
SPECIFIC+4 W !,"This bill is ",$S(IBFT=3:"UB-92",1:"HCFA 1500"),"/",$S($$INPAT^
IBCEF(IBIFN):"Inpatient",1:"Outpatient")
HLPTXT+4 ;;RENDERING: HCFA 1500 (both inpatient and outpatient): REQUIRED
HLPTXT+6 ;; Data will appear in form locator 24 of the HCFA 1500.
HLPTXT+8 ;; NOTE: There can be only one rendering provider per HCFA 1500
HLPTXT+9 ;; claim form, so there may be multiple HCFA 1500's for a
HLPTXT+11 ;; than one provider. For example, there will be 2 HCFA 15
00's
HLPTXT+14 ;; would be the rendering provider on the HCFA 1500 that
HLPTXT+16 ;; would be the rendering provider on the HCFA 1500 that
HLPTXT+41 ;; NOTE: Not applicable for HCFA 1500 form type as this would be
HLPTXT+43 ;; the HCFA 1500.
HLPTXT+54 ;;REFERRING: HCFA 1500 (both inpatient and outpatient): OPTIONAL
HLPTXT+57 ;; the HCFA 1500.
HLPTXT+60 ;;SUPERVISING: HCFA 1500 (both inpatient and outpatient): OPTIONAL
INSFT(IBIFN) ; Returns 1 if form type is UB92, 0 if HCFA 1500
IBCF
IBCF ;ALB/RLW - task HCFA 1500 ;12-JUN-92
EN5 ;queue HCFA 1500 Rx Addendum to Follow-up (AR) printer, IBIFN must b
e defined - no longer used
IBCF2
IBCF2 ;ALB/ARH - HCFA 1500 19-90 DATA (gather demographics) ;12-JUN-93
EN ;begin gathering data for printing of HCFA 1500
NAME31+1 ; formatted to print in Box 31 on the HCFA 1500. Max length is 21
DATE31(IBDT,IBIFN) ; Returns date to print in box 31 of HCFA 1500
IBCF21
IBCF21 ;ALB/ARH - HCFA 1500 19-90 DATA (gather insurance, cc) ;12-JUN-93
IBCF22
IBCF22 ;ALB/ARH - HCFA 1500 19-90 DATA (gather other data) ;12-JUN-93
EVENT+1 ; HCFA 1500
IBCF23
IBCF23 ;ALB/ARH - HCFA 1500 19-90 DATA (block 24, procs and charges) ;12-JU
N-93
IBCF23A
IBCF23A ;ALB/ARH - HCFA 1500 19-90 DATA - Split from IBCF23 ;12-JUN-93
PRC ; Extract procedure data for HCFA 1500
IBCF2P
IBCF2P ;ALB/ARH - PRINT HCFA 1500 12-90 FORM ; 17-JUL-93
IBCF2TP
IBCF2TP ;ALB/RLW - HCFA 1500 12-90 TEST PATTERN ; 1-JAN-92
ZIS+5 I $D(IO("Q")) K IO("Q") S ZTRTN="PRINT^IBCF2TP",ZTDESC="IB - TEST HC
FA 1500 PRINT" D ^%ZTLOAD K ZTSK D HOME^%ZIS G Q
IBCFP
IBCFP+7 I +$P(IBPAR1,U,22),$P($G(^IBE(353,+$$FNT^IBCU3("HCFA 1500"),0)),U,2)
="" W !,"Default printer in billing not defined for the HCFA 1500, n
one will print!",!
IBCFP1
SORT ;sort authorized bills by form type and requested sort order (notice
bill addendums only print for HCFA 1500's)
SORT+15 . ; Print Bill Addendums only for HCFA 1500's
SORT+16 . I $$FTN^IBCU3(XIBFT)'["HCFA 1500" Q
IBCIADD1
INIT1+29 D F^IBCEF("N-HCFA 1500 SERVICES (PRINT)",,,IBIFN)
IBCISC
0+4 ; Check the bill form type to make sure it's a HCFA 1500.
0+6 . W !!?5,"ClaimsManager is only available for HCFA 1500 claims."
IBCIUT1
CM+2 ; sure CM is running and that the bill is a HCFA 1500 form type bill
.
CK1(IBIFN) ;checks to see if it's a HCFA 1500 claim form
CK1+1 ;returns 0 if HCFA 1500, returns 1 if any other form type
LITMS+3 D F^IBCEF("N-HCFA 1500 SERVICES (PRINT)",,,IBIFN)
DIAG+6 D F^IBCEF("N-HCFA 1500 SERVICES (PRINT)",,,IBIFN)
IBCIUT4
SNTMSG+8 I IBCISNT=7 S IBCISMG="to delete the lines on this bill which is no
longer a HCFA 1500."
IBCRBC1
RX+4 ; - on HCFA 1500, the site parameter Default Rx Refill CPT (350.9,1.
3) is added as the CPT to all Rx RC entries
IBCSC8H
IBCSC8H ;ALB/ARH - MCCR SCREEN 8 (BILL SPECIFIC INFO) HCFA 1500 ;4/21/92
IBCSC8H+3 ; HCFA 1500 screen 8
IBCSCH
M+8 I $$FT^IBCEF(IBIFN)=2 W !,?5,"Enter '?HCFA' to view how block 24 wil
l print on a HCFA 1500."
BL24(IBIFN,IBNOSHOW) ; display block 24 of HCFA 1500
BL24+10 W @IOF,!,"Example of diagnoses, procedures and charges printing on t
he HCFA 1500"
IBCU1
RVCPRC(IBIFN,IBD0) ; returns 1 if CHAMPVA rate type + 2 if HCFA 1500, 0 otherwis
e
IBCU7
ADDTNL+6 S DIR("B")="NO",DIR("A")="EDIT HCFA 1500 SPECIAL PROGRAM FIELDS and
BOX 19?: ",DIR("A",1)=" ",DIR(0)="YA"
IBCU71
DISPDX ; - display diagnosis codes available for associated dx (HCFA 1500)
NO LONGER USED?
IBCVA1
ALLPROC+4 ; IBPROC(prnt order,"AUX")="AUX" node of 'CP' entry for HCFA 1500 f
orms
IBEPAR
4+5 W ?47,"HCFA 1500 Addr Col : " W $S($P(IBEPAR(1),U,27)]"":$P(IBEPAR(1
),"^",27),1:IBU)
IBJPS2
BLD2+27 S IBLN=$$SET("HCFA 1500 Addr Col",$P(IBPD1,U,27),IBLN,IBLR,IBSEL)
IBJTBA
RX ;RX refill info for HCFA 1500 TPJI display
PROS ;prosthetic info for HCFA 1500 TPJI display
IBJTCA1
BLD+40 . D F^IBCEF("N-HCFA 1500 BOX 19",,,IBIFN)
IBXPAR2
1 S DW="1;27",DV="NJ2,0",DU="",DLB="HCFA 1500 ADDRESS COLUMN",DIFLD=1.
27
IBYOENV
IBYOENV+17 F Z="N-BALANCE DUE","N-CURR INSURANCE CO STREET","N-CURR INSURANCE C
O CITY","N-CURR INSURANCE CO STATE","N-CURR INSURANCE CO ZIP CODE","
N-UB92 ADMISSION DATE","N-STATE CODE FOR ACCIDENT","N-HCFA 1500 BOX
19 (LINE 2)" D
FAC1+26 . S DIR("?",2)="the UB-92 in form locator 1 and in Box 33 of the HCF
A 1500."
IBYOPOS1
ADDFORMS ; Add the local forms for HCFA 1500 and UB92 if they don't
ADDFORMS+3 ; HCFA 1500 and UB-92
ADDFORMS+10 .. S IBFORMNM=$S(IBFORM=2:"HCFA 1500",1:"UB-92")
IBYOPRE
ENT5+3 S Z1="N-BALANCE DUE^N-CURR INSURANCE CO STREET^N-CURR INSURANCE CO C
ITY^N-CURR INSURANCE CO STATE^N-CURR INSURANCE CO ZIP CODE^N-UB92 AD
MISSION DATE^N-STATE CODE FOR ACCIDENT^N-HCFA 1500 BOX 19 (LINE 2)^N
-SPACER FOR 81 COLUMN UB-92"
ENT5+12 S DA=+$O(^IBA(364.5,"B","N-HCFA 1500 BOX 19 (LINE 1)",0))
ENT5+13 I DA S DIE="^IBA(364.5,",DR=".01////N-HCFA 1500 BOX 19;.08///@" D ^D
IE
ENT5+25 S DA=+$O(^IBA(364.5,"B","N-HCFA 1500 EIN FLAG (BOX 25)",0))
IBYPPCC
IBYPPCC ;ALB/TMP - IB*2*52 POST INSTALL: UPDATE HCFA 1500 ; 30-APR-1997
IBYSA
IBYSA ;ALB/ARH - IB*2.0*122 POST INIT: HCFA 1500 DATE LENGTHS ; 10-OCT-19
98
POST+4 D HDATES ; update width of HCFA 1500 date fields
HDATES ; update width of HCFA 1500 date fields to 10 characters to accomoda
te 4 digit years
HDATES+3 S IBA(1)=" Expand HCFA 1500 Date fields to 10 characters (364.
6)",IBA(2)=" "
HDATES+32 D MSG(" "),MSG(" "_IBCNT_" HCFA 1500 date fields updated (364.
6)")
IBYSB1
POSQ S IBA(1)=" * "_$J(IBCNT,3)_" HCFA 1500 Place of Service Codes
added (353.1)"
ZIBCEU4
BOX82NM+9 . I Z=4,$$FT^IBCEF(IBIFN)=2 S Z=3 ; Find rendering for HCFA 1500
ZQ232A
RPTOUT+25 ... D WRT(1," "_$E($P("BOTH^UB92^HCFA 1500",U,$P(IBX,U,4)+1)_$J(""
,9),1,9)_" "_$E($P(IBX,U,15)_$J("",23),1,23)_" "_$E(IBPNM_$J("",28)
,1,28)_" "_$E(IBPNUM,1,11))
HDR1+37 .. S Z0="*"_$J("",13)_"APPLIED TO A HCFA 1500 FORM TYPE." D WRT(1,Z0
_$J("",78-$L(Z0))_"*",IBCONT)
