27. EPMO Open Source Coordination Office Redaction File Detail Report

Produced by Araxis Merge on 9/19/2018 12:35:52 PM Central Daylight Time. See www.araxis.com for information about Merge. This report uses XHTML and CSS2, and is best viewed with a modern standards-compliant browser. For optimum results when printing this report, use landscape orientation and enable printing of background images and colours in your browser.

27.1 Files compared

#	Location	File	Last Modified
1	ePharmacy_Bundle 12.zip	TAS+ePhm+SDD+US3529+v1.05.docx	Wed Sep 12 15:17:00 2018 UTC
2	ePharmacy_Bundle 12.zip	TAS+ePhm+SDD+US3529+v1.05.docx	Wed Sep 19 16:03:15 2018 UTC

27.2 Comparison summary

Description	Between Files 1 and 2
Description	Text Blocks	Lines
Unchanged	1	9020
Changed	0	0
Inserted	0	0
Removed	0	0

27.3 Comparison options

Whitespace
Character case	Differences in character case are significant
Line endings	Differences in line endings (`CR` and `LF` characters) are ignored
CR/LF characters	Not shown in the comparison detail

27.4 Active regular expressions

No regular expressions were active.

27.5 Comparison detail

	1	MCCF EDI T AS US3529
	2	System Des ign Docume nt
	3
	4
	5
	6
	7
	8	Department of Vetera ns Affairs
	9	June 2018
	10	Version 1. 05
	11
	12
	13
	14
	15
	16
	17
	18	User Story Number: U SRX-
	19	User Story Name: Mos t Recent v ersion of NCPDP Tele com Standa rd
	20	Product Ba cklog ID:
	21	Backlog Pr iority:
	22	Initial Si zing Estim ate:
	23	Rational I D:
	24	Rally ID:
	25	Epic Taxon omy: eBiz Compliance
	26
	27	Design – S ummary
	28	The Nation al Council for Presc ription Dr ug Program s (NCPDP) publishes updates to the field s on a qua rterly bas is. The a nnual impl ementation schedule incorporat es up to f our (4) pu blications each year . The new annual im plementati ons become effective each Octo ber. NCPD P may publ ish emerge ncy update s which ar e required to be imp lemented a ny date pr ior to the scheduled annual im plementati on date, b ut must be at least 180 days f rom the pu blication date. Thi s user sto ry include s the upda tes for al l four of the public ations fro m 2017.
	29
	30	List of Co mponents:
	31	File: BPS CLAIMS
	32	File: BPS NCPDP FIEL D DEFS
	33	File: BPS NCPDP SEGM ENTS
	34	File: BPS RESPONSES
	35	File: BPS REQUESTS
	36	File: BPS TRANSACTIO N
	37	File: BPS PAYER RESP ONSE OVERR IDES
	38	File: BPS NCPDP PRES CRIBER PLA CE OF SERV ICE
	39	File: BPS NCPDP BENE FIT STAGE INDICATOR
	40	File: BPS NCPDP LTPA C DISPENSE FREQUENCY
	41	File: BPS NCPDP PATI ENT PAY CO MPONENT QU ALIFIER
	42	File: BPS NCPDP OTHE R PAYER PR OGRAM TYPE
	43	Routine: B PS24PRE
	44	Routine: B PSBUTL
	45	Routine: B PSECX0
	46	Routine: B PSFLD01
	47	Routine: B PSOSCD
	48	Routine: B PSOSCE
	49	Routine: B PSOSHF
	50	Routine: B PSOSRX3
	51	Routine: B PSOSSG
	52	Routine: B PSPRRX3
	53	Routine: B PSPRRX6
	54	Routine: B PSSCRL1
	55	Routine: B PSSCRLG
	56	Routine: B PSTEST
	57	Routine: B PSTEST2
	58	Routine: I BJTRX
	59	Routine: P SOREJP1
	60	Routine: P SOREJP5
	61
	62	Design – D etail
	63	In reviewi ng the lat est NCPDP Implementa tion Guide (October 2017), it was determ ined that updates mu st be made to the Vi stA files correspond ing to Dat a Elements .
	64	Because bo th the fie ld def num ber and na me are ide ntifier fi elds in fi le 9002313 .91, BPS N CPDP FIELD DEFS, fie ld name up dates for existing f ields must be perfor med in the BPS patch Pre-Insta llation ro utine ^BPS 24PRE. Th e name is also a ide ntifier fi eld in fil e 9002313. 9, BPS NCP DP SEGMENT S, therefo re field n ame update s for an e xisting fi eld must b e performe d in the B PS patch P re-Install ation rout ine ^BPS24 PRE. Modi fying the field name s in both of these f iles in th e pre-inst all routin e prevents duplicate entries f rom being created by KIDS when the data file is ad ded to the system.
	65
	66	Subroutine Name
	67	PRE^BPS24P RE
	68	Enhancemen t Category
	69	New
	70	Modify
	71	Delete
	72	No Change
	73	Related In tegration Control Re gistration s (ICRs)
	74	10141 for MES^XPDUTL
	75
	76
	77
	78	Current Lo gic
	79
	80	PRE ; Pre- install fu nctions ar e coded he re.
	81	;
	82	D MES^XPD UTL(" Sta rting pre- install of BPS1.02 4")
	83	D UPDOPT
	84	D BMES^XP DUTL(" Fi nished pre -install o f BPS1.0 24")
	85	Q
	86
	87	Modified L ogic (Chan ges are hi ghlighted)
	88
	89	PRE ; Pre- install fu nctions ar e coded he re.
	90	;
	91	D MES^XPD UTL(" Sta rting pre- install of BPS1.02 4")
	92	D UPDOPT
	93	; Update descriptio ns in BPS NCPDP FIEL D DEFS fil e #9002313 .91
	94	D FIELDS
	95	; Update segment na me in BPS NCPDP SEGM ENTS file #9002313.9 D UPDSEG
	96	D BMES^XP DUTL(" Fi nished pre -install o f BPS1.0 24")
	97	Q
	98
	99
	100
	101	Subroutine Name
	102	FIELDS^BPS 24PRE
	103	Enhancemen t Category
	104	New
	105	Modify
	106	Delete
	107	No Change
	108	Current Lo gic
	109
	110	n/a – new subroutine
	111
	112	Modified L ogic (Chan ges are hi ghlighted)
	113
	114	FIELDS ; U pdate Fiel ds Defs wi th new des criptions N LINE,DAT A,NUM,NAME ,DA,DIE,DR ,CNT D MES ^XPDUTL(" - Updating BPS NCPDP FIELD DEF S") S CNT= 0 F LINE=1 :1 S DATA= $P($T(NFLD S+LINE),"; ;",2,99) Q :DATA="" D . S NUM= $P(DATA,"; ",1),NAME= $P(DATA,"; ",2)
	115	. S DIE=9 002313.91 . S DA=$O (^BPSF(DIE ,"B",NUM," ")) . I 'D A D MES^XP DUTL(" - N o IEN foun d for entr y "_NUM_", field: "_N AME) Q . S DR=".03// //^S X=NAM E",CNT=CNT +1 . D ^DI E D MES^XP DUTL(" - " _CNT_" ent ries updat ed") D MES ^XPDUTL(" - Done wit h BPS NCPD P FIELD DE FS") D MES ^XPDUTL(" ") Q ;NFLD S ; Update d field na mes ;;101; IIN NUMBER ;;348;BAS IS OF CALC - REGULAT ORY FEE ;; 349;BASIS OF CALC - % TAX ;;43 3;PATIENT PAID AMOUN T REPORTED ;;481;REG ULATORY FE E AMT SUBM ITTED ;;48 2;PERCENT TAX AMT SU BMITTED ;; 483;PERCEN T TAX RATE SUBMITTED ;;484;PER CENTAGE TA X BASIS SB MTTD
	116	;;530;PRE VIOUS DATE OF SERVIC E ;;531;QT Y OF PREVI OUS DISPEN SING ;;551 ;FORMULARY ALT PRODU CT COUNT ; ;552;FORMU LARY ALT I D QUALIFIE R ;;553;FO RMULARY AL TERNATIVE ID ;;554;F ORMULARY A LT INCENTI VE ;;555;F ORMULARY A LT COST SH ARE ;;556; FORMULARY ALT DESCRI PTION ;;55 7;PERCENTA GE TAX EXE MPT INDICA TOR ;;558; REGULATORY FEE AMOUN T PAID ;;5 59;PERCENT AGE TAX AM OUNT PAID ;;560;PERC ENTAGE TAX RATE PAID ;;561;PER CENTAGE TA X BASIS PA ID ;;568;P AYER/HEALT H PLAN ID QUALIFIER ;;569;PAYE R/HEALTH P LAN ID ;;5 75;PATIENT PERCENTAG E TAX AMOU NT ;;A28;A DJUDICATED PROGRAM T YPE ;;A29 ;REPORTED ADJUDICATE D PROG TYP E ;;B56;LA ST KNOWN I IN NUMBER ;
	117
	118
	119	The follow ing entrie s in the B PS NCPDP F IELD DEFS file need to be edit ed to accu rately ref lect the N CPDP name/ descriptio n.
	120
	121	101-A1 – I IN NUMBER
	122	Curren t VistA Na me: BIN N UMBER
	123	Update d VistA Na me: IIN N UMBER
	124
	125	348-HK – B ASIS OF CA LCULATION- REGULATORY FEE
	126	Curren t VistA Na me: BASIS OF CALC – FLAT SALE S TAX
	127	Update d VistA Na me: BASIS OF CALC – REGULATOR Y FEE
	128
	129	349-HM – B ASIS OF CA LCULATION- PERCENTAGE TAX
	130	Curren t VistA Na me: BASIS OF CALC - % SALES T AX
	131	Update d VistA Na me: BASIS OF CALC - % TAX
	132
	133	433-DX – P ATIENT PAI D AMOUNT R EPORTED
	134	Curren t VistA Na me: PATIE NT PAID AM OUNT SUBMI TTED
	135	Update d VistA Na me: PATIE NT PAID AM OUNT REPOR TED
	136
	137	481-HA - R EGULATORY FEE AMOUNT SUBMITTED
	138	Curren t VistA Na me: FLAT SALES TAX AMT SUBMIT TED
	139	Update d VistA Na me: REGUL ATORY FEE AMT SUBMIT TED
	140
	141	482-GE – P ERCENT TAX AMOUNT SU BMITTED
	142	Curren t VistA Na me: PERCE NT SALES T AX AMT SBM TTD
	143	Update d VistA Na me: PERCE NT TAX AMT SUBMITTED
	144
	145	483-HE - P ERCENT TAX RATE SUBM ITTED
	146	Curren t VistA Na me: PERCE NT SALES T AX RATE SB MTTD
	147	Update d VistA Na me: PERCE NT TAX RAT E SUBMITTE D
	148
	149	484-JE - P ERCENTAGE TAX BASIS SUBMITTED
	150	Curren t VistA Na me: PERCE NT SALES T AX BASIS S BMTTD
	151	Update d VistA Na me: PERCE NTAGE TAX BASIS SBMT TD
	152
	153	530-FU - P REVIOUS DA TE OF SERV ICE
	154	Curren t VistA Na me: PREVI OUS DATE O F FILL
	155	Update d VistA Na me: PREVI OUS DATE O F SERVICE
	156
	157	531-FV - Q UANTITY OF PREVIOUS DISPENSING
	158	Curren t VistA Na me: QUANT ITY OF PRE VIOUS FILL
	159	Update d VistA Na me: QTY O F PREVIOUS DISPENSIN G
	160
	161	551-9F - F ORMULARY A LTERNATIVE PRODUCT C OUNT
	162	Curren t VistA Na me: PREFE RRED PRODU CT COUNT
	163	Update d VistA Na me: FORMU LARY ALT P RODUCT COU NT
	164
	165	552-AP - F ORMULARY A LTERNATIVE ID QUALIF IER
	166	Curren t VistA Na me: PREFE RRED PRODU CT ID QUAL IFIER
	167	Update d VistA Na me: FORMU LARY ALT I D QUALIFIE R
	168
	169	553-AR - F ORMULARY A LTERNATIVE ID
	170	Curren t VistA Na me: PREFE RRED PRODU CT ID
	171	Update d VistA Na me: FORMUL ARY ALTERN ATIVE ID
	172
	173	554-AS - F ORMULARY A LTERNATIVE INCENTIVE
	174	Curren t VistA Na me: PREFE RRED PRODU CT INCENTI VE
	175	Update d VistA Na me: FORMU LARY ALT I NCENTIVE
	176
	177	555-AT - F ORMULARY A LTERNATIVE COST SHAR E
	178	Curren t VistA Na me: PREF PRODUCT CO ST SHARE I NCNTV
	179	Update d VistA Na me: FORMU LARY ALT C OST SHARE
	180
	181	556-AU - F ORMULARY A LTERNATIVE DESCRIPTI ON
	182	Curren t VistA Na me: PREFE RRED PRODU CT DESCRIP TION
	183	Update d VistA Na me: FORMU LARY ALT D ESCRIPTION
	184
	185	557-AV – P ERCENTAGE TAX EXEMPT INDICATOR
	186	Curren t VistA Na me: TAX E XEMPT INDI CATOR
	187	Update d VistA Na me: PERCE NTAGE TAX EXEMPT IND ICATOR
	188
	189	558-AW - R EGULATORY FEE AMOUNT PAID
	190	Curren t VistA Na me: FLAT SALES TAX AMOUNT PAI D
	191	Update d VistA Na me: REGUL ATORY FEE AMOUNT PAI D
	192
	193	559-AX – P ERCENTAGE TAX AMOUNT PAID
	194	Curren t VistA Na me: PERCE NTAGE SALE S TAX AMT PAID
	195	Update d VistA Na me: PERCE NTAGE TAX AMOUNT PAI D
	196
	197	560-AY - P ERCENTAGE TAX RATE P AID
	198	Curren t VistA Na me: PERCE NTAGE SALE S TAX RATE PAID
	199	Update d VistA Na me: PERCE NTAGE TAX RATE PAID
	200
	201	561-AZ - P ERCENTAGE TAX BASIS PAID
	202	Curren t VistA Na me: PERCE NT SALES T AX BASIS P AID
	203	Update d VistA Na me: PERCE NTAGE TAX BASIS PAID
	204
	205	568-J7 - P AYER/HEALT H PLAN ID QUALIFIER
	206	Curren t VistA Na me: PAYER ID QUALIF IER
	207	Update d VistA Na me: PAYER /HEALTH PL AN ID QUAL IFIER
	208
	209	569-J8 - P AYER/HEALT H PLAN ID
	210	Curren t VistA Na me: PAYER ID
	211	Update d VistA Na me: PAYER /HEALTH PL AN ID
	212
	213	575-EQ - P ATIENT PER CENTAGE TA X AMOUNT
	214	Curren t VistA Na me: PATIE NT SALES T AX
	215	Update d VistA Na me: PATIE NT PERCENT AGE TAX AM OUNT
	216
	217	A28-ZR - A DJUDICATED PROGRAM T YPE
	218	Curren t VistA Na me: ADJUD ICATED PAY MENT TYPE
	219	Update d VistA Na me: ADJUD ICATED PRO GRAM TYPE
	220
	221	A29-ZS - R EPORTED AD JUDICATED PROGRAM TY PE
	222	Curren t VistA Na me: REPOR TED PAYMEN T TYPE
	223	Update d VistA Na me: REPOR TED ADJUDI CATED PROG TYPE
	224
	225	B56-3E - L AST KNOWN IIN NUMBER
	226	Curren t VistA Na me: LAST KNOWN BIN NUMBER
	227	Update d VistA Na me: LAST KNOWN IIN NUMBER
	228
	229
	230	The follow ing entry in the BPS NCPDP SEG MENTS file will need to be edi ted to acc urately re flect the NCPDP name .
	231
	232	Curren t Segment Name: RES PONSE COOR DINATION O F BENEFITS /OTHER PAY ERS
	233	Update d Segment Name: RES PONSE OTHE R PAYERS
	234
	235	Subroutine Name
	236	UPDSEG^BPS 24PRE
	237	Enhancemen t Category
	238	New
	239	Modify
	240	Delete
	241	No Change
	242	Current Lo gic
	243
	244	n/a – new subroutine
	245
	246	Modified L ogic (Chan ges are hi ghlighted)
	247
	248	UPDSEG ; U pdate Segm ent with n ew N DA,D IE,DR,NAME ,ONAME D M ES^XPDUTL( " - Updati ng BPS NCP DP SEGMENT S") S ONAM E="RESPONS E COORDINA TION OF BE NEF" S NAM E="RESPONS E OTHER PA YERS" S DI E=9002313. 9 S DA=$O( ^BPSF(DIE, "B",ONAME, "")) I 'DA D MES^XPD UTL(" - No IEN found for entry "_ONAME_" ,field: "_ NAME) Q S DR=".01/// /^S X=NAME " D ^DIE
	249	D MES^XPD UTL(" - en try update d") D MES^ XPDUTL(" - Done with BPS NCPDP SEGMENTS" ) D MES^XP DUTL(" ") Q ;
	250
	251
	252	The five ( 5) tables below desc ribe how a ll the new field def initions a re going t o be added to file 9 002313.91, BPS NCPDP FIELD DEF S, how the new outgo ing fields are going to be add ed to file 9002313.0 2, BPS CLA IMS, and h ow the new incoming fields are going to be added t o file 900 2313.03 , BPS RESPON SES.
	253
	254	1 The tabl e below de scribes ho w the new incoming f ields are going to b e added to file 9002 313.91, BP S NCPDP FI ELD DEFS.
	255
	256	.01 -
	257	NO
	258	.03 - NAME
	259	.04 -
	260	FORMAT
	261	.06
	262	ID
	263	.07 -
	264	LENGTH
	265	1 – VISTA
	266	FIELD NO
	267	1.01 – STA NDARD NCPD P FIELD NA ME
	268	3 – RESPON SE SEGMENT
	269	931
	270	Maximum Ag e Qualifie r
	271	A/N
	272	F8
	273	1
	274	931
	275	Maximum Ag e Qualifie r
	276	RESPONSE C LAIM
	277	932
	278	Maximum Ag e
	279	N
	280	GA
	281	3
	282	932
	283	Maximum Ag e
	284	RESPONSE C LAIM
	285	933
	286	Maximum Am ount
	287	N
	288	GB
	289	10
	290	933
	291	Maximum Am ount
	292	RESPONSE C LAIM
	293	934
	294	Maximum Am ount Quali fier
	295	A/N
	296	GC
	297	2
	298	934
	299	Maximum Am ount Quali fier
	300	RESPONSE C LAIM
	301	935
	302	Maximum Am ount Time Period
	303	A/N
	304	GF
	305	2
	306	935
	307	Maximum Am ount Time Period
	308	RESPONSE C LAIM
	309	936
	310	Max Amt Ti me Period Start Date
	311	N
	312	GG
	313	8
	314	936
	315	Maximum Am ount Time Period Sta rt Date
	316	RESPONSE C LAIM
	317	937
	318	Max Amt Ti me Period End Date
	319	N
	320	GH
	321	8
	322	937
	323	Maximum Am ount Time Period End Date
	324	RESPONSE C LAIM
	325	938
	326	Max Amt Ti me Period Units
	327	N
	328	GJ
	329	4
	330	938
	331	Maximum Am ount Time Period Uni ts
	332	RESPONSE C LAIM
	333	943
	334	Minimum Ag e Qualifie r
	335	A/N
	336	GQ
	337	1
	338	943
	339	Minimum Ag e Qualifie r
	340	RESPONSE C LAIM
	341	944
	342	Minimum Ag e
	343	N
	344	GR
	345	3
	346	944
	347	Minimum Ag e
	348	RESPONSE C LAIM
	349	C58
	350	Benefit Ty pe Opportu nity
	351	A/N
	352	AE
	353	2
	354	2158
	355	Benefit Ty pe Opportu nity
	356	RESPONSE C LAIM
	357	C59
	358	Benefit Ty pe Opportu nity Count
	359	N
	360	AF
	361	1
	362	2159
	363	Benefit Ty pe Opportu nity Count
	364	RESPONSE C LAIM
	365	C66
	366	Help Desk Business U nit Type
	367	A/N
	368	BA
	369	2
	370	2166
	371	Help Desk Business U nit Type
	372	RESPONSE S TATUS
	373	C67
	374	Help Desk Bus Unit T ype Count
	375	N
	376	BB
	377	2
	378	2167
	379	Help Desk Business U nit Type C ount
	380	RESPONSE S TATUS
	381	C68
	382	Help Desk Contact In formation
	383	A/N
	384	BC
	385	255
	386	2168
	387	Help Desk Contact In formation
	388	RESPONSE S TATUS
	389	C69
	390	Help Desk Contact In fo Ext
	391	A/N
	392	BD
	393	8
	394	2169
	395	Help Desk Contact In formation Extension
	396	RESPONSE S TATUS
	397	C70
	398	Help Desk Contact In fo Qual
	399	A/N
	400	BF
	401	2
	402	2170
	403	Help Desk Contact In formation Qualifier
	404	RESPONSE S TATUS
	405	C71
	406	Help Desk Support Ty pe
	407	A/N
	408	BG
	409	2
	410	2171
	411	Help Desk Support Ty pe
	412	RESPONSE S TATUS
	413	C72
	414	Help Desk Support Ty pe Count
	415	N
	416	BH
	417	2
	418	2172
	419	Help Desk Support Ty pe Count
	420	RESPONSE S TATUS
	421	C80
	422	Intermedia ry Help De sk Type
	423	A/N
	424	G8
	425	2
	426	2180
	427	Intermedia ry Help De sk Busines s Unit Typ e
	428	RESPONSE I NTERMEDIAR Y
	429	C81
	430	Intermedia ry HlpDsk Bus Count
	431	N
	432	G9
	433	2
	434	2181
	435	Intermedia ry Help De sk Busines s Unit Typ e Count
	436	RESPONSE I NTERMEDIAR Y
	437	C82
	438	Intermedia ry HlpDsk Contact
	439	A/N
	440	JP
	441	255
	442	2182
	443	Intermedia ry Help De sk Contact Informati on
	444	RESPONSE I NTERMEDIAR Y
	445	C83
	446	Intermedia ry HlpDsk Extension
	447	A/N
	448	JR
	449	8
	450	2183
	451	Intermedia ry Help De sk Contact Informati on Extensi on
	452	RESPONSE I NTERMEDIAR Y
	453	C84
	454	Intermedia ry HlpDsk Qualifier
	455	A/N
	456	KA
	457	2
	458	2184
	459	Intermedia ry Help De sk Contact Informati on Qualifi er
	460	RESPONSE I NTERMEDIAR Y
	461	C85
	462	Intermedia ry HlpDsk Suppt Type
	463	A/N
	464	KB
	465	2
	466	2185
	467	Intermedia ry Help De sk Support Type
	468	RESPONSE I NTERMEDIAR Y
	469	C86
	470	Intermedia ry HlpDsk Typ
	471	Count
	472	N
	473	KC
	474	2
	475	2186
	476	Intermedia ry Help De sk Support Type Coun t
	477	RESPONSE I NTERMEDIAR Y
	478	C93
	479	Patient Pa y Componen t Amount
	480	N
	481	KN
	482	8
	483	2193
	484	Patient Pa y Componen t Amount
	485	RESPONSE P RICING
	486	C94
	487	Patient Pa y Componen t Count
	488	N
	489	KP
	490	2
	491	2194
	492	Patient Pa y Componen t Count
	493	RESPONSE P RICING
	494	C95
	495	Patient Pa y Componen t Qual
	496	A/N
	497	KQ
	498	2
	499	2195
	500	Patient Pa y Componen t Qualifie r
	501	RESPONSE P RICING
	502	C96
	503	Payer/Heal th Plan ID Count
	504	N
	505	KR
	506	1
	507	2196
	508	Payer/Heal th Plan ID Count
	509	RESPONSE I NSURANCE
	510	D15
	511	Subrogtn R equestr Re concil ID
	512	A/N
	513	KY
	514	30
	515	2215
	516	Subrogatio n Requesto rs Reconci liation ID
	517	RESPONSE C LAIM
	518	D19
	519	Minimum Am ount
	520	N
	521	M1
	522	10
	523	2219
	524	Minimum Am ount
	525	RESPONSE C LAIM
	526	D20
	527	Minimum Am ount Quali fier
	528	A/N
	529	M2
	530	3
	531	2220
	532	Minimum Am ount Quali fier
	533	RESPONSE C LAIM
	534	D23
	535	Other Paye r Name
	536	A/N
	537	M5
	538	70
	539	2223
	540	Other Paye r Name
	541	RESPONSE O THER PAYER S
	542	D24
	543	Remaining Amount
	544	N
	545	M6
	546	10
	547	2224
	548	Remaining Amount
	549	RESPONSE C LAIM
	550	D25
	551	Remaining Amount Qua lifier
	552	A/N
	553	M7
	554	3
	555	2225
	556	Remaining Amount Qua lifier
	557	RESPONSE C LAIM
	558	D41
	559	Other Paye r Relation ship Type
	560	A/N
	561	PQ
	562	3
	563	2241
	564	Other Paye r Relation ship Type
	565	RESPONSE O THER PAYER S
	566	D42
	567	Formulary Alt Benefi t Tier
	568	A/N
	569	PV
	570	2
	571	2242
	572	Formulary Alternativ e Plan Ben efit Tier
	573	RESPONSE C LAIM
	574	D43
	575	Formulary Alt Reason Code
	576	A/N
	577	PZ
	578	2
	579	2243
	580	Formulary Alternativ e Reason C ode
	581	RESPONSE C LAIM
	582	D44
	583	Formulry A lt Req The rapy Count
	584	A/N
	585	P0
	586	2
	587	2244
	588	Formulary Alternativ e Required Therapy I ndicator C ount
	589	RESPONSE C LAIM
	590	D45
	591	Formulry A lt Therapy Indicator
	592	A/N
	593	P1
	594	2
	595	2245
	596	Formulary Alternativ e Required Therapy I ndicator
	597	RESPONSE C LAIM
	598	D46
	599	Formulry A lt Therapy Time Qual
	600	A/N
	601	P2
	602	2
	603	2246
	604	Formulary Alternativ e Required Therapy T ime Period Qualifier
	605	RESPONSE C LAIM
	606	D47
	607	Formulry A lt Therapy Duration
	608	A/N
	609	P3
	610	3
	611	2247
	612	Formulary Alternativ e Required Therapy T ime Period Duration
	613	RESPONSE C LAIM
	614	D48
	615	Formulary Alt Therap y Start Da te
	616	N
	617	P4
	618	8
	619	2248
	620	Formulary Alternativ e Required Therapy T ime Period Start Dat e
	621	RESPONSE C LAIM
	622	D49
	623	Formulry A lt Therapy End Date
	624	N
	625	P5
	626	9
	627	2249
	628	Formulary Alternativ e Required Therapy T ime Period End Date
	629	RESPONSE C LAIM
	630	D50
	631	Other Paye r Benefit Class
	632	A/N
	633	P6
	634	10
	635	2250
	636	Other Paye r Benefit Classifica tion
	637	RESPONSE O THER PAYER S
	638	D54
	639	Plan Overr ide Indica tor
	640	A/N
	641	RC
	642	6
	643	2254
	644	Plan Benef it Overrid e Indicato r
	645	RESPONSE C LAIM
	646	D55
	647	Plan Overr ide Value Count
	648	N
	649	RD
	650	1
	651	2255
	652	Plan Benef it Overrid e Value Co unt
	653	RESPONSE C LAIM
	654	D56
	655	Plan Benef it Overrid e Value
	656	A/N
	657	RF
	658	10
	659	2256
	660	Plan Benef it Overrid e Value
	661	RESPONSE C LAIM
	662	D62
	663	Regulatory Fee Exmpt Indicator
	664	A/N
	665	RM
	666	1
	667	2262
	668	Regulatory Fee Exemp t Indicato r
	669	RESPONSE P RICING
	670	D65
	671	Patient Re gulatory F ee Amount
	672	N
	673	RS
	674	8
	675	2265
	676	Patient Re gulatory F ee Amount
	677	RESPONSE P RICING
	678
	679	All of the new incom ing fields listed ab ove will h ave the sa me value f or the GET CODE fiel d #10 in f ile 900231 3.91, BPS NCPDP FIEL D DEFS. Th e value fo r the GET CODE field #10 will be "; This is a resp onse-only field whic h does not use the G ET, FORMAT , or SET c ode".
	680
	681
	682	2a The tab le below d escribes h ow the new outgoing fields are going to be added t o the non- coding fie lds in fil e 9002313. 91, BPS NC PDP FIELD DEFS. The re is anot her table that will contain th e coding f ields.
	683
	684	.01 -
	685	NO
	686	.03 - NAME
	687	.04 -
	688	FORMAT
	689	.06
	690	ID
	691	.07 -
	692	LENGTH
	693	1 – VISTA
	694	FIELD NO
	695	1.01 – STA NDARD NCPD P FIELD NA ME
	696	2 – REQUES T SEGMENT
	697	C49
	698	Other Paye r Reconcil iation ID
	699	A/N
	700	9V
	701	30
	702	2149
	703	Other Paye r Reconcil iation ID
	704	COORDINATI ON OF BENE FITS/OTHER
	705	C60
	706	Compound L evel of Co mplexity
	707	A/N
	708	AG
	709	2
	710	2160
	711	Compound L evel of Co mplexity
	712	COMPOUND
	713	C90
	714	LTPAC Bill ing Method ology
	715	N
	716	KH
	717	1
	718	2190
	719	LTPAC Bill ing Method ology
	720	CLAIM
	721	C91
	722	LTPAC Disp ense Frequ ency
	723	N
	724	KK
	725	2
	726	2191
	727	LTPAC Disp ense Frequ ency
	728	CLAIM
	729	C92
	730	Number LTP AC Dispens ing Events
	731	N
	732	KM
	733	3
	734	2192
	735	Number Of LTPAC Disp ensing Eve nts
	736	CLAIM
	737	C98
	738	Preparatio n Environm ent Code
	739	N
	740	KT
	741	3
	742	2198
	743	Preparatio n Environm ent Event Code
	744	CLAIM
	745	C99
	746	Preparatio n Environm ent Type
	747	A/N
	748	KU
	749	2
	750	2199
	751	Preparatio n Environm ent Type
	752	CLAIM
	753	D01
	754	Prescriber DEA Numbe r
	755	A/N
	756	KV
	757	15
	758	2201
	759	Prescriber DEA Numbe r
	760	PRESCRIBER
	761	D02
	762	Total Pres cribed Qty Remaining
	763	N
	764	KW
	765	10
	766	2202
	767	Total Pres cribed Qua ntity Rema ining
	768	CLAIM
	769	D14
	770	Subrogatio n Amount R equested
	771	N
	772	KX
	773	8
	774	2214
	775	Subrogatio n Amount R equested
	776	PRICING
	777	D16
	778	Submission Type Code Count
	779	N
	780	KZ
	781	1
	782	2216
	783	Submission Type Code Count
	784	CLAIM
	785	D17
	786	Submission Type Code
	787	A/N
	788	K8
	789	2
	790	2217
	791	Submission Type Code
	792	CLAIM
	793	D18
	794	Do Not Dis pense Befo re Date
	795	N
	796	K9
	797	8
	798	2218
	799	Do Not Dis pense Befo re Date
	800	CLAIM
	801	D21
	802	Multiple R x/Svc Grou p ID
	803	A/N
	804	M3
	805	35
	806	2221
	807	Multiple P rescriptio n/Service Order Grou p ID
	808	CLAIM
	809	D22
	810	Mult Rx/Sv c Group Re ason Code
	811	A/N
	812	M4
	813	2
	814	2222
	815	Multiple P rescriptio n/Service Order Grou p Reason C ode
	816	CLAIM
	817	D51
	818	Other Payr Tax Exemp t Indicatr
	819	A/N
	820	P7
	821	1
	822	2250
	823	Other Paye r Percenta ge Tax Exe mpt Indica tor
	824	COORDINATI ON OF BENE FITS/OTHER
	825	D52
	826	Other Payr Fee Exmpt Indicatr
	827	A/N
	828	P8
	829	1
	830	2251
	831	Other Paye r Regulato ry Fee Exe mpt Indica tor
	832	COORDINATI ON OF BENE FITS/OTHER
	833	D53
	834	Other Payr Fee Type Count
	835	N
	836	P9
	837	1
	838	2253
	839	Other Paye r Regulato ry Fee Typ e Count
	840	COORDINATI ON OF BENE FITS/OTHER
	841	D57
	842	Prescriber Place of Service
	843	N
	844	RG
	845	2
	846	2257
	847	Prescriber Place of Service
	848	PRESCRIBER
	849	D63
	850	Other Paye r Fee Type Code
	851	A/N
	852	RN
	853	2
	854	2263
	855	Other Paye r Regulato ry Fee Typ e Code
	856	COORDINATI ON OF BENE FITS/OTHER REQUEST
	857
	858
	859	2b The tab le below d escribes h ow the new outgoing fields are going to be added t o what are considere d the codi ng fields in file 90 02313.91, BPS NCPDP FIELD DEFS . In the table belo w the FORM AT CODE fi eld #40 wa s not incl uded becau se it has the same v alue as D0 FORMAT #2 0.
	860
	861	.01-NO
	862	10 – GET C ODE
	863	20 – D0 FO RMAT
	864	30 – SET C ODE
	865	C49
	866	; Handled by SET2149 ^BPSFLD01
	867	; Handled by SET2149 ^BPSFLD01
	868	D SET2149^ BPSFLD01
	869	C60
	870	S BPS("X") =""
	871	S BPS("X") =$$ANFF^BP SECFM($G(B PS(“X”)),2 )
	872	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," C50"),U,10 )=BPS("X")
	873	C90
	874	S BPS("X") =""
	875	S BPS("X") =$$NFF^BPS ECFM($G(BP S("X")),1)
	876	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," C80"),U,10 )=BPS("X")
	877	C91
	878	S BPS("X") =""
	879	S BPS("X") =$$NFF^BPS ECFM($G(BP S("X")),2)
	880	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," C90"),U,1) =BPS("X")
	881	C92
	882	S BPS("X") =""
	883	S BPS("X") =$$NFF^BPS ECFM($G(BP S("X")),3)
	884	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," C90"),U,2) =BPS("X")
	885	C98
	886	S BPS("X") =""
	887	S BPS("X") =$$NFF^BPS ECFM($G(BP S("X")),3)
	888	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," C90"),U,8) =BPS("X")
	889	C99
	890	S BPS("X") =""
	891	S BPS("X") =$$ANFF^BP SECFM($G(B PS(“X”)),2 )
	892	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," C90"),U,9) =BPS("X")
	893	D01
	894	S BPS("X") =$G(BPS("R X",BPS(900 2313.0201) , "Prescri ber DEA"))
	895	S BPS("X") =$$ANFF^BP SECFM($G(B PS(“X”)),1 5)
	896	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," D00"),U,1) =BPS("X")
	897	D02
	898	D FLDD02^B PSOSSG
	899	; Handled by FLDD02^ BPSOSSG
	900	D FLDD02^B PSOSSG
	901	D14
	902	S BPS("X") =""
	903	S BPS("X") =$$NFF^BPS ECFM($G(BP S("X")),8)
	904	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," D10"),U,4) =BPS("X")
	905	D16
	906	S BPS("X") =""
	907	S BPS("X") =$$NFF^BPS ECFM($G(BP S("X")),1)
	908	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," D10"),U,6) =BPS("X")
	909	D17
	910	S BPS("X") =""
	911	S BPS("X") =$$ANFF^BP SECFM($G(B PS(“X”)),2 )
	912	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," D10"),U,7) =BPS("X")
	913	D18
	914	S BPS("X") =""
	915	S BPS("X") =$$NFF^BPS ECFM($G(BP S("X")),8)
	916	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," D10"),U,8) =BPS("X")
	917	D21
	918	S BPS("X") =""
	919	S BPS("X") =$$ANFF^BP SECFM($G(B PS(“X”)),3 5)
	920	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," D20"),U,1) =BPS("X")
	921	D22
	922	S BPS("X") =""
	923	S BPS("X") =$$ANFF^BP SECFM($G(B PS(“X”)),2 )
	924	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," D20"),U,2) =BPS("X")
	925	D51
	926	S BPS("X") =""
	927	S BPS("X") =$$ANFF^BP SECFM($G(B PS(“X”)),1 )
	928	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," D50"),U,1) =BPS("X")
	929	D52
	930	S BPS("X") =""
	931	S BPS("X") =$$ANFF^BP SECFM($G(B PS(“X”)),1 )
	932	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," D50"),U,2) =BPS("X")
	933	D53
	934	S BPS("X") =""
	935	S BPS("X") =$$NFF^BPS ECFM($G(BP S("X")),1)
	936	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," D50"),U,3) =BPS("X")
	937	D57
	938	S BPS("X") =""
	939	S BPS("X") =$$NFF^BPS ECFM($G(BP S("X")),2)
	940	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," D50"),U,7) =BPS("X")
	941	D63
	942	S BPS("X") =""
	943	S BPS("X") =$$ANFF^BP SECFM($G(B PS(“X”)),2 )
	944	S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201)," D60"),U,3) =BPS("X")
	945
	946
	947	3 The tabl e below de scribes ho w new fiel ds appeari ng on both outgoing and incomi ng segment s are goin g to be ad ded to fil e 9002313. 91, BPS NC PDP FIELD DEFS.
	948
	949	.01 -
	950	NO
	951	.03 – NAME
	952	.04 -
	953	FORMAT
	954	.06
	955	ID
	956	.07 -
	957	LENGTH
	958	1 – VISTA
	959	FIELD NO
	960	1.01 – STA NDARD NCPD P FIELD NA ME
	961	2 – REQUES T SEGMENT
	962	3 – RESPON SE SEGMENT
	963	C47
	964	Other Paye r Program Type
	965	A/N
	966	9T
	967	3
	968	2147
	969	Other Paye r Adjudica ted Progra m Type
	970	RESPONSE O THER PAYER S SEGMENT
	971	C50
	972	Benefit St age Indica tor Count
	973	N
	974	9W
	975	1
	976	2150
	977	Benefit St age Indica tor Count
	978	COORDINATI ON OF BENE FITS/OTHER , RESPONS E PRICING
	979	C51
	980	Benefit St age Indica tor
	981	A/N
	982	9X
	983	2
	984	2151
	985	Benefit St age Indica tor
	986	COORDINATI ON OF BENE FITS/OTHER , RESPONSE PRICING
	987	D60
	988	Regulatory Fee Count
	989	N
	990	RK
	991	1
	992	2260
	993	Regulatory Fee Count
	994	PRICING,
	995	RESPONSE P RICING
	996	D61
	997	Regulatory Fee Type Code
	998	A/N
	999	RL
	1000	2
	1001	2261
	1002	Regulatory Fee Type Code
	1003	PRICING,
	1004	RESPONSE P RICING
	1005
	1006	The D0 LEN GTH #.08 h as the sam e value as the LENGT H #.07 and the D0 FO RMAT #.09 has the sa me value a s the FORM AT #.04 fo r the BPS NCPDP FIEL D DEFS tab les above.
	1007
	1008	4 The tabl e below de scribes ho w the new outgoing f ields are going to b e added to file 9002 313.0201, BPS CLAIMS , TRANSACT IONS sub-f ile.
	1009
	1010	* - the NC PDP field number is not part o f file 900 2313.0201 it was add ed only as a referen ce
	1011
	1012	NCPDP fiel d # *
	1013	NAME
	1014	FIELD
	1015	NO
	1016	NODE;
	1017	PIECE
	1018	FIELD TYPE
	1019	/ LENGTH
	1020	DESCRIPTIO N
	1021	C47-9T
	1022	OTHER PAYE R PROGRAM TYPE
	1023	2147
	1024	C40;7
	1025	POINTER / 9002313.38
	1026	The type o f prescrip tion benef it plan/pr ogram asso ciated wit h the Othe r Payer.
	1027	C49-9V
	1028	OTHER PAYE R RECONCIL IATION ID
	1029	2149
	1030	C40;9
	1031	FREE TEXT / 30
	1032	Reconcilia tion ID (B 98-34) as reported b y the Othe r Payer fo r Paid/Acc epted tran sactions O R for Info rmation Re porting tr ansactions , the desi gnated def ault value for repor ting a pre vious paye r's reject ed respons e as desig nated in t he Other P ayer Rejec t Code val ue(s) repo rted in th e COB clai m.
	1033	C50-9W
	1034	BENEFIT ST AGE INDICA TOR COUNT
	1035	2150
	1036	C40;10
	1037	NUMERIC
	1038	/ 1
	1039	Count of B enefit Sta ge Indicat or (C51-9X ) occurren ces.
	1040	C51-9X
	1041	BENEFIT ST AGE INDICA TOR
	1042	2151
	1043	C50;1
	1044	POINTER / 9002313.35
	1045	Code ident ifying the Benefit S tage(s) wh ich applie d to the c laim at th e time of adjudicati on.
	1046	C60-AG
	1047	COMPOUND L EVEL OF CO MPLEXITY
	1048	2160
	1049	C50;10
	1050	SET OF COD ES
	1051	Value used by the ph armacy to indicate t he complex ity involv ed in the preparatio n of the c ompounded prescripti on. 1=Low Level Com plexity, 1 0=Mid-Leve l Comp Non -Hazardous , 20=Mid-L evel Comp Hazardous, 30=High L evel Non-H azardous, 40=High Le vel Hazard ous, 50=Hi gh Level N on-Hazardo us Sterile , 60=High Level Haza rdous Ster ile
	1052	C90-KH
	1053	LTPAC BILL ING METHOD OLOGY
	1054
	1055	2190
	1056	C80;10
	1057	SET OF COD ES
	1058	/ 1
	1059	Code indic ating the billing me thodology used for t he claim.
	1060	1=Full qua ntity (dis pensed on date of se rvice),
	1061	2=Post-con sumption ( One or mor e dispensi ngs make u p the tota l quantity on the cl aim has be en dispens ed.), 3=Pr e-consumpt ion (One o r more dis pensings m ake up the total qua ntity on t he claim, but all di spsensings that make up the to tal quanti ty on the claim have not yet o ccurred.)
	1062	C91-KK
	1063	LTPAC DISP ENSE FREQU ENCY
	1064
	1065	2191
	1066	C90;1
	1067	POINTER / 9002313.36
	1068	Code indic ating the frequency of dispens ing medica tion to a LTPAC pati ent.
	1069	C92-KM
	1070	NUMBER LTP AC DISPENS ING EVENTS
	1071	2192
	1072	C90;2
	1073	NUMERIC
	1074	/ 3
	1075	Value indi cating the number of times pha rmacy disp ensed prod uct or ser vice for t he claim p eriod requ ested.
	1076	C98-KT
	1077	PREPARATIO N ENVIRONM ENT CODE
	1078	2198
	1079	C90;8
	1080	SET OF COD ES
	1081	Event whic h required a special preparati on environ ment.
	1082	Values: 1= Pill Split ting, 2=Ot her
	1083	C99-KU
	1084	PREPARATIO N ENVIRONM ENT TYPE
	1085	2199
	1086	C90;9
	1087	FREE TEXT
	1088	/ 2
	1089	Code ident ifying the environme nt in whic h the medi cation was prepared. 1=Speci fic Pressu re Environ ment Not R equired/No t Used, 2= Positive P ressure No n-sterile/ Non-hazard ous, 3=Neg ative Pres sure Non-s terile/Haz ardous, 4= Positive P ressure St erile/Non- hazardous, 5=Negativ e Pressure Sterile/H azardous
	1090	D01-KV
	1091	PRESCRIBER DEA NUMBE R
	1092
	1093	2201
	1094	D00;1
	1095	FREE TEXT
	1096	/ 15
	1097	ID assigne d to a hea lth care p rovider (e .g. Practi tioner, Ho spital, Ma nufacturer , etc.) by the US Dr ug Enforce ment Admin istration, allowing them to di stribute, dispense, administer , or condu ct researc h with res pect to co ntrolled s ubstances in the cou rse of pro fessional practice o r research .
	1098	D02-KW
	1099	TOTAL PRES CRIBED QTY REMAINING
	1100	2202
	1101	D00;2
	1102	NUMERIC
	1103	/ 10
	1104	Accumulate d Total Pr escribed Q uantity Re maining as of the da te of serv ice. Calcu lated valu e based on : (Prescri bed Quanti ty (460-ET )) * (Numb er Of Refi lls Author ized (415- DF) + 1) - Accumulat ed Quantit y Dispense d (442-E7) for each previous f ill.
	1105	D14-KX
	1106	SUBROGATIO N AMOUNT R EQUESTED
	1107	2214
	1108	D10;4
	1109	NUMERIC
	1110	/ 8
	1111	Amount pai d by the p lan to the pharmacy.
	1112	D16-KZ
	1113	SUBMISSION TYPE CODE COUNT
	1114
	1115	2216
	1116	D10;6
	1117	NUMERIC
	1118	/ 1
	1119	Count of t he Submiss ion Type C ode (D17-K 8) occurre nces.
	1120	D17-K8
	1121	SUBMISSION TYPE CODE
	1122	2217
	1123	D10;7
	1124	SET OF COD ES
	1125	Code ident ifying the type of s ubmission as needed for approp riate tran saction pr ocessing.
	1126	AA=340B, A B=Split Bi lling, AC= Encounter
	1127	D18-K9
	1128	DO NOT DIS PENSE BEFO RE DATE
	1129
	1130	2218
	1131	D10;8
	1132	NUMERIC
	1133	/ 8
	1134	The earlie st date th e prescrib er indicat es a presc ribed drug can be di spensed.
	1135	D21-M3
	1136	MULTIPLE R X/SVC GROU P ID
	1137	2221
	1138	D20;1
	1139	FREE TEXT
	1140	/ 35
	1141	Unique ID assigned b y the pres criber or pharmacy s ystem to l ink multip le product orders to gether.
	1142	D22-M4
	1143	MULTIPLE R X/SVC GROU P REASON C ODE
	1144	2222
	1145	D20;2
	1146	SET OF COD ES
	1147	Indicates the reason for the q uantity di spensed an d/or days supply as a result o f the pres criber iss uing group ed prescri ptions. 1=Injectab le Therapy , 2=Loadin g Qty, 3=M aintenance Qty, 4=Un breakable Pkg Multip le Locatio ns, 5=Tria l Fill, 6= Non-Commer cially Ava ilable Dos e, 7=Bundl ed Health Care Servi ce
	1148	D51-P7
	1149	OTHER PAYR TAX EXEMP T INDICATR
	1150	2251
	1151	D50;1
	1152	SET OF COD ES
	1153	Code indic ating the source of the percen tage tax e xempt stat us of the other paye r's claim. 1=Othe r Payer/Pl an Is Tax Exempt, 2= Other Paye r Religiou s Organiza tion, 3=Ot her Payer Tax Exempt Certifica te
	1154	D52-P8
	1155	OTHER PAYR FEE EXMPT INDICATR
	1156	2252
	1157	D50;2
	1158	SET OF COD ES
	1159	Code Indic ating the source of the regula tory fee e xempt stat us of the other paye r's claim.
	1160	1=Other Pa yer/Plan i s Regulato ry Fee Exe mpt,
	1161	2=Other Pa yer Religi ous Organi zation, 3= Other Paye r Regulato ry Fee Exe mpt Certif icate
	1162	D53-P9
	1163	OTHER PAYR FEE TYPE COUNT
	1164	2253
	1165	D50;3
	1166	NUMERIC / 1
	1167	Count of O ther Payer Regulator y Fee Type Code.
	1168	D57-RG
	1169	PRESCRIBER PLACE OF SERVICE
	1170	2257
	1171	D50;7
	1172	POINTER / 9002313.34
	1173	Code ident ifying the place whe re the pat ient encou nter occur red as rep orted by t he prescri ber.
	1174	D60-RK
	1175	REGULATORY FEE COUNT
	1176	2260
	1177	D50;10
	1178	NUMERIC / 1
	1179	Count of R egulatory Fee Type C ode (D61-R L).
	1180	D61-RL
	1181	REGULATORY FEE TYPE CODE
	1182	2261
	1183	D60;1
	1184	FREE TEXT
	1185	/ 2
	1186	Code ident ifying the type of r egulatory fee. AA =LA RS 46: 2625, AB=o ther
	1187	D63-RS
	1188	OTHER PAYE R FEE TYPE CODE
	1189	2263
	1190	D60;3
	1191	FREE TEXT
	1192	/ 2
	1193	Code ident ifying the type of R egulatory Fee report ed by the other paye r. AA=L A RS 46:26 25, AB=Oth er
	1194
	1195	5 The tabl e below de scribes ho w the new incoming f ields are going to b e added to file 9002 313.0301, BPS RESPON SES, RESPO NSES sub-f ile.
	1196
	1197	* - the NC PDP field number is not part o f file 900 2313.0301 it was add ed only as a referen ce
	1198
	1199	NCPDP fiel d # *
	1200	NAME
	1201	FIELD
	1202	NO
	1203	NODE;PIECE
	1204	FIELD TYPE / LENGTH
	1205	DESCRIPTIO N
	1206	931-F8
	1207	MAXIMUM AG E QUALIFIE R
	1208	931
	1209	930;1
	1210	SET OF COD ES
	1211	Qualifies Maximum Ag e (932-GA)
	1212	D-days (24 -hr period s), Y-year s (12-mont h periods)
	1213	932-GA
	1214	MAXIMUM AG E
	1215	932
	1216	930;2
	1217	NUMBER / 3
	1218	Maximum ag e at which the produ ct/service is covere d (inclusi ve). Quali fied by Ma ximum Age Qualifier (931-F80).
	1219	933-GB
	1220	MAXIMUM AM OUNT
	1221	933
	1222	930;3
	1223	FREE TEXT / 10
	1224	Qualified by Maximum Amount Qu alifier (9 34-GC).
	1225	OUTPUT TRA NSFORM: S Y=$J($$NFF ^BPSECFM(Y ,10),10,3)
	1226	934-GC
	1227	MAXIMUM AM OUNT QUALI FIER
	1228	934
	1229	930;4
	1230	SET OF COD ES
	1231	Qualifies Maximum Am ount (933- GB).
	1232	DL=Dollar Amount, DS =Days Supp ly, FL=Fil ls, QY=Qua ntity
	1233	935-GF
	1234	MAXIMUM AM OUNT TIME PERIOD
	1235	935
	1236	930;5
	1237	SET OF COD ES
	1238	Type of ti me period associated with the overall Ma ximum Amou nt Qualifi er (934-GC ).
	1239	CM=Calenda r Month, C Q=Calendar Quarter, CY=Calenda r Year, DY =Days, LT= Lifetime, PD=Per Dis pensing, S P=Specific Date Rang e
	1240	936-GG
	1241	MAX AMT TI ME PERIOD START DATE
	1242	936
	1243	930;6
	1244	FREE TEXT / 8
	1245	Starting d ate of Spe cific Date Range.
	1246	937-GH
	1247	MAX AMT TI ME PERIOD END DATE
	1248	937
	1249	930;7
	1250	FREE TEXT / 8
	1251	Ending dat e of Speci fic Date R ange.
	1252	938-GJ
	1253	MAX AMT TI ME PERIOD UNITS
	1254	938
	1255	930;8
	1256	NUMBER / 4
	1257	Number of units asso ciated wit h the over all Maximu m Amount T ime Period (935-GF).
	1258	943-GQ
	1259	MINIMUM AG E QUALIFIE R
	1260	943
	1261	940;3
	1262	FREE TEXT / 1
	1263	Qualifies Minimum Ag e (944-GR) .
	1264	D=Days, Y= Years
	1265	944-GR
	1266	MINIMUM AG E
	1267	944
	1268	940;4
	1269	NUMBER / 3
	1270	Qualified by Minimum Age Quali fier (943- GQ).
	1271	C47-9T
	1272	OTHER PAYE R PROGRAM TYPE
	1273	2147
	1274	C40;7
	1275	FREE TEXT / 3
	1276	The type o f prescrip tion benef it plan/pr ogram asso ciated wit h the Othe r Payer.
	1277	C50-9W
	1278	BENEFIT ST AGE INDICA TOR COUNT
	1279	2150
	1280	C40;10
	1281	NUMBER / 1
	1282	Count of B enefit Sta ge Indicat or (C51-9X ) occurren ces.
	1283	C51-9X
	1284	BENEFIT ST AGE INDICA TOR
	1285	2151
	1286	C50;1
	1287	POINTER / 9002313.35
	1288	Code ident ifying the Benefit S tage(s) wh ich applie d to the c laim at th e time of adjudicati on.
	1289	C58-AE
	1290	BENEFIT TY PE OPPORTU NITY
	1291	2158
	1292	C50;8
	1293	FREE TEXT / 2
	1294	The type o f addition al benefit the patie nt is elig ible for.
	1295	1=Flu Vacc ine Benefi t, 2=90 Da y At Retai l
	1296	C59-AF
	1297	BENEFIT TY PE OPPORTU NITY COUNT
	1298	2159
	1299	C50;9
	1300	NUMERIC / 1
	1301	Count of B enefit Typ e Opportun ity (C58-A E) that fo llow.
	1302	C66-BA
	1303	HELP DESK BUSINESS U NIT TYPE
	1304	2166
	1305	C60;6
	1306	FREE TEXT / 2
	1307	The type o f help des k support that is av ailable. 1 =Pharmacy Help Desk, 2=Clinica l/PA, 3=He alth Plan, 4=Eligibi lity-3rd P arty Liabi lity, 5=Ot her
	1308	C67-BB
	1309	HELP DESK BUS UNIT T YPE COUNT
	1310	2167
	1311	C60;7
	1312	NUMERIC / 2
	1313	The number of Help D esk Busine ss Unit Ty pes (C66-B A).
	1314	C68-BC
	1315	HELP DESK CONTACT IN FORMATION
	1316	2168
	1317	C60;8
	1318	FREE TEXT / 255
	1319	Value of t he specifi c help des k contact informatio n (e.g.: T elephone N umber, Fax Number, U RL).
	1320	C69-BD
	1321	HELP DESK CONTACT IN FO EXT
	1322	2169
	1323	C60;9
	1324	FREE TEXT / 8
	1325	Extension of the hel p desk con tact infor mation.
	1326	C70-BF
	1327	HELP DESK CONTACT IN FO QUAL
	1328	2170
	1329	C60;10
	1330	SET OF COD ES
	1331	Code quali fying the value in t he Help De sk Contact Informati on (C68-BC ). 1=Te lephone Nu mber, 2=Fa x Number, 3=URL, 4=O ther
	1332	C71-BG
	1333	HELP DESK SUPPORT TY PE
	1334	2171
	1335	C70;1
	1336	SET OF COD ES
	1337	The intend ed entity responsibl e for cont acting the help desk . 1=Pharm acy, 2=Pre scriber, 3 =Member Se rvices, 4= Other Paye r-N1 Repor ting, 5=Ot her
	1338	C72-BH
	1339	HELP DESK SUPPORT TY PE COUNT
	1340	2172
	1341	C70;2
	1342	NUMERIC / 2
	1343	The number of Help D esk Contac t Support Types.
	1344	C80-G8
	1345	INTERMEDIA RY HELP DE SK TYPE
	1346	2180
	1347	C70;10
	1348	SET OF COD ES
	1349	The type o f intermed iary help desk suppo rt that is available . 1-In termediary /Switch, 2 =REMS-Risk Evaluatio n Mitigati on Strateg y, 3=PDMP- Prescripti on Drug Mo nitoring P rogram, 4= Other
	1350	C81-G9
	1351	INTERMEDIA RY HLPDSK BUS COUNT
	1352	2181
	1353	C80;1
	1354	NUMERIC / 2
	1355	The number of Interm ediary Hel p Desk Bus iness Unit Types (C8 0-G8).
	1356	C82-JP
	1357	INTERMEDIA RY HLPDSK CONTACT
	1358	2182
	1359	C80;2
	1360	FREE TEXT / 255
	1361	Value of t he specifi c intermed iary help desk conta ct informa tion (e.g. : Telephon e Number, Fax Number , URL).
	1362	C83-JR
	1363	INTERMEDIA RY HLPDSK EXTENSION
	1364	2183
	1365	C80;3
	1366	FREE TEXT / 8
	1367	Extension of the int ermediary help desk contact in formation.
	1368	C84-KA
	1369	INTERMEDIA RY HLPDSK QUALIFIER
	1370	2184
	1371	C80;4
	1372	SET OF COD ES
	1373	Code quali fying the value in t he Interme diary Help Desk Cont act Inform ation (C82 -JP). 1 =Telephone Number, 2 =Fax Numbe r, 3=URL, 4=Other
	1374	C85-KB
	1375	INTERMEDIA RY HLPDSK SUPPT TYPE
	1376	2185
	1377	C80;5
	1378	SET OF COD ES
	1379	The intend ed entity responsibl e for cont acting the intermedi ary help d esk. 1=P harmacy, 2 =Prescribe r, 3=Membe r Services , 4=Other
	1380	C86-KC
	1381	INTERMEDIA RY HLPDSK TYP COUNT
	1382	2186
	1383	C80;6
	1384	NUMERIC / 2
	1385	The number of Interm ediary Hel p Desk Con tact Suppo rt Types.
	1386	C93-KN
	1387	PATIENT PA Y COMPONEN T AMOUNT
	1388	2193
	1389	C90;3
	1390	FREE TEXT / 8
	1391	The cost s hare amoun t attribut ed to the component of Patient Pay Amoun t (505-F5) .
	1392	OUTPUT TRA NSFORM:
	1393	S Y="$"_ $J($$DFF2E XT^BPSECFM (Y),7,2)
	1394	C94-KP
	1395	PATIENT PA Y COMPONEN T COUNT
	1396
	1397	2194
	1398	C90;4
	1399	NUMERIC / 2
	1400	Count of P atient Pay Component Qualifier (s) (C95-K Q) AND Pat ient Pay C omponent A mount(s) ( C93-KN) oc currences.
	1401	C95-KQ
	1402	PATIENT PA Y COMPONEN T QUAL
	1403
	1404	2195
	1405	C90;5
	1406	POINTER / 9002313.37
	1407	Code quali fying the Patient Pa y Componen t Amount ( C93-KN).
	1408	C96-KR
	1409	PAYER/HEAL TH PLAN ID COUNT
	1410	2196
	1411	C90;6
	1412	NUMERIC / 1
	1413	Count of P ayer/Healt h Plan ID Occurrence s.
	1414	D15-KY
	1415	SUBROGTN R EQUESTR RE CONCIL ID
	1416	2215
	1417	D10;5
	1418	FREE TEXT / 30
	1419	The Reconc iliation I D returned to the ph armacy on the paid c laim trans action fro m the orig inal/reque sting paye r.
	1420	D19-M1
	1421	MINIMUM AM OUNT
	1422	2219
	1423	D10;9
	1424	FREE TEXT / 10
	1425	Minimum am ount for a quantity limit as s pecified i n the Mini mum Amount Qualifier (D20-M2).
	1426	OUTPUT TRA NSFORM: S Y=$J($$NFF ^BPSECFM(Y ,10),10,3)
	1427	D20-M2
	1428	MINIMUM AM OUNT QUALI FIER
	1429	2220
	1430	D10;10
	1431	SET OF COD ES
	1432	Qualifies the amount in the Mi nimum Amou nt (D19-M1 ) field. MDL=Min Dollar Amt , MDS=Min Day Supply , MFL=Min Fills, MQY =Min Qty
	1433	D23-M5
	1434	OTHER PAYE R NAME
	1435	2223
	1436	D20;3
	1437	FREE TEXT / 70
	1438	Name of th e other pa yer.
	1439	D24-M6
	1440	REMAINING AMOUNT
	1441	2224
	1442	D20;4
	1443	FREE TEXT / 10
	1444	Qualified by Remaini ng Amount Qualifier (D25-M7).
	1445	Remaining Benefit Am ount as it relates t o benefit dollars is represent ed in Rema ining Bene fit Amount (514-FE) field.
	1446	OUTPUT TRA NSFORM: S Y=$J($$NFF ^BPSECFM(Y ,10),10,3)
	1447	D25-M7
	1448	REMAINING AMOUNT QUA LIFIER
	1449	2225
	1450	D20;5
	1451	SET OF COD ES
	1452	Qualifies Remaining Amount (D2 4-M6). RDS =Remaining Days Supp ly, RFL=Re maining Fi lls, RQY=R emaining Q ty
	1453	D41-PQ
	1454	OTHER PAYE R RELATION SHIP TYPE
	1455
	1456	2241
	1457	D40;1
	1458	SET OF COD ES
	1459	Identifies the relat ionship of the other payer inf ormation r eturned by the repor ting payer or entity for coord ination wi th the Oth er Payer C overage Ty pe (338-5C ) value fo r that pay er. CP= COB Covera ge Prior t o Respondi ng Payer, CS=COB Cov erage Subs equent to Responding Payer, MX =Mutually Exclusive Benefits, CC=Change in Coverag e, RP=Resp onding Pay er, CE=Cen tralized E ligibility
	1460	D42-PV
	1461	FORMULARY ALT BENEFI T TIER
	1462	2242
	1463	D40;2
	1464	SET OF COD ES
	1465	Patient co st share t ier applie d to the f ormulary a lternative product. 1=Tier 1 , 2=Tier 2 , 3=Tier 3 , 4=Tier 4 , 5=Tier 5 , 9=Other
	1466	D43-PZ
	1467	FORMULARY ALT REASON CODE
	1468	2243
	1469	D40;3
	1470	SET OF COD ES
	1471	Reason for formulary alternati ve option( s).
	1472	1=Step The rapy Requi red, 2=Pre scribed Dr ug Is Non- Formulary, 3=Prescri bed Drug R equires Pr ior Author ization, 4 =Preferred Product
	1473	D44-P0
	1474	FORMULRY A LT REQ THE RAPY COUNT
	1475	2244
	1476	D40;4
	1477	FREE TEXT / 2
	1478	Count of F ormulary A lternative Required Therapy In dicator Oc currences.
	1479	D45-P1
	1480	FORMULRY A LT THERAPY INDICATOR
	1481	2245
	1482	D40;5
	1483	SET OF COD ES
	1484	Code ident ifying req uired trea tment with specified formulary alternati ve. 1=R equired Tr eatment no t otherwis e specifie d, 2=Requi red Treatm ent, minim um time pe riod durat ion requir ed, 3=Requ ired Treat ment withi n specifie d Time Per iod Range
	1485	D46-P2
	1486	FORMULRY A LT THERAPY TIME QUAL
	1487	2246
	1488	D40;6
	1489	SET OF COD ES
	1490	Code quali fying Form ulary Alte rnative Re quired The rapy Time Period Dur ation. 1= Days, 2=Ca lendar Mon th, 3=Cale ndar Quart ers, 4=Cal endar Year s, 5=Speci fied Date Range
	1491	D47-P3
	1492	FORMULRY A LT THERAPY DURATION
	1493
	1494	2247
	1495	D40;7
	1496	FREE TEXT / 3
	1497	Minimum am ount of ti me period duration f or require d therapy. Qualified by Formul ary Altern ative Requ ired Thera py Time Pe riod Quali fier (D46- P2).
	1498	D48-P4
	1499	FORMULRY A LT THERAPY START DAT E
	1500	2248
	1501	D40;8
	1502	DATE / 8
	1503	Start date for the r equired th erapy time period ra nge.
	1504	D49-P5
	1505	FORMULRY A LT THERAPY END DATE
	1506	2249
	1507	D40;9
	1508	DATE / 8
	1509	End date f or the req uired ther apy time p eriod rang e.
	1510	D50-P6
	1511	OTHER PAYE R BENEFIT CLASS
	1512	2250
	1513	D40;10
	1514	FREE TEXT/ 10
	1515	Identifies the benef it classif ication fo r other pa yer inform ation asso ciated to the patien t. BEHAVOR IAL, DENTA L, DME, ME DICAL, RX, VISION, U NKNOWN
	1516	D54-RC
	1517	PLAN OVERR IDE INDICA TOR
	1518
	1519	2254
	1520	D50;4
	1521	FREE TEXT / 6
	1522	Restricted to valid NCPDP Tele communicat ion reques t fields ( field numb er-ID). Ex ample: 420 -DK, 462-E V, etc.
	1523	D55-RD
	1524	PLAN OVERR IDE VALUE COUNT
	1525
	1526	2255
	1527	D50;5
	1528	NUMERIC / 1
	1529	Count of p lan benefi t override values.
	1530	D56-RF
	1531	PLAN BENEF IT OVERRID E VALUE
	1532	2256
	1533	D50;6
	1534	FREE TEXT / 10
	1535	Identifies the plan supported value(s) f or the fie ld identif ied in Pla n Benefit Override I ndicator ( D54-RC).
	1536	D60-RK
	1537	REGULATORY FEE COUNT
	1538	2260
	1539	D50;10
	1540	NUMERIC / 1
	1541	Count of R egulatory Fee Type C ode (D61-R L).
	1542	D61-RL
	1543	REGULATORY FEE TYPE CODE
	1544	2261
	1545	D60;1
	1546	FREE TEXT / 2
	1547	Code ident ifying the type of r egulatory fee.
	1548	AA=LA RS 4 6:2625, AB =other
	1549	D62-RM
	1550	REGULATORY FEE EXMPT INDICATOR
	1551
	1552	2262
	1553	D60;2
	1554	SET OF COD ES
	1555	Code indic ating the source of the regula tory fee e xempt stat us of the claim. 1= Payer/Plan Is Regula tory Fee E xempt, 2=R eligious O rganizatio n, 3=Regul atory Fee Exempt Cer tificate
	1556	D65-RS
	1557	PATIENT RE GULATORY F EE AMOUNT
	1558
	1559	2265
	1560	D60;5
	1561	NUMERIC / 8
	1562	Patient re gulatory f ee amount obligation or portio n thereof when benef it is set up to dire ctly pass regulatory fee onto the patien t.
	1563
	1564
	1565
	1566
	1567
	1568	The new fi eld defini tions, lis ted in the table(s), will be a dded to Fi le 9002313 .91, BPS N CPDP FIELD DEFS, in our develo pment envi ronment. T he file wi ll be incl uded in ou r patch, s o that the new field s will be included i n the KIDS Build. W hen the KI DS Build i s installe d at the s ites, the new fields will be a utomatical ly added t o File 900 2313.91 on their sys tem.
	1569	The data d ictionary for file 9 002313.91, BPS NCPDP FIELD DEF S, will be sent with data to t he target sites. Th e table be low descri bes how th e file is to be incl uded in th e KIDS Bui ld.
	1570
	1571	File Name
	1572	BPS NCPDP FIELD DEFS
	1573	Send Full or Partial DD
	1574	FULL
	1575	Update the Data Dict ionary
	1576	YES
	1577	Send Secur ity Codes
	1578	YES
	1579	Screen to Determine DD Update
	1580	n/a
	1581	Data Comes with File
	1582	YES
	1583	Site’s Dat a
	1584	OVERWRITE
	1585	Resolve Po inters
	1586	NO
	1587	May User O verride Da ta Update
	1588	NO
	1589	Data List
	1590	n/a
	1591	Screen to Select Dat a
	1592	n/a
	1593
	1594	The new fi elds, list ed in the table(s) a bove, will be added to File 90 02313.02, BPS CLAIMS , in our t est enviro nment, and that file will be i ncluded in our patch , so that the new fi elds will be include d in the K IDS Build. When the KIDS Buil d is insta lled, the new fields will be a utomatical ly added t o File 900 2313.02.
	1595	The data d ictionary for file 9 002313.020 1, BPS CLA IMS-TRANSA CTIONS sub -file, wil l be sent without da ta to the target sit es. The t able below describes how the f ile is to be include d in the K IDS Build.
	1596	File Name
	1597	BPS CLAIMS
	1598	Send Full or Partial DD
	1599	PARTIAL
	1600	Data Dicti onary Numb er
	1601	9002313.02 01
	1602	Field Numb er
	1603	2147, 2149 , 2150, 21 51, 2160, 2190, 2191 , 2192, 21 98, 2199, 2201, 2202 , 2214, 22 16, 2217, 2218, 2221 , 2222, 22 51, 2252, 2253, 2257 , 2260, 22 61, 2263
	1604	Update the Data Dict ionary
	1605	YES
	1606	Send Secur ity Codes
	1607	NO
	1608	Screen to Determine DD Update
	1609	N/A
	1610	Data Comes with File
	1611	NO
	1612
	1613	The new fi elds, list ed in the table(s) a bove, will be added to File 90 02313.03, BPS RESPON SES, in ou r test env ironment, and that f ile will b e included in our pa tch, so th at the new fields wi ll be incl uded in th e KIDS Bui ld. When the KIDS B uild is in stalled, t he new fie lds will b e automati cally adde d to File 9002313.03 .
	1614	The data d ictionary for file 9 002313.030 1, BPS RES PONSES-RES PONSES sub -file, wil l be sent without da ta to the target sit es. The t able below describes how the f ile is to be include d in the K IDS Build.
	1615	File Name
	1616	BPS RESPON SES
	1617	Send Full or Partial DD
	1618	PARTIAL
	1619	Data Dicti onary Numb er
	1620	9002313.03 01
	1621	Field Numb er
	1622	931, 932, 933, 934, 935, 936, 937, 938, 943, 944, 2147, 2150 , 2151, 21 58, 2159, 2166, 2167 , 2168, 21 69, 2170, 2171, 2172 , 2180, 21 81, 2182, 2183, 2184 , 2185, 21 86, 2193, 2194, 2195 , 2196, 22 15, 2219, 2220, 2223 , 2224, 22 25, 2241, 2242, 2243 , 2244, 22 45, 2246, 2247, 2248 , 2249, 22 50, 2254, 2255, 2256 , 2261, 22 62, 2265
	1623	Update the Data Dict ionary
	1624	YES
	1625	Send Secur ity Codes
	1626	NO
	1627	Screen to Determine DD Update
	1628	N/A
	1629	Data Comes with File
	1630	NO
	1631
	1632	A new File 9002313.3 4, BPS NCP DP PRESCRI BER PLACE OF SERVICE , will nee d to be ad ded. The informatio n about th e new file is descri bed in the table bel ow.
	1633
	1634	File Name
	1635	BPS NCPDP PRESCRIBER PLACE OF SERVICE
	1636	File Numbe r
	1637	9002313.34
	1638	Internal G lobal Refe rence
	1639	^BPS(90023 13.34,
	1640	Descriptio n
	1641	NCPDP fiel d D57-RG P RESCRIBER PLACE OF S ERVICE COD E
	1642
	1643	This file is used to store the possible NCPDP PRES CRIBER PLA CE OF SERV ICE CODES, that can be sent wi th a claim . No local changes s hould ever be made t o this fil e. The da ta stored in this fi le is base d on the N CPDP stand ards and a re nationa lly distri buted.
	1644
	1645	Per VHA Di rective 20 04-038, th is file de finition s hould not be modifie d.
	1646
	1647	This new f ile will c ontain the list of P lace of Se rvice Code s for NCDP D field D5 7-RG Presc riber Plac e of Servi ce. The c odes that are being added are described in the tab le below.
	1648
	1649	.01 - CODE
	1650	.02 - NAME
	1651	1
	1652	PHARMACY
	1653	2
	1654	TELEHEALTH
	1655	3
	1656	SCHOOL
	1657	4
	1658	HOMELESS S HELTER
	1659	5
	1660	INDIDAN HE ALTH SERVI CE FREE-ST ANDING FAC ILITY
	1661	6
	1662	INDIAN HEA LTH SERVIC E PROVIDER -BASED FAC ILITY
	1663	7
	1664	TRIBAL 638 FREE-STAN DING FACIL ITY
	1665	8
	1666	TRIBAL 638 PROVIDER- BASED FACI LITY
	1667	9
	1668	PRISON/COR RECTIONAL FACILITY
	1669	11
	1670	OFFICE
	1671	12
	1672	HOME
	1673	13
	1674	ASSISTED L IVING FACI LITY
	1675	14
	1676	GROUP HOME
	1677	15
	1678	MOBILE UNI T
	1679	16
	1680	TEMPORARY LODGING
	1681	17
	1682	WALK-IN RE TAIL HEALT H CLINIC
	1683	18
	1684	PLACE OF E MPLOYMENT- WORKSITE
	1685	19
	1686	OFF CAMPUS -OUTPATIEN T HOSPITAL
	1687	20
	1688	URGENT CAR E FACILITY
	1689	21
	1690	INPATIENT HOSPITAL
	1691	22
	1692	ON CAMPUS- OUTPATIENT HOSPITAL
	1693	23
	1694	EMERGENCY ROOM-HOSPI TAL
	1695	24
	1696	AMBULATORY SURGICAL CENTER
	1697	25
	1698	BIRTHING C ENTER
	1699	26
	1700	MILIARY TR EATMENT FA CILITY
	1701	31
	1702	SKILLED NU RSING FACI LITY
	1703	32
	1704	NURSING FA CILITY
	1705	33
	1706	CUSTODIAL CARE FACIL ITY
	1707	34
	1708	HOSPICE
	1709	41
	1710	AMBULANCE- LAND
	1711	42
	1712	AMBULANCE- AIR OR WAT ER
	1713	49
	1714	INDEPENDEN T CLINIC
	1715	50
	1716	FEDERALLY QUALIFIED HEALTH CEN TER
	1717	51
	1718	INPATIENT PSYCHIATRI C FACILITY
	1719	52
	1720	PSYCHIATRI C FACILITY -PARTIAL H OSPITALIZA TION
	1721	53
	1722	COMMUNITY MENTAL HEA LTH CENTER
	1723	54
	1724	INTERMEDIA TE CARE FA CILITY/IND IVIDUALS W ITH INTELL ECTUAL DIS ABILITIES
	1725	55
	1726	RESIDENTAI L SUBSTANC E ABUSE TR EATMENT FA CILITY
	1727	56
	1728	PSYCHIATRI C RESIDENT IAL TREATM ENT CENTER
	1729	57
	1730	NON-RESIDE NTIAL SUBS TANCE ABUS E TREATMEN T FACILITY
	1731	60
	1732	MASS IMMUN IZATION CE NTER
	1733	61
	1734	COMPREHENS IVE INPATI ENT REHABI LITATION F ACILITY
	1735	62
	1736	COMPREHENS IVE OUTPAT IENT REHAB ILITATION FACILITY
	1737	65
	1738	END-STAGE RENAL DISE ASE TREATM ENT FACILI TY
	1739	71
	1740	PUBLIC HEA LTH CLINIC
	1741	72
	1742	RURAL HEAL TH CLINIC
	1743	81
	1744	INDEPENDEN T LABORATO RY
	1745	99
	1746	OTHER PLAC E OF SERVI CE
	1747
	1748	The new pl ace of ser vice codes will be a dded to Fi le 9002313 .34, BPS N CPDP PRESC RIBER PLAC E OF SERVI CE, in our developme nt environ ment. That file will be includ ed in our patch, so that the n ew codes w ill be inc luded in t he KIDS Bu ild.
	1749	The data d ictionary for the ne w file 900 2313.34, B PS NCPDP P RESCRIBER PLACE OF S ERVICE, wi ll be sent with data to the ta rget sites . The tab le below d escribes h ow the fil e is to be included in the KID S Build.
	1750
	1751	File Name
	1752	BPS NCPDP PRESCRIBER PLACE OF SERVICE
	1753	Send Full or Partial DD
	1754	FULL
	1755	Update the Data Dict ionary
	1756	YES
	1757	Send Secur ity Codes
	1758	YES
	1759	Screen to Determine DD Update
	1760	n/a
	1761	Data Comes with File
	1762	YES
	1763	Site’s Dat a
	1764	OVERWRITE
	1765	Resolve Po inters
	1766	NO
	1767	May User O verride Da ta Update
	1768	NO
	1769	Data List
	1770	n/a
	1771	Screen to Select Dat a
	1772	n/a
	1773
	1774
	1775	A new File 9002313.3 5, BPS NCP DP BENEFIT STAGE IND ICATOR, wi ll need to be added. The info rmation ab out the ne w file is described in the tab le below.
	1776
	1777	File Name
	1778	BPS NCPDP BENEFIT ST AGE INDICA TOR
	1779	File Numbe r
	1780	9002313.35
	1781	Internal G lobal Refe rence
	1782	^BPS(90023 13.35,
	1783	Descriptio n
	1784	NCPDP fiel d C51-9X B ENEFIT STA GE INDICAT OR
	1785
	1786	This file is used to store the possible NCPDP BENE FIT STAGE INDICATOR, that can be sent on a claim o r returned by the pa yer. No lo cal change s should e ver be mad e to this file. The data store d in this file is ba sed on the NCPDP sta ndards and are natio nally dist ributed.
	1787
	1788	Per VHA Di rective 20 04-038, th is file de finition s hould not be modifie d.
	1789
	1790	This new f ile will c ontain the list of B enefit Sta ge Indicat ors for NC DPD field C51-9X Ben efit Stage Indicator . The ind icators th at are bei ng added a re describ ed in the table belo w.
	1791
	1792	.01 - CODE
	1793	.02 - NAME
	1794	1
	1795	MEDICARE P ART D DEDU CTIBLE
	1796	2
	1797	MEDICARE P ART D INIT IAL BENEFI T
	1798	3
	1799	MEDICARE P ART D COVE RAGE GAP
	1800	4
	1801	MEDICARE P ART D CATA STROPHIC C OVERAGE
	1802	50
	1803	NOT PAID U NDER PART D, PAID UN DER PART C BENEFIT ( FOD MA-PD PLAN)
	1804	51
	1805	NOT PAID U NDER PART D, PAID UN DER PART C BENEFIT ( FOR MA-PD PLAN). BEN E IF A QUA LIFIED MED ICARE BENE -PHARMACY SHOULD NOT ATTEMPT T O COLLECT COST-SHARE , SHOULD A TTEMPT TO BILL COB T O MEDICAID COVERAGE.
	1806	61
	1807	PART D DRU G NOT PAID BY PART D BENEFIT. PAID AS OR UNDER A C O-ADMINIST ERED BENEF IT ONLY.
	1808	62
	1809	NON-PART D /NON-QUAL DRUG NOT P D BY PART D PLAN BEN EFIT
	1810	63
	1811	NON-PART D /NON-QUAL DRUG NO PA ID BY PART D PLAN BE NEFIT. PAI D UNDER ME DICARE BEN E ONLY OF THE MMP PL AN.
	1812	70
	1813	PART D DRU G NOT PAID BY PART D PLAN BENE FIT, PAID BY THE BEN EFICIARY U NDER PLAN- SPONSORED NEGOTIATED PRICING.
	1814	80
	1815	NON-PART D /NON-QUAL DRUG NOT P AID BY PAR T D PLAN B ENEFIT, HO SPICE BENE FIT OR ANY OTHER COM PONENT OF MEDICARE; PD BY THE BENE UNDER PLAN-SPON NEGOTIATE D PRICING.
	1816	90
	1817	ENHANCE OR OTC DRUG (PDE VALUE OF E/O) N OT APPLICA BLE TO THE PART D DR UG SPEND, BUT IS COV ERED BY TH E PART D P LAN.
	1818
	1819	The new pl ace of ser vice codes will be a dded to Fi le 9002313 .35, BPS N CPDP BENEF IT STAGE I NDICATOR, in our dev elopment e nvironment . That fil e will be included i n our patc h, so that the new c odes will be include d in the K IDS Build.
	1820	The data d ictionary for the ne w file 900 2313.35, B PS NCPDP B ENEFIT STA GE INDICAT OR will be sent with data to t he target sites. Th e table be low descri bes how th e file is to be incl uded in th e KIDS Bui ld.
	1821
	1822	File Name
	1823	BPS NCPDP BENEFIT ST AGE INDICA TOR
	1824	Send Full or Partial DD
	1825	FULL
	1826	Update the Data Dict ionary
	1827	YES
	1828	Send Secur ity Codes
	1829	YES
	1830	Screen to Determine DD Update
	1831	n/a
	1832	Data Comes with File
	1833	YES
	1834	Site’s Dat a
	1835	OVERWRITE
	1836	Resolve Po inters
	1837	NO
	1838	May User O verride Da ta Update
	1839	NO
	1840	Data List
	1841	n/a
	1842	Screen to Select Dat a
	1843	n/a
	1844
	1845	A new File 9002313.3 6, BPS NCP DP LTPAC D ISPENSE FR EQUENCY, w ill need t o be added . The inf ormation a bout the n ew file is described in the ta ble below.
	1846
	1847	File Name
	1848	BPS NCPDP
	1849	File Numbe r
	1850	9002313.36
	1851	Internal G lobal Refe rence
	1852	^BPS(90023 13.36,
	1853	Descriptio n
	1854	NCPDP fiel d C91-KK L TPAC DISPE NSE FREQUE NCY
	1855
	1856	This file is used to store the possible NCPDP LTPA C DISPENSE FREQUENCY , that can be sent o n a claim. No local changes sh ould ever be made to this file . The data stored in this file is based on the NCP DP standar ds and are nationall y distribu ted.
	1857
	1858	Per VHA Di rective 20 04-038, th is file de finition s hould not be modifie d.
	1859
	1860	This new f ile will c ontain the list of L TPAC Dispe nse Freque ncy’s for NCDPD fiel d C91-KK L TPAC Dispe nse Freque ncy. The frequency’ s that are being add ed are des cribed in the table below.
	1861
	1862	.01 - CODE
	1863	.02 - DESC RIPTION
	1864	1
	1865	Medication dispensed in a day- supply inc rement equ al to the billed day s supply
	1866	2
	1867	7 days - d ispenses m edication in 7-day s upplies
	1868	3
	1869	4 days - d ispenses m edication in 4-day s upplies
	1870	4
	1871	3 days - d ispenses m edication in 3-day s upplies
	1872	5
	1873	2 days - d ispenses m edication in 2-day s upplies
	1874	6
	1875	1 day - di spenses me dication i n 1-day su pplies
	1876	7
	1877	4-3 days - dispenses medicatio n in 4-day , then 3-d ay supplie s
	1878	8
	1879	2-2-3 days - dispens es medicat ion in 2-d ay, then 2 -day, then 3-day sup plies
	1880	9
	1881	Daily and 3-day week end - disp ensed dail y during t he week an d combines multiple days dispe nsing for weekends
	1882	10
	1883	Per shift dispensing (multiple med passe s)
	1884	11
	1885	Per med pa ss dispens ing
	1886	12
	1887	PRN on dem and
	1888	13
	1889	7-day or l ess cycle not otherw ise repres ented
	1890	14
	1891	14 days di spensing - dispenses medicatio n in 14-da y supplies
	1892	15
	1893	8-14-Day d ispensing cycle not otherwise represente d
	1894
	1895	The new pl ace of ser vice codes will be a dded to Fi le 9002313 .36, BPS N CPDP LTPAC DISPENSE FREQUENCY, in our de velopment environmen t. That fi le will be included in our pat ch, so tha t the new codes will be includ ed in the KIDS Build .
	1896	The data d ictionary for the ne w file 900 2313.36, B PS NCPDP L TPAC DISPE NSE FREQUE NCY will b e sent wit h data to the target sites. T he table b elow descr ibes how t he file is to be inc luded in t he KIDS Bu ild.
	1897
	1898	File Name
	1899	BPS NCPDP LTPAC DISP ENSE FREQU ENCY
	1900	Send Full or Partial DD
	1901	FULL
	1902	Update the Data Dict ionary
	1903	YES
	1904	Send Secur ity Codes
	1905	YES
	1906	Screen to Determine DD Update
	1907	n/a
	1908	Data Comes with File
	1909	YES
	1910	Site’s Dat a
	1911	OVERWRITE
	1912	Resolve Po inters
	1913	NO
	1914	May User O verride Da ta Update
	1915	NO
	1916	Data List
	1917	n/a
	1918	Screen to Select Dat a
	1919	n/a
	1920
	1921	A new File 9002313.3 7, BPS NCP DP PATIENT PAY COMPO NENT QUALI FIER, will need to b e added. The inform ation abou t the new file is de scribed in the table below.
	1922
	1923	File Name
	1924	BPS NCPDP
	1925	File Numbe r
	1926	9002313.37
	1927	Internal G lobal Refe rence
	1928	^BPS(90023 13.37,
	1929	Descriptio n
	1930	NCPDP fiel d C95-KQ P ATIENT PAY COMPONENT QUALIFIER
	1931
	1932	This file is used to store the possible NCPDP PATI ENT PAY CO MPONENT QU ALIFIER, t hat can be returned by the pay er. No loc al changes should ev er be made to this f ile. The d ata stored in this f ile is bas ed on the NCPDP stan dards and are nation ally distr ibuted.
	1933
	1934	Per VHA Di rective 20 04-038, th is file de finition s hould not be modifie d.
	1935
	1936	This new f ile will c ontain the list of P atient Pay Component Qualifier s for NCDP D field C9 5-KQ Patie nt Pay Com ponent Qua lifier. T he qualifi ers that a re being a dded are d escribed i n the tabl e below.
	1937
	1938	.01 - CODE
	1939	.02 - NAME
	1940	1
	1941	Amount App lied to Pe riodic Ded uctible
	1942	2
	1943	Amount Att ributed to Product S election/B rand Drug
	1944	3
	1945	Amount Att ributed to Percentag e Tax
	1946	4
	1947	Amount Exc eeding Per iodic Bene fit Maximu m
	1948	5
	1949	Amount of Copay
	1950	7
	1951	Amount of Coinsuranc e
	1952	8
	1953	Amount Att ributed to Product S election/N on-Preferr ed Formula ry Selecti on
	1954	9
	1955	Amount Att ributed to Health Pl an Assista nce Amount
	1956	10
	1957	Amount Att ributed to Provider Network Se lection
	1958	11
	1959	Amount Att ributed to Product S election/B rand Non-P referred F ormulary S election
	1960	12
	1961	Amount Att ributed to Coverage Gap
	1962	13
	1963	Amount Att ributed to Processor Fee
	1964	14
	1965	Amount Att ributed to Grace Per iod
	1966	15
	1967	Amount Att ributed to Catastrop hic Benefi t
	1968	16
	1969	Amount Att ributed to Unbalance d Patient Pay OPPRA
	1970	17
	1971	Amount Att ributed to Regulator y Fee
	1972
	1973	The new pl ace of ser vice codes will be a dded to Fi le 9002313 .37, BPS N CPDP PATIE NT PAY COM PONENT QUA LIFIER, in our devel opment env ironment. That file will be in cluded in our patch, so that t he new cod es will be included in the KID S Build.
	1974	The data d ictionary for the ne w file 900 2313.37, B PS NCPDP P ATIENT PAY COMPONENT QUALIFIER , will be sent with data to th e target s ites. The table bel ow describ es how the file is t o be inclu ded in the KIDS Buil d.
	1975
	1976	File Name
	1977	BPS NCPDP PATIENT PA Y COMPONEN T QUALIFIE R
	1978	Send Full or Partial DD
	1979	FULL
	1980	Update the Data Dict ionary
	1981	YES
	1982	Send Secur ity Codes
	1983	YES
	1984	Screen to Determine DD Update
	1985	n/a
	1986	Data Comes with File
	1987	YES
	1988	Site’s Dat a
	1989	OVERWRITE
	1990	Resolve Po inters
	1991	NO
	1992	May User O verride Da ta Update
	1993	NO
	1994	Data List
	1995	n/a
	1996	Screen to Select Dat a
	1997	n/a
	1998
	1999	A new File 9002313.3 8, BPS NCP DP OTHER P AYER PROGR AM TYPE, w ill need t o be added . The inf ormation a bout the n ew file is described in the ta ble below.
	2000
	2001	File Name
	2002	BPS NCPDP
	2003	File Numbe r
	2004	9002313.38
	2005	Internal G lobal Refe rence
	2006	^BPS(90023 13.38,
	2007	Descriptio n
	2008	NCPDP fiel d C47-9T O THER PAYER ADJUDICAT ED PROGRAM TYPE
	2009
	2010	This file is used to store the possible NCPDP OTHE R PAYER AD JUDICATED PROGRAM TY PE, that c an be retu rned by th e payer. N o local ch anges shou ld ever be made to t his file. The data s tored in t his file i s based on the NCPDP standards and are n ationally distribute d.
	2011
	2012	Per VHA Di rective 20 04-038, th is file de finition s hould not be modifie d.
	2013
	2014	This new f ile will c ontain the list of O ther Payer Adjudicat ed Program Types for NCDPD fie ld C47-9T Other Paye r Adjudica ted Progra m Type. T he qualifi ers that a re being a dded are d escribed i n the tabl e below.
	2015
	2016	.01 - CODE
	2017	.02 - DESC RIPTION
	2018	0
	2019	Cash
	2020	1
	2021	Medicaid T itle XIX
	2022	2
	2023	Medicare
	2024	3
	2025	Commercial
	2026	4
	2027	Workers Co mpensation
	2028	5
	2029	Self-Pay: Discount P rogram
	2030	6
	2031	Manufactur er Sponsor ed Patient Pay Reduc tion Progr am
	2032	7
	2033	Manufactur er Free Pr oduct
	2034	8
	2035	Veterans H ealth Admi nistration (VA)
	2036	9
	2037	Unknown
	2038	10
	2039	Hospice - Non Medica re
	2040	11
	2041	Medicaid M anaged Car e
	2042	12
	2043	Medicare P art A
	2044	13
	2045	Medicare A dvantage
	2046	14
	2047	Medicare P art D PDP
	2048	15
	2049	Self Pay: Cash
	2050	16
	2051	Medicare P art B
	2052	17
	2053	Indian Hea lth Servic es
	2054	18
	2055	ADAP/Ryan White
	2056	19
	2057	Black Lung
	2058	20
	2059	Casualty I nsurance
	2060	21
	2061	CHIP Title XXI
	2062	22
	2063	Health Mar ketplace E xchange Qu alified He alth Plan
	2064	23
	2065	HRSA 340B Indigent P rogram
	2066	24
	2067	Independen t Charity Patient As sistance P rogram
	2068	25
	2069	Manufactur er Patient Assistanc e Program
	2070	26
	2071	Medicare - Medicaid Plan (MMP)
	2072	27
	2073	SPAP
	2074	28
	2075	Tricare
	2076	29
	2077	Other Fede ral Payer
	2078	30
	2079	Programs o f All-Incl usive Care for the E lderly (PA CE)
	2080	99
	2081	Other
	2082
	2083	The new pl ace of ser vice codes will be a dded to Fi le 9002313 .38, BPS N CPDP OTHER PAYER PRO GRAM TYPE, in our de velopment environmen t. That fi le will be included in our pat ch, so tha t the new codes will be includ ed in the KIDS Build .
	2084	The data d ictionary for the ne w file 900 2313.38, B PS NCPDP O THER PAYER PROGRAM T YPE, will be sent wi th data to the targe t sites. The table below desc ribes how the file i s to be in cluded in the KIDS B uild.
	2085
	2086	File Name
	2087	BPS NCPDP OTHER PAYE R ADJ PROG RAM TYPE
	2088	Send Full or Partial DD
	2089	FULL
	2090	Update the Data Dict ionary
	2091	YES
	2092	Send Secur ity Codes
	2093	YES
	2094	Screen to Determine DD Update
	2095	n/a
	2096	Data Comes with File
	2097	YES
	2098	Site’s Dat a
	2099	OVERWRITE
	2100	Resolve Po inters
	2101	NO
	2102	May User O verride Da ta Update
	2103	NO
	2104	Data List
	2105	n/a
	2106	Screen to Select Dat a
	2107	n/a
	2108
	2109	MEDINFO^BP SOSCD will need to b e modified to includ e the PRES CRIBER DEA NUMBER (D 01-KV) fie ld in the BPS(“RX”) array. The Get code for field D01-KV wil l use it w hen the cl aim is bei ng built.
	2110
	2111	Subroutine Name
	2112	MEDINFO^BP SOSCD
	2113	Enhancemen t Category
	2114	New
	2115	Modify
	2116	Delete
	2117	No Change
	2118	Current Lo gic
	2119
	2120	BPSOSCD ;B HAM ISC/FC S/DRS/DLF - Set BPS( ) "RX" nod es for cur rent medic ation ;06/ 01/2004
	2121	;;1.0;E C LAIMS MGMT ENGINE;** 1,3,2,5,7, 8,10,11,15 ,19,20,23* *;JUN 2004 ;Build 27
	2122	;;Per VA Directive 6402, this routine s hould not be modifie d.
	2123	;
	2124
	2125	. . .
	2126
	2127	;MEDINFO, Set BPS(" RX)" nodes for curre nt medicat ion
	2128	; Called from BPSOS CA for eve ry transac tion in th e multiple
	2129	; IEN59 = IEN in BP S TRANSACT ION (#9002 313.59)
	2130	; IEN5902 = IEN for Insurance multiple of BPS Tra nsactions
	2131	; MEDN = Index numb er of medi cation bei ng process ed
	2132	; BPS arr ay shared by all of the BPSOSC * routines , created in BPSOSCA
	2133	; VAINFO created in BPSOSCB
	2134	MEDINFO(IE N59,IEN590 2,MEDN) ;
	2135	; Verify Parameters
	2136	I $G(IEN5 9)="" Q
	2137	I $G(IEN5 902)="" Q
	2138	I $G(MEDN )="" Q
	2139	;
	2140	N %,BPS0, DRUGIEN,IE NS,J,NDC,N PI,OSITEIE N,PRICING, PROVIEN,RT N,RXI,RXIE N,RXRFIEN, VANATURE,V AOIEN,X,AD FEE
	2141	;
	2142	;RXIEN=Rx IEN, RXRF IEN=Fill N umber, IEN S=FileMan style IENS
	2143	S BPS0=$G (^BPST(IEN 59,1)),RXI EN=$P(BPS0 ,U,11),RXR FIEN=$P(BP S0,U,1),IE NS=IEN5902 _","_IEN59 _","
	2144	. . .
	2145
	2146
	2147	; Get Pro vider Info
	2148	S PROVIEN =+$$RXAPI1 ^BPSUTIL1( RXIEN,4,"I ")
	2149	S BPS("RX ",MEDN,"Pr escriber I EN")=PROVI EN
	2150	I PROVIEN '="" D
	2151	.S X=$$GE T1^DIQ(200 ,PROVIEN,. 01)
	2152	.D NAMECO MP^XLFNAME (.X)
	2153	.S BPS("R X",MEDN,"P rescriber Last Name" )=X("FAMIL Y")
	2154	.S BPS("R X",MEDN,"P rescriber First Name ")=X("GIVE N") ; NCP DP field 3 64-2J
	2155	.S BPS("R X",MEDN,"P rescriber Phone #")= $$ACPHONE^ IBNCPDPI ; DBIA 4721 , Agent Ca shier Phon e Number
	2156	.S BPS("R X",MEDN,"P rescriber Billing Lo cation")=" "
	2157	.S NPI=$$ NPI^BPSNPI ("Individu al_ID",+PR OVIEN)
	2158	.I NPI<0 S NPI=""
	2159	.S BPS("R X",MEDN,"P rescriber NPI")=$P(N PI,U)
	2160	.S BPS("R X",MEDN,"P rimary Car e Provider NPI")=$P( NPI,U)
	2161	.S BPS("R X",MEDN,"P rovider NP I")=$P(NPI ,U)
	2162	.;
	2163	.S X=$$PR VADRS(IEN5 9,PROVIEN) ; provid e address info
	2164	.S BPS("R X",MEDN,"P rescriber Street Add ress")=$P( X,U)_$S($P (X,U,5)]"" :" ",1:"") _$P(X,U,5) ; NCPDP field 365- 2K
	2165	.S BPS("R X",MEDN,"P rescriber Street Add ress Line 1")=$P(X,U ) ; NCPDP field B27 -7U
	2166	.S BPS("R X",MEDN,"P rescriber Street Add ress Line 2")=$P(X,U ,5) ; NCP DP field B 28-8U
	2167	.S BPS("R X",MEDN,"P rescriber City Addre ss")=$P(X, U,2) ; NC PDP field 366-2M
	2168	.S BPS("R X",MEDN,"P rescriber State/Prov ince Addre ss")=$P(X, U,3) ; NC PDP field 367-2N
	2169	.S BPS("R X",MEDN,"P rescriber Zip/Postal Zone")=$T R($P(X,U,4 )," -") ; NCPDP fie ld 368-2P
	2170	.S BPS("R X",MEDN,"P rescriber Country")= $$COUNTRY( $P(X,U,3), $P(X,U,6)) ;NCPDP field B42 -3C
	2171	;
	2172	; Stop if Eligibili ty as we d o not need any of th e claim da ta below
	2173	I BPS("Tr ansaction Code")="E1 " Q
	2174	;
	2175	. . .
	2176
	2177
	2178	;
	2179	;;;
	2180	D LOG^BPS OSL(IEN59, "BPSOSCD-M EDINFO-Con tents of B PS") ;;; R emove afte r testing ;;;
	2181	D LOGARRA Y^BPSOSL(I EN59,"BPS" ,1000) ;;; Remove af ter testin g ;;;
	2182	;;;
	2183	Q
	2184
	2185	Modified L ogic (Chan ges are hi ghlighted)
	2186
	2187	BPSOSCD ;B HAM ISC/FC S/DRS/DLF - Set BPS( ) "RX" nod es for cur rent medic ation ;06/ 01/2004
	2188	;;1.0;E C LAIMS MGMT ENGINE; 1,3,2,5,7, 8,10,11,15 ,19,20,23, 24;JUN 2 004;Build 27
	2189	;;Per VA Directive 6402, this routine s hould not be modifie d.
	2190	;
	2191
	2192	. . .
	2193
	2194
	2195	;MEDINFO, Set BPS(" RX)" nodes for curre nt medicat ion
	2196	; Called from BPSOS CA for eve ry transac tion in th e multiple
	2197	; IEN59 = IEN in BP S TRANSACT ION (#9002 313.59)
	2198	; IEN5902 = IEN for Insurance multiple of BPS Tra nsactions
	2199	; MEDN = Index numb er of medi cation bei ng process ed
	2200	; BPS arr ay shared by all of the BPSOSC * routines , created in BPSOSCA
	2201	; VAINFO created in BPSOSCB
	2202	MEDINFO(IE N59,IEN590 2,MEDN) ;
	2203	; Verify Parameters
	2204	I $G(IEN5 9)="" Q
	2205	I $G(IEN5 902)="" Q
	2206	I $G(MEDN )="" Q
	2207	;
	2208	N %,BPS0, DRUGIEN,IE NS,J,NDC,N PI,OSITEIE N,PRICING, PROVIEN,RT N,RXI,RXIE N,RXRFIEN, VANATURE,V AOIEN,X,AD FEE
	2209	;
	2210	;RXIEN=Rx IEN, RXRF IEN=Fill N umber, IEN S=FileMan style IENS
	2211	S BPS0=$G (^BPST(IEN 59,1)),RXI EN=$P(BPS0 ,U,11),RXR FIEN=$P(BP S0,U,1),IE NS=IEN5902 _","_IEN59 _","
	2212	;
	2213	. . .
	2214
	2215
	2216	; Get Pro vider Info
	2217	S PROVIEN =+$$RXAPI1 ^BPSUTIL1( RXIEN,4,"I ")
	2218	S BPS("RX ",MEDN,"Pr escriber I EN")=PROVI EN
	2219	I PROVIEN '="" D
	2220	.S X=$$GE T1^DIQ(200 ,PROVIEN,. 01)
	2221	.D NAMECO MP^XLFNAME (.X)
	2222	.S BPS("R X",MEDN,"P rescriber Last Name" )=X("FAMIL Y")
	2223	.S BPS("R X",MEDN,"P rescriber First Name ")=X("GIVE N") ; NCP DP field 3 64-2J
	2224	.S BPS("R X",MEDN,"P rescriber Phone #")= $$ACPHONE^ IBNCPDPI ; DBIA 4721 , Agent Ca shier Phon e Number
	2225	.S BPS("R X",MEDN,"P rescriber Billing Lo cation")=" "
	2226	.S NPI=$$ NPI^BPSNPI ("Individu al_ID",+PR OVIEN)
	2227	.I NPI<0 S NPI=""
	2228	.S BPS("R X",MEDN,"P rescriber NPI")=$P(N PI,U)
	2229	.S BPS("R X",MEDN,"P rimary Car e Provider NPI")=$P( NPI,U)
	2230	.S BPS("R X",MEDN,"P rovider NP I")=$P(NPI ,U)
	2231	.;
	2232	.S BPS("R X",MEDN,"P rescriber DEA")=$$GE T1^DIQ(200 ,PROVIEN,5 3.2) ; NCP DP field D 01-KV
	2233	.S X=$$PR VADRS(IEN5 9,PROVIEN) ; provid e address info
	2234	.S BPS("R X",MEDN,"P rescriber Street Add ress")=$P( X,U)_$S($P (X,U,5)]"" :" ",1:"") _$P(X,U,5) ; NCPDP field 365- 2K
	2235	.S BPS("R X",MEDN,"P rescriber Street Add ress Line 1")=$P(X,U ) ; NCPDP field B27 -7U
	2236	.S BPS("R X",MEDN,"P rescriber Street Add ress Line 2")=$P(X,U ,5) ; NCP DP field B 28-8U
	2237	.S BPS("R X",MEDN,"P rescriber City Addre ss")=$P(X, U,2) ; NC PDP field 366-2M
	2238	.S BPS("R X",MEDN,"P rescriber State/Prov ince Addre ss")=$P(X, U,3) ; NC PDP field 367-2N
	2239	.S BPS("R X",MEDN,"P rescriber Zip/Postal Zone")=$T R($P(X,U,4 )," -") ; NCPDP fie ld 368-2P
	2240	.S BPS("R X",MEDN,"P rescriber Country")= $$COUNTRY( $P(X,U,3), $P(X,U,6)) ;NCPDP field B42 -3C
	2241	;
	2242	; Stop if Eligibili ty as we d o not need any of th e claim da ta below
	2243	I BPS("Tr ansaction Code")="E1 " Q
	2244	;
	2245	. . .
	2246
	2247	;
	2248	;;;
	2249	D LOG^BPS OSL(IEN59, "BPSOSCD-M EDINFO-Con tents of B PS") ;;; R emove afte r testing ;;;
	2250	D LOGARRA Y^BPSOSL(I EN59,"BPS" ,1000) ;;; Remove af ter testin g ;;;
	2251	;;;
	2252	Q
	2253
	2254
	2255	A new subr outine FLD D02^BPSOSS G will be created to be used b y the Set code for f ield TOTAL PRESCRIBE D QUANTITY (D02-K) i n BPS NCPD P FIELD DE FS field 2 202.
	2256
	2257	Subroutine Name
	2258	FLDD02^BPS OSSG
	2259	Enhancemen t Category
	2260	New
	2261	Modify
	2262	Delete
	2263	No Change
	2264	Current Lo gic
	2265
	2266	n/a – new subroutine
	2267
	2268	Modified L ogic (Chan ges are hi ghlighted)
	2269
	2270	BPSOSSG ;B HAM ISC/SD /lwj/FLS - Special g ets for fo rmats ;06/ 01/2004 ;; 1.0;E CLAI MS MGMT EN GINE;1,5 ,10,11,20, 24;JUN 2 004;Build 27 ;;Per V A Directiv e 6402, th is routine should no t be modif ied. ;
	2271	. . .
	2272	FLDD02 ; T otal Presc ribed Quan tity Remai ning field (D02-KW)
	2273	; called by SET COD E in BPS N CPDP Field DEFS for field 2202 (D02-KW)
	2274	;
	2275	I '$G(BPS (9002313.0 2)) S BPS( 9002313.02 )=$G(BPS02 )
	2276	Q:'$G(BPS (9002313.0 2)) ; m ust have B PS Claims IEN
	2277	Q:'$G(BPS (9002313.0 201)) ; m ust have T ransaction subfile I EN
	2278	;
	2279	N I,PREVF ILLS,REFIL LS,RTS,RXI EN,TOTALDI SP,TOTALQT Y,QTY
	2280	;
	2281	S REFILLS =$G(BPS("R X",BPS(900 2313.0201) ,"# Refill s"))
	2282	S QTY=$G( BPS("RX",B PS(9002313 .0201),"Qu antity"))
	2283	S TOTALQT Y=QTY*(REF ILLS+1) ; Total qua ntity for the prescr iption
	2284	S PREVFIL LS=$G(BPS( "RX",BPS(9 002313.020 1),"Refill #"))
	2285	;
	2286	; Determi ne if any previous f ills were returned t o stock.
	2287	S RXIEN=$ G(BPS("RX" ,BPS(90023 13.0201)," RX IEN"))
	2288	I RXIEN S RTS=0,I=0 D
	2289	. F S I= $O(^PSRX(R XIEN,"RTS" ,I)) Q:'I S RTS=RTS +1
	2290	;
	2291	; Subtrac t and retu rn to stoc k fills (R TS) from t he number of previou s fills (P REVFILLS).
	2292	S TOTALDI SP=(PREVFI LLS-RTS)*Q TY ; Tota l dispense d for all previous f ills
	2293	; D02-KW Total Pres cribed Qua ntity Rema ining
	2294	S BPS("X" )=TOTALQTY -TOTALDISP
	2295	S $P(^BPS C(BPS(9002 313.02),40 0,BPS(9002 313.0201), "D00"),U,2 )="KW"_$$N FF^BPSECFM (BPS("X"), 10)
	2296	Q
	2297
	2298
	2299	Subroutine Name
	2300	NEWCLAIM^B PSOSCE
	2301	Enhancemen t Category
	2302	New
	2303	Modify
	2304	Delete
	2305	No Change
	2306	Current Lo gic
	2307
	2308	BPSOSCE ;B HAM ISC/FC S/DRS/DLF - New entr y in 90023 13.02 ;06/ 01/2004 ;; 1.0;E CLAI MS MGMT EN GINE;1,5 ,7,8,10,11 ,15,19;J UN 2004;Bu ild 18 ;;P er VA Dire ctive 6402 , this rou tine shoul d not be m odified.
	2309	;
	2310	. . .
	2311
	2312	NEWCLAIM(S TART,END,T OTAL) ; fu nction, re turns null on succes s, else er ror ; N BP SIEN,CLAIM ID,COUNT,D A,DIC,DIK, DLAYGO,ERR OR,INDEX,N ODE0,ROU,S EG,X,Y S R OU=$T(+0), START=+$G( START),END =+$G(END), TOTAL=+$G( TOTAL) ; ; Create new record in Claim Sub mission Fi le (900231 3.02) ; tr y for excl usive acce ss for 1 m in. before logging e rror F L +^XTMP(ROU ,"NEWCLAIM "):60 Q:$T D .N A S A=$$IMPOS S^BPSOSUE( "L","RTI", "Single-th readed rou tine",,,RO U) ; Gener ate Claim ID S CLAIM ID=$$CLAIM ID^BPSECX1 ($G(BPS("R X",START," IEN59"))) I CLAIMID= "" D .S ER ROR="320^V A Claim ID not creat ed" .D LOG (ROU_"-Fai led to cre ate Claim ID") ; ; C reate clai m record D :'$G(ERROR ) .S DLAYG O=9002313. 02,DIC="^B PSC(",DIC( 0)="LXZ",X =CLAIMID . D ^DIC Q:Y >0 ; less than zero is error . S ERROR="3 21^Failed to create claim reco rd" .D LOG (ROU_"-Fai led to cre ate an ent ry in file 9002313.0 2") ; L -^ XTMP(ROU," NEWCLAIM") ; Q:$G(ER ROR) ERROR ; ; Updat e BPS and Log it S B PS(9002313 .02)=+Y ; Needed for Turn-Arou nd Stats - Do NOT de lete/alter !! D LOG(R OU_"-Creat ed claim I D "_CLAIMI D_" (IEN " _BPS(90023 13.02)_")" ) ; ; Upda te zero no de of the claim S NO DE0=$G(^BP SC(BPS(900 2313.02),0 )) S $P(NO DE0,U,2)=$ G(BPS("NCP DP","IEN") ) ; Electr onic Payor (Payer Sh eet) S $P( NODE0,U,4) =2 ; Trans mit Flag - 2 is 'Yes (Point of Sale)' S $P(NODE0,U ,6)=$$NOWF M^BPSOSU1( ) ; Create d On S ^BP SC(BPS(900 2313.02),0 )=NODE0 ; ; Update P atient Nam e S $P(^BP SC(BPS(900 2313.02),1 ),U,1)=$G( BPS("Patie nt","Name" )) S $P(^B PSC(BPS(90 02313.02), 1),U,4)=$G (BPS("Insu rer","IEN" )) ; Updat e TRANSACT ION field S $P(^BPSC (BPS(90023 13.02),0), U,8)=$G(BP S("RX",STA RT,"IEN59" )) ; ; Cou nt of meds in claim S BPS("Tra nsaction C ount")=TOT AL ; ; Pro cess the ' non-multip le' segmen ts (Header , Patient, Cardholde r) F SEG=1 00:10:120 D XLOOP^BP SOSCF(BPS( "NCPDP","I EN"),SEG) ; ; zero n ode for ME DICATIONS SUB-FIELD (#9002313. 0201) S:'$ D(^BPSC(BP S(9002313. 02),400,0) ) ^(0)="^9 002313.020 1PA^^" S C OUNT=0 F I NDEX=START :1:END D . ; Create z ero node f or entry i n multiple .S COUNT= COUNT+1,NO DE0="" .S $P(NODE0,U )=INDEX,$P (NODE0,U,4 )=$G(BPS(" RX",INDEX, "Drug Name ")),$P(NOD E0,U,5)=$G (BPS("RX", INDEX,"RX IEN")) .S ^BPSC(BPS( 9002313.02 ),400,INDE X,0)=NODE0 .S BPS(90 02313.0201 )=INDEX .; Process e ntries in medication multiple .F SEG=130 :10:300 D XLOOP^BPSO SCF(BPS("N CPDP","IEN "),SEG,IND EX) ; BPS* 1*19 - add Intermedi ary and La st Known 4 Rx segment s .; .; Up date the i ndices .S ^BPSC(BPS( 9002313.02 ),400,"B", INDEX,INDE X)="" .; U pdate top- level node of the mu ltiple .S NODE0=$G(^ BPSC(BPS(9 002313.02) ,400,0)) . S $P(NODE0 ,U,3)=COUN T,$P(NODE0 ,U,4)=COUN T,^BPSC(BP S(9002313. 02),400,0) =NODE0 ; ; Cross-Ref erence Cla im Submiss ion Record S DIK="^B PSC(",DA=B PS(9002313 .02) D IX1 ^DIK ; Q " " ; Retur n null on success
	2313
	2314	Modified L ogic (Chan ges are hi ghlighted)
	2315
	2316	BPSOSCE ;B HAM ISC/FC S/DRS/DLF - New entr y in 90023 13.02 ;06/ 01/2004 ;; 1.0;E CLAI MS MGMT EN GINE;*1,5 ,7,8,10,11 ,15,19,24 *;JUN 2004 ;Build 18 ;;Per VA D irective 6 402, this routine sh ould not b e modified .
	2317	;
	2318	. . .
	2319
	2320	NEWCLAIM(S TART,END,T OTAL) ; fu nction, re turns null on succes s, else er ror ; N BP SIEN,CLAIM ID,COUNT,D A,DIC,DIK, DLAYGO,ERR OR,INDEX,N ODE0,ROU,S EG,X,Y S R OU=$T(+0), START=+$G( START),END =+$G(END), TOTAL=+$G( TOTAL) ; ; Create new record in Claim Sub mission Fi le (900231 3.02) ; tr y for excl usive acce ss for 1 m in. before logging e rror F L +^XTMP(ROU ,"NEWCLAIM "):60 Q:$T D .N A S A=$$IMPOS S^BPSOSUE( "L","RTI", "Single-th readed rou tine",,,RO U) ; Gener ate Claim ID S CLAIM ID=$$CLAIM ID^BPSECX1 ($G(BPS("R X",START," IEN59"))) I CLAIMID= "" D .S ER ROR="320^V A Claim ID not creat ed" .D LOG (ROU_"-Fai led to cre ate Claim ID") ; ; C reate clai m record D :'$G(ERROR ) .S DLAYG O=9002313. 02,DIC="^B PSC(",DIC( 0)="LXZ",X =CLAIMID . D ^DIC Q:Y >0 ; less than zero is error . S ERROR="3 21^Failed to create claim reco rd" .D LOG (ROU_"-Fai led to cre ate an ent ry in file 9002313.0 2") ; L -^ XTMP(ROU," NEWCLAIM") ; Q:$G(ER ROR) ERROR ; ; Updat e BPS and Log it S B PS(9002313 .02)=+Y ; Needed for Turn-Arou nd Stats - Do NOT de lete/alter !! D LOG(R OU_"-Creat ed claim I D "_CLAIMI D_" (IEN " _BPS(90023 13.02)_")" ) ; ; Upda te zero no de of the claim S NO DE0=$G(^BP SC(BPS(900 2313.02),0 )) S $P(NO DE0,U,2)=$ G(BPS("NCP DP","IEN") ) ; Electr onic Payor (Payer Sh eet) S $P( NODE0,U,4) =2 ; Trans mit Flag - 2 is 'Yes (Point of Sale)' S $P(NODE0,U ,6)=$$NOWF M^BPSOSU1( ) ; Create d On S ^BP SC(BPS(900 2313.02),0 )=NODE0 ; ; Update P atient Nam e S $P(^BP SC(BPS(900 2313.02),1 ),U,1)=$G( BPS("Patie nt","Name" )) S $P(^B PSC(BPS(90 02313.02), 1),U,4)=$G (BPS("Insu rer","IEN" )) ; Updat e TRANSACT ION field S $P(^BPSC (BPS(90023 13.02),0), U,8)=$G(BP S("RX",STA RT,"IEN59" )) ; ; Cou nt of meds in claim S BPS("Tra nsaction C ount")=TOT AL ; ; Pro cess the ' non-multip le' segmen ts (Header , Patient, Cardholde r) F SEG=1 00:10:120 D XLOOP^BP SOSCF(BPS( "NCPDP","I EN"),SEG) ; ; zero n ode for ME DICATIONS SUB-FIELD (#9002313. 0201) S:'$ D(^BPSC(BP S(9002313. 02),400,0) ) ^(0)="^9 002313.020 1PA^^" S C OUNT=0 F I NDEX=START :1:END D . ; Create z ero node f or entry i n multiple .S COUNT= COUNT+1,NO DE0="" .S $P(NODE0,U )=INDEX,$P (NODE0,U,4 )=$G(BPS(" RX",INDEX, "Drug Name ")),$P(NOD E0,U,5)=$G (BPS("RX", INDEX,"RX IEN")) .S ^BPSC(BPS( 9002313.02 ),400,INDE X,0)=NODE0 .S BPS(90 02313.0201 )=INDEX .; Process e ntries in medication multiple .F SEG=130 :10:300 D XLOOP^BPSO SCF(BPS("N CPDP","IEN "),SEG,IND EX) ; BPS* 1*19 - add Intermedi ary and La st Known 4 Rx segment s .; Proce ss entries in "D00" node of th e Claim .; Prescribe r DEA Numb er D01-KV .S BPSIEN= $O(^BPSF(9 002313.91, "C","PRESC RIBER DEA NUMBER","" )) .I BPSI EN'="" D X FLDCODE^BP SOSCF(150, BPSIEN,"GF S") ; call s the GET, FORMAT an d SET for NCPDP Fiel d in file 9002313.91 .; Total Prescribed Qty Remai ning D02-K W .S BPSIE N=$O(^BPSF (9002313.9 1,"C","TOT AL PRESCRI BED QTY RE MAINING"," ")) .D FLD D02^BPSOSS G .; .; Up date the i ndices .S ^BPSC(BPS( 9002313.02 ),400,"B", INDEX,INDE X)="" .; U pdate top- level node of the mu ltiple .S NODE0=$G(^ BPSC(BPS(9 002313.02) ,400,0)) . S $P(NODE0 ,U,3)=COUN T,$P(NODE0 ,U,4)=COUN T,^BPSC(BP S(9002313. 02),400,0) =NODE0 ; ; Cross-Ref erence Cla im Submiss ion Record S DIK="^B PSC(",DA=B PS(9002313 .02) D IX1 ^DIK ; Q " " ; Retur n null on success
	2321
	2322
	2323
	2324
	2325	The new fi eld Patien t Pay Comp onent Amou nt (C93-KN ) will be added to t he Third P arty Joint Inquiry [ IBJ THIRD PARTY JOIN T INQUIRY] under the Patient R esponsibil ity Amount s section.
	2326	Subroutine Name
	2327	INIT^IBJTR X
	2328	Enhancemen t Category
	2329	New
	2330	Modify
	2331	Delete
	2332	No Change
	2333	Current Lo gic
	2334
	2335	IBJTRX ;AL B/ESG - TP JI ePharma cy ECME cl aim inform ation ;22- Oct-2010
	2336	;;2.0;INT EGRATED BI LLING;43 5,452,494, 521;21-M AR-94;Buil d 33
	2337	;;Per VA Directive 6402, this routine s hould not be modifie d.
	2338	;
	2339	. . .
	2340
	2341	INIT ; -- init varia bles and l ist array N IBM1,ECM E,ECMEAP,R XORG,DOCIE N,PHARMNPI ,DOCNPI,RE SPIEN,ZR,R SPSUB,ZM,B PSM,BPSMCO B,IBLINE,Z C,ZCTOT,ZC N N IBZ,IB RXDATA,IBR XIEN,IBRXF ILL,IBCOBN ,IBBPS,IB0 ,IBS,IBHPD ,IBVL,IBCP Y,IBM0 K ^ TMP("IBJTR X",$J) S V ALMCNT=0 ; S IBZ=+$O (^IBA(362. 4,"C",IBIF N,0)) S IB RXDATA=$G( ^IBA(362.4 ,IBZ,0)) S IBRXIEN=+ $P(IBRXDAT A,U,5) ; R X ien ptr file 52 S IBRXFILL=+ $P(IBRXDAT A,U,10) ; rx fill# S IBCOBN=+$ $COBN^IBCE F(IBIFN) ; current p ayer seque nce # S IB BPS=$$CLAI M^BPSBUTL( IBRXIEN,IB RXFILL,IBC OBN) ; DBI A 4719 ; S IBM1=$G(^ DGCR(399,I BIFN,"M1") ) S IB0=$G (^DGCR(399 ,IBIFN,0)) S IBS=$G( ^DGCR(399, IBIFN,"S") ) S ECME=$ P($P(IBM1, U,8),";",1 ) ; ECME# S ECMEAP=$ P(IBM1,U,9 ) ; ECME a pproval nu mber S RXO RG=$$RXSIT E^IBCEF73A (IBIFN) ; pharmacy f ile 4 ien S DOCIEN=$ $RXAPI1^IB NCPUT1(IBR XIEN,4,"I" ) ; ien of doctor wh o wrote th e Rx (52,4 ) S (PHARM NPI,DOCNPI )="" I RXO RG S PHARM NPI=$P($$N PI^XUSNPI( "Organizat ion_ID",RX ORG),U,1) ; pharmacy NPI I DOC IEN S DOCN PI=$P($$NP I^XUSNPI(" Individual _ID",DOCIE N),U,1) ; doctor NPI I PHARMNP I'>0 S PHA RMNPI="No NPI on fil e" I DOCNP I'>0 S DOC NPI="No NP I on file" ; S RESPI EN=+$P(IBB PS,U,3) ; BPS respon se file ie n I RESPIE N D . ; IB 2.0521 - add HPID from respo nse to TPJ I screen . S IBM0=$G (^DGCR(399 ,IBIFN,"M" )),IBCPY=$ S($P(IB0,U ,21)="P":$ P(IBM0,U), $P(IB0,U,2 1)="S":$P( IBM0,U,2), 1:$P(IBM0, "^",3)) . I $P($G(^B PSR(RESPIE N,560)),U, 8)="01" S IBHPD=$P($ G(^BPSR(RE SPIEN,560) ),U,9) S I BVL=$$HOD^ IBCNHUT1(I BHPD,IBCPY ) . S ZR=R ESPIEN_"," . S RSPSU B=+$O(^BPS R(RESPIEN, 1000,0)) . I RSPSUB D .. S ZM= RSPSUB_"," _RESPIEN_" ," .. D GE TS^DIQ(900 2313.0301, ZM,"129;13 3:137;505; 506;507;50 9;517:520; 571;572"," IEN","BPSM ") ; get s elected $ amount fie lds .. D G ETS^DIQ(90 02313.0301 ,ZM,"355.0 1*","IEN", "BPSMCOB") ; get cob /other pay er data fi elds .. Q . Q ; S IB LINE=$$SET L("",ECME, "ECME No", 25,11,1) S IBLINE=$$ SETL(IBLIN E,PHARMNPI ,"Pharmacy NPI",14,1 5,40) D SE T(IBLINE). . .
	2342
	2343
	2344	; D SET(" ") S IBLI NE=$$SETL( "",,"Patie nt Respons ibility Am ounts",,31 ,1) D SET( IBLINE,"3; 2;30") ; S IBLINE=$$ SETL("",$$ AMT($G(BPS M(9002313. 0301,ZM,51 7,"E")))," Deductible ",10,13,1) S IBLINE= $$SETL(IBL INE,$$AMT( $G(BPSM(90 02313.0301 ,ZM,572,"E "))),"Coin surance",1 0,13,27) S IBLINE=$$ SETL(IBLIN E,$$AMT($G (BPSM(9002 313.0301,Z M,518,"E") )),"Amount of Copay" ,9,18,52) D SET(IBLI NE) ; S IB LINE=$$SET L("",$$AMT ($G(BPSM(9 002313.030 1,ZM,137," E"))),"Cov erage Gap" ,10,13,1) S IBLINE=$ $SETL(IBLI NE,$$AMT($ G(BPSM(900 2313.0301, ZM,571,"E" ))),"Proce ssor Fee", 10,13,27) S IBLINE=$ $SETL(IBLI NE,$$AMT($ G(BPSM(900 2313.0301, ZM,520,"E" ))),"Excee d Benefit Max",9,18, 52) D SET( IBLINE) ; S IBLINE=$ $SETL("",$ $AMT($G(BP SM(9002313 .0301,ZM,1 29,"E"))), "Health Pl an-funded Assistance Amount",1 5,39,1) D SET(IBLINE ) ; D SET( " ") S IBL INE=$$SETL ("",,"Prod uct Select ion Amount s",,26,1) D SET(IBLI NE,"3;2;25 ") ;
	2345	. . .
	2346
	2347
	2348	;INITX ; D SET(" ") ,SET(" ") Q
	2349
	2350	Modified L ogic (Chan ges are hi ghlighted)
	2351
	2352	IBJTRX ;AL B/ESG - TP JI ePharma cy ECME cl aim inform ation ;22- Oct-2010
	2353	;;2.0;INT EGRATED BI LLING;43 5,452,494, 521,617; 21-MAR-94; Build 33
	2354	;;Per VA Directive 6402, this routine s hould not be modifie d.
	2355	;
	2356	. . .
	2357
	2358	INIT ; -- init varia bles and l ist array N IBM1,ECM E,ECMEAP,R XORG,DOCIE N,PHARMNPI ,DOCNPI,RE SPIEN,ZR,R SPSUB,ZM,B PSM,BPSMCO B,IBLINE,Z C,ZCTOT,ZC N N IBZ,IB RXDATA,IBR XIEN,IBRXF ILL,IBCOBN ,IBBPS,IB0 ,IBS,IBHPD ,IBVL,IBCP Y,IBM0 K ^ TMP("IBJTR X",$J) S V ALMCNT=0 ; S IBZ=+$O (^IBA(362. 4,"C",IBIF N,0)) S IB RXDATA=$G( ^IBA(362.4 ,IBZ,0)) S IBRXIEN=+ $P(IBRXDAT A,U,5) ; R X ien ptr file 52 S IBRXFILL=+ $P(IBRXDAT A,U,10) ; rx fill# S IBCOBN=+$ $COBN^IBCE F(IBIFN) ; current p ayer seque nce # S IB BPS=$$CLAI M^BPSBUTL( IBRXIEN,IB RXFILL,IBC OBN) ; DBI A 4719 ; S IBM1=$G(^ DGCR(399,I BIFN,"M1") ) S IB0=$G (^DGCR(399 ,IBIFN,0)) S IBS=$G( ^DGCR(399, IBIFN,"S") ) S ECME=$ P($P(IBM1, U,8),";",1 ) ; ECME# S ECMEAP=$ P(IBM1,U,9 ) ; ECME a pproval nu mber S RXO RG=$$RXSIT E^IBCEF73A (IBIFN) ; pharmacy f ile 4 ien S DOCIEN=$ $RXAPI1^IB NCPUT1(IBR XIEN,4,"I" ) ; ien of doctor wh o wrote th e Rx (52,4 ) S (PHARM NPI,DOCNPI )="" I RXO RG S PHARM NPI=$P($$N PI^XUSNPI( "Organizat ion_ID",RX ORG),U,1) ; pharmacy NPI I DOC IEN S DOCN PI=$P($$NP I^XUSNPI(" Individual _ID",DOCIE N),U,1) ; doctor NPI I PHARMNP I'>0 S PHA RMNPI="No NPI on fil e" I DOCNP I'>0 S DOC NPI="No NP I on file" ; S RESPI EN=+$P(IBB PS,U,3) ; BPS respon se file ie n I RESPIE N D . ; IB 2.0521 - add HPID from respo nse to TPJ I screen . S IBM0=$G (^DGCR(399 ,IBIFN,"M" )),IBCPY=$ S($P(IB0,U ,21)="P":$ P(IBM0,U), $P(IB0,U,2 1)="S":$P( IBM0,U,2), 1:$P(IBM0, "^",3)) . I $P($G(^B PSR(RESPIE N,560)),U, 8)="01" S IBHPD=$P($ G(^BPSR(RE SPIEN,560) ),U,9) S I BVL=$$HOD^ IBCNHUT1(I BHPD,IBCPY ) . S ZR=R ESPIEN_"," . S RSPSU B=+$O(^BPS R(RESPIEN, 1000,0)) . I RSPSUB D .. S ZM= RSPSUB_"," _RESPIEN_" ," .. D GE TS^DIQ(900 2313.0301, ZM,"129;13 3:137;505; 506;507;50 9;517:520; 571;572;21 93,"IEN"," BPSM") ; g et selecte d $ amount fields .. D GETS^DI Q(9002313. 0301,ZM,"3 55.01*","I EN","BPSMC OB") ; get cob/other payer dat a fields . . Q . Q ; S IBLINE=$ $SETL("",E CME,"ECME No",25,11, 1) S IBLIN E=$$SETL(I BLINE,PHAR MNPI,"Phar macy NPI", 14,15,40) D SET(IBLI NE). . .
	2359
	2360	; D SET(" ") S IBLI NE=$$SETL( "",,"Patie nt Respons ibility Am ounts",,31 ,1) D SET( IBLINE,"3; 2;30") ; S IBLINE=$$ SETL("",$$ AMT($G(BPS M(9002313. 0301,ZM,51 7,"E")))," Deductible ",10,13,1) S IBLINE= $$SETL(IBL INE,$$AMT( $G(BPSM(90 02313.0301 ,ZM,572,"E "))),"Coin surance",1 0,13,27) S IBLINE=$$ SETL(IBLIN E,$$AMT($G (BPSM(9002 313.0301,Z M,518,"E") )),"Amount of Copay" ,9,18,52) D SET(IBLI NE) ; S IB LINE=$$SET L("",$$AMT ($G(BPSM(9 002313.030 1,ZM,137," E"))),"Cov erage Gap" ,10,13,1) S IBLINE=$ $SETL(IBLI NE,$$AMT($ G(BPSM(900 2313.0301, ZM,571,"E" ))),"Proce ssor Fee", 10,13,27) S IBLINE=$ $SETL(IBLI NE,$$AMT($ G(BPSM(900 2313.0301, ZM,520,"E" ))),"Excee d Benefit Max",9,18, 52) D SET( IBLINE) ; S IBLINE=$ $SETL("",$ $AMT($G(BP SM(9002313 .0301,ZM,1 29,"E"))), "Health Pl an-funded Assistance Amount",1 5,39,1)
	2361	D SET(IBL INE)
	2362	S IBLINE= $$SETL("", $$AMT($G(B PSM(900231 3.0301,ZM, 2193,"E")) ),"Patient Pay Compo nent Amoun t",15,39,1 ) D SET(IB LINE) ; D SET(" ") S IBLINE=$$ SETL("",," Product Se lection Am ounts",,26 ,1) D SET( IBLINE,"3; 2;25") ;. . .
	2363
	2364	;INITX ; D SET(" ") ,SET(" ") Q
	2365
	2366
	2367
	2368	The CRI/Cl aim Respon se Inquiry will auto matically display th e new outg oing field s from the claim req uest whene ver they a re populat ed and the new incom ing fields on the cl aim respon se wheneve r it is po pulated. N o change t o existing logic is necessary. This is a lso true o f the VER, which con tains the CRI.
	2369
	2370
	2371	The tables below des cribe how the Prescr iber DEA N umber (D01 -KV) and T otal Presc ribed Quan tity Remai ning (D02- KW) are be ing added to the Cla im Log.
	2372
	2373	Subroutine Name
	2374	DISPCLM^BP SSCRL1
	2375	Enhancemen t Category
	2376	New
	2377	Modify
	2378	Delete
	2379	No Change
	2380	Current Lo gic
	2381	DISPCLM(BP LN,BP59,BP IEN02,BP57 ,BPSTYPE,B PSDTALT) ; N BPSCRLN S S BPSCRL NS=17 ;(se e "BPS LST MN LOG" LM template: Bottom=21 , Top = 4, 21-4=17) N BPX,BPLN 0,BPCNT,BP STR1,BPSTY P2,BPNFLDT S BPLN0=B PLN S BPST YP2=$S(BPS TYPE="C":" CLAIM REQU EST",BPSTY PE="R":"RE VERSAL",1: "") S BPST R1="Transm ission Inf ormation ( "_BPSTYP2_ ")(#"_BPIE N02_")" D SETLINE^BP SSCRLG(.BP LN,BPSTR1_ $$LINE^BPS SCRU3(79-$ L(BPSTR1), "-")) D SE TLINE^BPSS CRLG(.BPLN ,"Created on: "_$$CR EATEDT^BPS SCRLG(BPIE N02,BPSDTA LT)) D SET LINE^BPSSC RLG(.BPLN, "VA Claim ID: "_$P($ G(^BPSC(+B PIEN02,0)) ,U,1)) D S ETLINE^BPS SCRLG(.BPL N,"Submitt ed By: "_$ $SUBMTBY^B PSSCRLG(BP 57)) D SET LINE^BPSSC RLG(.BPLN, "Transacti on Type: " _$$TRTYPE^ BPSSCRU5($ $TRCODE^BP SSCRLG(BPI EN02))) D SETLINE^BP SSCRLG(.BP LN,"Date o f Service: "_$$DOSCL M^BPSSCRLG (BPIEN02)) ;Display Next Avail able Fill Date - BPS 1.015 S BPNFLDT=$$ NFLDT^BPSB UTL(BPRXIE N,BPREF,$$ RXCOB57^BP SSCRLG(BP5 7)) D:BPNF LDT SETLIN E^BPSSCRLG (.BPLN,"Ne xt Availab le Fill Da te: "_$$FM TE^XLFDT(B PNFLDT,"2Z M")) D SET LINE^BPSSC RLG(.BPLN, "NDC Code: "_$$LNDC^ BPSSCRU5(B PIEN02))
	2382	;
	2383	S BPUNITS =$$UNITS^B PSSCRLG(BP IEN02)
	2384	; if BPUN ITS is nul l get the BPUNITS fr om the PRE SCRIPTION file (#52)
	2385	I BPUNITS ="( )" S BPUNITS=$$ GETUNIT(BP RXIEN,$G(B PREF))
	2386	D SETLINE ^BPSSCRLG( .BPLN,"Qua ntity Subm itted on C laim: "_$$ QTY^BPSSCR LG(BPIEN02 )_" "_BPUN ITS)
	2387	; D SETLI NE^BPSSCRL G(.BPLN,"D ays Supply : "_$$DAYS SUPL^BPSSC RLG(BPIEN0 2)) D SETL INE^BPSSCR LG(.BPLN," Division: "_$$DIV^BP SSCRLG(BP5 7)) D SETL INE^BPSSCR LG(.BPLN," NPI#: "_$$ NPI^BPSSCR LG(BPIEN02 )) D SETLI NE^BPSSCRL G(.BPLN,"E CME Pharma cy: "_$$DI VNAME^BPSS CRDS($$LDI V^BPSSCRLG (BP57))) S BPX="Rx Q ty: "_$$BI LLQTY^BPSS CRLG(BP57) _" "_$$BIL LUNT^BPSSC RLG(BP57) S BPX=BPX_ " Unit Cos t: "_$$UNT PRICE^BPSS CRLG(BP57) S BPX=BPX _" Gross A mt Due: "_ $$TOTPRICE ^BPSSCRLG( BPIEN02) D SETLINE^B PSSCRLG(.B PLN,BPX) S BPX="Ingr edient Cos t: "_$$ING RCST^BPSSC RLG(BPIEN0 2) S BPX=B PX_" Dispe nsing Fee: "_$$DISPF EE^BPSSCRL G(BPIEN02) D SETLINE ^BPSSCRLG( .BPLN,BPX) S BPX="U& C Charge: "_$$UCCHRG ^BPSSCRLG( BPIEN02) S BPX=BPX_" Admin Fee : "_$$ADMN FEE^BPSSCR LG(BPIEN02 ) D SETLIN E^BPSSCRLG (.BPLN,BPX ) D SETLIN E^BPSSCRLG (.BPLN,"") D SETLINE ^BPSSCRLG( .BPLN,"Ins urance Nam e: "_$$INS UR57^BPSSC RLG(BP57)) D SETLINE ^BPSSCRLG( .BPLN,"Gro up Name: " _$$GRPNM^B PSSCRLG(BP IEN02)) D SETLINE^BP SSCRLG(.BP LN,"Rx Coo rdination of Benefit s: "_$$RXC OB57^BPSSC RLG(BP57)) D SETLINE ^BPSSCRLG( .BPLN,"Pha rmacy Plan ID: "_$$P HPLANID^BP SSCRLG(BP5 7)) D SETL INE^BPSSCR LG(.BPLN," BIN: "_$$B IN^BPSSCRL G(BPIEN02) ) D SETLIN E^BPSSCRLG (.BPLN,"PC N: "_$$PCN ^BPSSCRLG( BPIEN02)) D SETLINE^ BPSSCRLG(. BPLN,"NCPD P Version: "_$$GETVE R^BPSSCRLG (BPIEN02)) D SETLINE ^BPSSCRLG( .BPLN,"Gro up ID: "_$ $GRPID^BPS SCRLG(BPIE N02)) D SE TLINE^BPSS CRLG(.BPLN ,"Cardhold er ID: "_$ $CRDHLDID^ BPSSCRLG(B PIEN02)) D SETLINE^B PSSCRLG(.B PLN,"Patie nt Relatio nship Code : "_$$PATR ELSH^BPSSC RLG(BPIEN0 2)) D SETL INE^BPSSCR LG(.BPLN," Cardholder First Nam e: "_$$CRD HLDFN^BPSS CRLG(BPIEN 02,BP57)) D SETLINE^ BPSSCRLG(. BPLN,"Card holder Las t Name: "_ $$CRDHLDLN ^BPSSCRLG( BPIEN02,BP 57)) ; BPS 122 D SE TLINE^BPSS CRLG(.BPLN ,"Facility ID Qualif ier: "_$$F ACIDQ^BPSS CRLG(BPIEN 02)) F BPC NT=BPLN:1: BPLN0+BPSC RLNS D SET LINE^BPSSC RLG(.BPLN, "") S BPLN 0=BPLN D S ETLINE^BPS SCRLG(.BPL N,"Billing Request P ayer Sheet : "_$$B1PY RIEN^BPSSC RU5(BP57)) D SETLINE ^BPSSCRLG( .BPLN,"Rev ersal Paye r Sheet: " _$$B2PYRIE N^BPSSCRU5 (BP57)) D SETLINE^BP SSCRLG(.BP LN,"VA Cla im ID: "_$ P($G(^BPSC (+BPIEN02, 0)),U,1)) D SETLINE^ BPSSCRLG(. BPLN,"") Q
	2388
	2389	Modified L ogic (Chan ges are hi ghlighted)
	2390
	2391	DISPCLM(BP LN,BP59,BP IEN02,BP57 ,BPSTYPE,B PSDTALT) ; N BPSCRLN S S BPSCRL NS=17 ;(se e "BPS LST MN LOG" LM template: Bottom=21 , Top = 4, 21-4=17) N BPX,BPLN 0,BPCNT,BP STR1,BPSTY P2,BPNFLDT S BPLN0=B PLN S BPST YP2=$S(BPS TYPE="C":" CLAIM REQU EST",BPSTY PE="R":"RE VERSAL",1: "") S BPST R1="Transm ission Inf ormation ( "_BPSTYP2_ ")(#"_BPIE N02_")" D SETLINE^BP SSCRLG(.BP LN,BPSTR1_ $$LINE^BPS SCRU3(79-$ L(BPSTR1), "-")) D SE TLINE^BPSS CRLG(.BPLN ,"Created on: "_$$CR EATEDT^BPS SCRLG(BPIE N02,BPSDTA LT)) D SET LINE^BPSSC RLG(.BPLN, "VA Claim ID: "_$P($ G(^BPSC(+B PIEN02,0)) ,U,1)) D S ETLINE^BPS SCRLG(.BPL N,"Submitt ed By: "_$ $SUBMTBY^B PSSCRLG(BP 57)) D SET LINE^BPSSC RLG(.BPLN, "Transacti on Type: " _$$TRTYPE^ BPSSCRU5($ $TRCODE^BP SSCRLG(BPI EN02))) D SETLINE^BP SSCRLG(.BP LN,"Date o f Service: "_$$DOSCL M^BPSSCRLG (BPIEN02)) ;Display Next Avail able Fill Date - BPS 1.015 S BPNFLDT=$$ NFLDT^BPSB UTL(BPRXIE N,BPREF,$$ RXCOB57^BP SSCRLG(BP5 7)) D:BPNF LDT SETLIN E^BPSSCRLG (.BPLN,"Ne xt Availab le Fill Da te: "_$$FM TE^XLFDT(B PNFLDT,"2Z M")) D SET LINE^BPSSC RLG(.BPLN, "NDC Code: "_$$LNDC^ BPSSCRU5(B PIEN02))
	2392	;
	2393	S BPUNITS =$$UNITS^B PSSCRLG(BP IEN02)
	2394	; if BPUN ITS is nul l get the BPUNITS fr om the PRE SCRIPTION file (#52)
	2395	I BPUNITS ="( )" S BPUNITS=$$ GETUNIT(BP RXIEN,$G(B PREF))
	2396	D SETLINE ^BPSSCRLG( .BPLN,"Qua ntity Subm itted on C laim: "_$$ QTY^BPSSCR LG(BPIEN02 )_" "_BPUN ITS)
	2397	; D SETLI NE^BPSSCRL G(.BPLN,"D ays Supply : "_$$DAYS SUPL^BPSSC RLG(BPIEN0 2)) D SETL INE^BPSSCR LG(.BPLN," Division: "_$$DIV^BP SSCRLG(BP5 7)) D SETL INE^BPSSCR LG(.BPLN," NPI#: "_$$ NPI^BPSSCR LG(BPIEN02 ))
	2398	D SETLINE ^BPSSCRLG( .BPLN,"Pre scriber DE A Number: "_$$PDEA^B PSSCRLG(BP IEN02)) D SETLINE^BP SSCRLG(.BP LN,"ECME P harmacy: " _$$DIVNAME ^BPSSCRDS( $$LDIV^BPS SCRLG(BP57 )))
	2399	D SETLINE ^BPSSCRLG( .BPLN,"Tot al Prescri bed Quanti ty Remaini ng: "_$$TO TPQR^BPSSC RLG(BPIEN0 2))
	2400	S BPX="Rx Qty: "_$$ BILLQTY^BP SSCRLG(BP5 7)_" "_$$B ILLUNT^BPS SCRLG(BP57 ) S BPX=BP X_" Unit C ost: "_$$U NTPRICE^BP SSCRLG(BP5 7) S BPX=B PX_" Gross Amt Due: "_$$TOTPRI CE^BPSSCRL G(BPIEN02) D SETLINE ^BPSSCRLG( .BPLN,BPX) S BPX="In gredient C ost: "_$$I NGRCST^BPS SCRLG(BPIE N02) S BPX =BPX_" Dis pensing Fe e: "_$$DIS PFEE^BPSSC RLG(BPIEN0 2) D SETLI NE^BPSSCRL G(.BPLN,BP X) S BPX=" U&C Charge : "_$$UCCH RG^BPSSCRL G(BPIEN02) S BPX=BPX _" Admin F ee: "_$$AD MNFEE^BPSS CRLG(BPIEN 02) D SETL INE^BPSSCR LG(.BPLN,B PX) D SETL INE^BPSSCR LG(.BPLN," ") D SETLI NE^BPSSCRL G(.BPLN,"I nsurance N ame: "_$$I NSUR57^BPS SCRLG(BP57 )) D SETLI NE^BPSSCRL G(.BPLN,"G roup Name: "_$$GRPNM ^BPSSCRLG( BPIEN02)) D SETLINE^ BPSSCRLG(. BPLN,"Rx C oordinatio n of Benef its: "_$$R XCOB57^BPS SCRLG(BP57 )) D SETLI NE^BPSSCRL G(.BPLN,"P harmacy Pl an ID: "_$ $PHPLANID^ BPSSCRLG(B P57)) D SE TLINE^BPSS CRLG(.BPLN ,"BIN: "_$ $BIN^BPSSC RLG(BPIEN0 2)) D SETL INE^BPSSCR LG(.BPLN," PCN: "_$$P CN^BPSSCRL G(BPIEN02) ) D SETLIN E^BPSSCRLG (.BPLN,"NC PDP Versio n: "_$$GET VER^BPSSCR LG(BPIEN02 )) D SETLI NE^BPSSCRL G(.BPLN,"G roup ID: " _$$GRPID^B PSSCRLG(BP IEN02)) D SETLINE^BP SSCRLG(.BP LN,"Cardho lder ID: " _$$CRDHLDI D^BPSSCRLG (BPIEN02)) D SETLINE ^BPSSCRLG( .BPLN,"Pat ient Relat ionship Co de: "_$$PA TRELSH^BPS SCRLG(BPIE N02)) D SE TLINE^BPSS CRLG(.BPLN ,"Cardhold er First N ame: "_$$C RDHLDFN^BP SSCRLG(BPI EN02,BP57) ) D SETLIN E^BPSSCRLG (.BPLN,"Ca rdholder L ast Name: "_$$CRDHLD LN^BPSSCRL G(BPIEN02, BP57)) ; B PS122 D SETLINE^BP SSCRLG(.BP LN,"Facili ty ID Qual ifier: "_$ $FACIDQ^BP SSCRLG(BPI EN02)) F B PCNT=BPLN: 1:BPLN0+BP SCRLNS D S ETLINE^BPS SCRLG(.BPL N,"") S BP LN0=BPLN D SETLINE^B PSSCRLG(.B PLN,"Billi ng Request Payer She et: "_$$B1 PYRIEN^BPS SCRU5(BP57 )) D SETLI NE^BPSSCRL G(.BPLN,"R eversal Pa yer Sheet: "_$$B2PYR IEN^BPSSCR U5(BP57)) D SETLINE^ BPSSCRLG(. BPLN,"VA C laim ID: " _$P($G(^BP SC(+BPIEN0 2,0)),U,1) ) D SETLIN E^BPSSCRLG (.BPLN,"") Q
	2401
	2402	A new tag was create d to get t he data fo r the Pres criber DEA Number, w hich is de scribed be low.
	2403
	2404	Subroutine Name
	2405	PDEA^BPSSC RLG
	2406	Enhancemen t Category
	2407	New
	2408	Modify
	2409	Delete
	2410	No Change
	2411	Input Attr ibute Name and Defin ition
	2412	Name: BPIE N02
	2413	Definition : IEN to # 9002313.02
	2414	New Modify Delete No Cha nge
	2415	Output Att ribute Nam e and Defi nition
	2416	Name: $$PD EA
	2417	Definition : Prescri ber DEA Nu mber
	2418	New Modify Delete No Cha nge
	2419	Current Lo gic
	2420
	2421	N/A
	2422
	2423	Modified L ogic (Chan ges are hi ghlighted)
	2424
	2425	BPSSCRLG ; BHAM ISC/S S - ECME L OGINFO ;05 -APR-05 ;; 1.0;E CLAI MS MGMT EN GINE;1,5 ,7,8,10,11 ,15,18,20, 22,24;JU N 2004;Bui ld 27 ;;Pe r VA Direc tive 6402, this rout ine should not be mo dified. ;
	2426	. . .
	2427
	2428	;Prescrib er DEA Num ber
	2429	PDEA(BPIEN 02) ;
	2430	Q $E($P($ G(^BPSC(BP IEN02,400, 1,"D00")), U,1),3,18)
	2431	;
	2432
	2433
	2434	A new tag was create d to get t he data fo r the Tota l Prescrib ed Quantit y Remainin g, which i s describe d below.
	2435
	2436	Subroutine Name
	2437	TOTPQR^BPS SCRLG
	2438	Enhancemen t Category
	2439	New
	2440	Modify
	2441	Delete
	2442	No Change
	2443	Input Attr ibute Name and Defin ition
	2444	Name: BPIE N02
	2445	Definition : IEN to # 9002313.02
	2446	New Modify Delete No Cha nge
	2447	Output Att ribute Nam e and Defi nition
	2448	Name: $$TO TPQR
	2449	Definition : Total P rescribed Quantity R emaining
	2450	New Modify Delete No Cha nge
	2451	Current Lo gic
	2452
	2453	N/A
	2454
	2455	Modified L ogic (Chan ges are hi ghlighted)
	2456
	2457	;Total Pr escribed Q uantity Re maining
	2458	TOTPQR(BPI EN02) ; N X S X=$E($ P($G(^BPSC (BPIEN02,4 00,1,"D00" )),U,2),3, 99) Q +X ;
	2459
	2460
	2461
	2462
	2463	The table below list s new NCPD P fields t hat will a ppear on t he Reject Informatio n Screen o nly if a v alue exist s. These new fields will appe ar in the same locat ion as the Next Avai l Fill lab el.
	2464
	2465
	2466	FIELD #
	2467	ID
	2468	FIELD NAME
	2469	931
	2470	F8
	2471	Maximum Ag e Qualifie r
	2472	932
	2473	GA
	2474	Maximum Ag e
	2475	933
	2476	GB
	2477	Maximum Am ount
	2478	934
	2479	GC
	2480	Maximum Am ount Quali fier
	2481	935
	2482	GF
	2483	Maximum Am ount Time Period
	2484	936
	2485	GG
	2486	Maximum Am ount Time Period Sta rt Date
	2487	937
	2488	GH
	2489	Maximum Am ount Time Period End Date
	2490	938
	2491	GJ
	2492	Maximum Am ount Time Period Uni ts
	2493	943
	2494	GQ
	2495	Minimum Ag e Qualifie r
	2496	944
	2497	GR
	2498	Minimum Ag e
	2499	D19
	2500	M1
	2501	Minimum Am ount
	2502	D20
	2503	M2
	2504	Minimum Am ount Quali fier
	2505	D24
	2506	M6
	2507	Remaining Amount
	2508	D25
	2509	M7
	2510	Remaining Amount Qua lifier
	2511
	2512
	2513	A portion of the cod e from REJ ^PSOREJP1 will be mo ved to REJ ^PSOREJP5, due to th e size of PSOREJP1. REJ^PSORE JP5 will b e modified to add th e code fro m REJ^PSOR EJP1 and t o display the NCPDP fields abo ve on the Reject Inf ormation S creen if t here is a value.
	2514
	2515	Subroutine Name
	2516	REJ^PSOREJ P1
	2517	Enhancemen t Category
	2518	New
	2519	Modify
	2520	Delete
	2521	No Change
	2522	Current Lo gic
	2523
	2524	PSOREJP1 ; BIRM/MFR - Third Par ty Reject Display Sc reen ;04/2 9/05
	2525	;;7.0;OUT PATIENT PH ARMACY;1 48,247,260 ,281,287,2 89,290,358 ,359,385,4 03,421,427 ,448,478,4 82;DEC 1 997;Build 27
	2526	. . .
	2527
	2528	REJ ; - DU R Informat ion
	2529	N TYPE,PF LDT,TREJ,T DATA,PSOET ,PSONAF,PS OCOB,PSOTX T,PSOECME S TDATA=""
	2530	;
	2531	; LH;PSO* 7*448 - Di splay 'RES UBMISSION' where 'BA CK-BILL' c urrently
	2532	; display s if the c laim was r esubmitted from the ECME User Screen.
	2533	; To faci litate thi s, the fun ction $$RE SUBMIT^BPS BUTL was c reated.
	2534	;
	2535	; Back Bi ll indicat or - PSO7 421
	2536	S PSOTXT= "",PSOCOB= $G(DATA(RE J,"COB")), PSOCOB=$S( PSOCOB="SE CONDARY":2 ,PSOCOB="T ERTIARY":3 ,1:1)
	2537	I $$BBILL ^BPSBUTL(R X,FILL,PSO COB) S PSO TXT=" BACK -BILL"
	2538	E I $$RE SUBMIT^BPS BUTL(RX,FI LL,PSOCOB) S PSOTXT= " RESUBMIS SION" ; I A 4719.
	2539	D SETLN(" REJECT Inf ormation ( "_$$ELIGTC V(RX,FILL) _") "_PSOT XT,1,1)
	2540	S PSOECME =$$STATUS^ PSOBPSUT(R X,FILL)
	2541	I PSOECME ="E PAYABL E" D
	2542	. D SETLN ("Reject T ype : " ,,,18)
	2543	. D SETLN ("Reject S tatus : * * E PAYABL E **",,,18 )
	2544	. Q
	2545	E D
	2546	. S TYPE= $S($G(DATA (REJ,"CODE "))=79:"79 - REFILL TOO SOON", 1:"")
	2547	. I TYPE= "" S TYPE= DATA(REJ," CODE")_" - "_$E($$EX P(DATA(REJ ,"CODE")), 1,23)_"-"
	2548	. D SETLN ("Reject T ype : " _TYPE_" re ceived on "_$$FMTE^X LFDT($G(DA TA(REJ,"DA TE/TIME")) ),,,18)
	2549	. ;cnf, P SO7358, if TRICARE /CHAMPVA n on-billabl e then res et Status line
	2550	. S PSOET =$$PSOET^P SOREJP3(RX ,FILL)
	2551	. I PSOET D SETLN(" Status : NO CLAIM SUBM ITTED")
	2552	. I 'PSOE T D SETLN( "Reject St atus : "_ $G(DATA(RE J,"STATUS" ))_" - "_P SOECME,,,1 8)
	2553	. Q
	2554	S PSONAF= $$NFLDT^BP SBUTL(RX,F ILL) ; IA 4719
	2555	I PSONAF' ="" D SETL N("Next Av ail Fill: "_$$FMTE^X LFDT(PSONA F),,,18) ; PSO7421
	2556	D SET("PA YER MESSAG E",63)
	2557	D SET("RE ASON",63)
	2558	S PFLDT=$ $FMTE^XLFD T($G(DATA( REJ,"PLAN PREVIOUS F ILL DATE") ))
	2559	D SET("DU R TEXT",63 ,$S(PFLDT= "":1,1:0))
	2560	I PFLDT'= "" D SETLN ("Last Fil l Date : " _PFLDT_" ( from payer )",,1,18)
	2561	Q
	2562
	2563	Modified L ogic (Chan ges are hi ghlighted)
	2564
	2565	PSOREJP1 ; BIRM/MFR - Third Par ty Reject Display Sc reen ;04/2 9/05
	2566	;;7.0;OUT PATIENT PH ARMACY;1 48,247,260 ,281,287,2 89,290,358 ,359,385,4 03,421,427 ,448,478,4 82,512;D EC 1997;Bu ild 27
	2567	. . .
	2568
	2569	REJ ; - DU R Informat ion
	2570	N TYPE,PF LDT,TREJ,T DATA,PSOET ,PSONAF,PS OCOB,PSOTX T,PSOECME, PSOADD
	2571	S TDATA=" "
	2572	;
	2573	; LH;PSO* 7*448 - Di splay 'RES UBMISSION' where 'BA CK-BILL' c urrently
	2574	; display s if the c laim was r esubmitted from the ECME User Screen.
	2575	; To faci litate thi s, the fun ction $$RE SUBMIT^BPS BUTL was c reated.
	2576	;
	2577	; Back Bi ll indicat or - PSO7 421
	2578	S PSOTXT= "",PSOCOB= $G(DATA(RE J,"COB")), PSOCOB=$S( PSOCOB="SE CONDARY":2 ,PSOCOB="T ERTIARY":3 ,1:1)
	2579	I $$BBILL ^BPSBUTL(R X,FILL,PSO COB) S PSO TXT=" BACK -BILL"
	2580	E I $$RE SUBMIT^BPS BUTL(RX,FI LL,PSOCOB) S PSOTXT= " RESUBMIS SION" ; I A 4719.
	2581	D SETLN(" REJECT Inf ormation ( "_$$ELIGTC V(RX,FILL) _") "_PSOT XT,1,1)
	2582	S PSOECME =$$STATUS^ PSOBPSUT(R X,FILL)
	2583	I PSOECME ="E PAYABL E" D
	2584	. D SETLN ("Reject T ype : " ,,,18)
	2585	. D SETLN ("Reject S tatus : * * E PAYABL E **",,,18 )
	2586	. Q
	2587	E D
	2588	. S TYPE= $S($G(DATA (REJ,"CODE "))=79:"79 - REFILL TOO SOON", 1:"")
	2589	. I TYPE= "" S TYPE= DATA(REJ," CODE")_" - "_$E($$EX P(DATA(REJ ,"CODE")), 1,23)_"-"
	2590	. D SETLN ("Reject T ype : " _TYPE_" re ceived on "_$$FMTE^X LFDT($G(DA TA(REJ,"DA TE/TIME")) ),,,18)
	2591	. ;cnf, P SO7358, if TRICARE /CHAMPVA n on-billabl e then res et Status line
	2592	. S PSOET =$$PSOET^P SOREJP3(RX ,FILL)
	2593	. I PSOET D SETLN(" Status : NO CLAIM SUBM ITTED")
	2594	. I 'PSOE T D SETLN( "Reject St atus : "_ $G(DATA(RE J,"STATUS" ))_" - "_P SOECME,,,1 8)
	2595	. Q
	2596	; code mo ved to PSO REJP5
	2597	D REJ^PSO REJP5
	2598	Q
	2599
	2600
	2601	Subroutine Name
	2602	REJ^PSOREJ P5
	2603	Enhancemen t Category
	2604	New
	2605	Modify
	2606	Delete
	2607	No Change
	2608	Current Lo gic
	2609
	2610	n/a – new subroutine
	2611
	2612	Modified L ogic (Chan ges are hi ghlighted)
	2613
	2614	PSOREJP5 ; ALB/BNT - Third Part y Reject A dditional Reject Inf ormation S creen ;02/ 14/11 ;;7. 0;OUTPATIE NT PHARMAC Y;359,42 1,512;DE C 1997;Bui ld 15 ;
	2615	; Referen ce to $$BB ILL^BPSBUT L and $$RE SUBMIT^BPS BUTL suppo rted by IA 4719
	2616	; Referen ce to BPSN CPD3 suppo rted by IA 4560
	2617	;
	2618	. . .
	2619
	2620	REJ ; - DU R Informat ion - call ed from RE J^PSOREJP1 ; this co de moved f rom PSOREJ P1, routin e was too large ; S PSONAF=$$N FLDT^BPSBU TL(RX,FILL ) ; IA 471 9 I PSONAF '="" D SET LN^PSOREJP 1("Next Av ail Fill: "_$$FMTE^X LFDT(PSONA F),,,16) ; PSO7421 S PSOADD= $$ADDFLDS^ BPSBUTL(RX ,FILL) ; I A 4719
	2621	I '$G(PSO ADD) S PSO ADD="" I $ P(PSOADD,U )'="" D SE TLN^PSOREJ P1("Maximu m Age Qual ifier: "_$ P(PSOADD,U ),,,22) I $P(PSOADD, U,2)'="" D SETLN^PSO REJP1("Max imum Age: "_$P(PSOAD D,U,2),,,1 2) I $P(PS OADD,U,3)' ="" D SETL N^PSOREJP1 ("Maximum Amount: "_ $P(PSOADD, U,3),,,15) I $P(PSOA DD,U,4)'=" " D SETLN^ PSOREJP1(" Maximum Am ount Quali fier: "_$P (PSOADD,U, 4),,,25) I $P(PSOADD ,U,5)'="" D SETLN^PS OREJP1("Ma ximum Amou nt Time Pe riod: "_$P (PSOADD,U, 5),,,27) I $P(PSOADD ,U,6)'="" D SETLN^PS OREJP1("Ma ximum Amou nt Time Pe riod Start Date: "_$ $FMTE^XLFD T($P(PSOAD D,U,6)),,, 38) I $P(P SOADD,U,7) '="" D SET LN^PSOREJP 1("Maximum Amount Ti me Period End Date: "_$$FMTE^X LFDT($P(PS OADD,U,7)) ,,,36) I $ P(PSOADD,U ,8)'="" D SETLN^PSOR EJP1("Maxi mum Amount Time Peri od Units: "_$P(PSOAD D,U,8),,,3 3) I $P(PS OADD,U,9)' ="" D SETL N^PSOREJP1 ("Minimum Age Qualif ier: "_$P( PSOADD,U,9 ),,,22) I $P(PSOADD, U,10)'="" D SETLN^PS OREJP1("Mi nimum Age: "_$P(PSOA DD,U,10),, ,12) I $P( PSOADD,U,1 1)'="" D S ETLN^PSORE JP1("Minim um Amount: "_$P(PSOA DD,U,11),, ,15) I $P( PSOADD,U,1 2)'="" D S ETLN^PSORE JP1("Minim um Amount Qualifier: "_$P(PSOA DD,U,12),, ,25) I $P( PSOADD,U,1 3)'="" D S ETLN^PSORE JP1("Remai ning Amoun t: "_$P(PS OADD,U,13) ,,,17) I $ P(PSOADD,U ,14)'="" D SETLN^PSO REJP1("Rem aining Amo unt Qualif ier: "_$P( PSOADD,U,1 4),,,27) ; D SET^PSO REJP1("PAY ER MESSAGE ",63) D SE T^PSOREJP1 ("REASON", 63) S PFLD T=$$FMTE^X LFDT($G(DA TA(REJ,"PL AN PREVIOU S FILL DAT E"))) D SE T^PSOREJP1 ("DUR TEXT ",63,$S(PF LDT="":1,1 :0)) I PFL DT'="" D S ETLN^PSORE JP1("Last Fill Date : "_PFLDT_ " (from pa yer)",,1,1 8) Q
	2622
	2623
	2624
	2625	ADDFLDS^BP SBUTL will be create d to get t he data fo r the NCPD P fields t hat were l isted abov e so they can be dis played on the Reject Informati on Screen.
	2626
	2627	Subroutine Name
	2628	ADDFLDS^BP SBUTL
	2629	Enhancemen t Category
	2630	New
	2631	Modify
	2632	Delete
	2633	No Change
	2634	Input Attr ibute Name and Defin ition
	2635	Name: RX
	2636	Definition : RX IEN ( req)
	2637	New Modify Delete No Cha nge
	2638	Name: FIL
	2639	Definition : Fill Num ber (req)
	2640	New Modify Delete No Cha nge
	2641	Output Att ribute Nam e and Defi nition
	2642	Name: $$AD DFLDS
	2643	Definition : a strin g separate d by “^” c ontaining the output of the BP SARR array
	2644	New Modify Delete No Cha nge
	2645	Current Lo gic
	2646
	2647	N/A
	2648
	2649	Modified L ogic (Chan ges are hi ghlighted)
	2650
	2651	BPSBUTL ;B HAM ISC/MF R/VA/DLF - IB Commun ication Ut ilities ;0 6/01/2004 ;;1.0;E CL AIMS MGMT ENGINE;1 ,3,2,5,7,8 ,9,10,11,1 5,20,24; JUN 2004;B uild 27 ;; Per VA Dir ective 640 2, this ro utine shou ld not be modified. . . .
	2652
	2653	ADDFLDS(RX ,FIL) ;Ret urns Addit ional NCPD P fields f rom ECME
	2654	;Input:
	2655	; RX (re q) --> RX IEN
	2656	; FIL (r eq) --> Fi ll number
	2657	;Output:
	2658	; BPSREC --> a str ing separa ted by "^" containin g the outp ut of the BPSARR arr ay
	2659	;
	2660	Q:'$G(RX) !($G(FIL)= "") ""
	2661	N BPSAMT, BPSARR,BPS CNT,BPSEDT ,BPSFLDS,B PSREC,BPSS DT,IEN03,I EN59
	2662	;
	2663	S IEN59=$ $IEN59^BPS OSRX(RX,FI L,1)
	2664	S IEN03=+ $P($G(^BPS T(IEN59,0) ),U,5)
	2665	;
	2666	I '$G(IEN 03) Q "" ; Quit if I NE03 is no t found
	2667	;
	2668	S BPSFLDS ="931;932; 933;934;93 5;936;937; 938;943;94 4;2219;222 0;2224;222 5"
	2669	D GETS^DI Q(9002313. 0301,"1,"_ IEN03,BPSF LDS,"IE"," BPSARR")
	2670	;
	2671	S BPSREC= "",BPSCNT= 0
	2672	F I=1:1:$ L(BPSFLDS, ";") S BPS CNT=BPSCNT +1 D
	2673	. S $P(BP SREC,U,BPS CNT)=BPSAR R(9002313. 0301,"1,"_ IEN03_",", +$P(BPSFLD S,";",I)," E")
	2674	;
	2675	; Convert Dates to Fileman Fo rmat (936, 937)
	2676	S BPSSDT= BPSARR(900 2313.0301, "1,"_IEN03 _",",936," I") ; MAX AMT START DATE
	2677	S:BPSSDT BPSSDT=BPS SDT-170000 00,$P(BPSR EC,U,6)=BP SSDT
	2678	S BPSEDT= BPSARR(900 2313.0301, "1,"_IEN03 _",",937," I") ; MAX AMT END DA TE
	2679	S:BPSEDT BPSEDT=BPS EDT-170000 00,$P(BPSR EC,U,7)=BP SEDT
	2680	;
	2681	Q BPSREC
	2682
	2683
	2684
	2685	The table below list s new NCPD P fields t hat will b e added to File 9002 313.32, BP S PAYER RE SPONSE OVE RRIDES, so that the fields can be tested on an inc oming resp onse using the testi ng tool. The routin e BPSTEST will also be modifie d in order for these fields to be includ ed in the incoming r esponse fr om the pay er.
	2686
	2687
	2688	FIELD #
	2689	ID
	2690	FIELD NAME
	2691	931
	2692	F8
	2693	Maximum Ag e Qualifie r
	2694	932
	2695	GA
	2696	Maximum Ag e
	2697	933
	2698	GB
	2699	Maximum Am ount
	2700	934
	2701	GC
	2702	Maximum Am ount Quali fier
	2703	935
	2704	GF
	2705	Maximum Am ount Time Period
	2706	936
	2707	GG
	2708	Max Amt Ti me Period Start Date
	2709	937
	2710	GH
	2711	Max Amt Ti me Period End Date
	2712	938
	2713	GJ
	2714	Max Amt Ti me Period Units
	2715	943
	2716	GQ
	2717	Minimum Ag e Qualifie r
	2718	944
	2719	GR
	2720	Minimum Ag e
	2721	C47
	2722	9T
	2723	Other Paye r Program Type
	2724	C93
	2725	KN
	2726	Patient Pa y Componen t Amount
	2727	C94
	2728	KP
	2729	Patient Pa y Componen t Count
	2730	C95
	2731	KQ
	2732	Patient Pa y Componen t Qual
	2733	D19
	2734	M1
	2735	Minimum Am ount
	2736	D20
	2737	M2
	2738	Minimum Am ount Quali fier
	2739	D23
	2740	M5
	2741	Other Paye r Name
	2742	D24
	2743	M6
	2744	Remaining Amount
	2745	D25
	2746	M7
	2747	Remaining Amount Qua lifier
	2748	D41
	2749	PQ
	2750	Other Paye r Relation ship Type
	2751
	2752	The new fi elds will be added t o the data dictionar y of File 9002313.32 , BPS PAYE R RESPONSE OVERRIDES , in our d evelopment environme nt, and th at file wi ll be incl uded in ou r patch, s o that the new field will be i ncluded in the KIDS Build. Wh en the KID S Build is installed at the si tes, the n ew fields will be au tomaticall y added to File 9002 313.32 on their syst em.
	2753
	2754	The data d ictionary for file 9 002313.32, BPS PAYER RESPONSE OVERRIDES, will be s ent withou t data to the target sites. T he table b elow descr ibes how t he file is to be inc luded in t he KIDS Bu ild.
	2755
	2756	File Name
	2757	BPS PAYER RESPONSE O VERRIDES
	2758	Send Full or Partial DD
	2759	PARTIAL
	2760	Update the Data Dict ionary
	2761	YES
	2762	Send Secur ity Codes
	2763	YES
	2764	Screen to Determine DD Update
	2765	n/a
	2766	Data Comes with File
	2767	NO
	2768
	2769
	2770	The follow ing two ta bles descr ibe how th e new fiel ds are bei ng added t o file 900 2313.32, B PS PAYER R ESPONSE OV ERRIDES.
	2771
	2772	The table below desc ribes the Field Name , Field Nu mber, Node ;Piece, Fi eld Type a nd Field l ength. A descriptio n will als o need to be added t o this fil e, the des cription w ill be the same as t he one use d when the new field s were add ed to the BPS NCPDP FIELD DEFS file.
	2773	* - the NC PDP field number is not part o f file 900 2313.32 it was added only as a reference
	2774
	2775	NCPDP FIEL D #*
	2776
	2777	FIELD NAME
	2778	FIELD
	2779	NO
	2780	NODE;
	2781	PIECE
	2782
	2783	FIELD TYPE /LENGTH
	2784	931-F8
	2785	MAXIMUM AG E QUALIFIE R
	2786	4.01
	2787	4;1
	2788	SET / 1
	2789	‘D’ FOR DA YS; ‘Y’ FO R YEARS
	2790	932-GA
	2791	MAXIMUM AG E
	2792	4.02
	2793	4;2
	2794	NUMBER / 3
	2795	933-GB
	2796	MAXIMUM AM OUNT
	2797	4.03
	2798	4;3
	2799	NUMBER / 1 0
	2800	934-GC
	2801	MAXIMUM AM OUNT QUALI FIER
	2802	4.04
	2803	4;4
	2804	SET / 2
	2805	‘DL’ FOR D OLLAR AMOU NT; ‘DS’ F OR DAYS SU PPLY; ‘FL’ FOR FILLS ;
	2806	‘QY’ FOR Q UANTITY
	2807	935-GF
	2808	MAXIMUM AM OUNT TIME PERIOD
	2809	4.05
	2810	4;5
	2811	SET / 2
	2812	‘CM’ FOR C ALENDAR MO NTH;,
	2813	‘CQ’ FOR C ALENDAR QU ARTER;
	2814	‘CY’ FOR C ALENDAR YE AR;,
	2815	‘DY’ FOR D AYS;,
	2816	‘LT’ FOR L IFETIME,
	2817	‘PD’ FOR P ER DISPENS ING,
	2818	‘SP’ FOR S PECIFIC DA TE RANGE
	2819	936-GG
	2820	MAX AMT TI ME PERIOD START DATE
	2821	4.06
	2822	4;6
	2823	DATE / 8
	2824	937-GH
	2825	MAX AMT TI ME PERIOD END DATE
	2826	4.07
	2827	4;7
	2828	DATE / 8
	2829	936-GJ
	2830	MAX AMT TI ME PERIOD UNITS
	2831	4.08
	2832	4;8
	2833	NUMBER / 4
	2834	943-GQ
	2835	MINIMUM AG E QUALIFIE R
	2836	4.09
	2837	4;9
	2838	SET / 1
	2839	‘D’ FOR DA YS,
	2840	‘Y’ FOR YE ARS
	2841	944-GR
	2842	MINIMUM AG E
	2843	4.1
	2844	4;10
	2845	NUMBER / 3
	2846	C47-9T
	2847	OTHER PAYE R PROGRAM TYPE
	2848	4.11
	2849	4;11
	2850	POINTER / 9002313.38
	2851	C93-KN
	2852	PATIENT PA Y COMPONEN T AMOUNT
	2853	4.12
	2854	4;12
	2855	NUMBER / 8
	2856	C94-KP
	2857	PATIENT PA Y COMPONEN T COUNT
	2858	4.13
	2859	4;13
	2860	NUMBER / 2
	2861	C95-KP
	2862	PATIENT PA Y COMPONEN T QUAL
	2863	4.14
	2864	4;14
	2865	POINTER / 9002313.37
	2866	D19-M1
	2867	MINIMUM AM OUNT
	2868	4.15
	2869	4;15
	2870	NUMBER /10
	2871	D20-M2
	2872	MINIMUM AM OUNT QUALI FIER
	2873	4.16
	2874	4;16
	2875	SET / 3
	2876	‘MDL’ FOR MIN DOLLAR AMT;
	2877	‘MDS’ FOR MIN DAY SU PPLY;
	2878	‘MFL’ FOR MIN FILLS;
	2879	‘MQY’ FOR MIN QTY
	2880	D23-M5
	2881	OTHER PAYE R NAME
	2882	4.17
	2883	4;17
	2884	FREE TEXT / 70
	2885	D24-M6
	2886	REMAINING AMOUNT
	2887	4.18
	2888	4;18
	2889	NUMBER / 1 0
	2890	D25-M7
	2891	REMAINING AMOUNT QUA LIFIER
	2892	4.19
	2893	4;19
	2894	SET / 3
	2895	‘RFL’ FOR REMAINING FILLS;
	2896	‘RQY’ FOR REMAINING QTY;
	2897	‘RDS’ FOR REMAINING DAY SUPPLY
	2898	D41-PQ
	2899	OTHER PAYE R RELATION SHIP TYPE
	2900	4.2
	2901	4;20
	2902	SET / 3
	2903	‘CP’ FOR C OB COVERAG E PRIOR TO RESPONDIN G PAYER,
	2904	‘CS’ FOR C OB COVERAG E SUBSEQUE NT TO RESP ONDING PAY ER,
	2905	’MX’ FOR M UTUALLY EX CLUSIVE BE NEFITS,
	2906	‘CC’ FOR C HANGE IN C OVERAGE,
	2907	‘RP’ FOR RESPONDING PAYER,
	2908	‘CE’ FOR C ENTRALIZED ELIGIBILI TY
	2909
	2910	The table below desc ribes the Help Promp t and Desc ription fo r the new fields bei ng added.
	2911	* - the NC PDP field number is not part o f file 900 2313.32 it was added only as a reference
	2912
	2913	NCPDP FIEL D # *
	2914
	2915	FIELD NAME
	2916
	2917	HELP PROMP T
	2918
	2919	DESCRIPTIO N
	2920	931-F8
	2921	MAXIMUM AG E QUALIFIE R
	2922	Enter over ride value for the M aximum Age Qualifier .
	2923	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the M AXIMUM AGE QUALIFIER (#931) fi eld of the BPS RESPO NSES (#900 2313.03) f ile. Corre sponds to NCPDP code 931-F8 an d qualifie s MAXIMUM AGE (932-G A).
	2924	932-GA
	2925	MAXIMUM AG E
	2926	Enter over ride value between 0 and 999, for the Ma ximum Age.
	2927	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the M AXIMUM AGE (#932) fi eld of the BPS RESPO NSES (#900 2313.03) f ile. Corre sponds to NCPDP code 932-GA.
	2928	933-GB
	2929	MAXIMUM AM OUNT
	2930	Enter betw een 0 and 999999.999 , 3 decima l digits.
	2931	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the M AXIMUM AMO UNT (#933) field of the BPS RE SPONSES (# 9002313.03 ) file. Co rresponds to NCPDP c ode 933-GB .
	2932	934-GC
	2933	MAXIMUM AM OUNT QUALI FIER
	2934	Enter over ride value for the M aximum Amo unt Qualif ier.
	2935	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the M AXIMUM AMO UNT QUALIF IER (#934) field of the BPS RE SPONSES (# 9002313.03 ) file. Co rresponds to NCPDP c ode 934-GC and quali fies MAXIM UM AMOUNT (933-GB).
	2936	935-GF
	2937	MAXIMUM AM OUNT TIME PERIOD
	2938	Enter over ride value for the M aximum Amo unt Time P eriod.
	2939	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the M AXIMUM AMO UNT TIME P ERIOD (#93 5) field o f the BPS RESPONSES (#9002313. 03) file.
	2940	Correspond s to NCPDP code 935- GF.
	2941	936-GG
	2942	MAX AMT TI ME PERIOD START DATE
	2943	Enter the date for t he Maximum Amount Ti me Period Start Date .
	2944	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the M AXIMUM AMO UNT TIME P ERIOD STAR T DATE (#9 36) field of the BPS RESPONSES (#9002313 .03) file.
	2945	Correspond s to NCPDP code 936- GG.
	2946	937-GH
	2947	MAX AMT TI ME PERIOD END DATE
	2948	Enter the date for t he Maximum Amount Ti me Period End Date.
	2949	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the M AXIMUM AMO UNT TIME P ERIOD END DATE (#937 ) field of the BPS R ESPONSES ( #9002313.0 3) file.
	2950	Correspond s to NCPDP code 937- GH.
	2951	943-GQ
	2952	MAX AMT TI ME PERIOD UNITS
	2953	Enter an a mount betw een 0 and 9999, 0 de cimal digi ts, for th e Maximum Amount Tim e Period U nits.
	2954	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the M AXIMUM AMO UNT TIME P ERIOD UNIT S (#938) f ield of th e BPS RESP ONSES (#90 02313.03) file.
	2955	Correspond s to NCPDP code 938- GJ.
	2956	943-GQ
	2957	MINIMUM AG E QUALIFIE R
	2958	Enter over ride value for the M inimum Age Qualifier .
	2959	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the M INIMUM AGE QUALIFIER (#943) fi eld of the BPS RESPO NSES (#900 2313.03) f ile. Corre sponds to NCPDP code 934-GQ an d qualifie s MINIMUM AGE (944-G R).
	2960	944-GR
	2961	MINIMUM AG E
	2962	Enter over ride value between 0 and 999, for the Mi nimum Age.
	2963	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the M INIMUM AGE (#944) fi eld of the BPS RESPO NSES (#900 2313.03) f ile. Corre sponds to NCPDP code 944-GR.
	2964	C47-9T
	2965	OTHER PAYE R PROGRAM TYPE
	2966	Enter over ride value for the O ther Payer Adjudicat ed Program Type.
	2967	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the O THER PAYER ADJUDICAT ED PROGRAM TYPE (#21 47) field of the BPS RESPONSES (#9002313 .03) file. Correspo nds to NCP DP code C4 7-9T.
	2968	C93-KN
	2969	PATIENT PA Y COMPONEN T AMOUNT
	2970	Enter a do llar amoun t between 0 and 9999 99.99, 2 d ecimal dig its.
	2971	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the P ATIENT PAY COMPONENT AMOUNT (# 2193) fiel d of the B PS RESPONS ES (#90023 13.03) fil e. Corresp onds to NC PDP code C 93-KN.
	2972	C94-KP
	2973	PATIENT PA Y COMPONEN T COUNT
	2974	Enter a va lue betwee n 0 and 99 , for the Patient Pa y Componen t Count.
	2975	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the P ATIENT PAY COMPONENT COUNT (#2 194) field of the BP S RESPONSE S (#900231 3.03) file . Correspo nds to NCP DP code C9 4-KP.
	2976	C95-KP
	2977	PATIENT PA Y COMPONEN T QUAL
	2978	Enter over ride value for the P atient Pay Component Qualifier .
	2979	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the P ATIENT PAY COMPONENT QUALIFIER (#2195) f ield of th e BPS RESP ONSES (#90 02313.03) file. Corr esponds to NCPDP cod e C95-KQ a nd qualifi es PATIENT PAY COMPO NENT AMOUN T (C93-KN) .
	2980	D19-M1
	2981	MINIMUM AM OUNT
	2982	Enter an a mount betw een 0 and 999999.999 , 3 decima l digits.
	2983	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the M INIMUM AMO UNT (#2219 ) field of the BPS R ESPONSES ( #9002313.0 3) file. C orresponds to NCPDP code D19-M 1.
	2984	D20-M2
	2985	MINIMUM AM OUNT QUALI FIER
	2986	Enter over ride value for the M inimum Amo unt Qualif ier.
	2987	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the M AXIMUM AMO UNT QUALIF IER (#2220 ) field of the BPS R ESPONSES ( #9002313.0 3) file. C orresponds to NCPDP code D20-M 2 and qual ifies MINI MUM AMOUNT (D19-M1).
	2988	D23-M5
	2989	OTHER PAYE R NAME
	2990	Enter over ride value for the O ther Payer Name.
	2991	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the O THER PAYER NAME (#22 23) field of the BPS RESPONSES (#9002313 .03) file. Correspon ds to NCPD P code D23 -M5.
	2992	D24-M6
	2993	REMAINING AMOUNT
	2994	Enter betw een 0 and 999999.999 , 3 decima l digits.
	2995	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the R EMAINING A MOUNT (#22 24) field of the BPS RESPONSES (#9002313 .03) file. Correspon ds to NCPD P code D24 -M6.
	2996	D25-M7
	2997	REMAINING AMOUNT QUA LIFIER
	2998	Enter over ride value for the R emaining A mount Qual ifier.
	2999	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the R EMAINING A MOUNT QUAL IFIER (#22 25) field of the BPS RESPONSES (#9002313 .03) file.
	3000	Correspond s to NCPDP code D25- M7 and qua lifies REM AINING AMO UNT (D24-M 6).
	3001	D41-PQ
	3002	OTHER PAYE R RELATION SHIP TYPE
	3003	Enter over ride value for the O ther Payer Relations hip Type.
	3004	This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the O THER PAYER RELATIONS HIP TYPE ( #2241) fie ld of the BPS RESPON SES (#9002 313.03) fi le. Corres ponds to N CPDP code D41-PQ.
	3005
	3006
	3007
	3008
	3009
	3010
	3011
	3012	The subrou tines GETO VER and SE TOVER in B PSTEST wil l need to be modifie d to allow the user to enter t he new fie lds we add ed above t o the BPS PAYER RESP ONSE OVERR IDES file.
	3013
	3014	Subroutine Name
	3015	GETOVER^BP STEST
	3016	Enhancemen t Category
	3017	New
	3018	Modify
	3019	Delete
	3020	No Change
	3021	Current Lo gic
	3022
	3023	BPSTEST ;O AK/ELZ - E CME TESTIN G TOOL ;11 /15/07 09 :55
	3024	;;1.0;E C LAIMS MGMT ENGINE; 6,7,8,10,1 1,15,19,20 ,22,23;J UN 2004;Bu ild 27
	3025	;;Per VA Directive 6402, this routine s hould not be modifie d.
	3026	;
	3027	; Look at BPSTEST1 for additi onal docum entation o f the Test ing Tool
	3028	;
	3029	GETOVER(KE Y1,KEY2,BP SORESP,BPS WHERE,BPST YPE,BPPAYS EQ) ;
	3030	; called by BPSNCPD P to enter overrides for a par ticular RX
	3031	; INPUT
	3032	; KEY1 - Pr escription IEN/Patie nt IEN
	3033	; KEY2 - Fi ll Number/ Policy Num ber
	3034	; BPSO RESP - Pr evious res ponse when this clai m was proc essed
	3035	; BPSW HERE - RX Action pa ssed into BPSNCPDP
	3036	; BPST YPE - R (Reversal) , S (Submi ssion), E (Eligibili ty)
	3037	; BPPA YSEQ - pa yer sequen ce 1 - pri mary, 2 - secondary
	3038	; OUTPUT
	3039	; None - Table B PS PAYER R ESPONSE OV ERRIDE ent ry is crea ted.
	3040	;
	3041	N BPSTRAN S,BPSTIEN, BPSSRESP,D IC,X,Y,DIR ,DIK,DA
	3042	;
	3043	; Check i f testing is enabled
	3044	I '$$CHEC K() Q
	3045	;
	3046	; Option can not be run for D ate of Dea th option as it caus es errors
	3047	I $G(XQY0 )["DG DEAT H ENTRY" W !,"The te sting tool can not b e run from Date of D eath optio n" Q
	3048	;
	3049	; Do not run for ba ckground j obs
	3050	I $D(ZTQU EUED)!(",A REV,CRLB,C RLR,CRLX,C RRL,PC,PL, "[(","_BPS WHERE_",") ) Q
	3051	;
	3052	; Create Transactio n Number
	3053	S BPSTRAN S=$$IEN59^ BPSOSRX(KE Y1,KEY2,$S ($G(BPPAYS EQ)>0:+BPP AYSEQ,1:1) )
	3054	;
	3055	. . .
	3056
	3057	.. ; Addi tional ove rrides for E0-E6 (BP S119)
	3058	.. D PROM PT(BPSTIEN ,2.01,"04" ) ; % s ales tax b asis pd
	3059	.. D PROM PT(BPSTIEN ,2.02,11) ; oth er amount paid quali fier
	3060	.. D PROM PT(BPSTIEN ,2.03,"01" ) ; pay er id qual ifier
	3061	.. D PROM PT(BPSTIEN ,2.04,"") ; hel p desk pho ne# ext
	3062	.. D PROM PT(BPSTIEN ,2.05,"") ; pro service f ee cont/re im amt
	3063	.. D PROM PT(BPSTIEN ,2.06,"") ; oth er payer h elp desk p hone# ext
	3064	.. D PROM PT(BPSTIEN ,2.07,"") ; res ponse inte rmed auth type id
	3065	.. D PROM PT(BPSTIEN ,2.08,"") ; res ponse inte rmed auth id
	3066	.. D PROM PT(BPSTIEN ,3.01,"") ; res ponse inte rmed messa ge
	3067	.. ;
	3068	.. ; E7 o verrides ( BPS120)
	3069	.. D PROM PT(BPSTIEN ,.11,"") ; quan limit per speci fic time p eriod
	3070	.. D PROM PT(BPSTIEN ,.12,"") ; quan limit time peri od
	3071	.. D PROM PT(BPSTIEN ,.13,"") ; days supp limit per specific t ime period
	3072	.. D PROM PT(BPSTIEN ,.14,"") ; days supp limit time period
	3073	.. ; Over rides to t est functi onality - BPS122
	3074	.. D PROM PT(BPSTIEN ,2.09,"") ; reconcilia tion id
	3075	.. ;
	3076	.. D PROM PT(BPSTIEN ,2.1,"") ; Patient Pa y Amount
	3077	;
	3078	W ! D PRO MPT(BPSTIE N,.07,0)
	3079	Q
	3080
	3081	Modified L ogic (Chan ges are hi ghlighted)
	3082
	3083	BPSTEST ;O AK/ELZ - E CME TESTIN G TOOL ;11 /15/07 09 :55
	3084	;;1.0;E C LAIMS MGMT ENGINE;** 6,7,8,10,1 1,15,19,20 ,22,23,24* *;JUN 2004 ;Build 27
	3085	;;Per VA Directive 6402, this routine s hould not be modifie d.
	3086	;
	3087	; Look at BPSTEST1 for additi onal docum entation o f the Test ing Tool
	3088	;
	3089	GETOVER(KE Y1,KEY2,BP SORESP,BPS WHERE,BPST YPE,BPPAYS EQ) ;
	3090	; called by BPSNCPD P to enter overrides for a par ticular RX
	3091	; INPUT
	3092	; KEY1 - Pr escription IEN/Patie nt IEN
	3093	; KEY2 - Fi ll Number/ Policy Num ber
	3094	; BPSO RESP - Pr evious res ponse when this clai m was proc essed
	3095	; BPSW HERE - RX Action pa ssed into BPSNCPDP
	3096	; BPST YPE - R (Reversal) , S (Submi ssion), E (Eligibili ty)
	3097	; BPPA YSEQ - pa yer sequen ce 1 - pri mary, 2 - secondary
	3098	; OUTPUT
	3099	; None - Table B PS PAYER R ESPONSE OV ERRIDE ent ry is crea ted.
	3100	;
	3101	N BPSTRAN S,BPSTIEN, BPSSRESP,D IC,X,Y,DIR ,DIK,DA
	3102	;
	3103	; Check i f testing is enabled
	3104	I '$$CHEC K() Q
	3105	;
	3106	; Option can not be run for D ate of Dea th option as it caus es errors
	3107	I $G(XQY0 )["DG DEAT H ENTRY" W !,"The te sting tool can not b e run from Date of D eath optio n" Q
	3108	;
	3109	; Do not run for ba ckground j obs
	3110	I $D(ZTQU EUED)!(",A REV,CRLB,C RLR,CRLX,C RRL,PC,PL, "[(","_BPS WHERE_",") ) Q
	3111	;
	3112	; Create Transactio n Number
	3113	S BPSTRAN S=$$IEN59^ BPSOSRX(KE Y1,KEY2,$S ($G(BPPAYS EQ)>0:+BPP AYSEQ,1:1) )
	3114	;
	3115	. . .
	3116
	3117	.. ; Addi tional ove rrides for E0-E6 (BP S119)
	3118	.. D PROM PT(BPSTIEN ,2.01,"04" ) ; % s ales tax b asis pd
	3119	.. D PROM PT(BPSTIEN ,2.02,11) ; oth er amount paid quali fier
	3120	.. D PROM PT(BPSTIEN ,2.03,"01" ) ; pay er id qual ifier
	3121	.. D PROM PT(BPSTIEN ,2.04,"") ; hel p desk pho ne# ext
	3122	.. D PROM PT(BPSTIEN ,2.05,"") ; pro service f ee cont/re im amt
	3123	.. D PROM PT(BPSTIEN ,2.06,"") ; oth er payer h elp desk p hone# ext
	3124	.. D PROM PT(BPSTIEN ,2.07,"") ; res ponse inte rmed auth type id
	3125	.. D PROM PT(BPSTIEN ,2.08,"") ; res ponse inte rmed auth id
	3126	.. D PROM PT(BPSTIEN ,3.01,"") ; res ponse inte rmed messa ge
	3127	.. ;
	3128	.. ; E7 o verrides ( BPS120)
	3129	.. D PROM PT(BPSTIEN ,.11,"") ; quan limit per speci fic time p eriod
	3130	.. D PROM PT(BPSTIEN ,.12,"") ; quan limit time peri od
	3131	.. D PROM PT(BPSTIEN ,.13,"") ; days supp limit per specific t ime period
	3132	.. D PROM PT(BPSTIEN ,.14,"") ; days supp limit time period
	3133	.. ; Over rides to t est functi onality - BPS122
	3134	.. D PROM PT(BPSTIEN ,2.09,"") ; reconcilia tion id
	3135	.. ;
	3136	.. D PROM PT(BPSTIEN ,2.1,"") ; Patient Pa y Amount
	3137	.. ;
	3138	.. D PROM PT(BPSTIEN ,4.01,"") ; Maximum Ag e Qualifie r
	3139	.. D PROM PT(BPSTIEN ,4.02,"") ; Maximum Ag e
	3140	.. D PROM PT(BPSTIEN ,4.03,"") ; Maximum Am ount
	3141	.. D PROM PT(BPSTIEN ,4.04,"") ; Maximum Am ount Quali fier
	3142	.. D PROM PT(BPSTIEN ,4.05,"") ; Maximum Am ount Time Period
	3143	.. D PROM PT(BPSTIEN ,4.06,"") ; Maximum Am ount Time Period Sta rt Date
	3144	.. D PROM PT(BPSTIEN ,4.07,"") ; Maximum Am ount Time Period End Date
	3145	.. D PROM PT(BPSTIEN ,4.08,"") ; Maximum Am ount Time Period Uni ts
	3146	.. D PROM PT(BPSTIEN ,4.09,"") ; Minimum Ag e Qualifie r
	3147	.. D PROM PT(BPSTIEN ,4.1,"") ; Minimum Ag e
	3148	.. D PROM PT(BPSTIEN ,4.11,"") ; Other Paye r Adjudica ted Progra m Type
	3149	.. D PROM PT(BPSTIEN ,4.12,"") ; Patient Pa y Componen t Amount
	3150	.. D PROM PT(BPSTIEN ,4.13,"") ; Patient Pa y Componen t Count
	3151	.. D PROM PT(BPSTIEN ,4.14,"") ; Patient Pa y Componen t Qualifie r
	3152	.. D PROM PT(BPSTIEN ,4.15,"") ; Minimum Am ount
	3153	.. D PROM PT(BPSTIEN ,4.16,"") ; Minimum Am ount Quali fier
	3154	.. D PROM PT(BPSTIEN ,4.17,"") ; Other Paye r Name
	3155	.. D PROM PT(BPSTIEN ,4.18,"") ; Remaining Amount
	3156	.. D PROM PT(BPSTIEN ,4.19,"") ; Remaining Amount Qua lifier
	3157	.. D PROM PT(BPSTIEN ,4.2,"") ; O ther Payer Relations hip Type
	3158	;
	3159	W ! D PRO MPT(BPSTIE N,.07,0)
	3160	Q
	3161
	3162
	3163	With the c hanges for this user story the routine B PSTEST wil l be too l arge, exce ed SAC sta ndards, so the code was moved to SETOVER ^BPSTEST2. This is described in the tab les below.
	3164
	3165	Subroutine Name
	3166	SETOVER^BP STEST
	3167	Enhancemen t Category
	3168	New
	3169	Modify
	3170	Delete
	3171	No Change
	3172	Current Lo gic
	3173
	3174	SETOVER(BP STRANS,BPS TYPE,BPSDA TA) ;
	3175	; called by BPSECMP S to set t he overrid e data
	3176	; Input
	3177	; BPST RANS - Tra nsaction I EN
	3178	; BPST YPE - B1 for submis sion, B2 f or reversa ls
	3179	; Output
	3180	; BPSD ATA - P assed by r eference a nd updated with appr opriate ov errides
	3181	;
	3182	N BPSTIEN ,BPSRRESP, BPSSRESP,B PSPAID,BPS RCNT,BPSRI EN,BPSRCOD E,BPSRCD,B PSCOPAY,BP SXXXX,BPSU NDEF
	3183	N BPSAJPA Y,BPSNFLDT ,BPSX
	3184	N BPS506, BPS507,BPS 513,BPS517
	3185	;
	3186	; Check t he Test Fl ag in set in BPS SET UP
	3187	I '$$CHEC K() Q
	3188	; ; If a eligibilit y, check f or specifi c reversal overrides and set I BPSTYPE=" E1" D Q . S BPSRRES P=$$GET1^D IQ(9002313 .32,BPSTIE N_",",.08, "I") . ; . ; If the response i s Stranded , force an <UNDEF> e rror . I B PSRRESP="S " S BPSXXX X=BPSUNDEF . I BPSRR ESP]"" S B PSDATA(1,1 12)=BPSRRE SP . S BPS DATA(90023 13.03,9002 313.03,"+1 ,",501)=$S (BPSRRESP= "R":"R",1: "A") . ; . ; If the response is accepte d, delete the reject code coun t and code s . I BPSR RESP="A" K BPSDATA(1 ,510),BPSD ATA(1,511) . ; . ; If the res ponse is r ejected, d elete the rejections returned by payers . ; and pu t in the o nes entere d by the u ser . I BP SRRESP="R" D .. K BP SDATA(1,50 9),BPSDATA (1,511) .. S BPSRCNT =0 .. S BP SRIEN=0 F S BPSRIEN =$O(^BPS(9 002313.32, BPSTIEN,1, BPSRIEN)) Q:+BPSRIEN =0 D ... S BPSRCODE= $P($G(^BPS (9002313.3 2,BPSTIEN, 1,BPSRIEN, 0)),"^",1) ... ; Inc rement cou nter and s tore ... I BPSRCODE] "" D .... S BPSRCD=$ $GET1^DIQ( 9002313.93 ,BPSRCODE_ ",",.01,"E ") .... I BPSRCD]"" S BPSRCNT= BPSRCNT+1, BPSDATA(1, 511,BPSRCN T)=BPSRCD .. ; Store total num ber of rej ections .. S BPSDATA (1,510)=BP SRCNT ; ; If a rever sal, check for speci fic revers al overrid es and set I BPSTYPE ="B2" D . S BPSRRESP =$$GET1^DI Q(9002313. 32,BPSTIEN _",",.05," I") . ; . ; If the r esponse is Stranded, force an <UNDEF> er ror . I BP SRRESP="S" S BPSXXXX =BPSUNDEF . I BPSRRE SP]"" S BP SDATA(1,11 2)=$S(BPSR RESP="D":" S",1:BPSRR ESP) . S B PSDATA(900 2313.03,90 02313.03," +1,",501)= $S(BPSRRES P="R":"R", 1:"A") . ; . ; If th e response is accept ed or dupl icate, kil l the reje ct code co unt and co des . I BP SRRESP="A" !(BPSRRESP ="D") K BP SDATA(1,51 0),BPSDATA (1,511) . ; . ; If t he respons e is rejec ted, set t he reject codes . I BPSRRESP=" R" D SETRE J(BPSTRANS ) ; ; If a submissio n, check f or specifi c submissi on overrid es and set I BPSTYP E="B1" D . ; Get sub mission re sponse . S BPSSRESP= $$GET1^DIQ (9002313.3 2,BPSTIEN_ ",",.03,"I ") . ; . ; If the re sponse is Stranded, force an < UNDEF> err or . I BPS SRESP="S" S BPSXXXX= BPSUNDEF . ; . ; If BPSSRESP e xists, fil e it . I B PSSRESP]"" D .. S BP SDATA(1,11 2)=BPSSRES P .. S BPS DATA(90023 13.03,9002 313.03,"+1 ,",501)=$S (BPSSRESP= "R":"R",1: "A") .. ; If payable or duplic ate, get t he BPSPAID amount an d file it if it .. ; exists. A lso delete any rejec t codes .. I BPSSRES P="P"!(BPS SRESP="D") D ... ; . .. S BPSX= $$GET1^DIQ (9002313.3 2,BPSTIEN_ ",",2.1,"I ") ; 505-F 5 Patient Pay Amount ... I BPS X]"" S BPS DATA(1,"50 5")=$$DFF^ BPSECFM(BP SX,10) ... ; ... S B PSPAID=$$G ET1^DIQ(90 02313.32,B PSTIEN_"," ,.04,"I") ... I BPSP AID]"" S B PSDATA(1,5 09)=$$DFF^ BPSECFM(BP SPAID,8) ; 509 Total amount pa id ... ; . .. K BPSDA TA(1,510), BPSDATA(1, 511) ; kil l Reject C ount (510) and Rejec t Code (51 1) ... ; . .. S BPSCO PAY=$$GET1 ^DIQ(90023 13.32,BPST IEN_",",.0 6,"I") ... I BPSCOPA Y]"" S BPS DATA(1,518 )=$$DFF^BP SECFM(BPSC OPAY,8) ; 518 Copay Amount ... ; ... S B PS506=$$GE T1^DIQ(900 2313.32,BP STIEN_",", .15,"I") . .. I BPS50 6]"" S BPS DATA(1,506 )=$$DFF^BP SECFM(BPS5 06,8) ; 50 6 Ingredie nt Cost Pa id ... ; . .. S BPS50 7=$$GET1^D IQ(9002313 .32,BPSTIE N_",",.16, "I") ... I BPS507]"" S BPSDATA (1,507)=$$ DFF^BPSECF M(BPS507,8 ) ; 507 Di spensing F ee Paid .. . ; ... S BPS513=$$G ET1^DIQ(90 02313.32,B PSTIEN_"," ,.17,"I") ... I BPS5 13]"" S BP SDATA(1,51 3)=$$DFF^B PSECFM(BPS 513,8) ; 5 13 Remaini ng Deducti ble Amount ... ; ... S BPS517= $$GET1^DIQ (9002313.3 2,BPSTIEN_ ",",.18,"I ") ... I B PS517]"" S BPSDATA(1 ,517)=$$DF F^BPSECFM( BPS517,8) ; 517 Amou nt Applied to Period ic Deducti ble ... Q .. ; .. I BPSSRESP=" P"!(BPSSRE SP="D")!(B PSSRESP="R ") D ... ; D1-D9 fie lds (BPS1 15) ... S BPSAJPAY= $$GET1^DIQ (9002313.3 2,BPSTIEN_ ",",.1,"I" ) ; Adjudi cated Paym ent Type . .. I BPSAJ PAY]"" S B PSDATA(1,1 028)=$$NFF ^BPSECFM(B PSAJPAY,2) ... S BPS NFLDT=$$GE T1^DIQ(900 2313.32,BP STIEN_",", .09,"I") ; Override Next Avail able Fill ... I BPSN FLDT]"" S BPSDATA(1, 2004)=$$DT F1^BPSECFM (BPSNFLDT) ... ;
	3189	... ; E0- E6 overrid es (BPS1 19)
	3190	... ; PER CENTAGE SA LES TAX BA SIS PAID
	3191	... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",2.01 ,"I")
	3192	... I BPS X]"" S BPS DATA(1,561 )=BPSX
	3193	... ; OTH ER AMOUNT PAID QUALI FIER and a ssociated field
	3194	... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",2.02 ,"I")
	3195	... I BPS X]"" S BPS DATA(1,564 ,1)=$$NFF^ BPSECFM(BP SX,2),BPSD ATA(1,565, 1)=$$DFF^B PSECFM(5.6 4,8),BPSDA TA(1,563)= 1
	3196	... ; PAY ER ID QUAL IFIER
	3197	... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",2.03 ,"I")
	3198	... I BPS X]"" S BPS DATA(90023 13.03,9002 313.03,"+1 ,",568)=BP SX
	3199	... ; HEL P DESK TEL EPHONE NUM BER EXTENS ION
	3200	... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",2.04 ,"I")
	3201	... I BPS X]"" S BPS DATA(1,"20 22")=$$NFF ^BPSECFM(B PSX,8)
	3202	... ; PRO FESSIONAL SERVICE FE E CONTRACT ED/REIMURS EMENT AMOU NT
	3203	... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",2.05 ,"I")
	3204	... I BPS X]"" S BPS DATA(1,"20 33")=$$DFF ^BPSECFM(B PSX,8)
	3205	... ; OTH ER PAYER H ELPDESK TE LEPHONE EX TENSION
	3206	... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",2.06 ,"I")
	3207	... I BPS X]"" S BPS DATA(1,"20 23",1)=$$N FF^BPSECFM (BPSX,8),B PSDATA(1,3 38,1)="01"
	3208	... ; RES PONSE INTE RMEDIARY A UTHORIZATI ON TYPE ID and assoc iated fiel ds
	3209	... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",2.07 ,"I")
	3210	... I BPS X]"" S BPS DATA(1,"20 53",1)=$$N FF^BPSECFM (BPSX,2),B PSDATA(1,2 052)=1
	3211	... ; RES PONSE INTE RMEDIARY A UTHORIZATI ON ID and associated fields
	3212	... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",2.08 ,"I")
	3213	... I BPS X]"" S BPS DATA(1,"20 54",1)=$$A NFF^BPSECF M(BPSX,20) ,BPSDATA(1 ,2052)=1
	3214	... ; INT ERMEDIARY MESSAGE an d associat ed fields
	3215	... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",3.01 ,"I")
	3216	... I BPS X]"" S BPS DATA(1,"20 51",1)=$$A NFF^BPSECF M(BPSX,200 ),BPSDATA( 1,2052)=1
	3217	... ; (BP S122)
	3218	... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",2.09 ,"I") ; B9 8-34 recon ciliation id
	3219	... I BPS X]"" S BPS DATA(1,"20 98")=$$ANF F^BPSECFM( BPSX,30)
	3220	... ;
	3221	... ; E7 overrides (BPS120)
	3222	... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",.11, "I") I BPS X'="" D ; B88-3R quantity limit per spec time period
	3223	.... S BP SDATA(1,20 87)=1 ; count f ield
	3224	.... S BP SDATA(1,20 88,1)=$$NF F^BPSECFM( BPSX,10) ; data fr om overrid e file
	3225	.... Q
	3226	... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",.12, "I") I BPS X'="" D ; B89-3S quantity limit time period
	3227	.... S BP SDATA(1,20 87)=1 ; count f ield
	3228	.... S BP SDATA(1,20 89,1)=$$NF F^BPSECFM( BPSX,5) ; data fr om overrid e file
	3229	.... Q
	3230	... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",.13, "I") I BPS X'="" D ; B91-3W days supp ly limit p er spec ti me period
	3231	.... S BP SDATA(1,20 90)=1 ; count f ield
	3232	.... S BP SDATA(1,20 91,1)=$$NF F^BPSECFM( BPSX,3) ; data fr om overrid e file
	3233	.... Q
	3234	... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",.14, "I") I BPS X'="" D ; B92-3X days supp ly limit t ime period
	3235	.... S BP SDATA(1,20 90)=1 ; count f ield
	3236	.... S BP SDATA(1,20 92,1)=$$NF F^BPSECFM( BPSX,5) ; data fr om overrid e file
	3237	.... Q
	3238	... Q
	3239	.. ;
	3240	.. ; If r ejected, g et the rej ection cod e and file them
	3241	.. ; Also , delete t he BPSPAID amount
	3242	.. I BPSS RESP="R" D
	3243	... ; Del ete old re jections a nd BPSPAID amount
	3244	... K BPS DATA(1,509 ),BPSDATA( 1,511)
	3245	... ; Loo p through rejections and store
	3246	... S BPS RCNT=0
	3247	... S BPS RIEN=0 F S BPSRIEN= $O(^BPS(90 02313.32,B PSTIEN,1,B PSRIEN)) Q :+BPSRIEN= 0 D
	3248	.... S BP SRCODE=$P( $G(^BPS(90 02313.32,B PSTIEN,1,B PSRIEN,0)) ,"^",1)
	3249	.... ; In crement co unter and store
	3250	.... I BP SRCODE]"" D
	3251	..... S B PSRCD=$$GE T1^DIQ(900 2313.93,BP SRCODE_"," ,.01,"E")
	3252	..... I B PSRCD]"" S BPSRCNT=B PSRCNT+1,B PSDATA(1,5 11,BPSRCNT )=BPSRCD
	3253	... ; Sto re total n umber of r ejections
	3254	... S BPS DATA(1,510 )=BPSRCNT
	3255	Q
	3256
	3257	Modified L ogic (Chan ges are hi ghlighted)
	3258
	3259	SETOVER(BP STRANS,BPS TYPE,BPSDA TA) ;
	3260	; called by BPSECMP S to set t he overrid e data
	3261	; Input
	3262	; BPST RANS - Tra nsaction I EN
	3263	; BPST YPE - B1 for submis sion, B2 f or reversa ls
	3264	; Output
	3265	; BPSD ATA - P assed by r eference a nd updated with appr opriate ov errides
	3266	;
	3267	N BPSTIEN ,BPSRRESP, BPSSRESP,B PSPAID,BPS RCNT,BPSRI EN,BPSRCOD E,BPSRCD,B PSCOPAY,BP SXXXX,BPSU NDEF
	3268	N BPSAJPA Y,BPSNFLDT ,BPSX
	3269	N BPS506, BPS507,BPS 513,BPS517
	3270	;
	3271	; Check t he Test Fl ag in set in BPS SET UP
	3272	I '$$CHEC K() Q
	3273	; ; Check if the Tr ansaction Number is defined in BPS RESPO NSE OVERRI DES S BPST IEN=$O(^BP S(9002313. 32,"B",BPS TRANS,"")) I BPSTIEN ="" Q ; ; If a eligi bility, ch eck for sp ecific rev ersal over rides and set ; If a reversal, check for specific reversal o verrides a nd set ; I f a submis sion, chec k for spec ific submi ssion over rides and set ; th e code for the above checks wa s moved to SETOVER^B PSTEST2 D SETOVER^BP STEST2
	3274	Q
	3275
	3276
	3277	The code t hat is in Bold below was the c ode that w ill be add ed for thi s user sto ry.
	3278
	3279	Subroutine Name
	3280	SETOVER^BP STEST2
	3281	Enhancemen t Category
	3282	New
	3283	Modify
	3284	Delete
	3285	No Change
	3286	Current Lo gic
	3287
	3288	n/a – new subroutine
	3289
	3290	Modified L ogic (Chan ges are hi ghlighted)
	3291
	3292	BPSTEST2 ; AITC/CKB - ECME TEST ING TOOL ; 5/31/2018 ;;1.0;E CL AIMS MGMT ENGINE;2 4; ;;Per VA Direct ive 6402, this routi ne should not be mod ified. ; Q ;SETOVER ; ; the fo llowing co de was fro m SETOVER^ BPSTEST an d is calle d by SETOV ER^BPSTEST ; ; If a eligibilit y, check f or specifi c reversal overrides and set I BPSTYPE=" E1" D Q . S BPSRRES P=$$GET1^D IQ(9002313 .32,BPSTIE N_",",.08, "I") . ; . ; If the response i s Stranded , force an <UNDEF> e rror . I B PSRRESP="S " S BPSXXX X=BPSUNDEF . I BPSRR ESP]"" S B PSDATA(1,1 12)=BPSRRE SP . S BPS DATA(90023 13.03,9002 313.03,"+1 ,",501)=$S (BPSRRESP= "R":"R",1: "A") . ; . ; If the response is accepte d, delete the reject code coun t and code s . I BPSR RESP="A" K BPSDATA(1 ,510),BPSD ATA(1,511) . ; . ; If the res ponse is r ejected, d elete the rejections returned by payers . ; and pu t in the o nes entere d by the u ser . I BP SRRESP="R" D .. K BP SDATA(1,50 9),BPSDATA (1,511) .. S BPSRCNT =0 .. S BP SRIEN=0 F S BPSRIEN =$O(^BPS(9 002313.32, BPSTIEN,1, BPSRIEN)) Q:+BPSRIEN =0 D ... S BPSRCODE= $P($G(^BPS (9002313.3 2,BPSTIEN, 1,BPSRIEN, 0)),"^",1) ... ; Inc rement cou nter and s tore ... I BPSRCODE] "" D .... S BPSRCD=$ $GET1^DIQ( 9002313.93 ,BPSRCODE_ ",",.01,"E ") .... I BPSRCD]"" S BPSRCNT= BPSRCNT+1, BPSDATA(1, 511,BPSRCN T)=BPSRCD .. ; Store total num ber of rej ections .. S BPSDATA (1,510)=BP SRCNT ; ; If a rever sal, check for speci fic revers al overrid es and set I BPSTYPE ="B2" D . S BPSRRESP =$$GET1^DI Q(9002313. 32,BPSTIEN _",",.05," I") . ; . ; If the r esponse is Stranded, force an <UNDEF> er ror . I BP SRRESP="S" S BPSXXXX =BPSUNDEF . I BPSRRE SP]"" S BP SDATA(1,11 2)=$S(BPSR RESP="D":" S",1:BPSRR ESP) . S B PSDATA(900 2313.03,90 02313.03," +1,",501)= $S(BPSRRES P="R":"R", 1:"A") . ; . ; If th e response is accept ed or dupl icate, kil l the reje ct code co unt and co des . I BP SRRESP="A" !(BPSRRESP ="D") K BP SDATA(1,51 0),BPSDATA (1,511) . ; . ; If t he respons e is rejec ted, set t he reject codes . I BPSRRESP=" R" D SETRE J^BPSTEST( BPSTRANS) ; ; If a s ubmission, check for specific submission overrides and set I BPSTYPE= "B1" D . ; Get submi ssion resp onse . S B PSSRESP=$$ GET1^DIQ(9 002313.32, BPSTIEN_", ",.03,"I") . ; . ; I f the resp onse is St randed, fo rce an <UN DEF> error . I BPSSR ESP="S" S BPSXXXX=BP SUNDEF . ; . ; If BP SSRESP exi sts, file it . I BPS SRESP]"" D .. S BPSD ATA(1,112) =BPSSRESP .. S BPSDA TA(9002313 .03,900231 3.03,"+1," ,501)=$S(B PSSRESP="R ":"R",1:"A ") .. ; If payable o r duplicat e, get the BPSPAID a mount and file it if it .. ; e xists. Als o delete a ny reject codes .. I BPSSRESP= "P"!(BPSSR ESP="D") D ... ; ... S BPSX=$$ GET1^DIQ(9 002313.32, BPSTIEN_", ",2.1,"I") ; 505-F5 Patient Pa y Amount . .. I BPSX] "" S BPSDA TA(1,"505" )=$$DFF^BP SECFM(BPSX ,10) ... ; ... S BPS PAID=$$GET 1^DIQ(9002 313.32,BPS TIEN_",",. 04,"I") .. . I BPSPAI D]"" S BPS DATA(1,509 )=$$DFF^BP SECFM(BPSP AID,8) ; 5 09 Total a mount paid ... ; ... K BPSDATA (1,510),BP SDATA(1,51 1) ; kill Reject Cou nt (510) a nd Reject Code (511) ... ; ... S BPSCOPA Y=$$GET1^D IQ(9002313 .32,BPSTIE N_",",.06, "I") ... I BPSCOPAY] "" S BPSDA TA(1,518)= $$DFF^BPSE CFM(BPSCOP AY,8) ; 51 8 Copay Am ount ... ; ... S BPS 506=$$GET1 ^DIQ(90023 13.32,BPST IEN_",",.1 5,"I") ... I BPS506] "" S BPSDA TA(1,506)= $$DFF^BPSE CFM(BPS506 ,8) ; 506 Ingredient Cost Paid ... ; ... S BPS507= $$GET1^DIQ (9002313.3 2,BPSTIEN_ ",",.16,"I ") ... I B PS507]"" S BPSDATA(1 ,507)=$$DF F^BPSECFM( BPS507,8) ; 507 Disp ensing Fee Paid ... ; ... S BP S513=$$GET 1^DIQ(9002 313.32,BPS TIEN_",",. 17,"I") .. . I BPS513 ]"" S BPSD ATA(1,513) =$$DFF^BPS ECFM(BPS51 3,8) ; 513 Remaining Deductibl e Amount . .. ; ... S BPS517=$$ GET1^DIQ(9 002313.32, BPSTIEN_", ",.18,"I") ... I BPS 517]"" S B PSDATA(1,5 17)=$$DFF^ BPSECFM(BP S517,8) ; 517 Amount Applied t o Periodic Deductibl e ... Q .. ; .. I BP SSRESP="P" !(BPSSRESP ="D")!(BPS SRESP="R") D ... ; D 1-D9 field s (BPS11 5) ... S B PSAJPAY=$$ GET1^DIQ(9 002313.32, BPSTIEN_", ",.1,"I") ; Adjudica ted Paymen t Type ... I BPSAJPA Y]"" S BPS DATA(1,102 8)=$$NFF^B PSECFM(BPS AJPAY,2) . .. S BPSNF LDT=$$GET1 ^DIQ(90023 13.32,BPST IEN_",",.0 9,"I") ; O verride Ne xt Availab le Fill .. . I BPSNFL DT]"" S BP SDATA(1,20 04)=$$DTF1 ^BPSECFM(B PSNFLDT) . .. ; ... ; E0-E6 ove rrides (BP S119) .. . ; PERCEN TAGE SALES TAX BASIS PAID ... S BPSX=$$G ET1^DIQ(90 02313.32,B PSTIEN_"," ,2.01,"I") ... I BPS X]"" S BPS DATA(1,561 )=BPSX ... ; OTHER A MOUNT PAID QUALIFIER and assoc iated fiel d ... S BP SX=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",2.0 2,"I") ... I BPSX]"" S BPSDATA (1,564,1)= $$NFF^BPSE CFM(BPSX,2 ),BPSDATA( 1,565,1)=$ $DFF^BPSEC FM(5.64,8) ,BPSDATA(1 ,563)=1 .. . ; PAYER ID QUALIFI ER ... S B PSX=$$GET1 ^DIQ(90023 13.32,BPST IEN_",",2. 03,"I") .. . I BPSX]" " S BPSDAT A(9002313. 03,9002313 .03,"+1,", 568)=BPSX ... ; HELP DESK TELE PHONE NUMB ER EXTENSI ON ... S B PSX=$$GET1 ^DIQ(90023 13.32,BPST IEN_",",2. 04,"I") .. . I BPSX]" " S BPSDAT A(1,"2022" )=$$NFF^BP SECFM(BPSX ,8) ... ; PROFESSION AL SERVICE FEE CONTR ACTED/REIM URSEMENT A MOUNT ... S BPSX=$$G ET1^DIQ(90 02313.32,B PSTIEN_"," ,2.05,"I") ... I BPS X]"" S BPS DATA(1,"20 33")=$$DFF ^BPSECFM(B PSX,8) ... ; OTHER P AYER HELPD ESK TELEPH ONE EXTENS ION ... S BPSX=$$GET 1^DIQ(9002 313.32,BPS TIEN_",",2 .06,"I") . .. I BPSX] "" S BPSDA TA(1,"2023 ",1)=$$NFF ^BPSECFM(B PSX,8),BPS DATA(1,338 ,1)="01" . .. ; RESPO NSE INTERM EDIARY AUT HORIZATION TYPE ID a nd associa
	3293	ted fields ... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",2.07 ,"I") ... I BPSX]"" S BPSDATA( 1,"2053",1 )=$$NFF^BP SECFM(BPSX ,2),BPSDAT A(1,2052)= 1 ... ; RE SPONSE INT ERMEDIARY AUTHORIZAT ION ID and associate d fields . .. S BPSX= $$GET1^DIQ (9002313.3 2,BPSTIEN_ ",",2.08," I") ... I BPSX]"" S BPSDATA(1, "2054",1)= $$ANFF^BPS ECFM(BPSX, 20),BPSDAT A(1,2052)= 1 ... ; IN TERMEDIARY MESSAGE a nd associa ted fields ... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",3.01 ,"I") ... I BPSX]"" S BPSDATA( 1,"2051",1 )=$$ANFF^B PSECFM(BPS X,200),BPS DATA(1,205 2)=1 ... ; (BPS122 ) ... S BP SX=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",2.0 9,"I") ; B 98-34 reco nciliation id ... I BPSX]"" S BPSDATA(1, "2098")=$$ ANFF^BPSEC FM(BPSX,30 ) ... ; .. . S BPSX=$ $GET1^DIQ( 9002313.32 ,BPSTIEN_" ,",4.01,"I ") ; 931-F 8 maximum age qualif ier ... I BPSX]"" S BPSDATA(1, 931)=$$ANF F^BPSECFM( BPSX,1) .. . S BPSX=$ $GET1^DIQ( 9002313.32 ,BPSTIEN_" ,",4.02,"I ") ; 932-G A maximum age ... I BPSX]"" S BPSDATA(1, 932)=$$NFF ^BPSECFM(B PSX,3) ... S BPSX=$$ GET1^DIQ(9 002313.32, BPSTIEN_", ",4.03,"I" ) ; 933-GB maximum a mount ... I BPSX]"" S BPSDATA( 1,933)=$$D FF^BPSECFM (BPSX,10) ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",4.04, "I") ; 934 -GC maximu m amt qual ifier ... I BPSX]"" S BPSDATA( 1,934)=$$A NFF^BPSECF M(BPSX,2) ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",4.05, "I") ; 935 -GF maximu m amt time period .. . I BPSX]" " S BPSDAT A(1,935)=$ $ANFF^BPSE CFM(BPSX,2 ) ... S BP SX=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",4.0 6,"I") ; 9 36-GG maxi mum amt ti me period start date ... I BPS X]"" S BPS DATA(1,936 )=$$DTF1^B PSECFM(BPS X) ... S B PSX=$$GET1 ^DIQ(90023 13.32,BPST IEN_",",4. 07,"I") ; 937-GH max imum amt t ime period end date ... I BPSX ]"" S BPSD ATA(1,937) =$$DTF1^BP SECFM(BPSX ) ... S BP SX=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",4.0 8,"I") ; 9 38-GJ maxi mum amt ti me period units ... I BPSX]"" S BPSDATA( 1,938)=$$N FF^BPSECFM (BPSX,4) . .. S BPSX= $$GET1^DIQ (9002313.3 2,BPSTIEN_ ",",4.09," I") ; 943- GQ minimum age quali fier ... I BPSX]"" S BPSDATA(1 ,943)=$$AN FF^BPSECFM (BPSX,1) . .. S BPSX= $$GET1^DIQ (9002313.3 2,BPSTIEN_ ",",4.1,"I ") ; 944-G R minimum age ... I BPSX]"" S BPSDATA(1, 944)=$$NFF ^BPSECFM(B PSX,3) ... S BPSX=$$ GET1^DIQ(9 002313.32, BPSTIEN_", ",4.11,"I" ) ; C47-9T other pay er adjudic ate prog t ype ... I BPSX]"" S BPSDATA(1, 2147)=$$AN FF^BPSECFM (BPSX,30) ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",4.12, "I") ; C93 -KN patien t pay comp onent amou nt ... I B PSX]"" S B PSDATA(1,2 193)=$$DFF ^BPSECFM(B PSX,8) ... S BPSX=$$ GET1^DIQ(9 002313.32, BPSTIEN_", ",4.13,"I" ) ; C94-KP patient p ay compone nt count . .. I BPSX] "" S BPSDA TA(1,2194) =$$NFF^BPS ECFM(BPSX, 4) ... S B PSX=$$GET1 ^DIQ(90023 13.32,BPST IEN_",",4. 14,"I") ; C95-KQ pat ient payer component qualifier ... I BPS X]"" S BPS DATA(1,219 5)=$$ANFF^ BPSECFM(BP SX,2) ... S BPSX=$$G ET1^DIQ(90 02313.32,B PSTIEN_"," ,4.15,"I") ; D19-M1 minimum am ount ... I BPSX]"" S BPSDATA(1 ,2219)=$$D FF^BPSECFM (BPSX,10) ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",4.16, "I") ; D20 -M2 minimu m amount q ualifier . .. I BPSX] "" S BPSDA TA(1,2220) =$$ANFF^BP SECFM(BPSX ,3) ... S BPSX=$$GET 1^DIQ(9002 313.32,BPS TIEN_",",4 .17,"I") ; D23-M5 ot her payer name ... I BPSX]"" S BPSDATA(1 ,2223)=$$A NFF^BPSECF M(BPSX,30) ... S BPS X=$$GET1^D IQ(9002313 .32,BPSTIE N_",",4.18 ,"I") ; D2 4-M6 remai ning amoun t ... I BP SX]"" S BP SDATA(1,22 24)=$$DFF^ BPSECFM(BP SX,10,3) . .. S BPSX= $$GET1^DIQ (9002313.3 2,BPSTIEN_ ",",4.19," I") ; D25- M7 remaini ng amount qualifier ... I BPSX ]"" S BPSD ATA(1,2225 )=$$ANFF^B PSECFM(BPS X,3) ... S BPSX=$$GE T1^DIQ(900 2313.32,BP STIEN_",", 4.2,"I") ; D41-PA ot her payer relationsh ip type .. . I BPSX]" " S BPSDAT A(1,2241)= $$ANFF^BPS ECFM(BPSX, 3)
	3294	... ; ... ; E7 over rides (BPS 120) ... S BPSX=$$ GET1^DIQ(9 002313.32, BPSTIEN_", ",.11,"I") I BPSX'=" " D ; B88-3R qua ntity limi t per spec time peri od .... S BPSDATA(1, 2087)=1 ; count fiel d .... S B PSDATA(1,2 088,1)=$$N FF^BPSECFM (BPSX,10) ; data fro m override file .... Q ... S B PSX=$$GET1 ^DIQ(90023 13.32,BPST IEN_",",.1 2,"I") I B PSX'="" D ; B89- 3S quantit y limit ti me period .... S BPS DATA(1,208 7)=1 ; cou nt field . ... S BPSD ATA(1,2089 ,1)=$$NFF^ BPSECFM(BP SX,5) ; da ta from ov erride fil e .... Q . .. S BPSX= $$GET1^DIQ (9002313.3 2,BPSTIEN_ ",",.13,"I ") I BPSX' ="" D ; B91-3W d ays supply limit per spec time period .. .. S BPSDA TA(1,2090) =1 ; count field ... . S BPSDAT A(1,2091,1 )=$$NFF^BP SECFM(BPSX ,3) ; data from over ride file .... Q ... S BPSX=$$ GET1^DIQ(9 002313.32, BPSTIEN_", ",.14,"I") I BPSX'=" " D ; B92-3X day s supply l imit time period ... . S BPSDAT A(1,2090)= 1 ; count field .... S BPSDATA (1,2092,1) =$$NFF^BPS ECFM(BPSX, 5) ; data from overr ide file . ... Q ... Q .. ; .. ; If rejec ted, get t he rejecti on code an d file the m .. ; Als o, delete the BPSPAI D amount . . I BPSSRE SP="R" D . .. ; Delet e old reje ctions and BPSPAID a mount ... K BPSDATA( 1,509),BPS DATA(1,511 ) ... ; Lo op through rejection s and stor e ... S BP SRCNT=0 .. . S BPSRIE N=0 F S B PSRIEN=$O( ^BPS(90023 13.32,BPST IEN,1,BPSR IEN)) Q:+B PSRIEN=0 D .... S BP SRCODE=$P( $G(^BPS(90 02313.32,B PSTIEN,1,B PSRIEN,0)) ,"^",1) .. .. ; Incre ment count er and sto re .... I BPSRCODE]" " D ..... S BPSRCD=$ $GET1^DIQ( 9002313.93 ,BPSRCODE_ ",",.01,"E ") ..... I BPSRCD]"" S BPSRCNT =BPSRCNT+1 ,BPSDATA(1 ,511,BPSRC NT)=BPSRCD ... ; Sto re total n umber of r ejections ... S BPSD ATA(1,510) =BPSRCNT ; Q
	3295
	3296
	3297
	3298	GETBPS3^BP SECX0 will need to b e modified to includ e all the new outgoi ng fields to ensure that they will be ad ded to the BPS array , even if the field is always blank. Th e BPS arra y is used when the c laim is bu ilt during the claim submissio n process and when t he user pe rforms the RED Resub mit with E dits actio n.
	3299
	3300	Subroutine Name
	3301	GETBPS3^BP SECX0
	3302	Enhancemen t Category
	3303	New
	3304	Modify
	3305	Delete
	3306	No Change
	3307	Current Lo gic
	3308
	3309	BPSECX0 ;B HAM ISC/FC S/DRS/VA/D LF - Retri eve Claim submission record ;0 5/17/2004
	3310	;;1.0;E C LAIMS MGMT ENGINE; 1,5,8,10,1 5,19,23; JUN 2004;B uild 27
	3311	;;Per VA Directive 6402, this routine s hould not be modifie d.
	3312	. . .
	3313
	3314	;Retrieve data in T RANSACTION S multiple in BPS CL AIMS
	3315	; CLAIMIE N = ien in BPS CLAIM S (#900231 3.02)
	3316	; TRXIEN = ien in T RANSACTION S (#900231 3.0201)
	3317	; BPS - P assed by r eference
	3318	; returns : BPS(9002 313.0201,T RXIEN,fiel d #,"I") = internal format val ue
	3319	GETBPS3(CL AIMIEN,TRX IEN,BPS) ; called fro m BPSECA1
	3320	;
	3321	Q:$G(CLAI MIEN)="" Q:$G(TRXIE N)="" ; m ust have b oth
	3322	;
	3323	N D0,DA,D IC,DIQ,DIQ 2,DR
	3324	;
	3325	; There a re other a lphanumeri c fields t hat could be added b ut since t hey are fo r segments that are not
	3326	; suppor ted by E1, B1, B3 tr ansactions and/or no t segments not used by VA. Th ese can be added lat er, if
	3327	; needed for those segments.
	3328	S DIC=900 2313.02,DR ="400",DR( 9002313.02 01)="113:9 96" ; all TRANSACTI ON fields
	3329	S DR(9002 313.0201)= DR(9002313 .0201)_";1 023:1032"
	3330	S DR(9002 313.0201)= DR(9002313 .0201)_";2 024:2032;2 039:2043"
	3331	S DR=DR_" ;1093;2013 :2021;2034 ;2035;2037 "
	3332	S DR=DR_" ;2056:2061 ;2095:2097 ;2101;2102 "
	3333	S DA=CLAI MIEN,DA(90 02313.0201 )=TRXIEN ; IEN and sub-file I EN
	3334	S DIQ="BP S",DIQ(0)= "I" ; "I" for inter nal format
	3335	D EN^DIQ1
	3336	;
	3337	; Copy Pr escriber P hone Numbe r (498.12) to field 498 as thi s is where BPSOSH2
	3338	; expec ts to find it. This works for now but i f we imple ment the P rior Auth
	3339	; segme nt (which has multip le field l abelled 49 8), a more complete solution
	3340	; will need to be found
	3341	S BPS(900 2313.0201, TRXIEN,498 ,"I")=$G(B PS(9002313 .0201,TRXI EN,498.12, "I"))
	3342	Q
	3343	;
	3344
	3345	Modified L ogic (Chan ges are hi ghlighted)
	3346
	3347	BPSECX0 ;B HAM ISC/FC S/DRS/VA/D LF - Retri eve Claim submission record ;0 5/17/2004
	3348	;;1.0;E C LAIMS MGMT ENGINE; 1,5,8,10,1 5,19,23,24 ;JUN 200 4;Build 27
	3349	;;Per VA Directive 6402, this routine s hould not be modifie d.
	3350	. . .
	3351
	3352	;Retrieve data in T RANSACTION S multiple in BPS CL AIMS
	3353	; CLAIMIE N = ien in BPS CLAIM S (#900231 3.02)
	3354	; TRXIEN = ien in T RANSACTION S (#900231 3.0201)
	3355	; BPS - P assed by r eference
	3356	; returns : BPS(9002 313.0201,T RXIEN,fiel d #,"I") = internal format val ue
	3357	GETBPS3(CL AIMIEN,TRX IEN,BPS) ; called fro m BPSECA1
	3358	;
	3359	Q:$G(CLAI MIEN)="" Q:$G(TRXIE N)="" ; m ust have b oth
	3360	;
	3361	N D0,DA,D IC,DIQ,DIQ 2,DR
	3362	;
	3363	; There a re other a lphanumeri c fields t hat could be added b ut since t hey are fo r segments that are not
	3364	; suppor ted by E1, B1, B3 tr ansactions and/or no t segments not used by VA. Th ese can be added lat er, if
	3365	; needed for those segments.
	3366	S DIC=900 2313.02,DR ="400",DR( 9002313.02 01)="113:9 96" ; all TRANSACTI ON fields
	3367	S DR(9002 313.0201)= DR(9002313 .0201)_";1 023:1032"
	3368	S DR(9002 313.0201)= DR(9002313 .0201)_";2 024:2032;2 039:2043"
	3369	S DR(9002 313.0201)= DR(9002313 .0201)_";1 093;2013:2 021;2034;2 035;2037"
	3370	S DR(9002 313.0201)= DR(9002313 .0201)_";2 056:2061;2 095:2097;2 101;2102"
	3371	; new fie lds added in 2017 NC PDP update s
	3372	S DR(9002 313.0201)= DR(9002313 .0201)_";2 147;2149;2 150;2151;2 160;2190;2 191"
	3373	S DR(9002 313.0201)= DR(9002313 .0201)_";2 191;2192;2 198;2199;2 201;2202;2 214"
	3374	S DR(9002 313.0201)= DR(9002313 .0201)_";2 216;2217;2 218;2221;2 222;2251;2 252"
	3375	S DR(9002 313.0201)= DR(9002313 .0201)_";2 253;2257;2 260;2261;2 263"
	3376	;
	3377	S DA=CLAI MIEN,DA(90 02313.0201 )=TRXIEN ; IEN and sub-file I EN
	3378	S DIQ="BP S",DIQ(0)= "I" ; "I" for inter nal format
	3379	D EN^DIQ1
	3380	;
	3381	; Copy Pr escriber P hone Numbe r (498.12) to field 498 as thi s is where BPSOSH2
	3382	; expec ts to find it. This works for now but i f we imple ment the P rior Auth
	3383	; segme nt (which has multip le field l abelled 49 8), a more complete solution
	3384	; will need to be found
	3385	S BPS(900 2313.0201, TRXIEN,498 ,"I")=$G(B PS(9002313 .0201,TRXI EN,498.12, "I"))
	3386	Q
	3387	;
	3388
	3389
	3390	This story calls for taking a field (Rec onciliatio n ID) from the respo nse to a p rimary cla im and sen ding it on the secon dary claim request. The system already d oes this w ith other fields. Fo r example, the amoun t paid on the primar y claim co mes in on the respon se as fiel d 509-F9, Total Amou nt Paid, a nd is sent on the se condary cl aim reques t as field 431-DV, O ther Payer Amount Pa id. To acc omplish th is, the fo llowing ha ppens.
	3391	The system saves the field in the BPS RE SPONSES fi le when th e response is receiv ed and pro cessed.
	3392	When the s econdary c laim is in itiated, t he system puts the f ield on th e BPS REQU EST.
	3393	From there , it is co pied to th e BPS TRAN SACTION.
	3394	It is pull ed from th e BPS TRAN SACTION an d put onto the claim in BPS CL AIMS when the claim is created .
	3395	The value stored in BPS CLAIMS is put on to the cla im request that is s ent to the payer.
	3396
	3397	IncomingBP S BP SBPS BPS Outgoi ng
	3398	Claim R ESPONSES REQUESTS TRAN- CLAIMS Claim
	3399	ResponseAC TION Request
	3400
	3401	The new fu nctionalit y called f or in this story wil l work in the same w ay. Some o f the exis ting logic will hand le the new fields wi thout any modificati ons.
	3402
	3403	This secti on of the SDD will g enerally f ollow the above flow , from cap turing the Reconcili ation ID o n the inco ming claim response to sending the Other Payer Rec onciliatio n ID field on the ou tgoing cla im request . At the e nd of the SDD are se ctions cov ering the CRI/VER sc reens, and the PRO O ption and RED Action .
	3404
	3405
	3406	Fields in Each File
	3407
	3408	The file B PS RESPONS ES already has the f ield neces sary for t his story. The new f ield will need to be added to the files BPS REQUES TS, BPS TR ANSACTION, and BPS C LAIMS.
	3409
	3410
	3411	File
	3412	Field
	3413	New/Existi ng
	3414	Length
	3415	Format
	3416	Incoming C laim Respo nse
	3417	B98-34 REC ONCILIATIO N ID
	3418	Existing
	3419	30
	3420	free text
	3421	BPS RESPON SES
	3422	RECONCILIA TION ID (# 2098)
	3423	Existing
	3424	30
	3425	free text
	3426	BPS REQUES TS
	3427	OTHER PAYE R RECONCIL IATION ID (#.11)
	3428	New
	3429	30
	3430	free text
	3431	BPS TRANSA CTION
	3432	OTHER PAYE R RECONCIL IATION ID (#.11)
	3433	New
	3434	30
	3435	free text
	3436	BPS CLAIMS
	3437	OTHER PAYE R RECONCIL IATION ID (#2149)
	3438	New
	3439	30
	3440	free text
	3441	Outgoing C laim Reque st
	3442	C49-9V OTH ER PAYER R ECONCILIAT ION ID
	3443	New
	3444	30
	3445	free text
	3446
	3447	A new fiel d will be added to f ile# 90023 13.77, BPS REQUESTS, sub-file# 9002313.7 78, COB OT HER PAYERS , and a ne w field wi ll be adde d to file# 9002313.5 9, BPS TRA NSACTION, sub-file# 9002313.59 14, COB OT HER PAYERS , and a ne w field wi ll be adde d to file# 9002313.0 2, sub-fil e# 9002313 .0401, COB OTHER PAY MENTS.
	3448
	3449	Field Attr ibutes
	3450	Values
	3451	FILE
	3452	9002313.77 , BPS REQU ESTS
	3453	SUB-FILE
	3454	9002313.77 8, COB OTH ER PAYERS
	3455	FIELD NAME
	3456	OTHER PAYE R RECONCIL IATION ID
	3457	FIELD NUMB ER
	3458	.11
	3459	NODE;PIECE
	3460	^BPS(90023 13.77,D0,8 ,D1,0);11
	3461	FIELD TYPE
	3462	Free Text
	3463	FIELD LENG TH
	3464	30
	3465	HELP PROMP T
	3466	Enter an I D between 1 and 30 c haracters.
	3467	DESCRIPTIO N
	3468	NCPDP fiel d C49-9V – Other Pay er Reconci liation ID . Reconcil iation ID (B98-34) a s reported by the Ot her Payer for Paid/A ccepted tr ansactions OR for In formation Reporting transactio ns, the de signated d efault val ue for rep orting a p revious pa yer's reje cted respo nse as des ignated in the Other Payer Rej ect Code v alue(s) re ported in the COB cl aim.
	3469
	3470
	3471	Field Attr ibutes
	3472	Values
	3473	FILE
	3474	9002313.59 , BPS TRAN SACTION
	3475	SUB-FILE
	3476	9002313.59 14, COB OT HER PAYERS
	3477	FIELD NAME
	3478	OTHER PAYE R RECONCIL IATION ID
	3479	FIELD NUMB ER
	3480	.11
	3481	NODE;PIECE
	3482	^BPST(D0,1 4,D1,0);11
	3483	FIELD TYPE
	3484	Free Text
	3485	FIELD LENG TH
	3486	30
	3487	HELP PROMP T
	3488	Enter an I D between 1 and 30 c haracters.
	3489	DESCRIPTIO N
	3490	NCPDP fiel d C49-9V – Other Pay er Reconci liation ID . Reconcil iation ID (B98-34) a s reported by the Ot her Payer for Paid/A ccepted tr ansactions OR for In formation Reporting transactio ns, the de signated d efault val ue for rep orting a p revious pa yer's reje cted respo nse as des ignated in the Other Payer Rej ect Code v alue(s) re ported in the COB cl aim.
	3491
	3492
	3493	Field Attr ibutes
	3494	Values
	3495	FILE
	3496	9002313.02 , BPS CLAI MS
	3497	SUB-FILE
	3498	9002313.04 01, COB OT HER PAYMEN TS
	3499	FIELD NAME
	3500	OTHER PAYE R RECONCIL IATION ID
	3501	FIELD NUMB ER
	3502	2149
	3503	NODE;PIECE
	3504	^BPSC(D0,4 00,D1,337, D2,0);11
	3505	FIELD TYPE
	3506	Free Text
	3507	FIELD LENG TH
	3508	30
	3509	HELP PROMP T
	3510	Enter an I D between 1 and 30 c haracters.
	3511	DESCRIPTIO N
	3512	NCPDP fiel d C49-9V – Other Pay er Reconci liation ID . Reconcil iation ID (B98-34) a s reported by the Ot her Payer for Paid/A ccepted tr ansactions OR for In formation Reporting transactio ns, the de signated d efault val ue for rep orting a p revious pa yer's reje cted respo nse as des ignated in the Other Payer Rej ect Code v alue(s) re ported in the COB cl aim.
	3513
	3514
	3515	The tables below des cribe how the files BPS REQUES TS, BPS TR ANSACTION and BPS CL AIMS will be added t o the buil d.
	3516
	3517	File Name
	3518	BPS REQUES TS
	3519	Send Full or Partial DD
	3520	PARTIAL
	3521	Data Dicti onary Numb er
	3522	9002313.77
	3523	Sub-File N umber
	3524	9002313.77 8
	3525	Field Numb er
	3526	.11
	3527	Update the Data Dict ionary
	3528	YES
	3529	Send Secur ity Codes
	3530	NO
	3531	Screen to Determine DD Update
	3532	N/A
	3533	Data Comes with File
	3534	NO
	3535
	3536
	3537	File Name
	3538	BPS TRANSA CTION
	3539	Send Full or Partial DD
	3540	PARTIAL
	3541	Data Dicti onary Numb er
	3542	9002313.59
	3543	Sub-File N umber
	3544	9002313.59 14
	3545	Field Numb er
	3546	.11
	3547	Update the Data Dict ionary
	3548	YES
	3549	Send Secur ity Codes
	3550	NO
	3551	Screen to Determine DD Update
	3552	N/A
	3553	Data Comes with File
	3554	NO
	3555
	3556
	3557	File Name
	3558	BPS CLAIMS
	3559	Send Full or Partial DD
	3560	PARTIAL
	3561	Data Dicti onary Numb er
	3562	9002313.02
	3563	Sub-File N umber
	3564	9002313.04 01
	3565	Field Numb er
	3566	2149
	3567	Update the Data Dict ionary
	3568	YES
	3569	Send Secur ity Codes
	3570	NO
	3571	Screen to Determine DD Update
	3572	N/A
	3573	Data Comes with File
	3574	NO
	3575
	3576
	3577
	3578	Capturing the Incomi ng Reconci liation ID
	3579
	3580	The field Reconcilia tion ID, B 98-34, is already be ing captur ed in file # 9002313. 03, BPS RE PONSES, fi eld # 2098 , RECONCIL IATION ID. No change necessary .
	3581
	3582
	3583	BPS REQUES TS
	3584
	3585	The claim submission process c an be init iated from many plac es within the system , but they all event ually call EN^BPSNCP DP. When t hat functi on is call ed, someti mes COB da ta has alr eady been pulled and set into a local ar ray (passe d into EN^ BPSNCPDP a s the 16th parameter , BPSPRDAT ). If that array has already b een create d, it will automatic ally inclu de the Pat ient Pay A mount from the prima ry claim r esponse.
	3586
	3587	(The two p rocedures which pass the COB a rray into EN^BPSNCPD P are
	3588	SUBMCLM^BP SPRRX2
	3589	Called fro m
	3590	SECONDRY^B PSPRRX
	3591	COB array built in $ $PRIMDATA^ BPSPRRX6 a nd $$SECDA TA^BPSPRRX 6; see SEC ONDRY^BPSP RRX for ca lls
	3592	PRIMARY^BP SPRRX4
	3593	News the a rray BPSDA T in PRIMA RY^BPSPRRX 4
	3594	Never sets up the ar ray
	3595	SECNOPRM^B PSPRRX5
	3596	COB array built in $ $PRIMDATA^ BPSPRRX6 a nd $$SECDA TA^BPSPRRX 6; see SEC NOPRM^BPSP RRX for ca lls
	3597	DOSELCTD^B PSRES
	3598	Calls PROM PTS^BPSRES
	3599	COB array built in $ $PRIMDATA^ BPSPRRX6 a nd $$SECDA TA^BPSPRRX 6; see PRO MPTS^BPSRE S for call s
	3600	(So in all instances , the COB array is s et up in $ $PRIMDATA^ BPSPRRX6 a nd $$SECDA TA^BPSPRRX 6.
	3601
	3602	($$PRIMDAT A builds C OBARRAY(“O THER PAYER ”,BPSPIEN, 0) from fi elds on BP S RESPONSE S. $$SECDA TA builds BPSPRDAT(“ OTHER PAYE R”,BPSPIEN ,0) from f ields on B PS TRANSAC TION.)
	3603
	3604	When resub mitting a secondary claim, SEC DATA^BPSPR RX6 pulls COB data f rom the BP S TRANSACT ION entry. SECDATA^B PSPRRX6 wi ll not nee d to be up dated; it will pull the new fi eld, OTHER PAYER-PAT RESP AMOU NT as writ ten.
	3605	SECDATA+44 . S BPS PRDAT("OTH ER PAYER", COBPIEN,0) =$G(^BPST( IEN59SEC,1 4,COBPIEN, 0))
	3606
	3607
	3608
	3609	MKRQST^BPS OSRX3 (cal led only b y REQST^BP SOSRX) cre ates an en try in the BPS REQUE STS file. That funct ion will b e modified to pull t he RECONCI LIATION ID from the primary cl aim’s resp onse when creating t he new ent ry in BPS REQUESTS f or the sec ondary cla im.
	3610
	3611	Subroutine Name
	3612	MKRQST^BPS OSRX3
	3613	Enhancemen t Category
	3614	New
	3615	Modify
	3616
	3617
	3618	Routines W hich Call This Subro utine
	3619	REQST^BPSO SRX
	3620	Current Lo gic
	3621
	3622	BPSOSRX3 ; ALB/SS - E CME REQUES TS ;02-JAN -08 ;;1.0; E CLAIMS M GMT ENGINE ;7,8,10, 11,23;JU N 2004;Bui ld 27 ;;Pe r VA Direc tive 6402, this rout ine should not be mo dified. ;
	3623	. . .
	3624
	3625	MKRQST(BPR EQTYP,KEY1 ,KEY2,MORE DATA,BPIEN S78,BPCOBI ND,BILLNDC ,BPSKIP) ;
	3626	N BPIEN77,B PCOB,BPQ,B PIEN772,BP ERRMSG,BPI EN59,BPIEN 78,BPZ
	3627	N RETVAL,ST AT,TYPE,RE SULT,SUBMI TDT,BPNOW, BPACTTYP,B P77LCK
	3628	N DUR,BPIEN 771,BPCNT, BPSDUPL
	3629	...
	3630	; store sec ondary bil ling relat ed data en tered by t he user - esg 6/8/10
	3631	S BPQ=0,BPE RRMSG=""
	3632	I BPCOBIND= 2 D
	3633	. N AMTIEN, BPIEN1,BPI EN2,BPIEN7 78,BPZ,BPZ 1,BPZ2,OPA MT,OPAPQ,O PAYD,OPPRA ,OPREJ,PIE N,REJIEN
	3634	. S PIEN=0 F S PIEN= $O(MOREDAT A("OTHER P AYER",PIEN )) Q:'PIEN !BPQ D
	3635	. . S OPAYD= $G(MOREDAT A("OTHER P AYER",PIEN ,0)) Q:OPA YD=""
	3636	. . ;
	3637	. . ; count up the num ber of mul tiples we have in ea ch set
	3638	. . S BPZ=0 F BPZ1=0:1 S BPZ=$O( MOREDATA(" OTHER PAYE R",PIEN,"P ",BPZ)) Q: 'BPZ
	3639	. . S BPZ=0 F BPZ2=0:1 S BPZ=$O( MOREDATA(" OTHER PAYE R",PIEN,"R ",BPZ)) Q: 'BPZ
	3640	. . I BPZ1,B PZ2 S BPQ= 1,BPERRMSG ="Can't ha ve both pa yments and rejects f or the sam e OTHER PA YER" Q
	3641	. . ;
	3642	. . ; add a new entry to subfile 9002313.7 78
	3643	. . S BPIEN7 78=$$INSIT EM^BPSUTIL 2(9002313. 778,BPIEN7 7,PIEN,PIE N,"",,0)
	3644	. . I BPIEN7 78<1 S BPE RRMSG="Can 't create entry in C OB OTHER P AYERS mult iple of th e BPS REQU ESTS file" ,BPQ=1 Q
	3645	. . S BPERRM SG="Can't populate f ield in CO B OTHER PA YERS multi ple" ; j ust in cas e BPQ is s et below
	3646	. . ;
	3647	. . ; set th e rest of the pieces at this l evel
	3648	. . I $P(OPA YD,U,2)'=" " I $$FILL FLDS^BPSUT IL2(900231 3.778,.02, PIEN_","_B PIEN77,$P( OPAYD,U,2) )<1 S BPQ= 1 Q
	3649	. . I $P(OPA YD,U,3)'=" " I $$FILL FLDS^BPSUT IL2(900231 3.778,.03, PIEN_","_B PIEN77,$P( OPAYD,U,3) )<1 S BPQ= 1 Q
	3650	. . I $P(OPA YD,U,4)'=" " I $$FILL FLDS^BPSUT IL2(900231 3.778,.04, PIEN_","_B PIEN77,$P( OPAYD,U,4) )<1 S BPQ= 1 Q
	3651	. . I $P(OPA YD,U,5)'=" " I $$FILL FLDS^BPSUT IL2(900231 3.778,.05, PIEN_","_B PIEN77,$P( OPAYD,U,5) )<1 S BPQ= 1 Q
	3652	. . I $$FILL FLDS^BPSUT IL2(900231 3.778,.06, PIEN_","_B PIEN77,BPZ 1)<1 S BPQ =1 Q
	3653	. . I $$FILL FLDS^BPSUT IL2(900231 3.778,.07, PIEN_","_B PIEN77,BPZ 2)<1 S BPQ =1 Q
	3654	. . S BPERRM SG=""
	3655	. . ;
	3656	...
	3657
	3658	Modified L ogic (Chan ges are hi ghlighted)
	3659
	3660	BPSOSRX3 ; ALB/SS - E CME REQUES TS ;02-JAN -08 ;;1.0; E CLAIMS M GMT ENGINE ;7,8,10, 11,23,24 ;JUN 2004; Build 27 ; ;Per VA Di rective 64 02, this r outine sho uld not be modified. ;
	3661	. . .
	3662
	3663	MKRQST(BPR EQTYP,KEY1 ,KEY2,MORE DATA,BPIEN S78,BPCOBI ND,BILLNDC ,BPSKIP) ;
	3664	N BPIEN77,B PCOB,BPQ,B PIEN772,BP ERRMSG,BPI EN59,BPIEN 78,BPZ
	3665	N RETVAL,ST AT,TYPE,RE SULT,SUBMI TDT,BPNOW, BPACTTYP,B P77LCK
	3666	N DUR,BPIEN 771,BPCNT, BPSDUPL
	3667	...
	3668	; store sec ondary bil ling relat ed data en tered by t he user - esg 6/8/10
	3669	S BPQ=0,BPE RRMSG=""
	3670	I BPCOBIND= 2 D
	3671	. N AMTIEN, BPIEN1,BPI EN2,BPIEN7 78,BPZ,BPZ 1,BPZ2,OPA MT,OPAPQ,O PAYD,OPPRA ,OPREJ,PIE N,REJIEN
	3672	. S PIEN=0 F S PIEN= $O(MOREDAT A("OTHER P AYER",PIEN )) Q:'PIEN !BPQ D
	3673	. . S OPAYD= $G(MOREDAT A("OTHER P AYER",PIEN ,0)) Q:OPA YD=""
	3674	. . ;
	3675	. . ; count up the num ber of mul tiples we have in ea ch set
	3676	. . S BPZ=0 F BPZ1=0:1 S BPZ=$O( MOREDATA(" OTHER PAYE R",PIEN,"P ",BPZ)) Q: 'BPZ
	3677	. . S BPZ=0 F BPZ2=0:1 S BPZ=$O( MOREDATA(" OTHER PAYE R",PIEN,"R ",BPZ)) Q: 'BPZ
	3678	. . I BPZ1,B PZ2 S BPQ= 1,BPERRMSG ="Can't ha ve both pa yments and rejects f or the sam e OTHER PA YER" Q
	3679	. . ;
	3680	. . ; add a new entry to subfile 9002313.7 78
	3681	. . S BPIEN7 78=$$INSIT EM^BPSUTIL 2(9002313. 778,BPIEN7 7,PIEN,PIE N,"",,0)
	3682	. . I BPIEN7 78<1 S BPE RRMSG="Can 't create entry in C OB OTHER P AYERS mult iple of th e BPS REQU ESTS file" ,BPQ=1 Q
	3683	. . S BPERRM SG="Can't populate f ield in CO B OTHER PA YERS multi ple" ; j ust in cas e BPQ is s et below
	3684	. . ;
	3685	. . ; set th e rest of the pieces at this l evel
	3686	. . I $P(OPA YD,U,2)'=" " I $$FILL FLDS^BPSUT IL2(900231 3.778,.02, PIEN_","_B PIEN77,$P( OPAYD,U,2) )<1 S BPQ= 1 Q
	3687	. . I $P(OPA YD,U,3)'=" " I $$FILL FLDS^BPSUT IL2(900231 3.778,.03, PIEN_","_B PIEN77,$P( OPAYD,U,3) )<1 S BPQ= 1 Q
	3688	. . I $P(OPA YD,U,4)'=" " I $$FILL FLDS^BPSUT IL2(900231 3.778,.04, PIEN_","_B PIEN77,$P( OPAYD,U,4) )<1 S BPQ= 1 Q
	3689	. . I $P(OPA YD,U,5)'=" " I $$FILL FLDS^BPSUT IL2(900231 3.778,.05, PIEN_","_B PIEN77,$P( OPAYD,U,5) )<1 S BPQ= 1 Q
	3690	. . I $$FILL FLDS^BPSUT IL2(900231 3.778,.06, PIEN_","_B PIEN77,BPZ 1)<1 S BPQ =1 Q
	3691	. . I $$FILL FLDS^BPSUT IL2(900231 3.778,.07, PIEN_","_B PIEN77,BPZ 2)<1 S BPQ =1 Q
	3692	. . I $P(OPA YD,U,11)'= "" I $$FIL LFLDS^BPSU TIL2(90023 13.778,.11 ,PIEN_","_ BPIEN77,$P (OPAYD,U,1 1))<1 S BP Q=1 Q
	3693	. . S BPERRM SG=""
	3694	. . ;
	3695	...
	3696
	3697
	3698
	3699	BPS TRANSA CTION
	3700
	3701	Data is pu lled from the BPS RE QUESTS ent ry and put into the MOREDATA a rray in RE ADMORE^BPS OSRX4. No change is necessary to the exi sting code , since th e new fiel d is on th e same nod e already referenced in this l ine:
	3702	READMORE+5 0
	3703	… S MOREDA TA("OTHER PAYER",COB PIEN,0)=$G (^BPS(9002 313.77,BPI EN77,8,COB PIEN,0))
	3704
	3705
	3706	In SECBIL5 9^BPSPRRX6 , data in the MOREDA TA array i s used to populate f ields on t he BPS TRA NSACTION. The new fi eld will n eed to be added to t his code.
	3707
	3708	Subroutine Name
	3709	SECBIL59^B PSPRRX6
	3710	Enhancemen t Category
	3711	New
	3712	Modify
	3713
	3714
	3715	Routines W hich Call This Subro utine
	3716	INIT^BPSOS IY
	3717	Current Lo gic
	3718
	3719	BPSPRRX6 ; ALB/SS - e Pharmacy s econdary b illing ;12 -DEC-08 ;; 1.0;E CLAI MS MGMT EN GINE;8,1 0,11,19,23 ;JUN 200 4;Build 27 ;;Per VA Directive 6402, this routine s hould not be modifie d. ;
	3720	. . .
	3721
	3722	SECBIL59(M OREDATA,IE N59) ;
	3723	; Populate secondary billing fi elds in BP S TRANSACT ION
	3724	; MOREDATA array file d into 900 2313.59
	3725	N BPTYPE,BP STIME,BPCO B
	3726	N AMTIEN,BP IEN1,BPIEN 2,BPZ5914, BPZ,BPZ1,B PZ2,OPAMT, OPAPQ,OPAY D,OPPRA,OP REJ,PIEN,R EJIEN,BPQ
	3727	I +$G(IEN59 )=0 Q
	3728	;
	3729	I $L($G(MOR EDATA("337 -4C"))) I $$FILLFLDS ^BPSUTIL2( 9002313.59 ,1204,IEN5 9,MOREDATA ("337-4C") )<1 D LOG^ BPSOSL(IEN 59,$T(+0)_ "-Cannot p opulate (# 1204) of ( #9002313.5 9)") ; c ob other p ayments co unt
	3730	I $L($G(MOR EDATA("308 -C8"))) I $$FILLFLDS ^BPSUTIL2( 9002313.59 ,1205,IEN5 9,MOREDATA ("308-C8") )<1 D LOG^ BPSOSL(IEN 59,$T(+0)_ "-Cannot p opulate (# 1205) of ( #9002313.5 9)") ; o ther cover age code
	3731	;
	3732	; store sec ondary bil ling relat ed data en tered by t he user - esg 6/14/1 0
	3733	S BPQ=0
	3734	S PIEN=0 F S PIEN=$O (MOREDATA( "OTHER PAY ER",PIEN)) Q:'PIEN!B PQ D
	3735	. S OPAYD=$ G(MOREDATA ("OTHER PA YER",PIEN, 0)) Q:OPAY D=""
	3736	. ;
	3737	. ; count u p the numb er of mult iples we h ave in eac h set
	3738	. S BPZ=0 F BPZ1=0:1 S BPZ=$O(M OREDATA("O THER PAYER ",PIEN,"P" ,BPZ)) Q:' BPZ
	3739	. S BPZ=0 F BPZ2=0:1 S BPZ=$O(M OREDATA("O THER PAYER ",PIEN,"R" ,BPZ)) Q:' BPZ
	3740	. I BPZ1,BP Z2 S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C annot have both paym ents and r ejects for the same OTHER PAYE R.") Q
	3741	. ;
	3742	. ; add a n ew entry t o subfile 9002313.59 14
	3743	. S BPZ5914 =$$INSITEM ^BPSUTIL2( 9002313.59 14,IEN59,P IEN,PIEN," ",,0)
	3744	. I BPZ5914 <1 S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C an't creat e entry in COB OTHER PAYERS mu ltiple of the BPS TR ANSACTION file") Q
	3745	. ;
	3746	. ; set the rest of t he pieces at this le vel
	3747	. I $P(OPAY D,U,2)'="" I $$FILLF LDS^BPSUTI L2(9002313 .5914,.02, PIEN_","_I EN59,$P(OP AYD,U,2))< 1 S BPQ=1 D LOG^BPSO SL(IEN59,$ T(+0)_"-Ca nnot popul ate (#.02) of (#9002 313.5914)" ) Q
	3748	. I $P(OPAY D,U,3)'="" I $$FILLF LDS^BPSUTI L2(9002313 .5914,.03, PIEN_","_I EN59,$P(OP AYD,U,3))< 1 S BPQ=1 D LOG^BPSO SL(IEN59,$ T(+0)_"-Ca nnot popul ate (#.03) of (#9002 313.5914)" ) Q
	3749	. I $P(OPAY D,U,4)'="" I $$FILLF LDS^BPSUTI L2(9002313 .5914,.04, PIEN_","_I EN59,$P(OP AYD,U,4))< 1 S BPQ=1 D LOG^BPSO SL(IEN59,$ T(+0)_"-Ca nnot popul ate (#.04) of (#9002 313.5914)" ) Q
	3750	. I $P(OPAY D,U,5)'="" I $$FILLF LDS^BPSUTI L2(9002313 .5914,.05, PIEN_","_I EN59,$P(OP AYD,U,5))< 1 S BPQ=1 D LOG^BPSO SL(IEN59,$ T(+0)_"-Ca nnot popul ate (#.05) of (#9002 313.5914)" ) Q
	3751	. I $$FILLF LDS^BPSUTI L2(9002313 .5914,.06, PIEN_","_I EN59,BPZ1) <1 S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C annot popu late (#.06 ) of (#900 2313.5914) ") Q
	3752	. I $$FILLF LDS^BPSUTI L2(9002313 .5914,.07, PIEN_","_I EN59,BPZ2) <1 S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C annot popu late (#.07 ) of (#900 2313.5914) ") Q
	3753	. ;
	3754	. ; now loo p thru the other pay er payment array
	3755	. S AMTIEN= 0 F S AMT IEN=$O(MOR EDATA("OTH ER PAYER", PIEN,"P",A MTIEN)) Q: 'AMTIEN!BP Q D
	3756	. . S OPAMT= $G(MOREDAT A("OTHER P AYER",PIEN ,"P",AMTIE N,0))
	3757	. . S OPAPQ= $P(OPAMT,U ,2) ; 34 2-HC other payer amt paid qual ifier (ncp dp 5.1 bla nk is OK)
	3758	. . S OPPRA= $P(OPAMT,U ,3) ; 35 2-NQ, Othe r Payer-Pa tient Resp onsibility Amount
	3759	. . S OPAMT= +OPAMT ; 43 1-DV other payer amt paid
	3760	. . ;
	3761	. . ; add a new entry to subfile 9002313.5 9141
	3762	. . S BPIEN1 =$$INSITEM ^BPSUTIL2( 9002313.59 141,PIEN_" ,"_IEN59,O PAMT,AMTIE N,"",,0)
	3763	. . I BPIEN1 <1 S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C an't creat e entry in 9002313.5 9141 subfi le") Q
	3764	. . ;
	3765	. . ; set pi ece 2
	3766	. . I OPAPQ' ="" I $$FI LLFLDS^BPS UTIL2(9002 313.59141, .02,AMTIEN _","_PIEN_ ","_IEN59, OPAPQ)<1 D
	3767	. .. S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C annot popu late (#.02 ) of (#900 2313.59141 )")
	3768	. .. Q
	3769	. . ;
	3770	. . ; set pi ece 3
	3771	. . I OPPRA' ="" I $$FI LLFLDS^BPS UTIL2(9002 313.59141, .03,AMTIEN _","_PIEN_ ","_IEN59, OPPRA)<1 D
	3772	. .. S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C annot popu late (#.03 ) of (#900 2313.59141 )")
	3773	. .. Q
	3774	. . ;
	3775	. . Q
	3776	. ;
	3777	. ; now loo p thru the other pay er reject array
	3778	. S REJIEN= 0 F S REJ IEN=$O(MOR EDATA("OTH ER PAYER", PIEN,"R",R EJIEN)) Q: 'REJIEN!BP Q D
	3779	. . S OPREJ= $G(MOREDAT A("OTHER P AYER",PIEN ,"R",REJIE N,0)) Q:OP REJ="" Q: $P(OPREJ,U ,1)=""
	3780	. . ;
	3781	. . ; add a new entry to subfile 9002313.5 9142
	3782	. . S BPIEN2 =$$INSITEM ^BPSUTIL2( 9002313.59 142,PIEN_" ,"_IEN59,$ P(OPREJ,U, 1),REJIEN, "",,0)
	3783	. . I BPIEN2 <1 S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C an't creat e entry in 9002313.5 9142 subfi le") Q
	3784	. . Q
	3785	. Q
	3786	Q
	3787
	3788	Modified L ogic (Chan ges are hi ghlighted)
	3789
	3790	BPSPRRX6 ; ALB/SS - e Pharmacy s econdary b illing ;12 -DEC-08 ;; 1.0;E CLAI MS MGMT EN GINE;8,1 0,11,19,23 ,24;JUN 2004;Build 27 ;;Per VA Directi ve 6402, t his routin e should n ot be modi fied. ;
	3791	. . .
	3792
	3793	SECBIL59(M OREDATA,IE N59) ;
	3794	; Populate secondary billing fi elds in BP S TRANSACT ION
	3795	; MOREDATA array file d into 900 2313.59
	3796	N BPTYPE,BP STIME,BPCO B
	3797	N AMTIEN,BP IEN1,BPIEN 2,BPZ5914, BPZ,BPZ1,B PZ2,OPAMT, OPAPQ,OPAY D,OPPRA,OP REJ,PIEN,R EJIEN,BPQ
	3798	I +$G(IEN59 )=0 Q
	3799	;
	3800	I $L($G(MOR EDATA("337 -4C"))) I $$FILLFLDS ^BPSUTIL2( 9002313.59 ,1204,IEN5 9,MOREDATA ("337-4C") )<1 D LOG^ BPSOSL(IEN 59,$T(+0)_ "-Cannot p opulate (# 1204) of ( #9002313.5 9)") ; c ob other p ayments co unt
	3801	I $L($G(MOR EDATA("308 -C8"))) I $$FILLFLDS ^BPSUTIL2( 9002313.59 ,1205,IEN5 9,MOREDATA ("308-C8") )<1 D LOG^ BPSOSL(IEN 59,$T(+0)_ "-Cannot p opulate (# 1205) of ( #9002313.5 9)") ; o ther cover age code
	3802	;
	3803	; store sec ondary bil ling relat ed data en tered by t he user - esg 6/14/1 0
	3804	S BPQ=0
	3805	S PIEN=0 F S PIEN=$O (MOREDATA( "OTHER PAY ER",PIEN)) Q:'PIEN!B PQ D
	3806	. S OPAYD=$ G(MOREDATA ("OTHER PA YER",PIEN, 0)) Q:OPAY D=""
	3807	. ;
	3808	. ; count u p the numb er of mult iples we h ave in eac h set
	3809	. S BPZ=0 F BPZ1=0:1 S BPZ=$O(M OREDATA("O THER PAYER ",PIEN,"P" ,BPZ)) Q:' BPZ
	3810	. S BPZ=0 F BPZ2=0:1 S BPZ=$O(M OREDATA("O THER PAYER ",PIEN,"R" ,BPZ)) Q:' BPZ
	3811	. I BPZ1,BP Z2 S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C annot have both paym ents and r ejects for the same OTHER PAYE R.") Q
	3812	. ;
	3813	. ; add a n ew entry t o subfile 9002313.59 14
	3814	. S BPZ5914 =$$INSITEM ^BPSUTIL2( 9002313.59 14,IEN59,P IEN,PIEN," ",,0)
	3815	. I BPZ5914 <1 S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C an't creat e entry in COB OTHER PAYERS mu ltiple of the BPS TR ANSACTION file") Q
	3816	. ;
	3817	. ; set the rest of t he pieces at this le vel
	3818	. I $P(OPAY D,U,2)'="" I $$FILLF LDS^BPSUTI L2(9002313 .5914,.02, PIEN_","_I EN59,$P(OP AYD,U,2))< 1 S BPQ=1 D LOG^BPSO SL(IEN59,$ T(+0)_"-Ca nnot popul ate (#.02) of (#9002 313.5914)" ) Q
	3819	. I $P(OPAY D,U,3)'="" I $$FILLF LDS^BPSUTI L2(9002313 .5914,.03, PIEN_","_I EN59,$P(OP AYD,U,3))< 1 S BPQ=1 D LOG^BPSO SL(IEN59,$ T(+0)_"-Ca nnot popul ate (#.03) of (#9002 313.5914)" ) Q
	3820	. I $P(OPAY D,U,4)'="" I $$FILLF LDS^BPSUTI L2(9002313 .5914,.04, PIEN_","_I EN59,$P(OP AYD,U,4))< 1 S BPQ=1 D LOG^BPSO SL(IEN59,$ T(+0)_"-Ca nnot popul ate (#.04) of (#9002 313.5914)" ) Q
	3821	. I $P(OPAY D,U,5)'="" I $$FILLF LDS^BPSUTI L2(9002313 .5914,.05, PIEN_","_I EN59,$P(OP AYD,U,5))< 1 S BPQ=1 D LOG^BPSO SL(IEN59,$ T(+0)_"-Ca nnot popul ate (#.05) of (#9002 313.5914)" ) Q
	3822	. I $$FILLF LDS^BPSUTI L2(9002313 .5914,.06, PIEN_","_I EN59,BPZ1) <1 S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C annot popu late (#.06 ) of (#900 2313.5914) ") Q
	3823	. I $$FILLF LDS^BPSUTI L2(9002313 .5914,.07, PIEN_","_I EN59,BPZ2) <1 S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C annot popu late (#.07 ) of (#900 2313.5914) ") Q
	3824	. I $P(OPAY D,U,11)'=" " I $$FILL FLDS^BPSUT IL2(900231 3.5914,.11 ,PIEN_","_ IEN59,$P(O PAYD,U,11) )<1 S BPQ= 1 D LOG^BP SOSL(IEN59 ,$T(+0)_"- Cannot pop ulate (#.1 1) of (#90 02313.5914 )") Q
	3825	. ;
	3826	. ; now loo p thru the other pay er payment array
	3827	. S AMTIEN= 0 F S AMT IEN=$O(MOR EDATA("OTH ER PAYER", PIEN,"P",A MTIEN)) Q: 'AMTIEN!BP Q D
	3828	. . S OPAMT= $G(MOREDAT A("OTHER P AYER",PIEN ,"P",AMTIE N,0))
	3829	. . S OPAPQ= $P(OPAMT,U ,2) ; 34 2-HC other payer amt paid qual ifier (ncp dp 5.1 bla nk is OK)
	3830	. . S OPPRA= $P(OPAMT,U ,3) ; 35 2-NQ, Othe r Payer-Pa tient Resp onsibility Amount
	3831	. . S OPAMT= +OPAMT ; 43 1-DV other payer amt paid
	3832	. . ;
	3833	. . ; add a new entry to subfile 9002313.5 9141
	3834	. . S BPIEN1 =$$INSITEM ^BPSUTIL2( 9002313.59 141,PIEN_" ,"_IEN59,O PAMT,AMTIE N,"",,0)
	3835	. . I BPIEN1 <1 S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C an't creat e entry in 9002313.5 9141 subfi le") Q
	3836	. . ;
	3837	. . ; set pi ece 2
	3838	. . I OPAPQ' ="" I $$FI LLFLDS^BPS UTIL2(9002 313.59141, .02,AMTIEN _","_PIEN_ ","_IEN59, OPAPQ)<1 D
	3839	. .. S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C annot popu late (#.02 ) of (#900 2313.59141 )")
	3840	. .. Q
	3841	. . ;
	3842	. . ; set pi ece 3
	3843	. . I OPPRA' ="" I $$FI LLFLDS^BPS UTIL2(9002 313.59141, .03,AMTIEN _","_PIEN_ ","_IEN59, OPPRA)<1 D
	3844	. .. S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C annot popu late (#.03 ) of (#900 2313.59141 )")
	3845	. .. Q
	3846	. . ;
	3847	. . Q
	3848	. ;
	3849	. ; now loo p thru the other pay er reject array
	3850	. S REJIEN= 0 F S REJ IEN=$O(MOR EDATA("OTH ER PAYER", PIEN,"R",R EJIEN)) Q: 'REJIEN!BP Q D
	3851	. . S OPREJ= $G(MOREDAT A("OTHER P AYER",PIEN ,"R",REJIE N,0)) Q:OP REJ="" Q: $P(OPREJ,U ,1)=""
	3852	. . ;
	3853	. . ; add a new entry to subfile 9002313.5 9142
	3854	. . S BPIEN2 =$$INSITEM ^BPSUTIL2( 9002313.59 142,PIEN_" ,"_IEN59,$ P(OPREJ,U, 1),REJIEN, "",,0)
	3855	. . I BPIEN2 <1 S BPQ=1 D LOG^BPS OSL(IEN59, $T(+0)_"-C an't creat e entry in 9002313.5 9142 subfi le") Q
	3856	. . Q
	3857	. Q
	3858	Q
	3859
	3860
	3861
	3862	BPS CLAIMS
	3863
	3864	COB^BPSOSC D populate s portions of the BP S array wi th data fr om the BPS TRANSACTI ON. After the BPS ar ray is bui lt, it is used to cr eate an en try in BPS CLAIMS. N o change i s necessar y to the e xisting co de, since the new fi eld is on the same n ode alread y referenc ed in the line below , however a comment will be mo dified in COB^BPSOSC D.
	3865
	3866	COB+14^BPS OSCD
	3867	. S BPS(" RX",MEDN," OTHER PAYE R",COBPIEN ,0)=$G(^BP ST(IEN59,1 4,COBPIEN, 0))
	3868
	3869
	3870	Subroutine Name
	3871	COB^BPSOSC D
	3872	Enhancemen t Category
	3873	New
	3874	Modify
	3875
	3876
	3877	Routines W hich Call This Subro utine
	3878	MEDINFO^BP SOSCD
	3879	Current Lo gic
	3880
	3881	COB(IEN59, MEDN) ; pr ocess the COB fields and build the COB a rray
	3882	; Code for Benefit St ages multi ple not im plemented yet (excep t by
	3883	; certifica tion)
	3884	;
	3885	; build arr ay of COB secondary claim data from the BPS Transa ction file - esg - 6 /16/10
	3886	N COBPIEN,A PDIEN,REJI EN,DATA
	3887	K BPS("RX", MEDN,"OTHE R PAYER")
	3888	;
	3889	; Field 337 -4C COB OT HER PAYMEN TS COUNT ( 9002313.59 ,1204) mo ved into [ 1] below
	3890	S BPS("RX", MEDN,"OTHE R PAYER",0 )=$P($G(^B PST(IEN59, 12)),U,4)
	3891	;
	3892	S COBPIEN=0 F S COBP IEN=$O(^BP ST(IEN59,1 4,COBPIEN) ) Q:'COBPI EN D
	3893	. ; Note th at this wi ll set pie ces 1-7. Piece 8 is reserved for
	3894	. ; Payer- Patient Re sponsibili ty Count a nd is set by the cer tification code
	3895	. S BPS("RX ",MEDN,"OT HER PAYER" ,COBPIEN,0 )=$G(^BPST (IEN59,14, COBPIEN,0) )
	3896	. ;
	3897	. ; retriev e data fro m other pa yer amount paid mult iple
	3898	. S APDIEN= 0 F S APD IEN=$O(^BP ST(IEN59,1 4,COBPIEN, 1,APDIEN)) Q:'APDIEN D
	3899	. . S DATA=$ G(^BPST(IE N59,14,COB PIEN,1,APD IEN,0))
	3900	. . S BPS("R X",MEDN,"O THER PAYER ",COBPIEN, "P",APDIEN ,0)=
	3901	$P(DATA,"^ ",1)_"^"_$ $GET1^DIQ( 9002313.2, $P(DATA,"^ ",2),.01)
	3902	. . S BPS("R X",MEDN,"O THER PAYER ",COBPIEN, "PP",APDIE N,0)=$P(DA TA,"^",3)
	3903	. . I +$P(DA TA,"^",3) S $P(BPS(" RX",MEDN," OTHER PAYE R",COBPIEN ,"PP",APDI EN,0) ,"^" ,2)="06"
	3904	. . Q
	3905	. ;
	3906	. ; retriev e data fro m other pa yer reject multiple
	3907	. S REJIEN= 0 F S REJ IEN=$O(^BP ST(IEN59,1 4,COBPIEN, 2,REJIEN)) Q:'REJIEN D
	3908	. . S BPS("R X",MEDN,"O THER PAYER ",COBPIEN, "R",REJIEN ,0)=$G(^BP ST(IEN59,1 4,COBPIEN, 2,REJIEN,0 ))
	3909	Q
	3910
	3911	Modified L ogic (Chan ges are hi ghlighted)
	3912
	3913	COB(IEN59, MEDN) ; pr ocess the COB fields and build the COB a rray
	3914	; Code for Benefit St ages multi ple not im plemented yet (excep t by
	3915	; certifica tion)
	3916	;
	3917	; build arr ay of COB secondary claim data from the BPS Transa ction file - esg - 6 /16/10
	3918	N COBPIEN,A PDIEN,REJI EN,DATA
	3919	K BPS("RX", MEDN,"OTHE R PAYER")
	3920	;
	3921	; Field 337 -4C COB OT HER PAYMEN TS COUNT ( 9002313.59 ,1204) mo ved into [ 1] below
	3922	S BPS("RX", MEDN,"OTHE R PAYER",0 )=$P($G(^B PST(IEN59, 12)),U,4)
	3923	;
	3924	S COBPIEN=0 F S COBP IEN=$O(^BP ST(IEN59,1 4,COBPIEN) ) Q:'COBPI EN D
	3925	. ; Note th at this wi ll set pie ces 1-7 an d 11. Pie ce 89 is r eserved fo r
	3926	. ; Payer- Patient Re sponsibili ty Count B enefit Sta ge Count a nd is set by the cer tification code
	3927	. S BPS("RX ",MEDN,"OT HER PAYER" ,COBPIEN,0 )=$G(^BPST (IEN59,14, COBPIEN,0) )
	3928	. ;
	3929	. ; retriev e data fro m other pa yer amount paid mult iple
	3930	. S APDIEN= 0 F S APD IEN=$O(^BP ST(IEN59,1 4,COBPIEN, 1,APDIEN)) Q:'APDIEN D
	3931	. . S DATA=$ G(^BPST(IE N59,14,COB PIEN,1,APD IEN,0))
	3932	. . S BPS("R X",MEDN,"O THER PAYER ",COBPIEN, "P",APDIEN ,0)=
	3933	$P(DATA,"^ ",1)_"^"_$ $GET1^DIQ( 9002313.2, $P(DATA,"^ ",2),.01)
	3934	. . S BPS("R X",MEDN,"O THER PAYER ",COBPIEN, "PP",APDIE N,0)=$P(DA TA,"^",3)
	3935	. . I +$P(DA TA,"^",3) S $P(BPS(" RX",MEDN," OTHER PAYE R",COBPIEN ,"PP",APDI EN,0) ,"^" ,2)="06"
	3936	. . Q
	3937	. ;
	3938	. ; retriev e data fro m other pa yer reject multiple
	3939	. S REJIEN= 0 F S REJ IEN=$O(^BP ST(IEN59,1 4,COBPIEN, 2,REJIEN)) Q:'REJIEN D
	3940	. . S BPS("R X",MEDN,"O THER PAYER ",COBPIEN, "R",REJIEN ,0)=$G(^BP ST(IEN59,1 4,COBPIEN, 2,REJIEN,0 ))
	3941	Q
	3942
	3943
	3944
	3945	The Set co de for eac h field in the file BPS NCPDP FIELD DEFS sets the value of t hat field into the c orrespondi ng field i n the BPS CLAIMS fil e. SET2149 ^BPSFLD01 will be cr eated to s erve as th e Set code for field C49-9V.
	3946
	3947	Subroutine Name
	3948	SET2149^BP SFLD01
	3949	Enhancemen t Category
	3950	New
	3951	Modify
	3952
	3953
	3954	Current Lo gic
	3955
	3956	n/a – new subroutine
	3957
	3958	Modified L ogic (Chan ges are hi ghlighted)
	3959
	3960	BPSFLD01 ; ALB/SS - e Pharmacy s econdary b illing - C OB fields processing ;27-FEB-0 9 ;;1.0;E CLAIMS MGM T ENGINE;* 8,10,23,2 4*;JUN 20 04;Build 2 7 ;;Per VA Directive 6402, thi s routine should not be modifi ed. ;
	3961	. . .
	3962
	3963	SET2149 ; C49-9V Oth er Payer-P atient Rec onciliatio n ID
	3964	I '$G(BPS OPIEN) Q
	3965	S $P(^BPS C(BPS(9002 313.02),40 0,BPS(9002 313.0201), 337,BPSOPI EN,0),U,11 )=BPS("X")
	3966	Q
	3967
	3968
	3969
	3970	The many C OB fields in BPS NCP DP FIELD D EFS do not each have their own Get code. Rather, C OB^BPSOSHF pulls all the field s and exec utes the f ormat and set code f or each. T his proced ure will b e modified to make s ure the Ot her Payer Reconcilia tion ID fi eld will b e populate d if there is a valu e in Recon ciliation ID from th e primary claim.
	3971
	3972	Subroutine Name
	3973	COB^BPSOSH F
	3974	Enhancemen t Category
	3975	New
	3976	Modify
	3977
	3978
	3979	Routines W hich Call This Subro utine
	3980	XLOOP^BPSO SCF
	3981	Current Lo gic
	3982
	3983	BPSOSHF ;B HAM ISC/SD /lwj/DLF - Get/Forma t/Set valu e for repe ating segm ents ;06/0 1/2004 ;;1 .0;E CLAIM S MGMT ENG INE;1,5, 8,10,11,23 ;JUN 200 4;Build 27 ;;Per VA Directive 6402, this routine s hould not be modifie d. ;
	3984	. . .
	3985
	3986	COB(FORMAT ,NODE,MEDN ) ; COB fi elds proce ssing, NOD E=160
	3987	;-------- ---------- ---------- ---------- ---------- ---------- -----
	3988	; The COB data is s tored in t he followi ng local a rray:
	3989	;
	3990	; BP S("RX",MED N,"OTHER P AYER",.... .
	3991	;
	3992	; Array b uilt in ro utine BPSO SCD.
	3993	; Special note - Ov errides ar e not allo wed on thi s multiple .
	3994	; "Spe cial" code is not ac counted fo r either.
	3995	;-------- ---------- ---------- ---------- ---------- ---------- -----
	3996	;
	3997	N FIELD,F LD,OVERRID E,FLAG,ORD ,NCPFLD,BP D,BPD1,BPD 2,PCE,BPSO PIEN,BPSOA IEN,BPSORI EN,BPSCOUN T
	3998	S FLAG="F S"
	3999	;
	4000	; Quit if there is no data in the array
	4001	Q:'$D(BPS ("RX",MEDN ,"OTHER PA YER"))
	4002	;
	4003	; next we need to f igure out which fiel ds on this format ar e really
	4004	; needed, then we w ill loop t hrough and populate them
	4005	;
	4006	D GETFLDS (FORMAT,NO DE,.FIELD)
	4007	;
	4008	; re-sort this list by the NC PDP field#
	4009	; NCPFLD( NCPDP FIEL D#) = inte rnal field #
	4010	K NCPFLD S ORD=0 F S ORD=$O( FIELD(ORD) ) Q:'ORD S FLD=$P(F IELD(ORD), U,2) I FLD '="" S NCP FLD(FLD)=+ FIELD(ORD)
	4011	;
	4012	; see if 337-4C is needed
	4013	S FLD=337
	4014	I $D(NCPF LD(FLD)) D
	4015	. S BPS(" X")=$P($G( BPS("RX",M EDN,"OTHER PAYER",0) ),U,1) ; get
	4016	. I BPS(" X")="" Q
	4017	. D XFLDC ODE^BPSOSC F(NODE,NCP FLD(FLD),F LAG) ; format/ set
	4018	. Q
	4019	;
	4020	; now let s get, for mat and se t the rest of the CO B fields
	4021	S BPSOPIE N=0 F S B PSOPIEN=$O (BPS("RX", MEDN,"OTHE R PAYER",B PSOPIEN)) Q:'BPSOPIE N D
	4022	. S BPD=$ G(BPS("RX" ,MEDN,"OTH ER PAYER", BPSOPIEN,0 ))
	4023	. ; Note that piece 9 (Benefi t Stage Co unt) is on ly set by Certificat ion Code
	4024	. F PCE=1 :1:7,9 D
	4025	.. S FLD= $S(PCE=1:3 37,PCE=2:3 38,PCE=3:3 39,PCE=4:3 40,PCE=5:4 43,PCE=6:3 41,PCE=7:4 71,PCE=9:3 92,1:0) Q: 'FLD
	4026	.. I '$D( NCPFLD(FLD )) Q ; field no t needed
	4027	.. I $P(B PD,U,PCE)= "" Q ; data is nil
	4028	.. S BPS( "X")=$P(BP D,U,PCE) ; get
	4029	.. D XFLD CODE^BPSOS CF(NODE,NC PFLD(FLD), FLAG) ; format/s et
	4030	.. Q
	4031	. ;
	4032	. ; Now l ook at the other pay er amount paid field s
	4033	. S BPSOA IEN=0 F S BPSOAIEN= $O(BPS("RX ",MEDN,"OT HER PAYER" ,BPSOPIEN, "P",BPSOAI EN)) Q:'BP SOAIEN D
	4034	.. S BPD1 =$G(BPS("R X",MEDN,"O THER PAYER ",BPSOPIEN ,"P",BPSOA IEN,0))
	4035	.. F PCE= 1,2 D
	4036	... S FLD =$S(PCE=1: 431,PCE=2: 342,1:0) Q :'FLD
	4037	... I '$D (NCPFLD(FL D)) Q ; field n ot needed
	4038	... I $P( BPD1,U,PCE )="" Q ; data is nil
	4039	... S BPS ("X")=$P(B PD1,U,PCE) ; get
	4040	... D XFL DCODE^BPSO SCF(NODE,N CPFLD(FLD) ,FLAG) ; format/ set
	4041	.. Q
	4042	. ;
	4043	. ; Now l ook at the other pay er reject code field s
	4044	. S BPSOR IEN=0 F S BPSORIEN= $O(BPS("RX ",MEDN,"OT HER PAYER" ,BPSOPIEN, "R",BPSORI EN)) Q:'BP SORIEN D
	4045	.. S BPD2 =$G(BPS("R X",MEDN,"O THER PAYER ",BPSOPIEN ,"R",BPSOR IEN,0))
	4046	.. S FLD= 472
	4047	.. I '$D( NCPFLD(FLD )) Q ; field no t needed
	4048	.. I BPD2 ="" Q ; data is nil
	4049	.. S BPS( "X")=BPD2 ; get
	4050	.. D XFLD CODE^BPSOS CF(NODE,NC PFLD(FLD), FLAG) ; format/s et
	4051	.. Q
	4052	. . .
	4053
	4054	COBX ;
	4055	Q
	4056
	4057	Modified L ogic (Chan ges are hi ghlighted)
	4058
	4059	BPSOSHF ;B HAM ISC/SD /lwj/DLF - Get/Forma t/Set valu e for repe ating segm ents ;06/0 1/2004 ;;1 .0;E CLAIM S MGMT ENG INE;1,5, 8,10,11,23 ,24;JUN 2004;Build 27 ;;Per VA Directi ve 6402, t his routin e should n ot be modi fied. ;
	4060	. . .
	4061
	4062	COB(FORMAT ,NODE,MEDN ) ; COB fi elds proce ssing, NOD E=160
	4063	;-------- ---------- ---------- ---------- ---------- ---------- -----
	4064	; The COB data is s tored in t he followi ng local a rray:
	4065	;
	4066	; BP S("RX",MED N,"OTHER P AYER",.... .
	4067	;
	4068	; Array b uilt in ro utine BPSO SCD.
	4069	; Special note - Ov errides ar e not allo wed on thi s multiple .
	4070	; "Spe cial" code is not ac counted fo r either.
	4071	;-------- ---------- ---------- ---------- ---------- ---------- -----
	4072	;
	4073	N FIELD,F LD,OVERRID E,FLAG,ORD ,NCPFLD,BP D,BPD1,BPD 2,PCE,BPSO PIEN,BPSOA IEN,BPSORI EN,BPSCOUN T
	4074	S FLAG="F S"
	4075	;
	4076	; Quit if there is no data in the array
	4077	Q:'$D(BPS ("RX",MEDN ,"OTHER PA YER"))
	4078	;
	4079	; next we need to f igure out which fiel ds on this format ar e really
	4080	; needed, then we w ill loop t hrough and populate them
	4081	;
	4082	D GETFLDS (FORMAT,NO DE,.FIELD)
	4083	;
	4084	; re-sort this list by the NC PDP field#
	4085	; NCPFLD( NCPDP FIEL D#) = inte rnal field #
	4086	K NCPFLD S ORD=0 F S ORD=$O( FIELD(ORD) ) Q:'ORD S FLD=$P(F IELD(ORD), U,2) I FLD '="" S NCP FLD(FLD)=+ FIELD(ORD)
	4087	;
	4088	; see if 337-4C is needed
	4089	S FLD=337
	4090	I $D(NCPF LD(FLD)) D
	4091	. S BPS(" X")=$P($G( BPS("RX",M EDN,"OTHER PAYER",0) ),U,1) ; get
	4092	. I BPS(" X")="" Q
	4093	. D XFLDC ODE^BPSOSC F(NODE,NCP FLD(FLD),F LAG) ; format/ set
	4094	. Q
	4095	;
	4096	; now let s get, for mat and se t the rest of the CO B fields
	4097	S BPSOPIE N=0 F S B PSOPIEN=$O (BPS("RX", MEDN,"OTHE R PAYER",B PSOPIEN)) Q:'BPSOPIE N D
	4098	. S BPD=$ G(BPS("RX" ,MEDN,"OTH ER PAYER", BPSOPIEN,0 ))
	4099	. ; Note that piece 9 (Benefi t Stage Co unt) is on ly set by Certificat ion Code
	4100	. F PCE=1 :1:7,9,11 D
	4101	.. S FLD= $S(PCE=1:3 37,PCE=2:3 38,PCE=3:3 39,PCE=4:3 40,PCE=5:4 43,PCE=6:3 41,PCE=7:4 71,PCE=9:3 92, PCE=11 :2149,1:0) Q:'FLD
	4102	.. I '$D( NCPFLD(FLD )) Q ; field no t needed
	4103	.. I $P(B PD,U,PCE)= "" Q ; data is nil
	4104	.. S BPS( "X")=$P(BP D,U,PCE) ; get
	4105	.. D XFLD CODE^BPSOS CF(NODE,NC PFLD(FLD), FLAG) ; format/s et
	4106	.. Q
	4107	. . .
	4108
	4109	COBX ;
	4110	Q
	4111
	4112
	4113
	4114	The Outgoi ng Claim R equest
	4115
	4116	After the entry in B PS CLAIMS is created , the syst em uses th e data in that entry to build the claim to be sent to the pa yer. Befor e looping through th e segments and field s on the p ayer sheet , the syst em copies most of th e fields f rom the BP S CLAIMS r ecord into the BPS a rray. That is done i n GETBPS5^ BPSECX0 an d GETBPS7^ BPSECX0. G ETBPS5^BPS EXCX0 will need to b e modified to pick u p the new field.
	4117
	4118	A small er ror in GET BPS5^BPSEX C0 will al so be corr ected with this buil d. The fie ld number 993 was in correctly listed as 393.
	4119
	4120	Subroutine Name
	4121	GETBPS5^BP SECX0
	4122	Enhancemen t Category
	4123	New
	4124	Modify
	4125
	4126
	4127	Routines W hich Call This Subro utine
	4128	XLOOP^BPSO SCF
	4129	Current Lo gic
	4130
	4131	;Retrieve COB OTHER PAYMENTS m ultiple da ta
	4132	; CLAIMIE N = ien in BPS CLAIM S (#900231 3.02)
	4133	; TRXIEN = ien in T RANSACTION S (#900231 3.0201)
	4134	; BPCOBIE N= ien in COB OTHER PAYMENTS ( #9002313.0 401)
	4135	; BPS - P assed by r eference
	4136	; Output: BPS(90023 13.0401,BP COBIEN,fie ld #,"I") = Value
	4137	GETBPS5(CL AIMIEN,TRX IEN,BPCOBI EN,BPS) ;E P - from B PSECA1
	4138	;
	4139	Q:$G(CLAI MIEN)="" Q:$G(TRXIE N)="" Q:$ G(BPCOBIEN )=""
	4140	;
	4141	N BPREJCT ,BPSCNT,BP SPAMT,BPSO THR,D0,DA, DIC,DIQ,DI Q2,DR
	4142	;
	4143	S DIC=900 2313.02
	4144	S DA=CLAI MIEN
	4145	S DA(9002 313.0201)= TRXIEN
	4146	S DA(9002 313.0401)= BPCOBIEN
	4147	S DR="400 " ; field (#400) TRA NSACTIONS
	4148	S DR(9002 313.0201)= 337.01 ;f ield (#337 .01) COB O THER PAYME NTS
	4149	S DR(9002 313.0401)= ".01;338;3 39;340;341 ;443;471;3 53;392;393 " ; field s
	4150	S DIQ="BP S",DIQ(0)= "I"
	4151	D EN^DIQ1
	4152	;
	4153	; Loop th rough PAYE R AMT and get the da ta
	4154	S BPSPAMT =$P($G(^BP SC(CLAIMIE N,400,TRXI EN,337,BPC OBIEN,1,0) ),U,4)
	4155	F BPSCNT= 1:1:BPSPAM T D GETBPS 6(CLAIMIEN ,TRXIEN,BP COBIEN,BPS CNT,.BPS)
	4156	;
	4157	; Loop th rough OTHE R PAYER RE JECT CODE multiple a nd get the data
	4158	S BPREJCT =$P($G(^BP SC(CLAIMIE N,400,TRXI EN,337,BPC OBIEN,2,0) ),U,4)
	4159	F BPSCNT= 1:1:BPREJC T D GETBPS 7(CLAIMIEN ,TRXIEN,BP COBIEN,BPS CNT,.BPS)
	4160	;
	4161	; Loop th rough PAYE R-PATIENT RESP and g et the dat a
	4162	S BPSPAMT =$P($G(^BP SC(CLAIMIE N,400,TRXI EN,337,BPC OBIEN,3,0) ),U,4)
	4163	F BPSCNT= 1:1:BPSPAM T D GETBPS 8(CLAIMIEN ,TRXIEN,BP COBIEN,BPS CNT,.BPS)
	4164	;
	4165	; Loop th rough BENE FIT STAGES and get t he data
	4166	S BPSPAMT =$P($G(^BP SC(CLAIMIE N,400,TRXI EN,337,BPC OBIEN,4,0) ),U,4)
	4167	F BPSCNT= 1:1:BPSPAM T D GETBPS 9(CLAIMIEN ,TRXIEN,BP COBIEN,BPS CNT,.BPS)
	4168	Q
	4169
	4170	Modified L ogic (Chan ges are hi ghlighted)
	4171
	4172	;Retrieve COB OTHER PAYMENTS m ultiple da ta
	4173	; CLAIMIE N = ien in BPS CLAIM S (#900231 3.02)
	4174	; TRXIEN = ien in T RANSACTION S (#900231 3.0201)
	4175	; BPCOBIE N= ien in COB OTHER PAYMENTS ( #9002313.0 401)
	4176	; BPS - P assed by r eference
	4177	; Output: BPS(90023 13.0401,BP COBIEN,fie ld #,"I") = Value
	4178	GETBPS5(CL AIMIEN,TRX IEN,BPCOBI EN,BPS) ;E P - from B PSECA1
	4179	;
	4180	Q:$G(CLAI MIEN)="" Q:$G(TRXIE N)="" Q:$ G(BPCOBIEN )=""
	4181	;
	4182	N BPREJCT ,BPSCNT,BP SPAMT,BPSO THR,D0,DA, DIC,DIQ,DI Q2,DR
	4183	;
	4184	S DIC=900 2313.02
	4185	S DA=CLAI MIEN
	4186	S DA(9002 313.0201)= TRXIEN
	4187	S DA(9002 313.0401)= BPCOBIEN
	4188	S DR="400 " ; field (#400) TRA NSACTIONS
	4189	S DR(9002 313.0201)= 337.01 ;f ield (#337 .01) COB O THER PAYME NTS
	4190	S DR(9002 313.0401)= ".01;338;3 39;340;341 ;443;471;3 53;392;393 ;993;2149" ; fields
	4191	S DIQ="BP S",DIQ(0)= "I"
	4192	D EN^DIQ1
	4193	;
	4194	; Loop th rough PAYE R AMT and get the da ta
	4195	S BPSPAMT =$P($G(^BP SC(CLAIMIE N,400,TRXI EN,337,BPC OBIEN,1,0) ),U,4)
	4196	F BPSCNT= 1:1:BPSPAM T D GETBPS 6(CLAIMIEN ,TRXIEN,BP COBIEN,BPS CNT,.BPS)
	4197	;
	4198	; Loop th rough OTHE R PAYER RE JECT CODE multiple a nd get the data
	4199	S BPREJCT =$P($G(^BP SC(CLAIMIE N,400,TRXI EN,337,BPC OBIEN,2,0) ),U,4)
	4200	F BPSCNT= 1:1:BPREJC T D GETBPS 7(CLAIMIEN ,TRXIEN,BP COBIEN,BPS CNT,.BPS)
	4201	;
	4202	; Loop th rough PAYE R-PATIENT RESP and g et the dat a
	4203	S BPSPAMT =$P($G(^BP SC(CLAIMIE N,400,TRXI EN,337,BPC OBIEN,3,0) ),U,4)
	4204	F BPSCNT= 1:1:BPSPAM T D GETBPS 8(CLAIMIEN ,TRXIEN,BP COBIEN,BPS CNT,.BPS)
	4205	;
	4206	; Loop th rough BENE FIT STAGES and get t he data
	4207	S BPSPAMT =$P($G(^BP SC(CLAIMIE N,400,TRXI EN,337,BPC OBIEN,4,0) ),U,4)
	4208	F BPSCNT= 1:1:BPSPAM T D GETBPS 9(CLAIMIEN ,TRXIEN,BP COBIEN,BPS CNT,.BPS)
	4209	Q
	4210
	4211
	4212
	4213	After the values in BPS CLAIMS are copie d into the BPS array , the syst em uses th e data in that array to build the claim to be sent to the pa yer. This is largely done in X LOOP^BPSOS H2. This s ubroutine loops thro ugh each f ield on ea ch segment on the pa yer sheet, and for e ach field it pulls t he data fr om BPS CLA IMS and ad ds it to t he segment . XLOOP^BP SOSH2 call s PROCCOB^ BPSOSH2 to pull the COB fields , and both of those procedures are alrea dy pulling the Patie nt Respons ibility fi elds.
	4214
	4215
	4216
	4217	CRI/Claim Response I nquiry Scr een
	4218
	4219	The CRI/Cl aim Respon se Inquiry will auto matically display th e Other Pa yer Patien t Responsi bility fie lds from t he claim r equest whe never they are popul ated and t he Patient Pay Amoun t on the c laim respo nse whenev er it is p opulated. No change to existin g logic is necessary . This is also true of the VER , which co ntains the CRI.
	4220
	4221
	4222	PRO Option and RED A ction
	4223
	4224	Both the P RO option and the RE D action d isplay to the user a list of C OB fields if the cla im is seco ndary. The Other Pay er Reconci liation ID field wil l be added to this d isplay.
	4225
	4226	Both PRO a nd RED rel y on PRIMD ATA^BPSPRR X6 and GET OPAP^BPSPR RX6 to pul l the COB fields fro m the BPS RESPONSE o f the prim ary claim. No change to PRIMDA TA^BPSPRRX 6 is neces sary, but GETOPAP^BP SPRRX6 wil l be updat ed to incl ude the Re conciliati on ID fiel d.
	4227
	4228	If the sys tem is not able to p ull COB fi elds from the primar y claim, t hen both P RO and RED rely on S ECDATA^BPS PRRX6 to p ull the CO B fields f rom the BP S TRANSACT ION of the secondary claim if the system is attemp ting to re submit a s econdary c laim. No c hange to S ECDATA^BPS PRRX6 is n ecessary. As it is c urrently w ritten, SE CDATA^BPSP RRX6 will automatica lly pull t he new fie ld OTHER P AYER RECON CILIATION ID from th e BPS TRAN SACTION fi le after t hat field has been a dded to th e file.
	4229	SECDATA+44 ^BPSPRRX6
	4230	. S BPSPRD AT("OTHER PAYER",COB PIEN,0)=$G (^BPST(IEN 59SEC,14,C OBPIEN,0))
	4231
	4232
	4233	Subroutine Name
	4234	GETOPAP^BP SPRRX6
	4235	Enhancemen t Category
	4236	New
	4237	Modify
	4238
	4239
	4240	Related Me nu Options or ListMa n Actions
	4241	PRO Option
	4242	RED Action
	4243	Routines W hich Call This Subro utine
	4244	PRIMDATA^B PSPRRX6
	4245	Current Lo gic
	4246
	4247	GETOPAP(BP SRESP,BPSD AT) ;
	4248	; Get the O ther Payer Amount Pa id values and qualif iers
	4249	; Input:
	4250	; BPSRESP = IEN of BPS RESPON SE file
	4251	; BPSDAT( N)= Array of Other P ayer field s (passed by referen ce)
	4252	; [1] Paid Amou nt
	4253	; [2] Qualifier
	4254	; [3] Other Pay er Patient Responsib ility Amou nt
	4255	;
	4256	I '$G(BPSRE SP) Q
	4257	I '$D(^BPSR (BPSRESP,1 000)) Q
	4258	N CNT,BPS50 5,BPS509,B PS559,BPS5 58,BPS523, BPS563,BPS 562,BPS521 ,BPSQUAL,B PSAMNT,BPS TAX,BPSOAP ,BPSX
	4259	S CNT=0
	4260	; Set up D. 0 fields f or COB seg ment
	4261	S BPS509=$$ DFF2EXT^BP SECFM($P($ G(^BPSR(BP SRESP,1000 ,1,500)),U ,9))
	4262	; If Total Amount Pai d is a neg ative numb er, set it to zero.
	4263	; Zero Pay amount is allowed
	4264	I BPS509<0 S BPS509=0
	4265	;
	4266	; Cognitive Services Qualifier/ Profession al Service Fee Paid
	4267	S BPS562=$$ DFF2EXT^BP SECFM($P($ G(^BPSR(BP SRESP,1000 ,1,560)),U ,2))
	4268	I BPS562<0 S BPS562=0
	4269	I +BPS562 S CNT=CNT+1 ,BPSDAT(CN T)=BPS562_ U_"06"
	4270	;
	4271	; Incentive Qualifier /Incentive Amt Paid
	4272	S BPS521=$$ DFF2EXT^BP SECFM($P($ G(^BPSR(BP SRESP,1000 ,1,500)),U ,21))
	4273	I BPS521<0 S BPS521=0
	4274	I +BPS521 S CNT=CNT+1 ,BPSDAT(CN T)=BPS521_ U_"05"
	4275	; Subtract Incentive Qualifier from Paid Amount for Drug Bene fit
	4276	S BPS509=BP S509-BPS52 1
	4277	;
	4278	; Default a ll Tax val ues to zer o for nega tive value s
	4279	S BPS559=$$ DFF2EXT^BP SECFM($P($ G(^BPSR(BP SRESP,1000 ,1,550)),U ,9)) ; Per centage Sa les Tax Pa id
	4280	I BPS559<0 S BPS559=0
	4281	S BPS558=$$ DFF2EXT^BP SECFM($P($ G(^BPSR(BP SRESP,1000 ,1,550)),U ,8)) ; Fla t Sales Ta x Paid
	4282	I BPS558<0 S BPS558=0
	4283	S BPS523=$$ DFF2EXT^BP SECFM($P($ G(^BPSR(BP SRESP,1000 ,1,500)),U ,23)) ; Am ount Attri buted to S ales Tax
	4284	I BPS523<0 S BPS523=0
	4285	;
	4286	; Sales Tax Qualifier
	4287	S BPSTAX=BP S559+BPS55 8-BPS523
	4288	I BPSTAX<0 S BPSTAX=0
	4289	I +BPSTAX S CNT=CNT+1 ,BPSDAT(CN T)=BPSTAX_ U_"10"
	4290	; Subtract Sales Tax Qualifier from Paid Amount for Drug Bene fit
	4291	S BPS509=BP S509-BPSTA X
	4292	;
	4293	; Set OTHER AMOUNT PA ID multipl es
	4294	S BPS563=0 F S BPS56 3=$O(^BPSR (BPSRESP,1 000,1,563. 01,BPS563) ) Q:BPS563 ="" D
	4295	. S BPSQUAL =$P($G(^BP SR(BPSRESP ,1000,1,56 3.01,BPS56 3,1)),U,1)
	4296	. ; Quit if qualifier = 99 sinc e there is no NCPDP mapping fo r this qua lifier
	4297	. Q:BPSQUAL ']""!(BPSQ UAL=99)
	4298	. S BPSAMNT =$$DFF2EXT ^BPSECFM($ P($G(^BPSR (BPSRESP,1 000,1,563. 01,BPS563, 1)),U,2))
	4299	. ; Default negative amounts to zero
	4300	. I BPSAMNT <0 S BPSAM NT=0
	4301	. I $D(BPSO AP(BPSQUAL )) S BPSOA P(BPSQUAL) =BPSOAP(BP SQUAL)+BPS AMNT
	4302	. I '$D(BPS OAP(BPSQUA L)) S BPSO AP(BPSQUAL )=BPSAMNT
	4303	. ; Subtrac t Amount i f Qualifie r is 01, 0 2, 03, 04, 09 or 11
	4304	. I "010203 040911"[BP SQUAL S BP S509=BPS50 9-BPSAMNT
	4305	I $D(BPSOAP ) D
	4306	. S BPSX="" F S BPSX =$O(BPSOAP (BPSX)) Q: BPSX="" D
	4307	. . S CNT=C NT+1,BPSDA T(CNT)=BPS OAP(BPSX)_ U_$$GETPDI EN(BPSX)
	4308	; Set Drug Benefit Qu alifier
	4309	I BPS509<0 S BPS509=0
	4310	; Set Patie nt Pay Amo unt
	4311	S BPS505=$$ DFF2EXT^BP SECFM($P($ G(^BPSR(BP SRESP,1000 ,1,500)),U ,5))
	4312	;
	4313	S CNT=CNT+1 ,BPSDAT(CN T)=BPS509_ U_$$GETPDI EN("07")_U _BPS505
	4314	Q
	4315
	4316	Modified L ogic (Chan ges are hi ghlighted)
	4317
	4318	GETOPAP(BP SRESP,BPSD AT) ;
	4319	; Get the O ther Payer Amount Pa id values and qualif iers
	4320	; Input:
	4321	; BPSRESP = IEN of BPS RESPON SE file
	4322	; BPSDAT( N)= Array of Other P ayer field s (passed by referen ce)
	4323	; [1] Paid Amou nt
	4324	; [2] Qualifier
	4325	; [3] Other Pay er Patient Responsib ility Amou nt
	4326	; [4] Other Pay er Reconci liation ID
	4327	;
	4328	I '$G(BPSRE SP) Q
	4329	I '$D(^BPSR (BPSRESP,1 000)) Q
	4330	N CNT,BPS50 5,BPS509,B PS559,BPS5 58,BPS523, BPS563,BPS 562,BPS521 ,BPS2098,B PSQUAL,BPS AMNT,BPSTA X,BPSOAP,B PSX
	4331	S CNT=0
	4332	; Set up D. 0 fields f or COB seg ment
	4333	S BPS509=$$ DFF2EXT^BP SECFM($P($ G(^BPSR(BP SRESP,1000 ,1,500)),U ,9))
	4334	; If Total Amount Pai d is a neg ative numb er, set it to zero.
	4335	; Zero Pay amount is allowed
	4336	I BPS509<0 S BPS509=0
	4337	;
	4338	; Cognitive Services Qualifier/ Profession al Service Fee Paid
	4339	S BPS562=$$ DFF2EXT^BP SECFM($P($ G(^BPSR(BP SRESP,1000 ,1,560)),U ,2))
	4340	I BPS562<0 S BPS562=0
	4341	I +BPS562 S CNT=CNT+1 ,BPSDAT(CN T)=BPS562_ U_"06"
	4342	;
	4343	; Incentive Qualifier /Incentive Amt Paid
	4344	S BPS521=$$ DFF2EXT^BP SECFM($P($ G(^BPSR(BP SRESP,1000 ,1,500)),U ,21))
	4345	I BPS521<0 S BPS521=0
	4346	I +BPS521 S CNT=CNT+1 ,BPSDAT(CN T)=BPS521_ U_"05"
	4347	; Subtract Incentive Qualifier from Paid Amount for Drug Bene fit
	4348	S BPS509=BP S509-BPS52 1
	4349	;
	4350	; Default a ll Tax val ues to zer o for nega tive value s
	4351	S BPS559=$$ DFF2EXT^BP SECFM($P($ G(^BPSR(BP SRESP,1000 ,1,550)),U ,9)) ; Per centage Sa les Tax Pa id
	4352	I BPS559<0 S BPS559=0
	4353	S BPS558=$$ DFF2EXT^BP SECFM($P($ G(^BPSR(BP SRESP,1000 ,1,550)),U ,8)) ; Fla t Sales Ta x Paid
	4354	I BPS558<0 S BPS558=0
	4355	S BPS523=$$ DFF2EXT^BP SECFM($P($ G(^BPSR(BP SRESP,1000 ,1,500)),U ,23)) ; Am ount Attri buted to S ales Tax
	4356	I BPS523<0 S BPS523=0
	4357	;
	4358	; Sales Tax Qualifier
	4359	S BPSTAX=BP S559+BPS55 8-BPS523
	4360	I BPSTAX<0 S BPSTAX=0
	4361	I +BPSTAX S CNT=CNT+1 ,BPSDAT(CN T)=BPSTAX_ U_"10"
	4362	; Subtract Sales Tax Qualifier from Paid Amount for Drug Bene fit
	4363	S BPS509=BP S509-BPSTA X
	4364	;
	4365	; Set OTHER AMOUNT PA ID multipl es
	4366	S BPS563=0 F S BPS56 3=$O(^BPSR (BPSRESP,1 000,1,563. 01,BPS563) ) Q:BPS563 ="" D
	4367	. S BPSQUAL =$P($G(^BP SR(BPSRESP ,1000,1,56 3.01,BPS56 3,1)),U,1)
	4368	. ; Quit if qualifier = 99 sinc e there is no NCPDP mapping fo r this qua lifier
	4369	. Q:BPSQUAL ']""!(BPSQ UAL=99)
	4370	. S BPSAMNT =$$DFF2EXT ^BPSECFM($ P($G(^BPSR (BPSRESP,1 000,1,563. 01,BPS563, 1)),U,2))
	4371	. ; Default negative amounts to zero
	4372	. I BPSAMNT <0 S BPSAM NT=0
	4373	. I $D(BPSO AP(BPSQUAL )) S BPSOA P(BPSQUAL) =BPSOAP(BP SQUAL)+BPS AMNT
	4374	. I '$D(BPS OAP(BPSQUA L)) S BPSO AP(BPSQUAL )=BPSAMNT
	4375	. ; Subtrac t Amount i f Qualifie r is 01, 0 2, 03, 04, 09 or 11
	4376	. I "010203 040911"[BP SQUAL S BP S509=BPS50 9-BPSAMNT
	4377	I $D(BPSOAP ) D
	4378	. S BPSX="" F S BPSX =$O(BPSOAP (BPSX)) Q: BPSX="" D
	4379	. . S CNT=C NT+1,BPSDA T(CNT)=BPS OAP(BPSX)_ U_$$GETPDI EN(BPSX)
	4380	; Set Drug Benefit Qu alifier
	4381	I BPS509<0 S BPS509=0
	4382	; Set Patie nt Pay Amo unt
	4383	S BPS505=$$ DFF2EXT^BP SECFM($P($ G(^BPSR(BP SRESP,1000 ,1,500)),U ,5))
	4384	; Set Recon ciliation ID
	4385	S BPS2098=$ $ANFF^BPSE CFM($P($G( ^BPSR(BPSR ESP,1000,1 ,"B98")),U ,1)),30)
	4386	;
	4387	S CNT=CNT+1 ,BPSDAT(CN T)=BPS509_ U_$$GETPDI EN("07")_U _BPS505_U_ BPS2098
	4388	Q
	4389
	4390
	4391
	4392	Both the P RO option and the RE D action r ely on DIS PSEC^BPSPR RX3 to dis play the C OB fields. DISPSEC^B PSPRRX3 wi ll be upda ted to inc lude the n ew field.
	4393
	4394
	4395	Subroutine Name
	4396	DISPSEC^BP SPRRX3
	4397	Enhancemen t Category
	4398	New
	4399	Modify
	4400
	4401
	4402	Related Me nu Options or ListMa n Actions
	4403	PRO Option
	4404	RED Action
	4405	Routines W hich Call This Subro utine
	4406	PROMPTS^BP SPRRX3
	4407	Current Lo gic
	4408
	4409	BPSPRRX3 ; ALB/SS - e Pharmacy s econdary b illing ;16 -DEC-08 ;; 1.0;E CLAI MS MGMT EN GINE;8,1 0,11,19,23 ;JUN 200 4;Build 27 ;;Per VA Directive 6402, this routine s hould not be modifie d.
	4410	;
	4411	. . .
	4412
	4413	DISPSEC(BP SPRARR) ;
	4414	; Validate and Displa y the curr ent second ary insura nce inform ation and prompt to edit.
	4415	; Input:
	4416	; BPSPRAR R - Array of COB dat a, passed by referen ce
	4417	;
	4418	N BPSPIEN,B PSCOB,BPSC OV,BPX,BPS COV,DATA
	4419	;
	4420	; Other Pay er IEN def aults to 1 since we don't do t ertiary
	4421	S BPSPIEN=1 ,BPSCOB="S ECONDARY"
	4422	;
	4423	; Get Cover age Code
	4424	S BPSCOV=$G (BPSPRARR( "308-C8"))
	4425	I BPSCOV="0 2" S BPSCO V="02 (OTH ER COVERAG E EXISTS - PAYMENT C OLLECTED)"
	4426	E I BPSCOV ="03" S BP SCOV="03 ( OTHER COVE RAGE EXIST S - THIS C LAIM NOT C OVERED)"
	4427	E S BPSCOV ="04 (OTHE R COVERAGE EXISTS - PAYMENT NO T COLLECTE D)"
	4428	;
	4429	; Write Dat a
	4430	W !!,"Data for Second ary Claim"
	4431	W !,"------ ---------- --------"
	4432	W !,"Insura nce: "_$G (BPSPRARR( "INS NAME" ))_" CO B: "_BPSCO B
	4433	W !,"Rate T ype: "_$$ GET1^DIQ(3 99.3,$G(BP SPRARR("RT YPE"))_"," ,.01,,,,)
	4434	W !,"Other Coverage C ode: "_BP SCOV
	4435	W !,"Other Payer Cove rage Type: 01 (PRIM ARY)"
	4436	W !,"Other Payer ID Q ualifier: 03 (BANK INFORMATIO N NUMBER ( BIN))"
	4437	W !,"Other Payer ID: "_$P($G(B PSPRARR("O THER PAYER ",BPSPIEN, 0)),U,4)
	4438	W !,"Other Payer Date : "_$$FMT E^XLFDT($P ($G(BPSPRA RR("OTHER PAYER",BPS PIEN,0)),U ,5))
	4439	;
	4440	; Write Pai d Amounts if previou s claim if they are there
	4441	I $D(BPSPRA RR("OTHER PAYER",BPS PIEN,"P")) D
	4442	. S BPX=0 F S BPX=$O (BPSPRARR( "OTHER PAY ER",BPSPIE N,"P",BPX) ) Q:BPX="" D
	4443	. . S DATA= BPSPRARR(" OTHER PAYE R",BPSPIEN ,"P",BPX,0 )
	4444	. . W !,"Ot her Payer Paid Quali fier: "_$ $GET1^DIQ( 9002313.2, $P(DATA,U, 2),.01)_" ("_$$GET1^ DIQ(900231 3.2,$P(DAT A,U,2),.02 )_")"
	4445	. . W !,"Ot her Payer Amount Pai d: $"_$FN ($P(DATA,U ,1),",",2)
	4446	. . I $P(DA TA,U,3)'=" " D
	4447	. . . W !," Other Paye r Patient Responsibi lity Amoun t Qualifie r:"
	4448	. . . W !?4 0,"06 (AMT REPORTED BY PRIOR P AYER)"
	4449	. . . W !," Other Paye r Patient Responsibi lity Amoun t: $"_$FN ($P(DATA,U ,3),",",2)
	4450	;
	4451	; Write Rej ect Codes if previou s claims i f they are there
	4452	I $D(BPSPRA RR("OTHER PAYER",BPS PIEN,"R")) D
	4453	. S BPX=0 F S BPX=$O (BPSPRARR( "OTHER PAY ER",BPSPIE N,"R",BPX) ) Q:BPX="" D
	4454	. . W !,"Ot her Payer Reject Cod e: "_$$TR ANREJ^BPSE CFM($G(BPS PRARR("OTH ER PAYER", BPSPIEN,"R ",BPX,0)))
	4455	Q
	4456
	4457	Modified L ogic (Chan ges are hi ghlighted)
	4458
	4459	BPSPRRX3 ; ALB/SS - e Pharmacy s econdary b illing ;16 -DEC-08 ;; 1.0;E CLAI MS MGMT EN GINE;8,1 0,11,19,23 ,24;JUN 2004;Build 27 ;;Per VA Directi ve 6402, t his routin e should n ot be modi fied.
	4460	;
	4461	. . .
	4462
	4463
	4464	DISPSEC(BP SPRARR) ;
	4465	; Validate and Displa y the curr ent second ary insura nce inform ation and prompt to edit.
	4466	; Input:
	4467	; BPSPRAR R - Array of COB dat a, passed by referen ce
	4468	;
	4469	N BPSPIEN,B PSCOB,BPSC OV,BPX,BPS COV,DATA
	4470	;
	4471	; Other Pay er IEN def aults to 1 since we don't do t ertiary
	4472	S BPSPIEN=1 ,BPSCOB="S ECONDARY"
	4473	;
	4474	; Get Cover age Code
	4475	S BPSCOV=$G (BPSPRARR( "308-C8"))
	4476	I BPSCOV="0 2" S BPSCO V="02 (OTH ER COVERAG E EXISTS - PAYMENT C OLLECTED)"
	4477	E I BPSCOV ="03" S BP SCOV="03 ( OTHER COVE RAGE EXIST S - THIS C LAIM NOT C OVERED)"
	4478	E S BPSCOV ="04 (OTHE R COVERAGE EXISTS - PAYMENT NO T COLLECTE D)"
	4479	;
	4480	; Write Dat a
	4481	W !!,"Data for Second ary Claim"
	4482	W !,"------ ---------- --------"
	4483	W !,"Insura nce: "_$G (BPSPRARR( "INS NAME" ))_" CO B: "_BPSCO B
	4484	W !,"Rate T ype: "_$$ GET1^DIQ(3 99.3,$G(BP SPRARR("RT YPE"))_"," ,.01,,,,)
	4485	W !,"Other Coverage C ode: "_BP SCOV
	4486	W !,"Other Payer Cove rage Type: 01 (PRIM ARY)"
	4487	W !,"Other Payer ID Q ualifier: 03 (BANK INFORMATIO N NUMBER ( BIN))"
	4488	W !,"Other Payer ID: "_$P($G(B PSPRARR("O THER PAYER ",BPSPIEN, 0)),U,4)
	4489	W !,"Other Payer Date : "_$$FMT E^XLFDT($P ($G(BPSPRA RR("OTHER PAYER",BPS PIEN,0)),U ,5))
	4490	;
	4491	; Write Pai d Amounts if previou s claim if they are there
	4492	I $D(BPSPRA RR("OTHER PAYER",BPS PIEN,"P")) D
	4493	. S BPX=0 F S BPX=$O (BPSPRARR( "OTHER PAY ER",BPSPIE N,"P",BPX) ) Q:BPX="" D
	4494	. . S DATA= BPSPRARR(" OTHER PAYE R",BPSPIEN ,"P",BPX,0 )
	4495	. . W !,"Ot her Payer Reconcilia tion ID: " _$P(DATA,U ,4)
	4496	. . W !,"Ot her Payer Paid Quali fier: "_$ $GET1^DIQ( 9002313.2, $P(DATA,U, 2),.01)_" ("_$$GET1^ DIQ(900231 3.2,$P(DAT A,U,2),.02 )_")"
	4497	. . W !,"Ot her Payer Amount Pai d: $"_$FN ($P(DATA,U ,1),",",2)
	4498	. . I $P(DA TA,U,3)'=" " D
	4499	. . . W !," Other Paye r Patient Responsibi lity Amoun t Qualifie r:"
	4500	. . . W !?4 0,"06 (AMT REPORTED BY PRIOR P AYER)"
	4501	. . . W !," Other Paye r Patient Responsibi lity Amoun t: $"_$FN ($P(DATA,U ,3),",",2)
	4502	;
	4503	; Write Rej ect Codes if previou s claims i f they are there
	4504	I $D(BPSPRA RR("OTHER PAYER",BPS PIEN,"R")) D
	4505	. S BPX=0 F S BPX=$O (BPSPRARR( "OTHER PAY ER",BPSPIE N,"R",BPX) ) Q:BPX="" D
	4506	. . W !,"Ot her Payer Reject Cod e: "_$$TR ANREJ^BPSE CFM($G(BPS PRARR("OTH ER PAYER", BPSPIEN,"R ",BPX,0)))
	4507	Q
	4508
	4509
	4510