Optum360 BAR pairing HL7 segments and pulling charge codes

[Bill Pitts]

Hi

I’m having an issue in a tclproc with conditionally pairing segments and pulling data out from the 2nd  (ZPX) segment in the pair conditionally based upon values in the 1st (PR1) segment.

Specifically this is from an Optum360 HL7 BAR transaction with charge codes (ultimately need to be formatted to Cerner Invision 48/49 format – but that’s another issue!)

The Charge Code is in the ZPX.1 field, but we only want to pull it when the corresponding PR1 segment has PR109 = “CM” and PR115 is valued.

Tried various versions of the tclprocs but at this point they’re all a mess!

Having real difficulty pairing the PR1 and ZPX segments based upon the conditions defined above.

Complete format of Optum360 BAR source is attached.

Excerpt below:

The 1st PR1 PR109 is not valued and PR115 is valued, but there’s no corresponding ZPX segment – so in that case I’d need to skip the PR1

The 2nd PR1 segment matches the conditions and ZPX.1 has the charge code so I’d keep that

The 3rd PR1 segment doesn’t meet the conditions so I’d skip the PR1 and ZPX segments

….etc

PR1|1|C4|20610|DRAIN/INJ JOINT/BURSA W/|201607290000||||||118559||||LT|LT

PR1|2|C4|73564|X-RAY EXAM KNEE 4 OR MOR|201607290000|||1|CM|0320|||||RT|RT

ZPX|41100958|0.00

PR1|3|C4|87205|SMEAR GRAM STAIN        |201607290000|||1|CM|0306||||||

ZPX|21107042|0.00

Any suggestions appreciated!  Thanks!

Topic

[Michael Hertel]

Can you attach what you have for a tclproc?

[Jim Kosloskey]

For what it is worth, I would do this using Xlate.

email: jim.kosloskey@jim-kosloskey.com 29+ years Cloverleaf, 59 years IT - old fart.

[Bill Pitts]

Hi

We got this working, using some of Charlie Bursell’s code from another post on using the “lsearch” command and looping through segments,etc.

Used Charlie’s code as a baseline then modified as needed.

Thanks Charlie!

Attached is tcl script.

Script takes Optum HL7 BAR transactions and creates Invision 49 (Credit) and 48 (Charge) transactions.  Transactions are placed in a file.

Separate Unix shell scripts run to :

1) Count and parse transactions to max batch of 98 records (Invision requirement)

2)  Add header & trailer to batches

3) create “report”of batch content

4) Send email notifications to appropriate parties

File picked up by some custom programs (non-Clover) we have to do reconciling,etc.   Batches then sent back to Cerner (ex-Siemens) Openlink engine to feed into Invision BCF (Batch Collection Facility) for processing to Invision PA (Patient Accounting)

[Author]

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