Support flexiblility in code types utilized in claims

[openemr.git] / custom / code_types.inc.php

<?php
// Copyright (C) 2006-2010 Rod Roark <rod@sunsetsystems.com>
//
// This program is free software; you can redistribute it and/or
// modify it under the terms of the GNU General Public License
// as published by the Free Software Foundation; either version 2
// of the License, or (at your option) any later version.

// This array provides abstraction of billing code types.  This is desirable
// because different countries or fields of practice use different methods for
// coding diagnoses, procedures and supplies.  Fees will not be relevant where
// medical care is socialized.  Attribues are:
//
// id   - the numeric identifier of this code type in the codes table
// fee  - 1 if fees are used, else 0
// mod  - the maximum length of a modifier, 0 if modifiers are not used
// just - the code type used for justification, empty if none
// rel  - 1 if other billing codes may be "related" to this code type
// nofs - 1 if this code type should NOT appear in the Fee Sheet
// diag - 1 if this code type is for diagnosis
// active - 1 if this code type is activated
// label - label used for code type
// external - 0 for storing codes in the code table
//            1 for storing codes in external ICD10 tables
//            2 for storing codes in external SNOMED (RF1) tables
//            3 for storing codes in external SNOMED (RF2) tables
//            4 for storing codes in external ICD9 tables
//

/*********************************************************************
if ($GLOBALS['ippf_specific']) {
 // IPPF:
  $code_types = array(
    'ICD9'  => array('id' =>  2, 'fee' => 0, 'mod' => 0, 'just' => '', 'rel' => 0, 'nofs' => 0, 'diag' => TRUE),
    'MA'    => array('id' => 12, 'fee' => 1, 'mod' => 0, 'just' => '', 'rel' => 1, 'nofs' => 0),
    'IPPF'  => array('id' => 11, 'fee' => 0, 'mod' => 0, 'just' => '', 'rel' => 0, 'nofs' => 1),
    'ACCT'  => array('id' => 13, 'fee' => 0, 'mod' => 0, 'just' => '', 'rel' => 0, 'nofs' => 1),
  );
  $default_search_type = 'MA';
}
else if ($GLOBALS['athletic_team']) {
 // UK Sports Medicine:
  $code_types = array(
    'OSICS10' => array('id' =>  9, 'fee' => 0, 'mod' => 4, 'just' => '', 'rel' => 0, 'nofs' => 0, 'diag' => TRUE),
    'OPCS'    => array('id' =>  6, 'fee' => 0, 'mod' => 0, 'just' => '', 'rel' => 0, 'nofs' => 0),
    'PTCJ'    => array('id' =>  7, 'fee' => 0, 'mod' => 0, 'just' => '', 'rel' => 0, 'nofs' => 0),
    'CPT4'    => array('id' =>  1, 'fee' => 0, 'mod' => 0, 'just' => '', 'rel' => 0, 'nofs' => 0),
    'SMPC'    => array('id' => 10, 'fee' => 0, 'mod' => 0, 'just' => '', 'rel' => 0, 'nofs' => 0),
  );
  $default_search_type = 'OSICS10';
}
else {
 // USA Clinics:
  $code_types = array(
    'ICD9'  => array('id' => 2, 'fee' => 0, 'mod' => 2, 'just' => ''    , 'rel' => 0, 'nofs' => 0, 'diag' => TRUE),
    'CPT4'  => array('id' => 1, 'fee' => 1, 'mod' => 2, 'just' => 'ICD9', 'rel' => 0, 'nofs' => 0),
    'HCPCS' => array('id' => 3, 'fee' => 1, 'mod' => 2, 'just' => 'ICD9', 'rel' => 0, 'nofs' => 0),
  );
  $default_search_type = 'ICD9';
}
*********************************************************************/

$cd_external_options = array(
  '0' => xl('No'),
  '1' => xl('ICD10'),
  '2' => xl('SNOMED (RF1)'),
  '3' => xl('SNOMED (RF2)'),
  '4' => xl('ICD9')
);

// Code types are now stored in the database.
//
$code_types = array();
$default_search_type = '';
$ctres = sqlStatement("SELECT * FROM code_types WHERE ct_active=1 ORDER BY ct_seq, ct_key");
while ($ctrow = sqlFetchArray($ctres)) {
  $code_types[$ctrow['ct_key']] = array(
    'id'   => $ctrow['ct_id'  ],
    'fee'  => $ctrow['ct_fee' ],
    'mod'  => $ctrow['ct_mod' ],
    'just' => $ctrow['ct_just'],
    'rel'  => $ctrow['ct_rel' ],
    'nofs' => $ctrow['ct_nofs'],
    'diag' => $ctrow['ct_diag'],
    'mask' => $ctrow['ct_mask'],
    'label'=> ( (empty($ctrow['ct_label'])) ? $ctrow['ct_key'] : $ctrow['ct_label'] ),
    'external'=> $ctrow['ct_external']
  );
  if ($default_search_type === '') $default_search_type = $ctrow['ct_key'];
}

/********************************************************************/

function fees_are_used() {
 global $code_types;
 foreach ($code_types as $value) { if ($value['fee']) return true; }
 return false;
}

function modifiers_are_used($fee_sheet=false) {
 global $code_types;
 foreach ($code_types as $value) {
  if ($fee_sheet && !empty($value['nofs'])) continue;
  if ($value['mod']) return true;
 }
 return false;
}

function related_codes_are_used() {
 global $code_types;
 foreach ($code_types as $value) { if ($value['rel']) return true; }
 return false;
}

// Convert a code type id to a key
function convert_type_id_to_key($id) {
 global $code_types;
 foreach ($code_types as $key => $value) {
  if ($value['id'] == $id) return $key;
 } 
}

// Main code set searching function
// $form_code_type - code set key (special keywords are PROD and --ALL--)
// $search_term - search term
// $count - if true, then will only return the number of entries
// $active - if true, then will only return active entries (not pertinent for PROD or external code sets)
// $return_only_one - if true, then will only return one perfect matching item
// $start - Query start limit
// $number - Query number returned
// $filter_elements - Array that contains elements to filter
function code_set_search($form_code_type,$search_term="",$count=false,$active=true,$return_only_one=false,$start=NULL,$number=NULL,$filter_elements=array()) {
  global $code_types;

  $limit_query = '';
  if ( !is_null($start) && !is_null($number) ) {
    $limit_query = " LIMIT $start, $number ";
  }
  if ($return_only_one) {
     $limit_query = " LIMIT 1 ";
  }

  // build the filter_elements sql code
  $query_filter_elements="";
  if (!empty($filter_elements)) {
   foreach ($filter_elements as $key => $element) {
    $query_filter_elements .= " AND codes." . add_escape_custom($key) . "=" . "'" . add_escape_custom($element)  . "' ";
   }
  }

  if ($form_code_type == 'PROD') { // Search for products/drugs
   $query = "SELECT dt.drug_id, dt.selector, d.name " .
            "FROM drug_templates AS dt, drugs AS d WHERE " .
            "( d.name LIKE ? OR " .
            "dt.selector LIKE ? ) " .
            "AND d.drug_id = dt.drug_id " .
            "ORDER BY d.name, dt.selector, dt.drug_id $limit_query";
   $res = sqlStatement($query, array("%".$search_term."%", "%".$search_term."%") );
  }
  else if ($form_code_type == '--ALL--') { // Search all codes from the default codes table
   // Note this will not search the external code sets
   $active_query = '';
   if ($active) {
    // Only filter for active codes
    $active_query=" AND codes.active = 1 ";
   }
   $query = "SELECT `id`, `code_text`, `code_text_short`, `code`, `code_type`, `modifier`, `units`, `fee`, " .
            "`superbill`, `related_code`, `taxrates`, `cyp_factor`, `active`, `reportable`, `financial_reporting`, " .
            "code_types.ct_key as code_type_name " .
            "FROM `codes` " .
            "LEFT OUTER JOIN `code_types` " .
            "ON codes.code_type = code_types.ct_id " .
            "WHERE (codes.code_text LIKE ? OR " .
            "codes.code LIKE ?) AND code_types.ct_external = '0' " .
            " $active_query " .
            " $query_filter_elements " .
            "ORDER BY code_type,code+0,code $limit_query";
   $res = sqlStatement($query, array("%".$search_term."%", "%".$search_term."%") );
  }
  else if ( !($code_types[$form_code_type]['external']) ) { // Search from default codes table
   $active_query = '';
   if ($active) {
    // Only filter for active codes
    $active_query=" AND codes.active = 1 ";
   }
   $sql_bind_array = array();
   $query = "SELECT `id`, `code_text`, `code_text_short`, `code`, `code_type`, `modifier`, `units`, `fee`, " .
            "`superbill`, `related_code`, `taxrates`, `cyp_factor`, `active`, `reportable`, `financial_reporting`, " .
            "'" . add_escape_custom($form_code_type) . "' as code_type_name " .
            "FROM `codes` ";
   if ($return_only_one) {
    $query .= "WHERE codes.code = ? ";
    array_push($sql_bind_array,$search_term);
   }
   else {
    $query .= "WHERE (codes.code_text LIKE ? OR codes.code LIKE ?) ";
    array_push($sql_bind_array,"%".$search_term."%", "%".$search_term."%");
   }
   $query .= "AND code_type = ? $active_query $query_filter_elements " .
             "ORDER BY code+0,code $limit_query";
   array_push($sql_bind_array,$code_types[$form_code_type]['id']);
   $res = sqlStatement($query,$sql_bind_array);
  }
  else if ($code_types[$form_code_type]['external'] == 1 ) { // Search from ICD10 codeset tables
   $active_query = '';
   if ($active) {
    // Only filter for active codes
    // If there is no entry in codes sql table, then default to active
    //  (this is reason for including NULL below)
    $active_query=" AND (codes.active = 1 || codes.active IS NULL) ";
   }
   // Ensure the icd10_dx_order_code sql table exists
   $check_table = sqlQuery("SHOW TABLES LIKE 'icd10_dx_order_code'");
   if ( !(empty($check_table)) ) {
    $sql_bind_array = array();
    $query = "SELECT icd10_dx_order_code.formatted_dx_code as code, icd10_dx_order_code.long_desc as code_text, " .
             "codes.id, codes.code_type, codes.modifier, codes.units, codes.fee, " .
             "codes.superbill, codes.related_code, codes.taxrates, codes.cyp_factor, codes.active, codes.reportable, codes.financial_reporting, " .
             "'" . add_escape_custom($form_code_type) . "' as code_type_name " .
             "FROM `icd10_dx_order_code` " .
             "LEFT OUTER JOIN `codes` " .
             "ON icd10_dx_order_code.formatted_dx_code = codes.code AND codes.code_type = ? ";
    array_push($sql_bind_array,$code_types[$form_code_type]['id']);
    if ($return_only_one) {
     $query .= "WHERE icd10_dx_order_code.formatted_dx_code = ? AND icd10_dx_order_code.valid_for_coding = '1' $active_query $query_filter_elements ";
     array_push($sql_bind_array,$search_term);
    }
    else {
     $query .= "WHERE (icd10_dx_order_code.long_desc LIKE ? OR icd10_dx_order_code.formatted_dx_code LIKE ?) AND icd10_dx_order_code.valid_for_coding = '1' $active_query $query_filter_elements";
     array_push($sql_bind_array,"%".$search_term."%","%".$search_term."%");
    }
    $query .= "ORDER BY `formatted_dx_code`+0, `formatted_dx_code` $limit_query";
    $res = sqlStatement($query,$sql_bind_array);
   }
  }
  else if ($code_types[$form_code_type]['external'] == 2 ) { // Search from SNOMED (RF1) codeset tables
   if ($active) {
    // Only filter for active codes
    // If there is no entry in codes sql table, then default to active
    //  (this is reason for including NULL below)
    $active_query=" AND (codes.active = 1 || codes.active IS NULL) ";
   }
   // Ensure the sct_concepts sql table exists
   $check_table = sqlQuery("SHOW TABLES LIKE 'sct_concepts'");
   if ( !(empty($check_table)) ) {
    $sql_bind_array = array();
    $query = "SELECT `ConceptId` as code, `FullySpecifiedName` as code_text, " .
             "codes.id, codes.code_type, codes.modifier, codes.units, codes.fee, " .
             "codes.superbill, codes.related_code, codes.taxrates, codes.cyp_factor, codes.active, codes.reportable, codes.financial_reporting, " .
             "'" . add_escape_custom($form_code_type) . "' as code_type_name " .
             "FROM `sct_concepts` " .
             "LEFT OUTER JOIN `codes` " .
             "ON sct_concepts.ConceptId = codes.code AND codes.code_type = ? ";
    array_push($sql_bind_array,$code_types[$form_code_type]['id']);
    if ($return_only_one) {
     $query .= "WHERE (`ConceptId` = ? AND `FullySpecifiedName` LIKE '%(disorder)') $active_query $query_filter_elements ";
     array_push($sql_bind_array,$search_term);
    }
    else {
     $query .= "WHERE ((`FullySpecifiedName` LIKE ? OR `ConceptId` LIKE ?) AND `FullySpecifiedName` LIKE '%(disorder)') $active_query $query_filter_elements ";
     array_push($sql_bind_array,"%".$search_term."%","%".$search_term."%");
    }
    $query .= "AND `ConceptStatus` = 0 " .
              "ORDER BY `ConceptId` $limit_query";
    $res = sqlStatement($query,$sql_bind_array);
   }
  }
  else if ($code_types[$form_code_type]['external'] == 3 ) { // Search from SNOMED (RF2) codeset tables
   //placeholder
  }
  else if ($code_types[$form_code_type]['external'] == 4 ) { // Search from ICD9 codeset tables
   if ($active) {
    // Only filter for active codes
    // If there is no entry in codes sql table, then default to active
    //  (this is reason for including NULL below)
    $active_query=" AND (codes.active = 1 || codes.active IS NULL) ";
   }
   // Ensure the icd9_dx_code sql table exists
   $check_table = sqlQuery("SHOW TABLES LIKE 'icd9_dx_code'");
   if ( !(empty($check_table)) ) {
    $sql_bind_array = array();
    $query = "SELECT icd9_dx_code.formatted_dx_code as code, icd9_dx_code.long_desc as code_text, " .
             "codes.id, codes.code_type, codes.modifier, codes.units, codes.fee, " .
             "codes.superbill, codes.related_code, codes.taxrates, codes.cyp_factor, codes.active, codes.reportable, codes.financial_reporting, " .
             "'" . add_escape_custom($form_code_type) . "' as code_type_name " .
             "FROM `icd9_dx_code` " .
             "LEFT OUTER JOIN `codes` " .
             "ON icd9_dx_code.formatted_dx_code = codes.code AND codes.code_type = ? ";
    array_push($sql_bind_array,$code_types[$form_code_type]['id']);
    if ($return_only_one) {
     $query .= "WHERE icd9_dx_code.formatted_dx_code = ? $active_query $query_filter_elements ";
     array_push($sql_bind_array,$search_term);
    }
    else {
     $query .= "WHERE (icd9_dx_code.long_desc LIKE ? OR icd9_dx_code.formatted_dx_code LIKE ?) $active_query $query_filter_elements ";
     array_push($sql_bind_array,"%".$search_term."%","%".$search_term."%");
    }
    $query .= "ORDER BY `formatted_dx_code`+0, `formatted_dx_code` $limit_query";
    $res = sqlStatement($query,$sql_bind_array);
   }
  }
  else {
   //using an external code that is not yet supported, so skip.
  }
  if (isset($res)) {
   if ($count) {
    // just return the count
    return sqlNumRows($res);
   }
   else {
    // return the data
    return $res;
   }
  }
}

// Look up descriptions for one or more billing codes.  Input is of the
// form "type:code;type:code; etc.".
//
function lookup_code_descriptions($codes) {
  global $code_types;
  $code_text = '';
  if (!empty($codes)) {
    $relcodes = explode(';', $codes);
    foreach ($relcodes as $codestring) {
      if ($codestring === '') continue;
      list($codetype, $code) = explode(':', $codestring);
      if ( !($code_types[$codetype]['external']) ) { // Collect from default codes table
        $wheretype = "";
        $sqlArray = array();
        if (empty($code)) {
          $code = $codetype;
        } else {
          $wheretype = "code_type = ? AND ";
          array_push($sqlArray,$code_types[$codetype]['id']);
        }
        $sql = "SELECT code_text FROM codes WHERE " .
          "$wheretype code = ? ORDER BY id LIMIT 1";
        array_push($sqlArray,$code);
        $crow = sqlQuery($sql,$sqlArray);
        if (!empty($crow['code_text'])) {
          if ($code_text) $code_text .= '; ';
          $code_text .= $crow['code_text'];
        }
      }
      else if ($code_types[$codetype]['external'] == 1) { // Collect from ICD10 codeset tables
        // Ensure the icd10_dx_order_code sql table exists
        $check_table = sqlQuery("SHOW TABLES LIKE 'icd10_dx_order_code'");
        if ( !(empty($check_table)) ) {
          if ( !(empty($code)) ) {
            $sql = "SELECT `long_desc` FROM `icd10_dx_order_code` " .
                   "WHERE `formatted_dx_code` = ? LIMIT 1";
            $crow = sqlQuery($sql, array($code) );
            if (!empty($crow['long_desc'])) {
              if ($code_text) $code_text .= '; ';
              $code_text .= $crow['long_desc'];
            }
          }
        }
      }
      else if ($code_types[$codetype]['external'] == 2) { // Collect from SNOMED (RF1) codeset tables
        // Ensure the sct_concepts sql table exists
        $check_table = sqlQuery("SHOW TABLES LIKE 'sct_concepts'");
        if ( !(empty($check_table)) ) {
          if ( !(empty($code)) ) {
            $sql = "SELECT `FullySpecifiedName` FROM `sct_concepts` " .
                   "WHERE `ConceptId` = ? AND `ConceptStatus` = 0 LIMIT 1";
            $crow = sqlQuery($sql, array($code) );
            if (!empty($crow['FullySpecifiedName'])) {
              if ($code_text) $code_text .= '; ';
              $code_text .= $crow['FullySpecifiedName'];
            }
          }
        }
      }
      else if ($code_types[$codetype]['external'] == 3) { // Collect from SNOMED (RF2) codeset tables
        //placeholder
      }
      else if ($code_types[$codetype]['external'] == 4) { // Collect from ICD9 codeset tables
        // Ensure the icd9_dx_code sql table exists
        $check_table = sqlQuery("SHOW TABLES LIKE 'icd9_dx_code'");
        if ( !(empty($check_table)) ) {
          if ( !(empty($code)) ) {
            $sql = "SELECT `long_desc` FROM `icd9_dx_code` " .
                   "WHERE `formatted_dx_code` = ? LIMIT 1";
            $crow = sqlQuery($sql, array($code) );
            if (!empty($crow['long_desc'])) {
              if ($code_text) $code_text .= '; ';
              $code_text .= $crow['long_desc'];
            }
          }
        }
      }
      else {
        //using an external code that is not yet supported, so skip. 
      }
    }
  }
  return $code_text;
}
?>