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+<span class="mx-2 text-secondary">|</span>
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+<?php $componentID = rand(10001, 99999); ?>
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+<a href="#" onclick="return showStagPopup('update-claim-{{$componentID}}')">Update Claim</a>
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+<div class="stag-popup stag-popup-md mcp-theme-1" stag-popup-key="update-claim-{{$componentID}}">
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+ <form action="/api/claim/createForNote" id="updateClaimApp{{$componentID}}">
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+ <h3 class="stag-popup-title border-bottom-0 mb-0">
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+ <span>Update Claim</span>
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+ <span class="mx-2 text-secondary">|</span>
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+ <a href="#" v-on:click.prevent="addLine()">Add Line</a>
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+ <a href="#" class="ml-auto text-secondary"
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+ onclick="return closeStagPopup()"><i class="fa fa-times-circle"></i></a>
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+ </h3>
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+ <input type="hidden" name="uid" value="{{$claim->uid}}">
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+ <table class="table table-sm table-condensed mb-3 border-left border-right border-bottom">
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+ <thead>
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+ <tr class="bg-light">
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+ <th class="width-100px border-bottom-0">CPT Code</th>
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+ <th class="width-100px border-bottom-0">Date of Service</th>
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+ <th class="border-bottom-0">ICDs</th>
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+ <th class="border-bottom-0"> </th>
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+ </tr>
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+ </thead>
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+ <tbody>
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+ <tr v-for="(line, lineIndex) in payload.lines">
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+ <td class="py-2">
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+ <input required type="text" class="min-width-unset form-control form-control-sm" v-model="line.cpt">
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+ </td>
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+ <td class="py-2">
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+ <input required type="date" class="min-width-unset form-control form-control-sm" v-model="line.dateOfService">
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+ </td>
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+ <td class="p-2 bg-light">
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+ <div class="d-flex align-items-baseline">
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+ <a href="#" class="text-nowrap text-primary mr-2"
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+ v-on:click.prevent="addICD(lineIndex)" title="Add ICD">
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+ <i class="fa fa-plus-square text-primary"></i>
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+ </a>
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+ <div class="flex-grow-1">
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+ <div v-for="(icd, icdIndex) in line.icds" class="d-flex align-items-center" :class="icdIndex > 0 ? 'mt-1' : ''">
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+ <input required type="text" class="form-control form-control-sm width-100px"
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+ data-field="icd"
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+ :data-line-index="lineIndex"
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+ :data-icd-index="icdIndex"
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+ v-model="icd.code">
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+ <input required type="text" class="form-control form-control-sm flex-grow-1 ml-2"
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+ v-model="icd.description">
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+ <a href="#" class="text-nowrap text-danger ml-2"
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+ v-on:click.prevent="removeICD(lineIndex, icdIndex)"
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+ v-if="line.icds.length > 1" title="Remove ICD">
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+ <i class="fa fa-trash-alt text-danger"></i>
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+ </a>
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+ </div>
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+ </div>
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+ </div>
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+ </td>
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+ <td class="text-center pt-2">
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+ <a href="#" class="text-nowrap text-danger d-block mt-1"
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+ :class="payload.lines.length <= 1 ? 'opacity-60' : ''"
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+ v-on:click.prevent="removeLine(lineIndex)">
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+ <i class="fa fa-trash-alt text-danger"></i>
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+ Remove Line
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+ </a>
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+ </td>
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+ </tr>
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+ </tbody>
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+ </table>
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+
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+ <div class="mt-2">
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+ <button type="button" class="btn btn-primary btn-sm font-weight-bold" v-on:click.prevent="saveClaim()">Update</button>
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+ <button type="button" class="btn btn-default border btn-sm font-weight-bold ml-2" onclick="return closeStagPopup()">Cancel</button>
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+ </div>
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+ </form>
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+</div>
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+<script>
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+ <?php
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+ $loadedLines = [];
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+ foreach ($claim->lines as $line) {
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+ $newLine = (object)[];
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+ $newLine->cpt = $line->cpt;
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+ $newLine->dateOfService = $line->date_of_service;
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+ $newLine->icds = [];
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+ foreach ($line->claimLineIcds as $icd) {
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+ $newICD = (object)[];
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+ $newICD->code = $icd->code;
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+ $newICD->description = $icd->description;
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+ $newLine->icds[] = $newICD;
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+ }
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+ $loadedLines[] = $newLine;
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+ }
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+ ?>
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+ window.updateClaimApp{{$componentID}} = new Vue({
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+ el: '#updateClaimApp{{$componentID}}',
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+ delimiters: ['@{{', '}}'],
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+ data: {
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+ payload: {
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+ lines: <?= json_encode($loadedLines) ?>
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+ }
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+ },
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+ methods: {
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+ addLine: function () {
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+ this.payload.lines.push({
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+ cpt: '',
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+ dateOfService: '{{date('Y-m-d')}}',
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+ icds: [
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+ {
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+ code: '',
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+ description: '',
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+ }
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+ ]
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+ });
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+ Vue.nextTick(() => {
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+ this.initICDAutoSuggest();
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+ });
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+ },
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+ removeLine: function (_index) {
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+ if(this.payload.lines.length > 1) {
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+ this.payload.lines.splice(_index, 1);
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+ }
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+ },
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+ addICD: function(_lineIndex) {
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+ this.payload.lines[_lineIndex].icds.push({
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+ code: '',
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+ description: '',
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+ });
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+ Vue.nextTick(() => {
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+ this.initICDAutoSuggest();
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+ });
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+ },
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+ removeICD: function(_lineIndex, _icdIndex) {
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+ if(this.payload.lines[_lineIndex].icds.length > 1) {
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+ this.payload.lines[_lineIndex].icds.splice(_icdIndex, 1);
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+ }
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+ },
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+ initICDAutoSuggest: function () {
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+ let self = this;
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+ $('#updateClaimApp{{$componentID}} input[type="text"][data-field="icd"]:not([ac-initialized])').each(function () {
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+ var elem = this,
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+ dynID = 'icd-' + Math.ceil(Math.random() * 1000000),
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+ lineIndex = $(this).attr('data-line-index'),
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+ icdIndex = $(this).attr('data-icd-index');
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+ $(elem).attr('id', dynID);
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+ new window.Def.Autocompleter.Search(dynID,
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+ 'https://clinicaltables.nlm.nih.gov/api/icd10cm/v3/search?sf=code,name&ef=name', {
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+ tableFormat: true,
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+ valueCols: [0],
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+ colHeaders: ['Code', 'Name'],
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+ }
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+ );
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+ window.Def.Autocompleter.Event.observeListSelections(dynID, function () {
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+ let acData = elem.autocomp.getSelectedItemData();
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+ self.payload.lines[lineIndex].icds[icdIndex].code = acData[0].code;
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+ self.payload.lines[lineIndex].icds[icdIndex].description = acData[0].data.name;
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+ return false;
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+ });
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+ $(elem).attr('ac-initialized', 1);
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+ });
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+ },
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+ saveClaim: function() {
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+ let form = $('form#updateClaimApp{{$componentID}}').first();
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+ if(!form[0].checkValidity()) {
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+ form[0].reportValidity();
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+ return false;
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+ }
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+
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+ $.post('/api/claim/update', {
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+ uid: '{{$claim->uid}}',
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+ data: JSON.stringify(this.payload)
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+ }, function(_data) {
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+ if (!_data.success) {
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+ if (_data.message) {
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+ toastr.error(_data.message);
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+ }
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+ else {
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+ toastr.error('Unable to save the claim!');
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+ }
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+ }
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+ else {
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+ toastr.success('Claim saved!');
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+ closeStagPopup();
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+ fastReload();
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+ }
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+ }, 'json')
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+ }
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+ },
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+ mounted: function () {
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+ this.initICDAutoSuggest();
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+ }
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+ })
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+</script>
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