$TXT Created by at DEVESS.DOMAIN.EXT (KIDS) on Wednesday, 08/13/14 at 16:13 ============================================================================= Run Date: AUG 29, 2014 Designation: RMPR*3*168 Package : RMPR - PROSTHETICS Priority: Mandatory Version : 3 SEQ #152 Status: Released Compliance Date: SEP 12, 2014 ============================================================================= Associated patches: (v)RMPR*3*125 <<= must be installed BEFORE `RMPR*3*168' (v)RMPR*3*128 <<= must be installed BEFORE `RMPR*3*168' (v)RMPR*3*148 <<= must be installed BEFORE `RMPR*3*168' (v)RMPR*3*150 <<= must be installed BEFORE `RMPR*3*168' (v)RMPR*3*163 <<= must be installed BEFORE `RMPR*3*168' (v)LEX*2*80 <<= must be installed BEFORE `RMPR*3*168' (v)PX*1*199 <<= must be installed BEFORE `RMPR*3*168' (v)ICD*18*57 <<= must be installed BEFORE `RMPR*3*168' (v)GMRC*3*73 <<= must be installed BEFORE `RMPR*3*168' (v)OR*3*361 <<= must be installed BEFORE `RMPR*3*168' Subject: PROSTHETICS ICD-10 CLASS 1 REMEDIATION Category: - Routine - Data Dictionary - Enhancement (Mandatory) - Other Description: ============ IMPORTANT INFORMATION Please read the Overview Guide (ICD-10_Prod_Overview_Guide_Groups_5_6_7.pdf) posted on the Anonymous directory for installation order. This is critical for proper functionality of the ICD-10 Software. The International Classification of Diseases, Tenth Revision (ICD-10) Class 1 Software Remediation project replaces the 30-year-old set of diagnosis and procedure codes (ICD-9-CM) that medical personnel use. Dates of service, or dates of discharge for inpatients, that occur on or after the ICD-10 activation date will use the ICD-10 code set. Clinical Modification (ICD-10-CM) diagnosis codes increase from about 13,000 ICD-9 codes to more than 68,000. Procedure Coding System (ICD-10-PCS) procedure codes increase from about 3,800 ICD-9 codes to nearly 87,000. Both systems also expand the number of characters allotted to seven alpha-numeric characters. This value does not include the decimal point, which follows the third character for the ICD-10-CM code set. There is no decimal point in the ICD-10-PCS code set. These code sets have the potential to reveal more about quality of care, so that data can be used in a more meaningful way to better understand complications, better design clinically robust algorithms, and better track the outcomes of care. ICD-10-CM also incorporates greater specificity and clinical detail to provide information for clinical decision making and outcomes research. The following functionality within the Prosthetics application were updated to address the ICD-10 code set. These updates apply to both the VistA Prosthetics Roll & Scroll application and the Prosthetics Graphical User Interface (GUI) application; there will be a separate section listing the updates for each of these interfaces. =============================== WARNING ================================ The ICD-10 Class I Remediation project will update VistA to include the ICD-10 Diagnosis and Procedure codes. The first patches to be delivered by this project will be the STS patches ICD*18.0*57 and LEX*2.0*80 which will include both the ICD-10 Diagnosis and Procedure codes along with new or updated APIs that will be used by the other VistA applications to select, retrieve and display these new codes. There are several VistA applications that do not currently utilize code set versioning. Those applications are Prosthetics, Home Based Primary Care, and Lab Anatomic Pathology. As a result, these applications currently allow inactive ICD-9 codes to be displayed and selected for ICD-9 dates of service. During the interim, after the installation of the STS ICD-10 Class I Remediation patches and prior to the ICD-10 Implementation date (10/01/2015), these applications will also allow the display and selection of inactive ICD-10 codes including statuses of (Inactive) or (Pending). The users of these applications should use CAUTION to select ICD-9 or ICD-10 codes that are appropriate and active. The following examples show how the software would appear in these applications: EXAMPLE #1: Inactive ICD-9 codes. The warning (Inactive) appears at the end of the short description. ICD-9 DIAGNOSIS CODE: 100.81// 488. 12 matches found 1. 488. FLU D/T AVIAN FLU VIRUS (Inactive) 2. 488.0 FLU DT IDEN AVIAN VIRUS (Inactive) 3. 488.01 FLU DT IDEN AVIAN W PNEU (Major CC) 4. 488.02 FLU DT AVIAN W OTH RESP (CC) 5. 488.09 FLU DT AVIAN MANFEST NEC (CC) Press for more, '^' to exit, or Select 1-5: EXAMPLE #2: Inactive ICD-10 codes. The warning (Pending) appears at the end of the short description. ICD-9 DIAGNOSIS CODE: 100.81// S06.816 3 matches found 1. S06.816A Inj r int crtd,intcr w LOC >24 hr w/o ret consc w surv, init (10/01/2015) (Pending) 2. S06.816D Inj r int crtd,intcr w LOC >24 hr w/o ret consc w surv, subs (10/01/2015) (Pending) 3. S06.816S Inj r int crtd,intcr w LOC >24 hr w/o ret consc w surv, sqla (10/01/2015) (Pending) Select 1-3: When creating or editing records dated after the ICD-10 Activation Date (10/01/2015), the software will correctly screen out both the inactive ICD-9 and inactive ICD-10 codes. =========================== END OF WARNING ============================= PROSTHETICS ROLL & SCROLL ========================= 1. Add/Edit Home Oxygen Patient Full Menu Path: Home Oxygen Main Menu -> Add/Edit Home Oxygen Patient The software has been updated to determine the active coding system based on Date Of Interest, which is the Home Oxygen Prescription Date. Once the active coding system is determined, the software will respond in one of two ways: 1. If the ICD-9 coding system is active, the software will continue to function as it always has for the ICD-9 code set. This includes Look-ups, searches, and displayed information. 2. If the ICD-10 coding system is active, the software will utilize new Application Program Interfaces (APIs) to perform the Look-ups and searches. Because of the increased granularity of the ICD-10 code set, searches may return more matches than can be displayed on a single screen. For the ICD-10 active coding system, the user can enter any of the following: 1. A valid ICD-10 code. 2. A partial ICD-10 code. 3. A partial description of a valid ICD-10 code. If the user selects a valid ICD-10 code, the software will continue to the next function. If the user selects one partial ICD-10 code (i.e., a branch node denoted by a trailing "-" ), all of the immediate descendants of that branch node will be displayed to the user. This step will repeat until the user selects a valid ICD-10 code. The user can enter any of the following: 1. A valid ICD-10 code. 2. A partial ICD-10 code. 3. A partial description of a valid ICD-10 code. The example below shows the new ICD-10 search API drilling down two levels to select a valid ICD-10 code. Step #1: The user enters first three characters (F14) of a valid ICD-10 code. Result: The software then displays the total number of entries that match the three character input (20), a numbered list of matching codes, their descriptions, and designates leaf nodes matches. Step #2: The user reviews the list and selects entry #4 (F14.15-), which is a branch node. Result: The software then displays the total number of entries that match the partial ICD-10 code F14.15, a numbered list of matching code(s), their descriptions, and whether the entry is a branch (-) or a leaf node. In this example, there are three matches and all three of them are valid ICD-10 codes (no "-" at the end of the code). Step #3: The user reviews the list and selects entry #2 (F14.151), which is a valid ICD-10 code. Result: The software stores the selected ICD-10 code and advances to the next field in the edit list. Example noting just the fields immediately before and after the ICD field: UNIT COST: 1.00 UNIT OF ISSUE: EACH ICD-10 DIAGNOSIS CODE: F14 20 matches found 1. F14.10 Cocaine Abuse, Uncomplicated 2. F14.12- Cocaine abuse with intoxication (4) 3. F14.14 Cocaine Abuse with Cocaine-Induced Mood Disorder 4. F14.15- Cocaine abuse with cocaine-induced psychotic disorder (3) 5. F14.18- Cocaine abuse with other cocaine-induced disorder (4) 6. F14.19 Cocaine Abuse with unspecified Cocaine-Induced Disorder 7. F14.20 Cocaine Dependence, Uncomplicated 8. F14.21 Cocaine Dependence, in Remission Press for more, "^" to exit, or Select 1-8: 4 3 matches found 1. F14.150 Cocaine Abuse with Cocaine-Induced Psychotic Disorder with Delusions 2. F14.151 Cocaine Abuse with Cocaine-Induced Psychotic Disorder with Hallucinations 3. F14.159 Cocaine Abuse with Cocaine-Induced Psychotic Disorder, unspecified Select 1-3: 2 REMARKS: ITEM TYPE: Select FUND CONTROL POINT: The Add/Edit Home Oxygen Patient option has also been updated so that if the user selects an existing Item and that Item contains an ICD code which was inactive based on the Start Date of the currently selected prescription, the software will issue a warning and then prompt the user with options on how to proceed. The user has three options: 1) Select a different item with no ICD code or with an active ICD code. 2) Enter a new item. 3) Proceed with this item. If the user proceeds with this item, the existing ICD Diagnosis code will be DELETED. The user may then enter an active ICD Diagnosis code or they may leave the ICD Diagnosis field blank. 2. Appliance Transactions Accessed through the following menu paths: PROSTHETIC OFFICIAL'S MENU -> Suspense -> Suspense Processing -> Display 2319 -> Appliance Transactions Prosthetic Official's Menu -> Process Form 2529-3 -> 2529-3 Request Menu -> Create 2529-3 Request and screen#4 -> Appliance Transactions (show full entry) Prosthetic Official's Menu Option -> Purchasing -> Enter New Request -> 2421 Form -> Suspense Processing Screen ->Display 2319 action and screen#4 -> Appliance Transactions (show full entry) Prosthetic Official's Menu Option -> Purchasing -> Enter New Request -> 2914 Eyeglass Record -> Suspense Processing Screen ->Display 2319 action and screen#4 -> Appliance Transactions (show full entry) Prosthetic Official's Menu Option -> Purchasing -> Stock Issues -> Issue from Stock -> and screen#4 -> Appliance Transactions (show full entry) Prosthetic Official's Menu Option -> Home Oxygen Main Menu -> Billing Transactions-> Display 2319 action and screen#4 - > Appliance Transactions (show full entry). These options have been updated to determine the active coding system based on the Date of Interest, which is the Home Oxygen Prescription Date, and will then retrieve the necessary information and display it to the user. If the ICD-9 coding system is active, the software will continue to function as it always has for the ICD-9 code set. If the ICD-10 coding system is active, the software will utilize new APIs to retrieve and display the needed information. Due to the granularity of the ICD-10 code set, most of the Diagnosis descriptions are longer than the ICD-9 code set Diagnosis descriptions. When an ICD Description is too long to fit on a single line, the remainder of the description will be displayed on a second line, which will be indented two spaces to denote that this information is related to the preceding line. There is a possibility that the ICD code being displayed may have been inactive on the Date of Interest. In these instances, the software displays an alert message after the Diagnosis description and this alert may wrap onto the next line if the Diagnosis description is too long. To avoid this wrapping and to make the display more readable, the software has been updated to check the length of the information being displayed; if all of the alert information will not fit onto a single line, the entire warning will be displayed on the following line and will be indented two spaces to denote that the information is related to the previous line. The following is an example of this warning and indentation: PROSTHETICS,PATIENTONE SSN: 000-12-3456 DOB: 01-01-1000 APPLIANCE/REPAIR LINE ITEM DETAIL <4-1> TYPE OF FORM: INITIATOR: DATE: OCT 01, 2013 DELIVER TO: TYPE TRANS: INITIAL ISSUE QTY: SOURCE: COMMERCIAL VENDOR: DELIVERY DATE: TOTAL COST: OBL: REMARKS: DISABILITY SERVED: NSC/OP ITEM DESCRIPTION: COOKIE APPLIANCE: COOKIE CONTRACT #: EXCLUDED/WAIVER: PSAS HCPCS: A4364 ADHESIVE ICD-10 CODE: A00.0 CHOLERA DUE TO VIBRIO CHOLERAE 01, BIOVAR CHOLERAE ** Inactive ** Date: OCT 01, 2013 CPT MODIFIER: DESCRIPTION: EXTENDED DESCRIPTION: 3. PSAS HCPCS History Option This option has been updated to determine the active coding system based on the Date of Interest, which is the Entry Date, and will then retrieve the necessary information and display it to the user. If the ICD-9 coding system is active, the software will continue to function as it always has for the ICD-9 code set. If the ICD-10 coding system is active, the software will utilize new APIs to retrieve and display the needed information. Due to the granularity of the ICD-10 code set, most of the Diagnosis descriptions are longer than the ICD-9 code set Diagnosis descriptions. When an ICD Description is too long to fit on a single line, the remainder of the description will be displayed on a second line, which will be indented two spaces to denote that this information is related to the preceding line. There is a possibility that the ICD code being displayed may have been inactive on the date of interest. In these instances, the software displays an alert message after the Diagnosis description and this alert may wrap onto the next line if the Diagnosis description is too long. To avoid this wrapping and to make the display more readable, the software has been updated to check the length of the information being displayed; if all of the alert information will not fit onto a single line, the entire warning will be displayed on the following line and will be indented two spaces to denote that the information is related to the previous line. The following is an example of this warning and indentation: REQUEST DATE PATIENT NAME SSN VENDOR OCT 01, 2013-DEC 31, 2020 ========================================================================= MAR 30, 2020 PATIENT,NEW O 0000 ITEM: ACETAMINOPHEN W/CODE QTY: TOTAL COST: 0.00 INITIAL ISSUE INITIATOR: ICD-10 CODE: A01.09 Typhoid fever with other complications ** Inactive ** Date: DEC 31, 2020 TOTAL DOLLARS SPENT ON THIS HCPCS: $ 0.00 TOTAL QUANTITY ISSUED: 0 PROSTHETICS GUI =============== 1. RPC Broker Calls The following RPC broker calls were updated to support the Delphi front- end of Prosthetics: 1. Appliance Transaction Detail RPC: RMPR TRANS LIST EXPANDED Routine: EN^RMPR9S4E Notes: The client was updated to look for the code set value (9, 10, etc.) as the second caret-delimited "^" piece of array element RESULTS(49). 2. NPPD Detail Display RPC: RMPR NPPD LIST X Routine: EN^RMPR9LN1 Notes: This RPC populates the three dropdown lists from which the user picks for the optional custom data fields. The list contains the field description and the field number that is sent to the RMPR NPPD LIST remote procedure below. The description was changed from "Suspense ICD-9" to "Suspense ICD" to fit with either code set. RPC: RMPR NPPD LIST Routine: EN^RMPR9LNP Notes: The remote procedure returns the ICD code in either piece 19, 20, or 21 of the results string. The client has been updated to look for a tilde "~" as a secondary delimiter to separate the ICD and the code set value (9, 10, etc.) for pieces 19, 20 and 21. Research was done regarding the use of the tilde and it was confirmed that the tilde was safe to use as a delimiter. 3. View Prosthetic Billing Information RPC: RMPR PFFS LIST Routine: EN^RMPRPFFS Notes: The client was updated to look for the code set value (9, 10, etc.) as the second caret-delimited "^" piece of array element RESULTS(49). 2. User Interface changes 1. The appliance detail form of the Prosthetics GUI will reflect whether the ICD description is ICD-9 or ICD-10 on the field description label. Patch Components ================ Files & Fields Associated: File Name (#) Field Name (#) New/Mod/Del ------------- ----------------------------------- ----------- RECORD OF PROS APPLIANCE/REPAIR (#660) SUSPENSE ICD (#8.8) Mod PRIMARY ICD DIAGNOSIS CODE (#30) Mod SECONDARY ICD DIAGNOSIS CODE 1 (#31) Mod SECONDARY ICD DIAGNOSIS 2 (#32) Mod SECONDARY ICD DIAGNOSIS 3 (#33) Mod HOME OXYGEN PRESCRIPTION (sub-file)(#665.193) PRIMARY ICD DIAGNOSIS CODE (#30) Mod SECONDARY ICD DIAGNOSIS CODE 1 (#31) Mod SECONDARY ICD DIAGNOSIS CODE 2 (#32) Mod SECONDARY ICD DIAGNOSIS CODE 3 (#33) Mod HOME OXYGEN ITEM (sub-file)(#665.194) ICD CODE (#7) Mod PROSTHETIC SUSPENSE (#668) ICD (#1.6) Mod PRIMARY ICD DIAGNOSIS CODE (#30) Mod SECONDARY ICD DIAGNOSIS 1 (#31) Mod SECONDARY ICD DIAGNOSIS 2 (#32) Mod SECONDARY ICD DIAGNOSIS 3 (#33) Mod Forms Associated: Form Name File # New/Mod/Del --------- ------ ----------- N/A Mail Groups Associated: Mail Group Name New/Mod/Del --------------- ----------- N/A Options Associated: Option Name Type New/Mod/Del ----------- ---- ----------- N/A Protocols Associated: Protocol Name New/Mod/Del ------------- ----------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (#) New/Mod/Del ------------- ---- ---------------------- ----------- N/A Additional Information: N/A New Service Requests (NSRs): ----------------------------- NSR 20070902, ICD-10-CM Conversion Patient Safety Issues (PSIs): ------------------------------ N/A Remedy Ticket(s) & Overviews: ----------------------------- N/A Test Sites : ----------- Coatesville VAMC, Coatesville, PA Houston VAMC, Houston, TX Documentation and Software Retrieval Instructions ------------------------------------------------- Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to FTP the files from ftp://download.vista.domain.ext/. This transmits the files from the first available FTP server. Sites may also elect to retrieve software directly from a specific server as follows: OIFO FTP ADDRESS DIRECTORY ------------ ------------------------ ------------------ Albany ftp.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext Documentation can also be found on the VA Software Documentation Library (VDL) at: http://www4.domain.ext/vdl/ File Description File Name (FTP Mode) -------------------------------------------------------------------------- ICD-10 Release Notes for Prosthetics ICD-10_RN_RMPR_3_168.pdf (Binary) National Prosthetics Patient Database (NPPD) User Manual rmpr_3_nppdum.pdf (Binary) Prosthetics Basics User Manual prostheticsbasicsusermanual.pdf (Binary) Prosthetics View Billing Information (GUI) User Manual rmpr_3_pvbi_um.pdf (Binary) Prosthetics VistA Suite User Manual rmpr_3_pvs_um.pdf (Binary) Electronic Order/Suspense Processing User Manual rmpr_3_168.pdf (Binary) Prosthetics Administrative Home Oxygen Module User Manual rmpr3_o2um.pdf (Binary) Prosthetics GUI client installation wizard (packed) RMPR3_0P168GUI.zip (Binary) Production Overview Guide ICD-10_Prod_Overview_Guide_Groups_5_6_7.pdf (Binary) Patch Installation: Pre/Post Installation Overview ------------------------------ This patch updates the software version number of both the VistA server software and the Prosthetics client GUI to version 3.0.168.83. GUI client versions prior to version 3.0.168.83 are not compatible with the VistA server software for this patch. Therefore, it is crucial that the Prosthetics client GUI distributed with this patch be installed immediately following the VistA server software install to minimize service disruption to the Prosthetics System users. See GUI INSTALLATION INSTRUCTIONS section for complete details. Pre-Installation Instructions ----------------------------- This patch may be installed with users on the system although it is recommended that it be installed during non-peak hours to minimize potential disruption to users. This patch should take less than five minutes to install. If installed during the normal workday, it is recommended that the following selection(s) in the OPTION (#19) file, and all of their descendants are disabled to prevent possible conflicts while running the KIDS Install. Other VistA users will not be affected. RMPO ADD/EDIT PAT Add/Edit Home Oxygen Patient RMPR OFFICIAL Prosthetic Official's Menu Installation Instructions ------------------------- 1. Choose the PackMan message containing this patch. 2. Choose the INSTALL/CHECK MESSAGE PackMan option. 3. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, you may elect to use the following option. When prompted for the INSTALL enter the patch RMPR*3.0*168. a. Backup a Transport Global - This option will create a backup message of any routines exported with this patch. It will not backup any other changes such as Data Dictionaries (DDs) or templates. b. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when this patch is installed. It compares all components of this patch (routines, DDs, templates, etc.). c. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. 4. From the Installation Menu, select the Install Package(s) option and choose the patch to install. Enter RMPR*3.0*168. 5. If prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//' Answer YES unless your system does this in a nightly TaskMan process. 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//' answer NO. 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//' answer YES. 8. When prompted 'Enter options you wish to mark as 'Out Of Order':' Enter the following options: RMPO ADD/EDIT PAT Add/Edit Home Oxygen Patient RMPR OFFICIAL Prosthetic Official's Menu 9. When prompted 'Enter protocols you wish to mark as 'Out Of Order':' press . Post-Installation Instructions ------------------------------ There is no post-installation routine associated with this patch. GUI INSTALLATION INSTRUCTIONS ----------------------------- The Prosthetics GUI client software is being distributed as a self- extracting Install Shield executable (file ProstheticsSuite3_168_83.exe packed version - RMPR3_0P168GUI.zip). The installed executable for this patch is client ProsMenu.exe version 3.0.168.83 with a size of 2.64 MB. Install the Prosthetics GUI client software following the instructions in the Prosthetics GUI Installation Guide. Routine Information: ==================== The second line of each of these routines now looks like: ;;3.0;PROSTHETICS;**[Patch List]**;Feb 09, 1996;Build 43 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: RMPOICD1 Before: n/a After:B142909870 **168** Routine Name: RMPOICD2 Before: n/a After: B43615664 **168** Routine Name: RMPOPED Before: B86271815 After:B301665198 **29,44,41,52,77,110,140,148,168** Routine Name: RMPOPED1 Before: n/a After: B3131356 **168** Routine Name: RMPR9LN1 Before: B10038287 After: B10033385 **90,75,60,125,168** Routine Name: RMPR9LNP Before: B11512783 After: B42337320 **71,77,90,75,60,143,150,168** Routine Name: RMPR9S4E Before: B42900080 After: B55214876 **59,92,99,90,75,168** Routine Name: RMPRPAT3 Before: B41816871 After: B58098580 **3,12,25,28,32,41,69,92,99, 90,162,163,168** Routine Name: RMPRPFFS Before: B29300840 After: B39570031 **96,60,168** Routine Name: RMPRSE21 Before: B29249805 After: B42297840 **36,62,77,92,90,128,168** Routine list of preceding patches: 125, 128, 148, 150, 163 ============================================================================= User Information: Entered By : Date Entered : SEP 14, 2011 Completed By: Date Completed: AUG 21, 2014 Released By : Date Released : AUG 29, 2014 ============================================================================= Packman Mail Message: ===================== $END TXT