============================================================================= Run Date: APR 21, 2010 Designation: FB*3.5*111 Package : FB - FEE BASIS Priority: Mandatory Version : 3.5 SEQ #100 Status: Released Compliance Date: MAY 22, 2010 ============================================================================= Associated patches: (v)FB*3.5*98 <<= must be installed BEFORE `FB*3.5*111' (v)FB*3.5*99 <<= must be installed BEFORE `FB*3.5*111' (v)FB*3.5*103 <<= must be installed BEFORE `FB*3.5*111' (v)FB*3.5*110 <<= must be installed BEFORE `FB*3.5*111' (v)LEX*2*66 <<= must be installed BEFORE `FB*3.5*111' Subject: RBRVS 2009 QTRLY UPDATES, CORRECTS MENUS AND FORMS Category: - Other - Routine Description: ============ This patch provides the following 10 updates: 1. Updates the Resource Based Relative Value Schedule (RBRVS) fee schedule with changes made in January, April and July 2009 and updates the Department of Labor Office of Workers' Compensation Programs (OWCP) Modifier data to the 2009 values. 2. Corrects a problem when attempting to add multiple rates to a contract. 3. Corrects a problem when entering Current Procedural Terminology (CPT) code 0159T for payment. 4. Corrects the calculation for CPT code 0073T. 5. Corrects a problem with a warning message displaying inappropriately when using the Enter Authorization [FBAA ENTER AUTHORIZATION] option. 6. Corrects an erroneous message that a vendor is pending Austin Automation Center (AAC) approval when they aren't. 7. Corrects a problem where the FEE ID REPORT is missing patients. 8. Removes the Social Security Number (SSN)/Claim # from the NON-VA AUTHORIZATION FORM 9. Corrects a problem with the Automated Management Information System (AMIS) 349 report. 10. Corrects several record locking problems. Associated Remedy tickets: ========================== 1) HD0000000330388 - Quarterly Updates for RBRVS (Jan 09, Apr 09, Jul 09) 2) HD0000000304272 - Problem Adding Addtl Rates to a Contract 3) HD0000000308767 - Problem with HCPC 0159T 4) HD0000000316370 - The RBRVS rate for code 0073T is different from the Medicare rate. 5) HD0000000217639 - FBAA ENTER AUTHORIZTION 6) HD0000000237207 - Current Vendor information is pending Austin processing 7) HD0000000064378 - MENU NOT WORKING 8) HD0000000190740 - Remove SSN/Claim # from Non-VA Authorization Form 9) HD0000000064355 - AMIS 349 OUT OF BALANCE Duplicate: HD0000000133985 - AMIS 349 OUT OF BALANCE Associated NSR(s): ================== N/A Participating Test Sites: ========================= Montana HCS Cleveland, OH Remedy Overview: ================ 1) HD0000000330388 - Quarterly Updates for RBRVS (Jan 09, Apr 09, Jul 09) Problem: ======== There are three quarterly updates available for the Resource Based Relative Value Schedule (RBRVS). The details can be found in Change Requests (CR) CR6531, CR6397, and CR6484. CR6531 is available at: http://www.cms.hhs.gov/Transmittals/downloads/R1661CP.pdf CR6397 is available at: http://www.cms.hhs.gov/Transmittals/downloads/R1691CP.pdf CR6484 is available at: http://www.cms.hhs.gov/Transmittals/downloads/R1748CP.pdf Additionally, the Department of Labor has published Modifier data for calendar year 2009. Solution: ========= This patch updates the data needed to calculate fee schedule amounts based on the RBRVS (also referred to as the Medicare Physician Fee Schedule) for calendar year 2009. This patch also updates the Modifier Level data obtained from the Department of Labor for the 2009 values. The RBRVS fee schedule data is contained in four existing files. These files are all stored in global "^FB". The four files are: FEE BASIS GEOGRAPHIC INDEX (#162.96) file FEE BASIS CPT RVU (#162.97) file FEE BASIS MODIFIER TABLE INDEX (#162.98) file FEE BASIS HCFA CONVERSION (#162.99) file This patch does not update the FEE BASIS HCFA CONVERSION (#162.99) file or the FEE BASIS GEOGRAPHIC INDEX (#162.96) file. The additional data added by this patch will increase the size of the ^FB global by under 1 MB. 2) HD0000000304272 - Problem Adding Addtl Rates to a Contract Problem: ======== When attempting to add additional rates to a contract, a user may not be able to add a rate to a contract. This is because a check is performed to insure that the length of the new rate combined with all existing rates is less than 510 characters. This check was implemented to keep the function $$RATE^FBAAVD1 from returning a string that was over 512 characters long. Solution: ========= The check has been removed. The function $$RATE^FBAAVD1 now returns the number of rates associated with a contract. Additionally, if an array is passed in as a parameter it will contain the rates associated with the contract. 3) HD0000000308767 - Problem with HCPC 0159T Problem: ======== When entering Current Procedural Terminology (CPT) code 0159T at an option such as Enter Payment [FBAA ENTER PAYMENT] option, the Fee Basis software is incorrectly prompting the user for the anesthesia time. CPT code 0159T is not associated with an anesthesia related procedure so this in incorrect. This is caused by the function $$ANES^FBAAFS that identifies if CPT codes are anesthesia related. The function is converting CPT code 0159T to 00159. As CPT code 00159 falls under the range for anesthesia codes (00100-01999) the software treats it as an anesthesia related code and requests a time. Solution: ========= The function $$ANES^FBAAFS has been modified to identify the major category of the CPT code rather than checking to see if the code falls within a range. 4) HD0000000316370 - The RBRVS rate for code 0073T is different from the Medicare rate. Problem: ======== The Resource Based Relative Value Scale (RBRVS) rate for code 0073T is different from the Medicare rate. There are several CPT codes in the FEE BASIS CPT RVU (#162.97) file that have a CONVERSION CATEGORY (#.02) field of ANESTHESIA instead of MEDICINE. This is causing the Fee Basis software to use the ANESTHESIA conversion factor, resulting in a lower calculated payment. For example, in Current Year (CY)2009, the anesthesia conversion factor is 20.915 which is a much lower value than the medicine conversion factor of 36.0666. Solution: ========= The CONVERSION CATEGORY (#.02) field for these codes will be reclassified to MEDICINE. The following CPT codes are affected by this update: 0012F 0014F 0015F 0062T 0063T 0064T 0065T 0066T 0070T 0071T 0072T 0073T 0074T 0075T 0076T 0077T 0080T 0081T 0082T 0083T 0084T 0085T 0086T 0087T 0090T 0091T 0092T 0093T 0094T 0100T 0101T 0102T 0103T 0105T 0106T 0107T 0108T 0109T 0110T 0111T 0115T 0116T 0117T 0120T 0123T 0124T 0126T 0130T 0133T 0135T 0137T 0140T 0141T 0142T 0143T 0146T 0147T 0148T 0149T 0150T 0151T 0160T 0161T 0162T 0163T 0164T 0165T 0166T 0167T 0170T 0171T 0172T 0173T 0174T 0175T 0176T 0177T 0180T 0181T 0182T 0183T 0184T 0185T 0190T 0191T 0192T 0195T Additionally, these CPT codes are also classified incorrectly in the CPT (#81) file. The LEXICON UTILITY patch, LEX*2.0*66 (Q409 updates) has corrected the CPT codes listed above. 5) HD0000000217639 - FBAA ENTER AUTHORIZTION Problem: ======== Fee Basis software assumes a patient is ineligible if the discharge from the last period of service is Dishonorable. If more than one period of service exists and one is honorable the patient is still being cast as ineligible. Solution: ========= The software will be modified so that it will not only check the Service Discharge Type, as it does now, but it will also check to see if there is an ineligible date. If there is not an ineligible date, the patient will be considered eligible and the message will not be printed to the screen. 6) HD0000000237207 - Current Vendor information is pending Austin processing Problem: ======== Users are getting a message " Current Vendor information is pending Austin processing." but the vendor is not listed on the Medicare Remittance Advice (MRA)'s Awaiting Austin Approval report. Solution: ========= An unmatched set of parentheses in the routine, FBAAVD2, will be corrected and another condition will be added to a $S command in CHK^FBAADV so that the "Current Vendor" message only prints when the vendor's information is actually pending AAC processing. 7) HD0000000064378 - MENU NOT WORKING Problem: ======== FEE ID card numbers beginning with alpha characters are not appearing on the Valid ID Card List Report. Solution: ========= While attempting to run the Valid ID Cards List [FBAA ID CARDS CURRENT LIST] option, which is the Valid ID Card list report, it was noticed that there were patients missing from this list. Upon review, all of the missing patients had at least one alpha character preceding the ID number The software that looks for valid patients to list on the report was quitting whenever the patient's ID number was less than zero. That software will be modified by this patch to quit only if the patient's ID number is NULL. 8) HD0000000190740 - Remove SSN/Claim # from Non-VA Authorization Form Problem: ======== After releasing Fee Basis patch, FB*3.5*101, which blocks the printing of the first 5 digits of the patient's SSN, it was discovered that the claim number on the 7078 Print report is sometimes the same as the SSN. Therefore, it needs to be blocked here as well. This report is obtained from the 7078 Print [FBCH PRINT 7078] option. Solution: ========= The routine that prints the 10-7078 reports has been modified so that if the patient's claim number matches the SSN the claim number will be run through the same functionality that blocks the printing of the SSN. (The form is referred to as 10-7078 and the report is referred to as the 7078 Print.) 9) HD0000000064355 - AMIS 349 OUT OF BALANCE Problem: ======== The AMIS 349 Print [AMIS 349 PRINT FBCNH AMIS] option reports are reporting Veterans as being discharged when, in fact, they have not been discharged. Solution: ========= The AMIS 349 report creates a list of patient Community Nursing Home movements. If a patient is discharged from one community nursing home and admitted the same day to another community nursing home and if the original community nursing home has been deleted or found to be a duplicate of the new community nursing home, the software is supposed to check the "AH" and "AG" cross references of the FEE CNH ACTIVITY (#162.3) file and re-point them to the new vendor. The existing software was only updating the "AH" cross reference which was causing the AMIS 349 reports to be out of balance. This patch will change the software to re-point the "AG" cross reference whenever the "AH" cross reference is re-pointed. 10). Technical- correct several locking problems Problem: ======== According the SAC standards, any global lock that is attempted must be limited to a minimum of 3 seconds and, if unsuccessful, a message should be printed to the screen, warning the user of the failed lock attempt. Resolution: =========== Each attempt to lock shall be limited to a number of seconds set by the value of DILOCKTM. If DILOCKTM is not available, the attempt will be limited to three seconds. Should a lock not be obtained, a message will be printed to the screen, warning the user that someone else is editing the same record. The user will either keep getting the message until the lock is cleared or the user will be sent back to the original prompt which initiated the lock. INSTALLATION INSTRUCTIONS ========================= This patch may be installed during normal working hours with all users on the system. However, as it is necessary to disable some menu options when installing this patch, it is recommended that the install be done during non-peak hours. Additionally, installing during peak hours may lead to an unusually long install time. ************************************************************************* * Install Time * * During testing, one site installed in less than 20 minutes while * * another site took over 2 hours. A production install of a previous * * RBRVS update took slightly over 10 hours. * * * * Installation time will vary. * ************************************************************************* Routine FBXIP111 can be deleted after the patch installation is complete. 1. Retrieve the KIDS distribution host file. This patch will be distributed in a host file due to the amount of data contained in the patch. The name of the host file is: FEE3_5P111.KID Sites can retrieve VistA software from the following FTP addresses. The preferred method is to FTP the files from: download.vista.med.va.gov This will transmit the files from the first available FTP server. Sites may also elect to retrieve software directly from a specific server as follows: Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov The FEE3_5P111.KID host file is located in the anonymous.software directory. Use ASCII Mode when downloading the file. 2. Load the KIDS distribution that is contained in file FEE3_5P111.KID using the Load a Distribution option on the Installation menu. 3. Start up the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: Installation 1 Load a Distribution 2 Verify Checksums in Transport Global 3 Print Transport Global 4 Compare Transport Global to Current System 5 Backup a Transport Global 6 Install Package(s) Restart Install of Package(s) Unload a Distribution 4. From this menu, you may elect to use the following options (When prompted for the INSTALL NAME, enter FB*3.5*111): 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 DD's 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, DD's, 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. 5. Use the Install Package(s) option and select the package FB*3.5*111. a. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO. b. When prompted 'Want to DISABLE Scheduled Options and Menu Options and Protocols? YES//', answer YES. When prompted, 'Enter options you wish to mark as 'Out Of Order':', enter: Enter Payment [FBAA ENTER PAYMENT] Multiple Payment Entry [FBAA MULTIPLE PAYMENT ENTRY] C&P/Multiple Patient Payment Entry [FBAA C&P ENTER PAYMENT] Reimbursement Payment Entry [FBAA MEDICAL REIMBURSEMENT] Edit Payment [FBAA EDIT PAYMENT] Ancillary Contract Hosp/CNH Payment [FBCH ANCILLARY PAYMENT] Multiple Ancillary Payments [FBCH MULTIPLE PAYMENTS] Patient Reimbursement for Ancillary [FBCH ANCILLARY REIMBURSEMENT] Services Edit Ancillary Payment [FBCH EDIT ANCILLARY PAYMENT] Calculate Payment Amount [FBAA FEE SCHEDULE RATE] Valid ID Cards List [FBAA ID CARDS CURRENT LIST] 7078 Print [FBCH PRINT 7078] AMIS 349 Print [FBCNH AMIS] Enter Authorization [FBAA ENTER AUTHORIZATION] Vendor Menu [FBAA VENDOR OPTIONS] When prompted, 'Enter protocols you wish to mark as 'Out of Order':', enter: Routine Information: ==================== The second line of each of these routines now looks like: ;;3.5;FEE BASIS;**[Patch List]**;JAN 30, 1995;Build 13 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: FBAAAUT Before: B13109090 After: B14647205 **13,95,103,111** Routine Name: FBAADV Before: B4001048 After: B4262936 **111** Routine Name: FBAAFS Before: B26843378 After: B27984557 **4,53,71,92,99,111** Routine Name: FBAAPCC Before: B2449846 After: B2443592 **111** Routine Name: FBAAVD Before: B26287832 After: B27538301 **9,98,111** Routine Name: FBAAVD1 Before: B7961657 After: B8228905 **9,111** Routine Name: FBAAVD2 Before: B31257059 After: B33081836 **9,10,47,65,98,111** Routine Name: FBCHP78 Before: B33711436 After: B34766017 **12,23,52,101,103,111** Routine Name: FBMRASV1 Before: B16917102 After: B18658817 **111** Routine Name: FBNHEAU2 Before: B12538234 After: B12010653 **111** Routine Name: FBNHRDEL Before: B2712802 After: B2419908 **111** Routine Name: FBXIP111 Before: n/a After: B2260351 **111** Routine list of preceding patches: 98, 99, 103 ============================================================================= User Information: Entered By : CHANDARANA,RISHAN Date Entered : MAY 08, 2009 Completed By: TSAIMEUCHONG,BRENDA Date Completed: APR 09, 2010 Released By : MARSHALL,FALENCIA B. Date Released : APR 21, 2010 ============================================================================= Packman Mail Message: ===================== No routines included