============================================================================= Run Date: APR 30, 2019 Designation: FB*3.5*181 Package : FB - FEE BASIS Priority: Mandatory Version : 3.5 SEQ #154 Status: Released Compliance Date: MAY 30, 2019 ============================================================================= Associated patches: (v)FB*3.5*179 <<= must be installed BEFORE `FB*3.5*181' Subject: UPDATE RBRVS FOR CY2019 Category: - Routine - Other Description: ============ This patch addresses the following issue: 1. Updates the Resource Based Relative Value Scale (RBRVS) Fee Schedule with changes for Calendar Year (CY) 2019. Patch Components: ----------------- Files & Fields Associated: File Name and Number New/Modified/Deleted ------------------ -------------------- FEE BASIS GEOGRAPHIC INDEX (#162.96) FILE Modified FEE BASIS CPT RVU (#162.97) FILE Modified FEE BASIS MODIFIER TABLE INDEX (#162.98) FILE Modified FEE BASIS HCFA CONVERSION (#162.99) FILE Modified Forms Associated: Form Name File Number New/Modified/Deleted --------- ----------- -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- N/A Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- N/A Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A Additional Information: ----------------------- Blood Bank Team Coordination: N/A New Service Requests (NSRs): N/A Patient Safety Issues (PSIs): N/A Defect Tracking System Ticket(s) & Overview: 1. INC3781073 - The RBRVS Fee Schedule needs to be updated for the Calendar Year 2019. Problem: -------- The RBRVS Fee Schedule needs to be updated for the Calendar Year 2019. Resolution: ----------- This patch includes the data needed to calculate fee schedule amounts based on the RBRVS (also referred to as Medicare Physician Fee Schedule) for calendar year 2019. The RBRVS fee schedule for future calendar years will be issued by a patch as they become available. The RBRVS fee schedule data is contained in four existing files. These files are all stored in global "^FB". The following 3 files are included in the build of this patch, and will overwrite the current files upon install: FEE BASIS GEOGRAPHIC INDEX (#162.96) FILE FEE BASIS CPT RVU (#162.97) FILE FEE BASIS MODIFIER TABLE INDEX (#162.98) FILE The 4th file listed below will be updated by post install routine FBXIP181: FEE BASIS HCFA CONVERSION (#162.99) FILE The additional data added by this patch will increase the size of the FB global by approximately 8 MB. Installation of this patch will affect the menu options used to enter or edit payments for the Medical Fee program (Outpatient) and Ancillary Payments for the Civil Hospital program. The calendar year 2019 RBRVS fee schedule will be used for payments that have a date of service on or after January 1, 2019. The RBRVS fee schedules for calendar years beginning 1999 through 2018 will be retained in the VISTA database and will continue to be used for payments that have a date of service on or after September 1, 1999 and before January 1, 2019. The 2002 RBRVS fee schedule will be used for any payments entered prior to the installation of this patch that had a date of service on or before March 1, 2003. Existing payments are NOT modified by this patch. The fee schedule amount is only calculated when payments are entered or edited. The PLACE OF SERVICE (POS) code is used to determine if the facility or non-facility practice expense Relative Value Unit (RVU) should be used during RBRVS fee schedule calculations. The list of codes considered facility and non-facility has not changed since 2011. Here are the valid POS codes that are in effect. Codes considered as facility setting - 05,06,07,08,21,22,23,24,26,31,34,41,42,51,52,53,56,61 Codes considered as non-facility setting - 01,03,04,09,11,12,13,14,15,16,17,20,25,32,33,49,50,54, 55,57,60,62,65,71,72,81,99 The following four options are used to enter or edit payments for the Medical Fee (outpatient) program: Enter Payment [FBAA ENTER PAYMENT] Multiple Payment Entry [FBAA MULTIPLE PAYMENT ENTRY] Reimbursement Payment Entry [FBAA MEDICAL REIMBURSEMENT] Edit Payment [FBAA EDIT PAYMENT] The following four options are used to enter or edit ancillary payments for the Civil Hospital program: 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] The following option is used to calculate a fee schedule amount without having to enter a payment: Calculate Payment Amount [FBAA FEE SCHEDULE RATE] Components: ----------- UP SEND DATA USER DATE SEC. COMES SITE RSLV OVER FILE # FILE NAME DD CODE W/FILE DATA PTRS RIDE -------------------------------------------------------------------------- 162.96 FEE BASIS GEOGRAPHIC INDEX NO YES YES OVER NO NO 162.97 FEE BASIS CPT RVU NO YES YES OVER NO NO 162.98 FEE BASIS MODIFIER TABLE INDEX NO YES YES OVER NO NO Test Sites: ----------- Martinsburg VA Medical Center VA North Texas Health Care System (Dallas, Bonham) Software and Documentation Retrieval Instructions: -------------------------------------------------- N/A Patch Installation: ------------------- Pre-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. * ************************************************************************* Installation Instructions: -------------------------- 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: FB3_5181.KID Sites can retrieve VistA software from the following SFTP addresses. The preferred method is to SFTP the files from: download.vista.domain.ext This will transmit the files from the first available SFTP server. Sites may also elect to retrieve software directly from a specific server as follows: Hines domain.ext Salt Lake City domain.ext The FB3_5181.KID host file is located in the directory. Use ASCII Mode when downloading the file. 2. Load the KIDS distribution that is contained in file FB3_5181.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 ... 4. From this menu, you may elect to use the following options (When prompted for the INSTALL NAME, enter FB*3.5*181): 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*181: 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] 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] When prompted, 'Enter protocols you wish to mark as 'Out of Order':', enter: Post-Installation Instructions ------------------------------ Post-install routine, FBXIP181 may be deleted after the patch has been Installed. Back-Out Plan: -------------------- Due to the complexity of this patch, it is not recommended for back-out, and a restore from a backup of the Transport Global should not be attempted. In the event that a site decides to back out this patch, the site should contact the Enterprise Service Desk (ESD) to submit a help desk ticket. The development team will need to issue a follow-on patch in order to comprehensively back-out this patch and restore the system to a functioning state. Routine Information: ==================== The second line of each of these routines now looks like: ;;3.5;FEE BASIS;**[Patch List]**;JAN 30, 1995;Build 3 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: FBXIP181 Before: n/a After: B1857138 **181** ============================================================================= User Information: Entered By : Date Entered : DEC 26, 2018 Completed By: Date Completed: APR 30, 2019 Released By : Date Released : APR 30, 2019 ============================================================================= Packman Mail Message: ===================== No routines included