============================================================================= Run Date: MAR 26, 2009 Designation: FB*3.5*109 Package : FB - FEE BASIS Priority: Mandatory Version : 3.5 SEQ #97 Status: Released Compliance Date: APR 26, 2009 ============================================================================= Associated patches: (v)FB*3.5*105 <<= must be installed BEFORE `FB*3.5*109' Subject: RBRVS 2009 ANNUAL FEE SCHEDULE UPDATE Category: - Other Description: ============ This patch has the following changes: -Adds the Resource Based Relative Value Schedule (RBRVS) fee schedule for the calendar year 2009. -Adds Purpose of Visit (POV) codes 56, 67, 68, and 69. -Inactivates Purpose of Visit code 20 with effective date of January 01, 2009. ASSOCIATED REMEDY: ================= 1) HD0000000285255 - RBRVS CY 09 2) HD0000000285257 - Activation of POV 3) HD0000000285259 - Deactivation of POV ASSOCIATED NSR(s): ================== N/A PARTICIPATING TEST SITES: ======================== Montana HCS Columbus, OH Puget Sound HCS Hines, IL Maryland HCS REMEDY OVERVIEW: =============== 1) HD0000000285255 - RBRVS CY 09 Problem: ======== The RBRVS schedule needs to be updated for the calendar year 2009. Solution: ========= 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 2009. 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 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 The additional data added by this patch will increase the size of the FB global by approximately 5 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 2009 RBRVS fee schedule will be used for payments that have a date of service on or after January 1, 2009. The RBRVS fee schedules for calendar years beginning 1999 through 2008 will be retained in the computer and will continue to be used for payments that have a date of service on or after September 1, 1999 and before January 1, 2009. Additionally, both the calendar year 2008 and the calendar year 2009 modifier tables have been updated with an updated schedule from the Department of Labor. The computer would have used the 2002 RBRVS fee schedule 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 2007. Here are the 2009 valid POS codes that are in effect. Codes considered as facility setting - 21,22,23,24,26,31,34,41,42,51,52,53,56,61 Codes considered as non-facility setting - 01,03,04,09,11,12,13,14,15,20,25,32,33,49,50,54,55,57,60,62,65,71, 72,81,99 The following five 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] C&P/Multiple Patient Payment Entry [FBAA C&P ENTER PAYMENT] 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] 2) HD0000000285257 - Activation of POV Problem: ======== The following Purpose of Visits will need to be added to the FEE BASIS PURPOSE OF VISIT (#161.82) file. NAME AUSTIN CODE --------------------------------------------------------- Dialysis 56 Outpatient Maternity Care Services 67 Bowel and Bladder care: Agency 68 Bowel and Bladder care: Family caregiver 69 Solution: ========= The FEE BASIS PURPOSE OF VISIT (#161.82) file will be updated with the POVs noted above. NOTE: These codes will not be active until and should not be used until patch FB*3.5*110 is installed. FB*3.5*110 will update the remaining fields necessary to use these POVs. 3) HD0000000285259 - Deactivation of POV Problem: ======== The "CLASS IIr DENTAL TREATMENT" Purpose of Visit needs to be deactivated in the FEE BASIS PURPOSE OF VISIT (#161.82) file. Solution: ========= The "CLASS IIr DENTAL TREATMENT" Purpose of Visit will be updated with an inactivation date of January 01, 2009. INSTALLATION INSTRUCTIONS ========================= This patch may be installed during normal working hours with all users on the system. It is not necessary to disable any menu options or protocols when installing this patch. However, it is recommended that the install be done during non-peak hours to lessen the impact on system performance. ************************************************************************* * Install Time * * During testing, one site installed in less than 20 minutes while * * another site took over 2 hours. Installation time will vary. * ************************************************************************* ************************************************************************* * Please Note: * * The post install routine FBXIP109 may be deleted upon successful * * installation of this patch. * ************************************************************************* 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_5P109.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_5P109.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_5P109.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*109): 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*109. 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? NO//', answer NO. c. A post install will make the RBRVS 2009 fee schedule available for use by filing the conversion factor. Routine Information: ==================== The second line of each of these routines now looks like: ;;3.5;FEE BASIS;**[Patch List]**;JAN 30, 1995;Build 7 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: FBAAFSR Before: B41391822 After: B42432006 **4,53,71,84,92,93,99,102,105,109** Routine Name: FBXIP109 Before: n/a After: B7766471 **109** Routine list of preceding patches: 105 ============================================================================= User Information: Entered By : CHANDARANA,RISHAN Date Entered : NOV 17, 2008 Completed By: TSAIMEUCHONG,BRENDA Date Completed: MAR 10, 2009 Released By : HARRIS,ANGELA Date Released : MAR 26, 2009 ============================================================================= Packman Mail Message: ===================== No routines included