$TXT Created by at DEVESS.DOMAIN.EXT (KIDS) on Tuesday, 05/13/14 at 13:10 ============================================================================= Run Date: AUG 29, 2014 Designation: HBH*1*25 Package : HBH - HOSPITAL BASED HOME CARE Priority: Mandatory Version : 1 SEQ #23 Status: Released Compliance Date: SEP 12, 2014 ============================================================================= Associated patches: (v)HBH*1*24 <<= must be installed BEFORE `HBH*1*25' (v)LEX*2*80 <<= must be installed BEFORE `HBH*1*25' (v)ICD*18*57 <<= must be installed BEFORE `HBH*1*25' Subject: HOSPITAL BASED HOME CARE ICD-10 Class 1 Remediation Category: - Enhancement (Mandatory) - Routine - Data Dictionary - Input Template - 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 implementation 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. =============================== WARNING ================================ The ICD-10 Class I Remediation project updates VistA to include the ICD-10 Diagnosis and Procedure codes. The first patches to be delivered by this project are the STS patches ICD*18.0*57 and LEX*2.0*80 which includes both the ICD-10 Diagnosis and Procedure codes along with new or updated APIs that are 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. PRIMARY DIAGNOSIS @ ADMISSION: 100.0// 488.1 4 matches found 1. 488.1 FLU DT IDEN H1N1 VIRUS (Inactive) 2. 488.11 FLU DT 2009 H1N1 W PNEU (Major CC) 3. 488.12 FLU-2009 H1N1 W OTH RESP 4. 488.19 FLU-2009 H1N1 W OTH MAN (Inactive) Select 1-4: EXAMPLE #2: Inactive ICD-10 codes. The warning (Pending) appears at the end of the short description. PRIMARY DIAGNOSIS @ ADMISSION: 100.0// A27. 4 matches found 1. A27.0 Leptospirosis icterohemorrhagica (10/01/2015) (Pending) 2. A27.81 Aseptic meningitis in leptospirosis (10/01/2015) (Pending) 3. A27.89 Other forms of leptospirosis (10/01/2015) (Pending) 4. A27.9 Leptospirosis, unspecified (10/01/2015) (Pending) Once this patch is installed, the HBPC application now fully supports ICD-9 code set versioning based on the date of interest for the record being created or edited. When creating or editing records dated after the ICD-10 Activation Date (10/01/2015), the software correctly screens out both the inactive ICD-9 and inactive ICD-10 codes. =========================== END OF WARNING ============================= The following functionality within the Home Based Primary Care (HBPC) application was updated to address the ICD-10 code set. 1. Evaluation/Admission Data Entry Full Menu Path: HBPC Information System Menu -> Evaluation/Admission Data Entry The software has been updated to determine the active code set based on Date Of Interest, which is the Admission Date. Once the active coding set is determined, the software responds in one of two ways: a. If the ICD-9 code set is active, the software now fully supports ICD-9 code set versioning. This means that only active ICD-9 codes are selectable based on the date of interest for the selected record. This includes Look-ups, searches, and displayed information. b. If the ICD-10 coding set is active, the software utilizes 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 set, the user can enter any of the following: i. A valid ICD-10 code. ii. A partial ICD-10 code. iii. A partial description of a valid ICD-10 code. If the user selects a valid ICD-10 code, the software continues 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 are displayed to the user. This step repeats until the user selects 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 displays the valid ICD-10 code as well as the code's full description on the next line. ICD-10 Diagnosis code: F14 20 matches found 1. F14.10 Cocaine Abuse, Uncomplicated 2. F14.12- Cocaine abuse with intoxication 3. F14.14 Cocaine Abuse with Cocaine-Induced Mood Disorder 4. F14.15- Cocaine abuse with cocaine-induced psychotic disorder 5. F14.18- Cocaine abuse with other cocaine-induced disorder 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 (ICD-10-CM F14.150) 2. F14.151 Cocaine Abuse with Cocaine-Induced Psychotic Disorder with Hallucinations (ICD-10-CM F14.151) 3. F14.159 Cocaine Abuse with Cocaine-Induced Psychotic Disorder, unspecified (ICD-10-CM F14.159) Select 1-3: 2 ICD-10 Diagnosis code: F14.151 ICD-10 Diagnosis description: Cocaine Abuse with Cocaine-Induced Psychotic Disorder with Hallucinations (ICD-10-CM F14.151) If Admission date is updated such that the new active coding set is different than the previously entered Primary Diagnosis @ Admission's coding set, then the Primary Diagnosis will be deleted. 2. Discharge Data Entry Full Menu Path: HBPC Information System Menu -> Discharge Data Entry The software has been updated to determine the active coding set based on Date Of Interest, which is the Discharge Date. Once the active coding set is determined, the software will respond in one of two ways: a. If the ICD-9 code set is active, the software now fully supports ICD-9 code set versioning. This means that only active ICD-9 codes are selectable based on the date of interest for the selected record. This includes Look-ups, searches, and displayed information. b. If the ICD-10 coding set is active, the software utilizes 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. If the coding set of the Primary Diagnosis @ Admission is different from the coding set of the Primary Diagnosis @ Discharge then the Primary Diagnosis @ Admission are not defaulted for the Primary Diagnosis @ Discharge. If the Discharge Date is updated such that the code set based on the new Discharge Date is different from the code set of the previous Discharge Date, the Primary Diagnosis @ Discharge are deleted. 3. Edit Form Errors Data Full Menu Path: HBPC Information System Menu -> Transmission Menu ... -> Edit Form Errors Data The software has been updated to determine the active coding set based on Date Of Interest, which is the Discharge Date. Once the active coding set is determined, the software responds in one of two ways: a. If the ICD-9 code set is active, the software now fully supports ICD-9 code set versioning. This means that only active ICD-9 codes are selectable based on the date of interest for the selected record. This includes Look-ups, searches, and displayed information. b. If the ICD-10 coding set is active, the software utilizes 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. If the coding set of the Primary Diagnosis @ Admission is different from the coding set of the Primary Diagnosis @ Discharge then the Primary Diagnosis @ Admission are not defaulted for the Primary Diagnosis @ Discharge. If the Discharge Date is updated such that the code set based on the new Discharge Date is different from the code set of the previous Discharge Date, the Primary Diagnosis @ Discharge are deleted. 4. The following Menu Options have been updated to show "ICD" text in the title and/or description: a. Reports Menu b. ICD Code/Dx Text by Date Range Report (80) c. Admissions/Discharges by Date Range Report (132) d. Census Reports Menu e. Active Census with ICD Code/Text Report (132) f. Form Errors Report (80) 5. The following reports have been modified: a. Evaluation/Admission Data Report by Patient (80) Primary Diagnosis @ Adm field value now can show either ICD-9 or ICD-10 code based on active coding set on the Admission date. b. Discharge Data Report by Patient (80) Primary Diagnosis @ D/C field value now can show either ICD-9 or ICD-10 code based on the active coding set on the Discharge date. c. Admissions/Discharges by Date Range Report (132) If report date range is prior to ICD-10 implementation date then column header for ICD code states "ICD-9 Code". If the date range is after ICD-10 implementation date then column header states "ICD-10 Code". If date range includes ICD-10 implementation date then column header states "ICD Code". d. Patient Visit Data Report (80) Report shows either ICD-9 or ICD-10 code with description in the visit data. e. Visit Data by Date Range Report (80) Report shows either ICD-9 or ICD-10 code with description in the visit data. f. ICD Code/Dx Text by Date Range Report (80) If report date range is prior to ICD-10 implementation date then column header for ICD information states "ICD-9 Code/Diagnosis Text". If the date range is after ICD-10 implementation date then column header states "ICD-10 Code/Diagnosis Text". If date range includes ICD-10 implementation date then column header states "ICD Code/Diagnosis Text". If user does not wish to include all the ICD Diagnosis codes then "Select ICD Diagnosis:" prompt asks for ICD-9 codes if date range is before ICD-10 implementation date. The same prompt asks for ICD-10 codes if date range is after the ICD-10 implementation date. If date range includes ICD-10 implementation date then prompt inputs both ICD-9 and ICD-10 codes. g. Active Census with ICD Code/Text Report (132) If report date range is prior to ICD-10 implementation date then column header for ICD code states "ICD-9 Code". If the date range is after ICD-10 implementation date then column header states "ICD-10 Code". If date range includes ICD-10 implementation date then column header states "ICD Code". h. Form Errors Report (80) This report has been updated to show either ICD-9 or ICD-10 code with description in the visit data. 6. Build/Verify Transmission File Full Menu Path: HBPC Information System Menu -> Transmission Menu -> Build/Verify Transmission File MailMan messages that are transmitted to Austin Information Technology Center (AITC) with HBPC data have been updated to accommodate ICD-10 codes. The following messages have been updated: a. Admission data message b. Discharge data message c. Visit data message Patch Components ================ Files & Fields Associated: File Name (#) Field Name (#) New/Mod/Del ------------- -------------- ----------- HBHC PATIENT (631) PRIMARY DIAGNOSIS @ ADMISSION (18) Modified HBHC PATIENT (631) PRIMARY DIAGNOSIS @ DISCHARGE (46) Modified HBHC VISIT (632) DX (33) Modified Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- HBHC CENSUS REPORTS MENU menu Modified HBHC REPORTS MENU menu Modified HBHCR19A run routine Modified HBHCRP1 run routine Modified HBHCRP18 run routine Modified HBHCRP7 run routine Modified Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (#) New/Mod/Del ------------- ---- ------------- ----------- HBHC DISCHARGE Input HBHC PATIENT (#631) Modified HBHC UPDATE DISCHARGE Input HBHC PATIENT (#631) Modified 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: ----------- Orlando VAMC, Orlando, FL Battle Creek VA Medical Center, Battle Creek, MI Captain James A. Lovell Federal Health Care Center, N. Chicago, IL Coatesville VA Medical Center, Coatesville, PA Carl Vinson VA Medical Center, Dublin, GA Documentation 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: Albany ftp.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext The documentation will be in the form of Adobe Acrobat files. Documentation can also be found on the VA Software Documentation Library at: http://www4.domain.ext/vdl/ File Description File Name (FTP Mode) -------------------------------------------------------------------------- Home Based Primary Care User Manual HBH1_UM.PDF (binary) Home Based Primary Care Technical Manual HBH1_TM.PDF (binary) Home Based Primary Care Release Notes ICD-10_RN_HBH_1_25.PDF (binary) Production Overview Guide ICD-10_Prod_Overview_Guide_Groups_5_6_7.pdf (binary) Patch Installation: Pre/Post Installation Overview ------------------------------ N/A 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 5 minutes to install. The following menu options should be disabled: HBHC INFORMATION SYSTEM MENU HBPC Information System Menu HBHC MANAGER MENU Manager 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 # (HBH*1.0*25): 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. 4. From the Installation Menu, select the Install Package(s) option and choose the patch to install. Enter HBH*1.0*25. 5. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//', respond YES. 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', respond NO. 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond YES. HBHC INFORMATION SYSTEM MENU HBPC Information System Menu HBHC MANAGER MENU Manager Menu 8. If prompted 'Delay Install (Minutes): (0 - 60): 0//', respond 0. Post-Installation Instructions ------------------------------ Cleanup - The Pre-Install routine HBHCP25 should be deleted using the KERNEL option 'Delete Routines' [XTRDEL] upon completion of the installation. Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;HOSPITAL BASED HOME CARE;**[Patch List]**;NOV 01, 1993;Build 45 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: HBHCADM Before: B21342885 After: B27070975 **2,6,8,16,24,25** Routine Name: HBHCDIS Before: B3678339 After: B3891939 **2,25** Routine Name: HBHCLKU1 Before: n/a After:B243116135 **25** Routine Name: HBHCLKU2 Before: n/a After: B48982344 **25** Routine Name: HBHCP25 Before: n/a After: B328229 **25** Routine Name: HBHCR19A Before: B14539231 After: B18946773 **8,14,22,25** Routine Name: HBHCR19B Before: B7557416 After: B8115301 **8,14,22,25** Routine Name: HBHCRP18 Before: B10520126 After: B12246188 **6,22,24,25** Routine Name: HBHCRP1A Before: B19487017 After: B21729816 **6,8,10,13,16,24,25** Routine Name: HBHCRP1B Before: B17259643 After: B18895349 **6,8,10,16,25** Routine Name: HBHCRP2 Before: B26747023 After: B30714112 **1,2,5,6,9,19,22,25** Routine Name: HBHCRP5 Before: B21827854 After: B25295403 **2,5,6,22,25** Routine Name: HBHCRP7 Before: B20915954 After: B24145034 **5,6,21,22,24,25** Routine Name: HBHCUPD Before: B13872578 After: B46222725 **2,6,8,10,24,25** Routine Name: HBHCUTL Before: B28029686 After: B31187675 **2,6,8,16,24,25** Routine Name: HBHCUTL3 Before: B20865262 After: B26981634 **6,8,10,15,16,14,24,25** Routine Name: HBHCXMA Before: B38006559 After: B42800884 **1,6,9,19,24,25** Routine Name: HBHCXMA1 Before: B12692745 After: B13785119 **2,6,14,19,24,25** Routine Name: HBHCXMD Before: B23836635 After: B26724390 **4,6,9,10,13,19,24,25** Routine Name: HBHCXMD1 Before: B14260181 After: B17012648 **2,6,19,24,25** Routine Name: HBHCXMV Before: B19281997 After: B20835749 **2,5,6,9,12,15,17,14,19,24,25** Routine Name: HBHCXMV1 Before: B5766233 After: B6370071 **6,15,14,19,24,25** Routine list of preceding patches: 24 ============================================================================= User Information: Entered By : Date Entered : MAY 21, 2012 Completed By: Date Completed: AUG 22, 2014 Released By : Date Released : AUG 29, 2014 ============================================================================= Packman Mail Message: ===================== $END TXT