============================================================================= Run Date: MAY 17, 2013 Designation: IB*2*500 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #452 Status: Released Compliance Date: MAY 31, 2013 ============================================================================= Subject: REASONABLE CHARGES 3.12 RELOAD Category: - Informational Description: ============ ************************************************************************* PLEASE NOTE: There is a shortened Compliance Date for this patch. ************************************************************************* This patch is an informational patch about reloading the replacement of the Reasonable Charges host files. The replacement host files are available and these new host files have to be retrieved from anonymous and reloaded - even though IB*2*491 has been installed. ASSOCIATED REMEDY TICKETS: ========================== INC000000840389 Integrated Billing - Reasonable Charges ASSOCIATED NSR's: ================= N/A PARTICIPATING TEST SITES: ========================= Bay Pines VA Healthcare System James A. Haley Veterans' Hospital - Tampa Spokane VA Medical Center OVERVIEW OF REMEDY TICKETS(s): ============================== INC000000840389 Integrated Billing - Reasonable Charges Problem: -------- The Chief Business Office has requested that sites reload the replacement Reasonable Charges host files now that LEX*2.0*90 has been released. Resolution: ----------- The Facility Charge (CPT) host file and the Physician Charges (CPT) host file have been updated to remove 121 inactive CPT/HCPCS codes which are currently inactivated in the CPT (#81) file, turn on the outpatient facility charges for 729 CPT/HCPCS codes and change the professional charge type for 42 CPT/HCPCS codes to make their charges available when the reload process is complete. INSTALLATION INSTRUCTIONS ========================= No installation is needed. ********************** RC v3.12 Upload Instructions ******************** A typical upload of Reasonable Charges require approximately 1.8 - 2.0 MB of disk space for each Division. This re-load will not require as much space because most of the charges for 01/01/2013 are already on the file. Other files will be searched, but the new charges data will only be added to the Charge Item (#363) file. LEX*2.0*90 - Code Set FY13 3rd Qtr Update should be installed before uploading Reasonable Charges v3.12 host files. Files Required for Upload: -------------------------- The charge files are available on the following CIO Field Offices' Anonymous.Software directories. Use the appropriate FTP capability to retrieve the files (ASCII). OI FIELD OFFICE FTP ADDRESS DIRECTORY =============== =========== ========= ALBANY ftp.fo-albany.med.va.gov anonymous.software HINES ftp.fo-hines.med.va.gov anonymous.software SALT LAKE ftp.fo-slc.med.va.gov anonymous.software FIRST AVAILABLE SERVER download.vista.med.va.gov anonymous.software The Reasonable Charge v3.12 Host Files, effective 01/01/13: (ASCII) IBRC1301A.TXT Inpatient Facility Charges (DRG) IBRC1301B.TXT Facility Charge (CPT) IBRC1301C.TXT Physician Charges (CPT) IBRC1301D.TXT Service Category Codes IBRC1301E.TXT Area Factors IBRC1301F.TXT Site Identification Upload Steps: ============= Step 1: Get Host Files ----------------------- Delete the old .txt files you may still have on your system from uploading for patch IB*2*491. Then retrieve the new Host Files in ASCII format (see previous section for file sizes). Step 2: Determine Divisions ---------------------------- Use the Print Charge Master [IBCR REPORTS FOR CHARGE MASTER] option and print the Billing Regions report to find which Billing Regions and Divisions have charges loaded onto your system. These are the divisions that will need new charges loaded. Step 3: Begin Upload Process ----------------------------- Use the Load Host File into Charge Master [IBCR HOST FILE LOAD] option to load Reasonable Charges onto your system for every division for which care is billed at your site. Carefully follow the instructions below, for each Billing Region. You will see the prompt: Select one of the following: ============================================================================ 1.1 Load CMAC into XTMP 1.2 Load AWP into XTMP 1.3 Load RC into XTMP 1.4 Load TP into XTMP 2 Assign Charge Set 3 Check Data Validity 4 Load into Charge Master 5 Delete XTMP files Below, in more detail, the steps will guide you through the process of selecting first 1.3, then 3, then 4, and waiting until 4 stops before continuing on to the next division (and capturing or printing all output for future reference). Step 4: Load the Reasonable Charges ------------------------------------ From the menu, select option 1.3 - Load RC into XTMP This loads the Host Files into temporary storage and calculates charges for individual Divisions. - If there are no previously existing host files loaded, it will ask which version of Reasonable Charges to load. Select 3.12 - When loading Reasonable Charges v3.12 the IBRC1301x.TXT files may be used for multiple divisions without reloading. The first time through even though the files will match the IBRC1301x.TXT format, they should be deleted so the new files can be uploaded. - If there exists any previously calculated charges (files) for a division, they will be displayed, and you will get the prompt: The above files already exist in XTMP. Delete the above files and continue with upload? Select Yes, to delete the previously calculated charges. - Select Division: Select the division number to load charges for. This should correspond to the Divisions associated with the Billing Regions determined previously. Once the correct division is selected, answer Yes to Calculate Charges. Step 5: Check Data Validity --------------------------- From the menu, select option 3 - Check Data Validity. This is optional, but it is suggested that it be run at least once, for the first division loaded. If the resulting report has any Line Data Errors, then check that the latest version of CPT and DRG has been installed. The Error key at the end of the report does not mean that errors have occurred. It simply provides definitions of the types of errors that might occur. Check the individual line items in the report to see if any of the listed errors have been detected. Step 6: Load into Charge Master ------------------------------- From the menu, select option 4 - Load into Charge Master Moves the charges calculated in selection 1.3 to permanent storage in the Charge Master. The results report should match the examples below. It is important that this option completes before continuing. Allow the upload of a division's charges to finish before attempting to upload another division. A summary report will be printed when the upload is complete. This option uses the same temporary files to calculate the charges for all divisions, therefore they must be calculated and loaded serially. Step 7: Repeat steps 4-6 for each Division needed ------------------------------------------------- Steps 4-6 must be repeated for each division billed at your site. Refer to the Divisions that already have charges assigned using the Billing Region Report list determined previously. In most cases, simply using the above options for loading Reasonable Charges will result in the correct set up in the Charge Master. - Option 1.3, to calculate charges for a division - Option 4, to load those calculated charges into the Charge Master permanent files. However, if you are loading charges for a new site, or a site that may have changed its division number, then extra care is needed to ensure the setup of the Charge Master is correct. The following sections provide examples of displays and reports for the upload. ================= Reasonable Charges v3.12 Upload Details ================ The Charge Host Files should load with the following counts: The following files were created in XTMP, they will be purged in 2 days: ------------------------------------------------------------------------ IBRC1301A.TXT RC v3.12 Host File Upload, 4/11/13@15:40 by WANG,CHI 750 IBRC1301B.TXT RC v3.12 Host File Upload, 4/11/13@15:40 by WANG,CHI 6408 IBRC1301C.TXT RC v3.12 Host File Upload, 4/11/13@15:40 by WANG,CH 17178 IBRC1301D.TXT RC v3.12 Host File Upload, 4/11/13@15:40 by WANG,CHI 30 IBRC1301E.TXT RC v3.12 Host File Upload, 4/11/13@15:40 by WANG,CHI 917 IBRC1301F.TXT RC v3.12 Host File Upload, 4/11/13@15:40 by WANG,CHI 1144 Any division that provides Inpatient Care should result in a summary with the following counts: IBCR UPLOAD RC 402 TOGUS, ME Count = 53002 IB Upload RC v3.12 402 TOGUS, ME, 4/11/13@15:48 by WANG,CHI Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 Inpt Fac 1 CPT 24 RC-INPT FAC PR 402 2 Inpt Fac 2 CPT 6 RC-INPT FAC HR 402 3 Inpt Fac 4 CPT 5 RC-INPT FAC ML 402 4 Inpt Fac/Phys 1 CPT 3679 RC-INPT FAC PR 402 5 Inpt PD Anc DRG 749 RC-INPT ANC 402 6 Inpt PD Anc ICU DRG 749 RC-INPT ANC ICU 402 7 Inpt PD R&B DRG 749 RC-INPT R&B 402 8 Inpt PD R&B ICU DRG 749 RC-INPT R&B ICU 402 9 Inpt Phys 1 CPT 7814 RC-PHYSICIAN INPT PR 402 10 Inpt Phys 3 CPT 274 RC-PHYSICIAN INPT MN 402 11 Opt Fac 1 CPT 6396 RC-OPT FAC PR 402 12 Opt Fac 2 CPT 6 RC-OPT FAC HR 402 13 Opt Fac 4 CPT 5 RC-OPT FAC ML 402 14 Opt Fac/Phys 1 CPT 6187 RC-OPT FAC PR 402 15 Opt PD PHosp MISCE 1 RC-OPT MISC 402 16 Opt Phys 1 CPT 6205 RC-PHYSICIAN OPT PR 402 17 Opt Phys 3 CPT 214 RC-PHYSICIAN OPT MN 402 18 SNF Fac 1 CPT 6037 RC-SNF FAC PR 402 19 SNF Fac 2 CPT 6 RC-SNF FAC HR 402 20 SNF Fac 4 CPT 5 RC-SNF FAC ML 402 21 SNF Fac/Phys 1 CPT 5030 RC-SNF FAC PR 402 22 SNF PD INC BEDSE 2 RC-SNF INC 402 23 SNF Phys 1 CPT 7836 RC-PHYSICIAN SNF PR 402 24 SNF Phys 3 CPT 274 RC-PHYSICIAN SNF MN 402 IB Upload Summary Report of Charge Items Loaded into the Charge Master --------------------------------------------------------------------------- IBCR UPLOAD RC 402 TOGUS, ME Inpt Fac 1 24 of 24 records checked, 24 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-INPT FAC PR 402. Inpt Fac 2 6 of 6 records checked, 6 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-INPT FAC HR 402. Inpt Fac 4 5 of 5 records checked, 5 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-INPT FAC ML 402. Inpt Fac/Phys 1 3679 of 3679 records checked, 3676 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 3 entries added to the Charge Set RC-INPT FAC PR 402. Inpt PD Anc 749 of 749 records checked, 749 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-INPT ANC 402. Inpt PD Anc ICU 749 of 749 records checked, 749 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-INPT ANC ICU 402. Inpt PD R&B 749 of 749 records checked, 749 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-INPT R&B 402. Inpt PD R&B ICU 749 of 749 records checked, 749 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-INPT R&B ICU 402. Inpt Phys 1 7814 of 7814 records checked, 7777 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 37 entries added to the Charge Set RC-PHYSICIAN INPT PR 402. Inpt Phys 3 274 of 274 records checked, 274 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-PHYSICIAN INPT MN 402. Opt Fac 1 6396 of 6396 records checked, 6357 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 39 entries added to the Charge Set RC-OPT FAC PR 402. Opt Fac 2 6 of 6 records checked, 6 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-OPT FAC HR 402. Opt Fac 4 5 of 5 records checked, 5 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-OPT FAC ML 402. Opt Fac/Phys 1 6187 of 6187 records checked, 5451 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 736 entries added to the Charge Set RC-OPT FAC PR 402. Opt PD PHosp 1 of 1 records checked, 1 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-OPT MISC 402. Opt Phys 1 6205 of 6205 records checked, 6168 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 37 entries added to the Charge Set RC-PHYSICIAN OPT PR 402. Opt Phys 3 214 of 214 records checked, 214 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-PHYSICIAN OPT MN 402. SNF Fac 1 6037 of 6037 records checked, 6008 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 29 entries added to the Charge Set RC-SNF FAC PR 402. SNF Fac 2 6 of 6 records checked, 6 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-SNF FAC HR 402. SNF Fac 4 5 of 5 records checked, 5 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-SNF FAC ML 402. SNF Fac/Phys 1 5030 of 5030 records checked, 5026 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 4 entries added to the Charge Set RC-SNF FAC PR 402. SNF PD INC 2 of 2 records checked, 2 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-SNF INC 402. SNF Phys 1 7836 of 7836 records checked, 7799 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 37 entries added to the Charge Set RC-PHYSICIAN SNF PR 402. SNF Phys 3 274 of 274 records checked, 274 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-PHYSICIAN SNF MN 402. Any Provider based division that provides Outpatient Care Only should result in a summary with the following counts: IBCR UPLOAD RC 402GE AUBURN, ME Count = 19014 IB Upload RC v3.12 402GE AUBURN, ME, 4/11/13@16:02 by WANG,CHI Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 Opt Fac 1 CPT 6396 RC-OPT FAC PR 402GE 2 Opt Fac 2 CPT 6 RC-OPT FAC HR 402GE 3 Opt Fac 4 CPT 5 RC-OPT FAC ML 402GE 4 Opt Fac/Phys 1 CPT 6187 RC-OPT FAC PR 402GE 5 Opt PD PHosp MISCE 1 RC-OPT MISC 402GE 6 Opt Phys 1 CPT 6205 RC-PHYSICIAN OPT PR 402GE 7 Opt Phys 3 CPT 214 RC-PHYSICIAN OPT MN 402GE IB Upload Summary Report of Charge Items Loaded into the Charge Master --------------------------------------------------------------------------- IBCR UPLOAD RC 402GE AUBURN, ME Opt Fac 1 6396 of 6396 records checked, 6357 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 39 entries added to the Charge Set RC-OPT FAC PR 402GE. Opt Fac 2 6 of 6 records checked, 6 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-OPT FAC HR 402GE. Opt Fac 4 5 of 5 records checked, 5 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-OPT FAC ML 402GE. Opt Fac/Phys 1 6187 of 6187 records checked, 5451 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 736 entries added to the Charge Set RC-OPT FAC PR 402GE. Opt PD PHosp 1 of 1 records checked, 1 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-OPT MISC 402GE. Opt Phys 1 6205 of 6205 records checked, 6168 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 37 entries added to the Charge Set RC-PHYSICIAN OPT PR 402GE Opt Phys 3 214 of 214 records checked, 214 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rt 0 entries added to the Charge Set RC-PHYSICIAN OPT MN Any division with Non-Provider Based Freestanding Care should result in a summary with the following counts: IBCR UPLOAD RC 402GA CARIBOU, ME Count = 17373 IB Upload RC v3.12 402GA CARIBOU, ME, 4/11/13@16:05 by WANG,CHI Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 FS Phys 1 CPT 16830 RC-PHYSICIAN FS PR 402GA 2 FS Phys 3 CPT 274 RC-PHYSICIAN FS MN 402GA 3 FS Phys/Add 00 1 CPT 2 RC-PHYSICIAN FS PR 402GA 4 FS Phys/Opt 1 CPT 260 RC-PHYSICIAN FS PR 402GA 5 FS Phys/Opt 4 CPT 5 RC-PHYSICIAN FS ML 402GA 6 FS Phys/Opt TC 1 CPT 2 RC-PHYSICIAN FS PR 402GA IB Upload Summary Report of Charge Items Loaded into the Charge Master --------------------------------------------------------------------------- IBCR UPLOAD RC 402GA CARIBOU, ME FS Phys 1 16830 of 16830 records checked, 16781 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 49 entries added to the Charge Set RC-PHYSICIAN FS PR 402GA. FS Phys 3 274 of 274 records checked, 274 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-PHYSICIAN FS MN 402GA. FS Phys/Add 00 1 2 of 2 records checked, 2 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-PHYSICIAN FS PR 402GA. FS Phys/Opt 1 260 of 260 records checked, 223 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 37 entries added to the Charge Set RC-PHYSICIAN FS PR 402GA. FS Phys/Opt 4 5 of 5 records checked, 5 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-PHYSICIAN FS ML 402GA. FS Phys/Opt TC 1 2 of 2 records checked, 2 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 0 entries added to the Charge Set RC-PHYSICIAN FS PR 402GA. - - - Notice - not all of the charges are being added because most of them are already in the file. ************************************************************************* IMPORTANT: ************************************************************************* Step 8: Inform Billing that the upload is done ---------------------------------------------- Please send a message to CPAC VISTA PATCH NOTIFICATIONS (CPACVISTAPATCHNOTIFICATIONS@VA.GOV) confirming which Divisions have been completed. Something similar to the following: Subject Line: Patch IB*2*500 - Subject: REASONABLE CHARGES 3.12 RELOAD This is to let you know that the RELOAD has been done for the following divisions: RC 442 - CHEYENNE, WY RC 442GB - SIDNEY, NE RC 442GC - FORT COLLINS, CO RC 442GD - GREELEY, CO RC 442HK - CHEYENNE MOC, WY RC 442X1 - SCOTTSBLUFF, NE (But let them know what divisions you just uploaded.) Routine Information: ==================== No routines included. ============================================================================= User Information: Entered By : WANG,CHI Date Entered : APR 11, 2013 Completed By: DAWSON,TIM Date Completed: MAY 14, 2013 Released By : MURRAY,ANGELA Date Released : MAY 17, 2013 ============================================================================= Packman Mail Message: ===================== No routines included