============================================================================= Run Date: SEP 02, 2015 Designation: IB*2*522 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #499 Status: Released Compliance Date: SEP 16, 2015 ============================================================================= Associated patches: (v)IB*2*461 <<= must be installed BEFORE `IB*2*522' (v)IB*2*479 <<= must be installed BEFORE `IB*2*522' (v)IB*2*516 <<= must be installed BEFORE `IB*2*522' (v)DG*5.3*884 <<= must be installed BEFORE `IB*2*522' Subject: INPATIENT PTF CODE EXPANSION Category: - Routine - Informational Description: ============ ************************************************************************** * * * IMPORTANT: * * * * This patch is being released in support of the ICD-10 Patient * * Treatment File Modifications project. Patch DG*5.3*884 * * (Registration) is being released along with GMTS*2.7*111 (Health * * Summary), IB*2.0*522 (Integrated Billing), LR*5.2*442 (Lab Service), * * ROR*1.5*25 (Clinical Case Registries), and OR*3.0*406 (Order * * Entry/Results Reporting) in a multi-package build (host file). * * * * Because this is a multi-package build, it can only be distributed * * as a host file; no builds are included in the patch messages. The * * name of the host file is: ICD_10_PTF_MODIFICATIONS.KID; it can be * * obtained from one of the anonymous file transfer protocol (ftp) * * directories listed in the 'Software & Documentation Retrieval * * Instructions' section of this patch. * * * * Detailed information regarding pre-installation items, * * post-installation items, and installation instructions can be found * * in the Installation Guide: ICD_10_PTF_Modifications_IG.PDF. This * * document may be obtained from one of the anonymous file transfer * * protocol (ftp) directories listed in the 'Software & Documentation * * Retrieval Instructions' section of this patch. * * * * It is imperative that these patches be installed no later than the * * compliance date. Your understanding and support is appreciated. * * * ************************************************************************** For Inpatient care, the number of allowable Diagnosis and Procedure codes is being expanded in the Patient Treatment File (PTF) with DG*5.3*884. The following records in PTF are being expanded to allow up to 25 codes: Movement Diagnosis (501), Discharge Diagnosis (701), Surgical Episode Procedures (401) and Non-O/R Episode Procedures (601). This patch IB*2*522 will update the Inpatient Bill/Claim to accommodate the expanded number of Diagnosis and Procedure codes available in PTF. A. Inpatient Bill/Claims Diagnosis: ----------------------------------- Screen 4 option 3 of Enter/Edit Billing Information [IB EDIT BILLING INFO] has been updated to display and allow selection of all Diagnosis in the PTF record within the date range of the bill. This is up to 25 Diagnosis for each Movement (501) and the Discharge (701). The Present on Admission (POA) indicator associated with any selected PTF Diagnosis will be also added to the bill. The display of PTF Diagnosis will include the POA, if present in PTF. Beginning with ICD-10 bills the Present on Admission (POA) indicator entered in the DSS Encoder will no longer be added to a bill. For ICD-10 bills the Diagnosis POA will be available in PTF where it will be accessed for placement on the bill. Depending on the number of PTF Movements associated with the bill, the display and selection of Movement Diagnosis identifiers will now include both upper and lower case alpha characters (A-Z and a-z), with X/x being reserved for the Discharge. Previously only upper case alpha characters were selectable. B. Inpatient Bill/Claims Procedures: ------------------------------------- Screen 4 option 4 of Enter/Edit Billing Information [IB EDIT BILLING INFO] has been updated to display and allow selection of all Procedures in the PTF record within the date range of the bill. This is up to 25 ICD Procedures for each Surgical (401) and Non-O/R (601) Episode. It is possible that the same procedure may be completed multiple times on the same date. These duplicate ICD procedures will be displayed in the list of PTF ICD procedures as separate line items. If a duplicate ICD procedure is selected by the preceding indicator then these duplicates will be added to the bill. The display of PTF Surgical (401) and Non-O/R (601) ICD Procedures has been updated to display a '*' before each PTF ICD procedure that matches a procedure and date already assigned to the bill. The display and selection of the PTF Professional Services (801) has also been expanded to all CPT/HCPCS codes assigned within the bill date range. Previously a maximum of 5 CPT/HCPCS were displayed for each Professional Service although more than 5 may have been entered in PTF. The display of the PTF Professional Services (801) will now include the Quantity of the procedure performed if it is more than 1. Depending on the number of PTF Procedure Episodes associated with the bill, the display and selection of Procedure Episode identifiers will now include both upper and lower case alpha characters (A-Z and a-z). Previously only upper case alpha characters were selectable. C. Bill Charge Calculation: ---------------------------- For Inpatient Facility bill charges, the calculation of the DRG has been modified to use all the PTF Diagnosis and Procedure codes within the appropriate date range. D. Third Party Autobiller: --------------------------- Inpatient bills created by the Third Party Autobiller will add all the PTF Diagnosis, POA, and Procedure codes within the bill date range. Technical Description: ====================== IB*2*522 is dependent on DG*5.3*884 ICD-10 Patient Treatment File Modifications which adds the new PTF Diagnosis, POA, and Procedure fields. Integrated Billing has subscribed to the Registration ICR #6130 to access these new PTF fields. The following option has been updated with this patch: - Enter/Edit Billing Information [IB EDIT BILLING INFO] There is no Pre or Post Installation routine or modifications associated with this patch. Patch Components: ----------------- IB*2*522 contains Routines only. No Files, Fields, or Templates are modified. Files & Fields Associated: NA Forms Associated: NA Mail Groups Associated: NA Options Associated: NA - None Exported Protocols Associated: NA Security Keys Associated: NA Templates Associated: NA Patient Safety Issues (PSIs): NA New Service Requests (NSRs): ---------------------------- NSR #20070902 - ICD-10-CM Conversion Remedy Ticket(s) & Overview: ---------------------------- 1. INC000001243424 Billing Screen 10, section 3 Attending Provider Name missing Problem: -------- Attending provider is not being automatically added to Billing screen 10, Section 3 when a bill is created by the AutoBiller and the provider has a valid NPI. The Third Party AutoBiller had been modified to only add the Attending provider if that provider had a valid NPI. However the check for NPI was using the wrong field for the provider resulting in the NPI never being found and therefore the AutoBiller never added the Attending Provider to the bill. Resolution: ----------- The software was updated to correctly identify the Attending provider's NPI. The Third Party AutoBiller will add the Attending Provider to a bill it creates if that provider has a valid NPI. The Attending provider is then viewable on Screen 10, section 3 of Enter/Edit Billing Information [IB EDIT BILLING INFO] option. Test Sites: ---------- The following sites participated in testing this software. * Detroit, MI * Madison, WI * Richmond, VA * West Haven, CT Software & Documentation Retrieval Instructions: ------------------------------------------------ The software for this set of patches is not being distributed through the National Patch Module. Patch DG*5.3*884 (Registration) is being released along with GMTS*2.7*111 (Health Summary), IB*2.0*522 (Integrated Billing), LR*5.2*442 (Lab Service), ROR*1.5*25 (Clinical Case Registries), and OR*3.0*406 (Order Entry/Results Reporting) in a multi-package build (host file). Because this is a multi-package build, it can only be distributed as a host file; no builds are included in the patch messages. The name of the host file is: ICD_10_PTF_MODIFICATIONS.KID; it can be obtained from one of the anonymous file transfer protocol (ftp) directories listed below. Updated documentation describing the new functionality introduced by this patch is also available and can be obtained from one of the anonymous file transfer protocol (ftp) directories listed below. 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 Note: - Please use the 'Binary' transfer method for retrieval of .pdf files - Please use the 'ASCII' transfer method for retrieval of .KID files Documentation can also be found on the VA Software Documentation Library at: http://www.domain.ext/vdl/ The software distribution includes these file(s): ------------------------------------------------------------------------- ICD_10_PTF_MODIFICATIONS.KID The documentation includes these titles and file names: ------------------------------------------------------------------------- Title: Integrated Billing User Manual File Name: ib_2_0_um.pdf Title: Integrated Billing Technical Manual File Name: ib_2_0_tm.pdf Title: Integrated Billing IB*2.0*522 Release Notes File Name: IB_2_522_RN.pdf Title: ICD-10 PTF Installation Guide (all patches) File Name: ICD_10_PTF_MODIFICATIONS_IG.PDF Patch Installation: ================================================== Detailed information regarding pre-installation items, post-installation items, and installation instructions can be found in the Installation Guide: ICD_10_PTF_MODIFICATIONS_IG.PDF. This document may be obtained from one of the anonymous file transfer protocol (ftp) directories listed in the 'Software & Documentation Retrieval Instructions' of this patch description. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 7 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBCD3 Before: B32514703 After: B34628725 **14,55,52,91,106,125,51,148, 160,137,210,245,260,405,384, 516,522** Routine Name: IBCD4 Before: B18076054 After: B14091278 **14,80,106,160,309,276,347,522** Routine Name: IBCRBG Before: B66489178 After: B68718544 **52,80,106,51,142,159,210,245, 382,389,461,522** Routine Name: IBCSC4A Before: B32672806 After: B26406207 **106,228,339,479,522** Routine Name: IBCSC4B Before: B36503632 After: B14226360 **210,228,304,479,522** Routine Name: IBCSC4D Before: B75384760 After: B76016238 **55,62,91,106,124,51,210,403, 400,461,516,522** Routine Name: IBCSC4E Before: B45259248 After: B48958417 **8,106,121,124,210,266,403,479,522** Routine Name: IBCSC4F Before: B26386041 After: B34285009 **106,403,400,522** Routine Name: IBCU7 Before:B111564056 After:B113207672 **62,52,106,125,51,137,210,245, 228,260,348,371,432,447,488, 461,516,522** Routine list of preceding patches: 347, 479, 516 ============================================================================= User Information: Entered By : Date Entered : MAR 12, 2014 Completed By: Date Completed: AUG 28, 2015 Released By : Date Released : SEP 02, 2015 ============================================================================= Packman Mail Message: ===================== No routines included