$TXT Created by at MNTVBB.DOMAIN.EXT (KIDS) on Wednesday, 01/04/23 at 14:16 ============================================================================= Run Date: FEB 07, 2023 Designation: IB*2*755 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #682 Status: Released Compliance Date: FEB 14, 2023 ============================================================================= Associated patches: (v)IB*2*744 <<= must be installed BEFORE `IB*2*755' Subject: REASONABLE CHARGES V4.235 Category: - Routine - Other Description: ============ ************************************************************************ NOTE: This patch is being released with a shortened compliance date of 7 days. ************************************************************************ Integrated Billing patch, IB*2.0*755, is the Reasonable Charges v4.235. ************************************************************************** Implementation of Reasonable Charges v4.235 is a two-step process: 1. Installation of this patch. This will inactivate Reasonable Charges v4.23 charges with an inactive date of 12/31/22. (See Installation Instructions.) 2. Uploading the Reasonable Charges v4.235 charges. This will load new charges with an effective date of 01/01/23 and needs to be done immediately after the patch install. (See Upload Instructions.) PLEASE NOTE: It is recommended that you install the Lexicon Utility patch LEX*2.0*142 - CODE SET FY23 2ND QTR UPDATE Prior to IB*2.0*755 install. ************************************************************************** Reasonable Charges version 4.235 is a charge update to the existing Reasonable Charges billed to Third Party Payers. The primary update with this patch is to the charges, which will be implemented when the new RC v4.235 charges are uploaded (step 2). This version of Reasonable Charges implements the following charge changes: Effective Date of Reasonable Charges v4.235 is 01/01/23. Inactive Date of Reasonable Charges v4.23 is 12/31/22. Reasonable Charges v4.23 loaded on your system will be inactivated with an inactivation date of 12/31/22 when this patch is installed. Reasonable Charges v4.235 with an effective date of 01/01/23 will be loaded on your system when the charges are uploaded as described below. Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A 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 ----------- ---- -------------------- 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 Coordination: N/A New Service Requests (NSRs): N/A Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1. INC25162839: Initiate IB Outpatient Patch V4.235 for CY23 in VistA Problem: -------- Changes in the national CPT rates need to be distributed to all hospitals so that proper billing can take place. Resolution ----------- This patch updates the Reasonable Charges files and distributes them with a new version number and a new effective date. Routines: IBCRHBRV, IBYP755 Technical Description ===================== This patch exports 2 routines, one of which is the post-init (IBYP755). The post-init will inactivate all existing Reasonable Charges defined in the Charge Master. Reasonable Charges v4.23 will be inactivated with an inactivation date of 12/31/22 when the patch is installed. The following is an example of the post-init portion of the installation: Running Post-Install Routine: POST^IBYP755 Reasonable Charges v4.235 Post-Install ..... >> Inactivating Existing Reasonable Charges, Please Wait... Done. 55887 existing charges inactivated Reasonable Charges v4.235 Post-Install Complete Note: The actual number of charges inactivated and facility type of billing regions changed will vary based on the number of divisions billed at your site. This will also determine the time required for the installation. Test Sites: ----------- VA Connecticut Health Care System (West Haven, Newington) VISN 2 - Upstate New York Health Care System (Buffalo, Batavia, Canandaigua, Syracuse, Bath, Albany) Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. Sites may retrieve the charge files using Secure File Transfer Protocol (SFTP) in ASCII format at the location: /srv/vista/patches/SOFTWARE or by accessing the URL: https://download.vista.domain.ext/index.html/SOFTWARE. The Reasonable Charge v4.235 Host Files, effective 01/01/22: (ASCII) IBRC2301A.TXT Inpatient Facility Charges (DRG) IBRC2301B.TXT Facility Charge (CPT) IBRC2301C.TXT Physician Charges (CPT) IBRC2301D.TXT Service Category Codes IBRC2301E.TXT Area Factors IBRC2301F.TXT Site Identification Patch Installation: Pre/Post Installation Overview: ------------------------------- 1. Installation of this patch will inactivate Reasonable Charges v4.23 charges with an inactive date of 12/31/22. (See Installation Instructions.) 2. Uploading the Reasonable Charges v4.235 charges. This will load new charges with an effective date of 01/01/23 and needs to be done immediately after the patch install. (See Upload Instructions.) Pre-Installation Instructions: ------------------------------ If installed during the normal workday, it is recommended that the following selection(s) in the OPTION (#19) file be disabled to prevent possible conflicts while running the KIDS Install. Other Vista users will not be affected. Enter/Edit Billing Information [IB EDIT BILLING INFO] Enter/Edit Charge Master [IBCR DISPLAY CHARGE MASTER] Install Time - less than 30 minutes - but will vary from site to site depending on the size of the CHARGE ITEM (#363.2) file which is searched for charges to inactivate in the post-init routine. Loading the Charge Master with the new RC v4.235 charges is separate from the patch installation and will take additional time per division. Installation Instructions: -------------------------- 1. Choose the PackMan message containing this build. Then select the INSTALL/CHECK MESSAGE PackMan option to load the build. 2. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, A. Select the Verify Checksums in Transport Global option to confirm the integrity of the routines that are in the transport global. When prompted for the INSTALL NAME enter the patch or build name IB*2.0*755. B. Select the Backup a Transport Global option to create a backup message of any routines exported with this patch. For each patch you can specify what to backup; the entire Build or just Routines. When asked to specify what to backup, select Routines. When prompted for a response, select Routines: Select one of the following: B Build R Routines Enter response: Routines C. You may also elect to use the following options: i. Print Transport Global - This option will allow you to view the components of the KIDS build. ii. 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 of the components of this patch, such as routines, DDs, templates, etc. D. Select the Install Package(s) option and choose the patch to install, IB*2.0*755. i. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO ii. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', answer YES a. When prompted 'Enter options you wish to mark as 'Out Of Order':' Enter the following option: Option Name Menu Text ----------- --------- Enter/Edit Billing Information [IB EDIT BILLING INFO] Enter/Edit Charge Master [IBCR DISPLAY CHARGE MASTER] Press the Enter key when you are done selecting options. b. When prompted 'Enter protocols you wish to mark as 'Out Of Order':' press . c. When prompted 'Delay Install (Minutes): (0 - 60): 0//', answer 0. Post-Installation Instructions: UPLOAD REASONABLE CHARGES V4.235 -------------------------------- Follow instructions below: RC v4.235 Upload Instructions ********************** RC v4.235 Upload Instructions ********************** After patch installation, the Reasonable Charges v4.235 charges will need to be loaded into the Charge Master for each division billed at the site. The charges for each Division will require approximately 1.8 - 2.0 MB of disk space. Other files will be searched, but the new charges will be added to the CHARGE ITEM file (#363.2). Files Required for Upload: -------------------------- Sites may retrieve the charge files using Secure File Transfer Protocol (SFTP) in ASCII format at the location: /srv/vista/patches/SOFTWARE or by accessing the URL: https://download.vista.domain.ext/index.html/SOFTWARE. The Reasonable Charge v4.235 Host Files, effective 01/01/22: (ASCII) IBRC2301A.TXT Inpatient Facility Charges (DRG) IBRC2301B.TXT Facility Charge (CPT) IBRC2301C.TXT Physician Charges (CPT) IBRC2301D.TXT Service Category Codes IBRC2301E.TXT Area Factors IBRC2301F.TXT Site Identification Upload Instructions: ==================== Step 1: Get Host Files ----------------------- Retrieve the 6 Reasonable Charges v4.235 Host Files in ASCII format (see previous section). 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 wait 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 4.235 - When loading Reasonable Charges v4.235 the IBRC2301x.TXT files may be used for multiple divisions without reloading. - 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. - If there exist any previously loaded host files for any RC version, they will be displayed, and it will ask if they should be deleted. Select No, if the files are IBRC2301x.TXT since these are the correct files for v4.235, they may be re-used for multiple divisions. Select Yes only if the files are from a different version. - 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 v4.235 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: ------------------------------------------------------------------------- The following files were created in XTMP, they will be purged in 2 days: ------------------------------------------------------------------------ IBRC2301A.TXT RC v4.235 Host File Upload, 12/28/22@10:10 by XXXX,XX 766 IBRC2301B.TXT RC v4.235 Host File Upload, 12/28/22@10:10 by XXXX,XX 8481 IBRC2301C.TXT RC v4.235 Host File Upload, 12/28/22@10:10 by XXXX,XX 17440 IBRC2301D.TXT RC v4.235 Host File Upload, 12/28/22@10:10 by XXXX,XX 30 IBRC2301E.TXT RC v4.235 Host File Upload, 12/28/22@10:10 by XXXX,XX 917 IBRC2301F.TXT RC v4.235 Host File Upload, 12/28/22@10:10 by XXXX,XX 1493 Any division that provides Inpatient Care should result in a summary with the following counts: IBCR UPLOAD RC 442 CHEYENNE VA MEDICAL CENTER, WY Count = 55554 IB Upload RC v4.235 442 CHEYENNE VA MEDICAL CENTER, WY, 12/28/22@10:29 by M Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 Inpt Fac 1 CPT 91 RC-INPT FAC PR 442 2 Inpt Fac 2 CPT 3 RC-INPT FAC HR 442 3 Inpt Fac 4 CPT 5 RC-INPT FAC ML 442 4 Inpt Fac/Phys 1 CPT 2876 RC-INPT FAC PR 442 5 Inpt PD Anc DRG 765 RC-INPT ANC 442 6 Inpt PD Anc ICU DRG 765 RC-INPT ANC ICU 442 7 Inpt PD R&B DRG 765 RC-INPT R&B 442 8 Inpt PD R&B ICU DRG 765 RC-INPT R&B ICU 442 9 Inpt Phys 1 CPT 8369 RC-PHYSICIAN INPT PR 442 10 Inpt Phys 3 CPT 275 RC-PHYSICIAN INPT MN 442 11 Opt Fac 1 CPT 8472 RC-OPT FAC PR 442 12 Opt Fac 2 CPT 3 RC-OPT FAC HR 442 13 Opt Fac 4 CPT 5 RC-OPT FAC ML 442 14 Opt Fac/Phys 1 CPT 5349 RC-OPT FAC PR 442 15 Opt PD PHosp MISCE 1 RC-OPT MISC 442 16 Opt Phys 1 CPT 6741 RC-PHYSICIAN OPT PR 442 17 Opt Phys 3 CPT 225 RC-PHYSICIAN OPT MN 442 18 SNF Fac 1 CPT 7825 RC-SNF FAC PR 442 19 SNF Fac 2 CPT 3 RC-SNF FAC HR 442 20 SNF Fac 4 CPT 5 RC-SNF FAC ML 442 21 SNF Fac/Phys 1 CPT 3584 RC-SNF FAC PR 442 22 SNF PD INC BEDSE 2 RC-SNF INC 442 23 SNF Phys 1 CPT 8385 RC-PHYSICIAN SNF PR 442 24 SNF Phys 3 CPT 275 RC-PHYSICIAN SNF MN 442 IB Upload Data Validity Check on Temporary files 12/21 -------------------------------------------------------------------------- ------ IBCR UPLOAD RC 442 CHEYENNE VA MEDICAL CENTER, WY Inpt Fac 1 91 of 91 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt Fac 2 3 of 3 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt Fac/Phys 1 2876 of 2876 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD Anc 765 of 765 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD Anc ICU 765 of 765 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD R&B 765 of 765 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD R&B ICU 765 of 765 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt Phys 1 8369 of 8369 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt Phys 3 275 of 275 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac 1 8472 of 8472 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac 2 3 of 3 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac/Phys 1 5349 of 5349 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt PD PHosp 1 of 1 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Phys 1 6741 of 6741 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Phys 3 225 of 225 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Fac 1 7825 of 7825 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Fac 2 3 of 3 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Fac/Phys 1 3584 of 3584 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF PD INC 2 of 2 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Phys 1 8385 of 8385 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Phys 3 275 of 275 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Any provider-based division that provides Outpatient Care only should result in a summary with the following counts: IBCR UPLOAD RC 552GA MIDDLETOWN VA CLINIC, OH Count = 20796 IB Upload RC v4.235 552GA MIDDLETOWN VA CLINIC, OH, 12/28/22@11:02 by XXXX,XXXXX Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 Opt Fac 1 CPT 8472 RC-OPT FAC PR 552GA 2 Opt Fac 2 CPT 3 RC-OPT FAC HR 552GA 3 Opt Fac 4 CPT 5 RC-OPT FAC ML 552GA 4 Opt Fac/Phys 1 CPT 5349 RC-OPT FAC PR 552GA 5 Opt PD PHosp MISCE 1 RC-OPT MISC 552GA 6 Opt Phys 1 CPT 6741 RC-PHYSICIAN OPT PR 552GA 7 Opt Phys 3 CPT 225 RC-PHYSICIAN OPT MN 552GA IBCR UPLOAD RC 552GA MIDDLETOWN VA CLINIC, OH Opt Fac 1 8472 of 8472 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac 2 3 of 3 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac/Phys 1 5349 of 5349 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt PD PHosp 1 of 1 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Phys 1 6741 of 6741 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Phys 3 225 of 225 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Optional - Once this patch has been successfully installed you may delete the post init routines: IBYP755. Back-Out/Roll Back Plan: ------------------------ This patch for the selection of Reasonable Charges version 4.235 can be backed out by installing the routines/packman message created from the installation instruction, Step 2.B. Backup a Transport Global. If any Reasonable Charges 4.23 were not inactivated successfully, please contact Help desk to log a ticket for assistance. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 4 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBCRHBRV Before: B56022854 After: B56451046 **148,169,245,270,285,298,325, 334,355,360,365,382,390,408, 412,423,427,439,445,462,468, 484,491,508,520,536,542,556, 559,573,584,600,612,628,634, 658,667,683,693,719,724,744, 755** Routine Name: IBYP755 Before: n/a After: B5939463 **755** Routine list of preceding patches: 744 ============================================================================= User Information: Entered By : Date Entered : DEC 06, 2022 Completed By: Date Completed: FEB 07, 2023 Released By : Date Released : FEB 07, 2023 ============================================================================= Packman Mail Message: ===================== $END TXT