============================================================================= Run Date: APR 04, 2024 Designation: IB*2*789 Package : IB - INTEGRATED BILLING Priority: EMERGENCY Version : 2 SEQ #719 Status: Released Compliance Date: APR 08, 2024 ============================================================================= Associated patches: (v)IB*2*783 <<= must be installed BEFORE `IB*2*789' Subject: REASONABLE CHARGES V5.24 CY24 RELOAD Category: - Other Description: ============ ************************************************************************** NOTE: This patch is being released as an Emergency Patch with a shortened compliance period. ************************************************************************** IB*2.0*789 addresses the following ticket: INC31536635 - Reasonable Charges V5.24 Reload Missing CPT Codes A Lexicon patch deleted CPT codes by mistake causing charges to be removed. Recently another Lexicon patch was completed as an emergency patch to add those codes back in. These ten (10) high usage charge codes need to be reloaded and updated within Reasonable Charges version 5.24 with an effective date of 01/01/24. The Reasonable Charges v5.24 Reload is accomplished as follows: Reload the Reasonable Charges v5.24 charges using an updated host file containing the missing charges. This will load the ten (10) missing charges with an effective date of 01/01/24. All other charges will be flagged as duplicates and will not be reloaded. Only the ten (10) missing charges will be loaded. PLEASE NOTE: It is recommended that you install the Lexicon Utility patch LEX*2.0*148 - CODE SET FY24 2ND QTR INTERIM UPDATE and the DRG Grouper Update ICD*18*115 - FY2024 ANNUAL DRG GROUPER UPDATE, before IB*2.0*789 install. ************************************************************************* 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. INC31536635 - Reasonable Charges V5.24 Reload Missing CPT Codes Problem: -------- A Lexicon patch deleted CPT codes by mistake causing charges to be removed. Recently another Lexicon patch was completed as an emergency patch to add those codes back in. These ten (10) high usage charge codes need to be reloaded and updated within Reasonable Charges version 5.24 with an effective date of 01/01/24. Resolution ----------- This patch loads the Ten (10) missing Version 5.24 Reasonable Charges with an effective date of 01/01/24 on your system when the charges are uploaded. Ten (10) Missing Codes to be Added: CPT Code -------- 90480 91318 91319 91320 91321 91322 90678 90679 90380 90381 Routines: None New Host File: IBRC2401B.TXT Test Sites: ----------- VA Connecticut Health Care System (West Haven, Newington),CTVISN 2 - VISN 2 - Upstate New York Health Care System (Buffalo, Batavia,Canandaigua, Syracuse, Bath, Albany),NY SNOW Change Order #: -------------------------------- Connecticut - CHG0465223 VISN 2 - CHG0465224 Software and Documentation Retrieval Instructions: -------------------------------------------------- The revised file for this patch is being released as a host file. 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 v5.24 Host Files, effective 01/01/24: (ASCII) IBRC2401A.TXT Inpatient Facility Charges (DRG) IBRC2401B.TXT Facility Charge (CPT) IBRC2401C.TXT Physician Charges (CPT) IBRC2401D.TXT Service Category Codes IBRC2401E.TXT Area Factors IBRC2401F.TXT Site Identification Patch Installation: Pre/Post Installation Overview: ------------------------------- 1. Reloading the Reasonable Charges v5.24 charges with the new Host File (IBRC2401B.TXT). This will reload v5.24 charges, loading the missing charges with an effective date of 01/01/24 (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 Install. Other Vista users will not be affected. Select OPTION NAME: TOGGLE OPTIONS/PROTOCOLS ON AN XQOOTOG Toggle options/p rotocols on and off Toggle options/protocols on and off Enter the name or menu text of an option: Enter/Edit Billing InformatION IB EDI T BILLING INFO Enter/Edit Billing Information Enter a message to put this option out of order: Patch install IB*2.0*789 Enter the name or menu text of an option: Enter/Edit Charge MaSTER IBCR DISPLAY CHARGE MASTER Enter/Edit Charge Master Enter a message to put this option out of order: Patch install IB*2.0*789 Install time for uploading the Charge Master with the new RC v5.24 missing charges will vary from site to site depending on the size of the CHARGE ITEM (#363.2) file and will take additional time per division. Installation Instructions: -------------------------- UPLOAD REASONABLE CHARGES V5.24 -------------------------------- Follow instructions below: RC v5.24 Upload Instructions ********************** RC v5.24 Upload Instructions ********************** The Reasonable Charges v5.24 charges will need to be reloaded 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 v5.24 Host Files, effective 01/01/24: (ASCII) IBRC2401A.TXT Inpatient Facility Charges (DRG) IBRC2401B.TXT Facility Charge (CPT) IBRC2401C.TXT Physician Charges (CPT) IBRC2401D.TXT Service Category Codes IBRC2401E.TXT Area Factors IBRC2401F.TXT Site Identification Upload Instructions: ==================== Step 1: Get Host Files ----------------------- Retrieve the 6 Reasonable Charges v5.24 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 5.24 - When loading Reasonable Charges v5.24 the IBRC2401x.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 Yes, even if the files are IBRC2401x.TXT since these are the files for v5.24 that are being reloaded, they may be re-used for multiple divisions after reloaded. - 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 v5.24 Reload 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: ------------------------------------------------------------------------ IBRC2401A.TXT RC v5.24 Host File Upload, 3/12/24@23:11 by XXXX,XXXX 765 IBRC2401B.TXT RC v5.24 Host File Upload, 3/12/24@23:11 by XXXX,XXXX 8686 IBRC2401C.TXT RC v5.24 Host File Upload, 3/12/24@23:11 by XXXX,XXXX 17853 IBRC2401D.TXT RC v5.24 Host File Upload, 3/12/24@23:11 by XXXX,XXXX 30 IBRC2401E.TXT RC v5.24 Host File Upload, 3/12/24@23:11 by XXXX,XXXX 917 IBRC2401F.TXT RC v5.24 Host File Upload, 3/12/24@23:11 by XXXX,XXXX 1536 Any division that provides Inpatient Care should result in a summary with the following counts: IBCR UPLOAD RC 552 DAYTON VA MEDICAL CENTER, OH Count = 56486 IB Upload RC v5.24 552 DAYTON VA MEDICAL CENTER, OH, 3/12/24@23:14 by XXXX, XXXXX X Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 Inpt Fac 1 CPT 92 RC-INPT FAC PR 552 2 Inpt Fac 2 CPT 3 RC-INPT FAC HR 552 3 Inpt Fac 4 CPT 5 RC-INPT FAC ML 552 4 Inpt Fac/Phys 1 CPT 2888 RC-INPT FAC PR 552 5 Inpt PD Anc DRG 764 RC-INPT ANC 552 6 Inpt PD Anc ICU DRG 764 RC-INPT ANC ICU 552 7 Inpt PD R&B DRG 764 RC-INPT R&B 552 8 Inpt PD R&B ICU DRG 764 RC-INPT R&B ICU 552 9 Inpt Phys 1 CPT 8492 RC-PHYSICIAN INPT PR 552 10 Inpt Phys 3 CPT 275 RC-PHYSICIAN INPT MN 552 11 Opt Fac 1 CPT 8677 RC-OPT FAC PR 552 12 Opt Fac 2 CPT 3 RC-OPT FAC HR 552 13 Opt Fac 4 CPT 5 RC-OPT FAC ML 552 14 Opt Fac/Phys 1 CPT 5504 RC-OPT FAC PR 552 15 Opt PD PHosp MISCE 1 RC-OPT MISC 552 16 Opt Phys 1 CPT 6857 RC-PHYSICIAN OPT PR 552 17 Opt Phys 3 CPT 225 RC-PHYSICIAN OPT MN 552 18 SNF Fac 1 CPT 7906 RC-SNF FAC PR 552 19 SNF Fac 2 CPT 3 RC-SNF FAC HR 552 20 SNF Fac 4 CPT 5 RC-SNF FAC ML 552 21 SNF Fac/Phys 1 CPT 3704 RC-SNF FAC PR 552 22 SNF PD INC BEDSE 2 RC-SNF INC 552 23 SNF Phys 1 CPT 8508 RC-PHYSICIAN SNF PR 552 24 SNF Phys 3 CPT 275 RC-PHYSICIAN SNF MN 552 IBCR UPLOAD RC 552 DAYTON VA MEDICAL CENTER, OH Inpt Fac 1 92 of 92 records checked, 92 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt Fac 2 3 of 3 records checked, 3 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 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. Inpt Fac/Phys 1 2888 of 2888 records checked, 2888 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD Anc 764 of 764 records checked, 764 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD Anc ICU 764 of 764 records checked, 764 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD R&B 764 of 764 records checked, 764 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD R&B ICU 764 of 764 records checked, 764 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt Phys 1 8492 of 8492 records checked, 8492 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt Phys 3 275 of 275 records checked, 275 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac 1 8677 of 8677 records checked, 8667 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac 2 3 of 3 records checked, 3 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 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. Opt Fac/Phys 1 5504 of 5504 records checked, 5504 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 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. Opt Phys 1 6857 of 6857 records checked, 6857 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Phys 3 225 of 225 records checked, 225 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Fac 1 7906 of 7906 records checked, 7896 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Fac 2 3 of 3 records checked, 3 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 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. SNF Fac/Phys 1 3704 of 3704 records checked, 3704 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 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. SNF Phys 1 8508 of 8508 records checked, 8508 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Phys 3 275 of 275 records checked, 275 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 = 21272 IB Upload RC v5.24 552GA MIDDLETOWN VA CLINIC, OH, 3/12/24@23:26 by XXXX, XX XXX X Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 Opt Fac 1 CPT 8677 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 5504 RC-OPT FAC PR 552GA 5 Opt PD PHosp MISCE 1 RC-OPT MISC 552GA 6 Opt Phys 1 CPT 6857 RC-PHYSICIAN OPT PR 552GA 7 Opt Phys 3 CPT 225 RC-PHYSICIAN OPT MN 552GA IB Upload Data Validity Check on Temporary files 3/12/ 24@23:28:40 Page 1 -------------------------------------------------------------------------- ------ ------------------- IBCR UPLOAD RC 552GA MIDDLETOWN VA CLINIC, OH Opt Fac 1 8677 of 8677 records checked, 8667 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac 2 3 of 3 records checked, 3 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 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. Opt Fac/Phys 1 5504 of 5504 records checked, 5504 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 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. Opt Phys 1 6857 of 6857 records checked, 6857 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Phys 3 225 of 225 records checked, 225 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Post-Installation Instructions: ------------------------------ 1. Re-enable the following options if disabled prior to install: Select OPTION NAME: TOGGLE OPTIONS/PROTOCOLS ON AN XQOOTOG Toggle options/p rotocols on and off Toggle options/protocols on and off Enter the name or menu text of an option: Enter/Edit Billing InfORMATION IB EDI T BILLING INFO Enter/Edit Billing Information Option IB EDIT BILLING INFO is out with the message 'Remove it from use' Put it in service? YES// YES Enter the name or menu text of an option: Enter/Edit Charge MaSTER IBCR DISPLAY CHARGE MASTER Enter/Edit Charge Master Option IBCR DISPLAY CHARGE MASTER is out with the message 'Remove it from use' Put it in service? YES// YES 2. Mark Non-Kids Patch Install Complete Select Kernel Installation & Distribution System Option: patch Monitor Main Menu 1 Patch Processing ... 2 Patch Reports ... 3 Patch Monitor Management ... Select Patch Monitor Main Menu Option: 1 Patch Processing 1 Patch Inquiry 2 Edit Patch Information 3 Mark a Non-Kids Patch as Complete Select Patch Processing Option: 3 Mark a Non-Kids Patch as Complete Select PATCH MONITOR PATCH NAME: DATE COMPLETED: NON-KIDS PATCH COMPLETED BY: Back-Out/Roll Back Plan: ----------------------- In the event that the patch installer decides to back out this patch, the patch installer should log a Service Now ticket or contact the Enterprise Service Desk (ESD) at 855-673-4357. Backout or rollback of the software will be a joint decision between the development team, VA Routine Information: ==================== No routines included. ============================================================================= User Information: Entered By : Date Entered : FEB 27, 2024 Completed By: Date Completed: APR 04, 2024 Released By : Date Released : APR 04, 2024 ============================================================================= Packman Mail Message: ===================== No routines included