$TXT Created by at MNTVBB.DOMAIN.EXT (KIDS) on Monday, 12/09/24 at 12:42 ============================================================================= Run Date: JAN 15, 2025 Designation: IB*2*809 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #734 Status: Released Compliance Date: JAN 23, 2025 ============================================================================= Associated patches: (v)IB*2*783 <<= must be installed BEFORE `IB*2*809' Subject: FY25 REASONABLE CHARGES UPDATE Category: - Routine - Other Description: ============ ************************************************************************** NOTE: This patch is being released with a shortened compliance date of 7 days. ************************************************************************** Implementation of Reasonable Charges v5.241 is a two-step process: 1. Installation of this patch. This will inactivate Reasonable Charges v5.24 charges with an inactive date of 09/30/24. (See Installation Instructions.) 2. Uploading the Reasonable Charges v5.241 charges. This will load new charges with an effective date of 10/01/24 and needs to be done immediately after the patch install. (See Upload Instructions.) PLEASE NOTE: It is highly recommended that you install the Lexicon Utility patch LEX*2.0*151 - CODE SET FY25 1ST QTR UPDATE and the DRG Grouper Update ICD*18*120 - FY25 ANNUAL DRG GROUPER UPDATE before IB*2.0*809 install. Failure to install these patches may require uploading and installing Reasonable Charges twice. ************************************************************************** Reasonable Charges version 5.241 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 v5.241 charges are uploaded (step 2 in Installation Overview). This version of Reasonable Charges implements the following charge changes: Effective Date of Reasonable Charges v5.241 is 10/01/24. Inactive Date of Reasonable Charges v5.24 is 09/30/24. Reasonable Charges v5.24 loaded on your system will be inactivated with an inactivation date of 09/30/24 when this patch is installed. Reasonable Charges v5.241 with an effective date of 10/01/24 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. INC36378621 - Initiate IB Charge Update Outpatient/Inpatient Patch V5.241 for FY25 in VistA Problem: -------- Changes in the national Diagnosis Related Group (DRG) 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, IBYP809 Technical Description ===================== This patch exports 2 routines, one of which is the post-init (IBYP809). The post-init routine will inactivate all existing Reasonable Charges defined in the Charge Master. Reasonable Charges v5.24 will be inactivated with an inactivation date of 09/30/24 when the patch is installed. The following is an example of the post-init portion of the installation: Running Post-Install Routine: POST^IBYP809 Reasonable Charges v5.241 Post-Install ..... >> Inactivating Existing Reasonable Charges, Please Wait... Done. 330043 existing charges inactivated Reasonable Charges v5.241 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: ----------- Connecticut HCS VISN 2 (Upstate New York) SNOW Change Order #: -------------------------------- Connecticut HCS - CHG0555291 VISN 2 (Upstate New York) - CHG0554992 Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. This release also includes other software files. 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. Other Software Files: File Title File Name Format --------------------------------------------------------------------- Inpatient Facility Charges (DRG) IBRC2410A.TXT ASCII Facility Charge (CPT) IBRC2410B.TXT ASCII Physician Charges (CPT) IBRC2410C.TXT ASCII Service Category Codes IBRC2410D.TXT ASCII Area Factors IBRC2410E.TXT ASCII Site Identification IBRC2410F.TXT ASCII Patch Installation: Pre/Post Installation Overview: ------------------------------- 1. Installation of this patch will inactivate Reasonable Charges v5.24 charges with an inactive date of 09/30/24. (See Installation Instructions.) 2. Uploading the Reasonable Charges v5.241 charges. This will load new charges with an effective date of 10/01/24 and needs to be done immediately after the patch install. (See Upload Instructions.) (1) 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 v5.241 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*809. 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: Build 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*809. 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: (2) UPLOAD REASONABLE CHARGES V5.241 ------------------------------------ Follow instructions below: RC v5.241 Upload Instructions ********************** RC v5.241 Upload Instructions ******************** After patch installation, the Reasonable Charges v5.241 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 v5.241 Host Files, effective 10/01/24: (ASCII) IBRC2410A.TXT Inpatient Facility Charges (DRG) IBRC2410B.TXT Facility Charge (CPT) IBRC2410C.TXT Physician Charges (CPT) IBRC2410D.TXT Service Category Codes IBRC2410E.TXT Area Factors IBRC2410F.TXT Site Identification Upload Instructions: ==================== Step 1: Get Host Files ----------------------- Retrieve the 6 Reasonable Charges v5.241 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 5.241 - When loading Reasonable Charges v5.241 the IBRC2410x.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 IBRC2410x.TXT since these are the correct files for v5.241, 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. *** PLEASE NOTE *** Sites may see this error when uploading the reasonable charges. This error can be ignored. VA R&C published a National Interim Charge for CPT 90624 effective 10/1/2024 and distributed to the field in July 2024, however the CPT code 90624 was not effective until 10/1/2024 and was not available for loading the National Interim Charge when the field received the charge. It appears that some sites took the initiative to load the National Interim Charge for CPT 90624 effective 10/1/2024 which is causing the error. This is acceptable to ignore and okay to proceed with loading. Opt Fac 1 8724 of 8724 records checked, 8717 duplicates, 0 with $=0 1 line/data errors or warnings found for a .01% error rate. 15564 = 90624^3241001^^777.24^^ Line/Data Warning: Potential duplicate, a charge already exists for this item and effective date SNF Fac 1 7930 of 7930 records checked, 7923 duplicates, 0 with $=0 1 line/data errors or warnings found for a .01% error rate. 15563 = 90624^3241001^^777.24^^ Line/Data Warning: Potential duplicate, a charge already exists for this item and effective date ================= Reasonable Charges v5.241 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: ------------------------------------------------------------------------ IBRC2410A.TXT RC v5.241 Host File Upload, 12/11/24@11:22 by ROWE,DO 772 IBRC2410B.TXT RC v5.241 Host File Upload, 12/11/24@11:22 by ROWE,DO 8733 IBRC2410C.TXT RC v5.241 Host File Upload, 12/11/24@11:22 by ROWE,DO 17976 IBRC2410D.TXT RC v5.241 Host File Upload, 12/11/24@11:22 by ROWE,DO 30 IBRC2410E.TXT RC v5.241 Host File Upload, 12/11/24@11:22 by ROWE,DO 917 IBRC2410F.TXT RC v5.241 Host File Upload, 12/11/24@11:22 by ROWE,DO 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 = 56796 IB Upload RC v5.241 552 DAYTON VA MEDICAL CENTER, OH, 12/11/24@11:17 by 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 2911 RC-INPT FAC PR 552 5 Inpt PD Anc DRG 771 RC-INPT ANC 552 6 Inpt PD Anc ICU DRG 771 RC-INPT ANC ICU 552 7 Inpt PD R&B DRG 771 RC-INPT R&B 552 8 Inpt PD R&B ICU DRG 771 RC-INPT R&B ICU 552 9 Inpt Phys 1 CPT 8514 RC-PHYSICIAN INPT PR 552 10 Inpt Phys 3 CPT 275 RC-PHYSICIAN INPT MN 552 11 Opt Fac 1 CPT 8724 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 5595 RC-OPT FAC PR 552 15 Opt PD PHosp MISCE 1 RC-OPT MISC 552 16 Opt Phys 1 CPT 6875 RC-PHYSICIAN OPT PR 552 17 Opt Phys 3 CPT 225 RC-PHYSICIAN OPT MN 552 18 SNF Fac 1 CPT 7930 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 3739 RC-SNF FAC PR 552 22 SNF PD INC BEDSE 2 RC-SNF INC 552 23 SNF Phys 1 CPT 8530 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, 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 2911 of 2911 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD Anc 771 of 771 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD Anc ICU 771 of 771 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD R&B 771 of 771 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD R&B ICU 771 of 771 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt Phys 1 8514 of 8514 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 8724 of 8724 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 5595 of 5595 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 6875 of 6875 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 7930 of 7930 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 3739 of 3739 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 8530 of 8530 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 = 21428 IB Upload RC v5.241 552GA MIDDLETOWN VA CLINIC, OH, 12/11/24@11:22 by Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 Opt Fac 1 CPT 8724 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 5595 RC-OPT FAC PR 552GA 5 Opt PD PHosp MISCE 1 RC-OPT MISC 552GA 6 Opt Phys 1 CPT 6875 RC-PHYSICIAN OPT PR 552GA 7 Opt Phys 3 CPT 225 RC-PHYSICIAN OPT MN 552GA IB Upload Data Validity Check on Temporary files 12/11 /24@11:24:40 Page 1 -------------------------------------------------------------------------- ------ ------------------- IBCR UPLOAD RC 552GA MIDDLETOWN VA CLINIC, OH Opt Fac 1 8724 of 8724 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 5595 of 5595 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 6875 of 6875 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: IBYP809. Back-Out/Roll Back Plan: ------------------------ Due to the complexity of this patch, it is not recommended for back-out, and a restore from a backup of the Transport Global should not be attempted. 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 site/region personnel and other appropriate VA personnel and will require their concurrence. The development team will need to issue a follow-on patch in order to comprehensively back-out this patch. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 1 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBCRHBRV Before: B56871593 After: B57305217 **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, 755,783,809** Routine Name: IBYP809 Before: n/a After: B8424161 **809** Routine list of preceding patches: 783 ============================================================================= User Information: Entered By : Date Entered : NOV 19, 2024 Completed By: Date Completed: JAN 15, 2025 Released By : Date Released : JAN 15, 2025 ============================================================================= Packman Mail Message: ===================== $END TXT