$TXT Created by BOWEN,MARY JANE at MNTVBB.FO-ALBANY.MED.VA.GOV (KIDS) on Monday, 11/02/09 at 12:48 ============================================================================= Run Date: NOV 09, 2009 Designation: ICD*18*45 Package : ICD - DRG GROUPER Priority: Mandatory Version : 18 SEQ #43 Status: Released Compliance Date: NOV 14, 2009 ============================================================================= Associated patches: (v)ICD*18*43 <<= must be installed BEFORE `ICD*18*45' (v)LEX*2*67 <<= must be installed BEFORE `ICD*18*45' Subject: ANNUAL DRG GROUPER UPDATE FY10 Category: - Routine - Other - Enhancement (Mandatory) Description: ============ This patch provides the annual update to the MS-DRG Grouper v27.0. It is the second phase of the FY 2010 ICD/DRG Update and is the follow up to patch LEX*2.0*67 and ICD*18.0*44. No code files are included in the patch, as all changes are handled programmatically by the pre-init routines ICD1845*. This patch also corrects Grouper Calculation errors. ************************************************************************* **NOTE: Please take note of the shortened compliance date. The changes ** **included in this patch are effective 10/1/09 per the Federal Register** **Vol. 74. 165, dated August 27, 2009. ** ************************************************************************* ASSOCIATED REMEDY TICKETS: ========================== 1) HD0000000335836 - Annual Update to DRG Grouper 2) HD0000000346713 - VistA DRG and QuadraMed DRG do not match 3) HD0000000349036 - Incorrect crossover 4) HD0000000348907 - Incorrect grouping - DRG456 shows as 490 in Vista 5) HD0000000349191 - 099 crossing over to 23 ASSOCIATED NSRs: ================ N/A PARTICIPATING TEST SITES: ========================= Montana HCS Portland, OR. Bay Pines, FL. REMEDY OVERVIEW: ================ 1) HD0000000335836 - Annual Update to DRG Grouper The changes were published in the Federal Register, Vol. 74, No. 165, dated August 27, 2009 with an effective date of October 1, 2009. All page references below are to this issue. Changes include: I. New/inactivated/revised DRGs. II. Revised DRG relative weights & average length of stay (ALOS) values for all DRGs. III. Additional DRG-related data for the new ICD codes introduced by LEX*2.0*67 and ICD*18*44. IV. DRG Reclassification changes to the Grouper. This is a summary of the additions/changes made: I. Routine ICD1845A was written to update the DRG file #80.2: NEW DRG FOR FY10 ---------------- NO NEW DRG CODES FOR FY10 REVISED DRG descriptions (titles) for FY 2010 --------------------------------------------- NO REVISED DRG DESCRIPTIONS FOR FY10 II. Routine ICD1845A will also be used to update the finalized values for DRG relative weights and average length of stay (ALOS). III. Additional DRG-related values were taken from these Tables: Table 6A for 157 new diagnoses Table 6B for 27 new procedures Routine ICD1845B incorporated these values in the following fields in ICD Diagnosis file #80: Identifier (#2) as needed Major Diagnostic Category (#5) DRG Grouper Effective Date (#71) and its sub-file MDC Effective Date (#72) Routine ICD1845C incorporated these values in the following fields in ICD Operation/Procedure file #80.1: Identifier (#2) as needed DRG Grouper Effective Date (#71) and its sub-files Routines ICDDRG0 and ICDTBL0B-9B were added/modified to complete the proper grouping of these new diagnoses and procedures. IV. DRG RECLASSIFICATION. Changes to other DRGs: ---------------------- 1. MDC 8 (p.43787) a. Procedure codes 80.05 and 80.06 reassigned from DRGs 480, 481, and 482 and 495, 496, and 497 and assign them to MS DRGs 463, 464, and 465. Routine changed: ICDTBL4B. ICD1845D will add the new DRGs to the procedure codes for FY10. 2. Surgical Hierarchies a. Ranking of surgical DRGs has changed as follows: NO CHANGES TO SURGICAL HIERARCHIES FOR FY10 2) HD0000000346713 - VistA DRG and QuadraMed DRG do not match Problem: ======== DRG in Vista shows 286, should be 981. Solution: ========= Operation codes weren't looked at when determining the correct code to use. ICDTBL2A has been corrected. 3) HD0000000349036 - Incorrect crossover Problem: ======== DRG in Vista shows 282, should be 281. Solution: ========= ICDTBL2A was changed to check for secondary diagnosis that are not cardiac diagnosis codes before determining whether the code used should be a CC/MCC or Non CC/MCC. 4) HD0000000348907 - Incorrect grouping - DRG456 shows as 490 in Vista Problem: ======== DRG in Vista shows 490, should be 456. Solution: ========= ICDTBL4A was changed to look for identifier of 6 to show that the codes should be grouped to the spinal DRG. 5) HD0000000349191 - 099 crossing over to 23 Problem: ======== DRG in Vista shows 23, should be 99 Solution: ========= ICDTBL0A changed to look for identifier "k" for infection to group correctly. INSTALLATION INSTRUCTIONS: ========================== NOTE: Please do not forget to do step 6. This is a very important step as it updates/recalculates the transfer DRGs for PTF records opened during the current fiscal year. This patch can be loaded with users on the system. However, it would be preferable if Medical Records coders were off the system. Install Time - 5 to 10 minutes. Please ensure that your programming variables are set, including your DUZ(0)="@", otherwise installation will abort. This patch does not involve global file restoration. Nonetheless, we suggest you create global saves on files #80 (^ICD9), #80.1 (^ICD0) and #80.2 (^ICD) in the event problems develop during the install. If it became necessary to use the saved files, you should first kill all the records (except the zero node) before applying the global restores. 1. From the Kernel Installation and Distribution System Menu, select the Installation menu. 2. From this menu, you may elect to use the following options: (when prompted for INSTALL NAME, enter ICD*18.0*45) a. Backup a Transport Global - this option will create a backup message of any routines exported with the patch. It will NOT backup any other changes such as DDs or templates. b. Compare Transport Global to Current System - this option will allow you to view all changes that will be made when the patch is installed. It compares all components of the patch (routines, DDs, templates, etc.). c. Verify Checksums in Transport Global - this option will allow you to ensure the integrity of the routines that are in the transport global. d. Print Transport Global - this option will allow you to view the components of the KIDS build. 3. Use the Install Package(s) option and select the package ICD*18.0*45. 4. When prompted, 'Want KIDS to INHIBIT LOGONs during the install? NO//', respond NO 5. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', respond NO. 6. Following installation of this patch, it is necessary to run the [DG PTF UPDATE TRANSFER DRGs] option in order to make the transfer DRGs correspond to the appropriate grouper. This option updates/recalculates the transfer DRGs for PTF records opened during the current fiscal year. The option is locked with the DG PTFSUP security key. The Menu path is PTF Menu/Update DRG Information Menu/Update Transfer DRGs for current FY. 7. All routines ICD1845* can be deleted after the patch has been successfully installed. Routine Information: ==================== The second line of each of these routines now looks like: ;;18.0;DRG Grouper;**[Patch List]**;Oct 13, 2000;Build 14 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ICD1845A Before: n/a After: B66932713 **45** Routine Name: ICD1845B Before: n/a After: B32787351 **45** Routine Name: ICD1845C Before: n/a After: B9553553 **45** Routine Name: ICD1845D Before: n/a After: B7504397 **45** Routine Name: ICD1845E Before: n/a After: B6002371 **45** Routine Name: ICD1845F Before: n/a After: B59852067 **45** Routine Name: ICD1845G Before: n/a After: B60771715 **45** Routine Name: ICD1845H Before: n/a After: B62530797 **45** Routine Name: ICD1845I Before: n/a After: B60140189 **45** Routine Name: ICD1845J Before: n/a After: B62823823 **45** Routine Name: ICD1845K Before: n/a After: B66536058 **45** Routine Name: ICD1845L Before: n/a After: B3025509 **45** Routine Name: ICD1845P Before: n/a After: B653822 **45** Routine Name: ICDDRG0 Before: B60779119 After: B60779203 **1,2,7,10,14,17,20,24,27,30, 31,32,33,37,45** Routine Name: ICDTBL0A Before: B15517370 After: B15755895 **37,34,43,45** Routine Name: ICDTBL0B Before: n/a After: B15755904 **45** Routine Name: ICDTBL1B Before: n/a After: B6090903 **45** Routine Name: ICDTBL2A Before: B40060685 After: B45856405 **37,34,42,43,45** Routine Name: ICDTBL2B Before: n/a After: B45856686 **45** Routine Name: ICDTBL3B Before: n/a After: B7476997 **45** Routine Name: ICDTBL4A Before: B22524574 After: B23242140 **37,43,45** Routine Name: ICDTBL4B Before: n/a After: B23307720 **45** Routine Name: ICDTBL5B Before: n/a After: B6476038 **45** Routine Name: ICDTBL6B Before: n/a After: B8528284 **45** Routine Name: ICDTBL7B Before: n/a After: B14033270 **45** Routine Name: ICDTBL8A Before: B18587794 After: B19006556 **37,34,43,45** Routine Name: ICDTBL8B Before: n/a After: B18587720 **45** Routine Name: ICDTBL9B Before: n/a After: B4358416 **45** Routine list of preceding patches: 43 ============================================================================= User Information: Entered By : BOWEN,MARY JANE Date Entered : JUL 27, 2009 Completed By: SESSLER,APRIL Date Completed: NOV 06, 2009 Released By : HOLMES,MARY Date Released : NOV 09, 2009 ============================================================================= Packman Mail Message: ===================== $END TXT