$TXT Created by BOWEN,MARY JANE at MNTVBB.FO-ALBANY.MED.VA.GOV (KIDS) on Tuesday, 02/23/10 at 08:51 ============================================================================= Run Date: MAY 25, 2010 Designation: ICD*18*46 Package : ICD - DRG GROUPER Priority: Mandatory Version : 18 SEQ #45 Status: Released Compliance Date: JUN 25, 2010 ============================================================================= Associated patches: (v)ICD*18*45 <<= must be installed BEFORE `ICD*18*46' Subject: VARIOUS DRG GROUPER FIXES Category: - Routine Description: ============ The DRG (Diagnostic Related Group) Grouper is used to compute and display the DRG for a patient based on that patient's diagnoses and any operations/procedures performed. It uses a mixture of formulas, Diagnosis and Operation identifiers, and tables that rely on data added to the DRG (#80.2) file, the ICD DIAGNOSIS (#80) file and the ICD OPERATION/PROCEDURE (#80.1) file. These files, along with the date and the age of the patient, determine the codes and other information needed to pass into the formulas and tables used in those formulas to calculate the DRG. These codes and the DRG codes come from the Federal Register for Centers for Medicare and Medicaid Services (CMS) and are updated and added to yearly effective October 1 of each year. This patch corrects various DRG calculations. ASSOCIATED REMEDY TICKETS: ========================== 1) HD0000000354584 - DRGs not calculating correctly DUPLICATES: ========== HD0000000355251- DRG grouper Issue HD0000000373260- Principal Diagnosis of 730.28 crosses to DRG 547/sb DRG 540 HD0000000379217- coding mismatches HD0000000380542- Incorrect DRG (439-440) reported in Vista: 2) HD0000000351218- DRG's incorrect 3) HD0000000358660- VISTA DRG's calculating is incorrect. 4) HD0000000363291- incorrect DRG since patch 145 for DRG 844/847 5) HD0000000362752- Vista DRG's 422 is incorrect 6) HD0000000377980- Incorrect Calculation DUPLICATES: ========== HD0000000369592- Incorrect crossover HD0000000387694- VISTA is calculating the DRG incorrectly HD0000000389644- DRG not matching 440/438 and 460/540 7) HD0000000361653- VistA DRG 291 incorrect using 402.91 ASSOCIATED NSR(s): ================= N/A PARTICIPATING TEST SITES: ========================= Upstate NY HCS Ann Arbor, MI Louisville, KY Portland, OR Fargo, ND REMEDY OVERVIEW: ================ 1) HD0000000354584 - DRGs not calculating correctly Problem: ======== a) DRG calculating incorrectly in Vista as 66 instead of 64 b) DRG calculating incorrectly in Vista as 457 instead of 540 Solution: ========= a) Changed table routine ICDTBL0B to look for operation identifier to point to the correct DRG code. b) Changed table routine ICDTBL4B to look for operation identifier to point to the correct DRG code. 2) HD0000000351218- DRG's incorrect Problem: =========== DRG calculating incorrectly in Vista as 293 instead of 262 Solution: ============ Changed table routine ICDTBL2A AND ICDTBL2B to look for operation identifier to point to the correct DRG code. 3)HD0000000358660- VISTA DRG's calculating is incorrect. Problem: =========== DRG calculating incorrectly in Vista as 230 instead of 221 Solution: ============ Changed table routine ICDTBL2B to look for valve procedure code (35.33) to point to the correct DRG. 4)HD0000000363291- incorrect DRG since patch 145 for DRG 844/847 Problem: =========== DRG calculating incorrectly in Vista as 844 instead of 847 Solution: ============ Changed table routine ICDTBL8B to go to DRG 846 for verification if no operation procedures. 5)HD0000000362752- Vista DRG's 422 is incorrect Problem: =========== DRG calculating incorrectly in Vista as 422 instead of 410 Solution: ============ Add bile duct identifier to procedure code 51.42 in the ICD OPERATION/PROCEDURE (# 80.1) file. 6)HD0000000377980- Incorrect Calculation Problem: =========== DRG calculating incorrectly in Vista as 440 instead of 438 Solution: ============ Changed table routine ICDTBL4B to look for an operation identifier to point to the correct DRG code. 7)HD0000000361653- VistA DRG 291 incorrect using 402.91 Problem: =========== DRG calculating incorrectly in Vista as 292 instead of 291 Solution: ============ Changed table routine ICDTBL2B to check for existence of ICD codes 402.91 and 428.33 to verify Major Complicating Condition (MCC). INSTALLATION INSTRUCTIONS: =========================== This patch may be run with users on the system. However, it would be preferable if Medical Records coders were off the system. Installation will take less than 5 minutes. 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu to unload the KIDS distribution included with this message. NOTE: If the required patches are not installed, the transport global will be removed. If the transport global is removed you will need to repeat this step. 2. From the Kernel Installation and Distribution System Menu, select the Installation menu. 3. From this menu, you may elect to use the following options (when prompted for INSTALL NAME, enter ICD*18.0*46): a. 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.). b. Verify Checksums in Transport Global - this option will allow you to ensure the integrity of the routines that are in the transport global. c. Print Transport Global - this option will allow you to view the components of the KIDS build. d. Backup a Transport Global - This option will create a backup message of any routines exported with this patch. It will not backup any other changes such as DD's or templates. 4. Use the Install Package(s) option and select the package ICD*18.0*46. 5. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', respond NO. 6. When prompted,'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond Yes. When prompted,'Enter options you wish to mark as 'Out Of Order':', enter: PTF Menu [DG PTF MENU] When prompted,'Enter protocols you wish to mark as 'Out Of Order':', press enter. 7. Routines ICD1846* can be deleted after the patch has been successfully installed. 8. 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 (since 10/1/2009). 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. Routine Information: ==================== The second line of each of these routines now looks like: ;;18.0;DRG Grouper;**[Patch List]**;Oct 13,2000;Build 5 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ICD1846P Before: n/a After: B362772 **46** Routine Name: ICD1846Y Before: n/a After: B6110729 **46** Routine Name: ICDTBL0A Before: B15755895 After: B16182016 **37,34,43,45,46** Routine Name: ICDTBL0B Before: B15755904 After: B16180073 **45,46** Routine Name: ICDTBL2A Before: B45856405 After: B46981794 **37,34,42,43,45,46** Routine Name: ICDTBL2B Before: B45856686 After: B47636914 **45,46** Routine Name: ICDTBL4A Before: B23242140 After: B23890903 **37,43,45,46** Routine Name: ICDTBL4B Before: B23307720 After: B24401510 **45,46** Routine Name: ICDTBL8A Before: B19006556 After: B19162805 **37,34,43,45,46** Routine Name: ICDTBL8B Before: B18587720 After: B18743969 **45,46** Routine list of preceding patches: 45 ============================================================================= User Information: Entered By : BOWEN,MARY JANE Date Entered : DEC 02, 2009 Completed By: TSAIMEUCHONG,BRENDA Date Completed: MAY 07, 2010 Released By : HOLMES,MARY Date Released : MAY 25, 2010 ============================================================================= Packman Mail Message: ===================== $END TXT