$TXT Created by BOWEN,MARY JANE at MNTVBB.FO-ALBANY.MED.VA.GOV (KIDS) on Friday, 09/03/10 at 09:10 ============================================================================= Run Date: NOV 04, 2010 Designation: ICD*18*48 Package : ICD - DRG GROUPER Priority: Mandatory Version : 18 SEQ #47 Status: Released Compliance Date: DEC 05, 2010 ============================================================================= Associated patches: (v)ICD*18*42 <<= must be installed BEFORE `ICD*18*48' (v)ICD*18*46 <<= must be installed BEFORE `ICD*18*48' Subject: CORRECTIONS TO DRG CALCULATIONS 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. Per Federal guidelines DRGs are classified by principal diagnosis and up to eight additional diagnosis and up to six procedures performed during stay. It uses a mixture of formulas, Diagnosis and Operation identifiers, and tables that rely on data added to the DRG file (#80.2),the ICD DIAGNOSIS file (#80)and the ICD OPERATION/PROCEDURE file (#80.1). These files, the date and the age of the patient determine the codes and other information needed to pass into the formulas and the tables used in those formulas to calculate the DRG. These codes and the DRG codes come from the Federal Register for Center for Medicare and Medicaid Services (CMS) and are updated and added to yearly effective October 1 of the year. This patch corrects various DRG calculations. ASSOCIATED REMEDY TICKETS: ========================== 1) HD0000000383228-Calculations not Matching DUPLICATES: ========== HD0000000383902-DRG Mismatch 668 vs 670 and 65 vs 66 HD0000000396090-DRG not calculating correctly 669 vs 670 HD0000000418822-Vista calculating DRG incorrectly. DRG 669/670 2) HD0000000397928-DRG 064/66, 027/30, 459/490, 844/847 3) HD0000000425253-DRG correct in Quadramed, incorrect in VistA ASSOCIATED NSR's: ================= N/A PARTICIPATING TEST SITES: ========================= Louisville, KY Manchester, NH Upstate New York HCS REMEDY OVERVIEW: ================ 1) HD0000000383228-Calculations not Matching Problem: ======== a) DRG calculating incorrectly in Vista as 666 instead of 664 b) DRG calculating incorrectly in Vista as 309 instead of 310 c) DRG calculating incorrectly in Vista as 670 instead of 688 d) DRG calculating incorrectly in Vista as 023 instead of 098 e) DRG calculating incorrectly in Vista as 666 instead of 663 Solution: ========= a) Changed table routine ICDTBL6B to look for operation identifier to point to the correct DRG code. b) Changed table routine ICDTBL3B to look for operation identifier to point to the correct DRG code. c) Changed table routine ICDTBL6B to look for operation identifier to point to the correct DRG code. d) Changed table routine ICDTBL0B to look for operation identifier to point to the correct DRG code. e) Changed table routine ICDTBL6B to look for operation identifier to point to the correct DRG code. Also post install will add identifiers to diagnosis code 425.4, and to procedure codes 041.4 and 57.93. 2) HD0000000397928-DRG 064/66, 027/30, 459/490, 844/847 Problem: ======= a)DRG calculating incorrectly in Vista as 066 instead of 064 b)DRG calculating incorrectly in Vista as 030 instead of 027 c)DRG calculating incorrectly in Vista as 490 instead of 459 Solution: ========= a) Changed table routine ICDTBL0B to look for operation identifier to point to the correct DRG code. b) Remove major OR spine identifier from procedure code 86.94 c) Add identifier for operation codes 81.05 and 81.63 3) HD0000000425253-DRG correct in Quadramed, incorrect in VistA Problem: ======= DRG calculating incorrectly in Vista as 3 instead of 4 Solution: ======== Changed table routine ICDTBL0B to look for Major Operation variable to point to the correct DRG code. 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*48): 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*48. 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? NO//', 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 ICD1848* can be deleted after the patch has been successfully installed. 8. Following installation of this patch, it is necessary to run the Update Transfer DRGs for Current FY [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 17 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ICD1848L Before: n/a After: B3342324 **48** Routine Name: ICD1848P Before: n/a After: B553263 **48** Routine Name: ICD1848Y Before: n/a After: B8505442 **48** Routine Name: ICDTBL0A Before: B16182016 After: B16879268 **37,34,43,45,46,48** Routine Name: ICDTBL0B Before: B16180073 After: B17283241 **45,46,48** Routine Name: ICDTBL3A Before: B7476988 After: B7615481 **37,42,48** Routine Name: ICDTBL3B Before: B7476997 After: B7615490 **45,48** Routine Name: ICDTBL4A Before: B23890903 After: B24115998 **37,43,45,46,48** Routine Name: ICDTBL4B Before: B24401510 After: B24629645 **45,46,48** Routine Name: ICDTBL6A Before: B8528275 After: B9185370 **37,39,43,48** Routine Name: ICDTBL6B Before: B8528284 After: B9188579 **45,48** Routine list of preceding patches: 42, 46 ============================================================================= User Information: Entered By : BOWEN,MARY JANE Date Entered : MAY 03, 2010 Completed By: LEANORD,TATIANA Date Completed: NOV 04, 2010 Released By : HOLMES,MARY Date Released : NOV 04, 2010 ============================================================================= Packman Mail Message: ===================== $END TXT