$TXT Created by GILMORE,JEREMY at MNTVBB.FO-ALBANY.MED.VA.GOV (KIDS) on Monday, 10/31/11 at 10:06 ============================================================================= Run Date: NOV 28, 2011 Designation: ICD*18*56 Package : ICD - DRG GROUPER Priority: Mandatory Version : 18 SEQ #54 Status: Released Compliance Date: DEC 10, 2011 ============================================================================= Associated patches: (v)ICD*18*53 <<= must be installed BEFORE `ICD*18*56' (v)LEX*2*78 <<= must be installed BEFORE `ICD*18*56' Subject: ANNUAL DRG GROUPER UPDATE FY12 Category: - Routine - Other - Enhancement (Mandatory) Description: ============ This patch provides the annual update to the Medicare Severity Diagnosis Related Group (MS-DRG) Grouper v28.0. It is the second phase of the FY 2012 ICD/DRG Update and is the follow up to patch LEX*2.0*78. No code files are included in the patch, as all changes are handled programmatically by the pre-init routines ICD1856*. ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ PLEASE NOTE: It is HIGHLY recommended that you install LEX*2.0*78 prior to installing this patch. Otherwise, you will not be able to add the FY2012 DRG changes for the new diagnosis and procedure codes introduced with that patch without reloading the DRGs. Also, please take note of the shortened compliance date. The changes included in this patch were effective as of 10/1/11 per the Federal Register Vol. 76, No. 160, dated August 18, 2011. ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ASSOCIATED REMEDY TICKETS: ========================== 1) HD0000000483570 - FY12 ANNUAL GROUPER UPDATE ASSOCIATED NSRs: ================ N/A PARTICIPATING TEST SITES: ========================= Montana HCS Tampa, FL Upstate New York HCS REMEDY OVERVIEW: ================ 1) HD0000000483570 - FY12 ANNUAL GROUPER UPDATE The changes were published in the Federal Register, Vol. 76, No. 160, dated August 18, 2011 with an effective date of October 1, 2011. Resource documents can be found at http://www.cms.hhs.gov/ 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*78. IV. DRG Reclassification changes to the Grouper. This is a summary of the additions/changes made: I. Routine ICD1856A was written to update the DRG file (#80.2): NEW DRGs for FY 2012 -------------------- MS-DRG 016 (Autologous Bone Marrow Transplant with MCC/CC) MS-DRG 017 (Autologous Bone Marrow Transplant without MCC/CC) MS-DRG 570 (Skin Debridement with MCC) MS-DRG 571 (Skin Debridement with CC) MS-DRG 572 (Skin Debridement without CC/MCC) INACTIVATED DRGs for FY 2012 ---------------------------- DRG 015 Autologous Bone Marrow Transplant REVISED DRG descriptions (titles) for FY 2012 --------------------------------------------- MS-DRG 237 (Major Cardiovascular Procedures with MCC) MS-DRG 573 (Skin Graft for Skin Ulcer or Cellulitis with MCC) MS-DRG 574 (Skin Graft for Skin Ulcer or Cellulitis with CC) MS-DRG 575 (Skin Graft for Skin Ulcer or Cellulitis without CC/MCC) MS-DRG 576 (Skin Graft Except for Skin Ulcer or Cellulitis with MCC) MS-DRG 577 (Skin Graft except for Skin Ulcer or Cellulitis with CC) MS-DRG 578 (Skin Graft Except for Skin Ulcer or Cellulitis without CC/MCC) MS-DRG 640 (Miscellaneous Disorders of Nutrition, Metabolism, and Fluids and Electrolytes with MCC) MS-DRG 641 (Miscellaneous Disorders of Nutrition, Metabolism, and Fluids and Electrolytes without MCC) MS-DRG 642 (Inborn and Other Disorders of Metabolism) II. Routine ICD1856A 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 168 new diagnosis codes Table 6B for 19 new procedure codes Routine ICD1856B incorporated these values in the following fields of 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 ICD1856C incorporated these values in the following fields of ICD OPERATION/PROCEDURE file (#80.1): IDENTIFIER (#2) as needed DRG GROUPER EFFECTIVE DATE (#71) and its sub-files Routines ICDDRG0 and ICDTBL0D-9D were added/modified to complete the proper grouping of these new diagnoses and procedures. IV. DRG RECLASSIFICATION. Changes to other DRGs: --------------------- 1. PRE MDC (p.51525) a. Effective 10/1/2011 new DRGs 016 and 017 will replace DRG 015, which will be inactivated. 2. MDC1 (p.51526) a. Effective 10/1/2011 procedure codes 02.93 and 86.98 will be assigned to DRG023 and DRG024. 3. MDC5 (p.51529) a. Effective 10/1/2011 procedure codes 38.45 and 39.73 will be assigned to DRGs 216, 217, 218, 219, 220, and 221. 4. MDC9 (p.51536) a. Effective 10/1/2011 Procedure code 86.22 will be assigned to DRGs 570 through 572. Routine changes for 1 - 4: ICD1856E will change DRGs using the procedure codes for FY2012. 5. Surgical Hierarchies (P.51541) a. Ranking of surgical DRGs has changed as follows: PRE MDC - DRG016 and DRG017 above DRG010 MDC9 - DRG578 above DRG570 - DRG570 above DRG571 - DRG571 above DRG572 - DRG572 above DRG579 Routines changed: ICDDRG1, ICDDRG9 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 Patient Treatment File (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. 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*56) 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*56. 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? 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. 6. 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. 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 beginning with ICD1856* 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 18 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ICD1856A Before: n/a After: B66606503 **56** Routine Name: ICD1856B Before: n/a After: B39852167 **56** Routine Name: ICD1856C Before: n/a After: B13682523 **56** Routine Name: ICD1856E Before: n/a After: B9844057 **56** Routine Name: ICD1856F Before: n/a After: B62542809 **56** Routine Name: ICD1856G Before: n/a After: B61513555 **56** Routine Name: ICD1856H Before: n/a After: B63485012 **56** Routine Name: ICD1856I Before: n/a After: B62228183 **56** Routine Name: ICD1856J Before: n/a After: B64558643 **56** Routine Name: ICD1856K Before: n/a After: B67676576 **56** Routine Name: ICD1856O Before: n/a After: B2566307 **56** Routine Name: ICD1856P Before: n/a After: B614755 **56** Routine Name: ICDDRG0 Before: B61340562 After: B61340646 **1,2,7,10,14,17,20,24,27,30, 31,32,33,37,45,50,53,56** Routine Name: ICDDRG1 Before: B12785919 After: B16897990 **10,17,24,31,50,56** Routine Name: ICDDRG9 Before: B1598901 After: B2434022 **31,56** Routine Name: ICDTBL0D Before: n/a After: B21269416 **56** Routine Name: ICDTBL1D Before: n/a After: B6597931 **56** Routine Name: ICDTBL2D Before: n/a After: B49289607 **56** Routine Name: ICDTBL3D Before: n/a After: B8024597 **56** Routine Name: ICDTBL4D Before: n/a After: B24726724 **56** Routine Name: ICDTBL5D Before: n/a After: B7303976 **56** Routine Name: ICDTBL6D Before: n/a After: B10354424 **56** Routine Name: ICDTBL7D Before: n/a After: B14033288 **56** Routine Name: ICDTBL8D Before: n/a After: B25187707 **56** Routine Name: ICDTBL9D Before: n/a After: B4782477 **56** Routine list of preceding patches: 53 ============================================================================= User Information: Entered By : BOWEN,MARY JANE Date Entered : APR 28, 2011 Completed By: LEANORD,TATIANA Date Completed: NOV 28, 2011 Released By : BARFIELD,RICHARD Date Released : NOV 28, 2011 ============================================================================= Packman Mail Message: ===================== $END TXT