============================================================================= Run Date: OCT 02, 2017 Designation: ICD*18*90 Package : ICD - DRG GROUPER Priority: Mandatory Version : 18 SEQ #82 Status: Released Compliance Date: OCT 16, 2017 ============================================================================= Associated patches: (v)ICD*18*89 <<= must be installed BEFORE `ICD*18*90' Subject: FY2017 DRG ANNUAL UPDATE Category: - Routine - Other Description: ============ This patch provides the annual update to the Medicare Severity Diagnosis Related Group (MS-DRG) Grouper version 34. ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ PLEASE NOTE: Be aware of the shortened compliance date. The dates listed in the patch are accurate as the FY2017 annual patch was delayed. The changes included in this patch were effective as of 10/1/2016 per the Federal Register Vol. 81, No. 162, dated August 22, 2016. ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ASSOCIATED TICKETS: =================== 1) I12466955FY17 - FY2017 ANNUAL DRG GROUPER UPDATE duplicate(s): I13429319FY17 - Vista problem DRG999 error on ICD DAIG code: K85.90 I12519086FY17 - drg 999 ungroupable R15660002FY17 - Coder is having difficulty with DRG code 999. Code is showing displaying correctly in Clintegrity, but keeps coming back as 999 R10970280FY17 - DRG in Vista is incorrect and Nuance (separate ticket created for Nuance) Correct DRG 774/Wrong DRG 747 2) I13432382FY17 - DRG999 Ungroupable message / Vista DRG 999 / Correct DRG 699 ASSOCIATED NSRs: ================ N/A PARTICIPATING TEST SITES: ========================= VA Montana HCS VA North Florida/South Georgia HCS TICKEY OVERVIEW: =============== 1) I12466955FY17 - FY2017 ANNUAL DRG GROUPER UPDATE The following changes are published in the Federal Register, Vol. 81, No. 162, dated August 22, 2016 with an effective date of October 1, 2016. All page references below are for this annual update and resource documents can be found at https://www.cms.gov/. Changes include: I. 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 patch LEX*2.0*108 (released October 6, 2016). IV. DRG Reclassification changes to the Grouper. This is a summary of the additions/changes made: I. Routine ICD1882X was written to update the DRG file (#80.2). NEW DRGs for FY 2017 -------------------- n/a INACTIVATED DRGs for FY 2017 ---------------------------- MS-DRG 230 ACUTE ISCHEMIC STROKE WITH USE OF THROMBOLYTIC AGENT II. Routine ICD1890X is 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: Tables 6A-6M Tables 6P.1a-6P.4k (ICD-10-PCS Code Translations) For a complete description of all tables please visit the Centers for Medicare & Medicaid Services (WWW.CMS.GOV) or use the url below: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ AcuteInpatientPPS/FY2017-IPPS-Final-Rule-Home-Page.html?DLSort= 0&DLEntries=10&DLPage=1&DLSortDir=ascending IV. DRG RECLASSIFICATION. Changes to other DRGs: ---------------------- 1. PRE MDC (p.56791) Effective 10/1/2016 ICD-10 procedure codes 02RK0JZ and 02RL0JZ will be assigned as a code cluster to MS-DRGs 001 and 002 (Heart Transplant or Implant of Heart Assist System with and without MCC, respectively). 2. MDC 1 (p.56795) Reassignment of ICD-10-CM diagnosis codes T85.610A, T85.620A, T85.630A, and T85.690A from MDC 21 under MS-DRGs 919, 920, and 921 to MDC 1 under MS-DRGs 091, 092, and 093. The official code titles for these four codes were revised after publication of the proposed rule as well. Effective October 1, 2016, the revised code titles are reflected in Table 6E associated with this final rule, which is available via the Internet on the CMS Web site. 3. MDC 4 (p.56797) Reassignment of ICD-10-CM diagnosis code R22.2 from MDC 4 to MDC 9 under MS-DRGs 606 and 607 (Minor Skin Disorders with and without MCC, respectively.) 4. MDC 6 (p.56813) Assigned ICD-10-PCS code 06183DY (Bypass portal vein to lower vein with intraluminal device, percutaneous approach) to MDC 7 (Diseases and Disorders of the Hepatobiliary System and Pancreas) under MS-DRGs 405, 406, and 407 (Pancreas Liver and Shunt Procedures with MCC, with CC, and without CC/MCC, respectively). 5. MDC 13 (p.56825) Removed the following seven procedure codes currently listed as a "cluster" in MDC 6 under MS-DRGs 332, 333, and 334 effective October 1, 2016. The codes will remain as a cluster in MDC 13 under MS-DRGs 734 and 735 (Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy with CC/MCC and without CC/MCC, respectively). 0TTB0ZZ...................... Resection of bladder, open approach 0TTD0ZZ...................... Resection of urethra, open approach 0UT20ZZ............ Resection of bilateral ovaries, open approach 0UT70ZZ.... Resection of bilateral fallopian tubes, open approach 0UT90ZZ....................... Resection of uterus, open approach 0UTC0ZZ....................... Resection of cervix, open approach 0UTG0ZZ....................... Resection of vagina, open approach 6. MDC 19 (p.56826) Modified the title for ICD-10 MS-DRG 884. The new title for MS-DRG 884 for Version 34 is MS-DRG 884 Organic Disturbances and Intellectual Disability. 2) I13432382FY17 - DRG999 Ungroupable message / Vista DRG 999 / Correct DRG 699 Problem: ======== DRG 699 incorrectly calculating to DRG 999 in VistA. Solution: ========= Updated the DRG Grouper from version 33 to version 34. INSTALLATION INSTRUCTIONS: ========================== It is recommended that this patch be installed during non-peak hours to minimize potential disruption to users. Additionally, installing during peak hours may lead to an unusually long install time. Do not interrupt the installation. Do not Queue this installation. If it is queued, it may hang and not finish installing. Installation can take 40 mins to one (1) hour. Create a backup of the following global file before continuing. When you are creating a backup of non-subscripted globals, you are saving the entire global. You should use the utility ^%GO for non-subscripted globals, and when prompted for a global, enter the global root (global name only, no open parenthesis, no file number and no commas, as shown below). Examples: Enter To create a Backup copy of: ------ -------------------------- ^ICDD entire ICDD global 1. Retrieve the KIDS distribution host file. This patch will be distributed in a host file due to the amount of data contained in the patch. The name of the host file is: ICD_18_90.KID Sites can retrieve VistA software from the following SFTP addresses. The preferred method is to SFTP the files from: download.vista.domain.ext This will transmit the files from the first available SFTP server. Sites may also elect to retrieve software directly from a specific server as follows: Hines domain.ext Salt Lake City domain.ext The ICD_18_90.KID host file is located in the directory. Use ASCII Mode when downloading the file. 2. Load the KIDS distribution that is contained in file ICD_18_90.KID using the Load a Distribution option on the Installation menu. 3. Start up the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... 4. From this menu, you may elect to use the following options (When prompted for the INSTALL NAME, enter ICD*18.0*90): a. 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. b. 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 components of this patch (routines, DD's, 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. 5. Use the Install Package(s) option and select the package ICD*18.0*90: a. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO. b. When prompted 'Want to DISABLE Scheduled Options and Menu Options and Protocols? YES//', answer YES. When prompted, 'Enter options you wish to mark as 'Out Of Order':', enter: DRG Grouper [ICD DRG GROUPER] DRG Calculation [DG DRG CALCULATION] Load/Edit PTF Data [DG PTF SCREEN] Claims Tracking Edit [IBT EDIT TRACKING ENTRY] Enter/Edit Billing Information [IB EDIT BILLING INFO] DRG Information Report [DG PTF DRG INFORMATION OUTPUT] When prompted "Enter protocols you wish to mark as "Out of Order":" just press Routine Information: ==================== The second line of each of these routines now looks like: ;;18.0;DRG Grouper;**[Patch List]**;Oct 20, 2000;Build 13 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ICD1890A Before: n/a After: B66183101 **90** Routine Name: ICD1890F Before: n/a After: B57685162 **90** Routine Name: ICD1890G Before: n/a After: B62309016 **90** Routine Name: ICD1890H Before: n/a After: B59088830 **90** Routine Name: ICD1890I Before: n/a After: B57522747 **90** Routine Name: ICD1890J Before: n/a After: B59960902 **90** Routine Name: ICD1890K Before: n/a After: B62933390 **90** Routine Name: ICD1890O Before: n/a After: B2924602 **90** Routine Name: ICD1890P Before: n/a After: B2839532 **90** ============================================================================= User Information: Entered By : Date Entered : JAN 19, 2017 Completed By: Date Completed: SEP 28, 2017 Released By : Date Released : OCT 02, 2017 ============================================================================= Packman Mail Message: ===================== No routines included