============================================================================= Run Date: DEC 06, 2018 Designation: ICD*18*96 Package : ICD - DRG GROUPER Priority: Mandatory Version : 18 SEQ #87 Status: Released Compliance Date: DEC 13, 2018 ============================================================================= Associated patches: (v)ICD*18*93 <<= must be installed BEFORE `ICD*18*96' Subject: FY2019 ANNUAL DRG GROUPER UPDATE Category: - Routine - Other Description: ============ This patch provides the annual update to the Medicare Severity Diagnosis Related Group (MS-DRG) Grouper version 36. ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ PLEASE NOTE: Be aware of the shortened compliance date - 5 days after release. The dates listed in the patch are accurate as the FY2019 annual patch was delayed. The changes included in this patch were effective as of 10/1/2018 per the Federal Register Vol. 83, No. 160, dated August 17, 2018. ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- N/A Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- N/A Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A Additional Information: N/A New Service Requests (NSRs): -------------------------- N/A Patient Safety Issues (PSIs): ----------------------------- N/A Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1) INC2592959 - FY2019 Annual DRG Grouper update The following changes are published in the Federal Register, Vol. 83, No. 160, dated August 17, 2018 with an effective date of October 1, 2018. 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. DRG Reclassification changes to the Grouper. IV. Additional DRG-related data for the new ICD codes introduced by patch LEX*2.0*119 (released September 25, 2018). This is a summary of the additions/changes made: I. Routine ICD1896A was written to update the DRG file (#80.2). NEW DRGs for FY 2019 -------------------- MS-DRG 783 MS-DRG 784 MS-DRG 785 MS-DRG 786 MS-DRG 787 MS-DRG 788 MS-DRG 796 MS-DRG 797 MS-DRG 798 MS-DRG 805 MS-DRG 806 MS-DRG 807 MS-DRG 817 MS-DRG 818 MS-DRG 819 MS-DRG 831 MS-DRG 832 MS-DRG 833 INACTIVATED DRGs for FY 2019 ---------------------------- MS-DRG 685 MS-DRG 765 MS-DRG 766 MS-DRG 767 MS-DRG 774 MS-DRG 775 MS-DRG 777 MS-DRG 778 MS-DRG 780 MS-DRG 781 MS-DRG 782 II. Routine ICD1896A is used to update the finalized values for DRG relative weights and average length of stay (ALOS). III. DRG RECLASSIFICATION. Changes to other DRGs: ---------------------- 1. Pre MDC (p.41171) Effective 10/1/2018 ICD-10 changes to the titles of DRGs 11, 12 13 to the following: MS-DRG 11 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCC) MS-DRG 12 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CC) MS-DRG 13 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCC) 2. Pre MDC (p.41174) Effective 10/1/2018 ICD-10-PCS procedure codes XW033C3 and XW043C3 moved to Pre-MDC MS-DRG 016 for FY 2019 and revised the title of MS-DRG 16 from 'Autologous Bone Marrow Transplant with CC/MCC' to 'Autologous Bone Marrow Transplant with CC/MCC or T-cell Immunotherapy'. 3. MDC 1 (p.41174) Effective 10/1/2018 ICD-10 diagnosis codes G40.109 and G40.111 moved to the list of epilepsy diagnosis codes for assignment to MS-DRG 023. 4. MDC 6 (p.41195) Effective 10/1/2018 reassignment of ICD-10 diagnosis code D17.71 from DRGs 393, 394, and 395 under MDC 6 to DRGs 686, 687 and 688 under MDC 11, and to reassign ICD-10 diagnosis code D17.72 from DRGs 606 and 607 under MDC 9 to DRGs 686, 687 and 688 under MDC 11. 5. MDC 11 (p.41202) Effective 10/1/2018 inactivate MS-DRG 685 and reassign ICD-10-CM diagnosis codes Z49.01, Z49.02, Z49.31 and Z49.32 from MS-DRG 685 to MS-DRGs 698, 699 and 700 for FY 2019. 6. MDC 14 (p.41216) Revised MDC 14 MS-DRGs including the deletion of 10 MS-DRGs and the creation of 18 new MS-DRGs (below) in the ICD-10 MS-DRGs Version 36, effective October 1, 2018: Deletions --------- MS-DRG 765 Cesarean Section with CC/MCC MS-DRG 766 Cesarean Section without CC/MCC MS-DRG 767 Vaginal Delivery with Sterilization and/or D&C MS-DRG 774 Vaginal Delivery with Complicating Diagnosis MS-DRG 775 Vaginal Delivery without Complicating Diagnosis MS-DRG 777 Ectopic Pregnancy MS-DRG 778 Threatened Abortion MS-DRG 780 False Labor MS-DRG 781 Other Antepartum Diagnoses with Medical Complications MS-DRG 782 Other Antepartum Diagnoses without Medical Complications Additions --------- MS-DRG 783 Cesarean Section with Sterilization with MCC MS-DRG 784 Cesarean Section with Sterilization with CC MS-DRG 785 Cesarean Section with Sterilization without CC/MCC MS-DRG 786 Cesarean Section without Sterilization with MCC MS-DRG 787 Cesarean Section without Sterilization with CC MS-DRG 788 Cesarean Section without Sterilization without CC/MCC MS-DRG 796 Vaginal Delivery with Sterilization/D&C with MCC MS-DRG 797 Vaginal Delivery with Sterilization/D&C with CC MS-DRG 798 Vaginal Delivery with Sterilization/D&C without CC/MCC MS-DRG 805 Vaginal Delivery without Sterilization/D&C with MCC MS-DRG 806 Vaginal Delivery without Sterilization/D&C with CC MS-DRG 807 Vaginal Delivery without Sterilization/D&C without CC/MCC MS-DRG 817 Other Antepartum Diagnoses with O.R. Procedure with MCC MS-DRG 818 Other Antepartum Diagnoses with O.R. Procedure with CC MS-DRG 819 Other Antepartum Diagnoses with O.R. Procedure without CC/MCC MS-DRG 831 Other Antepartum Diagnoses without O.R. Procedure with MCC MS-DRG 832 Other Antepartum Diagnoses without O.R. Procedure with CC MS-DRG 833 Other Antepartum Diagnoses without O.R. Procedure without CC/MCC 7. MDC 18 (p.41218) Reassigning ICD-10-CM diagnosis codes R65.10 and R65.11 to MS-DRG 864 and to revise the title of MS-DRG 864 to 'Fever and Inflammatory Conditions'. Test Sites: ----------- VISN 02 (Buffalo, NY) Montana HCS (Fort Harrison, MT) North Florida HCS (Gainesville, FL) Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is not being distributed through the National Patch Module. This patch is being distributed as a host file. The host file will contain the following host file: Host file name: ICD_18_96.KID The preferred method is to retrieve the files from download.vista.domain.ext. This transmits the files from the first available server. Sites may also elect to retrieve the files directly from a specific server. Sites may retrieve the software and/or documentation directly using Secure File Transfer Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Hines: domain.ext Salt Lake City: domain.ext Documentation can also be found on the VA Software Documentation Library at: https://www.domain.ext/vdl/ Documentation Title File Name FTP Mode --------------------------------------------------------------------- N/A Host File Name FTP Mode --------------------------------------------------------------------- ICD_18_96.KID ASCII Patch Installation: ------------------- Pre/Post Installation Overview: Pre-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 Installation Instructions: -------------------------- 1. Download the host file ICD_18_96.KID from the ANONYMOUS.SOFTWARE directory of one of the following two Office of Information Field Offices (OIFOs): Hines or Salt Lake to the appropriate directory on your system. 2. Load the KIDS distribution that is contained in file ICD_18_96.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*96): 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*96: 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':', enter: 6. Please be aware that routine ICD1896P is deleted by design during the install process. Therefore, the ICD1896P post-install checksum is not applicable. Post-Installation Instructions: ------------------------------- N/A Back-Out/Roll Back Plan: ------------------------ Re-install patch ICD*18.0*93 if needed. Routine Information: ==================== The second line of each of these routines now looks like: ;;18.0;DRG Grouper;**[Patch List]**;Oct 20, 2000;Build 3 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ICD1896A Before: n/a After: B66185469 **96** Routine Name: ICD1896F Before: n/a After: B61072935 **96** Routine Name: ICD1896G Before: n/a After: B66333213 **96** Routine Name: ICD1896H Before: n/a After: B60957844 **96** Routine Name: ICD1896I Before: n/a After: B58475457 **96** Routine Name: ICD1896J Before: n/a After: B62187251 **96** Routine Name: ICD1896K Before: n/a After: B66047485 **96** Routine Name: ICD1896O Before: n/a After: B3282861 **96** Routine Name: ICD1896P Before: n/a After: B2854704 **96** ============================================================================= User Information: Entered By : Date Entered : JUL 26, 2018 Completed By: Date Completed: DEC 04, 2018 Released By : Date Released : DEC 06, 2018 ============================================================================= Packman Mail Message: ===================== No routines included