============================================================================= Run Date: NOV 06, 2019 Designation: ICD*18*97 Package : ICD - DRG GROUPER Priority: Mandatory Version : 18 SEQ #89 Status: Released Compliance Date: DEC 07, 2019 ============================================================================= Associated patches: (v)ICD*18*89 <<= must be installed BEFORE `ICD*18*97' Subject: DRG PROCEDURE CLUSTERS UPDATE Category: - Routine - Data Dictionary Description: ============ This patch updates the DRG Calculator to handle data and additional rules obtained from the Center for Medicaid and Medicare Services (CMS) to calculate a Diagnostic Related Grouping (DRG). Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- DRG MDC CATEGORY MDC TYPE (#.04) Modified FILE (#83) DRG PROCEDURE GROUPS ATTRIBUTES (#10) Modified FILE (#83.61) DRG PROCEDURE GROUPS EFFECTIVE (#.01) Modified FILE (#83.6101 multiple) DRG PROCEDURE GROUPS INACTIVE (#.02) New FILE (#83.6101 multiple) DRG PROCEDURE GROUPS PROCEDURE TYPE (#.03) New FILE (#83.6101 multiple) DRG PROCEDURE GROUPS PROCEDURES (#20) New FILE (#83.61) DRG PROCEDURE GROUPS PROCEDURE (#.01) New FILE (#83.6102 multiple) 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) INC3818583 - non-OR clusters need to be treated as OR's in certain instances Problem: -------- A request was made by the Chief Business Office (CBO) to update the ICD DRG Grouper application to incorporate the use of the entire Appendix E file provided by CMS. This file contains Operating Room Procedures and Procedure Code clusters which are used in certain instances when calculating the DRG value. Resolution: ----------- This patch updates a field in the DRG MDC CATEGORY (#83) file and adds multiple fields in the DRG PROCEDURE GROUPS (#83.61) file to support the data obtained from CMS annually. Routines ICDJC, ICDJC1, ICDJC2 and ICDJC3 were edited to incorporate the following rules: Cluster Attributes: An Attribute of 'OR' or 'NOR' has been added to each Cluster in the ATTRIBUTES (#10) field of the DRG PROCEDURE GROUPS (#83.61) file. When Event Procedures define a Cluster, the attribute of each of the clusters procedures are reset to the attribute of the cluster, overriding the procedures OR/NOR attribute. All CMS Appendix E2 File Clusters will be defined as Operating Room Clusters and all CMS Appendix E3 File Clusters will be defined as Non-Operating Room Clusters. Major Diagnostic Category (MDC) 00 Cluster/MDC Rule Exception: The Cluster/MDC Rule requires when Event Procedures define a Cluster the individual Procedures may not be used to select DRGs within any MDC where the Cluster is assigned. All MDC 00 Clusters are exempt from this rule. MDC Exclusion: A new MDC Exclusion Rule is added to define the relationship between MDCs when DRGs across multiple MDCs are satisfied. This is based on the updated MDC TYPE (#.04) field of the DRG MDC CATEGORY (#83) file. Primary affect is if a DRG from an Exclusive MDC (24, 25) is satisfied then all General MDC/DRGs (01-23) are rejected, bypassing the order of precedence. Test Sites: ----------- Upstate New York HCS VA Montana HCS VA North Florida/South Georgia HCS Software and Documentation Retrieval Instructions: -------------------------------------------------- Software documentation updated by this patch is available for downloading. 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 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 Title File Name FTP Mode --------------------------------------------------------------------- N/A Host File Name FTP Mode --------------------------------------------------------------------- ICD_18_97.KID ASCII Patch Installation: ------------------- Pre/Post Installation Overview: Pre-Installation Instructions: ------------------------------ This patch can be installed with users in the system, but it is recommended that it be installed when user activity is very low. 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 should take less than 10 mins. 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_97.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_97.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_97.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*97): 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.). 5. Use the Install Package(s) option and select the package ICD*18.0*97: 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: Post-Installation Instructions: ------------------------------- You may delete the routine ICD1897P from your production system after the patch has been successfully installed. Back-Out Plan: -------------- Prior to installing the updated KIDS package, the site/region should have saved a backup of the routines in a mail message using the Backup a Transport Global [XPD BACKUP] menu option. The message containing the backed up routines can be loaded with the "Xtract PackMan" function at the Message Action prompt. The PackMan function INSTALL/CHECK MESSAGE is then used to install the backed up routines onto the VistA system. Routine Information: ==================== The second line of each of these routines now looks like: ;;18.0;DRG Grouper;**[Patch List]**;Oct 20, 2000;Build 5 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ICD1897P Before: n/a After: B2370662 **97** Routine Name: ICDJC Before: B14003979 After: B14743678 **89,97** Routine Name: ICDJC1 Before: B56485540 After: B74776778 **89,97** Routine Name: ICDJC2 Before: B50437415 After: B46578946 **89,97** Routine Name: ICDJC3 Before: B51705763 After: B63707439 **89,97** Routine list of preceding patches: 89 ============================================================================= User Information: Entered By : Date Entered : FEB 20, 2019 Completed By: Date Completed: NOV 06, 2019 Released By : Date Released : NOV 06, 2019 ============================================================================= Packman Mail Message: ===================== No routines included