============================================================================= Run Date: FEB 13, 2020 Designation: ICD*18*99 Package : ICD - DRG GROUPER Priority: Mandatory Version : 18 SEQ #91 Status: Released Compliance Date: FEB 20, 2020 ============================================================================= Associated patches: (v)ICD*18*97 <<= must be installed BEFORE `ICD*18*99' Subject: FY2020 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 37. ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ PLEASE NOTE: Be aware of the shortened compliance date. The dates listed in the patch are accurate as the FY2020 annual patch was delayed. The changes included in this patch were effective as of 10/1/2019 per the Federal Register Vol. 84, No. 159, dated August 16, 2019. ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ 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 Additional Information: N/A New Service Requests (NSRs): -------------------------- N/A Patient Safety Issues (PSIs): ----------------------------- N/A Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1) INC6959379 - FY2020 ICD DRG Grouper annual update patch needed The following changes are published in the Federal Register, Vol. 84, No. 159, dated August 16, 2019 with an effective date of October 1, 2019. 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*123 (released September 23, 2019). This is a summary of the additions/changes made: I. Routine ICD1899A was written to update the DRG file (#80.2). NEW DRGs for FY 2020 -------------------- MS-DRG 319 MS-DRG 320 INACTIVATED DRGs for FY 2020 ---------------------------- MS-DRG 691 MS-DRG 692 II. Routine ICD1899A 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.42067) Rename the titles for MS-DRGs 207, 291, 296, and 870 to no longer reflect the 'or Peripheral Extracorporeal Membrane Oxygenation (ECMO)' terminology in the title under the ICD-10 MS-DRGs Version 37, effective October 1, 2019. 2. MDC 4 (p.42079) Effective 10/1/2019 ICD-10 diagnosis codes I26.01, I26.02, and I26.09 reassigned to the higher severity level MS-DRG 175 and revision of the title for MS-DRG 175 to 'Pulmonary Embolism with MCC or Acute Cor Pulmonale'. 3. MDC 5 (p.42088) Effective 10/1/2019 the addition of new MS-DRG 319 (Other Endovascular Cardiac Valve Procedures with MCC) and new MS-DRG 320 (Other Endovascular Cardiac Valve Procedures without MCC). 4. MDC 11 (p.42113) Delete MS-DRGs 691 and 692 and revise the titles for MS-DRGs 693 and 694 from 'Urinary Stones without ESW Lithotripsy with MCC' and 'Urinary Stones without ESW Lithotripsy without MCC', respectively to 'Urinary Stones with MCC' and 'Urinary Stones without MCC', in the ICD-10 MS-DRGs Version 37, effective October 1, 2019. 5. MDC 12 (p.42113) Reassigning ICD-10-CM diagnosis codes R93.811, R93.812, R93.813, and R93.819 from MDC 5 in MS-DRGs 302 and 303 to MDC 12 in MS-DRGs 729 and 730. 6. MDC 23 (p.42120) Effective 10/1/2019 reassignment of ICD-10-CM diagnosis code R93.89 from MDC 5 in MS-DRGs 302 and 303 to MDC 23 in MS-DRGs 947 and 948. TEST SITES: ----------- VISN 02 (Buffalo, NY) Montana HCS (Fort Harrison, MT) North Florida HCS (Gainesville, FL) 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_99.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_99.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_99.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*99): 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*99: 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 ICD1899P is deleted by design during the install process. Therefore, the ICD1899P post-install checksum is not applicable. Post-Installation Instructions: ------------------------------- N/A Back-Out Plan: -------------- Due to the complexity of this patch, it is not recommended for back-out, and a restore from a backup of the Transport Global should not be attempted. In the event that a site decides to back out this patch, the site should contact the National Service Desk (NSD) to submit a help desk ticket. The development team will need to issue a follow-on patch in order to comprehensively back-out this patch. Routine Information: ==================== The second line of each of these routines now looks like: ;;18.0;DRG Grouper;**[Patch List]**;Oct 20, 2000;Build 2 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ICD1899A Before: n/a After: B65519587 **99** Routine Name: ICD1899F Before: n/a After: B60841575 **99** Routine Name: ICD1899G Before: n/a After: B66440972 **99** Routine Name: ICD1899H Before: n/a After: B60841234 **99** Routine Name: ICD1899I Before: n/a After: B58386874 **99** Routine Name: ICD1899J Before: n/a After: B60196207 **99** Routine Name: ICD1899K Before: n/a After: B65203813 **99** Routine Name: ICD1899O Before: n/a After: B2960258 **99** Routine Name: ICD1899P Before: n/a After: B2854630 **99** ============================================================================= User Information: Entered By : Date Entered : AUG 08, 2019 Completed By: Date Completed: FEB 13, 2020 Released By : Date Released : FEB 13, 2020 ============================================================================= Packman Mail Message: ===================== No routines included