============================================================================= Run Date: FEB 04, 2021 Designation: ICD*18*105 Package : ICD - DRG GROUPER Priority: EMERGENCY Version : 18 SEQ #97 Status: Released Compliance Date: FEB 10, 2021 ============================================================================= Associated patches: (v)ICD*18*103 <<= must be installed BEFORE `ICD*18*105' Subject: FY2021 ANNUAL DRG GROUPER UPDATE Category: - Routine - Other Description: ============ Patch ICD*18.0*105 provides the annual update to the Medicare Severity Diagnosis Related Group (MS-DRG) Grouper version 38. Also, in response to the national emergency that was declared concerning the COVID-19 outbreak, the Centers for Disease Control and Prevention's (CDC) is implementing new codes into the Medicare Severity Diagnosis Related Group (MS-DRG) Grouper version 38.1, effective January 1, 2021. +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ PLEASE NOTE: Be aware of the shortened compliance date. The dates listed in the patch description are accurate as the FY2021 annual patch was delayed. The changes included in this patch were effective as of 10/1/2020 per the Federal Register Vol. 85, No. 182, dated September 18, 2020. +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Patch Components: ----------------- Files & Fields Associated: N/A Forms Associated: N/A Mail Groups Associated: N/A Options Associated: N/A Protocols Associated: N/A Security Keys Associated: N/A Templates Associated: N/A Remote Procedures Associated: N/A Parameter Definitions Associated: N/A Additional Information: Blood Bank Team Coordination: ---------------------------- N/A New Service Requests (NSRs): ---------------------------- N/A Patient Safety Issues (PSIs): ----------------------------- N/A Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1) INC12854404 - FY2021 DRG Grouper annual update patch needed The following changes are published in the Federal Register, Vol. 85, No. 182, dated September 18, 2020 with an effective date of October 1, 2020. 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 COVID-19 ICD codes introduced by patch LEX*2.0*131 (released December 22, 2020). This is a summary of the additions/changes made: I. Routine ICD18105A was written to update the DRG file (#80.2). NEW DRGs for FY 2021 -------------------- MS-DRG 018 MS-DRG 019 MS-DRG 140 MS-DRG 141 MS-DRG 142 MS-DRG 143 MS-DRG 144 MS-DRG 145 MS-DRG 521 MS-DRG 522 MS-DRG 650 MS-DRG 651 INACTIVATED DRGs for FY 2021 ---------------------------- MS-DRG 129 MS-DRG 130 MS-DRG 131 MS-DRG 132 MS-DRG 133 MS-DRG 134 II. Routine ICD18105A 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.83) Assign cases reporting ICD-10-PCS procedure codes XW033C3 or XW043C3 to new MS-DRG 018 (Chimeric Antigen Receptor (CAR) T-cell Immunotherapy) under the ICD-10 MS-DRGs Version 38, effective October 1, 2020. 2. Pre MDC (p.213) Effective 10/1/2020 creation of new MS-DRG 019 (Simultaneous Pancreas/Kidney Transplant with Hemodialysis) for cases describing the performance of hemodialysis during an admission where the patient received a simultaneous pancreas/kidney transplant. 3. MDC 3 (p.124) Effective 10/1/2020 the addition of new MS-DRGs 140 - 145 and inactivating MS-DRGs 129 - 134 (below): Activated: ---------- MS-DRG 140 MAJOR HEAD AND NECK PROCEDURES WITH MCC MS-DRG 141 MAJOR HEAD AND NECK PROCEDURES WITH CC MS-DRG 142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC MS-DRG 143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC MS-DRG 144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC MS-DRG 145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC Inactivated: ------------ MS-DRG 129 MAJOR HEAD AND NECK PROCEDURES WITH CC/MCC OR MAJOR DEVICE MS-DRG 130 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC MS-DRG 131 CRANIAL AND FACIAL PROCEDURES WITH CC/MCC MS-DRG 132 CRANIAL AND FACIAL PROCEDURES WITHOUT CC/MCC MS-DRG 133 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC/MCC MS-DRG 134 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC 4. MDC 8 (p.196) Effective 10/1/2020 addition of MS-DRGs 521 and 522 (Hip Replacement with Principal Diagnosis of Hip Fracture with and without MCC, respectively) for FY 2021. 5. MDC 11 (p.213) Effective 10/1/2020 the creation of new MS-DRG 650 (Kidney Transplant with Hemodialysis with MCC) and new MS-DRG 651 (Kidney Transplant with Hemodialysis without MCC) for cases describing the performance of hemodialysis in an admission where the patient received a kidney transplant. IV. Additional DRG-related changes for the new COVID-19 diagnosis codes 1. MDC 4 and MDC 25 Assign cases reporting diagnosis code J12.82 (Pneumonia due to coronavirus disease 2019) to DRGs 193-195 or DRGs 974-976 depending on the supporting diagnoses, effective January 1, 2021. 2. MDC 8 Assign cases reporting diagnosis codes M35.81 (Multisystem inflammatory syndrome) or M35.89 (Other specified systemic involvement of connective tissue) to DRGs 545-547, effective January 1, 2021. 3. MDC 23 Assign cases reporting diagnosis codes Z11.52 (Encounter for screening for COVID-19), Z20.822 (Contact with and (suspected) exposure to COVID-19) or Z86.16 (Personal history of COVID-19) to DRG 951, effective January 1, 2021. TEST SITES: ----------- VISN 02 (Buffalo, NY) Montana HCS (Fort Harrison, MT) North Florida HCS (Gainesville, FL) Software and Documentation Retrieval Instructions: -------------------------------------------------- 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. Sites can obtain the file at location: /srv/vista/patches/SOFTWARE or by accessing the URL: https://download.vista.domain.ext/index.html/SOFTWARE. File Title File Name Format ------------------------------------------------------------------- ICD_18_105.KID ICD_18_105.KID ASCII Documentation describing the new functionality is not included in this release. Documentation Title File Name --------------------------------------------------------- N/A 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. Use the Load a Distribution option contained on the Kernel Installation and Distribution System Menu to load the Host file. When prompted to "Enter a Host File:" enter /srv/vista/patches/SOFTWARE/ICD_18_105_V1.KID 2. From the Kernel Installation & Distribution System menu, select the Installation menu. 3. From this menu, you may elect to use the following options (When prompted for the INSTALL NAME, enter ICD*18.0*105): a. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. b. Print Transport Global - This option will allow you to view the components of the KIDS build. c. 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.). d. Backup a Transport Global - Select the Backup a Transport Global option to create a backup message of any routines exported with this patch. You can specify what to backup; the entire Build or just Routines. When asked to specify what to backup, select Routines. It is NOT recommended to use this backup to restore the system as it will NOT restore your system to pre-patch condition. When prompted for a response, select Build: Select one of the following: B Build R Routines Enter response: Routines 4. Use the Install Package(s) option and select the package ICD*18.0*105: 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: 5. Please be aware that routine ICD18105P is deleted by design during the install process. Therefore, the ICD18105P 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]**;October 20, 2000;Build 1 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ICD18105A Before: n/a After: B67463333 **105** Routine Name: ICD18105F Before: n/a After: B71987333 **105** Routine Name: ICD18105G Before: n/a After: B79622985 **105** Routine Name: ICD18105H Before: n/a After: B74507193 **105** Routine Name: ICD18105I Before: n/a After: B75025292 **105** Routine Name: ICD18105J Before: n/a After: B72362897 **105** Routine Name: ICD18105K Before: n/a After: B77167239 **105** Routine Name: ICD18105O Before: n/a After: B3075776 **105** Routine Name: ICD18105P Before: n/a After: B2861116 **105** ============================================================================= User Information: Entered By : Date Entered : SEP 03, 2020 Completed By: Date Completed: FEB 04, 2021 Released By : Date Released : FEB 04, 2021 ============================================================================= Packman Mail Message: ===================== No routines included