$TXT Created by BOWEN,MARY JANE at MNTVBB.FO-ALBANY.MED.VA.GOV (KIDS) on Monday, 05/19/08 at 14:59 ============================================================================= Run Date: JUL 24, 2008 Designation: ICD*18*33 Package : ICD - DRG GROUPER Priority: Mandatory Version : 18 SEQ #32 Status: Released Compliance Date: AUG 24, 2008 ============================================================================= Associated patches: (v)ICD*18*27 <<= must be installed BEFORE `ICD*18*33' (v)ICD*18*30 <<= must be installed BEFORE `ICD*18*33' (v)ICD*18*31 <<= must be installed BEFORE `ICD*18*33' (v)ICD*18*32 <<= must be installed BEFORE `ICD*18*33' Subject: DRG CORRECTIONS Category: - Routine Description: ============ This patch will fix incorrect DRG groupings. ASSOCIATED REMEDY TICKETS: ========================= 1. HD0000000233286 - DRG issues 2. HD0000000239947 - several groups of codes grouping to incorrect DRG Duplicate: HD0000000240468 - VIP (QUADRAMED) is pulling DRG 251 which is correct based on procedure. Vista pulls over DRG 248 which is incorrect. Duplicate: HD0000000247374 - wrong DRG. 3. HD0000000239801 - PTF Calculating DRG3, SHOULD be DRG4 4. HD0000000226718 - several DRG's calculating incorrectly 5. HD0000000207009 - QMed DRG 468 vice PTF 174. 6. HD0000000241831 - Problem with DRG 217 as ungroupable DRG470 ASSOCIATED NSR'S: ================ N/A PARTICIPATING TEST SITES: ======================== Connecticut HCS Houston, TX Tampa, FL REMEDY OVERVIEW: =============== 1. HD0000000233286 - DRG issues Problem: ======== Certain DRG codes are not calculating correctly a. DRG 829 calculating as 847 (FY08) b. DRG 029 calculating as 032 (FY08) Solution: ========= a. Per patch ICD*18*22: "New codes V58.11 and V58.12 replaced V58.1 on October 1, 2005. The Federal Register entry on Aug. 12, 2005 (p.47635) failed to include DRG 406-08 which can also apply. As a result, the DRG Grouper failed in its calculation. Routines ICDTLB6B and ICDTLB61 will be modified and pre-init routine ICD1822P will add DRGs 406-08 to the possible DRGs for V58.11 and V58.12, thus resulting in DRG 492." For FY08 the DRG codes 406-408 were changed to DRG codes 826-830. Pre-init routine ICD1833P will add these DRGs to the possible DRGs for V58.11 and V58.12, thus resulting in DRG 829. b. Pre-init routine ICD1833P will add Major OR code B to MAJOR O.R. PROC FIELD (#20) for ICD procedure code 03.98 IN ICD OPERATION/PROCEDURE FILE(#80.1). Change ICDTBL0 DRG26 to use - I ICDMAJ["B" D DRG28 2. HD0000000239947 - several groups of codes grouping to incorrect DRG Problem: ======== a. DRG 247 calculating as 246 in Vista (FY08) b. DRG 250 Calculating as 248 in Vista (FY08) c. DRG 251 calculating as 248 in Vista (FY08) d. DRG 282 Calculating as 280 in Vista (FY08) e. DRG 829 Calculating as 847 in Vista (FY08) Solution: ========= a. Problem corrected by fixing ICDTBL2 to set DRG to 247 if ICDMCC not 2. b. Changed ICDTBL2 in linetag CMS516 to account for procedures 36.06,92.27 or 36.07 - if they are not there D DRG251, if there D DRG248. c. Fix is the same as fix for item b- going to linetag DRG251 does the following and fixes both DRGs 250(b) and 251(c): DRG251 S ICDRG=$S(ICDMCC=2:250,1:251) Q d. Per site saying 410.71 is not a MCC when the principle diagnosis is another cardiovascular condition, changed ICDTBL2 to look for diagnosis 410.71 and diagnosis 428.0, then set DRG=282. e. Fix is in previous ticket updating diagnosis codes v58.11 and v58.12 3. HD0000000239801 - PTF Calculating DRG3, SHOULD be DRG4 (FY08) Problem: ======== a. Incorrect DRG calculation as 3 and should have DRG4. Solution: ========= a. Changed ICDTBL0 to look for CC when determining which DRG to use, correcting DRG to the NON CC DRG4. 4. HD0000000226718 - several DRG's calculating incorrectly Problem: ======== a. DRG 121 calculating as DRG 122 in Vista (FY07) b. DRG 863 calculating as DRG 856 in Vista (FY08) Solution: ========= a. Change ICDDRG0 to look for ICDSD["s" to determine if code should be 121 or 122. b. Change ICDTBL8 to look for ICDOR'["O" set to DRG862 to point to the correct DRG codes. 5. HD0000000207009 - QMed DRG 468 vice PTF 174. Problem: ======== a. DRG 982 calculating as DRG 378 in Vista (FY08) also for FY07 DRG 468 calculates as 174 Solution: ========= a. Change ICDDRG0 to look for ICDORI["O" instead of ICDORNI 6. HD0000000241831 - Problem with DRG 217 as ungroupable DRG470 (FY08) Problem: ======== a. DRG 217 calculating as ungroupable 470 in Vista Solution: ========= a. Changed ICDTLB3C - Add S DRG=217 to line DRG217. Line was missing. INSTALLATION INSTRUCTIONS: ========================== This patch may be run with users on the system, but it is recommended that Medical Records coders be off the system. Installation will take less than 2 minutes. 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu to unload the KIDS distribution included with this message. NOTE: If the required patches are not installed, the transport global will be removed. If the transport global is removed you will need to repeat this step. 2. From the Kernel Installation and Distribution System Menu, select the Installation menu. 3. From this menu, you may elect to use the following options (when prompted for INSTALL NAME, enter ICD*18.0*33): a. Compare Transport Global to Current System - this option will allow you to view all changes that will be made when the patch is installed. It compares all components of the patch (routines, DDs, templates, etc.). b. Verify Checksums in Transport Global - this option will allow you to ensure the integrity of the routines that are in the Transport Global. c. Print Transport Global - this option will allow you to view the components of the KIDS build. d. 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. 4. Use the Install Package(s) option and select the package ICD*18.0*33. 5. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//', respond NO. 6. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond NO. 7. Routine ICD1833P can be deleted after the patch has been successfully installed. POST-INSTALL INSTRUCTIONS: ========================== Following installation of this patch, it is necessary to run the DG PTF UPDATE TRANSFER DRG's/Update Transfer DRG's for Current FY option in order to make the transfer DRGs correspond to the appropriate grouper. This should be done soon after installing the patch, but should be run at a time when PTF options are not in use. This option updates/recalculates the transfer DRGs for PTF records opened during the current fiscal year. The option is locked with the DG PTFSUP security key. The Menu path is PTF Menu/Update DRG Information Menu/Update Transfer DRGs for current FY. Routine Information: ==================== The second line of each of these routines now looks like: ;;18.0;DRG Grouper;**[Patch List]**;Oct 13,2000;Build 8 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ICD1833P Before: n/a After: B2101687 **33** Routine Name: ICDDRG0 Before: B60142349 After: B59649900 **1,2,7,10,14,17,20,24,27,30, 31,32,33** Routine Name: ICDTBL0 Before: B14595541 After: B14918551 **31,33** Routine Name: ICDTBL2 Before: B37828418 After: B38947646 **31,32,33** Routine Name: ICDTBL8 Before: B17158747 After: B17255131 **31,33** Routine Name: ICDTLB3C Before: B22984557 After: B23196579 **24,27,33** Routine list of preceding patches: 32 ============================================================================= User Information: Entered By : BOWEN,MARY JANE Date Entered : FEB 27, 2008 Completed By: CHANDARANA,RISHAN Date Completed: JUL 24, 2008 Released By : HOLMES,MARY Date Released : JUL 24, 2008 ============================================================================= Packman Mail Message: ===================== $END TXT