$TXT Created by BOWEN,MARY JANE at MNTVBB.FO-ALBANY.MED.VA.GOV (KIDS) on Tuesday, 11/04/08 at 12:05 ============================================================================= Run Date: DEC 01, 2008 Designation: ICD*18*37 Package : ICD - DRG GROUPER Priority: Mandatory Version : 18 SEQ #36 Status: Released Compliance Date: DEC 15, 2008 ============================================================================= Associated patches: (v)ICD*18*33 <<= must be installed BEFORE `ICD*18*37' (v)LEX*2*61 <<= must be installed BEFORE `ICD*18*37' Subject: ANNUAL DRG GROUPER UPDATE Category: - Routine - Enhancement (Mandatory) - Other Description: ============ This patch provides the annual update to the MS-DRG Grouper v26.0. It is the second phase of the FY 2009 ICD/DRG Update and is the follow up to patch LEX*2.0*61 and ICD*18.0*38. It also contains corrections for Remedy tickets. No code files are included in the patch, as all changes are handled programmatically by the pre-init routines ICD1837*. ASSOCIATED REMEDY TICKETS: ========================== 1) HD0000000258863 - Annual Update to DRG Grouper 2) HD0000000271478 - ICD*18.0*33 - drg 847 not calculating correctly Duplicate: HD0000000277160 - DRG not grouping correctly HD0000000281042 - Problem with ICD Codes not grouping to DRG 847 3) HD0000000275718 - Incorrect DRG 4) HD0000000280791 - DRG's are not matching. Vista is pulling DRG 829 and Quantim is pulling 838 for same service. 5) HD0000000281593 - Grouper not using versioned MDC for calculating ASSOCIATED NSRs: ================= N/A PARTICIPATING TEST SITES: ======================== Bay Pines HCS Manchester, NH Montana HCS REMEDY OVERVIEW: =============== 1) HD0000000258863 - Annual Update to DRG Grouper The changes were published in the Federal Register, Vol. 73, No. 161, dated August 19, 2008 with an effective date of October 1, 2008. All page references below are to this issue. Changes include: I. New/inactivated/revised DRGs. II. Revised DRG relative weights & average length of stay (ALOS) values for all DRGs. III. Additional DRG-related data for the new ICD codes introduced by LEX*2.0*61 and ICD*18*38. IV. DRG Reclassification changes to the Grouper. This is a summary of the additions/changes made: I. Routine ICD1837A was written to update the DRG file #80.2: NEW DRG FOR FY09 ---------------- 265 AICD lead procedures REVISED DRG descriptions (titles) for FY 2009 --------------------------------------------- 245 AICD generator procedures 250 Perc cardiovasc proc w/o coronary artery stent w MCC 251 Perc cardiovasc proc w/o coronary artery stent w/o MCC 870 Septicemia or severe sepsis w MV 96+ hours 871 Septicemia or severe sepsis w/o MV 96+ hours w MCC 872 Septicemia or severe sepsis w/o MV 96+ hours w/o MCC II. Routine ICD1837A will also be used to update the finalized values for DRG relative weights and average length of stay (ALOS). III. Additional DRG-related values were taken from these Tables: Table 6A on p.48923 for 374 new diagnoses Table 6B on p.48943 for 60 new procedures Routine ICD1837B incorporated these values in the following fields in ICD DIAGNOSIS file (#80): Identifier (#2) as needed Major Diagnostic Category (#5) DRG Grouper Effective Date (#71) and its sub-file MDC Effective Date (#72) Routine ICD1837C incorporated these values in the following fields in ICD OPERATION/PROCEDURE file (#80.1): Identifier (#2) as needed DRG Grouper Effective Date (#71) and its sub-files Routines ICDDRG0 and ICDTBL0A-9A were added/modified to complete the proper grouping of these new diagnoses and procedures. IV. DRG RECLASSIFICATION. Changes to other DRGs: ====================== 1. Pre-MDCs (p.47939) a. Procedure code 37.52 reassigned to MS DRG 001. Routine changed: ICD1837E and ICDDRG0. 2. MDC 5 (p.48497) a. Procedure codes 37.95, 37.97 and 00.52 reassigned from DRG 245 to new DRG 265. Routine changed: ICDTBL2A 3. MDC 21 (p.48508) a. Diagnosis codes 958.90,958.91,958.92,958.93,958.99 assigned to the multiple trauma MS-DRGs 963 (Other Multiple Significant Trauma with MCC), MS- DRG 964 (Other Multiple Significant Trauma with CC), and MS-DRG 965 (Other Multiple Significant Trauma without CC/MCC) in MDC 24 (Multiple Significant Trauma). Routine changed: ICD1837D. 4. Surgical Hierarchies (p.48510) a. Ranking of surgical DRGs has changed as follows: MDC New Order ==== ========= 5 245 above 265 Routine ICDDRG5 was modified to use DRG rank orders depending on the effective date of the PTF record. 2) HD0000000271478 - ICD*18.0*33 - drg 847 not calculating correctly Problem: ======== The table routines that decide which DRG to put the codes to do not contain all of the conversions that were included before the CMS-DRG to MS-DRG conversion for some of the MDC 17 codes. Solution: ======== Changed table routine ICDTBL8 to include conversions for other MDC17 codes 846-849. 3) HD0000000275718 - Incorrect DRG Problem: ======== Normal delivery showing as ungroupable Solution: ======== Set Identifier to show that the diagnosis was a normal delivery. This will be done in post-init routine ICD1837L. 4) HD0000000280791 - DRG's are not matching. Vista is pulling DRG 829 and Quantim is pulling 838 for same service. Problem: ======== VistA DRG is not correct. Solution: ======== Set ICDTBL8A to look for identifier to determine correct DRG. 5) HD0000000281593 - Grouper not using versioned MDC for calculating Problem: ======= DRG Grouper is using the old MDC for calculations instead of the versioned MDC. Solution: ======== ICDDRG has been changed to use the versioned MDC code. INSTALLATION INSTRUCTIONS: (don't forget Step #6) ========================= This patch can be loaded with users on the system. However, it would be preferable if Medical Records coders were off the system. Install Time - 5 to 10 minutes. Please ensure that your programming variables are set, including your DUZ(0)="@", otherwise installation will abort. This patch does not involve global file restoration. Nonetheless, we suggest you create global saves on files #80 (^ICD9), #80.1 (^ICD0) and #80.2 (^ICD) in the event problems develop during the install. If it became necessary to use the saved files, you should first kill all the records (except the zero node) before applying the global restores. 1. From the Kernel Installation and Distribution System Menu, select the Installation menu. 2. From this menu, you may elect to use the following options: (when prompted for INSTALL NAME, enter ICD*18.0*37) a. Backup a Transport Global - this option will create a backup message of any routines exported with the patch. It will NOT backup any other changes such as DDs or templates. b. 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.). c. Verify Checksums in Transport Global - this option will allow you to ensure the integrity of the routines that are in the transport global. Routines ICD1837* can be removed once the patch is installed. d. Print Transport Global - this option will allow you to view the components of the KIDS build. 3. Use the Install Package(s) option and select the package ICD*18.0*37. 4. When prompted, 'Want KIDS to INHIBIT LOGONs during the install? YES//', respond NO 5. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond NO. 6. Following installation of this patch, it is necessary to run the Update Transfer DRG's for Current FY [DG PTF UPDATE TRANSFER DRG's] option in order to make the transfer DRGs correspond to the appropriate grouper. 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 [DG PTF MENU] -> Update DRG Information Menu/Update Transfer DRGs for current FY. 7. All routines ICD1837* can be deleted after the patch has been successfully installed. Routine Information: ==================== The second line of each of these routines now looks like: ;;18.0;DRG Grouper;**[Patch List]**;Oct 13, 2000;Build 20 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ICD1837A Before: n/a After: B66936960 **37** Routine Name: ICD1837B Before: n/a After:B138385480 **37** Routine Name: ICD1837C Before: n/a After: B40754213 **37** Routine Name: ICD1837D Before: n/a After: B7504394 **37** Routine Name: ICD1837E Before: n/a After: B6002399 **37** Routine Name: ICD1837F Before: n/a After: B55591542 **37** Routine Name: ICD1837G Before: n/a After: B56658574 **37** Routine Name: ICD1837H Before: n/a After: B58404029 **37** Routine Name: ICD1837I Before: n/a After: B56257862 **37** Routine Name: ICD1837J Before: n/a After: B58885935 **37** Routine Name: ICD1837K Before: n/a After: B62185082 **37** Routine Name: ICD1837L Before: n/a After: B2827880 **37** Routine Name: ICD1837P Before: n/a After: B913754 **37** Routine Name: ICD1837V Before: n/a After: B732396 **37** Routine Name: ICDDRG Before: B27390313 After: B27872352 **2,7,10,14,20,31,37** Routine Name: ICDDRG0 Before: B59649900 After: B60779119 **1,2,7,10,14,17,20,24,27,30, 31,32,33,37** Routine Name: ICDDRG5 Before: B26305796 After: B33887705 **2,5,7,10,20,22,31,37** Routine Name: ICDTBL0A Before: n/a After: B14919136 **37** Routine Name: ICDTBL1A Before: n/a After: B5951815 **37** Routine Name: ICDTBL2A Before: n/a After: B39939582 **37** Routine Name: ICDTBL3A Before: n/a After: B7476882 **37** Routine Name: ICDTBL4A Before: n/a After: B22172181 **37** Routine Name: ICDTBL5A Before: n/a After: B6463485 **37** Routine Name: ICDTBL6A Before: n/a After: B8171099 **37** Routine Name: ICDTBL7A Before: n/a After: B14033553 **37** Routine Name: ICDTBL8 Before: B17255131 After: B18000042 **31,33,37** Routine Name: ICDTBL8A Before: n/a After: B17865378 **37** Routine Name: ICDTBL9A Before: n/a After: B4358407 **37** Routine list of preceding patches: 33 ============================================================================= User Information: Entered By : BOWEN,MARY JANE Date Entered : JUN 20, 2008 Completed By: SESSLER,APRIL Date Completed: NOV 24, 2008 Released By : HOLMES,MARY Date Released : DEC 01, 2008 ============================================================================= Packman Mail Message: ===================== $END TXT