$TXT Created by at CHEYL106.FO-BAYPINES.DOMAIN.EXT (KIDS) on Friday, 12/26/25 at 15:55 ============================================================================= Run Date: DEC 30, 2025 Designation: LEX*2*157 Package : LEX - LEXICON UTILITY Priority: EMERGENCY Version : 2 SEQ #148 Status: Released Compliance Date: DEC 31, 2025 ============================================================================= Associated patches: (v)LEX*2*155 <<= must be installed BEFORE `LEX*2*157' Subject: CODE SET FY26 2ND QTR UPDATE Category: - Routine - Enhancement (Emergency) - Other - Data Dictionary Description: ============ This patch contains the FY26 2nd Quarter Code Set distribution with 590 changes effective Jan 01, 2026. This patch also exports 1929 changes to the SNOMED CT coding system and 423 changes to the VA SNOMED Extension coding system. This patch installs the data for the following Informational patch: ICPT*6.0*122 EHRM Impact Statement: ---------------------- This patch should have no EHRM impact and can be installed at all sites, including EHRM converted sites. Patch Components: ----------------- Files & Fields Associated: File Number File Name New/Modified/Deleted ------------------ ---------------------- -------------------- #81 CPT Modified #81.2 CPT COPYRIGHT Modified #757-757.4 LEXICON files Modified Forms Associated: Form Name File Number New/Modified/Deleted --------- ----------- -------------------- N/A Forms Associated: Form Name File Number 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: -------------------------------------------- N/A Problem: -------- N/A Resolution: ----------- N/A Test Sites: ----------- Montana HCS (Fort Harrison, MT) North Florida HCS (Gainesville, FL) SNOW Change Order #: -------------------- NFSG: CHG0678759 FHM: CHG0678756 ENHANCEMENTS: ============ FY26 2nd Quarter Update HCPCS Procedure Additions ------------------------- Effective Jan 01, 2026 (190 Codes) A4295 A4296 A4297 C1607 C1608 C7566 C7567 C7568 C7569 C7570 C7571 C9176 C9307 C9308 C9810 C9811 C9812 C9813 C9814 C9815 C9816 C9817 D0426 D0461 D1720 D5877 D5878 D5909 D5938 D5939 D5940 D5941 D5942 D5943 D5944 D5945 D5946 D5947 D5948 D5949 D6049 D6196 D6280 D9128 D9129 D9224 D9225 D9244 D9245 D9246 D9247 D9936 G0568 G0569 G0570 G0571 G0660 G0661 G0662 G0663 G0664 G0665 G0666 G0667 G0668 G9871 J0013 J0162 J0654 J1073 J1736 J1737 J1837 J2516 J2596 J2711 J3291 J3376 J3379 J3387 J3389 J7299 J7528 J9184 J9256 J9282 J9326 M1426 M1427 M1428 M1429 M1430 M1431 M1432 M1433 M1434 M1435 M1436 M1437 M1438 M1439 M1440 M1441 M1442 M1443 M1444 M1445 M1446 M1447 M1448 M1449 M1450 M1451 M1452 M1453 M1454 M1455 M1456 M1457 M1458 M1459 M1460 M1461 M1462 M1463 M1464 M1465 M1466 M1467 M1468 M1469 M1470 M1471 M1472 M1473 M1474 M1475 M1476 M1477 M1478 M1479 M1480 M1481 M1482 M1483 M1484 M1485 M1486 M1487 M1488 M1489 M1490 M1491 M1492 M1493 M1494 M1495 M1496 M1497 M1498 M1499 M1500 M1501 M1502 M1503 Q4398 Q4399 Q4400 Q4401 Q4402 Q4403 Q4404 Q4405 Q4406 Q4407 Q4408 Q4409 Q4410 Q4411 Q4412 Q4413 Q4414 Q4415 Q4416 Q4417 Q4420 Q4431 Q4432 Q4433 Q5160 HCPCS Procedure Inactivations ----------------------------- Effective Jan 01, 2026 (102 Codes) C5271 C5272 C5273 C5274 C5275 C5276 C5277 C5278 C9089 C9305 C9306 C9751 C9784 D1352 D1705 D1706 D1707 D1712 D9248 G0071 G0511 G0512 G6001 G6002 G6003 G6004 G6005 G6006 G6007 G6008 G6009 G6010 G6011 G6012 G6013 G6014 G6015 G6016 G6017 G9604 J0172 J0190 J0200 J0205 J0215 J0288 J0350 J0365 J0380 J0395 J0710 J0715 J0795 J0889 J1267 J1330 J1443 J1444 J1445 J1452 J1457 J1562 J1572 J1620 J1655 J1710 J1945 J2504 J2513 J2910 J2940 J2995 J3280 J3305 J3310 J3320 J3355 J3364 J3365 J3400 J7309 J7310 J7505 J7513 J8562 J8650 J9019 J9020 J9098 J9151 J9165 J9212 J9270 Q0174 Q2017 Q4100 Q4106 Q5109 Q9969 S0013 S0080 S0189 HCPCS Procedures Re-Used ------------------------ Effective Jan 01, 2026 (1 Code) D5930 HCPCS Procedure Revisions ------------------------- Effective Jan 01, 2026 (297 Codes) A2001 A2002 A2005 A2006 A2007 A2008 A2009 A2010 A2011 A2012 A2013 A2015 A2016 A2018 A2019 A2021 A2022 A2024 A2025 A2027 A2029 A2031 A2032 A2034 A2036 A2038 A2039 A4100 A4351 A4352 C1741 D0180 D6080 G0136 G2076 G2077 G8430 G9414 G9415 G9788 G9790 G9796 G9797 G9832 J0759 J7322 M1174 M1176 Q4101 Q4102 Q4103 Q4104 Q4105 Q4107 Q4108 Q4110 Q4111 Q4115 Q4116 Q4117 Q4121 Q4122 Q4123 Q4124 Q4125 Q4126 Q4127 Q4128 Q4130 Q4132 Q4133 Q4134 Q4135 Q4136 Q4137 Q4138 Q4140 Q4141 Q4142 Q4143 Q4146 Q4147 Q4148 Q4150 Q4151 Q4152 Q4153 Q4154 Q4156 Q4157 Q4158 Q4159 Q4160 Q4161 Q4163 Q4164 Q4165 Q4166 Q4167 Q4169 Q4170 Q4173 Q4175 Q4176 Q4178 Q4179 Q4180 Q4181 Q4182 Q4183 Q4184 Q4186 Q4187 Q4188 Q4190 Q4191 Q4193 Q4194 Q4195 Q4196 Q4197 Q4198 Q4199 Q4200 Q4201 Q4203 Q4204 Q4205 Q4208 Q4209 Q4211 Q4214 Q4216 Q4217 Q4218 Q4219 Q4220 Q4221 Q4222 Q4224 Q4225 Q4227 Q4229 Q4232 Q4234 Q4235 Q4236 Q4237 Q4238 Q4239 Q4247 Q4248 Q4249 Q4250 Q4251 Q4252 Q4253 Q4254 Q4255 Q4256 Q4257 Q4258 Q4259 Q4260 Q4261 Q4262 Q4263 Q4264 Q4265 Q4266 Q4267 Q4268 Q4269 Q4270 Q4271 Q4272 Q4273 Q4274 Q4275 Q4276 Q4278 Q4279 Q4280 Q4281 Q4282 Q4283 Q4284 Q4285 Q4286 Q4287 Q4288 Q4289 Q4290 Q4291 Q4292 Q4293 Q4294 Q4295 Q4296 Q4297 Q4298 Q4299 Q4300 Q4301 Q4302 Q4303 Q4304 Q4305 Q4306 Q4307 Q4308 Q4309 Q4311 Q4312 Q4313 Q4314 Q4315 Q4316 Q4317 Q4318 Q4319 Q4320 Q4321 Q4322 Q4323 Q4324 Q4325 Q4326 Q4327 Q4328 Q4329 Q4330 Q4331 Q4332 Q4333 Q4334 Q4335 Q4336 Q4337 Q4338 Q4339 Q4340 Q4341 Q4342 Q4343 Q4344 Q4345 Q4346 Q4347 Q4348 Q4349 Q4350 Q4351 Q4352 Q4353 Q4354 Q4355 Q4356 Q4357 Q4358 Q4359 Q4360 Q4361 Q4362 Q4363 Q4364 Q4365 Q4366 Q4367 Q4368 Q4369 Q4370 Q4371 Q4372 Q4373 Q4375 Q4376 Q4377 Q4378 Q4379 Q4380 Q4382 Q4383 Q4384 Q4385 Q4386 Q4387 Q4388 Q4389 Q4390 Q4391 Q4392 Q4393 Q4394 Q4395 Q4396 Q4397 SNOMED CT Changes ----------------- Effective Added Inact React Revise Total ---------- ----- ----- ----- ------ ----- SNOMED Codes 09/01/2025 313 89 1 72 475 SNOMED Terms Concepts 385 161 -- -- 546 Synonyms 276 168 -- -- 444 Fully Specified 375 89 -- -- 464 ----- ----- ----- ------ ----- 1349 507 1 72 1929 SNOMED CT Version ID: 20250901 VSE Changes ----------- Effective Added Inact React Revise Total ---------- ----- ----- ----- ------ ----- SNOMED Codes 09/15/2024 227 7 -- -- 234 SNOMED Terms Concepts 227 7 -- -- 234 Synonyms 124 -- -- -- 124 Fully Specified 227 7 -- -- 234 ----- ----- ----- ------ ----- 1539 7 -- -- 1542 VSE Version ID: 20250915 CPT Copyright ============== CPT (CPT is a registered trademark of the American Medical Association) codes, descriptions and other data are copyright 1966, 1970, 1973, 1977, 1981, 1983-2026 American Medical Association. CPT is commercial technical data developed exclusively at private expense by Contractor/Manufacturer American Medical Association, AMA Plaza, 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. The provisions of this Agreement between AMA and VA prevail, including prohibiting creating derivative works and providing CPT to any third parties outside of the Facilities. Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message as well as a global host file. The host file is available at the following location: /srv/vista/patches/SOFTWARE/LEX_2_157.GBL Patch Installation: ------------------- Pre Installation Instructions: ------------------------------ 1) Users may be on the system during the install of LEX*2.0*157. This patch should take from 25 to 90 minutes to install depending on the system. Create a backup 20-75 minutes Load the Global 1-5 minutes Kids Install 1-5 minutes 2) Size/Disk Space Requirements: The changes to the Lexicon, and CPT globals will result in a combined growth of about 15 MB of data. The import global ^LEXM is about 9 MB in size. Make sure there is sufficient space for the growth to the VistA globals and the import global before continuing 3) Create a backup of the following global files before continuing: CPT #81 ^ICPT( CPT Copyright #81.2 ^DIC(81.2, Lexicon Files #757-757.41 ^LEX( These backup files may get as large as 2.4 gigabytes. Make sure space is available before proceeding. It should take from 10 to 60 minutes to create the backup files. 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: ------ -------------------------- ^ICPT CPT ^LEX Lexicon Files When you are creating a backup of a subscripted global, you are saving a partial global (a file within a global). You should use the utility ^%GOGEN, and when prompted for a global, enter the open global reference as shown below. Examples: Enter To create a Backup copy of: ------ -------------------------- ^DIC(81.2, CPT Copyright INSTALLATION INSTRUCTIONS ------------------------- 1) Install the data from the global host file LEX_2_157.GBL. This file contains the Lexicon Utility's import global ^LEXM. This global is approximately 9 megabytes in size. Make sure there is sufficient space available to load this global on your system. The loading of the global should take from 1 to 5 minutes. From the Programmer prompt, execute the following routine: >D ^%GI Global input Device: /srv/vista/patches/SOFTWARE/LEX_2_157.GBL Parameter: "RS" => Globals were saved on 26 Dec 2025 20:53 PM IRIS with description: LEX*2.0*157/ICPT*6.0*122 Data Input option: A ^LEXM 2) Choose the PackMan message containing this build. Then select the INSTALL/CHECK MESSAGE PackMan option to load the build. 3) From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, A. Select the Verify Checksums in Transport Global option to confirm the integrity of the routines that are in the transport global. When prompted for the INSTALL NAME enter the patch or build name. (ex. or XXXXX BUILD X.X) NOTE: Using will not bring up a Multi-Package build even if it was loaded immediately before this step. It will only bring up the last patch in the build. B. You may also elect to use the following options: i. Print Transport Global - This option will allow you to view the components of the KIDS build. ii. 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 of the components of this patch, such as routines, DDs, templates, etc. C. Select the Install Package(s) option and choose the patch to install. i. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer . ii. If prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', answer NO//. Post-Installation Instructions: ------------------------------- Cleanup a) The Environment Check routine LEX2157 and the Post-Install routine LEX2157P should be deleted using the KERNEL option 'Delete Routines' [XTRDEL] upon completion of the installation. NOTE: The installation of this patch should trigger an update protocol and may spawn background tasks for the Clinical Reminders or Consult packages. You do not need to wait for these background jobs to complete to delete the Environment Check and Post-Install routines. Back-Out/Roll Back Plan: ------------------------ To back-out data from a production account could cause broken pointers, errors and hard MUMPS crashes. The back-out plan for data only patches is to report your findings and wait for a repair patch. Contact Help desk to log a ticket. Patch Verification: Kernel Installation & Distribution System-> Utilities-> Install File Print option can be used to check for any errors plus the status of the install being Completed. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;LEXICON UTILITY;**[Patch List]**;Sep 23, 1996;Build 2 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: LEX2157 Before: n/a After: B91280714 **157** Routine Name: LEX2157P Before: n/a After: B21696600 **157** ============================================================================= User Information: Entered By : Date Entered : DEC 23, 2025 Completed By: Date Completed: DEC 30, 2025 Released By : Date Released : DEC 30, 2025 ============================================================================= Packman Mail Message: ===================== $END TXT