$TXT Created by at CHEYL106.FO-BAYPINES.DOMAIN.EXT (KIDS) on Monday, 09/21/26 at 14:21 ============================================================================= Run Date: SEP 30, 2026 Designation: LEX*2*161 Package : LEX - LEXICON UTILITY Priority: EMERGENCY Version : 2 SEQ #152 Status: Released Compliance Date: OCT 02, 2026 ============================================================================= Associated patches: (v)LEX*2*160 <<= must be installed BEFORE `LEX*2*161' Subject: CODE SET FY27 1ST QTR UPDATE Category: - Routine - Enhancement (Emergency) - Other - Data Dictionary Description: ============ This patch contains the FY27 1st Quarter Code Set distribution with 445 changes effective Oct 01, 2026. This patch also contains three changes from FY25 2nd Qtr (effective Jan 01, 2025), five changes from FY26 3rd Qtr (effective Apr 01, 2026) and 21 changes from FY26 4th Qtr (effective Jul 01, 2026). Additionally, this patch exports 38068 changes to the SNOMED CT coding system. This patch installs the data for the following Informational patches: ICD*18.0*132 ICPT*6.0*126 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 ------------------ ----------------------- -------------------- #80 ICD Diagnosis Modified (Data only) #80.1 ICD Operation/Procedure Modified (Data only) #81 CPT Modified (Data only) #81.2 CPT Copyright Modified (Data only) #81.3 CPT Modifier Modified (Data only) #757-757.41 Lexicon Files Modified (Data only) 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: ----------- VISN 02 (Buffalo, NY) Montana HCS (Fort Harrison, MT) North Florida HCS (Gainesville, FL) SNOW Change Order #: -------------------- NFSG: CHG0789628 UNY: CHG0788853 FHM: CHG0789627 ENHANCEMENTS: ============ FY27 1st Quarter Update HCPCS Procedure Additions (63 Codes) ------------------------- Effective Jan 01, 2025 (FY25 2nd Qtr) (3 Codes) G0556 G0557 G0558 Effective Jul 01, 2026 (FY26 4th Qtr) (16 Codes) A9574 C1609 C8014 G0574 G0575 G0577 G0669 G0670 G0671 G0672 G0673 G0674 G0675 G0676 G0677 G0678 Effective Oct 01, 2026 (44 Codes) A2046 A2047 A2048 A2049 A2050 A4228 A6614 A9613 C9311 C9312 C9313 E0788 E2403 G0685 J0643 J0644 J0871 J1757 J1818 J1946 J1947 J1957 J1958 J3268 J3406 J7524 J7526 J7529 J7530 J7531 J9066 J9186 J9187 J9191 J9192 J9362 L1330 L1972 L8697 Q4207 Q4223 Q4243 Q5172 Q5173 HCPCS Procedure Inactivations (14 Codes) ----------------------------- Effective Jul 01, 2026 (FY26 4th Qtr) (1 Code) C9309 Effective Oct 01, 2026 (13 Codes) C8010 C9462 J0640 J1941 J1953 J7514 J7517 J7519 J7528 J9181 J9190 J9352 L8696 HCPCS Procedure Revisions (21 Codes) ------------------------- Effective Apr 01, 2026 (FY26 3rd Qtr) (5 Codes) A2040 A2041 A2042 A2043 A2045 Effective Jul 01, 2026 (FY26 4th Qtr) (4 Codes) A4459 A4479 C9761 C9809 Effective Oct 01, 2026 (12 Codes) A9595 C1982 C8004 C9797 C9812 J3300 J9033 L1971 L8030 L8031 L8035 S0169 ICD-10 Diagnosis Additions -------------------------- Effective Oct 01, 2026 (190 Codes) C78.31 C78.32 C79.83 D69.11 D69.19 E89.830 E89.838 F64.A I42.00 I42.01 I42.09 I42.81 I42.89 I47.22 I49.81 I49.82 I49.89 J34.830 J34.831 J34.832 J34.833 J34.839 J4B. K31.B K6A.01 K6A.09 K6A.8 K74.0A K76.83 L02.237 M04.3 M67.A01 M67.A02 M67.A09 M72.20 M72.21 M72.22 M86.8X11 M86.8X12 M86.8X19 M86.8X21 M86.8X22 M86.8X29 M86.8X31 M86.8X32 M86.8X39 M86.8X41 M86.8X42 M86.8X49 M86.8X51 M86.8X52 M86.8X59 M86.8X61 M86.8X62 M86.8X69 M86.8X71 M86.8X72 M86.8X79 M86.8X80 M86.8X81 M86.8X89 N99.860 N99.861 O00.121 O00.122 O00.129 O00.131 O00.132 O00.139 O00.31 O00.32 O00.41 O00.42 O00.511 O00.512 O00.519 O00.521 O00.522 O00.529 O31.40X0 O31.40X1 O31.40X2 O31.40X3 O31.40X4 O31.40X5 O31.40X9 O31.41X0 O31.41X1 O31.41X2 O31.41X3 O31.41X4 O31.41X5 O31.41X9 O31.42X0 O31.42X1 O31.42X2 O31.42X3 O31.42X4 O31.42X5 O31.42X9 O31.43X0 O31.43X1 O31.43X2 O31.43X3 O31.43X4 O31.43X5 O31.43X9 Q87.A QA1.71 QA1.790 QA1.791 QA1.792 QA1.798 R78.72 T52.811A T52.811D T52.811S T52.812A T52.812D T52.812S T52.813A T52.813D T52.813S T52.814A T52.814D T52.814S T52.821A T52.821D T52.821S T52.822A T52.822D T52.822S T52.823A T52.823D T52.823S T52.824A T52.824D T52.824S T52.891A T52.891D T52.891S T52.892A T52.892D T52.892S T52.893A T52.893D T52.893S T52.894A T52.894D T52.894S T59.821A T59.821D T59.821S T59.822A T59.822D T59.822S T59.823A T59.823D T59.823S T59.824A T59.824D T59.824S T65.851A T65.851D T65.851S T65.852A T65.852D T65.852S T65.853A T65.853D T65.853S T65.854A T65.854D T65.854S Z68.18 Z68.19 Z77.013 Z77.32 Z77.33 Z77.40 Z77.41 Z77.42 Z77.49 Z86.17 Z87.8901 Z87.8902 Z87.8903 Z87.8904 Z87.8909 Z87.893 ICD-10 Diagnosis Inactivations ------------------------------ Effective Oct 01, 2026 (30 Codes) D69.1 I42.0 I42.8 I49.8 M72.2 M86.8X1 M86.8X2 M86.8X3 M86.8X4 M86.8X5 M86.8X6 M86.8X7 M86.8X8 S23.420A S23.420D S23.420S T52.8X1A T52.8X1D T52.8X1S T52.8X2A T52.8X2D T52.8X2S T52.8X3A T52.8X3D T52.8X3S T52.8X4A T52.8X4D T52.8X4S Z68.1 Z87.890 ICD-10 Diagnosis Revisions -------------------------- Effective Oct 01, 2026 (4 Codes) L02.232 L03.312 L03.322 Z29.14 ICD-10 Procedure Additions -------------------------- Effective Oct 01, 2026 (101 Codes) 028F3Z0 028F3Z1 028G3Z0 028G3Z1 0RGA0E0 0RGA0EJ 0RGA3E0 0RGA3EJ 0RGA4E0 0RGA4EJ 0SG00E0 0SG00EJ 0SG03E0 0SG03EJ 0SG04E0 0SG04EJ 0SG10E0 0SG10EJ 0SG13E0 0SG13EJ 0SG14E0 0SG14EJ 0SG30E0 0SG30EJ 0SG33E0 0SG33EJ 0SG34E0 0SG34EJ 0W99003 0W99303 0W99403 0W9B003 0W9B303 0W9B403 0W9C003 0W9C303 0W9C403 30233S5 30243S5 3E00XGF 3E01XGF 5A0527D 5A1D701 5A1D801 5A1D901 B85A2ZZ B85B2ZZ B85G2ZZ B85H2ZZ X0HQ05C X27P3NC X27Q3NC X27R3NC X27S3NC X27T3NC X27U3NC X28M3DC X2H43MC X2RF3LC X2RG3FC X2RH0GC X2VJ3HC X2VW3JC X2VX0KC XEZ5XKC XEZD3QC XEZJ3NC XEZU3HC XEZZXJC XEZZXLC XEZZXMC XEZZXPC XEZZXRC XEZZXSC XFJB3CC XFJB4CC XFJB8BC XFJD3CC XFJD4CC XFJD8BC XHH80JC XRH10NC XRH13NC XRH14NC XRH20NC XRH23NC XRH24NC XRH40NC XRH43NC XRH44NC XRH60NC XRH63NC XRH64NC XW0134C XW0336C XW0337C XW0436C XW0Q35C XW0U0CC XW0V0BC XXE2XHC ICD-10 Procedure Inactivations ------------------------------ Effective Oct 01, 2026 (38 Codes) X2KB317 X2KC317 XD2G4V7 XD2G8V7 XD2H4V7 XD2H8V7 XRGA0R7 XRGA3R7 XRGA4R7 XRGB0R7 XRGB3R7 XRGB4R7 XRGC0R7 XRGC3R7 XRGC4R7 XRGD0R7 XRGD3R7 XRGD4R7 XW00X27 XW01397 XW01X27 XW023X7 XW03367 XW03377 XW03387 XW033B7 XW04367 XW04377 XW04387 XW043B7 XW0DXR7 XW0G7R7 XW0H7R7 XW133D7 XW133F8 XW143D7 XXE5XR7 XXE5XT7 ICD-10 Procedure Revisions -------------------------- Effective Oct 01, 2026 (13 Codes) X27535B X27635B X27735B X27835B X27935B X27A35B X27B35B X27C35B X27D35B X27E35B XW0E33B XW0V0P7 XW143F8 CPT/HCPCS Modifier Pairs ------------------------ Added Inact React Revise Total ----- ----- ----- ------ ----- Effective Apr 01, 1999 * -- -- -- 1 1 Effective Jan 01, 2014 * 4 -- -- -- 4 Effective Apr 01, 2015 * 1 -- -- -- 1 Effective Jan 01, 2016 * 35 -- -- 2 37 Effective Jan 01, 2017 * -- -- -- 1 1 Effective Jan 01, 2018 * -- -- -- 2 2 Effective Jan 01, 2026 * 2 -- -- -- 2 ----- ----- ----- ------ ----- Total 42 -- -- 6 48 * update from a previous quarter SNOMED CT Changes ----------------- Effective Added Inact React Revise Total ---------- ----- ----- ----- ------ ----- SNOMED Codes 07/01/2026 5356 736 30 930 7052 SNOMED Terms Concepts 6290 1666 -- -- 7956 Synonyms 12649 3307 -- -- 15956 Fully Specified 6368 736 -- -- 7104 ----- ----- ----- ------ ----- 30663 6445 30 930 38068 SNOMED CT Version ID: 20250731 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, 1983-2027 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_161.GBL Patch Installation: ------------------- Pre Installation Instructions: ------------------------------ 1) Users may be on the system during the install of LEX*2.0*161. 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 20 MB of data. The import global ^LEXM is about 45 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: ICD Diagnosis #80 ^ICD9( ICD Operation/Procedure #80.1 ^ICD0( CPT #81 ^ICPT( CPT Copyright #81.2 ^DIC(81.2, CPT Modifier #81.3 ^DIC(81.3, 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: ------ -------------------------- ^ICD9 ICD Diagnosis ^ICD0 ICD Operation/Procedure ^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 ^DIC(81.3, CPT Modifier 4) Install the data from the global host file LEX_2_161.GBL. This file contains the Lexicon Utility's import global ^LEXM. This global is approximately 45 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_161.GBL Parameter: "RS" => Globals were saved on 22 Sep 2026 1:12 PM IRIS with description: LEX*2.0*161/ICD*18.0*132/ICPT*6.0*126 Data Input option: A ^LEXM 5) Set up user and IO variables (D ^XUP) for programmer access. 6) Distribution Load: Load the KIDS Distribution from the Packman Message using the Packman function "Install/Check Message." 7) KIDS Installation: Install the patch using the KIDS Installation Menu action "Install Package(s)" and the install name LEX*2.0*161. Respond "NO" at the "Want KIDS to INHIBIT LOGONs during the install?" prompt. Respond "NO" at the "Want to DISABLE Scheduled Options, Menu Options, and Protocols?" prompt. The KIDs install should take from 1-5 minutes 8) Cleanup a) The Environment Check routine LEX2161 and the Post-Install routine LEX2161P 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. 9) Back-out 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. 10) 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 1 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: LEX2161 Before: n/a After: B91279154 **161** Routine Name: LEX2161P Before: n/a After: B21750729 **161** ============================================================================= User Information: Entered By : Date Entered : SEP 17, 2026 Completed By: Date Completed: SEP 29, 2026 Released By : Date Released : SEP 30, 2026 ============================================================================= Packman Mail Message: ===================== $END TXT