$TXT Created by ROWE,KIMBALL at LEXNXT.FO-BAYPINES.MED.VA.GOV (KIDS) on Tuesday, 03/23/10 at 11:31 ============================================================================= Run Date: APR 26, 2010 Designation: LEX*2*69 Package : LEX - LEXICON UTILITY Priority: Mandatory Version : 2 SEQ #64 Status: Released Compliance Date: MAY 03, 2010 ============================================================================= Associated patches: (v)LEX*2*55 <<= must be installed BEFORE `LEX*2*69' (v)LEX*2*68 <<= must be installed BEFORE `LEX*2*69' Subject: Code Set FY10 3rd Qtr Update Category: - Enhancement (Mandatory) - Routine - Data Dictionary - Other Description: ============ This patch contains the FY10 3rd Quarter Code Set distribution with 22 changes effective Apr 01, 2010. This patch also contains seven changes from FY10 2nd Qtr (effective Jan 01, 2010), 25 projected changes for FY10 4th Qtr (effective Jul 01, 2010), 6835 SNOMED CT changes (effective Jan 31, 2010), and 44 DMIS-ID changes (effective Aug 01, 2009). This patch installs the data for the following Informational patch: ICPT*6.0*51 This patch writes to the following files: CPT #81 ^ICPT( ICR 4489 CPT CATEGORY #81.1 ^DIC(81.1, ICR 4490 CPT MODIFIER #81.3 ^DIC(81.3, ICR 4492 LEXICON files #757-757.41 ^LEX( N/A ENHANCEMENTS ============ FY10 3rd Quarter Update CPT Procedure Additions ----------------------- Effective Jul 01, 2010 (15 Codes) 0223T 0224T 0225T 0226T 0227T 0228T 0229T 0230T 0231T 0232T 0233T 90664 90666 90667 90668 CPT Procedure Revisions (14 Codes) ----------------------- Effective Jan 01, 2010 (FY10 2nd Qtr) (2 Codes) 4180F 4200F Effective Apr 01, 2010 (2 Codes) 22901 4062F Effective Jul 01, 2010 (projected FY10 4th Qtr) (10 Codes) 0208T 0209T 0210T 0211T 0212T 0219T 0220T 0221T 0222T 4248F HCPCS Procedure Additions ------------------------- Effective Apr 01, 2010 (12 Codes) C9258 C9259 C9260 C9261 C9262 C9263 G0428 G0429 G0432 G0433 G0435 G9147 HCPCS Procedure Revisions (9 Codes) ------------------------- Effective Jan 01, 2010 (FY10 2nd Qtr) (5 Codes) C8923 C8924 C8928 G0129 G0275 Effective Apr 01, 2010 (4 Codes) G0425 G0426 G0427 L8680 CPT Modifier Additions ---------------------- Effective Apr 01, 2010 (1 Code) GX CPT Modifier Revisions ---------------------- Effective Apr 01, 2010 (3 Codes) GA RA RB Other Coding System Updates Systematized Nomenclature of Medicine, Clinical Terms (SNOMED CT) ----------------------------------------------------------------- Effective Jan 31, 2010 (6835 Codes) Additions 1733 Inactivations 433 Reactivations 3082 Revisions 1587 Defense Medical Information System (DMIS) ID Codes -------------------------------------------------- Effective Aug 01, 2009 (44 Codes) Additions 44 REMEDY TICKETS: ============== 374319 Lupus should be 710.0 not 017.00 374361 E&M CPT Codes with Modifier AI 378388 E&M CPT Codes with Modifier AI (dupe) 378558 Modifiers NU, RR, UE 380493 Modifiers 51 with 93541-93543 382801 Modifiers 51 with 93541-93543 (dupe) 380767 AX with A4215, A6216 & A6402 387018 Modifier 50 with 64490-64495 388760 Modifier 50 with 64490-64495 (dupe) 351846 Lookup inconsistencies (PSPO 1575) PATIENT SAFETY ISSUE: ==================== 1575 Lookup by text returns a term that is inconsistent with the term returned if the search was conducted using the associated code Example: Search for Text: Endocrine Gland Neoplasms Retrieves: ICD code 194.9 Search for Code: 194.9 Retrieves: Malignant neoplasm of endocrine gland Problem: "Endocrine Gland Neoplasms" does not indicate Malignant Re-code as: 239.7 - Neoplasm of unspecified nature of endocrine glands and other parts of nervous system A total of 101 terms for Neoplasms of Unspecified Nature were re-coded so a lookup by the associated ICD code does not return a Malignant Neoplasm term. FTP SOFTWARE RETRIEVAL: ======================= Global Host File: LEX_2_69.GBL (ASCII) The preferred method is to FTP the files from download.vista.med.va.gov, which will transmit the files from the first available FTP server. The files may also be downloaded directly from a particular FTP location at the following locations. Hines ftp.fo-hines.med.va.gov Albany ftp.fo-albany.med.va.gov Salt Lake ftp.fo-slc.med.va.gov Files are available in the ANONYMOUS.SOFTWARE directory. INSTALLATION INSTRUCTIONS ========================= 1) Users may be on the system during the install of LEX*2.0*69. It is recommended that this patch be installed during non-peak hours. This patch should take from 39 minutes to 1 hours and 47 minutes to install, depending on the system and system activity. Create a backup 35 to 75 minutes Load the Global 1 to 2 minutes KIDS Install 3 to 30 minutes 2) Create a backup of the following global files before continuing: CPT/HCPCS Procedure #81 ^ICPT( CPT Category #81.1 ^DIC(81.1, CPT Modifier #81.3 ^DIC(81.3, Lexicon Files #757-757.41 ^LEX( These backup files may get as large as 1.17 gigabytes. Make sure space is available before proceeding. It should take from 35 to 75 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/HCPCS Procedure ^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(81.1, CPT Category ^DIC(81.3, CPT Modifier 3) Make sure that the remnants of a previous import global do not exist on your system. If the global ^LEXM does exist, you will need to kill this global before proceeding. On a Cache system, the prevention of unsubscripted global kills is a system wide setting, but it can be allowed for a particular process using the $ZU command. The command for enabling unsubscripted global kills is: VAH>S X=$ZU(68,28,0) VAH>K ^LEXM The command for disabling unsubscripted kills for a process is S X=$ZU(68,28,1); however, halting out of the process and creating a new process will achieve the same effect. 4) Install the data from the global host file LEX_2_69.GBL. This file contains the Lexicon Utility's import global ^LEXM. This global is approximately 14.5 Mb megabytes in size. Make sure there is sufficient space available to load this global with journaling on. The loading of the global should take from 1 to 2 minutes. Thin Client Global Restore Using the Cache Thin Client, right-click on the Cache cube, then select "Explorer." Open the "Namespaces" folder, then open the "VAH" folder, and right click on the "Globals" folder. Select the "Import from disk" option. Click on the "Options..." button. Select the "Globals" tab, make sure the format is VAX DSM, then click "OK." Find the file in the directory, double click on LEX_2_69.GBL. Next, select "Import All." At the prompt "Do you wish to restore '^LEXM'," select "Yes." Programmer Mode From the Programmer prompt, execute the following routine: >D ^%GI Global input Device: VA5$:[ANONYMOUS.SOFTWARE]LEX_2_69.GBL Parameter: RS=> Globals were saved on 15 Mar 2010 11:56 AM Cache with description: LEX*2*69/ICPT*6*51 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*69. Respond "NO" at the "Want KIDS to INHIBIT LOGONs during the install?" prompt. Respond "NO" at the "Want to DISABLE Schedule Options, Menu Options, and Protocols?" prompt. The KIDs install should take from 3-30 minutes 8) Cleanup a) The Environment Check routine LEX2069 and the Post-Install routine LEX2069P 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. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;LEXICON UTILITY;**[Patch List]**;Sep 23, 1996;Build 3 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: LEX2069 Before: n/a After:B105945482 **69** Routine Name: LEX2069P Before: n/a After: B15181891 **69** ============================================================================= User Information: Entered By : ROWE,KIMBALL Date Entered : FEB 01, 2010 Completed By: BASKETT,BARBARA J Date Completed: APR 19, 2010 Released By : SCHWARTZ,VIKIE Date Released : APR 26, 2010 ============================================================================= Packman Mail Message: ===================== $END TXT