$TXT Created by DEVESS.DOMAIN.EXT (KIDS) on Friday, 04/04/14 at 17:50 ============================================================================= Run Date: AUG 15, 2014 Designation: LR*5.2*422 Package : LR - LAB SERVICE Priority: Mandatory Version : 5.2 SEQ #351 Status: Released Compliance Date: AUG 29, 2014 ============================================================================= Associated patches: (v)LR*5.2*322 <<= must be installed BEFORE `LR*5.2*422' (v)LR*5.2*350 <<= must be installed BEFORE `LR*5.2*422' (v)LEX*2*80 <<= must be installed BEFORE `LR*5.2*422' (v)ICD*18*57 <<= must be installed BEFORE `LR*5.2*422' (v)DG*5.3*850 <<= must be installed BEFORE `LR*5.2*422' Subject: ANATOMIC PATHOLOGY ICD-10 CLASS 1 REMEDIATION PROJECT Category: - Routine - Data Dictionary - Enhancement (Mandatory) - Other Description: ============ IMPORTANT INFORMATION Please read the Overview Guide (ICD-10_Production_Overview_Guide_Groups_3_4.pdf) posted on the Anonymous directory for installation order. This is critical for proper functionality of the ICD-10 Software. The International Classification of Diseases, Tenth Revision (ICD-10) Class 1 Software Remediation project replaces the 30-year-old set of diagnosis and procedure codes (ICD-9-CM) that medical personnel use. Dates of service, or dates of discharge for inpatients, that occur on or after the ICD-10 activation date will use the ICD-10 code set. Clinical Modification (ICD-10-CM) diagnosis codes increase from about 13,000 ICD-9 codes to more than 68,000. Procedure Coding System (ICD-10-PCS) procedure codes increase from about 3,800 ICD-9 codes to nearly 87,000. Both systems also expand the number of characters allotted to seven alpha-numeric characters. This value does not include the decimal point, which follows the third character for the ICD-10-CM code set. There is no decimal point in the ICD-10-PCS code set. These code sets have the potential to reveal more about quality of care, so that data can be used in a more meaningful way to better understand complications, better design clinically robust algorithms, and better track the outcomes of care. ICD-10-CM also incorporates greater specificity and clinical detail to provide information for clinical decision making and outcomes research. =============================== WARNING ================================ The ICD-10 Class I Remediation project will update VistA to include the ICD-10 Diagnosis and Procedure codes. The first patches to be delivered by this project will be the STS patches ICD*18.0*57 and LEX*2.0*80 which will include both the ICD-10 Diagnosis and Procedure codes along with new or updated APIs that will be used by the other VistA applications to select, retrieve and display these new codes. There are several VistA applications that do not currently utilize code set versioning. Those applications are Prosthetics, Home Based Primary Care, and Lab Anatomic Pathology. As a result, these applications currently allow inactive ICD-9 codes to be displayed and selected for ICD-9 dates of service. During the interim, after the installation of the STS ICD-10 Class I Remediation patches and prior to the ICD-10 Implementation date, these applications will also allow the display and selection of inactive ICD-10 codes including statuses of (Inactive) or (Pending). The users of these applications should use CAUTION to select ICD-9 or ICD-10 codes that are appropriate and active. The following examples show how the software would appear in these applications: EXAMPLE #1: Inactive ICD-9 codes. The warning (Inactive) appears at the end of the short description. Select ICD DIAGNOSIS: 100.0// 488.1 4 matches found 1. 488.1 FLU DT IDEN H1N1 VIRUS (Inactive) 2. 488.11 FLU DT 2009 H1N1 W PNEU (Major CC) 3. 488.12 FLU-2009 H1N1 W OTH RESP 4. 488.19 FLU-2009 H1N1 W OTH MAN (Inactive) Select 1-4: Select ICD DIAGNOSIS: EXAMPLE #2: Inactive ICD-10 codes. The warning (Pending) appears at the end of the short description. Select ICD DIAGNOSIS: 100.0// A27. 4 matches found 1. A27.0 Leptospirosis icterohemorrhagica (10/01/2014) (Pending) 2. A27.81 Aseptic meningitis in leptospirosis (10/01/2014) (Pending) 3. A27.89 Other forms of leptospirosis (10/01/2014) (Pending) 4. A27.9 Leptospirosis, unspecified (10/01/2014) (Pending) When creating or editing records dated after the ICD-10 Activation Date (10/01/2014), the software will correctly screen out both the inactive ICD-9 and inactive ICD-10 codes. =========================== END OF WARNING ============================= The following functionality within the Anatomic Pathology (AP) application addresses ICD-10 enhancements. 1. Option Updates The following options are modified to replace the word "ICD9CM" to "ICD". a) "Autopsy protocol & ICD9CM coding [LRAPAUDAA]" is changed to "Autopsy protocol & ICD coding [LRAPAUDAA]". b) "ICD9CM coding, anat path [LRAPICD]" is changed to "ICD coding, anat path [LRAPICD]". c) "FS/Gross/Micro/Dx/ICD9CM Coding [LRAPDGI]" is changed to "FS/Gross/Micro/Dx/ICD Coding [LRAPDGI]". d) "ICD9CM code search [LRAPSI]" is changed to "ICD code search [LRAPSI]". 2. Data Entry Updates Autopsy (AU), Cytopathology (CY), Electron Microscopy (EM), and Surgical Pathology (SP) data entry screens now allow the entry and display of the relevant ICD code sets based on the date of interest. The date of interest for AU is the Autopsy Date/Time. The date of interest for CY, EM, and SP is date the specimen is received. a) If the date of interest is prior to the ICD-10 activation date, then ICD-9 codes are available for data entry selection. b) If the date of interest is after the ICD-10 activation date, then ICD-10 codes are available for data entry selection. c) Screen prompts and displays are modified to replace the word "ICD9CM" to "ICD". d) The "Select ICD DIAGNOSIS CODE NUMBER:" prompt in the ICD code search [LRAPSI] is changed to "Select ICD Diagnosis:" 3. Report Updates The following reports are modified. a) ICD code search [LRAPSI] - The date range prompt and the Select ICD Diagnosis prompt are interchanged so that the ICD coding set displayed is based on an ICD coding date. - A warning message displays if the dates entered overlap the ICD coding system. The warning message is shown below:- Beginning and Ending dates must both be prior to (ICD-9) or both be on or after (ICD-10). - A search string displays findings based on a particular ICD coding system. For example, if the dates entered are for ICD-9, then a search of ICD codes will produce a list of ICD-9 codes, and the same will be true for ICD-10 codes. b) Five reports are changed to use the API $$ICDDX^ICDEX, instead of $$ICDDX^ICDCODE, to return ICD information based on the relevant ICD coding system. - Display surg path reports for a patient [LRAPSPCUM] - Display cytopath reports for a patient [LRAPCYCUM] - Display EM reports for a patient [LRAPEMCUM] - 10% random case review, surg path [LRAPQAR] - Tissue committee review cases [LRAPQAT] c) An existing problem was corrected in the Tissue committee review cases [LRAPQAT] report. Diagnosis codes from the PTF File (#45) were being accumulated from previous patients and displayed for subsequent patients. 4. Data Dictionary Updates The field descriptions in the LAB DATA File (#63) are changed to reflect the general term "ICD" instead of "ICD9CM". Patch Components ================ Files & Fields Associated: File Name (#) Field Name (#) New/Modified/Deleted ------------- ----------------------------------- -------------------- LAB DATA (#63) Mod AUTOPSY ICD CODE SUB-FIELD (63.808) Field (#80) AUTOPSY ICD CODE (#.01) EM SUB-FIELD (#63.02) Field (#2) ICD CODE SUB-FIELD (63.203) field (#80) ICD CODE (#.01) Mod Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- LRAPSI run routine Modified LRAPICD run routine Modified LRAPDGI run routine Modified LRAPAUDAA run routine Modified Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (#) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Additional Information: N/A New Service Requests (NSRs): ----------------------------- NSR 20070902, ICD-10-CM Conversion Patient Safety Issues (PSIs): ------------------------------ N/A Remedy Ticket(s) & Overviews: ----------------------------- HD0000000741712 - ICD10: LRAPSI option doesn't display data for EM section Problem: While testing the Anatomic Pathology application for the ICD10 remediation project, it was noted that the ICD code search [LRAPSI] option did not display any details in the Name, ID, Sex, Age, and ACC # columns for the Electron Microscopy (EM) section even though the selected ICD code was on file. Solution: The problem was related to how the M code checked if an ICD code existed in File (#63). For all the sections (Autopsy, Cytopathology, and Surgical Pathology), with the exception of Electron Microscopy (EM), the ICD code pointer to File (#80) is stored as a subscript in File (#63). When checking for ICD code of EM, the code failed to find any because of the way the data is stored. Test Sites: ----------- Battle Creek VAMC, Battle Creek, MI North Chicago, VAMC, Chicago, IL Orlando VAMC, Orlando, FL Phoenix VAMC, Phoenix, AZ Blood Bank Clearance Statement ------------------------------ VISTA Laboratory Package patch LR*5.2*422 contains changes to software controlled by VHA DIRECTIVE 2004-058, titled VISTA BLOOD BANK SOFTWARE. Changes include: Changes to Group B files: 63 LAB DATA Partial DD: field 80 Partial DD: subDD: 63.808 field: .01 Partial DD: subDD: 63.203 field: .01 All of the above changes have been reviewed by the VISTA Blood Bank Developer and found to have no impact on the VISTA BLOOD BANK SOFTWARE control functions. RISK ANALYSIS: Changes made by patch LR*5.2*422 have no effect on Blood Bank software functionality, therefore RISK is none. EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch LR*5.2*422 does not alter or modify any software design safeguards or safety critical elements functions. POTENTIAL IMPACT ON SITES: This patch contains changes to 0 routines and 1 file identified in Veterans Health Administration (VHA) Directive 2004-058, group B listing. The changes have no effect on Blood Bank functionality or medical device control functions. There is no adverse potential to sites. VALIDATION REQUIREMENTS BY OPTION: The options affected by this patch do not require validation. MINIMAL TEST CASE SCENARIOS BY OPTION, INCLUSIVE OF ALL CONTROL FUNCTIONS: There are no test case scenarios for this patch. Documentation Retrieval Instructions: ------------------------------------- Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to File Transfer Protocol (FTP) the files from ftp://download.vista.domain.ext/. This transmits the files from the first available FTP server. Sites may also elect to retrieve software directly from a specific server as follows: Albany ftp.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext The documentation will be in the form of Adobe Acrobat files. Documentation can also be found on the Department of Veterans Affairs (VA) Software Documentation Library (VDL) at: http://www4.domain.ext/vdl/ File Description File Name FTP Mode -------------------------------------------------------------------------- AP User Manual - Revised apump422.PDF (binary) AP CPT Corrections User lab_5_2_p422_ug.PDF (binary) Guide AP Alerts and CPRS Report lab_lr_5_2_422_ug.PDF (binary) Changes User Guide AP Electronic Signature lab_5_2_422_um.PDF (binary) User Manual ICD-10 Release Notes for ICD-10_RN_LR_5_2_422.PDF (binary) AP (LR*5.2*422) Production Overview Guide ICD-10_Production_Overview_Guide_ (binary) Groups_3_4.pdf Patch Installation: Pre/Post Installation Overview ------------------------------ Pre-Installation Instructions ----------------------------- This patch may be installed with users on the system although it is recommended that it be installed during non-peak hours to minimize potential disruption to users. This patch should take less than five minutes to install. The following menu options should be disabled. LRAP Anatomic pathology Installation Instructions ------------------------- 1. Choose the PackMan message containing this patch. 2. Choose the INSTALL/CHECK MESSAGE PackMan option. 3. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, you may elect to use the following option. When prompted for the INSTALL enter the patch # (LR*5.2*422): a. 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. b. 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 components of this patch (routines, DD's, 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. 4. From the Installation Menu, select the Install Package(s) option and choose the patch to install. Enter LR*5.2*422. 5. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//', respond NO. 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', respond NO. 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', respond YES. LRAP Anatomic pathology Enter options you wish to mark as 'Out Of Order': Enter protocols you wish to mark as 'Out Of Order': 8. If prompted 'Delay Install (Minutes): (0 - 60): 0//', respond 0. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.2;LAB SERVICE;**[Patch List]**;Sep 27, 1994;Build 29 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: LRAPCUM1 Before: B6249474 After: B6459175 **315,422** Routine Name: LRAPD1 Before: B22367539 After: B24459842 **41,91,248,259,317,350,422** Routine Name: LRAPDA Before: B88410283 After: B92935176 **72,73,91,121,248,259,295,317, 365,350,422** Routine Name: LRAPICD Before: n/a After:B174775261 **422** Routine Name: LRAPICD2 Before: n/a After: B43748147 **422** Routine Name: LRAPQAT1 Before: B4707143 After: B5116733 **201,315,422** Routine Name: LRAPX Before: B5097427 After: B8577110 **72,259,422** Routine Name: LRAUDA Before: B5184827 After: B5906621 **72,248,259,322,422** Routine Name: LRAUSICD Before: B4216631 After: B6291180 **72,253,315,422** Routine Name: LRSPRPT1 Before: B10719224 After: B10863662 **1,259,315,422** Routine Name: LRSPSICD Before: B4454107 After: B7174339 **72,253,315,422** Routine Name: LRSPSICP Before: B6145447 After: B6145397 **72,422** Routine Name: LRU Before: B44711331 After: B45238843 **1,72,201,248,350,422** ============================================================================= User Information: Entered By : Date Entered : APR 26, 2012 Completed By: Date Completed: AUG 08, 2014 Released By : Date Released : AUG 15, 2014 ============================================================================= Packman Mail Message: ===================== $END TXT