$TXT Created by at DEVESS.DOMAIN.EXT (KIDS) on Wednesday, 06/25/14 at 14:20 ============================================================================= Run Date: AUG 05, 2014 Designation: PX*1*199 Package : PX - PCE PATIENT CARE ENCOUNTER Priority: Mandatory Version : 1 SEQ #153 Status: Released Compliance Date: AUG 26, 2014 ============================================================================= Associated patches: (v)PX*1*62 <<= must be installed BEFORE `PX*1*199' (v)PX*1*146 <<= must be installed BEFORE `PX*1*199' (v)PX*1*165 <<= must be installed BEFORE `PX*1*199' (v)PX*1*194 <<= must be installed BEFORE `PX*1*199' (v)LEX*2*80 <<= must be installed BEFORE `PX*1*199' (v)ICD*18*57 <<= must be installed BEFORE `PX*1*199' (v)SD*5.3*593 <<= must be installed BEFORE `PX*1*199' (v)PX*1*203 <<= must be installed BEFORE `PX*1*199' Subject: PCE ICD-10 CLASS 1 REMEDIATION Category: - Routine - Data Dictionary - Enhancement (Mandatory) - Other Description: ============ IMPORTANT INFORMATION Please read the Overview Guide 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 implementation 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. This patch prepares the Patient Care Encounter (PCE) package for utilizing the ICD-10 codes when they become active. Forty-nine existing routines were modified, one routine which contains ICD-10 related utilities was added, two routines to control ICD-10 diagnosis look-up were added, and one pre-installation routine is included in the build. Throughout the package, both in the M code and in the Data Dictionary, instances of reference to ICD-9 were frequently changed to a generic reference such as ICD or Diagnosis. The ICD-9 label is retained in a few places where only ICD-9 codes will be displayed. All reports have been reformatted to accommodate the longer ICD-10 codes and the longer descriptions. Essentially though, the users should experience very little change. In addition, other VistA packages which utilize PCE services through API calls should experience no change in functionality. The API parameters for both Input and Output have remained the same. Example of the updated text changes where ICD-9 will now be generic: * * * * * Old: Associated Primary Diagnosis ICD9 Code not in File 80 New: Associated Primary Diagnosis ICD Code not in File 80 Examples of the updated places where ICD-9 or ICD-10 will be individually specified based on the transaction date or report date range: * * * * * Select ICD-9 Diagnosis: 100.81 or Select ICD-10 Diagnosis: F17.209 * * * * * HELP SCREEN ALL DIAGNOSES (ICD-9 CODES) ITEM CODE DESCRIPTION 1 001.1 CHOLERA DUE TO VIBRIO CHOLERAE EL TOR 2 001.9 CHOLERA, UNSPECIFIED 3 002.0 TYPHOID FEVER or HELP SCREEN ALL DIAGNOSES (ICD-10 CODES) ITEM CODE DESCRIPTION 1 A00.0 CHOLERA DUE TO VIBRIO CHOLERAE 01, BIOVAR CHOLERAE 2 A00.1 CHOLERA DUE TO VIBRIO CHOLERAE 01, BIOVAR ELTOR 3 A00.9 CHOLERA, UNSPECIFIED * * * * * 3 Most Frequent ICD9 Diagnoses: Code Description Frequency -------- ------------------------------------------ --------- 1. 280.8 IRON DEFIC ANEMIA NEC 4 2. 305.79 OTHER SYMPATHOMIMETIC, NEC 3 3. 812.09 FX UPPER HUMERUS NEC-CL 2 or 3 Most Frequent ICD10 Diagnoses: Code Description Frequency -------- ------------------------------------------ --------- 1. A00.0 Cholera due to Vibrio cholerae 01, biovar 4 2. E08.649 Diabetes due to underlying condition w hyp 3 3. H21.253 Iridoschisis, bilateral 2 Patch Components ================ Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ----------------------- --------------------- ----------------------- V POV (#9000010.07) POV (#.01) Modified, text only ICD NARRATIVE (#.019) Modified, new algorithm CLINICAL TERM (#.15) Modified, text only HEAD AND/OR NECK CANCER (#80006) Modified, text only "ACR" new style cross reference Modified, description & new ICD-10 format added V CPT (#9000010.18) DIAGNOSIS (#.05) Modified input transform DIAGNOSIS 2 (#.09) Modified input transform DIAGNOSIS 3 (#.1 ) Modified input transform DIAGNOSIS 4 (#.11) Modified input transform DIAGNOSIS 5 (#.12) Modified input transform DIAGNOSIS 6 (#.13) Modified input transform DIAGNOSIS 7 (#.14) Modified input transform DIAGNOSIS 8 (#.15) Modified input transform TREATMENT (#9999999.17) File Description Modified, text only 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 ----------- ---- -------------------- N/A Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- Diagnosis (ICD-9) [PXCE POV ADD] Modified Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Additional Information: New Service Requests (NSRs) ---------------------------------- NSR 20070902, ICD-10-CM Conversion Patient Safety Issues (PSIs) ----------------------------- N/A Remedy Ticket(s) & Overview --------------------------- This ICD-10 Remediation patch was not created as a result of any Remedy Tickets however Remedy Ticket INC000000820913 was created to document that PX*1.0*199 patch fixes a pre-existing condition as described immediately below. PCE does not retrieve DG codes associated with the AICS encounter form for the clinic being used. (PCE Encounter Data Entry - Supervisor. Go to Check Out Interview) This was found to be an error in logic by the routine PXBGPOV4 in existing ICD-9 code. The ICD10 Remediation development team (HP) fixed this for both ICD9 and ICD10 in the PCE patch PX*1.0*199. We want the problem documented so that users are aware that this is not an AICS problem and will be fixed when this PX*1.0*199 patch gets loaded. Problem: ------- N/A Resolution: ---------- N/A Test Sites: ---------- VA Pittsburgh Healthcare System, Pittsburgh, PA Boise VA Medical Center, Boise, ID G.V. (Sonny) Montgomery VA Medical Center, Jackson, MS John D. Dingell VA Medical Center, Detroit, MI Miami VA Healthcare System, Miami, FL Montana HCS Battle Creek VAMC, Battle Creek, MI Documentation Retrieval Instructions ------------------------------------ Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to 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 Documentation can also be found on the VA Software Documentation Library at: http://www.domain.ext/vdl/ Title File Name FTP Mode -------------------------------------------------------------------------- ICD-10 Release Notes (PX*1*199) ICD-10_RN_PX_1_199.PDF (binary) Production Overview Guide Group 2 Production_Overview_ (binary) Guide_Group_2.pdf Technical Manual pxtm.pdf (binary) User Manual pxum.pdf (binary) User Manual Appendices pxumappx.pdf (binary) Patch Installation: Pre/Post Installation Overview ------------------------------ This patch will run a brief pre-installation routine that will update the PXCE POV ADD protocol. The routine PX10P199 will not be automatically deleted. You may keep it or delete it per your local standards. There is no post-installation routine nor any special steps. Pre-Installation Instructions ----------------------------- 1a) It is recommended that this patch be installed during non-peak hours. 1b) All steps leading up to the KIDS Installation may be done with the users on the system. Users must be off of the system during the KIDS installation. There is a long list of applications that use PCE services to file data, and there is very real potential for errors to occur if this is installed while those services are in use. 1c) TaskMan must remain running but in a WAIT state for the duration of the KIDS installation. Once the install is complete, restore TaskMan by removing TaskMan from a WAIT state. 1d) This patch should take less than ten (10) minutes to install. Installation Instructions ------------------------- As noted above, users, background filers, CPRS RPC ports, etc. should be off the system, shut down or disabled before applying this patch. Approximately 30 packages utilize PCE services and over 50 routines are being modified. To avoid errors and avoid database degradation the system must be quiescent. 1. Choose the PackMan message containing this patch (PX*1.0*199). 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 # PX*1.0*199 : 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 DDs 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, 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. 4. From the Installation Menu, select the Install Package(s) option and choose the patch to install. 5. If prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//' We recommend answering YES, unless your system rebuilds menu trees nightly using TaskMan or you are installing other patches after this one for which you will also Rebuild Menu Trees. Answering YES will increase installation time and need only be done once after installing multiple patches. 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//' You may answer NO since all users should be off the system anyway. 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO// You may answer NO since all users should be off the system anyway. 8. If prompted "Delay Install (Minutes): (0 - 60): 0// respond 0. Post-Installation Instructions ------------------------------ There are no post-installation steps that need to be executed. Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;PCE PATIENT CARE ENCOUNTER;**[Patch List]**;Aug 12, 1996;Build 51 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: AUPNSICD Before: B1050074 After: B1233832 **121,149,190,194,199** Routine Name: PX10P199 Before: n/a After: B8361541 **199** Routine Name: PXAICPTV Before: B16278915 After: B23770661 **15,73,74,111,121,130,168,194,199** Routine Name: PXAIIMMV Before: B492495 After: B4109825 **199** Routine Name: PXAIPL Before: B4827876 After: B5170500 **69,124,168,199** Routine Name: PXAIPOV Before: B24363290 After: B24084108 **28,73,69,108,112,130,124,174, 168,203,199** Routine Name: PXAIPOVV Before: B2638479 After: B2657796 **121,194,199** Routine Name: PXAISKV Before: B439136 After: B3940836 **199** Routine Name: PXBAICS Before: B415459 After: B492354 **199** Routine Name: PXBDCPT Before: B45424112 After: B52464094 **11,73,89,108,121,124,199** Routine Name: PXBDPOV Before: B26935577 After: B32766424 **124,168,199** Routine Name: PXBDREQ Before: B9032260 After: B9107608 **73,124,199** Routine Name: PXBGPL2 Before: B14646395 After: B14633423 **11,199** Routine Name: PXBGPOV Before: B11193623 After: B11410055 **11,112,149,124,168,199** Routine Name: PXBGPOV2 Before: B37370726 After: B43166443 **1,5,11,136,149,124,203,199** Routine Name: PXBGPOV3 Before: B13078399 After: B13265811 **11,199** Routine Name: PXBGPOV4 Before: B17114546 After: B18370344 **11,28,121,199** Routine Name: PXBHLP3 Before: B15121600 After: B18181575 **11,19,62,199** Routine Name: PXBPCPT Before: B50760397 After: B52397890 **11,73,89,112,121,132,149,124, 190,199** Routine Name: PXBPCPT2 Before: B7116983 After: B10905536 **124,170,199** Routine Name: PXBPL Before: B19131975 After: B25222448 **11,94,115,130,168,199** Routine Name: PXBPPOV Before: B22074119 After: B34159394 **11,28,92,121,149,124,170,182,199** Routine Name: PXBPPOV1 Before: B23470728 After: B24879639 **11,112,121,124,199** Routine Name: PXBSTOR Before: B42381168 After: B42386628 **73,88,149,124,164,203,199** Routine Name: PXBUTL2 Before: B3542412 After: B4486692 **121,199** Routine Name: PXCACPT Before: B47966106 After: B43989781 **27,33,73,121,124,194,199** Routine Name: PXCADXP1 Before: B24306608 After: B21605401 **24,33,194,199** Routine Name: PXCAPL Before: B33553090 After: B30996914 **24,27,115,130,168,194,199** Routine Name: PXCAPL1 Before: B6017229 After: B6900352 **33,115,130,168,199** Routine Name: PXCAPL2 Before: B8360764 After: B9344999 **33,115,130,168,199** Routine Name: PXCAPOV Before: B38043079 After: B35019386 **24,27,33,121,130,124,168,199** Routine Name: PXCASK Before: B12106125 After: B15678860 **27,124,199** Routine Name: PXCAVIMM Before: B17122556 After: B20851145 **27,124,199** Routine Name: PXCEAE1 Before: B12204747 After: B16220510 **22,73,199** Routine Name: PXCECPT Before: B65495033 After: B73855102 **14,27,73,89,112,121,136,124, 170,164,182,199** Routine Name: PXCECPT1 Before: B2104203 After: B3081673 **170,164,199** Routine Name: PXCEPOV Before: B17257132 After: B13988253 **27,121,124,170,168,199** Routine Name: PXCEPOV1 Before: B33219732 After: B39167369 **134,149,124,170,203,199** Routine Name: PXCEVFI4 Before: B27747505 After: B26873797 **124,203,199** Routine Name: PXCEVFI5 Before: B5688048 After: B5687740 **14,99,124,199** Routine Name: PXCEVIMM Before: B27090719 After: B31390321 **27,124,199** Routine Name: PXDSLK Before: n/a After: B44674639 **199** Routine Name: PXDXUTL Before: n/a After: B9983043 **199** Routine Name: PXPXRM Before: B12998169 After: B24754616 **119,199** Routine Name: PXPXRMI2 Before: B80236604 After: B86987846 **119,194,199** Routine Name: PXQUTL3A Before: B55110955 After: B55077296 **29,199** Routine Name: PXRHS01 Before: B10447211 After: B10447211 **73,199** Routine Name: PXRHS12 Before: B8236713 After: B8270720 **73,199** Routine Name: PXRRFDP Before: B66324541 After: B74055950 **3,10,12,18,31,121,199** Routine Name: PXRRFDSD Before: B22536054 After: B37724715 **3,10,12,31,54,121,199** Routine Name: PXRRMDR Before: B37941513 After: B38033243 **124,174,168,199** Routine Name: PXRRMDR1 Before: B19546467 After: B20723539 **174,168,199** Routine Name: PXRRPAPI Before: B63792719 After: B64147348 **18,121,165,199** Routine Name: PXRRPCE3 Before: B26611053 After: B39482453 **121,146,199** Routine Name: PXRRPCE4 Before: B25666281 After: B24619827 **199** Routine Name: PXSCH4 Before: B8097371 After: B7784412 **194,199** Routine Name: PXSELDS Before: n/a After: B47899921 **199** Routine Name: PXUTL1 Before: B10780309 After: B11838187 **25,134,149,199** Routine list of preceding patches: 29, 62, 146, 165, 182, 194, 203 ============================================================================= User Information: Entered By : Date Entered : JUL 12, 2011 Completed By: Date Completed: JUL 31, 2014 Released By : Date Released : AUG 05, 2014 ============================================================================= Packman Mail Message: ===================== $END TXT