$TXT Created by at DEVRAD.DOMAIN.EXT (KIDS) on Thursday, 08/31/23 at 13:35 ============================================================================= Run Date: OCT 19, 2023 Designation: RA*5*204 Package : RA - RADIOLOGY/NUCLEAR MEDICINE Priority: Mandatory Version : 5 SEQ #186 Status: Released Compliance Date: NOV 20, 2023 ============================================================================= Associated patches: (v)RA*5*121 <<= must be installed BEFORE `RA*5*204' Subject: RADIOLOGY DIAGNOSTIC CODES ADDITIONS Category: - Routine Description: ============ This patch will correct the following issue: The National Radiology Program Office has provided new national standardized diagnostic codes for LI-RADS, TI-RADS, and PI-RADS along with some updates to LUNGRADS and Peer Review codes. Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (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 Procedure Name New/Modified/Deleted --------------------- -------------------- N/A Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A New Service Requests (NSRs): ---------------------------- NSR 20220128 Patient Safety Issues (PSIs): ----------------------------- N/A Defect Tracking System Ticket(s) & Overview: N/A Problem: -------- The National Radiology Program Office has provided new national standardized diagnostic codes for LI-RADS, TI-RADS, and PI-RADS along with some updates to LUNGRADS. They also requested that all of the Peer Review (PR) codes (1250-1256) be inactivated. Resolution: ------------ This patch will update the DIAGNOSTIC CODES file (#78.3) file for distribution to the sites. The following codes will be added: PRINT ON GENERATE ABNORMAL ABNORMAL NUMBER DIAGNOSTIC CODE REPORT ALERT? -------------------------------------------------------------------------- 1400 LI-RADS NC YES YES Noncategorizable due to image omission or degradation -------------------------------------------------------------------------- 1410 LI-RADS NO OBS YES NO No observations -------------------------------------------------------------------------- 1411 LI-RADS 1 YES NO Definitely benign -------------------------------------------------------------------------- 1412 LI-RADS 2 YES NO Probably benign -------------------------------------------------------------------------- 1413 LI-RADS 3 YES YES Intermediate probability of malignancy -------------------------------------------------------------------------- 1414 LI-RADS 4 YES YES Probably HCC -------------------------------------------------------------------------- 1415 LI-RADS 5 YES YES Definitely HCC -------------------------------------------------------------------------- 1416 LI-RADS TIV YES YES Tumor in vein (TIV) -------------------------------------------------------------------------- 1417 LI-RADS M YES YES Probably or definitely malignant, not necessarily HCC -------------------------------------------------------------------------- 1421 LI-RADS TR NONEVALUABLE YES YES Treated, response not evaluable due image omission or degradation -------------------------------------------------------------------------- 1422 LI-RADS TR NONVIABLE YES YES Treated, probably or definitely not viable -------------------------------------------------------------------------- 1423 LI-RADS TR EQUIVOCAL YES YES Treated, equivocally viable -------------------------------------------------------------------------- 1424 LI-RADS TR VIABLE YES YES Treated, probably or definitely viable -------------------------------------------------------------------------- 1450 US LI-RADS 1A YES NO No/Benign Observation(s) -- no/minimal visualization limitations -------------------------------------------------------------------------- 1451 US LI-RADS 1B YES YES No/Benign Observation(s) -- moderate visualization limitations -------------------------------------------------------------------------- 1452 US LI-RADS 1C YES YES No/Benign Observation(s) -- severe visualization limitations -------------------------------------------------------------------------- 1453 US LI-RADS 2A YES YES Observation(s) <10mm (not benign) -- no/minimal visualization limitations -------------------------------------------------------------------------- 1454 US LI-RADS 2B YES YES Observation(s) <10mm (not benign) -- moderate visualization limitations -------------------------------------------------------------------------- 1455 US LI-RADS 2C YES YES Observation(s) <10mm (not benign) -- severe visualization limitations -------------------------------------------------------------------------- 1456 US LI-RADS 3A YES YES Observation(s) >= 10mm (not benign) -- no/minimal visualization limitations -------------------------------------------------------------------------- 1457 US LI-RADS 3B YES YES Observation(s) >= 10mm (not benign) -- moderate visualization limitations -------------------------------------------------------------------------- 1458 US LI-RADS 3C YES YES Observation(s) >= 10mm (not benign) -- severe visualization limitations -------------------------------------------------------------------------- 1500 PI-RADS NC YES YES Noncategorizable due to image omission or degradation -------------------------------------------------------------------------- 1511 PI-RADS 1 YES NO Very low (clinically significant cancer highly unlikely to be present) -------------------------------------------------------------------------- 1512 PI-RADS 2 YES NO Low (clinically significant cancer is unlikely to be present) -------------------------------------------------------------------------- 1513 PI-RADS 3 YES YES Intermediate (the presence of clinically significant cancer is equivocal) -------------------------------------------------------------------------- 1514 PI-RADS 4 YES YES High (clinically significant cancer is likely to be present) -------------------------------------------------------------------------- 1515 PI-RADS 5 YES YES Very high (clinically significant cancer highly likely to be present) -------------------------------------------------------------------------- 1600 TI-RADS NC YES YES Noncategorizable due to image omission or degradation -------------------------------------------------------------------------- 1611 TI-RADS 1 YES NO Benign -- NO FNA OR FOLLOW-UP -------------------------------------------------------------------------- 1612 TI-RADS 2 YES NO Not suspicious -- No FNA or follow-up -------------------------------------------------------------------------- 1613 TI-RADS 3 YES YES Mildly suspicious -- FNA if >= 2.5 cm, follow-up if >= 1.5 cm -------------------------------------------------------------------------- 1614 TI-RADS 4 YES YES Moderately suspicious -- FNA if >= 1.5 cm, follow-up if >= 1 cm -------------------------------------------------------------------------- 1615 TI-RADS 5 YES YES Highly suspicious -- FNA if >= 1 cm, follow-up if >= 0.5 cm -------------------------------------------------------------------------- The following updates were made to LUNGRADS codes: CODES 1211,1212,1213 and 1218 PRINT ON ABNORMAL REPORT is changed from 'NO' to 'YES' CODES 1212,1213,1214,1215 and 1216 The word 'NODULE' is removed from the DIAGNOSTIC CODE (.01) field. For example: LUNGRADS 2: BENIGN NODULE APPEARANCE OR BEHAVIOR is change to LUNGRADS 2: BENIGN APPEARANCE OR BEHAVIOR All Peer Review codes are inactivated: NUMBER DIAGNOSTIC CODE INACTIVE -------------------------------------------------- 1250 PR 1 YES 1251 PR 2A YES 1252 PR 2B YES 1253 PR 3A YES 1254 PR 3B YES 1255 PR 4A YES 1256 PR 4B YES Test Sites: ----------- Boston HCS VAMC (Boston, MA) Battle Creek VAMC (Battle Creek, MI) SNOW Change Order #: -------------------- Boston HCS VAMC: CHG0407817 Battle Creek VAMC: CHG0408039 Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. Documentation describing the new functionality is not included in this release. Patch Installation: ------------------- 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 5 minutes to install. There are no options that need to be disabled. Create a backup of the following global file before continuing: DIAGNOSTIC CODES #78.3 ^RA(78.3 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. Note that you may need to use GOGEN^%ZSPECIAL if you don't have permissions to access ^%GOGEN directly. Enter To create a Backup copy of: ------ -------------------------- ^RA(78.3, DIAGNOSTIC CODES Installation Instructions: 1. Choose the PackMan message containing this build. Then select the INSTALL/CHECK MESSAGE PackMan option to load the build. 2. 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 RA*5.0*204 B. Select the Backup a Transport Global option to create a backup message. You must use this option and specify what to backup; the entire Build or just Routines. The backup message can be used to restore the routines and components of the build to the pre-patch condition. When prompted for the following, enter "B" for Build. Select one of the following: B Build R Routines Enter response: Build C. 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. D. Select the Install Package(s) option and choose the patch to install. i. If prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//', answer NO ii. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO. iii. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', answer NO. Post-Installation Instructions: Installers please alert the radiology ADPAC/PACS Managers that new diagnostic codes are available. If the sites want to utilize any of them, they will need to load the new codes into their reporting system(s). Back-out/Rollback Strategy: --------------------------- Back-out will be done only with the concurrence and participation of development team and appropriate VA site/region personnel. The decision to back-out or rollback software will be a joint decision between development team, VA site/region personnel and other appropriate VA personnel. A national help desk ticket should be logged before attempting any backout procedures. Prior to installing an updated KIDS package, the site/region should have saved a backup of the routines in a mail message using the Backup a Transport Global [XPD BACKUP] menu option (this is done at time of install). The message containing the backed up routines can be loaded with the "Xtract PackMan" function at the Message Action prompt. The Packman function "INSTALL/CHECK MESSAGE" is then used to install the backed up routines onto the VistA System. If the new backup build option was used, after Xtracting the patch message use the KIDS Installation menu and enter RA*5.0*204b at the INSTALL NAME prompt. Data modified by this patch will be rolled back by utilizing the backup of DIAGNOSTIC CODES (#78.3) file that was created before the patch was installed. Validation of Back-out Procedure -------------------------------- The Back-out Procedure can be verified by checking the entries in the DIAGNOSTIC CODES file (#78.3) file and verifying the pre-patch data is restored. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.0;Radiology/Nuclear Medicine;**[Patch List]**;Mar 16, 1998;Build 2 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: RAIPR204 Before: n/a After: B1960767 **204** Routine Name: RAIPS204 Before: n/a After: B54671524 **204** ============================================================================= User Information: Entered By : Date Entered : JUN 22, 2023 Completed By: Date Completed: OCT 19, 2023 Released By : Date Released : OCT 19, 2023 ============================================================================= Packman Mail Message: ===================== $END TXT