============================================================================= Run Date: SEP 24, 2003 Designation: DG*5.3*510 Package : DG - REGISTRATION Priority: Mandatory Version : 5.3 SEQ #471 Status: Released Compliance Date: OCT 15, 2003 ============================================================================= Associated patches: (v)DG*5.3*158 <<= must be installed BEFORE `DG*5.3*510' (v)DG*5.3*309 <<= must be installed BEFORE `DG*5.3*510' (v)DG*5.3*397 <<= must be installed BEFORE `DG*5.3*510' (v)DG*5.3*418 <<= must be installed BEFORE `DG*5.3*510' (v)DG*5.3*441 <<= must be installed BEFORE `DG*5.3*510' (v)DG*5.3*493 <<= must be installed BEFORE `DG*5.3*510' (v)ICD*18*7 <<= must be installed BEFORE `DG*5.3*510' (v)DG*5.3*512 <<= must be installed BEFORE `DG*5.3*510' Subject: PTF CODE SET VERSIONING Category: - Routine - Enhancement (Mandatory) - Informational Description: ============ ********************************************************************************** * THIS PATCH MUST BE INSTALLED AT ALL SITES BY * * SEPTEMBER 30, 2003 * ********************************************************************************** ************************************************************************** ************************************************************************** This patch supports Code Set Versioning, mandated under the Health Information Portability and Accountability Act (HIPAA). It contains routines, data, and data dictionary changes to recognize code sets for the Current Procedural Terminology (CPT) and Health Care Financing Administration (HCFA) Common Procedure Coding System (HCPCS). When implemented, applications will be able to retrieve appropriate CPT and HCPCS codes based upon a date that a clinical event occurred. This patch is contained in the MULTIPLE BUILD DISTRIBUTION: CSV MS 1.0 Installing the CSV MS 1.0 build provides all of the updates listed below. Sites will use the Multi-Build Distribution to ensure the proper order of installation for the VISTA Packages in the Management Systems Product Line. ************************************************************************** ************************************************************************** I. OVERVIEW --------------------- Gail Graham, Director of Information Assurance, requested modifications to the VHA Information Systems and Technology Architecture (VISTA) Patient Information Management System (PIMS) package that allows the use of multiple versions of the code sets employed in financial transactions. The Health Insurance Portability and Accessibility Act (HIPPA) stipulates that diagnostic and procedure codes used for billing purposes must be the codes that were applicable at the time the service was provided. This initiative is commonly referred to as the Code Set Versioning (CSV) project. For this project, four code sets required by HIPPA legislation are date sensitive and needed modification. These include: * International Classification of Diseases-9-Clinical Modifications (ICD-9-CM) * Diagnostic Related Group (DRG) codes, which is part of the ICD-9 code set * Clinical Procedure Terminology-4 (CPT-4), and * Healthcare Common Procedural Coding System (HCPCS) Level II Codes. This patch addresses the chances done within the PTF system in order to make the system compliant to the specifications of CSV. Modifications were done within PTF to assure the validity of ICD DIAGNOSIS CODE, ICD OPERATION/PROCEDURE, and DRG codes, by utilizing API's that return codes for a given date. II. TECHNICAL a. All Direct Global Accesses (DGA's) to the ICD OPERATION / PROCEDURE file (#80.1) or the ICD DIAGNOSIS file (#80) were changed to use newly-develop Application Program Interfaces (API's). The API's are passed the ICD/CPT code and the "effective date" and the proper information is returned. These new API's also check to verify that the ICD/CPT code is active for the given date. b. All DGA's to the DRG file (#80.2) were changed to use a newly-developed API. These API's determine the correct DRG code for the effective date and verify that the DRG code is active for the given date. III. Functional --------- * The users will be prompted for an "effective date" when calculating the DRG using the DRG Calculation menu * All calculations of ICD/CPT/DRG codes will be based on an effective date that was either entered by the user or extracted from the patient's data EXAMPLES Run the DRG Calculation menu option. The first question now is "Effective Date" (with the default of today). If you want to calculate the DRG for a date other than today, enter that date. All other functionality is the same. The DRG will be calculated using the entered date. ROUTINE SUMMARY: ================ The following is a list of the routine(s) included in this patch. The second line of each of these routine(s) will look like: ;;5.3;Registration;**[patch list]**;Aug 13, 1993 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== DGPT50DI 2517717 4212340 510 DGPT60PR 1981670 3094585 510 DGPT70DI 4404595 5850111 510 DGPT70DX 1522145 2507108 510 DGPTAE04 2501495 3842098 510 DGPTDRG 17051794 19044452 60,441,510 DGPTF4 13248010 14130082 114,115,397,510 DGPTFAPI 3827140 4633515 309,510 DGPTFD 7808671 9372939 60,441,510 DGPTFIC 16299987 18865637 510 DGPTFJC 13880129 17067883 158,510 DGPTFM 15913403 15699620 510 DGPTFM0 7287940 7653123 510 DGPTFM4 16019991 16288680 114,195,397,510 DGPTFM5 9123774 9392898 510 DGPTFM6 13727138 13999100 164,510 DGPTFMO 14647948 17252236 195,397,510 DGPTFTR0 8574159 10113549 247,510 DGPTFVC1 14426166 15164283 52,58,79,114,164 400,342,466,415 493,512,510 DGPTICD 2615025 3313314 375,441,510 DGPTLMU4 6778410 6929780 510 DGPTODR 4646557 4731060 510 DGPTOLC2 17120365 17439839 164,510 DGPTR0 9063913 10105370 114,247,338,342,510 DGPTR2 8330227 8785122 183,338,423,510 DGPTR4 5121100 6257615 338,423,415,510 DGPTSUD1 4459855 4676601 510 DGPTSUDO 10223204 11584043 441,510 DGPTTS 10874146 11381048 26,61,164,510 DGPTTS1 16551157 17069312 26,64,418,510 SOFTWARE AND DOCUMENTATION RETRIEVAL ==================================== The software for this patch is being distributed in host file CSV_MS_1_0.KID. The host file will contain nine KIDS builds. The builds contained in the CSV MS 1.0 multi-package distribution are: Package Patch(es) ------- --------- AICS IBD*3.0*51 Ambulatory Care DG*5.3*511 SD*5.3*295 DRG Grouper ICD*18.0*7 Event Capture EC*2.0*47 Fee Basis FB*3.5*55 Integrated Billing IB*2.0*210 PCE PX*1.0*121 Registration (PTF) DG*5.3*510 Please refer to the 'Software and Documentation Retrieval' section of the EC*2*47 patch description for instructions on how to acquire the patch software and documentation. INSTALLATION INSTRUCTIONS: ========================== Please refer to the Health Insurance Portability and Accountability Act (HIPAA) Code Set Versioning (CSV) Installation Guide for details of the installation procedure for this patch. The HIPAA CSV Installation Guide can be found in the following [ANONYMOUS.SOFTWARE] directories: Preferred Address ------------------------- First available FTP server download.vista.med.va.gov Specific Field Office FTP Address --------------------- ------------------------ Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov File Name Description Format FTP Protocol -------------- ------------- --------- ------------ CSV_1_0_IG.DOC Install Guide MS Word Binary Routine Information: ==================== Routine Name: - DGPT50DI UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPT60PR UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPT70DI UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPT70DX UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTAE04 UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTDRG UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTF4 UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTFAPI UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTFD UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTFIC UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTFJC UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTFM UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTFM0 UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTFM4 UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTFM5 UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTFM6 UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTFMO UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTFTR0 UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTFVC1 UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTICD UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTLMU4 UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTODR UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTOLC2 UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTR2 UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTR4 UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTSUDO UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTTS UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTTS1 UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTR0 UPDATED FOR CSV PROJECT Routine Checksum: Routine Name: - DGPTSUD1 Routine Checksum: ============================================================================= User Information: Entered By : LENART,ANTHONY D Date Entered : APR 10, 2003 Completed By: KRAUTER,DARYL Date Completed: SEP 16, 2003 Released By : NELSON,VICKI M Date Released : SEP 24, 2003 ============================================================================= Packman Mail Message: ===================== No routines included