============================================================================= Run Date: OCT 20, 2003 Designation: FB*3.5*61 Package : FB - FEE BASIS Priority: EMERGENCY Version : 3.5 SEQ #58 Status: Released Compliance Date: OCT 24, 2003 ============================================================================= Associated patches: (v)FB*3.5*5 <<= must be installed BEFORE `FB*3.5*61' (v)FB*3.5*12 <<= must be installed BEFORE `FB*3.5*61' (v)FB*3.5*32 <<= must be installed BEFORE `FB*3.5*61' (v)FB*3.5*55 <<= must be installed BEFORE `FB*3.5*61' (v)FB*3.5*57 <<= must be installed BEFORE `FB*3.5*61' Subject: FPPS EDI CLAIM ENHANCEMENT Category: - Enhancement () - Data Dictionary - Input Template - Routine - Other Description: ============ THIS PATCH MUST BE INSTALLED BY OCTOBER 24, 2003. IRM SHOULD PROVIDE THE FEE STAFF WITH A COPY OF THIS PATCH DESCRIPTION. This patch contains enhancements to VistA Fee Basis for the Fee Replacement Phase 1 project. This patch also corrects three minor bugs. The enhancements include updates to the invoice prompts and specified outputs to support EDI claims for HIPAA compliance. This patch adds a new interface that will send data concerning EDI claims to the Fee Payment Processing System (FPPS) hosted at the Health Administration Center (HAC) so FPPS can generate electronic remittance advice to the vendor. This patch adds new options that allow for the update of specified data elements on EDI claims that have been paid in VistA Fee and contain EDI specific data elements that were incorrectly data entered at time of invoice entry. The fixes include corrections for a problem that can occur when an existing (duplicate) payment is edited using Enter Payment [FBAA ENTER PAYMENT] option and a separate problem with the Payment Look-Up for Medical Vendor [FBAA VENDOR LOOKUP] option. A problem with entry of four ICD diagnosis or procedure codes on a civil hospital invoice is also corrected. The Fee Basis User Manual is being updated to reflect the changes introduced by this patch. The updated manual will be available shortly (a day or two) after the patch release date. It can be downloaded from the VistA Document Library web page. http://www.va.gov/vdl In the interim, a supplemental PDF document containing the User Manual updates is being released with the patch. This document provides users with a quick reference guide to the changes introduced with patch FB*3.5*61. These changes will also be incorporated into the online version of the VistA Fee Basis User Manual. See the installation section of this patch for more information. This patch addresses the following E3R(s): ------------------------------------------ There are no E3Rs associated with this patch. This patch addresses the following NOIS: ---------------------------------------- ISW-1102-22099, SAJ-1003-70752 The changes made by this patch are described below: 1. MAINTAIN CODE SETS TO SUPPORT NEW INVOICE DATA FIELDS This patch adds the data for several code sets to VistA Fee Basis so the application can ensure that only active HIPAA compliant codes are selected by a fee clerk when the results of the adjudication are entered for a health care claim. The code sets are Code Set Stored in New File ----------------------------- ------------------ Claim Adjustment Reason Codes ADJUSTMENT REASON (#161.91) Claim Adjustment Group Codes ADJUSTMENT GROUP (#161.92) Remittance Remarks Codes REMITTANCE REMARK (#161.93) 2. COLLECT ADDITIONAL DATA FOR UNAUTHORIZED CLAIMS This patch updates the unauthorized claims module to obtain the FPPS CLAIM ID for unauthorized EDI claims. The user will be prompted "Is this an EDI claim from the FPPS system?" when an unauthorized claim is entered or edited. If the answer is Yes then a FPPS CLAIM ID must be entered and stored. If the user answers No during an edit of an existing claim then any existing value in the FPPS CLAIM ID field will be deleted. The following options are modified: Enter Unauthorized Claim [FBUC ENTER] Modify Unauthorized Claim [FBUC MODIFY UNAUTHORIZED CLAIM] Re-open Unauthorized Claim [FBUC REOPEN] 3. COLLECT ADDITIONAL DATA FOR OUTPATIENT AND ANCILLARY INVOICES This patch updates the Fee Basis software to obtain additional data when an outpatient or ancillary payment is entered or edited. The changes are described below. a. Identify payments that are for an EDI claim The user will be prompted to identify when the payment is for an EDI claim from the Fee Payment Processing System (FPPS). The user will be prompted "Is this an EDI claim from the FPPS system?" However, this prompt will not be asked when the payment is for an approved unauthorized claim. For unauthorized claim payments, the identification of an EDI claim will be automatically derived based on the content of the FPPS CLAIM ID field for the unauthorized claim. If the user changes the answer from YES to NO for an existing payment then any existing value in the FPPS CLAIM ID field and the FPPS LINE ITEM field must be deleted. b. Collect information specific to payments for an EDI claim If the payment has been identified as for an EDI claim then the user will normally be prompted for two additional items (FPPS CLAIM ID and FPPS LINE ITEM). However, the FPPS CLAIM ID will be obtained from the unauthorized claim instead of a prompt when the payment is for an approved unauthorized claim. c. Collect additional payment information for both EDI and non-EDI claims. When appropriate, the user may be prompted for the following new data elements when entering or editing payments for both EDI and non-EDI claims. PATIENT ACCOUNT NUMBER REVENUE CODE UNITS PAID ADJUSTMENT REASON ADJUSTMENT GROUP ADJUSTMENT AMOUNT REMITTANCE REMARK For both EDI and non-EDI claim payments, the user will no longer be asked for the AMOUNT SUSPENDED, SUSPEND CODE, and DESCRIPTION OF SUSPENSION. Instead these fields will be automatically populated based on the contents of the ADJUSTMENT REASON and ADJUSTMENT AMOUNT fields. The following options are modified: C&P/Multiple Patient Payment Entry [FBAA C&P ENTER PAYMENT] Enter Payment [FBAA ENTER PAYMENT] Multiple Payment Entry [FBAA MULTIPLE PAYMENT ENTRY] Reimbursement Payment Entry [FBAA MEDICAL REIMBURSEMENT] Edit Payment [FBAA EDIT PAYMENT] Ancillary Contract Hosp/CNH Payment [FBCH ANCILLARY PAYMENT] Multiple Ancillary Payments [FBCH MULTIPLE PAYMENTS] Patient Reimbursement for Ancillary [FBCH ANCILLARY REIMBURSEMENT] Services Edit Ancillary Payment [FBCH EDIT ANCILLARY PAYMENT] Payments for Unauthorized Claims [FBUC PAYMENTS] 4. COLLECT ADDITIONAL DATA FOR PHARMACY INVOICES The patch updates the Fee Basis software to obtain additional data when an pharmacy invoice is entered or edited. The changes are described below. a. Identify invoices that are for an EDI claim The user will be prompted to identify when the invoice is for an EDI claim from the Fee Payment Processing System (FPPS). The user will be prompted "Is this an EDI claim from the FPPS system?". However, this prompt will not be asked when the payment is for an approved unauthorized claim. For unauthorized claim payments, the identification of an EDI claim will be automatically derived based on the content of the FPPS CLAIM ID field for the unauthorized claim. If the user changes the answer from YES to NO for an existing payment then any existing value in the FPPS CLAIM ID field and the FPPS LINE ITEM field will be deleted. b. Collect information specific to payments for an EDI claim If the payment has been identified as for an EDI claim then the user will normally be prompted for two additional items (FPPS CLAIM ID and FPPS LINE ITEM). However, the FPPS CLAIM ID will be obtained from the unauthorized claim instead of a prompt when the payment is for an approved unauthorized claim. c. Collect additional payment information for both EDI and non-EDI claims. When appropriate, the user may be prompted for the following new data elements when entering or editing invoices for both EDI and non-EDI claims. ADJUSTMENT REASON ADJUSTMENT GROUP ADJUSTMENT AMOUNT REMITTANCE REMARK For both EDI and non-EDI claim payments, the user will no longer be asked for the AMOUNT SUSPENDED, SUSPEND CODE, and DESCRIPTION OF SUSPENSION. Instead these fields will be automatically populated based on the contents of the ADJUSTMENT REASON and ADJUSTMENT AMOUNT fields. The following options are modified: Enter Pharmacy Invoice [FBAA ENTER PHARMACY INVOICE] Patient Re-imbursement [FBAA REIMBURSEMENT PHARMACY] Review Fee Prescription [FBAA PHARMACY REVIEW] Complete Pharmacy Invoice [FBAA COMPLETE PHARMACY INVOICE] List Invoices Pending MAS [FBAA PENDING MAS COMPLETION] Completion Edit Pharmacy Invoice [FBAA EDIT PHARMACY INVOICE] Payments for Unauthorized Claims [FBUC PAYMENTS] 5. COLLECT ADDITIONAL DATA FOR CIVIL HOSPITAL AND COMMUNITY NURSING HOME INVOICES This patch updates the Fee Basis software to obtain additional data when a civil hospital or community nursing home invoice is entered or edited. The changes are described below. a. Identify invoice that is for an EDI claim The user will be prompted to identify when the invoice is for an EDI claim from the Fee Payment Processing System (FPPS). The user will be prompted "Is this an EDI claim from the FPPS system?". However, this prompt will not be asked when the payment is for an approved unauthorized claim. For unauthorized claim payments, the identification of an EDI claim will be automatically derived based on the content of the FPPS CLAIM ID field for the unauthorized claim. If the user changes the answer from YES to NO for an existing payment then any existing value in the FPPS CLAIM ID field and the FPPS LINE ITEM field will be deleted. b. Collect information specific to payments for an EDI claim If the invoice has been identified as for an EDI claim then the user will normally be prompted for two additional items (FPPS CLAIM ID and FPPS LINE ITEM). However, the FPPS CLAIM ID will be obtained from the unauthorized claim instead of a prompt when the payment is for an approved unauthorized claim. c. Collect additional payment information for both EDI and non-EDI claims. When appropriate, the user may be prompted for the following new data elements when entering or editing payments for both EDI and non-EDI claims. PATIENT CONTROL NUMBER COVERED DAYS DRG WEIGHT ADJUSTMENT REASON ADJUSTMENT GROUP ADJUSTMENT AMOUNT REMITTANCE REMARK For both EDI and non-EDI claim payments, the user will no longer be asked for the AMOUNT SUSPENDED, SUSPEND CODE, and DESCRIPTION OF SUSPENSION. Instead these fields will be automatically populated based on the contents of the ADJUSTMENT REASON and ADJUSTMENT AMOUNT fields. The following options are modified: Enter Invoice/Payment [FBCH ENTER PAYMENT] Reimbursement for Inpatient [FBCH REIMBURSEMENT INVOICE] Hospital Invoice Invoice Edit [FBCH EDIT PAYMENT] Re-initiate Pricer Rejected Items [FBCH REINITIATE PRICER REJECTS] Complete A Payment [FBCH COMPLETE PAYMENT] Enter CNH Payment [FBCNH ENTER PAYMENT] Edit CNH Payment [FBCNH EDIT PAYMENT] Payments for Unauthorized Claims [FBUC PAYMENTS] 6. Ensure Line Items on an Invoice are Paid at the Same Time Outpatient, ancillary, and pharmacy invoices may have multiple line items on a single invoice. To ensure that all the line items on an invoice are paid at the same time, this patch modifies VistA Fee to require that all line items for a single invoice are located in the same payment batch. a. Options that allow new line items to be added to an existing invoice are modified to ensure that the new line items are placed in the same payment batch as the existing invoice. The following options are modified: C&P/Multiple Patient Payment [FBAA C&P ENTER PAYMENT] Entry Enter Payment [FBAA ENTER PAYMENT] Multiple Payment Entry [FBAA MULTIPLE PAYMENT ENTRY] Reimbursement Payment Entry [FBAA MEDICAL REIMBURSEMENT] Ancillary Contract Hosp/CNH [FBCH ANCILLARY PAYMENT] Payment Multiple Ancillary Payments [FBCH MULTIPLE PAYMENTS] Patient Reimbursement for [FBCH ANCILLARY REIMBURSEMENT] Ancillary Services Payments for Unauthorized Claims [FBUC PAYMENTS] b. Options that allow existing outpatient/ancillary line items to be moved to a different payment batch have been modified to assign a new invoice number to the moved line items if some of that invoice's line items are staying in the original batch. This splits the original invoice into two invoices so all the line items for a given invoice will be in the same payment batch. The following options are modified: Re-initiate Rejected Payment Items [FBAA REINITIATE REJECTS] 7. SUPPORT 0.00 PAYMENT FOR CH/CNH INVOICES The AMOUNT PAID (#8) field in the FEE BASIS INVOICE (#162.5) file is modified to allow entry of 0.00 for civil hospital and community nursing home invoices. The medical fee and pharmacy invoices already allow entry of a 0.00 payment. 8. USE UNITS IN FEE SCHEDULE CALCULATION This patch updates the fee schedule calculation for outpatient and ancillary services to consider units. When a fee schedule amount is calculated, the system shall multiply the fee schedule amount by the number of units and use the result as the default amount paid. This should always occur for the RBRVS fee schedule. However, units are not multiplied with the VA Fee Schedule amount until dates of service in fiscal year 2005 or later to ensure the fee schedule amount is a per unit value. 9. REPORT BY FPPS CLAIM ID This patch creates a new report to list VistA Invoice Numbers associated with a user-specified FPPS Claim ID. The new option is FPPS Claim Inquiry [FB FPPS CLAIM INQ]. It is attached to the following menus: Outputs Main Menu [FBAA OUTPUTS MENU] Pharmacy Fee Main Menu [FBAA PHARMACY MAIN MENU] Output Menu [FBCH OUTPUT MENU] Output Main Menu - CNH [FBCNH OUTPUTS MAIN MENU] Outputs for Unauthorized Claims [FBUC OUTPUTS] 10. MODIFY EXISTING OUTPUTS TO DISPLAY NEW INVOICE/CLAIM DATA This patch modifies many existing outputs to include some of the new invoice data elements that are being collected. Some of these outputs have more than one format depending on the type of invoice being displayed. For example, the List Items in Batch output has three different formats. One format for Outpatient/Ancillary invoices, another for Pharmacy invoices, and a third for CH/CNH (civil hospital/community nursing home) invoices. The modified outputs (formats) are listed below along with the options that can be used to generate them. a. List Items in Batch (Outpatient/Ancillary, Pharmacy, CH/CNH) Close-out Batch [FBAA CLOSE BATCH] Pricer Batch Release [FBCH PRICER RELEASE] - only CH/CNH format List Items in Batch [FBAA LIST BATCH] Release a Batch [FBAA SUPERVISOR RELEASE] Finalize a Batch [FBAA FINALIZE BATCH] Re-initiate Rejected Payment Items [FBAA REINITIATE REJECTS] Delete Reject Flag [FBAA VOUCHER DELETE REJECT] Print Rejected Payment Items [FBAA REJECT PRINT] b. Payment History Display report (Outpatient/Ancillary) Payment History Display [FBAA PAYMENT HISTORY DISPLAY] c. Invoice Display (Outpatient/Ancillary) Invoice Display [FBAA INVOICE DISPLAY] Payment Listing for Vendor/Veteran [FB VENDOR/VETERAN PAYMENTS] - Action ID for an outpatient/ancillary payment d. Invoice Display (Pharmacy) Display Pharmacy Invoice [FBAA PHARMACY INVOICE DISPLAY] Payment Listing for Vendor/Veteran [FB VENDOR/VETERAN PAYMENTS] - Action ID for a pharmacy payment e. Invoice Display (CH/CNH) Format 1 Invoice Display [FBCH INVOICE DISPLAY] Complete a Payment [FBCH COMPLETE PAYMENT] Invoice Edit [FBCH EDIT PAYMENT] Re-initiate Pricer Reject Items [FBCH REINITIATE PRICER REJECTS] Payment Listing for Vendor/Veteran [FB VENDOR/VETERAN PAYMENTS] - Action ID for a CH/CNH payment f. List Payments (Outpatient/Ancillary) Payment Display for Patient [FBAA VENDOR PAYMENT DISPLAY] Enter Payment [FBAA ENTER PAYMENT] Multiple Payment Entry [FBAA MULTIPLE PAYMENT ENTRY] C&P/Multiple Patient Payment Entry [FBAA C&P ENTER PAYMENT] Reimbursement Payment Entry [FBAA MEDICAL REIMBURSEMENT] Ancillary Contract Hosp/CNH Payment [FBCH ANCILLARY PAYMENT] Multiple Ancillary Payments [FBCH MULTIPLE PAYMENTS] Patient Reimbursement for Ancillary Services [FBCH ANCILLARY REIMBURSEMENT] Delete Payment Entry [FBAA DELETE PAYMENT] g. List Payments (Pharmacy) Format 1 List Pharmacy History [FBAA PHARMACY HISTORY] Enter Pharmacy Invoice [FBAA ENTER PHARMACY INVOICE] Patient Re-imbursement [FBAA REIMBURSEMENT PHARMACY] Review Fee Prescription [FBAA PHARMACY REVIEW] h. List Payments (Pharmacy) Format 2 Complete Pharmacy Invoice [FBAA COMPLETE PHARMACY INVOICE] List Invoices Pending MAS Completion [FBAA PENDING MAS COMPLETION] i. Check Display (Outpatient/Ancillary, Pharmacy, CH/CNH) Check Display [FB CHECK DISPLAY] j. Payment Look-Up for Medical Vendor (Outpatient/Ancillary) Payment Look-up for Medical Vendor [FBAA VENDOR LOOKUP] k. Display Unauthorized Claim (Unauthorized Claim) Display Unauthorized Claim [FBUC DISPLAY UNAUTHORIZED] 11. FPPS PAYMENT ADVICE INTERFACE This patch adds a new interface with the Fee Payment Processing System (FPPS) located at the Health Administration Center (HAC). VistA Fee Basis will transmit invoice data to FPPS for EDI claims so FPPS can generate the electronic remittance advice to the vendor as required by HIPAA regulations. An invoice will be automatically queued to be transmitted to FPPS when one of the following events occurs. o Payment confirmation/cancellation message is received from the Austin Automation Center for an invoice that was identified as an EDI claim from the FPPS system. o An invoice with a total amount paid of $0.00 is released with the Release a Batch [FBAA SUPERVISOR RELEASE] option and that invoice was identified as an EDI claim from the FPPS system. o A previously transmitted invoice is edited using the edit options on the FPPS Update & Transmit Menu [FB FPPS UPDATE MENU]. See paragraph 12 of patch description for more information. o A re-transmit of an invoice is requested using the Transmit Invoices to FPPS [FB FPPS TRANSMIT] option. This patch introduces a new file, FPPS QUEUED INVOICES (#163.5) to track invoices that have been queued for transmission to FPPS. A new menu has been added to hold options that are related to the interface with FPPS. The menu is the FPPS Update & Transmit Menu [FB FPPS UPDATE MENU] which is attached to the Supervisor Main Menu [FBAA SUPERVISOR OPTIONS]. The following options are attached to this new menu. Outpatient/Ancillary Invoice Edit [FBAA FPPS EDIT INVOICE] **> Locked with FBAASUPERVISOR Pharmacy Invoice Edit [FBRX FPPS EDIT INVOICE] **> Locked with FBAASUPERVISOR Inpatient Invoice Edit [FBCH FPPS EDIT INVOICE] **> Locked with FBAASUPERVISOR Audit Report for FPPS Data [FB FPPS AUDIT REPORT] Transmit Invoices to FPPS [FB FPPS TRANSMIT] **> Locked with FBAASUPERVISOR Report of Transmissions to FPPS [FB FPPS TRANSMIT REPORT] Purge Message Text [FB FPPS PURGE] **> Locked with FBAASUPERVISOR The first four options on the menu are described in item 12 of the patch description (EXCEPTION HANDLING). The last three options are described below. Transmit Invoices to FPPS [FB FPPS TRANSMIT] OPTION DESCRIPTION: This option transmits invoice data to the Fee Payment Processing System (FPPS) located at the Health Administration Center (HAC) so FPPS can send electronic remittance advice to the vendor for claims that were electronically submitted to VA. This option can be scheduled (with no output device needed) or it can be run interactively from a menu. If scheduled, it will transmit all pending invoices. If run interactively, the user is given an option to transmit a selected invoice or all pending invoices. If necessary, an invoice that has been previously sent to FPPS can be re-transmitted by selecting it. When all pending invoices are sent, a summary message will be mailed to the FEE mail group. The messages are generated using the VistA HL7 package. The HL7 package sends them to the VistA Interface Engine located at the site. The local VistA Interface Engine sends the messages to the Interface Engine located at the HAC. Report of Transmissions to FPPS [FB FPPS TRANSMIT REPORT] OPTION DESCRIPTION This option generates a report of fee invoices transmitted to the VistA HL7 package for delivery to the Fee Payment Processing System (FPPS) at the Health Administration Center (HAC). Note that the count displayed under the Accepted By Interface Engine column will only reflect acknowledgements received prior to the most recent transmit of all pending invoices. This is because the check for acknowledgements is performed at the beginning of the transmit all pending process. Therefore, if the user-specified period includes the date of the most recent transmit, the recently transmitted invoices will be included in the counts under the Payment Confirm and Payment Cancelled columns, but not under the Accepted By Interface Engine column. This is because VistA Fee Basis will not yet have checked to see if those invoices were acknowledged. Purge Message Text [FB FPPS PURGE] OPTION DESCRIPTION When an invoice is transmitted to FPPS via the HL7 package, a copy of the HL7 message text is saved in the FPPS QUEUED INVOICES (#163.5) file. This option purges the message text for invoices transmitted prior to a specified date. Messages that have not been accepted by the VistA Interface Engine will not be purged unless there is a later message for the same invoice number that has been accepted. 12. EXCEPTION HANDLING This patch adds three new edit options, a new file, and a report to support exception handling. The edit options can be used to edit VistA invoices that have previously been transmitted to FPPS in the event that FPPS reports an exception because of incorrect data. Only the FPPS Claim ID and FPPS Line Item can be changed. The edit options are locked with the FBAASUPERVISOR security key. If the invoice is changed then it will be automatically queued to be resent to FPPS. An audit log of changes is maintained in the new FEE BASIS FPPS AUDIT (#163.7) file. The four options are attached to the new FPPS Update & Transmit Menu [FB FPPS UPDATE MENU]. Outpatient/Ancillary Invoice Edit [FBAA FPPS EDIT INVOICE] OPTION DESCRIPTION This option is used to edit an outpatient or ancillary invoice that has previously been transmitted to FPPS. If changes are made, the invoice will be queued to be resent to FPPS. Pharmacy Invoice Edit [FBRX FPPS EDIT INVOICE] OPTION DESCRIPTION This option is used to edit a pharmacy invoice that has previously been transmitted to FPPS. If changes are made, the invoice will be queued to be resent to FPPS. Inpatient Invoice Edit [FBCH FPPS EDIT INVOICE] OPTION DESCRIPTION This option is used to edit an inpatient (civil hospital or community nursing home) invoice that has previously been transmitted to FPPS. If changes are made, the invoice will be queued to be resent to FPPS. Audit Report for FPPS Data [FB FPPS AUDIT REPORT] OPTION DESCRIPTION This option generates a report from the FEE BASIS FPPS AUDIT file. This file contains an audit log of changes made to an invoice using special edit options. The options allow editing of selected data after the invoice has been transmitted to FPPS to resolve exceptions. 13. FIX ENTER PAYMENT OPTION (NOIS ISW-1102-22099) Two different faults exist in the Enter Payment [FBAA ENTER PAYMENT] option. These faults only cause a problem in the following situation. A user is entering a new payment and the system detects that it is a potential duplicate. If the user decides not to continue entering the new payment and instead edits the pre-existing payment then the code in DOEDIT^FBAACO3 is used for the edit. The prompts would look like the following. Service selected for that date already in system. Do you want to add another service for the SAME DATE? No// NO Want to edit it? No// YES fault 1 - not all appropriate fields are asked/updated because the variable DR(1,162.03,3) is overwritten. The AMOUNT SUSPENDED, SUSPEND CODE, DESCRIPTION OF SUSPENSION, DATE CORRECT INVOICE REC'D, and VENDOR INVOICE DATE fields are not asked. fault 2 - If the service provided (CPT/HCPCS code) starts with a letter then a ?? is displayed to the screen and the edit does not occur. This patch corrects both these faults. NOIS ISW-1102-22099 14. FIX PAYMENT LOOK-UP FOR MEDICAL VENDOR The Payment Look-up for Medical Vendor [FBAA VENDOR LOOKUP] option can inappropriately exclude payments from the output. This option only lists payments that have been finalized. If the report finds a payment that was not finalized for a given date of service, vendor, and patient then it will stop looking at payments for the same date of service, vendor, and patient. However, there could be other payments that have been finalized and should be included in the report. This patch corrects the report so it examines all the payments for a given date of service, vendor, and patient. The problem was discovered during testing and is not associated with a NOIS. 15. FIX ICD CODE PROMPT FOR CIVIL HOSPITAL INVOICE (NOIS SAJ-1003-70752) When civil hospital invoices are entered or edited the software is inappropriately requiring entry of a fifth code whenever four ICD codes have been entered. This problem occurs with both the diagnosis code (ICD5 prompt) and the procedure code (PROC5 prompt). The software displays "Invalid Code" when no value is entered at these prompts and doesn't allow the user to continue until a value is entered. Example of problem for diagnosis code ICD5: Invalid Code ICD5: Invalid Code ICD5: ^ EXIT NOT ALLOWED This problem occurs within the following three options Enter Invoice/Payment [FBCH ENTER PAYMENT] Invoice Edit [FBCH EDIT PAYMENT] Payments for Unauthorized Claims [FBUC PAYMENTS] This problem was introduced by patch FB*3.5*55 (CODE SET VERSIONING) which was released on SEP 24,2003. Patch FB*3.5*61 corrects the software so a value does not have to be entered at the ICD5 and PROC5 prompts. ====================== INSTALLATION INSTRUCTIONS ====================== If installed during the normal workday it is recommended that the following menu options (File #19) and all of their descendants be disabled to prevent possible conflicts while running the KIDS Install. Other VISTA users will not be affected. Civil Hospital Main Menu [FBCH MAIN MENU] Community Nursing Home Main Menu [FBCNH MAIN MENU] Medical Fee Main Menu [FBAA MEDICAL MAIN MENU] Pharmacy Fee Main Menu [FBAA PHARMACY MAIN MENU] Telephone Inquiry Menu [FB PHONE MENU] Unauthorized Claim Main Menu [FBUC MAIN] Install Time - The estimated install time for this patch is approximately 10 minutes. 1. PLACE NEW FBHL GLOBAL --------------------- This patch introduces a new global ^FBHL. This global is recommended for journaling. The global will contain a list of VistA invoices that are awaiting transmission or have been transmitted to FPPS. It will also contain a copy of the HL7 data transmitted to FPPS. This global will start with no data and grow as EDI claims are processed. Each EDI invoice transmitted to FPPS will take approximately 1K bytes of space in the new global. About half of this space can be recovered using the Purge Message Text [FB FPPS PURGE] option. Only a small percentage of health care claims are expected to be submitted to VA Medical Centers via EDI in October 2003. Over time, this percentage will grow. CHAMPVA currently receives 30% of their claims via EDI. It is not uncommon for a medical center to enter from 10,000 to 30,000 total invoices in VistA Fee Basis each year. The size of the FBHL global will depend on the percentage of claims that are submitted via EDI. This global should be placed in appropriate translation tables. It is suggested that journaling be enabled. The FBHL global MUST be placed with appropriate protections prior to installing the KIDS distribution. The protections should be the same as those for the existing FB namespaced globals. 2. RETRIEVE THE KIDS DISTRIBUTION HOST FILE ---------------------------------------- This patch will be distributed in a host file due to the size of the patch. The name of the host file is FEE3_5P61.KID. Sites can retrieve VistA software from the following FTP addresses. 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. Sites may also elect to retrieve software directly from a specific server as follows: Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov The FEE3_5P61.KID host file is located in the anonymous.software directory. Use ASCII Mode when downloading the file. The filename for the Fee Basis User Manual Replacement pages is FEE3_5P61UM.PDF. Use Binary Mode when downloading the file. 3. LOAD TRANSPORT GLOBAL --------------------- Load the KIDS distribution that is contained in file FEE3_5P61.KID using the Load a Distribution option on the Installation menu. 4. DISABLE ROUTINE MAPPING (DSM for Open VMS sites only) ----------------------- Disable routine mapping on all systems for the routines listed in step 5 below. NOTE: If the routines included in this patch are not currently in your mapped routine set, please skip this step. 5. COMPONENTS SENT WITH PATCH -------------------------- The following is a list of the routines included in this patch. The second line of each of these routines now looks like: ;;3.5;FEE BASIS;**[patch list]**;JAN 30, 1995 CHECK^XTSUMBLD results Routine Before Patch After Patch Patch List -------- ------------ ----------- ---------- FBAACCB 15922406 16780162 **4,61** FBAACCB1 13369194 13478672 **55,61** FBAACIE 10971469 11039954 **38,61** FBAACO 18113415 19215887 **4,61** FBAACO0 13662971 14424593 **4,38,52,57,61** FBAACO1 14721753 15081421 **4,61** FBAACO2 10848429 10651553 **4,55,61** FBAACO3 17993269 20665988 **4,38,55,61** FBAACP 14014765 15300323 **4,38,55,61** FBAACP1 5358195 5851424 **4,61** FBAAEPI 7020809 10180857 **38,61** FBAAEPI1 new 2667771 **61** FBAAFA new 2767105 **61** FBAAFED new 6318802 **61** FBAAFR new 838564 **61** FBAAMP 21171437 22067655 **4,21,38,55,61** FBAAMP1 8041334 5470247 **4,55,61** FBAAPET 15511474 19994018 **4,38,55,61** FBAAPET1 new 3131046 **61** FBAAPH 15776642 16727372 **2,4,32,61** FBAAPIE 14735959 14992676 **61** FBAAPIN 14496047 12503826 **4,61** FBAAPP 17772954 17931826 **61** FBAAPP0 6578102 3413335 **61** FBAAPPH 11682386 10584385 **12,61** FBAARR 17198810 20331581 **61** FBAARR1 15532156 15633757 **61** FBAASCB 14230209 14181929 **38,61** FBAAVLU 11228584 12278614 **4,61** FBAAVS 8290129 9039550 **4,61** FBCHEAP 12574723 11956719 **38,55,61** FBCHEP 18999908 19724066 **4,61** FBCHEP1 7220585 8018808 **38,61** FBCHFA new 2728082 **61** FBCHFED new 3795505 **61** FBCHFR new 851164 **61** FBCHPET 14169072 18371312 **4,38,61** FBCHRR 7282468 7773003 **61** FBCHVH 10910632 10411533 **55,61** FBCKDIS 16692982 18156401 **4,61** FBFHLD3 new 4532082 **61** FBFHLD5 new 4220710 **61** FBFHLD9 new 2396557 **61** FBFHLL new 3900869 **61** FBFHLP new 5815900 **61** FBFHLS new 6761384 **61** FBFHLS1 new 2237899 **61** FBFHLU new 1268710 **61** FBFHLX new 10276335 **61** FBFHLX1 new 8277429 **61** FBFPAR new 5006350 **61** FBFPCI new 4319806 **61** FBFPTR new 8593158 **61** FBNHEDPA 6175427 6717976 **61** FBNHEP1 6194686 7275887 **12,61** FBPAID 8118147 8704536 **5,61** FBRXFA new 2712418 **61** FBRXFED new 5100355 **61** FBRXFR new 839109 **61** FBUCEN 15158562 15394551 **32,61** FBUTL1 new 2499659 **61** FBUTL2 new 9831445 **61** FBUTL3 new 1183049 **61** FBUTL4 new 6241413 **61* FBUTL5 new 4719547 **61** FBXIP61 new 433612 **61** Total number of routines: 66 New Routines: 30 The following is a list of template(s) included in this patch. Type Name File Comments ------ ------------------------------ ------ ----------- Input FB ADD RX #162.1 Modified Input FB UNAUTHORIZED EDIT #162.7 Modified Input FB UNAUTHORIZED ENTER #162.7 Modified Input FBCH EDIT PAYMENT #162.5 Modified Input FBCH ENTER PAYMENT #162.5 Modified Input FBNH EDIT PAYMENT #162.5 Modified The following is a list of option(s) included in this patch. Menu Text Option Name Comments --------------------------------- ---------------------- -------- Audit Report for FPPS Data FB FPPS AUDIT REPORT new FPPS Claim Inquiry FB FPPS CLAIM INQ new Purge Message Text FB FPPS PURGE new Transmit Invoices to FPPS FB FPPS TRANSMIT new Report of Transmissions to FPPS FB FPPS TRANSMIT REPORT new FPPS Update & Transmit Menu FB FPPS UPDATE MENU new Outpatient/Ancillary Invoice Edit FBAA FPPS EDIT INVOICE new Inpatient Invoice Edit FBCH FPPS EDIT INVOICE new Pharmacy Invoice Edit FBRX FPPS EDIT INVOICE new The following is a list of protocols included in this patch. FB FEE TO FPPS EVENT FB FEE TO FPPS SUBSCRIBER The following is a list of HL7 Application Parameters included in this patch. FB CPE FPPS FB FEE-FPPS The following is a list of HL Logical Links included in this patch. FBFEE-FPPS This patch adds or modifies the data dictionary of the following files. ADJUSTMENT REASON (#161.91) new ADJUSTMENT GROUP (#161.92) new REMITTANCE REMARK (#161.93) new FEE BASIS PAYMENT (#162) modified FEE BASIS PHARMACY INVOICE (#162.1) modified FEE BASIS INVOICE (#162.5) modified FEE BASIS UNAUTHORIZED CLAIMS (#162.7) modified FPPS QUEUED INVOICES (#163.5) new FEE BASIS FPPS AUDIT (#163.7) new FEE BASIS FEE SCHEDULE (#163.99) modified This patch enters data in the following files. ADJUSTMENT REASON (#161.91) ADJUSTMENT GROUP (#161.92) REMITTANCE REMARK (#161.93) 6. START UP KIDS ------------- Start up the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: INStallation --- Load a Distribution Print Transport Global Compare Transport Global to Current System Verify Checksums in Transport Global Install Package(s) Restart Install of Package(s) Unload a Distribution Backup a Transport Global Select Installation Option: 7. Select Installation Option: -------------------------- NOTE: The following are OPTIONAL - (When prompted for the INSTALL NAME, enter FB*3.5*61): 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. 8. Select Installation Option: Install Package(s) ------------------ **This is the step to start the installation of this KIDS patch: a. Choose the Install Package(s) option to start the patch install. b. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//' answer per your site's normal procedures. c. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//' answer NO. d. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//' answer YES. e. When prompted 'Enter options you wish to mark as 'Out Of Order':' Enter the following options: Civil Hospital Main Menu [FBCH MAIN MENU] Community Nursing Home Main Menu [FBCNH MAIN MENU] Medical Fee Main Menu [FBAA MEDICAL MAIN MENU] Pharmacy Fee Main Menu [FBAA PHARMACY MAIN MENU] Telephone Inquiry Menu [FB PHONE MENU] Unauthorized Claim Main Menu [FBUC MAIN] f. When prompted 'Enter protocols you wish to mark as 'Out Of Order':' press . 9. REBUILD MAPPED ROUTINE(S) (DSM for Open VMS sites only) ------------------------- (Optional) Include the routines distributed with this patch in the mapped routine set. NOTE: This step is only necessary if you performed step 4 or if you wish to include the routines in your mapped set. 10. SET UP HL LOGICAL LINK ---------------------------------------------- The appropriate IP address for the local VistA Interface Engine must be obtained before performing this step. The IP address for each site can be obtained from the link: VistA Interface Engine Cluster IPs (29 Sep 03).xls located on the web page: http://vista.med.va.gov/messaging/vie/vie_projectdocs.asp Perform the following steps to set up the new HL logical link. Use the Link Edit [HL EDIT LOGICAL LINKS] option to edit the link. Select HL LOGICAL LINK NODE: FBFEE-FPPS Set AUTOSTART: Enabled Move the cursor to the LLP TYPE field and press to access the tcp lower level parameters. Set TCP/IP ADDRESS: address of the local Vista Interface Engine Set PERSISTENT: NO Press C to close the page Press E to save and exit 11. START THE HL LOGICAL LINK ------------------------- Use the Start/Stop Links [HL START] option to start the link. Select HL LOGICAL LINK NODE: FBFEE-FPPS 12. SCHEDULE TRANSMIT OPTION ------------------------ The Transmit Invoices to FPPS [FB FPPS TRANSMIT] option should be scheduled to run on a daily basis at a local time that is equivalent to 23:00 Central Time. This timing will transmit payment confirmations to FPPS shortly after they have been received from the AAC, but before FPPS runs it's daily job to generate HIPAA 835 remittance advice transactions. The Schedule/Unschedule Options [XUTM SCHEDULE] option can be used to schedule the task. Do not specify an output device. A mail message will be sent to the FEE mail group with results each time the task runs. 13. DELETE INSTALL ROUTINES FROM SYSTEM ----------------------------------- (Optional) Delete the FBXIP61 pre install routine. Routine Information: ==================== Routine Name: - FBAACCB Routine Checksum: Routine Name: - FBAACCB1 Routine Checksum: Routine Name: - FBAACIE Routine Checksum: Routine Name: - FBAACO Routine Checksum: Routine Name: - FBAACO0 Routine Checksum: Routine Name: - FBAACO1 Routine Checksum: Routine Name: - FBAACO2 Routine Checksum: Routine Name: - FBAACO3 Routine Checksum: Routine Name: - FBAACP Routine Checksum: Routine Name: - FBAACP1 Routine Checksum: Routine Name: - FBAAEPI Routine Checksum: Routine Name: - FBAAEPI1 Routine Checksum: Routine Name: - FBAAFA Routine Checksum: Routine Name: - FBAAFED Routine Checksum: Routine Name: - FBAAFR Routine Checksum: Routine Name: - FBAAMP Routine Checksum: Routine Name: - FBAAMP1 Routine Checksum: Routine Name: - FBAAPET Routine Checksum: Routine Name: - FBAAPET1 Routine Checksum: Routine Name: - FBAAPH Routine Checksum: Routine Name: - FBAAPIE Routine Checksum: Routine Name: - FBAAPIN Routine Checksum: Routine Name: - FBAAPP Routine Checksum: Routine Name: - FBAAPP0 Routine Checksum: Routine Name: - FBAAPPH Routine Checksum: Routine Name: - FBAARR Routine Checksum: Routine Name: - FBAARR1 Routine Checksum: Routine Name: - FBAASCB Routine Checksum: Routine Name: - FBAAVLU Routine Checksum: Routine Name: - FBAAVS Routine Checksum: Routine Name: - FBCHEAP Routine Checksum: Routine Name: - FBCHEP Routine Checksum: Routine Name: - FBCHEP1 Routine Checksum: Routine Name: - FBCHFA Routine Checksum: Routine Name: - FBCHFED Routine Checksum: Routine Name: - FBCHFR Routine Checksum: Routine Name: - FBCHPET Routine Checksum: Routine Name: - FBCHRR Routine Checksum: Routine Name: - FBCHVH Routine Checksum: Routine Name: - FBCKDIS Routine Checksum: Routine Name: - FBFPAR Routine Checksum: Routine Name: - FBFPCI Routine Checksum: Routine Name: - FBNHEDPA Routine Checksum: Routine Name: - FBNHEP1 Routine Checksum: Routine Name: - FBPAID Routine Checksum: Routine Name: - FBRXFA Routine Checksum: Routine Name: - FBRXFED Routine Checksum: Routine Name: - FBRXFR Routine Checksum: Routine Name: - FBUCEN Routine Checksum: Routine Name: - FBUTL1 Routine Checksum: Routine Name: - FBUTL2 Routine Checksum: Routine Name: - FBUTL3 Routine Checksum: Routine Name: - FBUTL4 Routine Checksum: Routine Name: - FBUTL5 Routine Checksum: Routine Name: - FBFHLL Routine Checksum: Routine Name: - FBFHLD3 Routine Checksum: Routine Name: - FBFHLD5 Routine Checksum: Routine Name: - FBFHLD9 Routine Checksum: Routine Name: - FBFHLP Routine Checksum: Routine Name: - FBFHLS Routine Checksum: Routine Name: - FBFHLS1 Routine Checksum: Routine Name: - FBFHLU Routine Checksum: Routine Name: - FBFHLX Routine Checksum: Routine Name: - FBFHLX1 Routine Checksum: Routine Name: - FBFPTR Routine Checksum: Routine Name: - FBXIP61 Routine Checksum: ============================================================================= User Information: Hold Date : OCT 19, 2003 Entered By : BAUMANN,SCOTT A Date Entered : MAY 19, 2003 Completed By: TORRANCE,LORI Date Completed: OCT 16, 2003 Released By : JACKSON,SHERYL Date Released : OCT 20, 2003 ============================================================================= Packman Mail Message: ===================== No routines included