$TXT Created by HARPER,AMY R at DEVFEX.FO-ALBANY.MED.VA.GOV (KIDS) on Wednesday, 11/30/05 at 16:30 ============================================================================= Run Date: JUN 06, 2006 Designation: IB*2*332 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #309 Status: Released Compliance Date: JUN 26, 2006 ============================================================================= Associated patches: (v)IB*2*175 <<= must be installed BEFORE `IB*2*332' (v)IB*2*176 <<= must be installed BEFORE `IB*2*332' Subject: NHCU Treating Specialty Category: - Routine - Enhancement (Mandatory) Description: ============ *********************************************************************** * NOTE: The compliance date for this patch install is June 26, 2006. * * This release is to support compliance with VHA Directive 2006-014 * * "ADMISSION CRITERIA, SERVICE CODES, AND DISCHARGE CRITERIA FOR VA * * NURSING HOME CARE UNITS (NHCU)" * *********************************************************************** IB*2*332 is being released to support the Treating Specialty changes released in DG*5.3*683. Treating Specialties (#42.4) are being updated with patch DG*5.3*683. This patch IB*2*332 will update Integrated Billing to properly handle the billing of the new and changed Treating Specialties. There will be 11 new and 2 modified Treating Specialties, the following details the billing set up for these new/modified Treating Specialties. New Treating Specialties and Billable Bedsection ------------------------------------------------ The new Treating Specialties (#42.4) will be assigned to the following Billable Bedsections. The Billable Bedsection determines the Third Party Cost Based and the Means Test Copay and Per Diem charges billed for care in the Treating Specialty. Code New Treating Specialty Billable Bedsection 42 NH LONG STAY DEMENTIA CARE NURSING HOME CARE 43 NH LONG STAY SKILLED NURSING NURSING HOME CARE 44 NH LONG STAY MAINTENANCE CARE NURSING HOME CARE 45 NH LONG STAY PSYCHIATRIC CARE NURSING HOME CARE 46 NH LONG STAY SPINAL CORD INJ NURSING HOME CARE 47 NH RESPITE CARE (NHCU) 64 NH SHORT STAY REHABILITATION NURSING HOME CARE 66 NH SHORT STAY RESTORATIVE NURSING HOME CARE 67 NH SHORT STAY MAINTENANCE NURSING HOME CARE 68 NH SHORT STAY PSYCHIATRIC CARE NURSING HOME CARE 69 NH SHORT STAY DEMENTIA CARE NURSING HOME CARE Notice that 47 - NH Respite Care (NHCU) has no associated Billable Bedsection because it is considered non-billable for these rates. New Treating Specialties and Long Term Care ------------------------------------------- The new Treating Specialties are all identified as Long Term Care Treating Specialties and are assigned to the following Long Term Care Copayment. Code New Treating Specialty Long Term Care Copay 42 NH LONG STAY DEMENTIA CARE LTC INPT NHCU 43 NH LONG STAY SKILLED NURSING LTC INPT NHCU 44 NH LONG STAY MAINTENANCE CARE LTC INPT NHCU 45 NH LONG STAY PSYCHIATRIC CARE LTC INPT NHCU 46 NH LONG STAY SPINAL CORD INJ LTC INPT NHCU 47 NH RESPITE CARE (NHCU) LTC INPT RESPITE 64 NH SHORT STAY REHABILITATION LTC INPT NHCU 66 NH SHORT STAY RESTORATIVE LTC INPT NHCU 67 NH SHORT STAY MAINTENANCE LTC INPT NHCU 68 NH SHORT STAY PSYCHIATRIC CARE LTC INPT NHCU 69 NH SHORT STAY DEMENTIA CARE LTC INPT NHCU Updated Treating Specialties ---------------------------- Two previously existing Treating Specialties are being updated. Treating Specialty Service Bedsection Long Term Care Old: 83 RESPITE CARE RESPITE LTC INPT RESPITE New: 83 RESPITE CARE (MEDICINE) RESPITE LTC INPT RESPITE The name of Treating Specialty 83 will be changed from 'Respite Care' to 'Respite Care (Medicine)'. This has no impact on billing and therefore results in no change to IB. Treating Specialty Service Bedsection Long Term Care Old: 95 INTERMEDIATE MEDICINE - LTC INTERM INTERMEDIATE New: 95 NH SHORT STAY SKILLED NURSING NHCU NURSING HOME LTC INPT NHCU Treating Specialty 95 is being changed from a Treating Specialty for Intermediate Care to NHCU care. Since the definition of the type of care provided in this Treating Specialty is being changed, the billing of this Treating Specialty must be changed to correspond. - The Billable Bedsection for Treating Specialty 95 will change from Intermediate Care to Nursing Home Care. - Treating Specialty 95 will be added to the list of Long Term Care Treating Specialties with the LTC INPT NHCU rate. The result is that for care in Treating Specialty 95, Third Party billing will be changed from Cost Based Intermediate Care charges to Nursing Home Care charges and First Party Charges will be changed from Means Test Copay/PerDiem to the Long Term Care Copay. New/Updated Treating Specialties and Reasonable Charges ------------------------------------------------------- The Reasonable Charges Facility charge for most Inpatient care is based on a DRG per diem, except Skilled Nursing which is based on a daily per diem. The Treating Specialties associated with Nursing Home Care are currently exempt from the automatic calculation of the DRG charges, since they usually should be billed the Skilled Nursing Per Diem. The following new and updated Treating Specialties will be added to the list of the Treating Specialties exempt from the automatic DRG charge calculation to reduce the possibility that they will be incorrectly billed the DRG per diem. Code New Treating Specialty Billable Bedsection 42 NH LONG STAY DEMENTIA CARE NURSING HOME CARE 43 NH LONG STAY SKILLED NURSING NURSING HOME CARE 44 NH LONG STAY MAINTENANCE CARE NURSING HOME CARE 45 NH LONG STAY PSYCHIATRIC CARE NURSING HOME CARE 46 NH LONG STAY SPINAL CORD INJ NURSING HOME CARE 64 NH SHORT STAY REHABILITATION NURSING HOME CARE 66 NH SHORT STAY RESTORATIVE NURSING HOME CARE 67 NH SHORT STAY MAINTENANCE NURSING HOME CARE 68 NH SHORT STAY PSYCHIATRIC CARE NURSING HOME CARE 69 NH SHORT STAY DEMENTIA CARE NURSING HOME CARE 95 NH SHORT STAY SKILLED NURSING NURSING HOME CARE This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- 20050101 NHCU Treating Specialties This patch addresses the following NOIS/Remedy Ticket(s): --------------------------------------------------------- There is no NOIS/Remedy tickets associated with this patch. Components Sent With Patch -------------------------- 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: ;;2.0;INTEGRATED BILLING;**[patch list]**;21-MAR-94 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== IBAECU1 600293 890361 164,171,176,332 IBCRBG2 2985576 3140758 245,175,332 CHECK1^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== IBAECU1 1411270 2570454 164,171,176,332 IBCRBG2 7011356 7280940 245,175,332 Number of Routines = 2 Test Sites: ----------- Coatesville VAMC Puget Sound VAMC West Palm Beach VAMC ================INSTALLATION INSTRUCTIONS ================= If installed during the normal workday, it is recommended that the following selection in the OPTION (#19) file be disabled to prevent possible conflicts while running the KIDS Install. Other VISTA users will not be affected. Enter/Edit Billing Information [IB EDIT BILLING INFO] This patch should not be installed when the IB MT NIGHT COMP job is running. Install Time - less than 5 minutes ********************* PRE-INSTALLATION INSTRUCTIONS ********************* Patch IB*2.0*332 should be installed before patch DG*5.3*683. Installation of the IB patch without installation of the DG patch will not negatively impact the system. ************************************************************************* 1. LOAD TRANSPORT GLOBAL --------------------- Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. 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: 3. Select Installation Option: --------------------------- NOTE: The following are OPTIONAL - (When prompted for the INSTALL NAME, enter IB*2*332): 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. 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 INHIBIT LOGONs during the install? YES//' answer NO (unless otherwise indicated) c. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//' answer YES (unless otherwise indicated) d. When prompted 'Enter options you wish to mark as 'Out Of Order':' Enter the following options: Enter/Edit Billing Information [IB EDIT BILLING INFO] e. When prompted 'Enter protocols you wish to mark as 'Out Of Order':' press . Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBAECU1 Before: B1411270 After: B2570454 **164,171,176,332** Routine Name: IBCRBG2 Before: B7011356 After: B7280940 **245,175,332** ============================================================================= User Information: Entered By : HARPER,AMY R Date Entered : NOV 21, 2005 Completed By: ROBBINS,BRADLEY Date Completed: JUN 06, 2006 Released By : GANUS,MAUNETTE Date Released : JUN 06, 2006 ============================================================================= Packman Mail Message: ===================== $END TXT