$TXT Created by HALFPENNY,KENNETH at NPI.FELIX.PROXY-HC-LAB.COM (KIDS) on Tuesday, 02/06/07 at 11:35 ============================================================================= Run Date: FEB 09, 2007 Designation: IB*2*343 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #328 Status: Released Compliance Date: MAR 12, 2007 ============================================================================= Associated patches: (v)IB*2*320 <<= must be installed BEFORE `IB*2*343' (v)XU*8*410 <<= must be installed BEFORE `IB*2*343' (v)XU*8*416 <<= must be installed BEFORE `IB*2*343' (v)IB*2*358 <<= must be installed BEFORE `IB*2*343' Subject: NPI ENHANCEMENTS Category: - Routine - Enhancement (Mandatory) - Data Dictionary Description: ============ The purpose of this patch is to meet the requirements for the VistA Integrated Billing (IB) software application as they apply to the use of the National Provider Identifier (NPI) and provider taxonomy codes. The NPI is a Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirement with a usage requirement date of May 23, 2008. The purpose of the software and database modifications is to utilize the NPI and provider taxonomy codes on the Electronic Data Interchange (EDI) X12 transmissions as defined by HIPAA. The NPI numbers are issued by the Center for Medicare and Medicaid Services (CMS) and the taxonomy codes are released by the National Uniform Claims Committee (NUCC). These transmissions include the X12 837, 835 and 270 electronic forms. Providers fall into two categories; individual providers and organizational providers. The individual providers are the individual persons who receive and utilize NPIs, e.g. medical doctors, dentists, physician assistants, nurse practitioners, etc. The organizational providers are institutions which may bill under their own ID, e.g. hospitals, clinics, pharmacies, etc. The taxonomy code provides a specialty breakout for individual and organizational providers. The taxonomy code will replace the built in intelligence within the payer issued IDs. The payers, at times, do issue multiple IDs for one provider in order to determine the treating specialty the provider was utilizing during a course of treatment that was being billed. The taxonomy code used in conjunction with the NPI will provide this treating specialty identification. List of Patch Items: 1. Data dictionary definitions were changed to include NPI and taxonomy-related fields: a. The following fields were added to the IB NON/OTHER BILLING PROVIDER (#355.93) file: NPI (#41.01) - This field contains the current NPI for this provider. DATE/TIME OF LAST NPI CHANGE (#40) - This multiple contains a history of changes made to the NPI field. TAXONOMY CODE (#42) - This multiple contains the list of taxonomy codes associated with this provider. b. The following fields were added to the BILL/CLAIMS (#399) file: DEFAULT DIVISION TAXONOMY (#243) - This is the taxonomy associated with field DEFAULT DIVISION (#.22) for this claim. NON-VA FACILITY TAXONOMY (#244) - This is the taxonomy associated with field NON-VA FACILITY (#232) for this claim. PROVIDER (#222) multiple field TAXONOMY (#.15) - This is the taxonomy associated with the individual specified in field PERFORMED BY (#.02) in the PROVIDER multiple. c. A trigger was added to the following fields in the BILL/CLAIMS (#399) file: DEFAULT DIVISION (#.22) - When edited, automatically populates field DEFAULT DIVISION TAXONOMY (#243) with the primary taxonomy associated with the Division selected. NON-VA FACILITY (#232) - When edited, automatically populates field NON-VA FACILITY TAXONOMY (#244) with the primary taxonomy associated with the Non-VA Facility selected. PROVIDER (#222) multiple field PERFORMED BY (#.02) - When edited, automatically populates field TAXONOMY (#.15) with the primary taxonomy associated with the Provider selected. 2. The option Enter/Edit Billing Information [IB EDIT BILLING INFO] has been modified to include the following: a. Screen 6 (inpatient) has been changed to display the X12 Code and Specialty Code associated with field DEFAULT DIVISION TAXONOMY in information group 1 directly below the current Division. The input template associated with that group allows the user to override the DEFAULT DIVISION TAXONOMY for the current claim. b. Screen 7 (outpatient) has been changed to display the X12 Code and Specialty Code associated with field DEFAULT DIVISION TAXONOMY in information group 1 directly below the current Division. The input template associated with that group allows the user to override the DEFAULT DIVISION TAXONOMY for the current claim. c. For UB92 (UB-04) claims, screen 8 has been changed to display the X12 Code and Specialty Code associated with field TAXONOMY in information group 2 (Providers) next to the current Provider Name. The input template associated with that group allows the user to override the TAXONOMY for the current claim. d. For UB92 (UB-04) claims, screen 8 has been changed to display the X12 Code and Specialty Code associated with field NON-VA FACILITY TAXONOMY in information group 8 (Other Facility) next to the current facility name. The input template associated with that group allows the user to override the NON-VA FACILITY TAXONOMY for the current claim. e. For HCFA 1500 (CMS 1500) claims, screen 8 has been changed to display the X12 Code and Specialty Code associated with field TAXONOMY in information group 3 (Providers) next to the current Provider Name. The input template associated with that group allows the user to override the TAXONOMY for the current claim. f. For HCFA 1500 (CMS 1500) claims, screen 8 has been changed to display the X12 Code and Specialty Code associated with field NON-VA FACILITY TAXONOMY in information group 4 (Other Facility) next to the current facility name. The input template associated with that group allows the user to override the NON-VA FACILITY TAXONOMY for the current claim. 3. The Authorization Edits in option Enter/Edit Billing Information [IB EDIT BILLING INFO] have been changed to check whether DEFAULT DIVISION, NON-VA FACILITY, and each PROVIDER on a Bill have an associated NPI number and taxonomy code. If the bill date falls before the May 23, 2008 usage requirement date, then any missing NPI number or taxonomy code will trigger a warning which the user may override to submit the claim. If the date falls after the May 23, 2008 date, then any missing NPI number or taxonomy code will trigger an error which will prevent the claim from being submitted until the missing NPI number or taxonomy code has been added. 4. The option Provider ID Maintenance [IBCE PROVIDER MAINT], which is also accessible through option Enter/Edit Billing Information [IB EDIT BILLING INFO] via screen 8 group 7 [Provider ID Maint], has been modified to include the following: a. For individual providers, the provider's NPI number and taxonomy codes are displayed below his specialty information. b. For individual providers, the Edit Demographics action has been changed to allow entering/editing the provider's NPI number and taxonomy codes. c. For facilities, the facility's NPI number and taxonomy codes are displayed below the mammography certification number. d. For facilities, the Provider Info action has been renamed Facility Info and the Secondary ID Maint action has been renamed ID Maintenance. e. For facilities, the Facility Info action has been changed to allow entering/editing the facility's NPI number and taxonomy codes. 5. A new segment, NPI, has been added to the 837 transmission. It contains the NPI number and taxonomy code associated with DEFAULT DIVISION, NON-VA FACILITY, and each PROVIDER on a bill. This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- There is no NSR associated with this patch. This patch addresses the following Remedy Ticket(s): ---------------------------------------------------- There are no Remedy tickets associated with this patch. 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: ;;2.0;INTEGRATED BILLING;**[patch list]**;21-MAR-94 CHECK^XTSUMBLD results Routine Before Patch After Patch Patch List ------- ------------ ----------- ---------- IBCBB1 19038116 19058297 27,52,80,93,106, 51,151,148,153,137, 232,280,155,320,343 IBCBB11 1185376 7032988 51,343 IBCEF73A N/A 4991600 343 IBCEF74 20516126 19271830 232,280,155,290,291, 320,358,343 IBCEF74A 5515316 5982921 320,343 IBCEP8 11112922 15038720 51,137,232,288,320, 343 IBCEP81 N/A 6315978 343 IBCEP82 N/A 9257964 343 IBCSC6 9136603 9608438 52,80,109,106,51,137, 343 IBCSC7 5165398 5637729 52,80,109,106,343 IBCSC82 9973859 11562841 51,137,210,232,155, 343 IBCSC8H 13877552 15429852 51,137,207,210,232, 155,320,343 IBY343PO N/A deleted** 343 IBY343PR N/A deleted** 343 ** This routine is automatically deleted. Total number of routines modified: 9 Total number of new routines: 3 Total number of deleted routines: 2 Total number of routines: 14 CHECK1^XTSUMBLD results (new method) Routine Before Patch After Patch Patch List ------- ------------ ----------- ---------- IBCBB1 69487454 71423794 27,52,80,93,106, 51,151,148,153,137, 232,280,155,320,343 IBCBB11 1812610 13216318 51,343 IBCEF73A N/A 18056830 343 IBCEF74 57131951 56167229 232,280,155,290,291, 320,358,343 IBCEF74A 17345464 19549924 320,343 IBCEP8 54137838 72198572 51,137,232,288,320, 343 IBCEP81 N/A 19908581 343 IBCEP82 N/A 27027320 343 IBCSC6 16564182 17895378 52,80,109,106,51,137, 343 IBCSC7 7583946 8540222 52,80,109,106,343 IBCSC82 16576811 20168513 51,137,210,232,155, 343 IBCSC8H 30414621 34960375 51,137,207,210,232, 155,320,343 IBY343PO N/A deleted** 343 IBY343PR N/A deleted** 343 ** This routine is automatically deleted. Total number of routines modified: 9 Total number of new routines: 3 Total number of deleted routines: 2 Total number of routines: 14 The following is a list of files included in this patch: UP SEND DATA DATE SEC. COMES SITE RSLV FILE # NAME DD CODE W/FILE DATA PTS ----------------------------------------------------------------------- 350.8 IB ERROR NO NO YES MERG YES 355.93 IB NON/OTH VA BILLING PROVIDER YES NO NO 355.97 IB PROVIDER ID # TYPE NO NO YES OVER YES 364.5 IB DATA ELEMENT DEFINITION NO NO YES OVER YES 364.6 IB FORM SKELETON DEFINITION NO NO YES OVER YES 364.7 IB FORM FIELD CONTENT NO NO YES OVER YES 399 BILL/CLAIMS YES NO NO The following is a list of fields included in this patch: Field Name (Number) File Name (Number) ------------------- ------------------ NPI (41.01) IB NON/OTHER VA BILLING PROVIDER (355.93) DATE/TIME OF LAST NPI CHANGE (.01) DATE/TIME OF LAST NPI CHANGE (sub-file) (355.9301) STATUS (.02) DATE/TIME OF LAST NPI CHANGE (sub-file) (355.9301) NPI (.03) DATE/TIME OF LAST NPI CHANGE (sub-file) (355.9301) PERSON AFFECTING LAST CHANGE (.04) DATE/TIME OF LAST NPI CHANGE (sub-file) (355.9301) TAXONOMY CODE (.01) TAXONOMY CODE (sub-file) (355.9342) PRIMARY CODE (.02) TAXONOMY CODE (sub-file) (355.9342) STATUS (.03) TAXONOMY CODE (sub-file) (355.9342) DEFAULT DIVISION (.22) BILL/CLAIMS (399) NON-VA FACILITY (232) BILL/CLAIMS (399) DEFAULT DIVISION TAXONOMY (243) BILL/CLAIMS (399) NON-VA FACILITY TAXONOMY (244) BILL/CLAIMS (399) PERFORMED BY (.02) PROVIDER (sub-file) (399.0222) TAXONOMY (.15) PROVIDER (sub-file) (399.0222) The following is a list of templates included in this patch: Template Name Type File Name (Number) ------------- ---- ------------------ IB SCREEN6 INPUT BILL/CLAIMS (399) IB SCREEN7 INPUT BILL/CLAIMS (399) IB SCREEN82 INPUT BILL/CLAIMS (399) IB SCREEN8H INPUT BILL/CLAIMS (399) The following is a list of protocols included in this patch: Protocol Name ------------- IBCE PRVNVA PROVINFO IBCE PRVNVA SECIDS Test Sites: ----------- Battle Creek Little Rock Heartland West Sheridan Documentation Retrieval ----------------------- The EDI Billing User's Guide has been updated. This guide is available for download at the following websites 1 to 3 days after National Release: http://www.va.gov/vdl/Financial_Admin.asp?appID=45 http://vaww.vistau.med.va.gov/VistaU/e-bp/e-claims.htm The user's guide may also be retrieved from the following OI Field Offices' Anonymous.Software Directories. Use the appropriate FTP capability to retrieve the files and use BINARY format. OI Field Office FTP Address Directory --------------- ----------- --------- ALBANY ftp.fo-albany.med.va.gov anonymous.software HINES ftp.fo-hines.med.va.gov anonymous.software SALT LAKE ftp.fo-slc.med.va.gov anonymous.software FIRST AVAILABLE SERVER download.vista.med.va.gov anonymous.software File Name --------- IB_2_343UG.PDF Pre/Post Installation Overview ------------------------------ The pre-installation routine removes the entries from the output formatter files IB DATA ELEMENT DEFINITION (364.5), IB FORM SKELETON DEFINITION (364.6), and IB FORM FIELD CONTENT (364.7) as well as file IB PROVIDER ID # TYPE (355.97) that are included with this patch. This prevents certain problems with pointer resolution. The pre-installation and post-installation routines combined move data from node NPI to node NPISTATUS in file IB NON/OTHER VA BILLING PROVIDER (355.93) which is required for Kernel to be able to check for duplicate NPIs in that file when NPIs are being entered in files INSTITUTION (4) or NEW PERSON (200). The pre-installation routine is automatically deleted after this patch is installed. ================INSTALLATION INSTRUCTIONS ================= It is recommended that this patch be installed outside of normal working hours when no Integrated Billing users are on the system. However, if installed during the normal workday, it is recommended that the following selection(s) in the OPTION (#19) file, and all of their descendants be disabled to prevent possible conflicts while running the KIDS Install. Other VISTA users will not be affected. EDI Menu For Electronic Bills [IBCE 837 EDI MENU] Provider ID Maintenance [IBCE PROVIDER MAINT] Enter/Edit Billing Information [IB EDIT BILLING INFO] Install Time less than 5 minutes 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*2.0*343): 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 c. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//' answer YES if you are installing this patch during normal working hours. d. When prompted 'Enter options you wish to mark as 'Out Of Order':' Enter the following options: EDI Menu For Electronic Bills [IBCE 837 EDI MENU] Provider ID Maintenance [IBCE PROVIDER MAINT] 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: IBCBB1 Before: B69487454 After: B71423794 **27,52,80,93,106,51,151,148, 153,137,232,280,155,320,343** Routine Name: IBCBB11 Before: B1812610 After: B13216318 **51,343** Routine Name: IBCEF73A Before: n/a After: B18056830 **343** Routine Name: IBCEF74 Before: B57131951 After: B56167229 **232,280,155,290,291,320,358,343** Routine Name: IBCEF74A Before: B17345464 After: B19549924 **320,343** Routine Name: IBCEP8 Before: B54137838 After: B72198572 **51,137,232,288,320,343** Routine Name: IBCEP81 Before: n/a After: B19908581 **343** Routine Name: IBCEP82 Before: n/a After: B27027320 **343** Routine Name: IBCSC6 Before: B16564182 After: B17895378 **52,80,109,106,51,137,343** Routine Name: IBCSC7 Before: B7583946 After: B8540222 **52,80,109,106,343** Routine Name: IBCSC82 Before: B16576811 After: B20168513 **51,137,210,232,155,343** Routine Name: IBCSC8H Before: B30414621 After: B34960375 **51,137,207,210,232,155,320,343** Routine Name: IBY343PO Before: n/a After: B3071313 **343** Routine Name: IBY343PR Before: n/a After: B11894613 **343** ============================================================================= User Information: Entered By : WHITE,DARLENE Date Entered : APR 10, 2006 Completed By: ROBBINS,BRADLEY Date Completed: FEB 07, 2007 Released By : JACKSON,SHERYL Date Released : FEB 09, 2007 ============================================================================= Packman Mail Message: ===================== $END TXT