$TXT Created by HARRIS,DONNA H at MNTVBB.ISC-ALBANY.VA.GOV (KIDS) on MONDAY, 02/28/00 at 10:15 ============================================================================= Run Date: MAR 09, 2000 Designation: IBD*3*38 Package : IBD - AUTOMATED INFO SYSPriority: Mandatory Version : 3 SEQ #26 Status: Released ============================================================================= Associated patches: (v)IBD*3*34 <<= must be installed BEFORE `IBD*3*38' (v)ICPT*6*6 <<= must be installed BEFORE `IBD*3*38' (v)PX*1*73 <<= must be installed BEFORE `IBD*3*38' Subject: CPT MODIFIERS FOR AICS Category: - Routine - Data Dictionary - Input Template Description: ============ The Current Procedural Terminology (CPT) provides a standard coding method for procedures performed by medical providers, in which each CPT code represents a distinct procedural service. CPT Modifiers provide the means by which providers can indicate that a procedure has been altered by some specific circumstance, without altering the definition or code of the procedure itself. In short, CPT Modifiers provide additional information about the procedure. This patch implements the CPT Modifiers in AICS. One important benefit of implementing CPT Modifiers in AICS is that they provide additional information about clinical procedures, thereby enriching the data stored in PCE. Another major benefit is that it will provide many of the necessary building blocks to permit the implementation of CPT modifiers by other packages (i.e., PCE, TIU, CPRS). This patch will be cleaning the Import/Export Workspace during Pre-Init. DATABASE ======== Field ASK FOR CPT MODIFIERS? (#.21), which is a Y/N question, was added to the PACKAGE INTERFACE file (357.6). Field CPT MODIFIER (#3) was added to SELECTION file (357.3). Field SELECTION (#.14) within the BUBBLES (1) multiple was added to FORM DEFINITION file (357.95). Field CPT MODIFIER (#3) was added to IMP/EXP SELECTION file (358.3). Field ASK FOR CPT MODIFIERS? (#.21), which is a Y/N question, was added to the IMP/EXP PACKAGE INTERFACE file (358.6). DATABASE INTEGRATION AGREEMENTS (DBIA) ====================================== Several packages utilize AICS DBIA #1296 GETLST^IBDF18A to retrieve a list of components on Encounter Forms for a given Clinic. The output will be modified to include CPT Modifiers if applicable. See below for details. -- output The format of the returned array is as follows @ARY@(0) = count of array element (0 of nothing found) @ARY@(1) = ^group header @ARY@(2) = P1 := cpt or icd code / ien of other items P2 := user defined text p6 := user defined expanded text to send to PCE p7 := second code or item defined for line item p8 := third code or item defined for line item p9 := associated clinical lexicon term @ARY@(2,"MODIFIER",0)=count of CPT Modifiers for entry @ARY@(2,"MODIFIER",1)=2 character CPT Modifier value @ARY@(2,"MODIFIER",2)=2 character CPT Modifier value @ARY@(2,"MODIFIER",k+1)=2 character CPT Modifier value @ARY@(k) = ^next group header @ARY@(k+1) = problem ien or cpt or icd code^user define text MANUAL DATA ENTRY CHANGES ========================= The AICS Data Entry Menu [IBD MANUAL DATA ENTRY MENU] option will display an additional prompt to allow for the entry of modifiers when entering CPT Codes for a given encounter. See below for example. Select Encounter Forms Option: EE Edit Encounter Forms ... PR Print Options ... PM Print Manager ... TK Edit Tool Kit ... IR Encounter Form IRM Options ... DE AICS Data Entry Menu ... RU Reports and Utilities ... Select Encounter Forms Option: DE AICS Data Entry Menu CDE Clinic based Data Entry FDE Data Entry by Form GDE Group Clinic Data entry INQ Form Component Inquiry PDE Pre-printed Form Data Entry Select AICS Data Entry Menu Option: CDE Clinic based Data Entry Data Entry of Encounter Forms (by Clinic) Select Clinic: AICS CLINIC M-F Appointment Date: T (SEP 29, 1999) Clinic: AICS CLINIC M-F Date: Sep 29, 1999 Basic Form: AICS #1 Active Forms: 1 Appointments: 3 ========================================================================== Select Patient: p0000 1 PATIENT,AICS I 0000 Sep 29, 1999@08:00 NO FORM PRINTED (0) 2 PATIENT,AICS I 0000 Sep 29, 1999@09:00 NO FORM PRINTED (0) 3 PATIENT,AICS I 0000 Sep 29, 1999@10:00 NO FORM PRINTED (0) Choose 1-3: 1 PATIENT,AICS I No forms Printed for Patient Enter Data from [A]ny form, [C]linic Setup, [D]efault, [N]one:CLINIC SETUP// Please wait, Creating the necessary entry..... PATIENT,AICS I 111-22-0000 Jan 01, 1960 Form ID: 19758078 ========================================================================== Clinic: AICS CLINIC M-F Date/Time: Sep 29, 1999@08:00 Form Name: AICS #1 Form Status: AVAILABLE FOR DATA ENTRY Items available for Input: Check out interview...required. DIAGNOSIS CODE (ICD9) PROCEDURE CODE (CPT4) PROVIDER BODY WEIGHT BLOOD PRESSURE VISIT TYPE ========================================================================== >>> Check out interview...required. Checkout Date: NOW// (SEP 29, 1999@13:03) Select Diagnosis Code: R 1 V24.2 ROUT POSTPART FOLLOW-UP 2 V70.0 ROUTINE MEDICAL EXAM Choose 1-2: 2 Select a Qualifier 1 PRIMARY 2 SECONDARY 3 ADD TO PROBLEM LIST Choose 1-3: 1 PRIMARY ROUTINE MEDICAL EXAM V70.0 Select Diagnosis Code: Select CPT Procedure Code: 80050 1 80050 GENERAL HEALTH PANEL w/ mod x 2 General CPT Codes 2 80050 GENERAL HEALTH PANELw/ TC General CPT Codes Choose 1-2: 1 GENERAL HEALTH PANEL w/ mod x 2 80050 General CPT Codes Select CPT MODIFIER: Select CPT Procedure Code: 14000-22,26 SKIN TISSUE REARRANGEMENT WARNING: Item selected not from Encounter Form....Entry of Narrative Required! Narrative: SKIN TISSUE REARRANGEMENT Replace SKIN TISSUE REARRANGEMENT 14000 Select CPT MODIFIER: Select CPT Procedure Code: 14000 1 14000 SKIN TISSUE REARRANGEMENT General CPT Codes 2 14000 SKIN TISSUE REARRANGEMENT General CPT Codes 3 14000 SKIN TISSUE REARRANGEMENTw/ mod AICS's Special Codes Choose 1-3: 1 SKIN TISSUE REARRANGEMENT 14000 General CPT Codes Select CPT MODIFIER: ?? Choose from: 22 UNUSUAL PROCEDURAL SERVICES 23 UNUSUAL ANESTHESIA 26 PROFESSIONAL COMPONENT 32 MANDATED SERVICES 47 ANESTHESIA BY SURGEON 50 BILATERAL PROCEDURE 51 MULTIPLE PROCEDURES 52 REDUCED SERVICES 53 DISCONTINUED PROCEDURE 54 SURGICAL CARE ONLY 55 POSTOPERATIVE MANAGEMENT ONLY 56 PREOPERATIVE MANAGEMENT ONLY 57 DECISION FOR SURGERY 58 STAGED OR RELATED PROC BY SAME PHYS DURING POSTOP PERIOD 59 DISTINCT PROCEDURAL SERVICE 62 TWO SURGEONS 66 SURGICAL TEAM 73 DISC O/P HOSP/AMB SURG CENTER (ASC) PROC PRIOR ADMIN-ANESTH 74 DISC O/P HOSP/AMB SURG CENTER (ASC) PROC AFTER ADMIN-ANESTH 76 REPEAT PROCEDURE BY SAME PHYSICIAN 77 REPEAT PROCEDURE BY ANOTHER PHYSICIAN Select CPT MODIFIER: 62 TWO SURGEONS Select CPT MODIFIER: Select CPT Procedure Code: Select Provider: SKINNER,ALAN PRIMARY SKINNER,ALAN 1453 Weight: Blood Press.: Select Visit Type (EM) Code: 99211 Brief Exam 1-5 Min 99211 ESTABLISHED PATIENT Select CPT MODIFIER: 21 PROLONGED EVALUATION AND MANAGEMENT SERVICES Select CPT MODIFIER: You have entered the following: Check out interview...required. 1 Checkout Date Sep 29, 1999@13:03 2 DIAGNOSIS CODE (ICD9) ROUTINE MEDICAL EXAM V70.0 PRIMARY 3 PROCEDURE CODE (CPT4) GENERAL HEALTH PANEL w/ mod x 80050 2 Associated Modifier(s): 22 UNUSUAL PROCEDURAL SERVICES QP INDIVIDUALLY ORDERED LAB TST TC TECHNICAL COMPONENT 26 PROFESSIONAL COMPONENT 4 PROCEDURE CODE (CPT4) SKIN TISSUE REARRANGEMENT 14000 Selected during Data Entry Modifier(s): 22 UNUSUAL PROCEDURAL SERVICES 26 PROFESSIONAL COMPONENT 5 PROCEDURE CODE (CPT4) SKIN TISSUE REARRANGEMENT 14000 1 Associated Modifier(s): Selected during Data Entry Modifier(s): 62 TWO SURGEONS 6 PROVIDER SKINNER,ALAN 1453 PRIMARY 7 VISIT TYPE Brief Exam 1-5 Min 99211 Is this Okay? No// YES Sending Data to PCE... The following data was sent to PCE for: PATIENT,AICS I Clinic: AICS CLINIC M-F at Sep 29, 1999@08:00 Checkout Date/Time: Sep 29, 1999@13:03 Primary Provider: SKINNER,ALAN Visit Type CPT: 99211 Primary Diagnosis/Problem ' ROUTINE MEDICAL EXAM', Clinical Lexicon term : Routine General Medical Examination at a Health Care Facility, Procedure: 80050 - General CPT Codes - GENERAL HEALTH PANEL w/ mod x 2 - Qu antity: 2 Procedure: 14000 - - SKIN TISSUE REARRANGEMENT - Quantity: 1 Procedure: 14000 - General CPT Codes - SKIN TISSUE REARRANGEMENT - Quantity : 1 ADDING CPT MODIFIERS TO THE ENCOUNTER FORM ========================================== Edit Encounter Forms [IBDF EDIT ENCOUNTER FORMS] has been modified to allow for three additional design choices. a. CPT Modifiers at Selection of List Building b. Marking areas for writing in CPT Modifiers that will have to be Input during manual Data Entry. c. Creation of a List of CPT Modifiers to be printed on the form. This List will serve as a key (printed only/ not selectable). When a modifier is to be associated with a CPT Code, the CPT Code block will need to be edited down to the level that the CPT Code is selected. After the selection of the CPT Code, the Quantity, Print Order within group, CPT Modifier, and SubColumn Header will be prompted for input. See below for a partial example. The CPT Modifier will not display on the form but will be passed to PCE when the CPT Code is selected at data collection either via scanning or manual data entry. Select CPT: 80050 GENERAL HEALTH PANEL Quantity: 1// 3 PRINT ORDER WITHIN GROUP: 18// 18 Select CPT MODIFIER: ?? Choose from: 22 UNUSUAL PROCEDURAL SERVICES 26 PROFESSIONAL COMPONENT 32 MANDATED SERVICES 52 REDUCED SERVICES 53 DISCONTINUED PROCEDURE 59 DISTINCT PROCEDURAL SERVICE 79 UNRELATED PROC OR SERVICE BY SAME PHYS DURING POSTOP PERIOD 90 REFERENCE (OUTSIDE) LABORATORY 99 MULTIPLE MODIFIERS QP INDIVIDUALLY ORDERED LAB TST TC TECHNICAL COMPONENT Select CPT MODIFIER: 52 REDUCED SERVICES Are you adding '52' as a new CPT MODIFIER (the 1ST for this SELECTION)? No// Y (Yes) Select CPT MODIFIER: 32 MANDATED SERVICES Are you adding '32' as a new CPT MODIFIER (the 2ND for this SELECTION)? No// Y (Yes) Select CPT MODIFIER: Subcolumn Header: Edit Subcolumn 2: GENERAL HEALTH PANEL x 3w/ mod An additional Marking Area Type is being added to the MARKING AREA TYPE file. It will display as follows if used in forms design. Mods ____ An additional ToolKit will be added. The CPT MODIFIER DISPLAY (V3.0) ToolKit can be added to a form to be used as a key. The list contents will contain CPT Modifiers defined by the user. The list will print on the form but will not be selectable at data collection. It's purpose will be to assist providers in selecting appropriate CPT Modifiers when filling out a form manually. RELEASE NOTES: ============== More detailed information is available in the Release Notes. The Release Notes can be found on the following anonymous directories. CIO FIELD OFFICE FTP ADDRESS DIRECTORY ================ =========== ========= HINES 152.129.1.110 anonymous.software ALBANY 152.127.1.5 anonymous.software SALT LAKE 152.131.2.1 anonymous.software file name: ibd_3_38_release_notes.doc If installed during the normal work day 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 DHCP users will not be affected. IBDF ENCOUNTER FORM Encounter Forms ****This patch may be installed at any time EXCEPT for between February 28, 2000 and March 3, 2000.**** Install time - Less than 5 minutes ************************ INSTALLATION INSTRUCTIONS *********************** 1. LOAD TRANSPORT GLOBAL --------------------- Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. DISABLE ROUTINE MAPPING (DSM for Open VMS sites only) ---------------------------------------- Disable routine mapping on all systems for the routines listed in Step 3 below. NOTE: If the routines included in this patch are not currently in your mapped routine set, please skip this step. 3. ROUTINES SENT WITH PATCH ------------------------ 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: ;;3.0;AUTOMATED INFO COLLECTION SYS;**[patch list]**;APR 24, 1997 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== IBDF17 7062222 7109907 38 IBDF18A 8370390 8398548 34,38 IBDF18A1 8931687 9279910 34,38 IBDF18E 12563735 13307968 3,25,38 IBDF18E0 15110223 16185266 11,25,38 IBDF18E1 10786734 11954438 1,3,38 IBDF2A2 5398601 4973246 38 IBDF2D3 12284133 12404716 38 IBDF4 19318543 19462389 19,38 IBDF4A 13810939 13735339 38 IBDF4C N/A 767167 38 IBDFBK3 16668426 16936249 12,38 IBDFDBS N/A 1251140 38 IBDFDE1 13698331 14781892 38 IBDFDE21 20640462 21087829 4,38 IBDFDE23 N/A 2097571 38 IBDFFRFT 11419466 11430025 15,38 IBDFLST 11658073 9956702 9,38 IBDFM1 13865228 14211022 13,25,38 IBDFN12 1728420 1863328 12,38 IBDFN14 2476040 2523998 12,38 IBDFN4 2973307 3329920 38 IBDFN7 1460739 1479979 38 IBDFN8 288740 263203 25,38 IBDFN9 194363 250085 38 IBDFQEA 11917102 11769145 15,38 IBDFRPC2 12592283 12635215 34,38 IBDFRPC4 5575808 5651878 38 IBDFRPC5 4234564 4241183 3,38 IBDFRPC6 12316146 12300419 3,25,38 IBDFU2B 14408614 14682219 38 IBDY338 N/A 3692381 38 4. 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 --- 1 Load a Distribution 2 Verify Checksums in Transport Global 3 Print Transport Global 4 Compare Transport Global to Current System 5 Backup a Transport Global 6 Install Package(s) Restart Install of Package(s) Unload a Distribution Select Installation Option: 5. SELECT INSTALLATION OPTION -------------------------- NOTE: The following are OPTIONAL (When prompted for the INSTALL NAME, enter IBD*3.0*38): 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 the 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. 6. INSTALL KIDS PATCH ------------------ a. Choose the Install Package(s) option of the Installation menu to start the patch install. b. When prompted 'Want KIDS to INHIBIT LOGONs during the install?', answer NO. c. When prompted 'Want to DISABLE Scheduled Options and Menu Options? YES//', take the default (YES). d. When prompted "Enter options you wish to mark as 'Out of Order':", enter the following option: IBDF ENCOUNTER FORM Encounter Forms e. When prompted 'Enter protocols you wish to mark as 'Out of Order':', press return. 7. REBUILD MAPPED ROUTINES (DSM for Open VMS sites only) ----------------------------------------------------- Optional - If you disabled the routines in Step 2 above. 8. DELETE PRE AND POST-INIT ROUTINE AFTER INSTALLATION --------------------------------------------------- After successful installation of this patch, routine IBDY338 can be deleted. Routine Information: ==================== Routine Name: - IBDF17 Routine Checksum: Routine Name: - IBDF18A Routine Checksum: Routine Name: - IBDF18A1 Routine Checksum: Routine Name: - IBDF18E Routine Checksum: Routine Name: - IBDF18E0 Routine Checksum: Routine Name: - IBDF18E1 Routine Checksum: Routine Name: - IBDF2A2 Routine Checksum: Routine Name: - IBDF2D3 Routine Checksum: Routine Name: - IBDF4 Routine Checksum: Routine Name: - IBDF4A Routine Checksum: Routine Name: - IBDF4C Routine Checksum: Routine Name: - IBDFBK3 Routine Checksum: Routine Name: - IBDFDBS Routine Checksum: Routine Name: - IBDFDE1 Routine Checksum: Routine Name: - IBDFDE21 Routine Checksum: Routine Name: - IBDFDE23 Routine Checksum: Routine Name: - IBDFFRFT Routine Checksum: Routine Name: - IBDFLST Routine Checksum: Routine Name: - IBDFM1 Routine Checksum: Routine Name: - IBDFN12 Routine Checksum: Routine Name: - IBDFN14 Routine Checksum: Routine Name: - IBDFN4 Routine Checksum: Routine Name: - IBDFN7 Routine Checksum: Routine Name: - IBDFN8 Routine Checksum: Routine Name: - IBDFN9 Routine Checksum: Routine Name: - IBDFQEA Routine Checksum: Routine Name: - IBDFRPC2 Routine Checksum: Routine Name: - IBDFRPC4 Routine Checksum: Routine Name: - IBDFRPC5 Routine Checksum: Routine Name: - IBDFRPC6 Routine Checksum: Routine Name: - IBDFU2B Routine Checksum: Routine Name: - IBDY338 Routine Checksum: ============================================================================= User Information: Hold Date : MAR 06, 2000 Entered By : HARRIS,DONNA H Date Entered : MAY 18, 1999 Completed By: SURI,ASHWANI Date Completed: MAR 02, 2000 Released By : DU GARD,ROBERT Date Released : MAR 09, 2000 ============================================================================= Packman Mail Message: ===================== $END TXT