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Run Date: JAN 22, 1998                     Designation: IBD*3*22
Package : IBD - AUTOMATED INFO  SYSPriority: Mandatory
Version : 3        SEQ #14                      Status: Released
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Subject: SCANNING MULTIPLE PRIMARY DX CODES

Category: 
  - Informational

Description: 
============

 This informational patch is intended as a guide for sites using AICS v3.0
 and scanning implementation.
  
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 AICS SCANNING WARNING
  
 WARNING:
 If you are building your AICS Encounter Forms utilizing the selection 
 rules of AT MOST ONE or EXACTLY ONE for your Primary diagnoses (DXs), you
 may be throwing away data when users inadvertantly fill in more than one
 Primary bubble.
  
 WHY:
 When you use the selection rules of AT MOST ONE or EXACTLY ONE, you 
 are indicating that for the particular row of bubbles (such as Primary 
 DX), you want no more than one code filled in.  In the instance that 
 someone fills in two bubbles within that row, the Paper Keyboard software 
 will warn you that there are "Too Many Primary Diagnoses".  The field value 
 box displayed will show you the current code selected and ask if you wish
 to accept it.  Accepting this code will discard any other Primary code 
 previously selected from that block!!!!
  
 WHAT TO DO:
 Currently, there are two options available to you.  They are:
 1) When users receive the "Too Many Primary Diagnoses" warning, they can
    choose to CANCEL and then DISCARD the form.  Doing so will not process
    the form through to PCE.  At this point, the form should be retrieved
    and returned to the provider for clarification of the ONE bubble that
    should be filled in.
 2) Design your forms with the selection rules of ANY NUMBER.  This will 
    allow the scanner to pass all your Primary codes through to PCE (i.e. 
    don't stop it at the scanner).  Dependent upon your PCE parameters, 
    PCE will either file no data and return an error or it will accept the
    first code as Primary and change all subsequent codes to secondary, 
    returning a warning.
  
 No matter which method is selected, the importance of communicating 
 this information back to the provider is critical.  Training on selecting 
 only one Primary DX per encounter form is crucial to preventing this 
 problem entirely.
  
 FUTURE PLANS
 An E3R (#10565) on this issue is currently being discussed by the MCCR 
 Systems Committee.  Possible solutions include an expanded warning from  
 Paper Keyboard before discarding data, or the rejection of the form all 
 together when this scenario is discovered.
  

Routine Information:
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User Information:                               
Entered By  : SNYDER,JACK                    Date Entered : JAN 20, 1998
Completed By: SURI,ASHWANI                  Date Completed: JAN 22, 1998
Released By : BOTTINI,STEVE                 Date Released : JAN 22, 1998
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