$TXT Created by THEROUX,JOHN at MNTVBB.FO-ALBANY.MED.VA.GOV (KIDS) on Monday, 06/27/05 at 13:09 ============================================================================= Run Date: AUG 04, 2005 Designation: ICD*18*17 Package : ICD - DRG GROUPER Priority: Mandatory Version : 18 SEQ #17 Status: Released Compliance Date: SEP 04, 2005 ============================================================================= Associated patches: (v)ICD*18*14 <<= must be installed BEFORE `ICD*18*17' Subject: ASSORTED FIXES TO DRG GROUPER Category: - Routine - Other Description: ============ This patch: 1) Adds data to the IDENTIFIER (#2) field of three ICD OPERATION/PROCEDURE file (#80.1) records; 2) Adds a DRG calculation for bone marrow transplants; 3) Corrects the DRG code associated with diagnosis 309.81 to DRG 427; 4) Corrects the DRG codes associated with procedure code 51.23; 5) Removes the entry under DRG Grouper Effective Date for October 1,2004 for operation code 80.51; 6) Removes the "F" from the IDENTIFIER (#2) field of ICD OPERATION/PROCEDURE (#80.1) file for code 81.61; 7) Associates the correct DRG when using operation/procedure code 96.72; 8) Associates the correct DRG when using diagnosis 402.91 or 428.32 with card cath procedures; 9) Associates the correct DRG when using operation/procedure 01.59, and reviews DRG 1,2,3,528 and 543 for proper assignment; 10) Corrects the MDC (#5) field for diagnosis 250.70. 11) Adds missing data to diagnosis 428.0 (Congestive Heart Failure Unspecified) ASSOCIATED TICKETS: =================== 1) HD 66607 PTF grouping to wrong DRG in VistA duplicates: HD 66487 470 DRG Ungroupable HD 86266 DRG 470 - Ungroupable HD 86537 drg 470 ungroupable HD 97851 ^Default summary HD 100718 470 DRG problem also mentioned by: HD 91750 DRG's ungroupable HD 96330 Trouble with DRGs 2) HD 64460 PUG-1204-50050 DRG Grouper Error 3) HD 87443 DRG Problems duplicate: HD 99134 Incurring problems with the DRG calculations. also mentioned by: HD 91750 DRGs UNGROUPABLE 4) HD 65287 Incorrect DRG link duplicates: HD 84629 DRG not being recognized HD 85470 DRG 207 SHOULD BE 493 HD 99123 Incorrect PTF code also mentioned by: HD 66528 DRG Grouper produces incorrect DRG's HD 88741 DRG PROBLEM HD 89251 DRG codes not correct HD 91750 DRG's UNGROUPABLE HD 94694 3M DRG different in VISTA 5) HD 66528 DRG Grouper produces incorrect DRG's duplicate: HD 99123 Incorrect PTF code also mentioned by: HD 87443 DRG problems HD 96330 Trouble with DRGs 6) HD 93777 DRG problems on PTF 7) HD 89251 DRG codes not correct 8) HD 86329 DRG should be 124 but calculates to 125 duplicate: HD 64353 RIC-1004-22027 DRG Grouper 9) HD 96330 Trouble with DRGs 10) HD 97370 Problem with grouping 11) HD 99384 DRG ungroupable duplicates: HD 99882 DRG UNGROUPABLE HD 101294 Ungroupable DRG HD 102262 DRG error generated on one of thePTF's HD 102845 Problems with Patient Treatment File ASSOCIATED E3R(s): ================== N/A PARTICIPATING TEST SITES: ========================= Little Rock, AR Fayetteville, AR Central Texas HCS Puget Sound HCS Minneapolis, MN Northport, NY North Texas HCS Cincinnati, OH Bay Pines, FL Lexington, KY TICKET OVERVIEW: ================ 1) HD 66607 PTF grouping to wrong DRG in VistA Problem: ======== Use of ICD OPERATION/PROCEDURE codes 36.12, 36.13 or 36.14 gives DRG 470 UNGROUPABLE. Solution: ========= The IDENTIFIER (#2) field in ICD OPERATION/PROCEDURE file (#80.1) was modified to include a "6". 2) HD 64460 PUG-1204-50050 DRG Grouper Error Problem: ======== Bone marrow transplants are generating the wrong DRG. Solution: ========= Use of ICD OPERATION/PROCEDURE codes 41.00 thru 41.09 should give DRG 481 regardless of the diagnosis being used because bone marrow transplants are "pre-MDC". Routine ICDDRG0 has been modified. 3) HD 87443 DRG Problems Problem: ======== Use of primary diagnosis 309.81 gives DRG 429 instead of 427. Solution: ========= The diagnosis code has been corrected by removing the October 1,2004 entry for DRG Grouper Effective Date and the 2004 entry for MDC Effective Date. 4) HD 65287 Incorrect DRG link Problem: ======== Use of operation/procedure code 51.23 (LAPAROSCOPIC CHOLECYSTECTOMY) with a primary diagnosis within MDC 7 (Major Diagnostic Category of HEPATOBILIARY & PANCREA) does not give DRGs 493/494. Solution: ========= The identifier field (#2) in ICD OPERATION/PROCEDURE file (#80.1) was changed back from "Nz" to "TT" to signify a laparoscopic cholecystectomy. Routines ICDGTDRG and ICDREF were also modified, such that if the MDC is not found under the DRG Grouper Effective Date for the effective year, the software will look in the prior year. 5) HD 66528 DRG Grouper produces incorrect DRG's Problem: ======== Operation code 80.51 had a superfluous entry under the DRG Grouper Effective Date for October 1,2004. This could result in DRG 243 being assigned instead of DRG 500. Solution: ========= The superfluous entry was removed. 6) HD 93777 DRG problems on PTF Problem: ======== Use of operation/procedure code 81.61 is causing the Grouper to give DRG 496 instead of 497/498 because the IDENTIFIER (#2) field of the code contains an "F" signifying "combined spinal fusion". Solution: ========= The "F" was removed. 7) HD 89251 DRG codes not correct Problem: ======== Use of operation/procedure code 96.72 within Respiratory System (MDC 4) gives DRG 79 instead of 475. Solution: ========= Routines ICDGTDRG and ICDREF were modified as explained in Problem (4). 8) HD 86329 DRG should be 124 but calculates to 125 Problem: ======== When diagnosis code 402.91 is used with cardiac cath procedures, it gives DRG 125 instead of 124. The same is true for diag 428.32. Solution: ========= An "X" was added to the IDENTIFIER (#2) field of each diagnosis. "X" signifies "cmplx/cmplctd". 9) HD 96330 Trouble with DRGs Problem: ======== Using operation/procedure code 01.59 without implant chemotherapy agent and without an acute complex cns principal diagnosis is giving DRG 543 instead of DRG 1/2. Solution: ========= In addition to DRG 543, DRGs 1/2/3 were added under the DRG Grouper Effective Date for October 1, 2004 for code 01.59. We also took the opportunity to review the assignment of DRGs 1,2,3, 528 and new DRG 543 and made the following adjustments: a) made the same change done for code 01.59 to all other op codes in DRG 543; b) added a "K" to the IDENTIFIER (#2) field of diagnoses 430., 431. and 432.9 so as to give DRG 528 instead of 543 because of surgical hierarchy; c) added a "K" to the IDENTIFIER (#2) field of all op codes in DRG 528; d) modified routines ICDTLB1A, ICDTLB6A and ICDDRG1. 10) HD 97370 Problem with grouping Problem: ======== Diagnosis 250.70 with secondary 785.4 with op/pro code 84.11 is giving DRG 7 instead of 114. When the description was changed for diagnosis 250.70, the MAJOR DIAGNOSTIC CATEGORY (MDC) (#5) field was inadvertently changed from 5 (Circulatory System) to 1 (Nervous System). Solution: ========= The MDC field has been corrected to 5 (Circulatory System) and the DRG Grouper Effective Date entry for October 1, 2004 has been deleted, resulting in DRG 114. 11) HD 99384 DRG ungroupable Problem: ======== Diagnosis 428.0 is giving DRG 470 - Ungroupable. Solution ======== Data related to the DRG Grouper Effective Date and MDC Effective Date was added to the record. Use of the code (without others) now gives DRG 127. 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: ;;18.0;DRG Grouper;**[patch list]**;Oct 13,2000 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== ICD1817E N/A 464488 17 ICD1817P N/A 2986714 17 ICDDRG0 13946481 14108331 1,2,7,10,14 17 ICDDRG1 1320770 1346812 10,17 ICDGTDRG 12371989 12425081 7,12,14,17 ICDREF 549413 864052 14,17 ICDTLB1A 6720875 6900639 14,17 ICDTLB6A 11870587 11888532 14,17 INSTALLATION INSTRUCTIONS: ========================= This patch can be loaded with users on the system. Installation should take less than 5 minutes. 1. From the Kernel Installation and Distribution System Menu, select the Installation menu. 2. From this menu, you may elect to use the following options: (when prompted for INSTALL NAME, enter ICD*18.0*17) a. Backup a Transport Global - this option will create a backup message of any routines exported with the patch. It will NOT backup any other changes such as DDs 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 the patch (routines, DDs, 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. Routines ICD1817* can be removed once the patch is installed. d. Print Transport Global - this option will allow you to view the components of the KIDS build. 3. Use the Install Package(s) option and select the package ICD*18.0*17. 4. When prompted, 'Want KIDS to INHIBIT LOGONs during the install? YES//', respond NO 5. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond NO. 6. Following installation of this patch, it is necessary to run the DG PTF UPDATE TRANSFER DRGs option in order to make the transfer DRGs correspond to the appropriate grouper. This option updates/recalculates the transfer DRGs for PTF records opened during the current fiscal year (since 10/1/2004). The option is locked with the DG PTFSUP security key. The Menu path is PTF Menu/Update DRG Information Menu/Update Transfer DRGs for current FY. 7. All routines ICD1817* can be deleted after the patch has been successfully installed. Routine Information: ==================== Routine Name: - ICDDRG0 Routine Checksum: Routine Name: - ICD1817P Routine Checksum: Routine Name: - ICDGTDRG Routine Checksum: Routine Name: - ICDREF Routine Checksum: Routine Name: - ICDDRG1 Routine Checksum: Routine Name: - ICDTLB1A Routine Checksum: Routine Name: - ICDTLB6A Routine Checksum: ============================================================================= User Information: Entered By : THEROUX,JOHN Date Entered : APR 01, 2005 Completed By: TSAIMEUCHONG,BRENDA Date Completed: AUG 03, 2005 Released By : FIELDS-BARNES,JANETTE Date Released : AUG 04, 2005 ============================================================================= Packman Mail Message: ===================== $END TXT