$TXT Created by THEROUX,JOHN at MNTVBB.FO-ALBANY.MED.VA.GOV (KIDS) on Wednesday, 06/27/07 at 16:58 ============================================================================= Run Date: AUG 29, 2007 Designation: ICD*18*27 Package : ICD - DRG GROUPER Priority: Mandatory Version : 18 SEQ #27 Status: Released Compliance Date: SEP 29, 2007 ============================================================================= Associated patches: (v)ICD*18*20 <<= must be installed BEFORE `ICD*18*27' (v)ICD*18*24 <<= must be installed BEFORE `ICD*18*27' (v)ICD*18*26 <<= must be installed BEFORE `ICD*18*27' Subject: VISTA DRG GROUPER vs. QUADRAMED Category: - Routine Description: ============ This patch corrects the VistA DRG Grouper to conform to the QuadraMed Encoder for cases explained in the Remedy tickets below: No code files are included in the patch, as all table maintenance is performed programmatically by the pre-init routine ICD1827G. ASSOCIATED REMEDY TICKETS: ========================== 1) HD153719 - PTFs with DRGs that do not match between the encoder duplicate: HD188386 HD192495 2) HD178759 - DRG differs in Vista and QuadraMed 3) HD169895 - DRG 160 NOT CALCULATING CORRECTLY 4) HD192474 - 053.19 not grouping correctly ASSOCIATED E3R's: ================= N/A PARTICIPATING TEST SITES: ======================== Bay Pines HCS Puget Sound HCS San Juan, PR REMEDY OVERVIEW: ================ 1) HD153719 - PTFs with DRGs that do not match between the encoder Problem: ======== Several cases were documented in the ticket where the DRG calculated by the VistA Grouper did not agree with QuadraMed. Solution: ========= Responding to the spreadsheet attachment in the ticket:-- 1. Has already been corrected. VISTA now gives DRG 535. 2. Pre-init routine ICD1827G will add a "z" to the identifiers for procedure 53.61 resulting in correct DRG 477. 3. More than one surgical procedure eliminates DRG 468. 4. Has already been corrected. VISTA now gives DRG 297. 5. Patch will fix diagnosis 707.05 and others in the 707.0 line to be a complication/comorbidity resulting in DRG 174 when present. 6-9. Patch will correct these to be DRG 520 by amending procedures 81.02, 81.03, 81.32 and 81.33 to give DRG 519/520. 10. Has already been corrected. VISTA now gives DRG 553. 11. Patch will correct DRG to be 542 because none of the other procedures (excluding 31.1 and 96.72) are O.R. Routines ICDDRG0 and ICDDRGX were modified. 12. Patch will correct procedure 78.63 and others in 78.6 line to give DRG 477 by adding a "z" to the identifiers. Responding to other work log entries -- 13. Prime dx 334.4 is a manifestation and not acceptable as prime dx. 14. DRG 194 vs DRG 198 Patch will correct calculation to be 194 by changing routines ICDTLB3B (2005) and ICDTLB3C (2006). 15. DRG 243 VS DRG 247 Patch will correct dx 724.8 to give 243. 16. DRG 111 VS DRG 110 Patch will add a "7" to the identifiers for procedure 39.52 resulting in correct DRG 111. 17. DRG 520 vs DRG 498 Same as #6-9 18. DRG 566 vs 470 Has already been corrected. VISTA now gives DRG 566. 19. DRG 520 vs DRG 498 Same as #6-9 20. DRG 316 vs DRG 315 Patch will fix dx code 585.6 and others in 585 line to give DRG 316 when no procedures. 21. Diagnoses 590.81 and 595.4 should be acceptable as prime dx and yield DRG 320/321/322. 2) HD178759 - DRG differs in Vista and QuadraMed Problem: ======== Dx code 813.42 with procedures 79.02 and 78.13 incorrectly gives DRG 223. Solution: ========= Procedure code 78.13 will be corrected to give DRG 224 when no complications (w/o CC). 3) HD 169895 - DRG 160 NOT CALCULATING CORRECTLY Problem: ======== Dx code 553.21 with procedures 53.61 and 53.04 incorrectly gives DRG 162. Solution: ========= Routine ICDDRG6 has been modified to give DRG 160. 4) HD 192474 - 053.19 not grouping correctly Problem: ======== Diagnosis 053.19 yields DRG 470 (ungroupable). Solution: ========= The code was changed to replace DRG 20 (no longer valid) with DRG 18/19. Routine ICD1827G was modified. INSTALLATION INSTRUCTIONS: =========================== This patch may be run with users on the system. However, it would be preferable if Medical Records coders were off the system. Installation will take less than 5 minutes. Please ensure that your programming variables are set, including your DUZ(0)="@", otherwise installation will abort. 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu to unload the KIDS distribution included with this message. NOTE: If the required patches are not installed, the transport global will be removed. If the transport global is removed you will need to repeat this step. 2. From the Kernel Installation and Distribution System Menu, select the Installation menu. 3. From this menu, you may elect to use the following options (when prompted for INSTALL NAME, enter ICD*18.0*27): a. 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.). b. Verify Checksums in Transport Global - this option will allow you to ensure the integrity of the routines that are in the transport global. c. Print Transport Global - this option will allow you to view the components of the KIDS build. d. 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. 4. Use the Install Package(s) option and select the package ICD*18.0*27. 5. When prompted ' Want KIDS to INHIBIT LOGONs during the install? YES//', respond NO. 6. When prompted,' Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', respond Yes. When prompted,'Enter options you wish to mark as 'Out Of Order':', enter: PTF Menu [DG PTF MENU] When prompted,'Enter protocols you wish to mark as 'Out Of Order':', press enter. 7. Routines ICD1827* can be deleted after the patch has been successfully installed. 8. 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 10/1/2006). 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. 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 ============ ============ =========== ========== ICD1827G N/A 5622936 27 ICD1827V N/A 464630 27 ICDDRG0 15132590 15198496 1,2,7,10,14 17,20,24,27 ICDDRG6 1219216 1219216 24,27 ICDDRGX 9076335 10899065 1,2,5,7,10 14,20,24,27 ICDTLB3B 7293357 7591847 20,27 ICDTLB3C 7293400 7591855 24,27 Routine Information: ==================== The second line of each of these routines now looks like: ;;18.0;DRG Grouper;**[Patch List]**;Oct 13,2000;Build 2 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ICD1827G Before: n/a After: B24133153 **27** Routine Name: ICD1827V Before: n/a After: B732389 **27** Routine Name: ICDDRG0 Before: B35377486 After: B35757184 **1,2,7,10,14,17,20,24,27** Description of Changes: ICDDRG0.INT.1 +2 ;;18.0;DRG Grouper;**1,2,7,10,14,17,20,24,27**;Oct 20, 2000;Build 5 ................... |"PATVEE"|ICDDRG0.INT.1 +2 ;;18.0;DRG Grouper;**1,2,7,10,14,17,20,24**;Oct 20, 2000;Build 5 --------------------------------------- ICDDRG0.INT.1 +73 I $D(ICDOP(" 39.65")) S ICDRG=541,ICDNMDC(1)="" ................... Routine Name: ICDDRG6 Before: B2492700 After: B2492686 **24,27** Description of Changes: ICDDRG6.INT.1 +2 ;;18.0;DRG Grouper;**24,27**;Oct 20, 2000;Build 5 ................... |"PATVEE"|ICDDRG6.INT.1 +2 ;;18.0;DRG Grouper;**24**;Oct 20, 2000;Build 5 --------------------------------------- ICDDRG6.INT.1 +15 I ICDJ=159 S ICDJ(9)=ICDJ Q +16 I ICDJ=161 S ICDJ(10)=ICDJ Q ................... |"PATVEE"|ICDDRG6.INT.1 +15 I ICDJ=161 S ICDJ(9)=ICDJ Q +16 I ICDJ=159 S ICDJ(10)=ICDJ Q --------------------------------------- ICDDRG6.INT.1 +36 I ICDJ=159 S ICDJ(16)=ICDJ Q +37 I ICDJ=161 S ICDJ(17)=ICDJ Q ................... |"PATVEE"|ICDDRG6.INT.1 +36 I ICDJ=161 S ICDJ(16)=ICDJ Q +37 I ICDJ=159 S ICDJ(17)=ICDJ Q ************************************************************************** ***** Routine Name: ICDDRGX Before: B15940302 After: B19008413 **1,2,5,7,10,14,20,24,27** Description of Changes: ICDDRGX.INT.1 +2 ;;18.0;DRG Grouper;**1,2,5,7,10,14,20,24,27**;Oct 20, 2000 ................... |"PATVEE"|ICDDRGX.INT.1 +2 ;;18.0;DRG Grouper;**1,2,5,7,10,14,20**;Oct 20, 2000 --------------------------------------- ICDDRGX.INT.1 +45 I ICDDATE>3040930.9 D I ICDRG=541!(ICDRG=542) S ICDRTC=0 Q ;Use D RG FY 05 logic +46 .;S ICDRG=$S($D(ICDOP(" 31.1"))!($D(ICDOP(" 31.21")))!($D(ICDOP(" 3 1.29")))&(($P($$ICDDX^ICDCODE(ICDDX(1),ICDDATE),"^",3)'["Y")!($D(ICDOP(" 96.72")))):541,1:ICDRG) +47 .;I ICDRG=541&(($P($$ICDDX^ICDCODE(ICDDX(1),ICDDATE),"^",3))["Y") S ICDRG=542 S ICDRTC=0 +48 .I $D(ICDOP(" 39.65")) S ICDRG=541 Q +49 .I $D(ICDOP(" 31.1"))!($D(ICDOP(" 31.21")))!($D(ICDOP(" 31.29"))) I $P($$ICDDX^ICDCODE(ICDDX(1),ICDDATE),"^",3)'["Y"!(($D(ICDOP(" 96.72")))) S ICDRG=542 +50 .I $D(ICDOP(" 31.1"))!($D(ICDOP(" 31.21")))!($D(ICDOP(" 31.29"))) I $P($$ICDDX^ICDCODE(ICDDX(1),ICDDATE),"^",3)'["Y"!(($D(ICDOP(" 96.72")))) I ICDOR["O"&(ICDOR'["z")&(ICDOR'["y") S ICDRG=541 ................... |"PATVEE"|ICDDRGX.INT.1 +45 I ICDDATE>3040930.9 D Q:ICDRG=541!(ICDRG=542) ;Use DRG FY 05 logi c +46 .S ICDRG=$S($D(ICDOP(" 31.1"))!($D(ICDOP(" 31.21")))!($D(ICDOP(" 31 .29")))&(($P($$ICDDX^ICDCODE(ICDDX(1),ICDDATE),"^",3)'["Y")!($D(ICDOP(" 9 6.72")))):541,1:ICDRG) +47 .I ICDRG=541&(($P($$ICDDX^ICDCODE(ICDDX(1),ICDDATE),"^",3))["Y") S ICDRG=542 S ICDRTC=0 ************************************************************************** ***** Routine Name: ICDTLB3B Before: B21430728 After: B22984548 **20,27** Description of Changes: ICDTLB3B.INT.1 |"PATVEE"|ICDTLB3B.INT.1 ************************************************************************** ***** ICDTLB3B.INT.1 +2 ;;18.0;DRG Grouper;**20,27**;Oct 20, 2000;Build 2 ................... |"PATVEE"|ICDTLB3B.INT.1 +2 ;;18.0;DRG Grouper;**20**;Oct 20, 2000 --------------------------------------- ICDTLB3B.INT.1 +43 ; ICD*18*27 +44 ;I ICDOR["T"&(ICDOR'["3"&(ICDOR'["h")) D Q:"195^196^197^198"[ICDRG +45 ;.I ICDOR["E" S ICDRG=$S(ICDCC:195,1:196) Q +46 ;.I ICDOR'["E" S ICDRG=$S(ICDCC:197,1:198) +47 ;I ICDOR["3"!(ICDOR["E") S ICDRG=$S(ICDCC:193,1:194) Q +48 I ICDOR["3" S ICDRG=$S(ICDCC:193,1:194) Q +49 I ICDOR["E" I $D(ICDOP(" 51.21"))!$D(ICDOP(" 51.22"))!$D(ICDOP(" 51 .23"))!$D(ICDOP(" 51.24")) S ICDRG=$S(ICDCC:195,1:196) Q +50 I $D(ICDOP(" 51.21"))!$D(ICDOP(" 51.22")) S ICDRG=$S(ICDCC:197,1:19 8) Q +51 I $D(ICDOP(" 51.23"))!$D(ICDOP(" 51.24")) S ICDRG=$S(ICDCC:493,1:49 4) Q +52 ; end of ICD*18*27 ................... |"PATVEE"|ICDTLB3B.INT.1 +43 I ICDOR["T"&(ICDOR'["3"!(ICDOR'["h")) D Q:"195^196^197^198"[ICDRG +44 .I ICDOR["E" S ICDRG=$S(ICDCC:195,1:196) Q +45 .I ICDOR'["E" S ICDRG=$S(ICDCC:197,1:198) +46 I ICDOR["3"!(ICDOR["E") S ICDRG=$S(ICDCC:193,1:194) Q --------------------------------------- ICDTLB3B.INT.1 +59 DRG195 ;G:ICDOR["TT" DRG493^ICDTLB6B D DRG193 Q +60 D DRG193 Q ................... |"PATVEE"|ICDTLB3B.INT.1 +53 DRG195 G:ICDOR["TT" DRG493^ICDTLB6B D DRG193 Q --------------------------------------- ICDTLB3B.INT.1 +62 DRG197 ;S ICDRG=$S(ICDCC:197,1:198) Q +63 D DRG193 Q +64 DRG198 ;S ICDRG=$S(ICDCC:197,1:198) Q +65 D DRG193 Q ................... |"PATVEE"|ICDTLB3B.INT.1 +55 DRG197 S ICDRG=$S(ICDCC:197,1:198) Q +56 DRG198 S ICDRG=$S(ICDCC:197,1:198) Q Routine Name: ICDTLB3C Before: B21430825 After: B22984557 **24,27** Description of Changes: ICDTLB3C.INT.1 |"PATVEE"|ICDTLB3C.INT.1 ************************************************************************** ***** ICDTLB3C.INT.1 +2 ;;18.0;DRG Grouper;**24,27**;Oct 20, 2000;Build 2 ................... |"PATVEE"|ICDTLB3C.INT.1 +2 ;;18.0;DRG Grouper;**24**;Oct 20, 2000;Build 5 --------------------------------------- ICDTLB3C.INT.1 +43 ; ICD*18*27 +44 ;I ICDOR["T"&(ICDOR'["3"&(ICDOR'["h")) D Q:"195^196^197^198"[ICDRG +45 ;.I ICDOR["E" S ICDRG=$S(ICDCC:195,1:196) Q +46 ;.I ICDOR'["E" S ICDRG=$S(ICDCC:197,1:198) +47 ;I ICDOR["3"!(ICDOR["E") S ICDRG=$S(ICDCC:193,1:194) Q +48 I ICDOR["3" S ICDRG=$S(ICDCC:193,1:194) Q +49 I ICDOR["E" I $D(ICDOP(" 51.21"))!$D(ICDOP(" 51.22"))!$D(ICDOP(" 51 .23"))!$D(ICDOP(" 51.24")) S ICDRG=$S(ICDCC:195,1:196) Q +50 I $D(ICDOP(" 51.21"))!$D(ICDOP(" 51.22")) S ICDRG=$S(ICDCC:197,1:19 8) Q +51 I $D(ICDOP(" 51.23"))!$D(ICDOP(" 51.24")) S ICDRG=$S(ICDCC:493,1:49 4) Q +52 ; end of ICD*18*27 ................... |"PATVEE"|ICDTLB3C.INT.1 +43 I ICDOR["T"&(ICDOR'["3"!(ICDOR'["h")) D Q:"195^196^197^198"[ICDRG +44 .I ICDOR["E" S ICDRG=$S(ICDCC:195,1:196) Q +45 .I ICDOR'["E" S ICDRG=$S(ICDCC:197,1:198) +46 I ICDOR["3"!(ICDOR["E") S ICDRG=$S(ICDCC:193,1:194) Q --------------------------------------- ICDTLB3C.INT.1 +59 DRG195 ;G:ICDOR["TT" DRG493^ICDTLB6C +60 D DRG193 Q ................... |"PATVEE"|ICDTLB3C.INT.1 +53 DRG195 G:ICDOR["TT" DRG493^ICDTLB6C D DRG193 Q --------------------------------------- ICDTLB3C.INT.1 +62 DRG197 ;S ICDRG=$S(ICDCC:197,1:198) Q +63 D DRG193 Q +64 DRG198 ;S ICDRG=$S(ICDCC:197,1:198) Q +65 D DRG193 Q ................... |"PATVEE"|ICDTLB3C.INT.1 +55 DRG197 S ICDRG=$S(ICDCC:197,1:198) Q +56 DRG198 S ICDRG=$S(ICDCC:197,1:198) Q ************************************************************************** ***** Routine list of preceding patches: 24 ============================================================================= User Information: Entered By : THEROUX,JOHN Date Entered : JAN 10, 2007 Completed By: CHANDARANA,RISHAN Date Completed: AUG 29, 2007 Released By : CANNEDY,JOELLEN Date Released : AUG 29, 2007 ============================================================================= Packman Mail Message: ===================== $END TXT