$TXT Created by ROWE,KIM at LEXCST.FO-BAYPINES.MED.VA.GOV (KIDS) ============================================================================= Run Date: JUL 29, 2004 Designation: LEX*2*29 Package : LEX - LEXICON UTILITY Priority: Mandatory Version : 2 SEQ #28 Status: Released Compliance Date: AUG 29, 2004 ============================================================================= Associated patches: (v)LEX*2*28 <<= must be installed BEFORE `LEX*2*29' Subject: FIX FILE 81.2/ADD CPT MODIFIER PAIRS Category: - Data Dictionary - Routine - Enhancement (Mandatory) - PATCH FOR A PATCH Description: ============ This patch exports CPT Modifier Pairs, DMIS IDs, and selected abbreviations for clinical terminology. It also contains several fixes for NOIS and E3R reports. ENHANCEMENTS ============ Modifier Pairs The annual 2004 update to modifiers that may be used with CPT (Current Procedural Terminology) and HCPCS (Healthcare Common Procedure Coding System) codes are provided with this patch. These modifier pairings are supplied by Ingenix (the designated authoritative source for modifier pairs) and provide the only valid pairs (i.e., linked codes and modifiers) that may be used to encode special circumstances which adjust or modify codes. Note: This data is part of Informational patch ICPT*6.0*18 and exported with Lexical Services under patch LEX*2.0*29. DMIS IDs The Lexicon provides translation of DMIS Identifiers. DMIS IDs represent the Department of Defense (DoD) identifying numbers, names, and installations for each treatment facility, catchment area, or other entity used by DoD to uniquely identify sites of care. This patch provides an update (i.e., adds new sites and modifies existing site information) for all DoD medical treatment facilities as of March 2004. Abbreviations Members of the Coding Council provided 176 common medical abbreviations to assist users in identifying applicable International Classification of Diseases - Clinical Modification, 9th Revision, (ICD-9-CM) diagnoses codes. These abbreviations have been included with this patch to aid in the search functionality of the Lexicon. NOIS/E3R SUMMARY ================ The date in file 81.2 was not updated to NOIS AUG-0204-32253 reflect the latest version of CPT/HCPCS ASH-0204-31578 codes. This caused the reports from the ICPT OUTPUT MENU to return incorrect data. With this patch, the date in file 81.2 has been updated to Jan 1, 2004. The Lexicon expression "Gait, Limp" was NOIS BIL-1203-30691 incorrectly coded at ICD 443.9. 443.9 refers to "Peripheral Vascular Disease, Unspecified." "Gait, Limp" has been re-coded to 781.2, "ABNORMALITY OF GAIT". When the diagnosis "hypogonadism" is entered NOIS LEX-0204-41676 in the search, it only returns female related diagnosis (no male related diagnosis). The keyword "HYPOGONADISM" has been added to male related diagnosis, such as "Other Testicular Hypofunction". The ICD code E915. exists with the correct NOIS SAG-1203-41852 description in the ICD DIAGNOSIS file. When an attempt is made to add a problem in CPRS (which uses the Lexicon), it returns the wrong description. E915. has been linked with the correct term "Foreign Body Accidentally entering other Orifice" as the preferred term in the Lexicon (instead of "hairball"). When searching for 'HYPOGONADISM' the Lexicon NOIS SAG-1103-40488 responds with one (1) term instead of a list of relevant terms. The keyword "HYPOGONADISM" was added to selected expressions to assist in the data retrieval, resulting in a list of terms to select from. A similar condition existed for "PULMONARY HYPERTENSION" and was also fixed by adding keywords to assist the lookup. When the Lexicon performs a "lookup by code", it NOIS PHO-0104-60329 does not honor the user's default display parameter. The lookup has been changed to make use of the default display, with one exception, that is when the code that is found is not of a code type contained in the default display string. CPT code 88112 had the wrong long description NOIS CIN-0404-40409 in file 81. This has been replaced with "CYTOPATHOLOGY, SELECTIVE CELLULAR ENHANCEMENT TECHNIQUE WITH INTERPRETATION (EG, LIQUID BASED SLIDE PREPARATION METHOD), EXCEPT CERVICAL OR VAGINAL" A similar fix was made to the Lexicon. The ICD code for "Macrocytosis" in Lexicon was E3R 18827 inactivated, and no longer available to calling applications. "Macrocytosis" has been re-coded as ICD 289.89 (an active ICD code) and can now be accessed by calling applications. ROUTINE SUMMARY =============== The second line of each of these routines will look like: ;;2.0;LEXICON UTILITY;**[PATCH LIST]**;Sep 23, 1996 Checksums Checksums Before After Routine Patch Patch Patch List (2nd Line) -------------------------------------------------------- LEX2029 14516000 29 LEX2029P 4042512 29 LEXABC 15744221 16242579 4,25,26,29 LEXXGI 17952580 18234368 4,25,26,27,28,29 LEXXGI2 14298367 12750627 25,26,28,29 FTP SOFTWARE RETRIEVAL: ======================= Global Host File: LEX_2_29.GBL (ASCII) The preferred method is to FTP the files from download.vista.med.va.gov which will transmit the files from the first available FTP server. The files may also be downloaded directly from a particular FTP location at the following locations. Hines ftp.fo-hines.med.va.gov Albany ftp.fo-albany.med.va.gov Salt Lake ftp.fo-slc.med.va.gov Files are available in the ANONYMOUS.SOFTWARE directory. Installation Instructions: ========================== 1) Users may be on the system during the install of LEX*2.0*29. It is recommended that this patch be installed during non-peak hours. This patch should take less than 10 minutes to install. 2) Review your mapped set. If LEXABC, LEXXGI, and LEXXGI2 are are mapped, they should be removed from the mapped set at this time. >>>>>>>>>>>>>>>>>>>>>>> IMPORTANT <<<<<<<<<<<<<<<<<<<<<<<<<< If you have installed LEX*2.0*29 into another account, and the Lexicon global ^LEX is translated into the current account, you may go directly to step 8 of the installation instructions. It is not necessary to install the data more than once per translation. >>>>>>> IMPORTANT <<<<<<<<<<<>>>>>>>>>> IMPORTANT <<<<<<<<< 3) Backup the following globals before continuing: CPT #81 ^ICPT( CPT COPYRIGHT #81.2 ^DIC(81.2 CPT MODIFIER #81.3 ^DIC(81.3, Lexicon #757-757.41 ^LEX( 4) Make sure that the remnants of a previous import global do not exist on your system. If the global ^LEXM does exist, you will need to kill this global before proceeding. To kill the unsubscripted global ^LEXM: DSM K ^LEXM Cache The prevention of unsubscripted global kills is a system wide setting, but can be allowed for a particular process using the $ZU command. The command for enabling unsubscripted global kills is: VAH>S X=$ZU(68,28,0) VAH>K ^LEXM The command for disabling unsubscripted kills for a process is S X=$ZU(68,28,1); however, halting out of the process and creating a new process will achieve the same effect. 5) Install the data from the global host file LEX_2_29.GBL. This file contains the Lexicon Utility's import global ^LEXM. DSM Use ^%GTI and the input device LEX_2_29.GBL Cache/NT and Cache/VMS Cache v2.1.6 - Global Restore We recommend that the GUI Thin Client be used to restore the global. Be sure to select the VAH namespace in the "Global Utilities" window. Make sure that you select the global host file LEX_2_29.GBL (File / Open) before changing the file format. With the namespace and file selected, change the restore file format to VAX DSM. Cache v3.2 - Global Restore Using the Cache 3.2 Thin Client, right click on the Cache cube, then select "Explorer." Open the "Namespaces" folder, then open the "VAH" folder, and right click on the "Globals" folder. Select the "Import from disk" option. Click on the "Options..." button. Select the "Globals" tab, make sure the format is VAX DSM, then click "OK." Find the file in the directory, double click on LEX_2_29.GBL. Next, select "Import All" at the prompt "Do you wish to restore '^LEXM'," select "Yes." Using the GUI utilities will prevent an error when restoring a global saved under DSM (usually seen when using the CHUI %GI utility to restore a DSM global). The loading of the global should take from 1 to 2 minutes. 6) Turn journaling off for globals ^LEX, ^LEXT and ^LEXM. DSM Use ^%GLOMAN For the globals ^LEX, ^LEXT and ^LEXM Select "Change Journaling Capabilities" Select "D" for "Disabled" Cache/NT Cache v2.1.6 - Journaling We recommend using the GUI System Operations Utilities. Select the database where the globals ^LEX, ^LEXT and ^LEXM reside using the Databases tab (to find out where a global resides use the GUI global utility directory tab). Then select the menu item Action / Database / Global attributes. In the Attributes and Journaling window, click on the "Globals" button. Select the globals ^LEX, ^LEXT and ^LEXM (note the "All Globals" check box needs to be unmarked to select a specific global). Make sure the check box under the column heading "Journal" is unmarked for the ^LEX, ^LEXT and ^LEXM globals and then click "OK." Cache v3.2 - Journaling Using the Cache v3.2 Thin Client, right click on the Cache cube, then, select "Control Panel." Open the "Local Databases" folder, then open the folder where the ^LEX* globals reside. Right click ^LEX, select "Properties," and uncheck the "Journal global" box. Repeat for ^LEXT and ^LEXM globals. Cache/VMS It is not possible to disable journaling for individual files on Cache/VMS systems. Caution should be exercised with regard to the amount of journal space that may be required. 7) Set up user and IO variables (D ^XUP) for programmer access. 8) Distribution Load: Load the Distribution from the Packman Message using the Packman function "Install/Check Message." Environment Check: Only package components and system variables will be checked during the loading of the transport global. 9) KIDS Installation: Install the patch using the KIDS Installation Menu action "Install Package(s)" and the install name LEX*2.0*29. The KIDS installation should take less than a minute (with journaling off) depending on the number of users/jobs on the system. Environment Check: LEX*2.0*29 data exists (by global translation): If the data for LEX*2.0*29 has been installed and is translated into the current account, then only package components and system variables will be checked. LEX*2.0*29 data does not exist: If the data for LEX*2.0*29 can not be found (either in the current account or by translation) then the environment check routine will verify the import global ^LEXM by build namespace and global checksum. This is to insure that the correct import global is loaded and that all of the data contained in the import global arrived at your site during the FTP transfer. If you have inadvertently loaded the wrong import global or the global fails the checksum, the install will stop and you will need to kill ^LEXM and FTP another copy of the import global (see the section on FTP Software Retrieval and step 4 of the Installation Instructions). Respond "NO" at the "Want KIDS to INHIBIT LOGONs during the install? YES//" prompt. Respond "NO" at the "Want to DISABLE Schedule Options, Menu Options, and Protocols?" prompt. 10) Cleanup a) Check that the export global ^LEXM has been killed automatically. If it has not been automatically killed you will need to kill the "unsubscripted" import global ^LEXM to prevent import global checksum errors on future installations. (see step 5 for "unsubscripted" kills) b) If journaling was turned off in step 6 for the ^LEX and ^LEXT globals, turn journaling back on. DSM Same instructions as in step 6 except select "E" for "Enabled" Cache/NT and Cache/VMS Same instructions as in step 6 except make sure the check box under the column heading "Journal" is marked for the ^LEX and ^LEXT globals. c) If Lexicon routines were unmapped as part of step 2 above, then they should be returned to the mapped set once the installation has run to completion. d) Routines LEX2029 and LEX2029P may be deleted from your system upon completion of the installation. These are the environment check and post-install routines. Routine Information: ==================== Routine Name: - LEX2029 Routine Checksum: Routine Name: - LEX2029P Routine Checksum: Routine Name: - LEXABC Routine Checksum: Routine Name: - LEXXGI Routine Checksum: Routine Name: - LEXXGI2 Routine Checksum: ============================================================================= User Information: Entered By : ROWE,KIMBALL Date Entered : MAR 03, 2004 Completed By: SCHLEHUBER,PAM Date Completed: JUL 27, 2004 Released By : BELSCHWINDER,MICHAEL Date Released : JUL 29, 2004 ============================================================================= Packman Mail Message: ===================== $END TXT