$TXT Created by ROWE,KIMBALL at DEVCUR.FO-SLC.MED.VA.GOV (KIDS) on Wednesday, 03/15/06 at 12:49 Run Date: APR 04, 2006 Designation: LEX*2*38 Package : LEX - LEXICON UTILITY Priority: Mandatory Version : 2 SEQ #38 Status: Released Compliance Date: APR 11, 2006 ============================================================================= Associated patches: (v)LEX*2*15 <<= must be installed BEFORE `LEX*2*38' (v)LEX*2*29 <<= must be installed BEFORE `LEX*2*38' (v)LEX*2*36 <<= must be installed BEFORE `LEX*2*38' (v)LEX*2*39 <<= must be installed BEFORE `LEX*2*38' Subject: Miscellaneous fixes for ICD/CPT Code Sets Category: - Routine - Enhancement (Mandatory) - Other - Data Dictionary Description: ============ This patch contains fixes for 24 Remedy Tickets (and 6 duplicates), updates the FY06 2nd Quarter Code Set distribution with 105 late code releases, fixes problems in 6 routines involving the Lexicon Lookup, and fixes problems found in the data dictionaries by SQA process for patch LEX*2.0*39, and listed in the Report of Findings. This patch writes to the following files: ICD Diagnosis #80 ^ICD9( DBIA 4485 CPT/HCPCS Procedure #81 ^ICPT( DBIA 4489 CPT Modifiers #81.3 ^DIC(81.3, DBIA 4492 Data Dictionary ### ^DD DBIA 4475 Lexicon Files #757-757.41 ^LEX( DBIA N/A ENHANCEMENTS ============ I. REMEDY TICKETS CPT/HCPCS CPT Code C1368 Inactive Jan 1, 2001 HD0000000 090529 CPT Modifier Add LT/RT Modifiers for CPT code 73500 HD0000000 064223 Add GY Modifier for CPT codes 69200, 69210, HD0000000 064379 92507, 92508, 92510, and 97112 Add P5 Modifier with Anesthesia codes HD0000000 064495 Add 50 Modifier for CPT code 92250 HD0000000 084545 ICD Supress DSM code 298.9 with ICD 298.9 HD0000000 128092 Make ICD Code 453.42 Recognized as CC HD0000000 085063 Make ICD Code 453.41 & 401.9 Recognized as CC HD0000000 094694 Add Synonym CHF for Congestive Heart Failure HD0000000 100042 Make ICD Code V45.77 not specifically Male HD0000000 103173 Make ICD Codes 426.2, 426.3 and 426.4 HD0000000 103729 Acceptable as Principal Dx Make ICD Code V58.3 Acceptable Principal Dx HD0000000 105214 Make ICD Code 070.70 Recognized as CC HD0000000 105216 HD0000000 117080 HD0000000 066609 ICD Code V70.5 Acceptable as Principal Dx HD0000000 125867 Lexicon Cervix Carcinoma re-coded to 180.8 HD0000000 068764 Link ICD Code 289.0 to term Erythrocytosis HD0000000 099835 Re-Code Volvulus of Intestine to ICD Code 560.2 HD0000000 101081 Re-Code Arthropathy as ICD Code 716.90 HD0000000 108402 HD0000000 121505 ICD Code 238.7 for Myelodysplastic Syndrome HD0000000 111864 HD0000000 125933 ICD Code 515. Flagged as Primary Code HD0000000 120112 ICD Code 362.83 Flagged as Primary Code HD0000000 121195 Replace 'Auricular' with 'Atrial' HD0000000 122717 Inapproptrate case for 'Stage i' HD0000000 123143 Pyuria re-coded as 791.9 HD0000000 124008 One outstanding issue remains from the testing of HD0000000 135804 this patch. VistA is calculating the wrong DRG result 479 vs 544 due to the ICD code 401.9 being flagged as "CC." (See 135804) To expedite the release of LEX*2.0*38 and not hold up the creation of LEX*2.0*40 (3rd quarter CSV update), this issue is being deferred/fixed in patch LEX*2.0*40. II. Lexicon Lookup Fix Two major problems were recently discovered with the Lexicon Lookup mechanism while investigating Remedy Tickets and Test Site reports from previous patches. 1. The first problem involves the lookup not passing the versioning date to Fileman's special lookup utility. The calling application correctly sets up the environment variables and user preferences using the supported Lexicon call CONFIG^LEXSET(,,). Then the Fileman Lookup is called using ^DIC. Since the Lexicon has a Special Lookup (see ^DD(757.01,0,"DIC")), the control for the lookup is passed to the routine LEXA1. However, what is not passed is the versioning date used to set the environment. The screen is set to look for dated information, and the lookup is searching for TODAY. This mismatch is responsible for not finding inactivated codes for an old encounter. It is responsible for the errors reported in the following Remedy Tickets: HD0000000125146 HD0000000124688 HD0000000124196 HD0000000123800 It may also be responsible for the LI1+29^PXBPPOV error in Remedy Tickets HD0000000121688 and HD0000000121775, but the error trap and testing have been inconclusive. It can be said that it will fix a condition that existed that resulted in a term being found with an ICD code of -1 (as suggested by the error trap). This fix is contained in the routines LEXA, LEXA1, LEXA2, LEXAR5, and LEXSRC. 2. The second problem was discovered in the testing of a previous Lexicon patch. When searching for a code that is not active for the versioning date being passed, the "Lookup-by-Code" program will stop without finding an entry in the Lexicon. At this point, the user's input (in this case, G0032) is treated as a string of text and the Lexicon begins looking for the string "G0032". When it cannot find the string "G0032", it sends the string to a spell-check routine. S X=$$SPL^LEXAS("G0032") W !,X G032 The spell checker returns the string "G032." This time the string search returns a completely unrelated term based on "G032": Electromagnetic Therapy, to one or more areas, for Wound Care other than described in G0329 or for other uses This fix is contained in the routines LEXA and LEXABC. III. LEX*2.0*38 Report of Findings Fixes for Data Dictionaries The following DD fixes were deferred from the Report of Findings from patch LEX*2.0*39. Data found beyond the 7th piece of ^LEX(757.02,D0,0), data removed and VERSION Field #10 deleted. RELATED CODES Field 9, Subfile 757.29, Field 2 (RELATIONSHIP) points to missing file, Field 9, Subfile 757.29 deleted. Data exists but no DD for ^LEX(757.02,D0,6), data removed. Input Transform for CPT CATEGORY file 81.1, Field BEGIN CPT RANGE Field #4 modified for 4 numeric 1 alpha input. Input Transform for CPT CATEGORY file 81.1, Field END CPT RANGE Field #5 modified for 4 numeric 1 alpha input. File #757.28, Index "ACT" has duplicate Fields, .01 and 1. File #757.02, Index "APCODE" has duplicate Fields, 1 and 4. File #757.02, field 2 Points to missing file. File #81.02, Index "ACT" has duplicate Fields, .01 and .02. File #81.33, Index "ACT" has duplicate Fields, .01 and .02. File #80.066, Index "ACT" has duplicate Fields, .01 and .02. IV. FY06 2nd Quarter CSV Late Releases New Code Sets HCPCS Codes 82 codes G8054 G9050 G9051 G9052 G9053 G9054 G9055 G9056 G9057 G9058 G9059 G9060 G9061 G9062 G9063 G9064 G9065 G9066 G9067 G9068 G9069 G9070 G9071 G9072 G9073 G9074 G9075 G9076 G9077 G9078 G9079 G9080 G9081 G9082 G9083 G9084 G9085 G9086 G9087 G9088 G9089 G9090 G9091 G9092 G9093 G9094 G9095 G9096 G9097 G9098 G9099 G9100 G9101 G9102 G9103 G9104 G9105 G9106 G9107 G9108 G9109 G9110 G9111 G9112 G9113 G9114 G9115 G9116 G9117 G9118 G9119 G9120 G9121 G9122 G9123 G9124 G9125 G9126 G9127 G9128 G9129 G9130 Re-Activated Code Sets HCPCS Codes 4 codes E1239 G0252 J7317 J7320 Inactivated Code Sets HCPCS Codes 14 codes E0590 G9021 G9022 G9023 G9024 G9025 G9026 G9027 G9028 G9029 G9030 G9031 G9032 J7318 Revised Code Sets HCPCS Codes 6 codes J7640 G9041 G9042 G9043 G9044 Q0510 ROUTINE SUMMARY =============== The second line of each of these routines will look like: ;;2.0;LEXICON UTILITY;**[PATCH LIST]**;Sep 23, 1996 Checksums Checksums Routine Before Patch After Patch Patch List (2nd Line) -------- ------------- ------------- --------------------- LEX2038 69633934 38 LEX2038P 26870118 38 LEX2038A 59696397 38 LEX2038B 45158816 38 LEX2038C 54091222 38 LEX2038D 47235973 38 LEXA 29821376 30812811 3,4,6,19,25,36,38 LEXA1 27536211 30130787 3,4,6,11,15,38 LEXA2 508535 535269 38 LEXABC 35959964 40502743 4,25,26,29,38 LEXAR5 26526937 25100906 14,25,26,38 LEXSRC 6297697 5546229 7,25,26,38 FTP SOFTWARE RETRIEVAL ====================== The KIDs build is being distributed in a Packman Message from the National Patch Module (NPM). Data for this patch is being distributed in a global host file: Filename FTP Protocol ------------ ------------ LEX_2_38.GBL ASCII The preferred method is to FTP this file from download.vista.med.va.gov which will transmit the file from the first available FTP server. This file 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 The file is available in the ANONYMOUS.SOFTWARE directory. INSTALLATION INSTRUCTIONS ========================= 1) Users may be on the system during the install of LEX*2.0*38. It is recommended that this patch be installed during non-peak hours. This patch should take less than 10 minutes to install. 2) Create a backup of the following globals files before continuing: ICD Diagnosis #80 ^ICD9( CPT/HCPCS Procedure #81 ^ICPT( CPT Modifiers #81.3 ^DIC(81.3, Lexicon Files #757-757.41 ^LEX( 3) 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. On a Cache system, 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. 4) Install the data from the global host file LEX_2_38.GBL. This file contains the Lexicon Utility's import global ^LEXM. Thin Client Global Restore Using the Cache 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_38.GBL. Next, select "Import All" At the prompt "Do you wish to restore '^LEXM'," select "Yes." Programmer Mode Global Restore. From the Programmer prompt, execute the following routine: >D ^%GI Global input Device: VA5$:[ANONYMOUS.SOFTWARE]LEX_2_38.GBL Parameters:"RS"=> Globals were saved on 07 Feb 2006 4:07 PM Cache with description: LEX*2*38/ICPT*6*27 Data Input option: A ^LEXM The loading of the global should take from 1 to 2 minutes. NOTE: Unlike the quarterly updates, this data global needs to be loaded and installed in each account and for each subsequent install, even if you install multiple times in the same account. 5) (OPTIONAL) Turn journaling off for globals ^ICPT, ^ICD9, ^DIC(81.3) and ^LEX Journaling OFF Journaling on a Cache system cannot be disabled by individual global. Journaling CAN BE disabled for a user's current process. In this case, the process will be the installation of this patch. It is important to know that for this to work, the KIDS installation CANNOT be tasked off. The installation MUST be run on your screen for the disabled journaling to be in effect. To determine if your process has journaling enabled you can call: >W $$CURRENT^%NOJRN() 0 means journaling is disabled, 1 means it's on To disable journaling for the current process: >D DISABLE^%NOJRN Double check your process to be sure journaling is disabled: >W $$CURRENT^%NOJRN() 0 means journaling is disabled, 1 means it's on Proceed with the installation remembering NOT to task off the install. 6) Set up user and IO variables (D ^XUP) for programmer access. 7) Distribution Load: Load the KIDS Distribution from the Packman Message using the Packman function "Install/Check Message." 8) KIDS Installation: Install the patch using the KIDS Installation Menu action "Install Package(s)" and the install name LEX*2.0*38. The KIDS installation should take less than five minutes (with journaling off) depending on the number of users/jobs on the system. Respond "NO" at the "Want KIDS to INHIBIT LOGONs during the install? YES//" prompt. Respond "NO" at the "Want to DISABLE Schedule Options, Menu Options, and Protocols?" prompt. 9) Cleanup a) Check that the export global ^LEXM has been killed automatically. If it has not been automatically killed you will need to kill the "unsubscripted" import global ^LEXM to prevent import global checksum errors on future installations. On a Cache system, the prevention of unsubscripted global kills is a system wide setting, but can be allowed for a particular process using the $ZU command. The command for enabling unsubscripted global kills is: VAH>S X=$ZU(68,28,0) VAH>K ^LEXM The command for disabling unsubscripted kills for a process is S X=$ZU(68,28,1); however, halting out of the process and creating a new process will achieve the same effect. b) If you opted to turn journaling off prior to installation, then the journaling must be turned back on when the installation is complete. Journaling ON Journaling on a Cache system can only be turned back on for the user's current process. When the installation of this patch has completed (interactively - not tasked), you may enable journaling for the current process. To determine if your process has journaling disabled, you can call: >W $$CURRENT^%NOJRN() 0 means journaling is disabled, 1 means it's on To enable journaling for the current process: >D ENABLE^%NOJRN Double check your process to be sure journaling is enabled: >W $$CURRENT^%NOJRN() 0 means journaling is disabled, 1 means it's on c) If routines LEX2038, LEX2038P,LEX2038A, LEX2038B, LEX2038C, and LEX2038D are found on your system, they may be deleted upon completion of the installation. These routines are the environment check and post-install routines for this installation. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: LEX2038 Before: n/a After: B69633934 **38** Routine Name: LEX2038A Before: n/a After: B59696397 **38** Routine Name: LEX2038B Before: n/a After: B45158816 **38** Routine Name: LEX2038C Before: n/a After: B54091222 **38** Routine Name: LEX2038D Before: n/a After: B47235973 **38** Routine Name: LEX2038P Before: n/a After: B26870118 **38** Routine Name: LEXA Before: B29821376 After: B30812811 **3,4,6,19,25,36,38** Routine Name: LEXA1 Before: B27536211 After: B30130787 **3,4,6,11,15,38** Routine Name: LEXA2 Before: B508535 After: B535269 **38** Routine Name: LEXABC Before: B35959964 After: B40502743 **4,25,26,29,38** Routine Name: LEXAR5 Before: B26526937 After: B25100906 **14,25,26,38** Routine Name: LEXSRC Before: B6297697 After: B5546229 **7,25,26,38** ============================================================================= User Information: Entered By : ROWE,KIMBALL Date Entered : SEP 14, 2005 Completed By: BASKETT,BARBARA J Date Completed: MAR 29, 2006 Released By : MONTGOMERY,ALAN Date Released : APR 04, 2006 ============================================================================= Packman Mail Message: ===================== $END TXT