============================================================================= Run Date: NOV 15, 2007 Designation: LEX*2*52 Package : LEX - LEXICON UTILITY Priority: Mandatory Version : 2 SEQ #49 Status: Released Compliance Date: NOV 23, 2007 ============================================================================= Associated patches: (v)LEX*2*50 <<= must be installed BEFORE `LEX*2*52' Subject: Lexicon/CPT Remedy Ticket Fixes Category: - Routine - Other - Enhancement (Mandatory) - Data Dictionary - Informational Description: ============ This patch contains fixes for several problems reported on Remedy tickets, Data Dictionary changes for file 80, three modified routines, and the FY08 1st Quarter Code Set update for both the CPT and ICD coding systems. The FY08 1st Quarter Code Set distribution contains 251 changes effective Oct 1, 2007, and 17 changes effective Jan 1, 2008. Patches contained in this distribution by order of installation: 1 LEX*2.0*52 Fixes 18 problems reported in Remedy 2 ICPT*6.0*37 Fixes logic in routines ICPTMOD and ICPTMOD2 3 ICD*18.0*29 Adds a field for Versioned Complication/Comorbidity (CC) 4 LEX*2.0*53 Updates Lexicon, ICD, and CPT files with FY08 data This patch consists of two host files; one is a Kernel Installation and Distribution System (KIDS) distribution, and the other is a global host file containing the new data for FY08. This patch writes to the following files: File Name or Group File Numbers Global DBIA ------------------------ ------------ ---------- ---------- Lexicon Files #757-757.41 ^LEX( DBIA N/A ICD Diagnosis #80 ^ICD9( DBIA 4485 ICD Operation/Procedures #80.1 ^ICD0( DBIA 4486 CPT/HCPCS Procedure #81 ^ICPT( DBIA 4489 CPT Category #81.1 ^DIC(81.1, DBIA 4490 CPT Modifier #81.3 ^DIC(81.3, DBIA 4492 Before continuing, make a backup copy of these global files. ENHANCEMENTS: ============ LEX*2.0*52 ---------- Remedy Ticket Fixes CPT/HCPCS Procedures File #81 Change 32002 to "THORACENTESIS W/INSERT TUBE" HD0000000 137320 CPT Modifiers File #81.3 Modifiers UN,UP,UQ,UR & US with CPT 99499 HD0000000 163358 TC-26 Modifiers with code 77071 HD0000000 177452 TC-26 Modifiers with code 77071 (dupe) HD0000000 178171 Modifiers LT and RT with 77055 HD0000000 183280 Modifier 51 with Surgery Codes HD0000000 183497 Modifier 51 with Surgery Codes (dupe) HD0000000 186884 CPT Modifiers needing code ranges HD0000000 196817 Add CPT Code ranges to CPT Modifiers 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1I, 1J, 2L, 2M, 2N, 2O, 2Q, 2R, 2S, 2T, 3K, 4I, 4J, 4K, 4L, 4M, 4N, 4O, 6E, 6F, 7F, 8B, 8C, 9B, 9C, 9D, AE, AF, AG, AK, AQ, AR, CD, CE, CF, CR, J1, J2, J3, KC, KG, KK, KL, QR, RD, SW, SY, UF, UG, UH, UJ, and UK The following Remedy ticket is fixed by the data contained in LEX*2.0*52 and the corrected logic in routine ICPTMOD contained in patch ICPT*6.0*37. Inactive Modifiers on Encounters (ICPTMOD) HD0000000 063523 The following Remedy Tickets are partially satisfied by patch LEX*2.0*52 by inactivating all CPT Code pairs for CPT Modifier GC, effectively discontinuing the use of the GC CPT Modifier. Modifier GC on Encounter Forms CPT 6.0 HD0000000 185482 Discontinue use of Modifier GC CPT 6.0 HD0000000 187712 VHA DIRECTIVE 2006-045 Modifier GC IB 2.0 HD0000000 168818 Modifier GC being sent to CPRS AICS 3.0 HD0000000 178546 Lexicon Files #757.01, #757.02, and #757.05 Add ICD Code 238.71 to Thrombocytosis HD0000000 131737 Add key word MYELODYSPLASIA for MYELODYSPLASTIC HD0000000 184174 Fix spelling error "Vascualar" for ICD 443.9 HD0000000 184273 Re-code "Elevation, blood pressure" to 796.2 HD0000000 192950 Code 259.0 incorrect for Hypogonadism HD0000000 193847 ICPT*6.0*37 ----------- CPT Modifiers - ICPTMOD $$MODP^ICPTMOD Sub-routine function $$MODP^ICPTCOD was modified to consider all activation/inactivation dates for a code found in the CPT Code Range multiple. Previously the logic stopped looking at activation/inactivation dates after the first qualifying CPT Code Range was found. This had allowed codes contained in inactivated code ranges to be selected and displayed on encounter forms. ICD*18.0*29 ----------- ICDDX^ICDCODE (included in companion patch ICD*18.0*29) The API $$ICDDX^ICDCODE(CODE,DATE) has been changed to accommodate the retrieval of the versioned complication/comorbidity flag. The return string includes an additional data element (piece 19) that contains one of a set of codes that represents the value of the complication/comorbidity flag. The values of the additional data element can be 0 - non-CC; 1 - CC; 2 - MCC; or if there is no versioned complication/comorbidity code on file for the given code and date. ICDDX^ICDCODE(CODE,CDT) Input: CODE Code/IEN (required) CDT Date (default = TODAY) Output: Returns a 19 piece string delimited by ^ 1 IEN of code in ^ICD9( 2 ICD-9 Dx Code (#.01) 3 ID (#2) 4 Versioned Dx (67 multiple) 5 Unacceptable as Principal Dx (#101) 6 Major Dx Cat (#5) 7 MDC13 (5.5) 8 Complication/Comorbidity (#70) 9 ICD Expanded (#8) 1:Yes 0:No 10 Status (66 multiple) 11 Sex (#9.5) 12 Inactive Date (66 multiple) 13 MDC24 (#5.7) 14 MDC25 (#5.9) 15 Age Low (#14) 16 Age High (#15) 17 Activation Date (.01 of 66 multiple) 18 Message 19 Versioned Complication/Comorbidity (#103) <---- NEW 0 = Non-CC 1 = CC 2 = MCC no data on file or -1^Error Description LEX*2.0*53 ---------- FY08 1st Quarter Update CPT Procedures Additions (37 Codes) Effective Oct 01, 2007 (27 Codes) 1116F 2035F 3215F 3216F 3217F 3218F 3219F 3220F 3230F 3260F 4130F 4131F 4132F 4133F 4134F 4135F 4136F 4150F 4151F 4152F 4153F 4154F 4155F 4156F 4157F 4158F 4159F Effective Jan 01, 2008 (projected FY08 2nd Qtr) (10 Codes) 0183T 0184T 0185T 0186T 0187T 90661 90662 90663 90681 90696 CPT Procedures Re-Used Effective Jan 01, 2008 (1 Code) 90650 CPT Procedures Revisions (3 Codes) Effective Oct 01, 2007 (2 Codes) 2000F 3017F Effective Jan 01, 2008 (projected FY08 2nd Qtr) (1 Code) 0124T CPT Modifiers Additions Effective Jan 01, 2008 (5 Codes) EA EB EC ED EE ICD Diagnosis Additions Effective Oct 01, 2007 (140 Codes) 040.41 040.42 058.10 058.11 058.12 058.21 058.29 058.81 058.82 058.89 079.83 200.30 200.31 200.32 200.33 200.34 200.35 200.36 200.37 200.38 200.40 200.41 200.42 200.43 200.44 200.45 200.46 200.47 200.48 200.50 200.51 200.52 200.53 200.54 200.55 200.56 200.57 200.58 200.60 200.61 200.62 200.63 200.64 200.65 200.66 200.67 200.68 200.70 200.71 200.72 200.73 200.74 200.75 200.76 200.77 200.78 202.70 202.71 202.72 202.73 202.74 202.75 202.76 202.77 202.78 233.30 233.31 233.32 233.39 255.41 255.42 258.01 258.02 258.03 288.66 315.34 331.5 359.21 359.22 359.23 359.24 359.29 364.81 364.89 388.45 389.05 389.06 389.13 389.17 389.20 389.21 389.22 414.2 415.12 423.3 440.4 449. 488. 525.71 525.72 525.73 525.79 569.43 624.01 624.02 624.09 664.60 664.61 664.64 733.45 787.20 787.21 787.22 787.23 787.24 787.29 789.51 789.59 999.31 999.39 V12.53 V12.54 V13.22 V16.52 V17.41 V17.49 V18.11 V18.19 V25.04 V26.41 V26.49 V26.81 V26.89 V49.85 V68.01 V68.09 V72.12 V73.81 V84.81 V84.89 ICD Diagnosis Inactivations Effective Oct 01, 2007 (17 Codes) 233.3 255.4 258.0 284.8 359.2 364.8 389.2 624.0 787.2 789.5 999.3 V17.4 V18.1 V26.4 V26.8 V68.0 V84.8 ICD Diagnosis Re-Used Effective Oct 01, 2007 (2 Codes) 284.81 284.89 ICD Diagnosis Revisions Effective Oct 01, 2007 (5 Codes) 005.1 359.3 389.14 389.18 389.7 ICD Procedures Additions Effective Oct 01, 2007 (39 Codes) 00.19 00.94 01.10 01.16 01.17 07.83 07.84 07.95 07.98 32.20 32.30 32.39 32.41 32.49 32.50 32.59 33.20 34.06 34.20 34.52 50.13 50.14 70.53 70.54 70.55 70.63 70.64 70.78 70.93 70.94 70.95 84.80 84.81 84.82 84.83 84.84 84.85 88.59 92.41 ICD Procedures Inactivations Effective Oct 01, 2007 (4 Codes) 32.3 32.4 32.5 84.58 ICD Procedures Revisions Effective Oct 01, 2007 (15 Codes) 00.18 00.74 00.75 00.76 00.77 07.81 07.82 07.92 07.99 34.24 39.8 53.41 53.61 53.69 99.14 Remedy Ticket Fixes Lexicon Expressions File 757.01 Respiratory is misspelled as Repiratory HD0000000 208151 Lexicon Codes File 757.02 Wrong ICD Code for Anticoagulation HD0000000 203050 CPT Modifiers File 81.3 Discontinue Modifier TC/26 with CPT Code 77071 HD0000000 177452 (Duplicate of HD0000000 177452) HD0000000 178171 AH and AJ Modifiers w/Mental Health Codes HD0000000 209719 Discontinue using 0A-9Z with EM codes HD0000000 209696 ICD Diagnosis File 80 V53.01 & V53.02 not accepted as Principal DX HD0000000 205216 FTP SOFTWARE RETRIEVAL: ======================= Host Files Name FTP Protocol ----------------------- ------------ ------------ Global Host File (data) LEX_2_52.GBL ASCII KIDS Distribution LEX_2_52.KID 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 The files are available in the ANONYMOUS.SOFTWARE directory. INSTALLATION INSTRUCTIONS: ========================= 1) Users may be on the system during the install of this patch. It is recommended that this patch be installed during non-peak hours. This patch should take less than 15 minutes to install. 2) Create a backup of the following globals files before continuing: Global Content File # Global ---------------- ----------- ---------- Lexicon Files #757-757.41 ^LEX ICD Diagnosis #80 ^ICD9 ICD Operation/Procedures #80.1 ^ICD0 CPT/HCPCS Procedure #81 ^ICPT CPT Category #81.1 ^DIC(81.1) CPT Modifier #81.3 ^DIC(81.3) 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 it 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=$ZU(68,28,1); however, halting out of the process and creating a new process will achieve the same effect. 4) Install the data from the global host file LEX_2_52.GBL. This file contains the Lexicon Utility's import global ^LEXM. Thin Client Global Restore Using the Cache Thin Client, right-click on the Cache cube, then select "Explorer." Open the "Namespaces" folder, then open the "VAH" folder, and right click on the "Globals" folder. Select the "Import from disk" option. Click on the "Options..." button. Select the "Globals" tab, make sure the format is VAX DSM, then click "OK." Find the file in the directory; double click on LEX_2_52.GBL. Next, select "Import All." At the prompt "Do you wish to restore '^LEXM'," select "Yes." Programmer Mode From the Programmer prompt, execute the following routine: >D ^%GI Global input Device: VA5$:[BETA]LEX_2_52.GBL Parameters: "RS"=> Globals were saved on 10 Oct 2007 2:14 PM Cache with description: Lexicon/ICD/CPT FY08 1st Qtr Data Input option: A ^LEXM The loading of the global should take less than 5 minutes. 5) Set up user and IO variables (D ^XUP) for programmer access. 6) Distribution Load: Use the "Load a Distribution" option on the KIDS installation menu. When prompted to enter a host file, type in LEX_2_52.KID. 7) KIDS Installation: Install the patch using the KIDS Installation Menu action "Install Package(s)" and the install name LEX*2.0*52. The KIDS installation should take less than fifteen minutes depending on the number of users/jobs on the system. Respond "NO" at the "Want KIDS to INHIBIT LOGONs during the install? NO//" prompt. Respond "NO" at the "Want to DISABLE Schedule Options, Menu Options, and Protocols? NO//" prompt. 8) 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 it 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) The Environment Check/Post-Install routines LEX2052, LEX2052P, LEX2053, and LEX2053P should be deleted using the KERNEL option 'Delete Routines' [XTRDEL] upon completion of the installation. Routines LEX2052A, LEX2052B, LEX2052C, LEX2052D, LEX2052E, LEX2052F, LEX2052G, LEX2052H will be deleted by the post-install routine LEX2052P upon completion of the install. Routine LEX2053A will be deleted by the post-install routine LEX2053P upon completion of the install. MULTI-PACKAGE BUILD ROUTINE SUMMARY: =================================== LEX*2.0*52 - Installed 1st -------------------------- The second line of each of these routines will look like: ;;2.0;LEXICON UTILITY;**[PATCH LIST]**;Sep 23, 1996 The following checksums were created using CHECK^XTSUMBLD Checksums Checksums Routine Before After Patch List (2nd Line) -------- ------------- ------------- --------------------- LEX2052 4573205 52 LEX2052P 7690261 52 LEX2052A 18745677 52 LEX2052B 25229553 52 LEX2052C 11757416 52 LEX2052D 25963216 52 LEX2052E 18528211 52 LEX2052F 9191498 52 LEX2052G 17718237 52 LEX2052H 17455644 52 The following checksums were created using CHECK1^XTSUMBLD Checksums Checksums Routine Before After Patch List (2nd Line) -------- ------------- ------------- --------------------- LEX2052 12878269 52 LEX2052P 14203256 52 LEX2052A 64464440 52 LEX2052B 51845809 52 LEX2052C 21185674 52 LEX2052D 54625889 52 LEX2052E 44536375 52 LEX2052F 31135086 52 LEX2052G 50280818 52 LEX2052H 43592107 52 ICPT*6.0*37 - Installed 2nd --------------------------- The second line of each of these routines will look like: ;;6.0;CPT/HCPCS;**[PATCH LIST]**;May 19, 1997 The following checksums were created using CHECK^XTSUMBLD Checksums Checksums Routine Before After Patch List (2nd Line) -------- ------------- ------------- --------------------- ICPTMOD 14867260 8642707 6,12,13,14,19,30,37 ICPTMOD2 2459015 12168941 30,37 The following checksums were created using CHECK1^XTSUMBLD Checksums Checksums Routine Before After Patch List (2nd Line) -------- ------------- ------------- --------------------- ICPTMOD 68557022 35707569 6,12,13,14,19,30,37 ICPTMOD2 6025453 34943505 30,37 ICD*18.0*29 - Installed 3rd --------------------------- The second line of the routine will look like: ;;18.0;DRG Grouper;**[PATCH LIST]**;Oct 20, 2000 The following checksums were created using CHECK^XTSUMBLD Checksums Checksums Routine Before After Patch List (2nd Line) -------- ------------- ------------- --------------------- ICDCODE 9919747 9973969 6,12,14,29 The following checksums were created using CHECK1^XTSUMBLD Checksums Checksums Routine Before After Patch List (2nd Line) -------- ------------- ------------- --------------------- ICDCODE 69532850 75863718 6,12,14,29 LEX*2.0*53 - Installed Last --------------------------- The second line of each of these routines will look like: ;;2.0;LEXICON UTILITY;**[PATCH LIST]**;Sep 23, 1996 The following checksums were created using CHECK^XTSUMBLD Checksums Checksums Routine Before After Patch List (2nd Line) -------- ------------- ------------- --------------------- LEX2053 17731973 53 LEX2053P 3383422 53 LEX2053A 11046263 53 The following checksums were created using CHECK1^XTSUMBLD Checksums Checksums Routine Before After Patch List (2nd Line) -------- ------------- ------------- --------------------- LEX2053 85479743 53 LEX2053P 7669278 53 LEX2053A 31973876 53 Routine Information: ==================== Routine Name: LEX2052 Routine Name: LEX2052A Routine Name: LEX2052B Routine Name: LEX2052C Routine Name: LEX2052D Routine Name: LEX2052E Routine Name: LEX2052F Routine Name: LEX2052G Routine Name: LEX2052H Routine Name: LEX2052P ============================================================================= User Information: Entered By : ROWE,KIMBALL Date Entered : JUN 05, 2007 Completed By: PETRUSKA,BETH Date Completed: NOV 08, 2007 Released By : MONTGOMERY,ALAN Date Released : NOV 15, 2007 ============================================================================= Packman Mail Message: ===================== No routines included