============================================================================= Run Date: OCT 08, 2004 Designation: PX*1*149 Package : PX - PCE PATIENT CARE ENCOUNTER Priority: Mandatory Version : 1 SEQ #115 Status: Released Compliance Date: NOV 08, 2004 ============================================================================= Associated patches: (v)PX*1*134 <<= must be installed BEFORE `PX*1*149' (v)PX*1*136 <<= must be installed BEFORE `PX*1*149' (v)ICD*18*12 <<= must be installed BEFORE `PX*1*149' (v)ICPT*6*19 <<= must be installed BEFORE `PX*1*149' Subject: CTD - PCE CODE TEXT DESCRIPTORS Category: - Routine - Enhancement (Mandatory) - Informational - Data Dictionary Description: ============ I. BACKGROUND Office of Information Assurance, Office of Information, Veterans Health Administration, requested modifications to the VHA Information Systems and Technical Architecture (VistA) Patient Information Management System (PIMS) package that would allow for the use of multiple versions of the code sets employed in financial transactions. This work was completed in 2003 in the Code Set Versioning (CSV) project that was deployed in October of 2003. CSV included the Health Information Portability and Accessibility Act (HIPAA) stipulation that diagnosis and procedure codes used for billing purposes must be the codes that were applicable at the time service was provided. Four code sets, (ICD-9-CM, DRG, CPT, and HCPCS) for this project were modified as required under HIPAA legislation to be date-sensitive under the first phase of the project, i.e., CSV I. At the time that CSV I was developed, a request was made to defer applicable text versioning to the next iteration. This deferment of the short and long-text versions from the CSV project makes up the scope of this Code Text Descriptor (CTD) project. This follow-up project, Code Text Descriptors, intends to add the functionality of date-sensitive versioning for all applicable code text descriptors for the four code sets, effective with all textual changes occurring since October 1, 2002. This patch addresses the changes done within the Patient Care Encounter package in compliance to the specifications of CTD. Modifications were done within the Patient Care Encounter application to assure the correct descriptors are being displayed for CPT procedure codes, CPT modifiers, and ICD diagnosis and CPT procedure codes for a given encounter date. The changes affects to the following options: PXCE ENCOUNTER DATA ENTRY PCE Encounter Data Entry PXCE ENCOUNTER ENTRY SUPER PCE Encounter Data Entry - Supervisor PXCE ENCOUNTER ENTRY & DELETE PCE Encounter Data Entry and Delete PXCE ENCOUNTER ENTRY NO DELETE PCE Encounter Data Entry without Delete PXCE ENCOUNTER VIEWER PCE Encounter Viewer PX PCE CLINICIAN MENU PCE Clinician Menu The changes affects to the following protocols: PXCE ADD/EDIT Update Encounter PXCE ADD/EDIT DISPLAY BRIEF Display Brief PXCE ADD/EDIT DISPLAY DETAIL Display Detail PXCE ADD/EDIT INTERVIEW Check Out Interview PXCE CPT ADD CPT (Procedure) PXCE EDIT V-FILE Edit an Item PXCE NEW ENCOUNTER Add Standalone Enc. PXCE POV ADD Diagnosis (ICD-9) PXCE SDAM INTERVIEW Check Out Interview PXCE SDAM STANDALONE Add Standalone Enc. PXCE SDAM DISPLAY DETAIL Display Detail (DD) PXCE SDAM MENU Appointment Menu DATA DICTIONARY UPDATE ---------------------- The following DD change was made to use the CPT^ICPTCOD API. - File 9000010.18, field .01 (CPT) Changes:- Old Input Transform: S DIC("S")="I '$P($G(^ICPT(Y,0)),""^"",4)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X New Input Transform: S DIC("S")="I $P($$CPT^ICPTCOD(+Y),""^"",7)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X Old Screen: S DIC("S")="I '$P($G(^ICPT(Y,0)),""^"",4)" New Screen: S DIC("S")="I $P($$CPT^ICPTCOD(+Y),""^"",7)" After Installation field .01 description would be as follows:- 9000010.18,.01CPT 0;1 POINTER TO CPT FILE (#81) (Required) INPUT TRANSFORM: S DIC("S")="I $P($$CPT^ICPTCOD(+Y),""^"",7)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X LAST EDITED: MAY 27, 2004 HELP-PROMPT: Enter a CPT code or the name of the procedure done to the patient. DESCRIPTION: This is the entry in the CPT file that most closely represents the clinical procedure done to the patient during the encounter. The preferred text for the procedure performed may be specified in the Provider Narrative field. This field is used for Administrative and Clinical purposes. If a procedure performed is to be billable, the CPT code must be specified here. SCREEN: S DIC("S")="I $P($$CPT^ICPTCOD(+Y),""^"",7)" EXPLANATION: Only active CPTs NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER CROSS-REFERENCE: 9000010.18^B 1)= S ^AUPNVCPT("B",$E(X,1,30),DA)="" 2)= K ^AUPNVCPT("B",$E(X,1,30),DA) CROSS-REFERENCE: 9000010.18^AATOO^MUMPS 1)= I $P(^AUPNVCPT(DA,0),U,2)]"",$P(^(0),U,3)]" " S ^AUPNVCPT("AA",$P(^AUPNVCPT(DA,0),U,2),X,(9 999999-$P(+^AUPNVSIT($P(^AUPNVCPT(DA,0),U,3),0) ,".",1)),DA)="" 2)= I $P(^AUPNVCPT(DA,0),U,2)]"",$P(^(0),U,3)]" " K ^AUPNVCPT("AA",$P(^AUPNVCPT(DA,0),U,2),X,(9 999999-$P(+^AUPNVSIT($P(^AUPNVCPT(DA,0),U,3),0) ,".",1)),DA) This cross reference is used for searches in sequence by Patient, CPT internal entry number, inverted visit date, and internal entry number. "AA",PATIENT,CPT,VISIT,DA Test Sites ---------- Greater LA Hines Loma Linda Madison Puget Sound 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: ;;1.0;PCE PATIENT CARE ENCOUNTER;**[patch list]**;Aug 12, 1996 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== AUPNSICD 359325 505233 121,149 PXAICPT 5763653 5821201 19,73,108,112,149 PXBGCPT 2217272 2270044 73,149 PXBGCPT2 8927495 9143467 11,19,108,149 PXBGPOV 3337347 3374254 11,112,149 PXBGPOV2 9019147 8999898 1,5,11,136,149 PXBPCPT 10708939 10859136 11,73,89,112,121,132 149 PXBPMOD 1376443 1439679 73,88,89,108,121 149 PXBPPOV 9422313 9549111 11,28,92,121,149 PXBSTOR 7568411 7612031 73,88,149 PXCEPOV1 5706679 5829184 134,149 PXUTL1 3858119 4164735 25,134,149 SOFTWARE AND DOCUMENTATION RETRIEVAL ==================================== The software for this patch is not being distributed through the National Patch Module. This patch is being distributed as a host file. The host file is a multi-package build containing five (5) KIDS builds. Host file name: CTD_MS_1_0.KID Multi-Package Build: CTD MS 1.0 Builds: EC*2.0*63 : PX*1.0*149 : SD*5.3*351 : DG*5.3*606 : IB*2.0*266 Sites may retrieve the software and documentation directly using FTP from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany: ftp.fo-albany.med.va.gov Hines: ftp.fo-hines.med.va.gov Salt Lake City: ftp.fo-slc.med.va.gov The following files will be available: File Name Description --------- ----------- CTD_MS_1_0.KID Host file containing KIDS software distribution CTD_Install_Guide_1_0.pdf Code Text Descriptors (CTD) Installation Guide EC2_0P63.EXE Event Capture GUI * Note: Use ASCII mode when transferring the .KID file. Use Binary mode when transferring the .EXE and .PDF files. The .PDF files can be read on a PC using the Adobe Acrobat Reader program. INSTALLATION INSTRUCTIONS: ========================= This patch can be installed with users on the system, however it should be installed during off hours to minimize disruption to users. This patch affects the check-out process and must be installed when the SCDX AMBCAR NIGHTLY XMIT background job is not running. Installation will take less than 10 minutes. Note: The following is a list of REQUIRED builds for this multi-package distribution. KIDS will not allow the installation of this patch without the prior installation of them. DG*5.3*158 DG*5.3*243 DG*5.3*511 DG*5.3*594 DG*5.3*599 EC*2*55 EC*2*56 EC*2*62 IB*2*115 IB*2*210 IB*2*245 ICD*18*12 ICPT*6*19 PX*1.0*136 PX*1.0*134 SD*5.3*324 SD*5.3*329 1. Download the KIDS file CTD_MS_1_0.KID from the ANONYMOUS.SOFTWARE directory of either Albany, Hines or the Salt Lake OIFO to the appropriate directory on your system. 2. Use LOAD A DISTRIBUTION option on the KIDS INSTALLATION menu, and enter: CTD_MS_1_0.KID 3. Review your mapped set. If any of the routines listed in the ROUTINE SUMMARY section are mapped, they should be removed from the mapped set at this time. 4. From the Kernel Installation and Distribution System Menu, select the Installation menu. 5. From this menu, you may elect to use the following options (when prompted for INSTALL NAME, enter the appropriate patch designation - EC*2.0*63, PX*1.0*149, SD*5.3*351, DG*5.3*606 and IB*2.0*266): 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. d. Print Transport Global - this option will allow you to view the components of the KIDS build. 6. Use the Install Package(s) option and select the package CTD MS 1.0. 7. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//',respond NO. 8. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', respond YES. When prompted to select the options you would like to place out of order, enter the following: DG PTF MENU PTF Menu DG REGISTRATION 10/10 REPRINT 10/10 Print without New Registration ECMENU Event Capture Menu EC GUI CONTEXT EC GUI Context PXCE ENCOUNTER DATA ENTRY PCE Encounter Data Entry PXCE ENCOUNTER ENTRY & DELETE PCE Encounter Data Entry & Delete PXCE ENCOUNTER ENTRY NO DELETE PCE Encounter Entry Without Delete PXCE ENCOUNTER ENTRY SUPER PCE Encounter Data Entry - Supervisor SCDX AMBCAR NIGHTLY XMIT Ambulatory Care Nightly Transmission to NPCDB SDAM APPT MGT Appointment Management SDAM APPT CHECK IN/OUT Appointment Check-in/Check-out SDADDEDIT Add/Edit Stop Codes SDAPP Appointment Menu SDI Check-in/Unsched. Visit SDM Make Appointment 9. If routines were unmapped as part of step 3, they should be returned to the mapped set once the installation has run to completion. Routine Information: ==================== Routine Name: - PXBPPOV Routine Checksum: Routine Name: - PXBGCPT Routine Checksum: Routine Name: - PXBPCPT Routine Checksum: Routine Name: - PXBSTOR Routine Checksum: Routine Name: - PXAICPT Routine Checksum: Routine Name: - PXUTL1 Routine Checksum: Routine Name: - AUPNSICD Routine Checksum: Routine Name: - PXBGCPT2 Routine Checksum: Routine Name: - PXBGPOV Routine Checksum: Routine Name: - PXBGPOV2 Routine Checksum: Routine Name: - PXCEPOV1 Routine Checksum: Routine Name: - PXBPMOD Routine Checksum: ============================================================================= User Information: Entered By : MORRISON,JENNIFER Date Entered : MAY 18, 2004 Completed By: LAVERTY,TIM Date Completed: OCT 06, 2004 Released By : GROOMS,ANTHONY E Date Released : OCT 08, 2004 ============================================================================= Packman Mail Message: ===================== No routines included