============================================================================= Run Date: AUG 31, 2005 Designation: PX*1*124 Package : PX - PCE PATIENT CARE ENCOUNTER Priority: Mandatory Version : 1 SEQ #126 Status: Released Compliance Date: OCT 01, 2005 ============================================================================= Associated patches: (v)PX*1*45 <<= must be installed BEFORE `PX*1*124' (v)PX*1*99 <<= must be installed BEFORE `PX*1*124' (v)OR*3*195 <<= must be installed BEFORE `PX*1*124' (v)PX*1*130 <<= must be installed BEFORE `PX*1*124' (v)PX*1*132 <<= must be installed BEFORE `PX*1*124' (v)IB*2*257 <<= must be installed BEFORE `PX*1*124' (v)PX*1*141 <<= must be installed BEFORE `PX*1*124' (v)PX*1*143 <<= must be installed BEFORE `PX*1*124' (v)PX*1*149 <<= must be installed BEFORE `PX*1*124' (v)PX*1*151 <<= must be installed BEFORE `PX*1*124' Subject: CLINICAL INDICATORS DATA CAPTURE(CIDC) - PCE Category: - Routine - Data Dictionary - Enhancement (Mandatory) - Informational Description: ============ This patch is the Patient Care Encounter(PCE) part of Clinical Indicator Data Capture (CIDC) project. There are no NOIS messages or E3Rs associated with this patch. Overview ======== Patient Care Encounter(PCE) has been identified by the Clinical Indicators Data Capture(CIDC) Team as one of the systems that needs to be modified in order to send the required data at the optimal time to improve the billing process, and thus improve VHA's revenue collection process. The patch PX*1.0*124 represents the PCE portion of the CIDC effort of Revenue Improvement. Functional Description ====================== Modifications to the VHA Information Systems and Technology Architecture Patient Care Encounter (PCE) package have been made such that the Integrated Billing(IB) package be able to distinguish billable from non-billable patient care events. The modifications include: * All diagnoses entered into PCE shall be identified as being Service Connected or Non-service connected, and where appropriate, be classified with Combat Veteran, Environmental indicators, Military Sexual Trauma, and Head and Neck Cancer. The legacy requirement that Environmental Indicator classification questions will not be asked when the Service Connection is true, is in effect for diagnoses. * All procedure codes will be identified as having clinical indicators which shall be selectable from the VISTA diagnosis list. * The changes above will be made to both the interactive PCE functionality as well as the non-interactive Application Programmer Interface(API) driven functionality. * The Encounter level Service Connection Indicator together with the other encounter classifications: Agent Orange exposure, Irradiation exposure, Environmental Contaminants, Military Sexual Trauma, Head and/or Neck Cancer, Combat Vet, known collectively as the SC/EI classification, shall be auto-populated. Technical Description ====================== This patch PX*1.0*124 implements the following functionality: 1) Enhances the PCE Procedure File to include diagnoses which are associated with the PCE procedures. 2) Enhances the PCE Diagnosis File to include an Ordering/Resulting field. 3) Enhances the PCE Immunization File to include diagnoses which are associated with the PCE immunizations. 4) Enhances the PCE Skin Test File to include diagnoses which are associated with the PCE skin tests. 5) Enhances the Visit File to include Classification Edit Flags 6) Makes changes to the data filing API's DATA2PCE(IA 1889) and PXCA (IA 1899) to enable the use of the new CPT Diagnosis fields and the new Diagnosis Classification fields. 7) The Encounter level SC/EI classifications will be auto-populated according to the following rules: If the SC/EI for at least one ICD-9 is "Yes" the Encounter Level SC/EI will automatically be set to "Yes" regardless of whether the Encounter Level SC (or EI) was previously populated ("Yes", "No" or Null). If the SC/EI for all ICD-9s are "No" the Encounter Level SC/EI will automatically be set to "No" regardless of whether the Encounter Level SC/EI was previously populated ("Yes", "No" or Null). If at least one ICD-9 is missing SC/EI determination and none of the other ICD-9s SC/EI determination is "Yes" do not change the SC/EI determination of the Encounter level. 8) An error in PXAIPL was corrected to treat the PL ADD parameter correctly in the DATA2PCE call. The error was that all diagnoses were being sent to the problem list, and not only those with PL ADD set to 1. Further, when the diagnosis was sent to the problem list without a provider, the problem list was erroring with a provider class error. 9) An error in the primary/secondary determination in PXAIPRV was corrected. The error incorrectly warned that a provider was identified as primary. 10) Changes made to support the DATA2PCE API a) The DATA2PCE API now accepts the seven additional Procedure Clinical Indicators DIAGNOSIS 2, DIAGNOSIS 3, DIAGNOSIS 4, DIAGNOSIS 5, DIAGNOSIS 6, DIAGNOSIS 7, and DIAGNOSIS 8. The results are stored in the V CPT (#9000010.18) file for the encounter. Support for the Skin Test and Immunization files are supported through the Code mapping file (#811). The following routine was modified to support the additional functionality: PXAICPT b) The DATA2PCE API now accepts "P" AND "S" for Primary and Secondary Diagnosis as well as 1 and 0. The following routines were either modified or added to support the additional functionality: PXAIPOV c) Typographical errors were corrected in routine PXAIPRV in the TMP subscript 812 and in routine PXAIVSTV for OUTSIDE LOCATION. Changes were made to fix warning errors for primary/secondary designations. d) A change was made to PXAIPL to fix an error in the PL ADD parameter. The PL ADD parameter was being ignored. e) The following additions/modifications were made to the DATA2PCE parameters: "PROCEDURE" ,i, "DIAGNOSIS 2" ) ICD DIAGNOSIS File (#80) "PROCEDURE" ,i, "DIAGNOSIS 3" ) ICD DIAGNOSIS File (#80) "PROCEDURE" ,i, "DIAGNOSIS 4" ) ICD DIAGNOSIS File (#80) "PROCEDURE" ,i, "DIAGNOSIS 5" ) ICD DIAGNOSIS File (#80) "PROCEDURE" ,i, "DIAGNOSIS 6" ) ICD DIAGNOSIS File (#80) "PROCEDURE" ,i, "DIAGNOSIS 7" ) ICD DIAGNOSIS File (#80) "PROCEDURE" ,i, "DIAGNOSIS 8" ) ICD DIAGNOSIS File (#80) "PROCEDURE" ,i, "ORD PROVIDER") "DX/PL",i,"PRIMARY" ) [P | 1 | S | 0 | null ] "DX/PL",i,"ORD/RES") [O | R | OR | null ] "SKIN TEST" ,i, "DIAGNOSIS" ) ICD DIAGNOSIS File (#80) "SKIN TEST" ,i, "DIAGNOSIS 2" ) ICD DIAGNOSIS File (#80) "SKIN TEST" ,i, "DIAGNOSIS 3" ) ICD DIAGNOSIS File (#80) "SKIN TEST" ,i, "DIAGNOSIS 4" ) ICD DIAGNOSIS File (#80) "SKIN TEST" ,i, "DIAGNOSIS 5" ) ICD DIAGNOSIS File (#80) "SKIN TEST" ,i, "DIAGNOSIS 6" ) ICD DIAGNOSIS File (#80) "SKIN TEST" ,i, "DIAGNOSIS 7" ) ICD DIAGNOSIS File (#80) "SKIN TEST" ,i, "DIAGNOSIS 8" ) ICD DIAGNOSIS File (#80) "IMMUNIZATION" ,i, "DIAGNOSIS" ) ICD DIAGNOSIS File (#80) "IMMUNIZATION" ,i, "DIAGNOSIS 2" ) ICD DIAGNOSIS File (#80) "IMMUNIZATION" ,i, "DIAGNOSIS 3" ) ICD DIAGNOSIS File (#80) "IMMUNIZATION" ,i, "DIAGNOSIS 4" ) ICD DIAGNOSIS File (#80) "IMMUNIZATION" ,i, "DIAGNOSIS 5" ) ICD DIAGNOSIS File (#80) "IMMUNIZATION" ,i, "DIAGNOSIS 6" ) ICD DIAGNOSIS File (#80) "IMMUNIZATION" ,i, "DIAGNOSIS 7" ) ICD DIAGNOSIS File (#80) "IMMUNIZATION" ,i, "DIAGNOSIS 8" ) ICD DIAGNOSIS File (#80) 11) Changes made to support the PCE Device Interface API LOCAL("PROCEDURE",,i) = 1^2^3^4^5^6^7^8^9^10^11^12 ^13^14, where: Position Description 8 1st Secondary Diagnosis ICD DIAGNOSIS File (#80) 9 2nd Secondary Diagnosis ICD DIAGNOSIS File (#80) 10 3rd Secondary Diagnosis ICD DIAGNOSIS File (#80) 11 4th Secondary Diagnosis ICD DIAGNOSIS File (#80) 12 5th Secondary Diagnosis ICD DIAGNOSIS File (#80) 13 6th Secondary Diagnosis ICD DIAGNOSIS File (#80) 14 7th Secondary Diagnosis ICD DIAGNOSIS File (#80) LOCAL("DIAGNOSIS/PROBLEM",,i) = 1^2^3^4^5^6^7^8^9 ^10^11^12^13^14^15^16^17^18, where: Position Description 18 Ordering/Resulting [O | R | OR | null ] LOCAL("SKIN TEST",,i) = 1^2^3^4^5^6^7^8^9^10^11^12 ^13, where: Position Description 6 Primary Associated Diagnosis ICD DIAGNOSIS File (#80) 7 1st Secondary Diagnosis 2 ICD DIAGNOSIS File (#80) 8 2nd Secondary Diagnosis 3 ICD DIAGNOSIS File (#80) 9 3rd Secondary Diagnosis 4 ICD DIAGNOSIS File (#80) 11 4th Secondary Diagnosis 5 ICD DIAGNOSIS File (#80) 12 5th Secondary Diagnosis 6 ICD DIAGNOSIS File (#80) 13 6th Secondary Diagnosis 7 ICD DIAGNOSIS File (#80) 14 7th Secondary Diagnosis 8 ICD DIAGNOSIS File (#80) LOCAL("IMMUNIZATION",,i) = 1^2^3^4^5^6^7^8^9^10^11 ^12^13^14^15, where: Position Description 8 Primary Associated Diagnosis ICD DIAGNOSIS File (#80) 9 1st Secondary Diagnosis 2 ICD DIAGNOSIS File (#80) 10 2nd Secondary Diagnosis 3 ICD DIAGNOSIS File (#80) 11 3rd Secondary Diagnosis 4 ICD DIAGNOSIS File (#80) 12 4th Secondary Diagnosis 5 ICD DIAGNOSIS File (#80) 13 5th Secondary Diagnosis 6 ICD DIAGNOSIS File (#80) 14 6th Secondary Diagnosis 7 ICD DIAGNOSIS File (#80) 15 7th Secondary Diagnosis 8 ICD DIAGNOSIS File (#80) 12) The following Database Integration Agreements were affected by the changes made by PX*1.0*124 and were updated accordingly. 8.1 DATA2PCE - DBIA 1889-A 1889 8.2 PXCA - DBIA 1889-A 1899 8.3 PXUTLSCC - SERVICE CONNECTED CONDITIONS 2348 13) The following routines were changed to support PCE Encounter Data Entry a) Procedure associated diagnoses: PXCECPT, PXCEC800 PXCEVFI4, PXKFCPT b) Diagnosis classification indicators: PXCEPOV, PXCEPOV1, PXKFPOV, PXCED800 c) Support routines: PXCEVFI1, PXCEFIL, PXCEFI4 d) Immunization: PXCESK, PXKFIMM e) Skin Test: PXCESK, PXKFSK 14) The following routines were changed to support Appointment Management a) Procedure associated diagnoses: PXBDCPT, PXBMCPT2, PXBPCPT, PXBPCPT2, PXBGCPT b) Diagnosis classification indicators: PXBDPOV, PXBMPOV, PXBPPOV, PXBGPOV c) Screen management, display management: PXBCC, PXBDREQ d) Help routines: PXBHLP2, PXBHLPR, PXBUTL0 e) Support routines: PXBSTOR, PXBSTOR1, PXBPORD 15) The following routines were changed to support PCE Device Interface a) Procedure associated diagnoses: PXCA0, PXCAPCT, PXCACPT1 b) Diagnosis classification indicators: PXCAPOV c) Immunization associated diagnoses: PXCAVIMM d) Skin Test associated diagnoses: PXCASK 16) The following routines were added or modified to support the auto-population of the Encounter level SC/EI classifications: PXCECCLS, PXKMAIN 17) Related Options APPOINTMENT MANAGEMENT APPOINTMENT MENU SUP PCE Encounter Data Entry -Supervisor PCE PCE Encounter Data Entry DEL PCE Encounter Data Entry and Delete NOD PCE Encounter Data Entry without Delete 18) Related Protocols PROCEDURE UPDATE APPOINTMENT CHECK-IN/CHECK-OUT SDCO INTERVIEW PXCE SDAM INTERVIEW PXCE ADD/EDIT INTERVIEW PXCE INTERVIEW PXCE ADD/EDIT PXCE CPT ADD PXCE EDIT V-FILE PXCE DELETE V-FILE PXCE DISPLAY DETAIL SDAM CPT Procedure Update 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 ============ ============ =========== ========== PXAICPT 5821201 6521746 19,73,108,112,149 124 PXAIIMM 1978822 2400748 45,124 PXAIPL 1563460 1575650 69,124 PXAIPOV 6162167 6323448 28,73,69,108,112 130,124 PXAIPRV 5592599 5700915 5,108,124 PXAISK 1864030 2285956 45,124 PXAIVST 5382765 5868353 5,9,15,74,111 96,130,124 PXAIVSTV 29044768 29077558 9,15,19,74,111 116,130,124 PXAPI 8525873 8566521 14,15,27,28,124 PXBAPI1 8965151 9169888 1,9,23,56,104 111,113,122,116,130 147,151,124 PXBAPI21 5273789 8609388 130,147,124 PXBCC 6296028 6304359 7,73,141,124 PXBDCPT 7589626 8755924 11,73,89,108,121 124 PXBDPOV 8212402 8519121 124 PXBDREQ 1920364 2136948 73,124 PXBGCPT 2270044 2803582 73,149,124 PXBGPOV 3374254 4780196 11,112,149,124 PXBGPOV2 8999898 9000627 1,5,11,136,149 124 PXBHLP2 6539318 8179559 124 PXBHLPR 734674 913653 124 PXBMCPT2 3589622 4477933 11,73,88,89,108 124 PXBMPOV 2896537 3061834 11,14,108,124 PXBPCPT 10859136 11466293 11,73,89,112,121 132,149,124 PXBPCPT1 6087155 7034684 7,73,88,89,108 112,121,124 PXBPCPT2 N/A 3261534 124 PXBPORD N/A 1117769 124 PXBPPOV 9549111 9323903 11,28,92,121,149 124 PXBPPOV1 5230066 6895247 11,112,121,124 PXBPPRV1 5680964 5703481 11,19,27,88,124 PXBSTOR 7612031 8956334 73,88,149,124 PXBSTOR1 1670721 3471352 88,124 PXBUTL0 8652920 9096009 108,124 PXCA0 6269497 6295050 5,14,33,124 PXCACPT 11272075 22141152 27,33,73,121,124 PXCACPT1 3548373 5244291 73,121,124 PXCAPOV 14955427 17370369 24,27,33,121,130 124 PXCASK 6158146 7480031 27,124 PXCAVIMM 9020591 10662139 27,124 PXCEAPPM 4521435 4615707 22,74,111,130,124 PXCEC800 N/A 1342514 124 PXCECCLS N/A 11982570 124 PXCECPT 8612097 15066899 14,27,73,89,112 121,136,124 PXCED800 N/A 1214512 124 PXCEPOV 4867172 10953989 27,121,124 PXCEPOV1 5829184 5834557 134,149,124 PXCEPRV 8580655 8567491 7,27,124 PXCESIT 6053362 6148945 22,74,111,130,124 PXCESK 6789131 8721742 27,124 PXCEVFI1 6148844 6639573 23,73,112,136,143 124 PXCEVFI2 9333893 11669591 22,73,95,96,124 PXCEVFI4 5368384 9878198 124 PXCEVFI5 2535124 2543093 14,99,124 PXCEVFIL 12681208 12681208 9,30,22,73,88 89,104,147,124 PXCEVIMM 5784826 10549239 27,124 PXCEVST 4521720 4615992 22,74,111,130,124 PXKFCPT 501773 576909 22,73,117,124 PXKFCPT1 6556330 8260104 11,73,124 PXKFIMM 357523 434628 22,124 PXKFPOV 631277 635058 22,130,124 PXKFSK 346031 423463 22,124 PXKFVST 1810564 1723649 22,56,111,130,124 PXKMAIN 10854965 10876433 22,59,73,88,69 117,130,124 PXKMAIN1 7231815 7609843 22,73,124 PXRRMDR N/A 19496035 124 VSITFLD 4330103 5302550 76,81,111,130,124 DATA DICTIONARY SUMMARY ======================== V CPT (#9000010.18) DIAGNOSIS 2 .09 DIAGNOSIS 3 .1 DIAGNOSIS 4 .11 DIAGNOSIS 5 .12 DIAGNOSIS 6 .13 DIAGNOSIS 7 .14 DIAGNOSIS 8 .15 V POV (#9000010.07) ORDERING/RESULTING .17 V IMMUNIZATION (#9000010.11) DIAGNOSIS .08 DIAGNOSIS 2 .09 DIAGNOSIS 3 .1 DIAGNOSIS 4 .11 DIAGNOSIS 5 .12 DIAGNOSIS 6 .13 DIAGNOSIS 7 .14 DIAGNOSIS 8 .15 V SKIN TEST (#9000010.12) DIAGNOSIS .08 DIAGNOSIS 2 .09 DIAGNOSIS 3 .1 DIAGNOSIS 4 .11 DIAGNOSIS 5 .12 DIAGNOSIS 6 .13 DIAGNOSIS 7 .14 DIAGNOSIS 8 .15 VISIT (#9000010) SERVICE CONNECTION EDIT FLAG 80011 AGENT ORGANGE EDIT FLAG 80012 IONIZING RADIATION EDIT FLAG 80013 ENVIRONMENTAL CONTAMINANT EDIT FLAG 80014 MILITARY SEXUAL TRAUMA EDIT FLAG 80015 HEAD AND NECK CANCER EDIT FLAG 80016 COMBAT VETERAN EDIT FLAG 80017 Test Sites: =========== Loma Linda, CA Cleveland, OH Dayton, OH Boston, MA Memphis, TN Charleston, SC SOFTWARE AND DOCUMENTATION RETRIEVAL ==================================== The software for this patch is being distributed in host file PX_CLINICAL_INDICATOR_DATA_CAPTURE.KID. The host file will contain nine KIDS builds. The builds contained in the CIDC multi-package distribution are: Package Patch ------- --------- PCE PATIENT CARE ENCOUNTER PX*1.0*124 INTEGRATED BILLING IB*2.0*260 RADIOLOGY/NUCLEAR MEDICINE RA*5.0*41 SURGERY SR*3.0*119 PROSTHETICS RMPR*3.0*78 OUTPATIENT PHARMACY PSO*7.0*143 Host file name: PX_CLINICAL_INDICATOR_DATA_CAPTURE.KID File Name Description Format FTP Protocol -------------- ------------- ------- ------ PX_CLINICAL_INDICATOR_DATA_CAPTURE.KID Software Host File KIDS ASCII PX_1_P124_RN.PDF Release Notes PDF Binary PX_1_P124_TM_CP.PDF Technical Manual PDF Binary Change Pages PX_1_P124_UM_CP.PDF User Manual PDF Binary Change Pages Sites may retrieve the software and documentation directly using FTP from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: The documentation for this patch and the install instructions can be found in the following [ANONYMOUS.SOFTWARE] directories: Preferred Address ------------------------- First available FTP server download.vista.med.va.gov Specific Field Office FTP Address --------------------- ------------------------ Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov INSTALLATION ============ Please refer to the CIDC_INSTALLATION_GUIDE.PDF Install Guide in the [ANONYMOUS.SOFTWARE] directories for details of the installation procedure for this patch. Routine Information: ==================== Routine Name: - PXAICPT Routine Checksum: Routine Name: - PXAIPOV Routine Checksum: Routine Name: - PXAIPRV Routine Checksum: Routine Name: - PXAIVST Routine Checksum: Routine Name: - PXAIVSTV Routine Checksum: Routine Name: - PXBAPI1 Routine Checksum: Routine Name: - PXBCC Routine Checksum: Routine Name: - PXBDCPT Routine Checksum: Routine Name: - PXBDPOV Routine Checksum: Routine Name: - PXBDREQ Routine Checksum: Routine Name: - PXBGCPT Routine Checksum: Routine Name: - PXBGPOV Routine Checksum: Routine Name: - PXBHLP2 Routine Checksum: Routine Name: - PXBHLPR Routine Checksum: Routine Name: - PXBMCPT2 Routine Checksum: Routine Name: - PXBMPOV Routine Checksum: Routine Name: - PXBPCPT Routine Checksum: Routine Name: - PXBPCPT2 Routine Checksum: Routine Name: - PXBPORD Routine Checksum: Routine Name: - PXBPPOV Routine Checksum: Routine Name: - PXBSTOR Routine Checksum: Routine Name: - PXBSTOR1 Routine Checksum: Routine Name: - PXBUTL0 Routine Checksum: Routine Name: - PXCA0 Routine Checksum: Routine Name: - PXCACPT Routine Checksum: Routine Name: - PXCACPT1 Routine Checksum: Routine Name: - PXCAPOV Routine Checksum: Routine Name: - PXCEC800 Routine Checksum: Routine Name: - PXCECPT Routine Checksum: Routine Name: - PXCED800 Routine Checksum: Routine Name: - PXCEPOV Routine Checksum: Routine Name: - PXCEPOV1 Routine Checksum: Routine Name: - PXCEVFI1 Routine Checksum: Routine Name: - PXCEVFI4 Routine Checksum: Routine Name: - PXKFCPT Routine Checksum: Routine Name: - PXKFPOV Routine Checksum: Routine Name: - PXKFCPT1 Routine Checksum: Routine Name: - PXCEVIMM Routine Checksum: Routine Name: - PXCESK Routine Checksum: Routine Name: - PXKFSK Routine Checksum: Routine Name: - PXKFIMM Routine Checksum: Routine Name: - PXCASK Routine Checksum: Routine Name: - PXCAVIMM Routine Checksum: Routine Name: - PXCEVFIL Routine Checksum: Routine Name: - PXAIPL Routine Checksum: Routine Name: - PXBAPI21 Routine Checksum: Routine Name: - PXBPPOV1 Routine Checksum: Routine Name: - PXCEAPPM Routine Checksum: Routine Name: - PXCECCLS Routine Checksum: Routine Name: - PXCEPRV Routine Checksum: Routine Name: - PXCESIT Routine Checksum: Routine Name: - PXCEVFI2 Routine Checksum: Routine Name: - PXCEVFI5 Routine Checksum: Routine Name: - PXCEVST Routine Checksum: Routine Name: - PXKFVST Routine Checksum: Routine Name: - PXKMAIN Routine Checksum: Routine Name: - PXKMAIN1 Routine Checksum: Routine Name: - VSITFLD Routine Checksum: Routine Name: - PXAIIMM Routine Checksum: Routine Name: - PXBGPOV2 Routine Checksum: Routine Name: - PXAISK Routine Checksum: Routine Name: - PXRRMDR Routine Checksum: Routine Name: - PXBPPRV1 Routine Checksum: Routine Name: - PXBPCPT1 Routine Checksum: Routine Name: - PXAPI Routine Checksum: ============================================================================= User Information: Hold Date : AUG 29, 2005 Entered By : SMITH,DEAN Date Entered : MAY 20, 2003 Completed By: LYNCH,MARY F. Date Completed: AUG 31, 2005 Released By : FIELDS-BARNES,JANETTE Date Released : AUG 31, 2005 ============================================================================= Packman Mail Message: ===================== No routines included