$TXT Created by CEBELINSKI,GREGORY J at DEV.DEV.FO-HINES.MED.VA.GOV (KIDS) on Tuesday, 06/27/06 at 14:16 ============================================================================= Run Date: JUL 31, 2006 Designation: RA*5*64 Package : RA - RADIOLOGY/NUCLEAR MEDICINE Priority: Mandatory Version : 5 SEQ #60 Status: Released Compliance Date: AUG 31, 2006 ============================================================================= Associated patches: (v)FB*3.5*93 <<= must be installed BEFORE `RA*5*64' Subject: Conversion of VISN 3 RIS RVU Report from Class III to Class I software Category: - Routine - Enhancement (Mandatory) - Data Dictionary Description: ============ The relative value unit (RVU) is a measure of the time and effort associated with the performance of a given procedure. The Centers for Medicare and Medicaid (CMS) has incorporated RVUs into the Medicare physician fee schedule. Radiologists spend a majority of their workday involved with procedures, so the RVU can account for much of their workload. To be consistent with the current practices of the Office of Quality and Performance, there will be no national roll-up of RVU report data as reports contain provider specific RVU totals. Previous personnel workload reports such as the 'Staff Report' work off of AMIS Code, AMIS Code Weight, AMIS Code multiplier, and the bilateral indicator linked to the AMIS code. The 'Staff Report' also looks at all the exams for a particular staff physician; cancelled cases and cases without a verified report are counted to be part of a physician's workload. The new personnel workload reports work off of the wRVU value associated with the CPT code of the rad/nuc med procedure. The application of scaling factors (if appropriate) is based on the imaging type of a procedure and is applied as a multiplier to the wRVU value for a rad/nuc med procedure. The criteria used to determine physician workload differs from business rules applied to workload reports in the past; physician specific exams must not be in an examination status of cancelled and all non-cancelled exams must be linked to verified reports. The Inspector General (IG) has indicated that physician productivity will be included in Combined Assessment Program (CAP) audits. The RVU reports would be used locally to satisfy IG requirements. To meet these goals, both FB*3.5*93 and RA*5.0*64 have been created. For more information of FB*3.5*93, please refer to the FB*3.5*93 patch description. 508 Compliance ============== Not Applicable- No Graphical User Interface front end Related New Service Requests (NSRs) =================================== 20050208 - Conversion of VISN 3 Radiology RVU Report to Class I Documentation ============= This application documentation for patch RA*5*64 is located in the [ANONYMOUS.SOFTWARE] directory of 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 application documentation distribution includes: File Name Description ========= =========== ra5-0tm.pdf The Technical Manual in .pdf format ra5-0um.pdf The User Manual in .pdf format Once released, documentation may also be retrieved from VISTA Documentation Library (VDL) on the Internet at the following address, http://www.va.gov/vdl Components Exported =================== Data Dictionaries: ------------------ IMAGING TYPE (#79.2) data does not come with the file (see Note below), Data dictionaries are updated; a new sub-file has been added: WORK RVU (wRVU) SCALING FACTOR (#79.22) Note: The Society of Chairmen of Academic Radiology Departments (SCARD) has determined that the wRVU (which was derived for billing) may over or under estimate the actual time required to interpret a study and has proposed scaling factors to better calculate personal workload. 79.2,200 WORK RVU (wRVU) SCALING FACTOR CY;0 Multiple #79.22 DESCRIPTION: Identifies the 'Society of Chairmen in Academic Radiology Departments' (SCARD) scaling factor for a specific imaging type by calendar year. 79.22,.01 CALENDAR YEAR node: 0, piece: 1, data type: number Acceptable numeric range: 1980-2099 DESCRIPTION: This field identifies the calendar year to associate a specific 'Society of Chairmen in Academic Radiology Departments' (SCARD) scaling factor to imaging type specific procedures with an associated wRVU value. 79.22,2 SCALING FACTOR node: 0, piece: 2, data type: number Acceptable numeric range: 0-99.99 DESCRIPTION: This field identifies the appropriate scaling factor applied to the wRVU value for an imaging type specific rad/nuc med procedure. Note: The new sub-file will be populated by a post-install (RA64PST) process. Calendar year 2006 scaling factors will only be introduced for the following IMAGING TYPE records: 'GENERAL RADIOLOGY, 'NUCLEAR MEDICINE', 'MAGNETIC RESONANCE IMAGING', 'CT SCAN', and 'ANGIO/NEURO/INTERVENTIONAL'. For calendar year 2006 scaling factors will not be introduced for the following imaging types: 'ULTRASOUND', 'CARDIOLOGY STUDIES (NUC MED)', 'VASCULAR LAB', and 'MAMMOGRAPHY' because the wRVU values used to compute personal productivity within these imaging types are accurate. Options: -------- New options under the 'Personnel Workload Reports' [RA WKL] menu: 'Physician CPT Report by Imaging Type' [RA WKLIPHY CPT ITYPE] 'Physician scaled wRVU Report by Imaging Type' [RA WKLIPHY SWRVU ITYPE] 'Physician scaled wRVU Report by CPT' [RA WKLIPHY SWRVU CPT] 'Physician wRVU Report by CPT' [RA WKLIPHY WRVU CPT] 'Physician wRVU Report by Imaging Type' [RA WKLIPHY WRVU ITYPE] New options under the 'Special Reports' [RA SPECRPTS] menu: 'Procedure Scaled wRVU/CPT Report' [RA PROC CPTSWRVU] 'Procedure wRVU/CPT Report' [RA PROC CPTWRVU] Routines: --------- RA64PRE RA64PST RAWKLU RAWKLU1 RAWKLU2 RAWKLU3 RAWRVUP The following is a list of the routines included in this patch. The second line of each of these routines now looks like: ;;5.0;Radiology/Nuclear Medicine;**64**;Mar 16, 1998 CHECK^XTSUMBLD results Routine Before Patch After Patch Patch List ------- ------------ ----------- ---------- RA64PRE N/A 2997221 64 RA64PST N/A 2309767 64 RAWKLU N/A 10301185 64 RAWKLU1 N/A 9589688 64 RAWKLU2 N/A 9350761 64 RAWKLU3 N/A 5903412 64 RAWRVUP N/A 8102893 64 Total number of exported routines: 7 Test Sites ========== Southern AZ HCS at Tucson Central TX VHCS Charleston, SC VAMC INSTALLATION INSTRUCTIONS ========================= This patch should be installed outside of normal working hours with all users off the system. The install time for this patch may be more than five minutes because Menu Trees will be rebuilt during installation. Please check with your IRM supervisor regarding rebuilding Menu Trees. The installation of this patch should be coordinated with the Radiology ADPAC due to menu structure changes. NOTE: MailMan and Kernel patches must be current on the target system to avoid problems loading and installing this patch. 1. Use the 'INSTALL/CHECK MESSAGE' option of your PackMan menu to load the KIDS distribution onto your system. 2. From the Kernel Installation & Distribution System menu, select the 'Installation' menu. From this menu you may select the following options prior to installing the patch: a. Backup a Transport Global - this option will create a backup message of any routines exported with the patch. 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. c. Verify Checksums in Transport Global - this option will ensure the integrity of the routines that are in the transport global. 3. Use the 'Install Package(s)' option under the 'Installation' menu. When prompted for INSTALL NAME, enter: RA*5.0*64 When prompted "Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//" answer according to your facility's policy concerning the rebuilding of menu trees. When prompted "Want KIDS to INHIBIT LOGONs during the install? YES//", respond NO. When prompted "Want to DISABLE Scheduled Options and Menu Options? YES//", respond YES. When prompted "Enter options you wish to mark as 'Out of Order':", enter the following to disable all Rad/Nuc Med options: RA* When prompted "Enter protocols you wish to mark as 'Out of Order':", enter the following to disable all Rad/Nuc Med protocols: RA* 4. A pre-installation will run at sites that have previously installed a version of RA*5.0*64 that will change the MENU TEXT for the following options (3): 1) RA WKLIPHY CPT ITYPE From: Physician CPT Report by I-Type To: Physician CPT Report by Imaging Type 2) RA WKLIPHY SWRVU ITYPE From: Physician scaled wRVU Report by I-Type To: Physician scaled wRVU Report by Imaging Type 3) RA WKLIPHY WRVU ITYPE From: Physician wRVU Report by I-Type To: Physician wRVU Report by Imaging Type 5. Verify that the patch installation completed correctly by using the KIDS 'Utilities...' [XPD UTILITY] option 'Install File Print' [XPD PRINT INSTALL FILE] and selecting this patch (RA*5.0*64). 6. After the post-installation has completed successfully, the following action should be taken: Delete the following routines: RA64PRE & RA64PST Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: RA64PRE Before: n/a After: B6590378 **64** Routine Name: RA64PST Before: n/a After: B4334607 **64** Routine Name: RAWKLU Before: n/a After: B43942290 **64** Routine Name: RAWKLU1 Before: n/a After: B32092526 **64** Routine Name: RAWKLU2 Before: n/a After: B37550729 **64** Routine Name: RAWKLU3 Before: n/a After: B12473282 **64** Routine Name: RAWRVUP Before: n/a After: B28533070 **64** ============================================================================= User Information: Entered By : CEBELINSKI,GREGORY Date Entered : AUG 11, 2005 Completed By: PATRICK,PAT Date Completed: JUL 28, 2006 Released By : HINES,RICK Date Released : JUL 31, 2006 ============================================================================= Packman Mail Message: ===================== $END TXT