============================================================================= Run Date: SEP 24, 2003 Designation: SD*5.3*295 Package : SD - SCHEDULING Priority: Mandatory Version : 5.3 SEQ #273 Status: Released Compliance Date: OCT 15, 2003 ============================================================================= Associated patches: (v)SD*5.3*199 <<= must be installed BEFORE `SD*5.3*295' (v)SD*5.3*243 <<= must be installed BEFORE `SD*5.3*295' (v)SD*5.3*258 <<= must be installed BEFORE `SD*5.3*295' (v)ICPT*6*14 <<= must be installed BEFORE `SD*5.3*295' (v)ICD*18*6 <<= must be installed BEFORE `SD*5.3*295' (v)SD*5.3*296 <<= must be installed BEFORE `SD*5.3*295' Subject: AMBCARE CODE SET VERSIONING Category: - Routine - Other - Enhancement (Mandatory) - Informational Description: ============ ************************************************************************** * THIS BUILD IS PART OF THE CSV PROJECT AND * * MUST BE INSTALLED AT ALL SITES BY SEPTEMBER 30, 2003 * ************************************************************************** ************************************************************************** ************************************************************************** This patch supports Code Set Versioning, mandated under the Health Information Portability and Accountability Act (HIPAA). It contains routines, data, and data dictionary changes to recognize code sets for the Current Procedural Terminology (CPT) and Health Care Financing Administration (HCFA) Common Procedure Coding System (HCPCS). When implemented, applications will be able to retrieve appropriate CPT and HCPCS codes based upon a date that a clinical event occurred. This patch is contained in the Kernel Installation & Distribution System (KIDS): CSV MS 1.0 Installing the CSV MS 1.0 build provides all of the updates listed below. Sites will use the KIDS to ensure the proper order of installation for the VISTA Packages in the Management Systems Product Line. ************************************************************************** ************************************************************************** --------------------- I. BACKGROUND Gail Graham, Director of Information Assurance, requested modifications to the VHA Information Systems and Technology Architecture (VISTA) Patient Information Management System (PIMS) package that allows the use of multiple versions of the code sets employed in financial transactions. This includes multiple versions of the Veterans Health Administration (VHA) diagnostic related grouping software, also known as the "VHA Grouper". TheHealth Insurance Portability and Accessibility Act (HIPAA) stipulates that diagnostic and procedure codes used for billing purposes must be the codes that were applicable at the time the service was provided. This initative is commonly referred to as the Code Set Versioning (CSV) project. For this project, four code sets required by HIPAA legislation are date sensitive and needed modification. These include: * International Classification of Diseases-9-Clinical Modifications (ICD-9-CM), * Diagnostic Related Group (DRG) Codes, which is part of the ICD-9 code set, * Clinical Procedure Terminology-4 (CPT-4), and * Healthcare Common Procedural Coding System (HCPCS) Level II Codes. Additional code sets may be determined by the Department of Health and Human Services for future inclusion. This patch addresses the changes done within the AMBCARE package in compliance to the specifications of CSV. Modifications were done within the AMBCARE application to assure validity of CPT codes, and CPT modifiers, and ICD diagnosis and CPT procedure codes, by utilizing an API that return codes for a given encounter date. This patch also updates the data stored in VALIDATION LOGIC field (#31) in TRANSMITTED OUTPATIENT ENCOUNTER ERROR CODE file (#409.76). For Error Code 6050, the encounter date will be checked when validating the procedure code. The following reports are modified by utilizing API. The reports reflect to current text. SCRPW AD HOC REPORT ACRP Ad Hoc Report SCRPW DX/CPT FREQUENCY REPORT Outpatient Diagnosis/Procedure Frequency Report SCRPW DX/PROCEDURE CODE SEARCH Outpatient Diagnosis/Procedure Code Search SCRPW DVM CPT FREQUENCY Most Frequent 50 CPT Codes (OP6) SCRPW DVM DX FREQUENCY Most Frequent 50 ICD-9-CM Codes (OP7) 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: ;;5.3;Scheduling;**[patch list]**;Aug 13,1993 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List =========== ============ =========== ========== SCMSVUT1 3009811 2954177 66,143,180,239,247,258,296,295 SCRPW15 33278721 33365408 139,144,166,180,295 SCRPW24 27360097 27654614 144,163,180,254,243,295 SCRPW46 18885603 18957210 144,180,199,295 SCRPW57 16419759 16471759 144,295 SOFTWARE AND DOCUMENTATION RETRIEVAL ==================================== The software for this patch is being distributed in host file CSV_MS_1_0.KID. The host file will contain nine KIDS builds. The builds contained in the CSV MS 1.0 multi-package distribution are: Package Patch(es) ------- --------- AICS IBD*3.0*51 Ambulatory Care DG*5.3*511 SD*5.3*295 DRG Grouper ICD*18.0*7 Event Capture EC*2.0*47 Fee Basis FB*3.5*55 Integrated Billing IB*2.0*210 PCE PX*1.0*121 Registration (PTF) DG*5.3*510 Please refer to the 'Software and Documentation Retrieval' section of the EC*2*47 patch description for instructions on how to acquire the patch software and documentation. INSTALLATION ============ Please refer to the Health Insurance Portability and Accountability Act (HIPAA) Code Set Versioning (CSV) Installation Guide for details of the installation procedure for this patch. The HIPAA CSV Installation Guide 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 File Name Description Format FTP Protocol ______________ _____________ _______ ____________ CSV_1_0_IG.DOC Install Guide MS Word Binary Routine Information: ==================== Routine Name: - SCMSVUT1 Routine Checksum: Routine Name: - SCRPW15 Routine Checksum: Routine Name: - SCRPW24 Routine Checksum: Routine Name: - SCRPW46 Routine Checksum: Routine Name: - SCRPW57 Routine Checksum: ============================================================================= User Information: Entered By : TSAI,ANNIE Date Entered : APR 09, 2003 Completed By: SMITH,DEAN Date Completed: AUG 27, 2003 Released By : NELSON,VICKI M Date Released : SEP 24, 2003 ============================================================================= Packman Mail Message: ===================== No routines included