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VA Code in Flight Submission - ICD-10 Patient Treatment File Modifications (patch IB*2*522)
Please use this identifier to cite or link to this publication: http://hdl.handle.net/10909/11025
Submitted by OI&T EPMO Lean Systems Engineering Open Source Coordination Office on 01-28-2015.
For Inpatient care, the number of allowable Diagnosis and Procedure codes
is being expanded in the Patient Treatment File (PTF) with DG*5.3*884.
The following records in PTF are being expanded to allow up to 25 codes:
Movement Diagnosis (501), Discharge Diagnosis (701), Surgical Episode
Procedures (401) and Non-O/R Episode Procedures (601).

This patch IB*2*522 will update the Inpatient Bill/Claim to accommodate
the expanded number of Diagnosis and Procedure codes available in PTF.


A. Inpatient Bill/Claims Diagnosis:
-----------------------------------
Screen 4 option 3 of Enter/Edit Billing Information [IB EDIT BILLING INFO]
has been updated to display and allow selection of all Diagnosis in the
PTF record within the date range of the bill. This is up to 25 Diagnosis
for each Movement (501) and the Discharge (701).

The Present on Admission (POA) indicator associated with any selected PTF
Diagnosis will be also added to the bill. The display of PTF Diagnosis
will include the POA, if present in PTF.

Beginning with ICD-10 bills the Present on Admission (POA) indicator
entered in the DSS Encoder will no longer be added to a bill. For ICD-10
bills the Diagnosis POA will be available in PTF where it will be accessed
for placement on the bill.

Depending on the number of PTF Movements associated with the bill, the
display and selection of Movement Diagnosis identifiers will now include
both upper and lower case alpha characters (A-Z and a-z), with X/x being
reserved for the Discharge. Previously only upper case alpha characters
were selectable.

B. Inpatient Bill/Claims Procedures:
-------------------------------------
Screen 4 option 4 of Enter/Edit Billing Information [IB EDIT BILLING INFO]
has been updated to display and allow selection of all Procedures in the
PTF record within the date range of the bill. This is up to 25 ICD
Procedures for each Surgical (401) and Non-O/R (601) Episode.

The display and selection of the PTF Professional Services (801) has also
been expanded to all CPT/HCPCS codes assigned within the bill date range.
Previously a maximum of 5 CPT/HCPCS were displayed for each Professional
Service although more than 5 may have been entered in PTF.

The display of the PTF Professional Services (801) will now include the
Quantity of the procedure preformed if it is more than 1.

Depending on the number of PTF Procedure Episodes associated with the bill,
the display and selection of Procedure Episode identifiers will now
include both upper and lower case alpha characters (A-Z and a-z).
Previously only upper case alpha characters were selectable.

C. Bill Charge Calculation:
----------------------------
For Inpatient Facility bill charges, the calculation of the DRG has been
modified to use all the PTF Diagnosis and Procedure codes within the
appropriate date range.

D. Third Party Autobiller:
---------------------------
Inpatient bills created by the Third Party Autobiller will add all the PTF
Diagnosis, POA, and Procedure codes within the bill date range.

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