| DESCRIPTION OF ENHANCEMENTS |
This patch is part of the Patient Financial Services System (PFSS) project.
system. The project consists of the implementation of the billing
o Quarterly Report - Surgical Service [SRO QUARTERLY REPORT] option
o Report of Missing Quarterly Report Data [SROQ MISSING DATA] option
Note: The Other CPT Codes no longer affect this report and
references to Other CPT Codes are removed. The display of "I" in
the footer of this report is removed.
o Annual Report of Non-O.R. Procedures [SRONOP-ANNUAL] option
o List of Invasive Diagnostic Procedures [SROQIDP] option
- The following Surgery reports and options are modified to remove CPT
and/or ICD codes from the display.
o Update Status of Returns within 30 Days [SRO UPDATE RETURNS] option
replacement system, business process improvements, and enhancements to
o Update Operations as Unrelated/Related to Death [SRO DEATH RELATED]
option
o Non-OR Procedure Information [SR NON-OR INFO] option
o Deaths Within 30 Days of Surgery [SROQD] option
o Admissions Within 14 Days of Outpatient Surgery [SROQADM] option
o List of Operations Included on Quarterly Report [SROQ LIST OPS]
option
3. Modified Risk Assessment Options
- Surgery case CPT and/or ICD codes used in the following options are
VistA to support integration with the COTS billing replacement system.
displayed from the SURGERY PROCEDURE/DIAGNOSIS CODES file (#136):
o Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT] option
o List of Surgery Risk Assessments [SROA ASSESSMENT LIST] option
o Exclusion Criteria (Enter/Edit) [SR NO ASSESSMENT REASON] option
Note: The new CPT code fields will not be editable from this
option.
o Update 1-Liner Case [SROA ONE-LINER UPDATE] option
Note: The new CPT code fields will not be editable from this
option.
o Queue Assessment Transmissions [SROA TRANSMIT ASSESSMENTS] option
Significant changes to VistA legacy systems and ancillary packages are
- In the following options CPT codes are removed from the screen
headings:
o Preoperative Information (Enter/Edit) [SROA PREOP DATA] option
o Laboratory Test Results (Enter/Edit) [SROA LAB] option
o Operation Information (Enter/Edit) [SROA OPERATION DATA] option
Note: The CPT code and Postoperative Diagnosis fields will not be
editable from this option.
o Patient Demographics (Enter/Edit) [SROA DEMOGRAPHICS] option
o Intraoperative Occurrences (Enter/Edit) [SRO INTRAOP COMP] option
o Postoperative Occurrences (Enter/Edit) [SRO POSTOP COMP] option
necessary.
o Clinical Information (Enter/Edit) [SROA CLINICAL INFORMATION]
option
o Laboratory Test Results (Enter/Edit) [SROA LAB-CARDIAC] option
o Enter Cardiac Catheterization & Angiographic Data [SROA
CATHETERIZATION] option
o Operative Risk Summary Data (Enter/Edit) [SROA CARDIAC OPERATIVE
RISK] option
Note: The CPT code fields will not be editable from this option.
o Cardiac Procedures Operative Data (Enter/Edit) [SROA CARDIAC
PROCEDURES] option
o Outcome Information (Enter/Edit) [SROA CARDIAC-OUTCOMES] option
o Resource Data [SROA CARDIAC RESOURCE] option
- The Update Assessment Status to 'COMPLETE' [SROA COMPLETE ASSESSMENT]
option is modified to remove the ability to edit CPT and ICD codes
from this option.
4. Functions that are currently part of the Surgery Nightly Cleanup and
Updates [SRTASK-NIGHT] option are modified as follows:
- Store Operation Times function uses the CPT code fields in the
SURGERY PROCEDURE/DIAGNOSIS CODES file (#136).
Some of the PFSS software components are not operational until the PFSS
- File Surgery Data in PCE function is removed.
5. The Surgery to PCE interface is modified to send coding data from the
SURGERY PROCEDURE/DIAGNOSIS CODES file (#136). The interface now passes
data to PCE in real time when the coder completes the coding process
for a case. After a case is filed with PCE, if certain data passed to
PCE is changed within the Surgery software, the Surgery to PCE
interface sends an update to PCE immediately. ICD coding related data
is updated through the Update/Verify Procedure/Diagnosis Codes
[SRCODING EDIT] option.
On/Off Switch, distributed with patch IB*2*260, is set to "ON". The ability
for the local site to set the switch to "ON" will be provided at the
appropriate time with the release of a subsequent Integrated Billing patch.
PFSS patches are being released on various schedules. Some patch
For more information about the PFSS project, review the documentation
accompanying this patch and refer to the following website:
http://vista.domain.ext/billreplace/
Features of patch SR*3*142 are listed below:
1. Modified Surgery Coding Option
Coders currently use the Update/Verify Procedure/Diagnosis Codes
[SRCODING EDIT] option, which updates coded data directly in the
functionality will not be active until a new PFSS switch is activated
SURGERY file (#130). However, the SURGERY file (#130) does not
currently make a distinction between procedure and diagnosis data
entered by clinicians and that entered by coders. Today, coding a
surgical case impacts the clinical data for the patient and causes an
addendum to be generated because each code is directly associated with
a free-text procedure or diagnosis entry. This patch separates final
coded procedures and diagnoses from the clinically captured procedures
and diagnoses.
A new file, the SURGERY PROCEDURE/DIAGNOSIS CODES file (#136), is
during final implementation. PFSS will initially be implemented at select
created to store coded procedure and coded diagnosis data for a Surgery
case. Data entered into this file will be the new source coding data
sent by the Surgery package to PCE. In the SURGERY file (#130), the
existing PRINCIPAL CPT Code field (#27), PRIN DIAGNOSIS CODE field
(#66), OTHER PROCEDURE CPT CODE field (#3 of sub-file #130.16) and ICD
DIAGNOSIS CODE field (#3 of sub-file #130.18) are modified to include
the word "PLANNED" in the field labels and titles.
The Update/Verify Procedure/Diagnosis Codes [SRCODING EDIT] option is
modified to allow entry of final billing Current Procedural
pilot sites ONLY.
Terminology (CPT) codes for surgical procedures and International
Classification of Disease (ICD) diagnosis codes in the SURGERY
PROCEDURE/DIAGNOSIS CODES file (#136).
Modified features of the Update/Verify Procedure/Diagnosis Codes
[SRCODING EDIT] option are listed below:
- Upon record creation for a case in the SURGERY PROCEDURE/DIAGNOSIS
CODES file (#136), the record will be auto-populated with clinician
entered coding data, if any, from the SURGERY file (#130).
- A principal ICD code and a principal CPT code are initial
requirements for coding a surgical case.
- An unlimited number of ICD codes may be entered for other diagnoses
and an unlimited number of CPT codes may be entered for other
procedures performed.
- Each CPT code entered must be assigned the associated ICD code(s)
related to the procedure performed.
- An unlimited number of CPT modifiers may be entered for each CPT code
entered.
- For every ICD code entered, the following questions must be answered
as appropriate for the patient based upon enrollment indicators:
The purpose of the PFSS project is to prepare the Veterans Health
o Treatment related to Service Connected condition?
o Treatment related to Agent Orange Exposure?
o Treatment related to Ionizing Radiation Exposure?
o Treatment related to Environmental Contaminant Exposure?
o Treatment related to Military Sexual Trauma?
o Treatment related to Head and/or Neck Cancer?
o Treatment related to Combat?
- Upon completion of coding for a case, the coder is allowed to mark
the record as complete and to send the record immediately to PCE.
- Before allowing the record to be marked as complete, the option
Information Systems and Technology Architecture (VistA) environment for the
checks to see if a specific code, 065.0 CRIMEAN HEMORRHAGIC FEV, is
entered as a diagnosis code. If it is entered, the software prompts
the user to make sure that the code is correct for the case. This
check is added to prevent the inadvertent assignment of code 065.0
when "CHF" is entered for the Principal or Other ICD Diagnosis
codes.
2. Modified Surgery Reports and Other Options
- The following Surgery reports and options as modified to use the
coder entered CPT and/or ICD codes from the SURGERY
implementation of a commercial off-the-shelf (COTS) billing replacement
PROCEDURE/DIAGNOSIS CODES file (#136):
o Cumulative Report of CPT Codes [SROACCT] option
o Report of CPT Coding Accuracy [SR CPT ACCURACY] option
o List Completed Cases Missing CPT Codes [SRSCPT] option
Note: The option descriptions are updated to read "The List
Completed Cases Missing CPT Codes option generates a report of
completed cases that are missing the Principal CPT code for a
specified date range."
o Annual Report of Surgical Procedures [SROARSP] option
o PCE Filing Status Report [SRO PCE STATUS] option
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