| [604] | 1 | English French Notes Complete/Exclude
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| 2 | Charges Sets Removed.
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| 3 | Clinic Required for Surgical Procedures (10000-69999, 93501-93533)
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| 4 | >> Error Code IB320 Added to IB Error File (#350.8)
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| 5 | Reasonable Charges v2.0 Post-Install .....
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| 6 | Reasonable Charges v2.0 Post-Install Complete
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| 7 | RI-
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| 8 | NF-
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| 9 | WC-
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| 10 | Rate Schedules inactivated on
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| 11 | RC OUTPATIENT FACILITY
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| 12 | .01///RC FACILITY PR;.02///RC F/PR
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| 13 | RC OUTPATIENT FACILITY to RC FACILITY PR
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| 14 | .01///RC PHYSICIAN PR;.02///RC P/PR
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| 15 | RC PHYSICIAN to RC PHYSICIAN PR
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| 16 | Billing Rate Names Updated (363.3)...
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| 17 | STANDARD RVCD LINKS^RC FACILITY
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| 18 | STANDARD RVCD LINKS^RC PHYSICIAN
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| 19 | RC PROVIDER DISCOUNTS^RC PHYSICIAN
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| 20 | Billing Rates added to Special Groups (363.32)...
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| 21 | Revenue Codes activated (399.2)...
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| 22 | Billable Services added (399.1)...
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| 23 | *** Billable Service
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| 24 | not defined, BS
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| 25 | not created
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| 26 | Bedsection added (399.1)...
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| 27 | Billing Items added (363.21)...
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| 28 | Billing Rates added (363.3)...
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| 29 | not defined, RS
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| 30 | *** Rate Type
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| 31 | not Active, RS
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| 32 | Rate Schedules added, active on
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| 33 | >> Inactivating Existing Reasonable Charges, Please Wait...
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| 34 | existing charges inactivated
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| 35 | APPLYING EDITS TO FILE
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| 36 | IEN
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| 37 | IN USE
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| 38 | UPDATING
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| 39 | TO INACTIVE
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| 40 | UPDATING INACTIVE FLAG FOR
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| 41 | >>> Deleting ICD OPERATION/PROCEDURE file (#80.1)...
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| 42 | >>> Deleting ICD DIAGNOSIS file (#80)...
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| 43 | >>> File deletion complete! Please use the appropriate global loader
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| 44 | to restore the files from ICD0_18.GBL and ICD9_18.GBL
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| 45 | IMMEDIATELY after installing this package.
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| 46 | >>> IMPORTANT: Please restore your ICD9 and ICD0 global files from <<<
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| 47 | >>> ICD9_18.GBL and ICD0_18.GBL at this time. <<<
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| 48 | >>> Correcting duplicate
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| 49 | cross-ref entries in the Description
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| 50 | multiple of the DRG file (#80.2)...
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| 51 | >>> Revising DRG records in the DRG file (#80.2)...
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| 52 | was not found and could not be
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| 53 | >>> Adding FY 97 Weights & Trims...
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| 54 | CODE TEXT MAY BE INACCURATE
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| 55 | INVALID CODE
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| 56 | **CODE INACTIVE
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| 57 | AS OF
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| 58 | -1^NO CODE SELECTED
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| 59 | -1^INVALID CODE
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| 60 | -1^VA LOCAL CODE SELECTED
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| 61 | -1^NO DATA
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| 62 | ABC(
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| 63 | -1~NO CODE SELECTED
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| 64 | INVALID
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| 65 | DRG Grouper Version
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| 66 | DRGs for Registered PATIENTS (Y/N)
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| 67 | Enter 'Yes' if the patient has been previously registered, enter 'No' for other patient, or '^' to quit.
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| 68 | Enter Primary diagnosis:
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| 69 | Avg len of stay:
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| 70 | Low day(s):
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| 71 | Local low day(s):
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| 72 | High days:
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| 73 | Local High days:
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| 74 | Principal Diagnosis
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| 75 | Operation/Procedure
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| 76 | Grouper needs to know if patient died during this episode!
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| 77 | Grouper needs to know if patient was transferred to an acute care facility!
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| 78 | Grouper needs to know if patient was discharged against medical advice!
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| 79 | Patient assigned newborn diagnosis code. Check diagnosis!
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| 80 | Grouping function error - contact IRMFO
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| 81 | Patient's age:
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| 82 | Enter how old the patient is (0-124).
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| 83 | Was patient transferred to an acute care facility
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| 84 | Was patient discharged against medical advice
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| 85 | Enter M for Male and F for Female
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| 86 | Patient's Sex
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| 87 | -1;NO CODE SELECTED;0
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| 88 | -1;NO FILE INPUT;0
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| 89 | -1;INVALID FILE INPUT;0
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| 90 | -1;NO SUCH ENTRY;0
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| 91 | -1;NO DRG LEVEL;0
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| 92 | -1^NO SUCH ENTRY
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| 93 | effective date
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| 94 | -1^NO FILE SELECTED
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| 95 | -1^INVALID FILE
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| 96 | -1^NO DATE SELECTED
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| 97 | Ogz
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| 98 | Hp
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| 99 | Both the data and data dictionary will be deleted for the following files:
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| 100 | 81 - CPT; 81.1 - CPT CATEGORY; 81.2 - CPT COPYRIGHT; and 81.3 - CPT MODIFIER
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| 101 | Files 81.4 - CPT MODIFIER CATEGORY and 81.5 - CPT SOURCE will be
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| 102 | permanently deleted with this release.
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| 103 | ... File data and DD deletions complete.
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| 104 | File #81.1, CPT CATEGORY, has been deleted
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| 105 | File #81.2, CPT COPYRIGHT has been deleted
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| 106 | File #81.3, CPT MODIFIER has been deleted
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| 107 | File #81.4, CPT MODIFIER CATEGORY has been permanently deleted.
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| 108 | File #81.5, CPT SOURCE has been permanently deleted.
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| 109 | >>> Deleting data and data dictionary for file #81, CPT...
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| 110 | Deleting the CPT CATEGORY file (#81.1)...
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| 111 | Deleting the CPT COPYRIGHT file (#81.2)...
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| 112 | Deleting the CPT MODIFIER file (#81.3)...
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| 113 | Deleting the CPT file (#81)...
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| 114 | >>> File deletions complete! Please use the appropriate global loader
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| 115 | to restore the CPT global files from ICPT6_13.GLB (CPT file, #81)
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| 116 | and ICPT6_13A.GLB [CPT CATEGORY (#81.1); CPT COPYRIGHT (#81.2)
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| 117 | and the CPT MODIFIER (#81.3) files] IMMEDIATELY after installing
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| 118 | this patch. >>>
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| 119 | to restore the CPT global files from ICPT6_4A.GBL (CPT file, #81)
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| 120 | and ICPT6_4B.GBL [CPT CATEGORY (#81.1); CPT COPYRIGHT (#81.2)
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| 121 | and the CPT MODIFIER (#81.3) files] IMMEDIATELY after installing
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| 122 | this patch. >>>
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| 123 | and ICPT6_8A.GLB [CPT CATEGORY (#81.1); CPT COPYRIGHT (#81.2)
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| 124 | -1^NO CATEGORY SELECTED
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| 125 | -1^INVALID CATEGORY FORMAT
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| 126 | -1^NO SUCH CATEGORY
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| 127 | -1^TYPE OF CATEGORY UNSPECIFIED
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| 128 | -1^NO SUCH CODE
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| 129 | -1^NO CPT SELECTED
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| 130 | -1^INACTIVE CODE
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| 131 | -1^NO MODIFIER SELECTED
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| 132 | -1^INVALID MODIFIER FORMAT
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| 133 | -1^Multiple modifiers w/same name. Select IEN:
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| 134 | -1^NO SUCH MODIFIER
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| 135 | -1^VA LOCAL MODIFIER SELECTED
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| 136 | -1^NO SUCH CPT CODE
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| 137 | -1^CPT CODE INACTIVE
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| 138 | -1^modifier inactive
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| 139 | -1^bad modifier file entry
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| 140 | Recently INACTIVATED CPT Codes effective Jan 01, 2003
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| 141 | NEW CPT Codes effective
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| 142 | Recently REVISED CPT Codes effective
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| 143 | TEXT+
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| 144 | Do you want to:
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| 145 | 1. List Access Violations
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| 146 | 2. Delete Entries from the file
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| 147 | Select your choice:
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| 148 | All entries over 30 days old have been removed
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| 149 | List IMR Access Violations
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| 150 | DUZ =
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| 151 | For each entry on this list there should be a complete listing of the current
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| 152 | local variables in the system error log, which may provide more information
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| 153 | on these access attempts.
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| 154 | USER ID
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| 155 | LOCATION OF VIOLATION
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| 156 | **NO DATA FOUND FOR THIS PERIOD**
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| 157 | *** NO ACTIVE PHARMACY DATA ***
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| 158 | *** NO DATA FOUND ***
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| 159 | Last Activity:
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| 160 | Local ARV Report-At Least ONE
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| 161 | You have selected Antiretroviral Drugs as a search group. I will now search for
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| 162 | patients who have had AT LEAST ONE of the drugs listed in this group.
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| 163 | Do you want the unique patients listed by name (Y/N)?
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| 164 | Answer YES to see a list of individual names.
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| 165 | Local Antiretroviral (ARV) Drug Report
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| 166 | Number of VA HIV/AIDS Patients Receiving AT LEAST ONE of the ARV Drugs
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| 167 | Station Report
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| 168 | ***NO DATA FOUND FOR THIS PERIOD***
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| 169 | TOTALS >>>>>>
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| 170 | ******** UNIQUE PATIENTS ********
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| 171 | >>>>>> # of Unique Patients:
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| 172 | ***NO PATIENTS FOUND IN THIS DATE RANGE***
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| 173 | Unique Category 4 Patients NOT on ARVs
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| 174 | REIM LEVEL
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| 175 | ARV Report by Reimbursement
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| 176 | patients who have had any of the drugs listed in this group. I will also
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| 177 | search for all Category 4 ICR patients seen in the selected time period.
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| 178 | Do you want the unique ARV patients listed by name (Y/N)?
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| 179 | Do you want the unique Category 4 patients listed by name (Y/N)?
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| 180 | Local Antiretroviral (ARV) Drug Reimbursement Report
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| 181 | ARV DRUG
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| 182 | ******** List of Unique Patients on ARVs ********
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| 183 | >>>>>> # of Unique Patients on ARVs:
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| 184 | >>>>>> # of Unique Category 4 Patients NOT on ARVs:
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| 185 | CH,MI,...
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| 186 | COST UNKNOWN
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| 187 | Process Data Extract for a Date Range
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| 188 | The categories for each are as follows:
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| 189 | 1. HIV+, CD4+ (T4) Count 500/mm3 or Greater.
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| 190 | a. Confirmed HIV serum antibody positive (two positive ELISAs and
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| 191 | a confirmatory Western Blot)
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| 192 | b. CD4+ (T4) count 500/mm3 or greater.
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| 193 | 2. HIV+, CD4+ Count between 200 and 500/mm3.
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| 194 | Press return to continue:
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| 195 | 3. AIDS with CD4+ (T4) LESS THAN 200/mm3.
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| 196 | b. CD4+ (T4) count less than 200/mm3 or CD4+ percent less than 14.
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| 197 | c. No AIDs defining diseases. See below (Category 4).
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| 198 | 4. AIDS WITH AIDS DEFINING DISEASES.
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| 199 | a confirmatory Western Blot) as above
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| 200 | b. CDC defined diseases (see MMWR, December 18, 1992, Vol. 41/RR-17
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| 201 | for listing of AIDs defining diseases).
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| 202 | Want to add a new VIRAL LOAD test for this patient
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| 203 | You may enter another Viral Load Test, by entering the name below
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| 204 | Select section of CDC form for editing:
|
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| 205 | Patient ID Header (not edited)
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| 206 | Health Dept. Info (not edited)
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| 207 | 1. Demographic Information
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| 208 | 2. Facility of Diagnosis
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| 209 | 3. Patient History
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|---|
| 210 | 4. Laboratory Data
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| 211 | Other Header Data (not edited)
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| 212 | 5. Clinical Status
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|---|
| 213 | 6. Treatment/Services Referrals
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| 214 | 8. The complete form (all of above)
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| 215 | Select section (1 to 8):
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| 216 | Enter a number 1 to 8, or '^' or RETURN to quit
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| 217 | SELECT THE DISEASES THAT APPLY
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|---|
| 218 | Enter 'N' to remove a disease incorrectly selected.
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| 219 | Select Disease:
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| 220 | Enter the number or first couple of characters of the desired disease
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|---|
| 221 | Please select the desired disease by number:
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|---|
| 222 | Need 132 character wide printer.
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| 223 | Print Blank CDC Form
|
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| 224 | Select PHYSICIAN NAME for form:
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| 225 | PHYSICIAN Phone Number
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| 226 | Enter the following phone number in the format (NNN)NNN-NNNN
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| 227 | YOUR OFFICE Phone Number
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| 228 | Enter your Phone Number in the format (NNN)NNN-NNNN
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| 229 | PRINT CDC FORM
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| 230 | I. STATE/LOCAL USE ONLY
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| 231 | Patient's Name:
|
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| 232 | Phone No.:
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| 233 | Zip
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| 234 | VII. STATE/LOCAL USE ONLY
|
|---|
| 235 | Physician's Name:
|
|---|
| 236 | Record No.
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| 237 | Person
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| 238 | Hospital/Facility:
|
|---|
| 239 | Completing Form:
|
|---|
| 240 | This report is authorized by law (Sections 304 and 306 of the Public Health Service Act, 42 USC 242b and 242k). Response in this
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| 241 | base is voluntary for federal government purposes, but may be mandatory under state and local statutes. Your cooperation is
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| 242 | necessary for the understanding and control of HIV/AIDS. Information in the surveillance system that would permit identification
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| 243 | of any individual on whom a record is maintained, is collected with a guarantee that it will be held in confidence, will be used
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| 244 | only for the purposes stated in the assurance on file at the local health department, and will not otherwise be disclosed or
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| 245 | released without the consent of the individual in accordance with Section 308(d) of the Public Health Service Act (42 USC 242m).
|
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| 246 | Public burden for this collection of information is estimated to average 10 minutes per response. Send comments regarding this
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| 247 | burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to PHS
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| 248 | Reports Clearance Officer: ATTN: PRA; Hubert H. Humphrey Bldg. Rm 721-B; 200 Independence Ave., SW; Washington, DC 20201, and to
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| 249 | the Office of Management and Budget; Paperwork Reduction Project (0920-0009); Washington, DC 20503. -DO NOT MAIL CASE REPORT FORMS
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| 250 | TO THESE ADDRESSES --
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| 251 | RETURN TO STATE/LOCAL HEALTH DEPARTMENT - PATIENT IDENTIFIER INFORMATION IS NOT TRANSMITTED TO CDC! -
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| 252 | U.S. DEPARTMENT OF HEALTH ADULT HIV/AIDS CONFIDENTIAL CASE REPORT CDC
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| 253 | & HUMAN SERVICES (Patients >=13 years of age at time of diagnosis) CENTERS FOR DISEASE CONTROL
|
|---|
| 254 | Public Health Service AND PREVENTION
|
|---|
| 255 | II. HEALTH DEPARTMENT USE ONLY
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|---|
| 256 | DATE FORM COMPLETED
|
|---|
| 257 | MO. DAY YR. | SOUNDEX REPORT STATUS REPORTING HEALTH DEPARTMENT STATE |
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| 258 | | CODE STATE: _______________ PATIENT NO.: __________ |
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| 259 | | | NEW REPORT CITY/ CITY/COUNTY |
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| 260 | | REPORT SOURCE: ___ | | ____ | | UPDATE COUNTY:_______________ PATIENT NO.: __________ |
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|---|
| 261 | ------------------------------------------------- III. DEMOGRAPHIC INFORMATION -------------------------------------------------
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|---|
| 262 | DIAGNOSTIC STATUS AGE AT DIAGNOSIS: | DATE OF BIRTH | CURRENT STATUS | DATE OF DEATH | STATE/TERRITORY OF DEATH
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|---|
| 263 | AT REPORT (check one): | Mo. Day Yr. |
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|---|
| 264 | Alive Dead Unk. | Mo. Day Yr. |
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|---|
| 265 | | HIV Infection (not AIDS)
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|---|
| 266 | | |
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|---|
| 267 | |
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|---|
| 268 | SEX: |RACE/ETHNICITY: |COUNTRY OF BIRTH:
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|---|
| 269 | | White (not Hispanic) |
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|---|
| 270 | | Black (not Hispanic) |
|
|---|
| 271 | | U.S. Dependencies and Possessions (in-
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|---|
| 272 | | American Indian/ |
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|---|
| 273 | | Not | cluding Puerto Rico (specify):
|
|---|
| 274 | | Islander Alaskan Native Specified ||
|
|---|
| 275 | RESIDENCE AT DIAGNOSIS:
|
|---|
| 276 | State/
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|---|
| 277 | Country:
|
|---|
| 278 | - IV. FACILITY OF DIAGNOSIS ---- --------------------------------------- V. PATIENT HISTORY -----------------------------------
|
|---|
| 279 | | | AFTER 1977 AND PRECEDING THE FIRST POSITIVE HIV ANTIBODY TEST |
|
|---|
| 280 | | FACILITY NAME: | | OR AIDS DIAGNOSIS, THIS PATIENT HAD (Respond to ALL Categories): Yes No Unk. |
|
|---|
| 281 | | | * Sex with male
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|---|
| 282 | | City | | * Sex with female ..........................................................
|
|---|
| 283 | | | * Injected nonprescription drugs ........................................... |
|
|---|
| 284 | | State/Country | | * Received clotting factor for hemophilia/coagulation disorder ............. |
|
|---|
| 285 | | | | Specify disorder: |
|
|---|
| 286 | | Factor VIII |
|
|---|
| 287 | | Factor IX |
|
|---|
| 288 | | FACILITY SETTING (check one) | | * (Hemophilia A) (Hemophilia B) (specify):
|
|---|
| 289 | | Private | | * HETEROSEXUAL relations with any of the following: |
|
|---|
| 290 | | Unknown | | * Intravenous/injection drug user ........................................ |
|
|---|
| 291 | | | | * Bisexual male .......................................................... |
|
|---|
| 292 | | | | * Person with hemophilia/coagulation disorder ............................ |
|
|---|
| 293 | | FACILITY TYPE (check one) | | * Transfusion recipient with documented HIV infection .................... |
|
|---|
| 294 | | Physician,HMO | | * Transplant recipient with documented HIV infection ..................... |
|
|---|
| 295 | | Hospital,Inpatient | | * Person with AIDS or documented HIV infection, risk not specified ....... |
|
|---|
| 296 | | Other (specify): | | * Received transfusion of blood/blood components (other than clotting factor) |
|
|---|
| 297 | | * Received transplant of tissue/organs or artificial insemination .......... |
|
|---|
| 298 | | * Worked in a health-care or clinical laboratory setting ................... |
|
|---|
| 299 | | (specify occupation):
|
|---|
| 300 | ======================================================== VI. LABORATORY DATA ====================================================
|
|---|
| 301 | | 1. HIV ANTIBODY TESTS AT DIAGNOSIS: Not Test Date | Mo. Yr. |
|
|---|
| 302 | | (Indicate FIRST test) Pos Neg Ind Done Mo. Yr. | * Date of last documented NEGATIVE HIV test
|
|---|
| 303 | #################### #################### ####################
|
|---|
| 304 | #################### #################### ####################
|
|---|
| 305 | #################### #################### ####################
|
|---|
| 306 | #################### #################### ####################
|
|---|
| 307 | #################### #################### ####################
|
|---|
