English French Notes Complete/Exclude Charges Sets Removed. Clinic Required for Surgical Procedures (10000-69999, 93501-93533) >> Error Code IB320 Added to IB Error File (#350.8) Reasonable Charges v2.0 Post-Install ..... Reasonable Charges v2.0 Post-Install Complete RI- NF- WC- Rate Schedules inactivated on RC OUTPATIENT FACILITY .01///RC FACILITY PR;.02///RC F/PR RC OUTPATIENT FACILITY to RC FACILITY PR .01///RC PHYSICIAN PR;.02///RC P/PR RC PHYSICIAN to RC PHYSICIAN PR Billing Rate Names Updated (363.3)... STANDARD RVCD LINKS^RC FACILITY STANDARD RVCD LINKS^RC PHYSICIAN RC PROVIDER DISCOUNTS^RC PHYSICIAN Billing Rates added to Special Groups (363.32)... Revenue Codes activated (399.2)... Billable Services added (399.1)... *** Billable Service not defined, BS not created Bedsection added (399.1)... Billing Items added (363.21)... Billing Rates added (363.3)... not defined, RS *** Rate Type not Active, RS Rate Schedules added, active on >> Inactivating Existing Reasonable Charges, Please Wait... existing charges inactivated APPLYING EDITS TO FILE IEN IN USE UPDATING TO INACTIVE UPDATING INACTIVE FLAG FOR >>> Deleting ICD OPERATION/PROCEDURE file (#80.1)... >>> Deleting ICD DIAGNOSIS file (#80)... >>> File deletion complete! Please use the appropriate global loader to restore the files from ICD0_18.GBL and ICD9_18.GBL IMMEDIATELY after installing this package. >>> IMPORTANT: Please restore your ICD9 and ICD0 global files from <<< >>> ICD9_18.GBL and ICD0_18.GBL at this time. <<< >>> Correcting duplicate cross-ref entries in the Description multiple of the DRG file (#80.2)... >>> Revising DRG records in the DRG file (#80.2)... was not found and could not be >>> Adding FY 97 Weights & Trims... CODE TEXT MAY BE INACCURATE INVALID CODE **CODE INACTIVE AS OF -1^NO CODE SELECTED -1^INVALID CODE -1^VA LOCAL CODE SELECTED -1^NO DATA ABC( -1~NO CODE SELECTED INVALID DRG Grouper Version DRGs for Registered PATIENTS (Y/N) Enter 'Yes' if the patient has been previously registered, enter 'No' for other patient, or '^' to quit. Enter Primary diagnosis: Avg len of stay: Low day(s): Local low day(s): High days: Local High days: Principal Diagnosis Operation/Procedure Grouper needs to know if patient died during this episode! Grouper needs to know if patient was transferred to an acute care facility! Grouper needs to know if patient was discharged against medical advice! Patient assigned newborn diagnosis code. Check diagnosis! Grouping function error - contact IRMFO Patient's age: Enter how old the patient is (0-124). Was patient transferred to an acute care facility Was patient discharged against medical advice Enter M for Male and F for Female Patient's Sex -1;NO CODE SELECTED;0 -1;NO FILE INPUT;0 -1;INVALID FILE INPUT;0 -1;NO SUCH ENTRY;0 -1;NO DRG LEVEL;0 -1^NO SUCH ENTRY effective date -1^NO FILE SELECTED -1^INVALID FILE -1^NO DATE SELECTED Ogz Hp Both the data and data dictionary will be deleted for the following files: 81 - CPT; 81.1 - CPT CATEGORY; 81.2 - CPT COPYRIGHT; and 81.3 - CPT MODIFIER Files 81.4 - CPT MODIFIER CATEGORY and 81.5 - CPT SOURCE will be permanently deleted with this release. ... File data and DD deletions complete. File #81.1, CPT CATEGORY, has been deleted File #81.2, CPT COPYRIGHT has been deleted File #81.3, CPT MODIFIER has been deleted File #81.4, CPT MODIFIER CATEGORY has been permanently deleted. File #81.5, CPT SOURCE has been permanently deleted. >>> Deleting data and data dictionary for file #81, CPT... Deleting the CPT CATEGORY file (#81.1)... Deleting the CPT COPYRIGHT file (#81.2)... Deleting the CPT MODIFIER file (#81.3)... Deleting the CPT file (#81)... >>> File deletions complete! Please use the appropriate global loader to restore the CPT global files from ICPT6_13.GLB (CPT file, #81) and ICPT6_13A.GLB [CPT CATEGORY (#81.1); CPT COPYRIGHT (#81.2) and the CPT MODIFIER (#81.3) files] IMMEDIATELY after installing this patch. >>> to restore the CPT global files from ICPT6_4A.GBL (CPT file, #81) and ICPT6_4B.GBL [CPT CATEGORY (#81.1); CPT COPYRIGHT (#81.2) and the CPT MODIFIER (#81.3) files] IMMEDIATELY after installing this patch. >>> and ICPT6_8A.GLB [CPT CATEGORY (#81.1); CPT COPYRIGHT (#81.2) -1^NO CATEGORY SELECTED -1^INVALID CATEGORY FORMAT -1^NO SUCH CATEGORY -1^TYPE OF CATEGORY UNSPECIFIED -1^NO SUCH CODE -1^NO CPT SELECTED -1^INACTIVE CODE -1^NO MODIFIER SELECTED -1^INVALID MODIFIER FORMAT -1^Multiple modifiers w/same name. Select IEN: -1^NO SUCH MODIFIER -1^VA LOCAL MODIFIER SELECTED -1^NO SUCH CPT CODE -1^CPT CODE INACTIVE -1^modifier inactive -1^bad modifier file entry Recently INACTIVATED CPT Codes effective Jan 01, 2003 NEW CPT Codes effective Recently REVISED CPT Codes effective TEXT+ Do you want to: 1. List Access Violations 2. Delete Entries from the file Select your choice: All entries over 30 days old have been removed List IMR Access Violations DUZ = For each entry on this list there should be a complete listing of the current local variables in the system error log, which may provide more information on these access attempts. USER ID LOCATION OF VIOLATION **NO DATA FOUND FOR THIS PERIOD** *** NO ACTIVE PHARMACY DATA *** *** NO DATA FOUND *** Last Activity: Local ARV Report-At Least ONE You have selected Antiretroviral Drugs as a search group. I will now search for patients who have had AT LEAST ONE of the drugs listed in this group. Do you want the unique patients listed by name (Y/N)? Answer YES to see a list of individual names. Local Antiretroviral (ARV) Drug Report Number of VA HIV/AIDS Patients Receiving AT LEAST ONE of the ARV Drugs Station Report ***NO DATA FOUND FOR THIS PERIOD*** TOTALS >>>>>> ******** UNIQUE PATIENTS ******** >>>>>> # of Unique Patients: ***NO PATIENTS FOUND IN THIS DATE RANGE*** Unique Category 4 Patients NOT on ARVs REIM LEVEL ARV Report by Reimbursement patients who have had any of the drugs listed in this group. I will also search for all Category 4 ICR patients seen in the selected time period. Do you want the unique ARV patients listed by name (Y/N)? Do you want the unique Category 4 patients listed by name (Y/N)? Local Antiretroviral (ARV) Drug Reimbursement Report ARV DRUG ******** List of Unique Patients on ARVs ******** >>>>>> # of Unique Patients on ARVs: >>>>>> # of Unique Category 4 Patients NOT on ARVs: CH,MI,... COST UNKNOWN Process Data Extract for a Date Range The categories for each are as follows: 1. HIV+, CD4+ (T4) Count 500/mm3 or Greater. a. Confirmed HIV serum antibody positive (two positive ELISAs and a confirmatory Western Blot) b. CD4+ (T4) count 500/mm3 or greater. 2. HIV+, CD4+ Count between 200 and 500/mm3. Press return to continue: 3. AIDS with CD4+ (T4) LESS THAN 200/mm3. b. CD4+ (T4) count less than 200/mm3 or CD4+ percent less than 14. c. No AIDs defining diseases. See below (Category 4). 4. AIDS WITH AIDS DEFINING DISEASES. a confirmatory Western Blot) as above b. CDC defined diseases (see MMWR, December 18, 1992, Vol. 41/RR-17 for listing of AIDs defining diseases). Want to add a new VIRAL LOAD test for this patient You may enter another Viral Load Test, by entering the name below Select section of CDC form for editing: Patient ID Header (not edited) Health Dept. Info (not edited) 1. Demographic Information 2. Facility of Diagnosis 3. Patient History 4. Laboratory Data Other Header Data (not edited) 5. Clinical Status 6. Treatment/Services Referrals 8. The complete form (all of above) Select section (1 to 8): Enter a number 1 to 8, or '^' or RETURN to quit SELECT THE DISEASES THAT APPLY Enter 'N' to remove a disease incorrectly selected. Select Disease: Enter the number or first couple of characters of the desired disease Please select the desired disease by number: Need 132 character wide printer. Print Blank CDC Form Select PHYSICIAN NAME for form: PHYSICIAN Phone Number Enter the following phone number in the format (NNN)NNN-NNNN YOUR OFFICE Phone Number Enter your Phone Number in the format (NNN)NNN-NNNN PRINT CDC FORM I. STATE/LOCAL USE ONLY Patient's Name: Phone No.: Zip VII. STATE/LOCAL USE ONLY Physician's Name: Record No. Person Hospital/Facility: Completing Form: This report is authorized by law (Sections 304 and 306 of the Public Health Service Act, 42 USC 242b and 242k). Response in this base is voluntary for federal government purposes, but may be mandatory under state and local statutes. Your cooperation is necessary for the understanding and control of HIV/AIDS. Information in the surveillance system that would permit identification of any individual on whom a record is maintained, is collected with a guarantee that it will be held in confidence, will be used only for the purposes stated in the assurance on file at the local health department, and will not otherwise be disclosed or released without the consent of the individual in accordance with Section 308(d) of the Public Health Service Act (42 USC 242m). Public burden for this collection of information is estimated to average 10 minutes per response. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to PHS Reports Clearance Officer: ATTN: PRA; Hubert H. Humphrey Bldg. Rm 721-B; 200 Independence Ave., SW; Washington, DC 20201, and to the Office of Management and Budget; Paperwork Reduction Project (0920-0009); Washington, DC 20503. -DO NOT MAIL CASE REPORT FORMS TO THESE ADDRESSES -- RETURN TO STATE/LOCAL HEALTH DEPARTMENT - PATIENT IDENTIFIER INFORMATION IS NOT TRANSMITTED TO CDC! - U.S. DEPARTMENT OF HEALTH ADULT HIV/AIDS CONFIDENTIAL CASE REPORT CDC & HUMAN SERVICES (Patients >=13 years of age at time of diagnosis) CENTERS FOR DISEASE CONTROL Public Health Service AND PREVENTION II. HEALTH DEPARTMENT USE ONLY DATE FORM COMPLETED MO. DAY YR. | SOUNDEX REPORT STATUS REPORTING HEALTH DEPARTMENT STATE | | CODE STATE: _______________ PATIENT NO.: __________ | | | NEW REPORT CITY/ CITY/COUNTY | | REPORT SOURCE: ___ | | ____ | | UPDATE COUNTY:_______________ PATIENT NO.: __________ | ------------------------------------------------- III. DEMOGRAPHIC INFORMATION ------------------------------------------------- DIAGNOSTIC STATUS AGE AT DIAGNOSIS: | DATE OF BIRTH | CURRENT STATUS | DATE OF DEATH | STATE/TERRITORY OF DEATH AT REPORT (check one): | Mo. Day Yr. | Alive Dead Unk. | Mo. Day Yr. | | HIV Infection (not AIDS) | | | SEX: |RACE/ETHNICITY: |COUNTRY OF BIRTH: | White (not Hispanic) | | Black (not Hispanic) | | U.S. Dependencies and Possessions (in- | American Indian/ | | Not | cluding Puerto Rico (specify): | Islander Alaskan Native Specified || RESIDENCE AT DIAGNOSIS: State/ Country: - IV. FACILITY OF DIAGNOSIS ---- --------------------------------------- V. PATIENT HISTORY ----------------------------------- | | AFTER 1977 AND PRECEDING THE FIRST POSITIVE HIV ANTIBODY TEST | | FACILITY NAME: | | OR AIDS DIAGNOSIS, THIS PATIENT HAD (Respond to ALL Categories): Yes No Unk. | | | * Sex with male | City | | * Sex with female .......................................................... | | * Injected nonprescription drugs ........................................... | | State/Country | | * Received clotting factor for hemophilia/coagulation disorder ............. | | | | Specify disorder: | | Factor VIII | | Factor IX | | FACILITY SETTING (check one) | | * (Hemophilia A) (Hemophilia B) (specify): | Private | | * HETEROSEXUAL relations with any of the following: | | Unknown | | * Intravenous/injection drug user ........................................ | | | | * Bisexual male .......................................................... | | | | * Person with hemophilia/coagulation disorder ............................ | | FACILITY TYPE (check one) | | * Transfusion recipient with documented HIV infection .................... | | Physician,HMO | | * Transplant recipient with documented HIV infection ..................... | | Hospital,Inpatient | | * Person with AIDS or documented HIV infection, risk not specified ....... | | Other (specify): | | * Received transfusion of blood/blood components (other than clotting factor) | | * Received transplant of tissue/organs or artificial insemination .......... | | * Worked in a health-care or clinical laboratory setting ................... | | (specify occupation): ======================================================== VI. LABORATORY DATA ==================================================== | 1. HIV ANTIBODY TESTS AT DIAGNOSIS: Not Test Date | Mo. Yr. | | (Indicate FIRST test) Pos Neg Ind Done Mo. Yr. | * Date of last documented NEGATIVE HIV test #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### ####################