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