Software version 5.2.1 July 2009 Installation and setup guide 3M Connections Software ™ 3 Document number 07/09 05–016 3M™ Codefinder™ - Copyright© 1987-2009 3M. All rights reserved. It is the policy of 3M to improve products as new technology and software become available. Because of this, 3M reserves the right to make changes in the specifications and materials contained herein without notice. All features, functions, and operations described herein may not be available in all locations. Consult your 3M representative for the latest information. 3M and the Commonwealth of Australia shall not be liable for any direct, indirect, special, consequential, or other damages or economic loss arising out of any use of, errors in using, or inability to use this document. 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This document and the information contained in it may not be used, copied, reproduced, stored in a retrieval system or transmitted in whole or part without prior written permission of 3M and the Commonwealth of Australia. ————————————————————————————————————————————————————————————————————————————————————————————————————— 3M Health Information Systems 3M Australia Pty Ltd 950 Pacific Highway Pymble NSW 2073 For production information and support within Australia, call (1800)-029 706 For production information and support in New Zealand, call (0800)-444 639 ————————————————————————————————————————————————————————————————————————————————————————————————————— This manual was written, designed, and produced by the Documentation Department of 3M Health Information Systems. 3M is a trademark of 3M Company. AR-DRG AR-DRG AR-DRG AR-DRG AR-DRG AR-DRG Version Version Version Version Version Version 6.0 5.2 5.1 5.0 4.2 4.1 Classification Classification Classification Classification Classification Classification © © © © © © Commonwealth Commonwealth Commonwealth Commonwealth Commonwealth Commonwealth of of of of of of Australia Australia Australia Australia Australia Australia 2008 2006 2004 2002 2000 1998 ICD-10-AM, Sixth Edition and associated mappings from and to ICD-10-AM, Second, Third, Fourth and Fifth editions (if applicable): Copyright Commonwealth of Australia 2008, AND Based on the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) Copyright World Health Organization 2004. All rights reserved. Modified by permission for Australian Government purposes. ii 3M Connections Software Installation and Setup Guide 07/09 Australian Classification of Health Interventions (ACHI) and associated mappings for ACHI/MBSE Second, Third, Fourth and Fifth Editions and Australian Coding Standards (ACS) Sixth Edition: Copyright Commonwealth of Australia 2008 Microsoft and Windows are registered trademarks of Microsoft Corporation in the United States and/or other countries. Adobe, Acrobat, and Reader are either registered trademarks or trademarks of Adobe Systems Incorporated in the United States and/or other countries. 07/09 iii iv 3M Connections Software Installation and Setup Guide 07/09 Contents Chapter 1 3M Connections Software basics 1.3 1.3 How the 3M™ Codefinder™ software works 1.4 How the interfaced 3M Codefinder works 1.8 Interface options 1.9 Basic (32-bit DLL) 1.9 TCP/IP 1.11 Programming languages (Basic option) 1.13 Data formats 1.14 Tagged data format 1.14 HL7 data format 1.14 Code display formats 1.15 Legacy display format 1.15 CodAllTags display format 1.16 Reimbursement data 1.17 Processing options 1.19 Utilities 1.20 Summary of interface choices 1.21 Interface responsibilities 1.22 Interface developer 1.22 3M 1.22 Requirements: Chapter 2 Installing and updating the Connections Software 2.3 Installing and configuring 3M Connections Software 2.4 Conventional file-server/client installations 2.4 Thin-client installations 2.4 Software security 2.4 Installation prerequisites 2.5 Installing the software 2.6 Updating the software 2.7 File descriptions and .ini and registry information 2.8 Basic option - file descriptions 2.8 07/09 Contents iii TCP/IP option - file descriptions 2.9 Chapter 3 Creating the vendor interface 3.3 Using the CFINT32.DLL (dynamic link library) 3.4 Guidelines 3.5 CFINT32.DLL function calls 3.6 Testing the function calls 3.9 Testing the Basic interface: Tagged format 3.9 Testing the Basic interface: HL7 format 3.10 Testing TCP/IP function calls 3.12 Chapter 4 Creating a tagged format file 4.3 Code display formats 4.4 Legacy display format 4.4 Code All Tags display format 4.5 Designing the input packet 4.7 Sample packets 4.8 General requirements 4.9 Basic requirements for Single-record/interactive batch input packet 4.10 Basic requirements for Automatic batch input packet 4.10 Grouper ( payor) specific requirements 4.11 Output packet description 4.13 Tags for the Coding and Reimbursement System 4.16 End of record 4.36 How codes and code information are sent and returned 4.37 Codefind.ini settings 4.38 Legacy and Code All Tags display formats 4.39 Returning code-related information (TXT: and TXI:) 4.41 “Block” number prefix to procedure code description 4.42 Returning DRG text 4.49 Code formats 4.50 The format of inpatient codes 4.50 Morphology/Diagnosis code pairing 4.51 Sequencing of † and * codes pairs and Morphology Codes 4.63 Inpatient packet examples 4.64 Output packet examples 4.66 Chapter 5 Chapter 6 Creating an HL7 format packet 5.3 HL7 processing in 3M Connections Software Utilities Intredit tool 5.4 6.3 6.4 Modifying the codefind.ini file Modifying the Registry 6.6 6.5 Interface Test Packet tool (IPKTST32) 6.8 New input files 6.9 Using existing input packets 6.11 Unload program (UNLOAD32.EXE) 6.13 Debug Display tool (debug32.exe) 6.15 Debug Display for tagged format packets 6.15 Debug Display for HL7 format packets 6.17 Debug Display with TCP/IP 6.19 ERRLOG.TXT 6.20 Batch processing (CFWINFIL.EXE) 6.21 iv Introduction to the 3M™ Codefinder™ Software 07/09 Creating an input file for batch processing Configuring the batch option 6.22 Running the batch file 6.22 Additional parameters 6.24 6.21 Tags.txt Editor utility 6.28 TAGS.TXT file 6.28 Using the Tags.txt Editor (TAG.EXE) Appendix A 6.31 Reimbursement options A.3 Australian State of Victoria—WIES reimbursement Victoria WIES reimbursement overview A.4 Data requirements for reimbursement A.5 Input tags A.6 Output tags A.7 Sample data packet for reimbursement A.11 New Zealand—WIES reimbursement A.13 Data requirements for WIES A.13 Input tags A.14 Sample data packet for reimbursement A.17 Index 07/09 A.4 I.1 Contents v vi Introduction to the 3M™ Codefinder™ Software 07/09 Figures Figure 1–1 1–2 5–1 07/09 Title and page Flow of data on the Interface between Codefinder and the PMI system 1.8 Basic interface data flow 1.10 Basic interface data flow 5.4 Figures vii viii Introduction to the 3M™ Codefinder™ Software 07/09 Tables Table 2–1 3–1 4–1 4–2 4–3 4–4 4–5 4–6 6–1 A–1 A–2 A–3 A–4 07/09 Title and page Installation prerequisites 2.5 CFINT32.DLL function calls 3.6 Input requirements for 3M groupers 4.12 Codefinder interface tags 4.17 Relationship of display formats, .ini settings, and TXT:/TXI: values 4.46 TXT choices with Legacy display format 4.47 Relationship of DTXAllTags and Legacy/Code All Tags 4.49 Inpatient code formats 4.50 Default TAGS.TXT values 6.30 Input tags A.6 WIES reimbursement output tags A.8 WIES reimbursement input tags A.14 WIES reimbursement output tags A.15 Tables ix x Introduction to the 3M™ Codefinder™ Software 07/09 Chapter 1 3M Connections Software basics 1 1.2 Introduction to the 3M™ Codefinder™ Software 07/09 Chapter 1 3M Connections Software basics THE 3M™ CODEFINDER™ SOFTWARE is a 32 bit Windows® application that uses expert system technology to guide a medical records coder in assigning diagnosis and procedure codes in accordance with coding guidelines. It can be installed locally on the C: drive of a PC, and, though not a true client/server application, installed on a server and run in a server/node configuration. It can also be installed in thin client or Citrix® environments. The 3M™ Connections software provides an interface that allows Codefinder to communicate with hospitals’ Patient Management Information (PMI) systems. The Connections software option to be used, is installed and configured as part of the installation of Codefinder. Requirements: 07/09 Please refer to the latest 3M™ Codefinder™ System Configuration document. This can be found in the “Readme” folder on the CD containing the latest release of the 3M Codefinder software. 3M Connections Software basics1.3 How the 3M™ Codefinder™ software works When the Codefinder software is used by a coder in the medical records department in stand-alone mode (that is, not interfaced to a PMI system), the Patient Information window is presented first. The default coding product and grouper that will be used is displayed on the right hand side of the window. These could be changed, if required, using the dropdown field options. Patient demographic information is entered by the coder at this window. This information is used in coding, grouping and the calculation of reimbursement. The coder then clicks on the Continue button. 1.4 Introduction to the 3M™ Codefinder™ Software 07/09 How the 3M™ Codefinder™ software works At the next screen, the coder selects the mode of Separation from those presented, referring to that documented in the medical record. The diagnosis screen is then presented. Diagnoses codes are arrived at by the coder entering keywords as found in the medical record and choosing items from short menus presented by Codefinder. When the diagnosis or diagnoses have been assigned, the procedure codes are then assigned in the same 07/09 3M Connections Software basics1.5 How the 3M™ Codefinder™ software works manner. At the end of the process, the diagnosis and procedure codes assigned are presented in the Patient Summary Code window. At this window the coder has the option to reorder the codes, delete codes, edit the code text, add code modifiers, add a doctor’s name and date of procedure to a procedure code, copy and paste codes, view Coding Reference information, and view or add notes to the codes. The coder then clicks the Compute DRG button to have the software group the codes. Also, if reimbursement was enabled, it is calculated. 1.6 Introduction to the 3M™ Codefinder™ Software 07/09 How the 3M™ Codefinder™ software works The Patient Summary window is updated with the results of the grouping process. The coder then has the option of printing the results before selecting the Next Patient button and repeating the process for the next patient episode to be coded. 07/09 3M Connections Software basics1.7 How the interfaced 3M Codefinder works Typically, Codefinder is interfaced to a hospital’s PMI system. This allows patient demographic data that resides on the PMI to be passed directly to Codefinder, eliminating the need for manual entry. At the completion of the coding and grouping process, the codes and grouper information generated by the session is passed back to the PMI system so that it can be stored in the patient record, eliminating the need for manual entry of this data into the PMI system. PMI System The coder initiates the coding session from within the PMI system, usually by pressing a button. Vendor interface component The vendor interface creates an input packet. This packet often specifies the product and grouper to be used and contains demographic information. Input packet to Codefinder The vendor interface makes the appropriate function calls to Codefinder and passes the input packet. Codefinder The coder completes the coding session and groups the codes. Output packet from Codefinder Vendor interface component The output packet is passed from Codefinder back to the vendor interface. The vendor interface translates the Codefinder output packet and transfers the data back into the patient record in the PMI system. PMI System Figure 1–1. system 1.8 Introduction to the 3M™ Codefinder™ Software Flow of data on the Interface between Codefinder and the PMI 07/09 Interface options Creating an interface is the responsibility of the developer of the PMI system. This involves creating the input data packet, communicating with Codefinder, sending and retrieving of data packets to and from Codefinder and storing the received data in the PMI database. Interface options The Connections Software offers two interface options. 1. BASIC (32bit Windows® DLL) 2. TCP/IP (Transmission Control Protocol/ Internet Protocol) The interface option chosen is dependant on the operating system (O/S) that the hosting PMI system runs under. PMI systems that run under Windows® O/S generally use the Basic option (32bit Windows® DLL). As Codefinder is also a Windows® application this provides a very high speed interface as the PMI communicates with Codefinder in the same memory space, using Windows® function calls. PMI systems that run on hardware and O/S systems that are totally independent of that on which Codefinder runs (PC and Windows®), generally use the TCP/IP option to interface. The interface option to be used is installed and configured as part of the installation of the Codefinder software. This is covered in chapter 2 of this manual. Basic (32-bit DLL) How the Basic interface works 07/09 The Basic option uses a 3M 32-bit Windows ™ DLL (CFINT32.DLL). This installs along with other interface files to the \3MHIS\WINCODER\INTERFAC directory on the drive where the Codefinder software resides. The data formats supported are 3M tag variable length record and HL7. While at a patient record in the PMI system, the coder initiates a coding session, usually by clicking a button or an icon on the screen. This initiates the host interface program that then creates an input data packet with the patient’s demographic information from the PMI database. The host interface then makes a function call to the Windows® O/S to load CFINT32.DLL. When loaded, CFINT32 in turn loads Codefinder. The host interface then passes the data packet through memory to CFINT32 using Windows® function calls. CFINT32 in turn passes it to 3M Connections Software basics1.9 Interface options Codefinder and gives Codefinder focus bringing it up for the coder to start the coding. When coding is complete, Codefinder creates a data packet containing the information from the coding session and passes it back to CFINT32. CFINT32 then passes it back to the host interface. The host interface processes the received data and stores it in relevant fields of the PMI database for that patient record. While the PMI is running the host interface can, after the first initiation of CFINT32, keep it in memory minimised, for subsequent calls, till the PMI is shut down by the user. Alternatively, it can be initiated each time the host interface is called. It is adviseable to use the former, as this avoids multiple initiations and releases of CFINT32. If the data is sent in HL7 format, CFINT32, after receiving the data packet from the host interface, calls the HL723M32.EXE program and passes the HL7 packet to it. HL723M32 stores the HL7 header information and passes the packet to the pre/post processor PP32.EXE. The pre/post processor converts the HL7 data to the 3M tagged data format and passes it back to CFINT32 which passes to Codefinder. This process is reversed when coding is completed. CFINT32 receives a data packet from Codefinder in 3M tagged data format and passes it to PP32 where it is converted to a HL7 data packet. HL723M32 adds the saved header information and the completed HL7 data packet is sent back to the host interface program to be processed by CFINT32. PMI System Input packet data (usually demographics but can be anything) 3M Coding and Reimbursement System Vendor interface CFINT32.DLL Coding and grouping session output packet Data from output packet HL7 only PrePost Processor HLT23M32.EXE PrePost Processor PP32.EXE Figure 1–2. 1.10 Introduction to the 3M™ Codefinder™ Software Basic interface data flow 07/09 Interface options TCP/IP TCP/IP terminology The TCP/IP option installs interface software to the \3MHIS\WINCODER\INTERFAC directory on the drive where the Codefinder software resides. This includes a TCP/IP server and CFINT32.DLL and other interface files. The data formats supported are 3M tag variable length record and the HL7. Glossary of terms that are used in reference to the TCP/IP interface. TCP/IP server. The TCP/IP server is a software program that is executed on the PC that runs Codefinder. The host interface application, on the system that the PMI resides on, communicates with this TCP/IP Server. When the TCP/IP server is started it in turn loads files that control the coding system. This includes the CFINT32.DLL. Interface or Client application. The host interface or client application resides on the PMI system where patient data is stored. This interface program constructs and sends the input packet to the TCP/IP server on the PC that Codefinder runs on. It also processes the data returned by the TCP/IP server, from the completed coding session. Terminal emulator. Software that allows a PC to act as a specific type of dumb computer terminal. The emulator allows the user to communicate with the PMI application running on another hardware platform from the PC on which Codefinder is running. Interface files. Other files included with the 3M Connections software that allow the TCP/IP server to send and receive data from the Codefinder. How the TCP/IP interface works The coder initiates the 3M TCP/IP interface by clicking the “CF tcp-ip interface” icon on the desktop of the PC that runs Codefinder. This loads the 3M TCP/IP server program and shows it minimized. It sits, listening on the port specified in the command line of the start up icon, for the host interface program to connect. The coder starts up the PMI system, generally using a Terminal emulator on the PC running Codefinder. The PMI initiates the host interface program that communicates with the TCP/IP server and makes the connection. The status of the TCP/IP Server connection could be checked if necessary, by maximizing the TCP/IP server application (in the task bar). The “Systems Connected to Server” window displayed shows the active connections if there are any. While at a patient record in the PMI system, the coder initiates a coding session, usually by clicking a button or an icon on the screen. This initiates the host interface program that then creates 07/09 3M Connections Software basics1.11 Interface options an input data packet with the patients demographic information from the PMI database. A header (escape sequence) and an end of record (EOR) sequence is added to the record before it is sent to the TCP/IP server. When the TCP/IP server recognizes the header sequence of the data packet it reads and stores the data being sent till it sees the EOR sequence. The data packet with the header and EOR sequence stripped is sent to CFINT32.DLL. CFINT32 in turn passes this data to Codefinder and gives Codefinder focus bringing it up for the coder to start the coding. When coding is complete, Codefinder creates a data packet containing the information from the coding session and passes it back to CFINT32. CFINT32 then passes it back to the TCP/IP server where the header and EOR sequence are added prior to the packet being passed back to the host interface. The host interface strips the header and EOR sequence then processes the received data and stores it in relevant fields of the PMI database for that patient record. If the data is sent in HL7 format, CFINT32 after receiving the data packet from the TCP/IP server, calls the HL723M32.EXE program and passes the HL7 packet to it. HL723M32 stores the HL7 header information and passes the packet to the pre/post processor PP32.EXE. The pre/post processor converts the HL7 data to the 3M tagged data format and passes it back to CFINT32 which passes to Codefinder. This process is reversed when coding is completed. CFINT32 receives a data packet from Codefinder in 3M tagged data format and passes it to PP32 where it is converted to a HL7 data packet. HL723M32 adds the saved header information and the completed HL7 data packet is sent back to the host interface program to be processed by CFINT32. Codefinder uses a codefind.ini that resides in the Windows or WinNT directory on the PC that it is running on to find the locations of other programs that it requires to interact with. This includes the path to the CFINT32.DLL program. Some of this information is duplicated in the Registry in HKEY_LOCAL_MACHINE\Software\3M\HIS\Interface 1.12 Introduction to the 3M™ Codefinder™ Software 07/09 Programming languages (Basic option) With the Basic option the PMI system, host interface program and Codefinder run in the same PC or virtual PC environment. The host interface program is required to takes data from the PMI database, convert it into a 3M tag variable length record, make function calls to Windows® O/S to load and communicate with CFINIT32.DLL, send and receive the data packets to CFINT32 and process the received packet putting the data into the PMI database. The host interface program can be developed using C/C++, Visual Basic or the Java programming language. The 3M dynamic link library CFINT32.DLL, located in the \3MHIS\ WINCODER\INTERFAC directory, contains the Connections Software API functions calls. There are six function calls supported by CFINT32 Dynamic link library. These are listed below. A sample program could be written using just five of the six function calls. The sixth, Check Status, is useful in finding out the status of the interface. Other function calls have been added to increase the functionality when needed. These calls and guidelines for using them are discussed in Chapter 3. ◆ ◆ ◆ ◆ ◆ ◆ 07/09 Initiate Instance Write Packet Read Packet Codefinder Focus Release Instance Check Status 3M Connections Software basics1.13 Data formats Data can be sent to and from the Connections Software in one of two data formats: 3M tagged or HL7. The Basic and TCP/IP interface options can use either data format. Tagged data format Sample tagged input packet HL7 data format Sample HL7 data format packet The 3M tagged data is a 3M proprietary format used to pass coding, grouping, and reimbursement information to and from Codefinder. It is a variable-length format consisting of multiple fields. Each field is identified with a tag and they are separated with line feeds. The field data elements vary in length depending on the amount and type of information they contain. The start of record is identified by the CMD: and the end of the record by the tag EOR:. Chapter 4 contains information on all the tags (reimbursement tags are listed in appendix A) and how to use them. CMD:004 PAY:0 PID:Test Patient SEX:F AGE:55 DSP:1 ADT:01/10/2004 DDT:01/10/2004 EOR: The HL7 data format uses the standard HL7 segments and fields along with a number of segments and fields created by 3M for the Coding System. The Coding System does not process the HL7 format directly. 3M Connections Software includes programs that translate the HL7 format to the 3M proprietary tagged format and back again. Note: The following sample contains ICD-9 codes, and is for example purposes only. MSH|^~\&|from|01|encoder||19991119173607||P10|||2.3 PID||1|222334455|1|BISHOP|||19700921|F| PV1||0|0^CARPAL TUNNEL SYNDROME^19|||F|1||||||||1| PR1|2||0443^RELEASE OF CARPAL TUNNEL^I9|||||||||||2| PR1|3||29848^ARTHROSCOPY WRIST LEG REL^CP|||||||||||3| ZIN||013|23|||| The HL7 uses the Codefinder “Code All Tags” code display format (see page 1.16). This requires the “CodAllTags=” setting in the codefind.ini file to be set to “YES.” Refer to chapter 4 for further details. Chapter 5 contains information on the HL7 input and output segments and on creating input packets. 1.14 Introduction to the 3M™ Codefinder™ Software 07/09 Code display formats The codes and associated code information, such as code text, physician ID, and procedure date, can be presented in two different code display formats. The choice of code display format is made through a setting in the codefind.ini file. Legacy display format Sample packet using the legacy display format The Legacy display format was developed for the original Codefinder. This format returns Diagnosis and Procedure codes along with their associated information in a single block under one COD: tag. The value sent with COD: tag indicates the number of codes in the block. DRG, MDC and PCCL are returned in this block and included in the COD: value. The Diagnosis, Procedure, DRG, MDC and PCCL codes are identified by a specific prefix followed by a period then the code. Code descriptions, physician ID, and procedure date follow the code on separate lines. CMD:004 PID:Test Packet 3. Legacy format of I10E3 record PAY:11 SYS:0 DDT:10/07/02 ADT:07/07/02 DSP:9 AGE:70 SEX:1 MRP:1 HMV:12 COD:7 T.C341-00 TM.81403-00 T.C787-01 T.C7988-01 TM.81406-01 T.D485-02 TM.88211-02 EOR: Diagnosis/Morphology code pairing numbers are concatenated with the codes as are grouper flags. Diagnosis/Morphology code pairing numbers: *T.C793-01 TM.M81406-01 Grouper flags: T.O049-ARE1-ARCL0 07/09 3M Connections Software basics1.15 Code display formats The Legacy code display format is only maintained for compatibility with old interfaces. All new interfaces must be developed using the CodAllTags code display format. Old interfaces using the legacy code display format must be converted to the ‘CodAllTags’ format when it is modified to add new functionality to the interface. CodAllTags display format Sample packet using the Code All Tags display format ➤ The ‘CodeAllTag’ code display format uses a tag for each code and for associated information in the block of codes. Each code is sent in a COD: tag followed by a prefix, a period, and then the code. CMD:004 PID:Test Packet 6. I10E3 input packet format is CodAllTags PAY:11 SYS:0 DDT:12/07/2002 ADT:07/07/2002 DSP:9 AGE:34 SEX:2 COD:T.O049 COD:T.O350 COD:T.O091 COD:ACHI.3564302 DATE:04/07/2002 PHYS:DrSmith TXT: DTX: EOR: Note: Use of HL7 format requires the Code All Tags display format. Chapter 4 discusses the creation of tagged input data packets for both code display formats as well as the format of the output data packet. 1.16 Introduction to the 3M™ Codefinder™ Software 07/09 Reimbursement data ➤ Note: Packet samples here show the Victorian WIES reimbursement structure. Please refer to appendix A for further information on alternate formats. When reimbursement is turned on, the AUR: tag is used to pass additional elements of data, available on the PMI system and required in the calculation, to Codefinder. If these additional elements are not sent, defaults values will be used making the outcome less accurate. Sample RCS input packet, AR-DRG V5.1 grouper CMD:004 AUR:CTYPE=4|CROLE=A|ACLS=MP|ATSI=2 PID: Sample data required to initiate 3M Codefinder with reimbursement. PAY:33 MDC:2 VSN:1 RV3:0 SEX:2 AGE:40 DSP:09 DDT:12/01/2005 ADT:01/01/2005 ISD:0 MLS:2 HMV:5 LOS:11 LEV:2 COD:T.D569 COD:T.I10 MRP:1 TXT: DTX:1 EOR: Reimbursement information is passed in the output packet under the RCS: Tag. Only elements that do not evaluate to zero are passed back. Sample RCS output packet, AR-DRG V5.1 grouper 07/09 ERR:0 ETX:(3M CF) No Error PID: Sample data required to initiate 3M Codefinder with reimbursement. COD: R.Q61C TEXT:RED BLOOD CELL DISORDERS W/O CATASTROPHIC or SEVERE CC COD: T.D569 TEXT:Thalassaemia, unspecified COD: T.I10 TEXT:Essential (primary) hypertension COD: PCCL.0 TEXT:PCCL 0 - SDX is not a CC, or is included in ADRG definition, or is excluded 3M Connections Software basics1.17 Reimbursement data COD: MDC.16 TEXT:DISEASES & DISORDERS OF BLOOD, BLOOD FORMING ORGANS, IMMUNOLOG DISORD COD: VSN.I10E4 COD: VSN.AR50 ALOS:2.3 RCS: TREIMB:4131.55 DRGWT:1.4154 TOTWT:1.4154 BWIES:1.1506 BRATE:2919.00 PAYER:Public VICDRG:Q61C LOSCAT:M THALCP:0.2648 STN:2 STX:High Outlier EOR:34 All the values that can be returned by the RCS: tag RCS: TREIMB:4131.55 DRGWT:1.4154 TOTWT:1.4154 ATSICP:0.0000 BWIES:1.1506 BRATE:2919.00 PAYER:Public RURISO:0.00 VICDRG:Q61C LOSCAT:M MVCP:0.0000 AAACP:0.0000 ASDCP:0.0000 THALCP:0.2648 COLONCP:0.0000 STN:2 STX:High Outlier Some information required in the calculation may not be available on the PMI to be passed in the input packet and may be entered by the coder during the coding session. When batch grouping this information must be passed in the input packet. 1.18 Introduction to the 3M™ Codefinder™ Software 07/09 Processing options Patient records can be processed through Codefinder in one of two ways. This is controlled by the value passed in the CMD: tag: 1. Interactive (Coding and Grouping) Interactive processing is done one record at a time. From the PMI system, the coder initiates a coding session. Codefinder is launched and presented to the coder by the interface. When coding is completed and the episode grouped, the data from that session is returned to the PMI system. 2. Batch (Grouping) Batch mode is used for grouping patient episodes that have been previously coded. There is no interaction by a coder with the process. Each patient record on the PMI that requires to be grouped is sent to Codefinder by the interface. Codefinder groups the record and returns the data to the PMI system. The input requirements are substantially higher for batch processing as the diagnosis and procedure codes, along with other information that impacts the assignment of the DRG must be sent in the input packet. See page 4.8 in Chapter 4 for batch requirements. 07/09 3M Connections Software basics1.19 Utilities The Connections Software package provides several utilities that can be used to modify, test, and troubleshoot the packets and perform other setup and maintenance tasks. ◆ The Intredit utility is used to modify the codefind.ini file or registry settings. ◆ The Interface Test Program provides a way to test the input and output packets. ◆ The Unload utility is used to unload the Codefinder DLL, if it is left orphaned. ◆ The Debug tool displays function calls and the packets sent to and from Codefinder. ◆ The Codefinder Stand-alone program can be used to run a concurrent Codefinder session without exiting the interfaced session. ◆ The Tags.text editor tool is used to set the default output operation of a tag. ◆ The Batch Interface program is used to process a file of patient records, either interactively for coding, or for grouping a previously coded batch of patient records. The use of these utilities is covered in chapter 6. 1.20 Introduction to the 3M™ Codefinder™ Software 07/09 Summary of interface choices The table below summarizes the choices available to develop an interface to Codefinder. In general, a specific choice in one criterion does not preclude choices in the other criteria. For example, the choice of communications mode does not affect the choice of programming language or data format. Communication mode Basic Interface (dll) TCP/IP Programming language C/C++ C# Visual Basic Java Data format Tagged HL7 Code display format (tagged) CodeAllTags Processing option 07/09 Interactive (Coding and Grouping) Batch (Grouping only) 3M Connections Software basics1.21 Interface responsibilities The responsibilities of a vendor for the creation of the interface are listed below, as well as the specific responsibilities of 3M. Interface developer 3M Information 3M needs from vendors: ◆ Signed and returned Confidential Disclosure agreement ◆ Contact name and number for ongoing communications Information and services provided by 3M: ◆ Confidential Disclosure Agreements (software, documentation, and updates in a timely manner) ◆ Technical support (8:00 a.m. until 5:00 p.m. EST) ◆ Sample files or data packets to help test communications, error tracking, and debugging ◆ Consultation during the design of the interface ◆ Help with software Installation, interface development, testing and debugging ◆ Making update software available for testing the interface prior to general release 1.22 Introduction to the 3M™ Codefinder™ Software 07/09 Chapter 2 Installing and updating the Connections Software 2 2.2 Introduction to the 3M™ Codefinder™ Software 07/09 Chapter 2 Installing and updating the Connections Software B EFORE AND DURING THE SOFTWARE INSTALLATION, certain responsibilities must be completed by both the vendor and 3M. These are listed on page 1.22 in the Connections Software Basics chapter. The 3M™ Connections Software is installed as part of the installation of the 3M™ Codefinder software. The actual installation involves both the vendor and a 3M support representative. The remainder of this chapter contains instructions for installing and configuring the software. 07/09 Installing and updating the Connections Software2.3 Installing and configuring 3M Connections Software Conventional file-server/client installations The software can be installed to the local drive of a PC for standalone operation or to a network drive and made available to multiple PCs. For network installations, the file server install is performed from a client PC that is to be sued for creating and testing the interface. If additional PCs are required to run Codefinder, client/node installation are performed on these PCs. This done from setup program that resides under the install directory that is created by the initial install to the network drive. Thin-client installations You can install the software to run in thin client on a terminal server. Install the master image to an application server using a fat client. Then log into a thin client session on the terminal server and perform a node install from the install directory on the application server. Then publish the profile created to all user logins that will use Codefinder. The software can also be installed to the application server using a thin client session. In Terminal server farms it is preferable to allocate Codefinder to run on the same terminal server all the time. If this is not possible users will need to maintain a list of security keys for each terminal server in the farm as the key is different for each of them. Software security The Codefinder software is setup to use Getkey security. A security key is required for each stand-alone PC, client PC or Terminal server. These keys are provided by the 3M technical support person when assisting with the initial installation of the software and when performing a client/node install. 2.4 Introduction to the 3M™ Codefinder™ Software 07/09 Installing and configuring 3M Connections Software Installation prerequisites The installation will require the most current 3M™ Codefinder™ Install/Update CD. Establish the type of installation that is to be performed, stand-alone or server. Decide on which option you will be using to develop the interface, Basic or TCP/IP. Table 2–1 outlines the prerequisites for the different types of installation. Table 2–1. Installation prerequisites Windows NetWare server Windows server ◆ Win 2003 Standard, Enterprise & Datacenter (32bit only) ◆ Citrix® Presentation™ Server 3.0 NetWare server Novell NetWare 5.1 or 6.x ◆ Workstation ◆ TCP/IP protocol ◆ Mapped network drive to appropriate share ◆ CDROM drive Administrator rights on server and Workstation to ◆ Create a directory ◆ Write registry entries ◆ Create/Delete files Stand-alone PC ◆ Workstation TCP/IP or IPX/SPX protocol ◆ Mapped network drive to the appropriate share ◆ CDROM drive Workstation ◆ Windows -XP S/P 1 ◆ CDROM drive Administrator rights on server and Workstation to ◆ Create a directory ◆ Write registry entries ◆ Create/Delete files Administrator rights on server and Workstation to ◆ Create a directory ◆ Write registry entries ◆ Create/Delete files Please refer to the 3M System Configuration document found in the Readme folder on the Software CD for updated information on hardware configuration. HL7 07/09 If you are sending and receiving HL7 packets, establish if the packets are formatted with a line feed or a carriage return as the new line character. The HL7 standard is to have a carriage return as the new line character. If the new line character is not a carriage return then the PcktProcessorExe2 entry in the registry must be edited and pre=-h post=-h added to the end of the line as shown below (HKEY_LOCAL_MACHINE\SOFTWARE\3M\HIS\Interface). Installing and updating the Connections Software2.5 Installing and configuring 3M Connections Software ❑ Installing the software If necessary, go to the Registry and add pre=-h post=-h to the end of the PcktProcessorExe2 line. The initial installation of Codefinder and the Connections software will be performed with the assistance of the 3M technical support person over the phone. Call 3M Technical support on1 800 029 706 (Australia) or 0 800 444 639 (New Zealand) The server installation needs to be performed from a client PC. The PC will require a mapped drive on the server where the software is to be installed. Additional client PCs can be setup at same time as the initial installation or later. This requires mapping a drive on the client PC to the share on the server where Codefinder is installed then running the setup.exe found in ?:\3MHIS\Install\Codefindr directory on the server. A security key will need to be obtained from 3M technical support at the appropriate time during the install. This setup will create registry keys and a Codefind.ini in file in the Windows or Winnt directory on the client PC with pointers to the software loaded on the server. 2.6 Introduction to the 3M™ Codefinder™ Software 07/09 Installing and configuring 3M Connections Software Updating the software ➤ Before you begin ❑ The 3M Codefinder Software is updated at least twice per year. ◆ January release. This release includes enhancements and fixes. ◆ June release This release includes mandated changes to Coding and Grouping, enhancements and fixes. Note: When the update is run to a network installation, only the CODEFIND.INI file of the client PC (node) the update was run from will be updated. If there are changes to the INI file that are required on each client PC or you are advised by 3M, run the update on each client PC to implement these changes. You should always run the update from the same client PC used to install the software if possible. Before you begin you must: ◆ Have administrator rights ◆ Update Windows to the latest service packs ◆ Load all previous Codefinder updates ◆ Run the update from a PC that has the Codefinder loaded; preferably the PC used for the initial install Make sure all users are out of Codefinder and their PC’s turned off. Turn on the PC that the update is to be run from. If all users are not out of Codefinder the update will terminate. ❑ Insert the Codefinder CD into the CD drive. If the AutoRun feature is enabled the setup program will run automatically. If it is not, go to Start > Run, browse the Codefinder update CD for setup.exe, and launch it. ❑ Answer any prompts that appear. The status of the update is indicated on the progress indicator bar. You will receive a message when the update is complete Please consult the documentation accompanying each update CD. Changes may be required to the User Defined Grouper configurations and the Reimbursement module. Perform all other actions as requested in the documentation. 07/09 Installing and updating the Connections Software2.7 File descriptions and .ini and registry information Basic option - file descriptions Basic option - codefind.ini settings The following interface files are installed to \3MHIS\WINCODER\INTERFAC except TAGS.TXT, which is copied to \3MHIS\ENCODER. CFPARSE.DLL Application that parses incoming data (3M format only) so that the data can be sent into the coding software. It also parses data returning from the coding system according to the requirements of the CODEFIND.INI file and the TAGS.TXT file. CFINT32.DLL (32-bit only) Codefinder Interface Dynamic Link Library for 32-bit programs. It sends data to and reads data from the coding system software. CDF_???????.VI files Interface test packet: tagged format files for checking the basic interface with the interface test program. TAG.EXE TAGS.TXT editor program: displays information and allows you to modify information in the TAGS.TXT file. TAGS.TXT Contains setting for each TAG and resides in the 3MHIS\ENCODER directory IPKTST32.EXE The interface test program DEBUG32.EXE The interface debug program UNLOAD32.EXE The DLL unload program INTREDIT.EXE INI file and Registry editor CFSTDLAN.EXE Runs a second standalone copy of Codefinder The install program adds the following lines to the CODEFIND.INI file when using the PMI (host) interface. [Interface] CODAllTags=YES DTXAllTags= DecorateCodes= PassThroughSize=0 ReturnDeleteIndicators=NO TagTxtPath=X:\3MHIS\ENCODER\TAGS.TXT TXTWithCODAllTags=NO CfInt32DllPath=X:\3MHIS\WINCODER\INTERFAC\CFINT32.DLL ParseDLLPath=X:\3MHIS\WINCODER\INTERFAC\CFPARSE.DLL CfIntDLLPath=X:\3MHIS\WINCODER\INTERFAC\CFTHUNK.DLL Splashexe=X:\3MHIS\WINCODER\CDFSTART.EXE NOEXEC 2.8 Introduction to the 3M™ Codefinder™ Software 07/09 File descriptions and .ini and registry information Basic option - Registry entries (32-bit) The installation program adds these lines to the HKEY_Local_Machine\Software\3M\HIS\Interface folder in the Registry (Default) Cfint32DLLPath CfstdalnResend CodefindExe CodefindExeParams PcktProcessorExe SaveBeforeModifyPckt REG_SZ REG_SZ REG_DWORD REG_SZ REG_SZ REG_SZ REG_DWORD (value not set) X:\3MHIS\WINDCODER\INTERFAC\CFINT32.DLL 0x00000000 (0) X:\3MHIS\WINCODER\CODEFIND.EXF 0x00000000 (0) Substitute the drive letter where Codefinder resides on your installation for X: TCP/IP option - file descriptions 07/09 In addition to the files used to run the TCP/IP option, there are log files created that store information useful for diagnosing interface problems. These log files are located on the C:\ drive of the PC or in the location specified in the RIPDATA Registry key. They are only created when the software is in debug mode. TCPS.EXE (TCP/IP) 3M TCP/IP Server application. Resides in the 3MHIS\RIP\BIN directory. VIEWFILE.EXE (TCP/IP) Program that allows you to view the text file contents (for example, log files). Resides in the 3MHIS\RIP\BIN directory. 8000.PNC (TCP/IP) Default Port Number Configuration (PNC) file. The PNC file defines information about all connecting machines on a specific port. Resides in the 3MHIS\RIP\LIBDATA directory. CFINTER.CSC (TCP/IP) Connection Specific Configuration (CSC) file. Defines how data is exchanged between the coding system and another application. Resides in the 3MHIS\RIP\LIBDATA directory. 8000.LOG (Log) Contains startup and connection information for a specific port. Resides in the location specified in the registry entry “RipData” CFINTER.LOG (Log) Contains detailed information about TCP/IP connection and the data passed between Codefinder and the PMI system. Resides in the location specified in the registry entry “RipData” Generally C:\ Installing and updating the Connections Software2.9 File descriptions and .ini and registry information TCP/IP option - Codefind.ini settings TCP/IP option - Registry entries (32-bit) The install program adds the following lines to the CODEFIND.INI file. [Interface] CODAllTags=YES DTXAllTags= DecorateCodes= PassThroughSize=0 ReturnDeleteIndicators=NO TagTxtPath=X:\3MHIS\ENCODER\TAGS.TXT TXTWithCODAllTags=NO CfInt32DllPath=X:\3MHIS\WINCODER\INTERFAC\CFINT32.DLL ParseDLLPath=X:\3MHIS\WINCODER\INTERFAC\CFPARSE.DLL CfIntDLLPath=X:\3MHIS\WINCODER\INTERFAC\CFTHUNK.DLL Splashexe=X:\3MHIS\WINCODER\CDFSTART.EXE NOEXEC The installation program adds these lines to the HKEY_Local_Machine\Software\3M\HIS\Interface folder in the Registry (Default)REG_SZ Cfint32DLLPath CfstdalnResend CodefindExe CodefindExeParams PcktProcessorExe RipData RipLibdata SaveBeforeModifyPckt REG_SZ REG_DWORD REG_SZ REG_SZ REG_SZ REG_SZ REG_SZ REG_DWORD (value not set) X:\3MHIS\WINDCODER\INTERFAC\CFINT32.DLL 0x00000000 (0) X:\3MHIS\WINCODER\CODEFIND.EXF C:\ X:\3MHIS\RIP\DATA 0x00000000 (0) Substitute the drive letter where Codefinder resides on your installation for X: 2.10 Introduction to the 3M™ Codefinder™ Software 07/09 Chapter 3 Creating the vendor interface 3 3.2 Introduction to the 3M™ Codefinder™ Software 07/09 Chapter 3 Creating the vendor interface T HIS CHAPTER PROVIDES INFORMATION needed to create the vendor component of the interface. It assumes an in depth knowledge of interface programming for the PMI system application and focuses on 3M-specific information that is needed. The interface can be written using C/C++, Visual Basic, or Java programming languages. C/C++ would be the best choice as 3M™ Codefinder™ is written in this language. 07/09 Creating the vendor interface3.3 Using the CFINT32.DLL (dynamic link library) The dynamic link library CFINT32.DLL located in the \3MHIS\WINCODER\INTERFAC directory contain the Connections Software API extensions. You should use the CFINT32.DLL (Basic Option) when you develop 32-bit applications. A sample program can be written using five function calls located in the CFINT32.DLL link library: ◆ Initiate Instance: int nInitInstance(HWND hwnd, UINT nMessage) ◆ Write Packet: char* sWritePacket(char*sInPacket, int nInstance) or int nWritePacket(char*sInPacket, int nInstance) ◆ Read Packet: char* sReadPacket(int nInstance) ◆ Codefinder Focus: int nCodefinderFocus(int nInstance) ◆ Release Instance: int nReleaseInstance(int nInstance) The Check Status call is useful in finding out the status of the interface. ◆ Check Status: int nChkStatus(int nInstance) These calls are discussed in greater detail on page 3.6. Other function calls may be added, as needed, to increase the functionality. 3.4 Introduction to the 3M™ Codefinder™ Software 07/09 Using the CFINT32.DLL (dynamic link library) Guidelines 07/09 Use the following guidelines when creating an application using CFINT32.DLL. ◆ Declare all function calls for routines in the link library. ◆ Declare Windows 32 API calls to load the CFINT32.DLL library into memory. ◆ Call nInitInstance to load CFINT32.dll the first time the host PMI application first needs to interface to Codefinder to initiate a coding session and do not release the this instance till the PMI is shut down or the user logs out. Performance problems arise if nInitInstance is issued followed by a nReleaseInstance for each Coding session. ◆ Send in a unique message as the second argument to nInitInstance. CFINT32 will write this message back to the calling programs message loop when coding is complete. Write a handler that will read the coding session’s output packet when this message is received. ◆ Call the write packet function to send patient data to the coding software. ◆ Call the read packet function to copy the return packet into a string when the software is “aware” of an event notification message (a message in the message loop). ◆ Make sure nReleaseInstance is called when the PMI application is shut down. If this is not done CFINT32.DLL and Codefinder will remain loaded in memory. ◆ Do not send messages to resize the Codefinder window. These messages have caused problems in the past. The user can manually resize the Codefinder screens and the new setting will automatically be saved to the Codefind.in file. ◆ nChkStatus is useful in finding out the status of the interface. ◆ Please call 3M Technical support if you have any questions. Creating the vendor interface3.5 Using the CFINT32.DLL (dynamic link library) A sample interface program can be created using just five function calls located in the CFINT32 dynamic link library. New function calls maybe added in the future to increase functionality. The table below details the function call, it’s purpose, the function it provides, the format of call, the parameters passed and the return values. CFINT32.DLL function calls Table 3–1. CFINT32.DLL function calls Initiate Instance Creates a minimized instance of the Codefinder software and stores information detailing where to send an event notification message when an output packet is ready. Function Initiate Instance (returns integer value) Format int nInitInstance(HWND hwnd, UINT nMessage) The return value is the packet identifier or nInstance, which is used in the other functions. Parameters hwnd The calling program’s Windows handle. It indicates to the Windows application where nMessage should be sent when a call to the coding products is completed. If the value of hwnd is NULL, no message is sent. Note: When interfaced, the Codefinder software is minimized after coding a patient unless hwnd is no longer valid. Therefore, it is recommended that the calling program pass a Windows handle. Return value nMessage Sent by CFINT32.DLL to the calling program’s message loop to indicate to the calling program that the packet is ready to be read. Define nMessage in the calling program (i.e., WM_USERS). WM_USERS is the start of the user defined message range. nInitInstance Creates a minimized version of the Codefinder software. It also stores information detailing where to send an event notification message when an output packet is ready to be read. >0 0 -1 Valid instance identifier for Codefinder software Valid instance is not available Codefinder is not started Write Packet The nWritePacket function sends the input packet to the Codefinder software. To ensure that the Codefinder software is ready for input, the CheckStatus function can be used before a WritePacket is issued. Note: Each line of data in the input packet is terminated using a single Linefeed character and not a Carriage Return Linefeed sequence. Function 1 Write Packet (returns integer value) Format 1 char* sWritePacket(char*sInPacket, int nInstance) The component sInPacket points to the memory location of the PMI system’s input packet to the Codefinder software. This function returns a packet when the coding session is completed. The input packet uses the tagged variable-length record format. The nInstance component is the packet identifier returned from nInitInstance. 3.6 Introduction to the 3M™ Codefinder™ Software 07/09 Using the CFINT32.DLL (dynamic link library) Table 3–1. CFINT32.DLL function calls (continued) Parameters 1 sInPacket nInstance A string containing patient information passed to the Codefinder software An integer containing the instance of the Codefinder software Function 2 Write Packet (returns integer value) Format 2 int nWritePacket(char*sInPacket, int nInstance) This function returns a value that is the status of the packet or error condition. Error conditions are listed in the Return values section below. The component sInPacket points to the memory location of the PMI system’s input packet to the coding product. The input packet uses the Codefinder software tagged (variable-length) record format. The nInstance component is the packet identifier returned from nInitInstance. Parameters 2 sInPacket nInstance Return values 2 1 -1 -3 -4 -5 A string containing patient information passed to the Codefinder software An integer containing the instance of the Codefinder software Packet successfully received from application. Codefinder is not started. Invalid instance number passed. Error allocating memory for packet with CFINT32.DLL. Codefinder is currently processing a packet. Read Packet Returns the output packet from the Codefinder software Function Read Packet (returns character string) Format char* sReadPacket(int nInstance) Parameters nInstance Integer containing the instance of the Codefinder software Codefinder Focus Sends the focus to the Codefinder software where the instance is maximized Function Codefinder Focus (returns integer) Format int nCodefinderFocus(int nInstance) nInstance is the packet identifier returned from nInitInstance. Return values -3 -6 4 Invalid instance Codefinder not processing packet Message sent to Codefinder Check Status It may be necessary to place a delay timer in your interface to allow the Codefinder software to open. The check status function is also recommended to ensure a valid instance number was returned before issuing the nWrite packet. Function Check Status (returns integer) Format int nChkStatus(int nInstance) The return value indicates the packet status or error condition. nInstance is the packet identifier returned from the nInitInstance function call. 07/09 Creating the vendor interface3.7 Using the CFINT32.DLL (dynamic link library) Table 3–1. CFINT32.DLL function calls (continued) Return values -8 -7 -6 -5 -4 -3 -2 -1 0 1 2 3 4 Return packet is larger than the string buffer. Packet will not be copied. This number is only returned by the nVBReadPacket function. Codefinder executable not found, only returned by nInitInstance. Codefinder is not processing a record; only returned by nCodefinderFocus. Codefinder processing a packet and nWritePacket is called; only returned by nWritePacket. Error allocating memory for packet within CFINT32.DLL. Invalid instance number passed in. Instance not assigned to an application. Coding software did not start. Instance assigned to an application. Packet not received from application. Instance assigned to an application. Packet received from application. Coding software is processing packet. The coding software has completed processing. The calling application can read packet. Message sent to the coding software to maximize. Release Instance Closes the existing instance of the Codefinder software. The coding session associated with this instance is closed when this function is called. Function Release Instance (returns integer) Format int nReleaseInstance(int nInstance) nReleaseInstance terminates the active instance of Codefinder software. nInstance is the instance identifier returned from nInitInstance. Return values true -2 Parameter Return values 3.8 Error condition (invalid instance number) Instance 1 -1 -3 Integer containing the instance of the Codefinder software Indicates that Codefinder software was successfully terminated. An instance is not assigned to an application. Invalid instance number passed. Introduction to the 3M™ Codefinder™ Software 07/09 Testing the function calls Function calls, input and output data packets only reside in memory. The Debug Display tool provide with the Connections software is a means to view the function calls made and the data passed between the interface program and CFINT32.DLL during testing. To test the function calls, a tagged or HL7 format data packet will need to be created. See chapters 4 and 6 for information on creating input packets. Additional information on the Debug Display tool appears on page 6.14 in the Utilities chapter. Testing the Basic interface: Tagged format To test the function calls using a tagged format input packet, ❑ Launch your PMI application. ❑ In the 3MHIS\WINCODER\INTERFAC directory, execute DEBUG32.EXE. ❑ Minimize the Debug Display window. ❑ From the PMI application, launch Codefinder and complete the coding session. ❑ Maximize the Debug Display window. The left pane shows the function calls. Any errors will also be listed here. The right pane has two tabs, one to display the input packet and the other the output packet. 07/09 Creating the vendor interface3.9 Testing the function calls Running the Unload utility When you exit your PMI application, the interface program must close CFINT32. CFINT32 in turn will close Codefinder and all components that it opened. If CFINT32 is not closed, you will be unable to launch Codefinder again. If you encounter this situation, use the Unload32.exe utility to release CFINT32.DLL and the Codefinder application from memory To run the Unload utility to clear Codefinder from memory: ❑ In the 3MHIS\WINCODER\INTERFAC directory, execute the Unload32.exe program. ❑ First check if CODEFIND.EXF is displayed in the list. If so Highlight it and click the Unload button ❑ If CFINT32.DLL is displayed in the list Highlight it and click the Unload button. Repeat the process if more than one instance is in memory ➤ Note: Always select the CODEFIND.EXF file before you unload any other files. The selected files are unloaded from memory and disappear from the list in the unload program window. Testing the Basic interface: HL7 format Before testing the function calls using an HL7 format input packet, you need to make some changes to the Registry. ❑ From the 3MHIS\WINCODER\INTERFAC directory, launch INTREDIT.EXE. ❑ Choose HKEY_LOCAL_MACHINE > SOFTWARE > 3M > HIS > INTERFACE. ❑ Click on the PcktProcessExe2 line and modify it to read C:\3MHIS\RIP\BIN\PP32.EXE pre=-h post=-h. ❑ Click on the SaveBeforeModifyPckt line and change the (0) to (1). ❑ Exit INTREDIT. ❑ Launch your PMI application. ❑ In the 3MHIS\WWINCODER\INTERFAC directory, select DEBUG32.EXE. ❑ Minimize the Debug Display window. 3.10 Introduction to the 3M™ Codefinder™ Software 07/09 Testing the function calls ❑ From the PMI application, launch Codefinder and complete the coding session. ❑ Maximize the Debug Display window. ➤ Note: The above illustration contains an ICD-9 coded example. The left pane shows the function calls. Any errors will also be listed here. For HL7 testing, the right pane has four tabs displaying the following packets: ◆ ◆ ◆ ◆ PrePacket. Contains the original input file in HL7 format. Input Packet. Contains the input file that has been translated from HL7 to tagged format. Output Packet. Contains the Codefinder output file in tagged format. PostPacket. Contains the output file translated back into HL7 format. See page 6.16 in the Utilities chapter for examples of each packet. Running the Unload utility If an error occurs before running another test packet, you need to run the Unload32 utility to clear CFINT32.DLL and Codefinder from memory. See instructions on preceding page for running this utility. 07/09 Creating the vendor interface3.11 Testing the function calls Testing TCP/IP function calls ❑ Testing functions calls when using the TCP/IP option is the same as when testing the Basic interface, with the exception of making an adjustment to the Target statement for the TCP server desktop icon. Right click the 3M TCP server icon and choose Properties. The default statement should read: c:\3mhis\rip\bin\tcps.exe -i -p 8000 -l cfint32.dll (Note: The -l argument is a lower case L, not a capital I.) The components within the statement are: -p -l cfint32.dll -i ❑ Port number Launch CFINT32.DLL and Codefinder Run Codefinder (minimized) To enable the debug mode, add -D to the Target statement c:\3mhis\rip\bin\tcps.exe -i -p 8000 -l cfint32.dll -D TimeInfo log file Adding the -D to the target statement, creates a TimeInfo.log file in the interface directory. It lists the function calls and CPU time. The log is useful in determining if any function calls are not working properly. ❑ Add a string value named TimeFile in the Registry. Give it the value 1. ❑ To test the function calls using the DEBUG32 program, following the instructions in Basic Interface, tagged format (page 3.9), or Basic Interface, HL7 format (page 3.10). 3.12 Introduction to the 3M™ Codefinder™ Software 07/09 Chapter 4 Creating a tagged format file 4 4.2 Introduction to the 3M™ Codefinder™ Software 07/09 Chapter 4 Creating a tagged format file T HIS CHAPTER DESCRIBES the requirements for the input packet and covers tags used in the input and output packets. It also discusses how codes and text are returned and provides examples to help design the interface between a PMI system and Codefinder. Tagged format is a 3M proprietary architecture that provides flexibility in passing data between the coding, grouping and reimbursement functions of the Codefinder software with other programs. A record has multiple fields and is variable in length. Fields are identified by tags and the field data elements vary in length depending on the amount and type of information they contain. 07/09 Creating a tagged format file4.3 Code display formats The codes and associated code information, such as code text, physician ID, and procedure date, can be presented in the output file in two different code display formats: Legacy and Code All Tags. Development of new interfaces must use the Code All Tags display format. This new format provides flexibility in accommodating the increasing number of new casemix-related data elements being introduced and needing to be passed on the interface. Recommendation Legacy display format 4.4 It is advised that Legacy interfaces be changed to the Code All Tags display format when they require to be modified to accommodate any new data elements. The legacy display format was developed for the original DOS Codefinder Software and is maintained for these dated interfaces only. The Legacy display format, which was developed for the original DOS Codefinder Software, returns the codes and associated information in a single block under one tag “COD:xxx”, where xxx is a numeric value. This value reflects the number of codes being sent in the packet. The code is identified by a prefix followed by a period (T.T794). The following codes and their identifying prefixes in brackets, are included under this tag; Diagnosis codes (P.), Procedure codes (ACHI.), Morphology codes (TM), DRG (R.), MDC (MDC.), Code edition (VSN.), DRG version (VSN.) and PCCL (PCCL.). If enabled Code text, physician ID, and procedure date are positioned under each code with no prefix. DRG flags are concatenated with the code and separated by hyphens as are morphology / diagnosis code pairing numbers. Introduction to the 3M™ Codefinder™ Software 07/09 Code display formats Sample Output packet using the legacy display format With code edition, DRG version and DRG flags turned off ERR:0 ETX:(3M CF) No Error PID:Test Packet 6 TXT: COD:7 R.O05Z T.O049 T.O350 T.O091 ACHI.3564302 PCCL.0 MDC.014 EOR:119 With code edition, DRG version and DRG flags turned on ERR:0 ETX:(3M CF) No Error PID:Test Packet 6 COD:9 R.O05Z T.O049-ARE1-ARCL0 T.O350-ARE0-ARCL0 T.O091-ARE0-ARCL0 ACHI.3564302-ARE5-ARCL0 MDC.014 PCCL.0 VSN.I10E5 VSN.AR51 EOR:9 Morphology/diagnosis code pair, identifying numbers concatenated with the code. T.C793-01 TM.M81406-01 Code All Tags display format Sample output packet using the Code All Tags format drg flags turned on 07/09 The Code All Tags display format uses a COD: tag before each code. The codes are still identified by a prefix followed by a period, as in the legacy display format. Code text, physician ID, procedure date, DRG flags and morphology / diagnosis code pairing numbers are positioned under each code with their own tags. ERR:0 ETX:(3M CF) No Error PID:Test Packet 6 HMV:0 COD: R.O05Z TEXT:Abortion W OR Procedure COD: T.O049 ARE:1 ARCL:0 Creating a tagged format file4.5 Code display formats TEXT:Medical abortion, complete or unspecified, without complication COD: T.O350 ARE:0 ARCL:0 TEXT:Maternal care for (suspected) central nervous system malformation in fetus COD: T.O091 ARE:0 ARCL:0 TEXT:Duration of pregnancy 5-13 completed weeks COD: ACHI.3564302 ARE:5 ARCL:0 TEXT:[1267] Dilation and evacuation of uterus [D&E] DATE:04/07/2006 PHYS:Dr Smith COD: MDC.014 TEXT:Pregnancy, Childbirth & the Puerperium COD: PCCL.0 TEXT:PCCL 0 - SDX is not a CC, or is included in ADRG definition, or is excluded COD: VSN.I10E5 COD: VSN.AR51 DTX:1 AR Cost Wt 0.45 ALOS 1.07 FMT:2 AR Cost Wt|AR Cost Wt|12|2|2 ALOS|ALOS|24|2|2 EOR:15` 4.6 Introduction to the 3M™ Codefinder™ Software 07/09 Designing the input packet Records could be processed through Codefinder as either a Single or as a Batch of records. Batch processing can be interactive or automatic and uses the CFWINFIL.EXE utility. This utility is found in the 3MHIS\WINCODER\INTERFAC directory if installed. Single-record processing is done one patient episode at a time. While in the PMI system and at a patient record, the user clicks a button to invoke a coding session. The interface calls Codefinder and passes an input data packet to it. The user performs the coding and clicks on the complete button. Codefinder returns the codes for that session to the PMI in an output data packet through the interface. In batch mode, a group of patient records from the PMI system is placed in a file on disk. The CFWINFIL.EXE utility is then launched with the input file and an output file name as parameters in the command line. Each patient record in the input file is processed in turn by Codefinder and output written to the output file. Batch mode can be used in two ways. With interactive batch processing, each record is presented in turn, in the Codefinder software to the coder to complete the coding and grouping. Automatic Batch processing is primarily used to group large volumes of previously coded patient records. The input packet must contain all the coding information required for grouping. The software will process each record, determining DRG and reimbursement values and writing them to the output file. After all the records in the input file are processed, the output file could be passed back to the PMI system for processing. Although there are certain basic requirements for all input packets, the requirements are substantially higher for automatic batch processing. This is because the diagnosis and procedure codes along with other data that is required by the grouper, must be sent in the input packet. Failure to include the required data results in the record not being processed. See “Batch Processing” in Chapter 6 for information on configuring and running the batch file. 07/09 Creating a tagged format file4.7 Designing the input packet Sample packets Minimum single-record/ interactive input packet These sample input packets show the basic single-record or interactive batch input packet, a single-record/interactive input packet with patient information, and an automatic batch input packet. At a minimum, the interactive input packet contains the command tag (CMD:004), to identify the function (leading 0 = allow coding & grouping) and product (04 = Coding & Grouping as shown) and the end of record tag (EOR:). All other required information will be prompted for by the Codefinder software. The value in the CMD: tag could contain other combinations of numbers that invoke alternate functions in the Codefinder product. CMD:004 EOR: Single-record/interactive input packet with patient information Typically, the input packet includes the choice of product, function, grouper (payor), as well as the patient demographic information required for coding and grouping. The coder then determines the codes and computes the DRG in Codefinder. CMD:004 PAY:11 PID:Test Patient SEX:F AGE:55 DSP:9 ADT:01/10/2004 DDT:01/10/2004 EOR: Automatic Batch input record The input packet for automatic batch processing must contain all the information required for grouping. The number 5 in the CMD: value invokes the batch mode function in Codefinder. The hard returns between the codes are place holders for the code text to be returned in the output file. These place holders will depend on the value sent with the TXT: tag. CMD:504 PAY:11 PID:Test Patient SEX:F AGE:55 DSP:9 TXT:4 TXI:4 CHG:00.0 ADT:01/10/2004 DDT:01/10/2004 COD:4 T.T292 <hard return> T.T794 <hard return> T.T3120 4.8 Introduction to the 3M™ Codefinder™ Software 07/09 Designing the input packet <hard return> ACHI.1388201 <hard return> EOR: ➤ General requirements Note: Additional examples of input files can be found beginning on page 4.50. All input packets, have the following characteristics and requirements. ◆ Each field is identified with a tag. It is important to specify each tag correctly. Invalid tags as well as invalid data in a valid tag is ignored by interface. A tag is followed by a colon then the data (CMD:004). ◆ Each field is terminated using a line feed. ◆ The command (CMD:) Tag is mandatory. The command field designates the type of processing followed by the coding product to be used. If the command field is omitted from the input packet, Codefinder is not invoked and an error code returned in the output packet. Generally this is CMD:004 or CMD:504. See page 4.19 for a list of the command field options. The last two columns specify the product to be used where 04 specifies Coding and Grouping. The first column is the function number where 0 = Interactive Code and Group; 5 = Batch Group followed by this Product number, makes up the three digits sent in the CMD: tag (CMD:004 Interactive or CMD:504 Batch) 07/09 ◆ Tags with patient and episode information must precede the tags for ICD codes. This is especially important for batch grouping. We recommend this order: age, sex, admit date, discharge date, Reimbursement (if required), disposition, and tags that carry information required by the grouper first. Then any tags controlling the coding process, such as turning off integrated encoding or reimbursement. Finally any codes being sent in the input packet. ◆ For Legacy format, the TXT: and TXI: tags must be in the input record if you want code information (code text, physician info, and/or date of procedure) to be in the output packet. See page 4.41 for instructions. ◆ Each packet should end with the End of Record (EOR:) tag. If you want to process more than one record at a time, the records must be separated by the EOR: tag. Otherwise, the interface software treats all your records as if they were a single record. Creating a tagged format file4.9 Designing the input packet ◆ Basic requirements for Single-record/interactive batch input packet Basic requirements for Automatic batch input packet The code display format for the input and output packets must be Code All Tags. The Legacy display format is shown for reference only. See page 4.39 for more information about the code formats. The Codefinder software requires specific information for coding and grouping. Additional information could be required if the reimbursement is turned on. With interactive processing, if the required information is not sent in the input packet, the software will prompt the coder for it. See the table on page 4.12 for information about the data required for each grouper and each reimbursement formula. ◆ Age (AGE:). If the age is not sent in the input packet, the software prompts for it. ◆ Sex (SEX:). If the sex is not sent in the input packet, the software prompts for it. The default is (F) female. ◆ Admit date (ADT:). If the admit date is not sent in the input packet, the software prompts for it. The default is the current date. ◆ Discharge date (DDT:). If the discharge date is not sent in the input packet, the software prompts for it. The default is the current date. ◆ Reimbursement (AUR:) If data related to reimbursement is available on the PMI system and is not sent, Codefinder does not prompt for it, instead defaults are used. If this data is available it must be sent for accurate, calculation of patient specific Reimbursment. ◆ Discharge disposition (DSP:). If the disposition is not sent in the input packet, the software prompts for it. Automatic batch processing requires that all the data elements required for coding and grouping be sent in the input packet. If reimbursement is turned on, the data elements required for reimbursement must also be sent in the input packet. If all the required elements are not in the input packet, the record will not be processed. See the tables on pages 4.12 and 4.17 for information about the data required for each grouper and each reimbursement formula. ◆ Age (AGE:). Required for coding and grouping. Either the patient’s age or the birth date and the admit date can be sent. ◆ Sex (SEX:). Required for coding and grouping. ◆ Admit date (ADT:) Required for coding and grouping. 4.10 Introduction to the 3M™ Codefinder™ Software 07/09 Designing the input packet ➤ ◆ Discharge date (DDT:). Required for coding and grouping. ◆ Discharge disposition (DSP:). Required for coding and grouping. ◆ Reimbursement (AUR:) Refer to appendix A for state/ country specific reimbursement requirements. ◆ Grouper-specific requirements such as Intended Length of Stay, Mental Health Legal Status, leave days, hours on mechanical ventilation, etc. ◆ Diagnosis codes. Required for grouping. ◆ Procedure codes. Required for grouping. ◆ Other procedure information such as date and physician ID, modifiers, and revenue codes, could also be sent if you want them in the output packet. Note: Codes in the interface packet have no periods by default. If you want to use periods, change the value of the DecorateCodes line in the interface section of the Codefind.ini file to Yes. [Interface] CODAllTags=YES DTXAllTags=YES DecorateCodes=YES For more information on the format of codes sent in the input packet or returned in the output packet see the Inpatient and outpatient code format section beginning on page 4.50. Grouper ( payor) specific requirements In addition to the basic requirements, groupers and reimbursement may require specific information. During interactive processing, if this information is not sent via the interface and is required, the software will prompt the coder for it. Batch processing requires that all necessary information be in the input packet. The table below lists the groupers numbers passed in the PAY: tag, Coding Product number that is passed in the CMD: tag, the associated reimbursement scheme, fields required for code assignment and grouping, and additional fields required for reimbursement. 07/09 Creating a tagged format file4.11 Designing the input packet Table 4–1. Input requirements for 3M groupers AR-DRG grouper and number Coding Product Reimbursement scheme Required fields without reimbursement Additional fields required for reimbursement Sample reimb. packets 11 - Default 04 None AGE:, SEX:, ADT, DDT:, WGT, DSP, INT, ISD, LEV, MLS, NLS N/A Refer to appendix A for sample reimbursement packets. 33 04 Victorian state WIES AGE:, SEX:, ADT, DDT:, WGT, DSP, INT, ISD, LEV, MLS, NLS HMV , RV3, AUR 300 04 New Zealand WIES AGE:, SEX:, ADT, DDT:, WGT, DSP, INT, ISD, LEV, MLS, NLS HMV and LEV 300-Series predefined by region 900- Series user defined by function a a a. Note: The HMV field is required without reimbursement when grouping to AR-DRG V4.1 or V4.2 but not for AR-DRG V5.0, V5.1, or V5.2. 4.12 Introduction to the 3M™ Codefinder™ Software 07/09 Output packet description Output packets contain the error code, error text, patient identification, codes, code modifiers if turned on, code text if turned on, Physicians name if entered, date of procedure if entered, all the demographic data (age, sex, etc.) if it was set to be passed through from the input packet and the results of the grouping process. If the Reimbursement is enabled, the output packet also contains the calculated reimbursement information under the RCS: tag. ➤ Note: If turned on, the Reimbursement segment under the RCS: tag of the output packet, could also return an ERR: tag if there is a problem in calculation module. This is in addition to the ERR: tag for the main packet. Please ensure that your program checks for the main packet ERR: tag once and not again till after an EOR: tag is serviced. If Reimbursement data is being used by the interface, check separately for the return of an ERR: tag after the RCS: tag. The software outputs a default list of tags based on the grouper and reimbursement scheme you are using. You can use the Tag.exe Editor utility to enable or disable the passing through of input tags to the output. If data is not passed in an input tag Codefinder will prompt the user to enter it if required. For this user entered data to be passed to the output, the related tag must be set to “Return if input packet=-1” or “Always return or special case” Tag.exe Editor. If the tag is set to “Return if input packet=-1” a -1 must be sent as the value for tag on the input if no data for that tag is available on the PMI. See page 6.27 for a list of the default tags and instructions on making modifications. 07/09 Creating a tagged format file4.13 Output packet description Sample DRG output packet in Legacy display format Demographic information Number of codes returned DRG Principal diagnosis Secondary diagnosis Patient Clinical Complexity Level Major Diagnostic Category ICD 10 Edition number AR-DRG Version number Normative cost weight, ALOS and trim point data Victorian reimbursement information ERR:0 ETX:(3M CF) No Error PID:123456 (Minimum data required to initiate 3M Codefinder via host interface - test usage only) COD:7 R.Q61C T.D569 T.I10 PCCL.0 MDC.16 VSN.I10E4 VSN.AR50 DTX:1 VIC INL WT 0.6790 ALOS 2.3 LT 1 HT 9 MTDRG N FMT:5 VIC INL WT|VIC INL WT|13|2|4 ALOS|ALOS|27|3|1 LT|LT|37|3|0 MTDRG|MTDRG|55|1|0 RCS: TREIMB:4131.55 DRGWT:1.4154 TOTWT:1.4154 ATSICP:0.0000 BWIES:1.1506 BRATE:2919.00 PAYER:Public RURISO:0.00 VICDRG:Q61C LOSCAT:M MVCP:0.0000 AAACP:0.0000 ASDCP:0.0000 THALCP:0.2648 COLONCP:0.0000 STN:2 STX:High Outlier EOR:4 4.14 Introduction to the 3M™ Codefinder™ Software 07/09 Output packet description Sample DRGfinder output packet in Code All Tags format Patient identification DRG Principal diagnosis Secondary diagnosis Patient Clinical Complexity Level Major Diagnostic Category ICD 10 Edition number AR-DRG Version number ALOS data Victorian reimbursement information ERR:0 ETX:(3M CF) No Error PID:123456 (Minimum data required to initiate 3M Codefinder via host interface - test usage only.) COD: R.Q61C TEXT:RED BLOOD CELL DISORDERS W/O CATASTROPHIC or SEVERE CC COD: T.D569 TEXT:Thalassaemia, unspecified COD: T.I10 TEXT:Essential (primary) hypertension COD: PCCL.0 TEXT:PCCL 0 - SDX is not a CC, or is included in ADRG definition, or is excluded COD: MDC.16 TEXT:DISEASES & DISORDERS OF BLOOD, BLOOD FORMING ORGANS, IMMUNOLOG DISORD COD: VSN.I10E4 COD: VSN.AR50 ALOS:2.3 RCS: TREIMB:4131.55 DRGWT:1.4154 TOTWT:1.4154 ATSICP:0.0000 BWIES:1.1506 BRATE:2919.00 PAYER:Public RURISO:0.00 VICDRG:Q61C LOSCAT:M MVCP:0.0000 AAACP:0.0000 ASDCP:0.0000 THALCP:0.2648 COLONCP:0.0000 STN:2 STX:High Outlier EOR:34 Additional sample output packets for both inpatient and outpatient products are found beginning on page 4.64. 07/09 Creating a tagged format file4.15 Tags for the Coding and Reimbursement System The table lists the tags that the Codefinder uses to send and retrieve data via an interface. It lists both tags (ending in a colon), code identifiers (ending in a period) and code modifiers or additional information (beginning with a hyphen). These are listed in alphabetical order. The table contains the following information: ◆ The tag ◆ An example with data of both Legacy and Code All Tags display formats if there is a difference ◆ The corresponding HL7 segment ◆ Whether the tag is for input (I), prompted for during interactive processing if tag or data is not sent (P), or output (O) ◆ A description of the tag and the data format Most input tags can be passed through the interface to the output. ➤ Note: Input tags such as the CMD: tag, that are not normally included in the output packet, can be configured to be passed through to the output by enabling this option using the Tag Editor. Refer to the Tag.exe Editor in the Utilities chapter for further information. 4.16 Introduction to the 3M™ Codefinder™ Software 07/09 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags Tag Example ADT: ADT:10/01/2000 Description Admit Date. HL7 segment (not available at present) I/P/O I/P/O Required for grouping and reimbursement.Used in both Legacy and Code All Tags display formats. The data element contains the patient’s date of addmission. The default date format for Australia is European (DDMMYYYY). The software accepts any of the following date formats (examples use the European format): DDMMYY, DD MM YY, DD/MM/YY, DD-MM-YY, DDMMYYYY, DD MM YYYY, DD/MM/YYYY, or DD-MM-YYYY. Interactive processing: If the ADT: is not sent or sent with no data, Codefinder will display the Patient Information window with the Admit Date field displaying todays date and highlighted. Batch processing: If the ADT: is not sent or sent with no data, the software generates an error message and the record is not processed. The date format can be set to U.S. (MMDDYYYY), European (DDMMYYYY) or International (YYYYMMDD). This is done using the Configuration Utility as also is the setting for the two or four digit year. Refer to the Configuration Utility online help for details. AGE: AGE:32 AGE:0 45d AGE:16/12/1979 01/10/2002 Description Patients Age. I/P/O Required for grouping and reimbursement. Used in both Legacy and Code All Tags display formats. The data element contains the patient’s age in years (55) or days (55d) or the Birth date a space and the Admit date. The default date format for Australia is European (DDMMYYYY). Age in years AGE:XX Age in days AGE:Xd or AGE:0 Xd Age in years with remainder in days AGE:XX Xd Age calculated on birth date and the admit date AGE:DD/MM/YYYY DD/MM/YYYY The software accepts any of the following date formats (examples use the European format): DDMMYY, DD MM YY, DD/MM/YY, DD-MM-YY, DDMMYYYY, DD MM YYYY, DD/MM/YYYY, or DD-MM-YYYY. Interactive processing: If the AGE: tag is not sent or sent with no data or sent with a single date, Codefinder will display the Patient Information window at the cursor in the Age field. Batch processing: If the AGE: tag is not sent or sent with no data or sent with a single date, the software generates an error message and the record is not processed. The date format can be set to U.S. (MMDDYYYY), European (DDMMYYYY) or International (YYYYMMDD). This is done using the Configuration Utility. Refer to the Configuration Utility online help for details. As also two or four digit year 07/09 Creating a tagged format file4.17 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) HL7 segment Tag Example ARE: and ARCL: Code All Tags Legacy COD: T.O049 ARE:1 ARCL:0 TEXT:Medical abortion … COD: T.O350 ARE:0 ARCL:0 TEXT:Maternal care ……. COD: T.O091 ARE:0 ARCL:0 TEXT: Duration of ……. T.O049-ARE1-ARCL0 Medical abortion ….. T.O350-ARE0-ARCL0 Maternal care …. T.O091-ARE0-ARCL0 Duration of ……. Description DRG Flags: (not available at present) I/P/O O Grouping in AR-DRG V5.0 and above, produces two flags that indicates how a code was used in the assignment of the DRG. The value passed with it indicates if it affected the DRG assignment, or was a complication or comorbidity (CC). ◆ Displayed on screen in the Patient summary window after grouping show related values that are also passed in the output packet. (See listing below.) ◆ The passing of the ARE and ARCL flags in the output packet may be enabled or disabled using the Configuration Editor. On-screen code suffix Tag Value - Code All Tags Tag Value - Legacy < No suffix > ARE:0 -ARE0 DRG ARE:1 -ARE1 CC ARE:2 -ARE2 DRGCC ARE:3 -ARE3 OR ARE:4 -ARE4 DRGOR ARE:5 -ARE5 NOR ARE:8 -ARE8 DRGNOR ARE:9 -ARE9 CCL=0 ARCL:0 -ARCL0 CCL=1 ARCL:1 -ARCL1 CCL=2 ARCL:2 -ARCL2 CCL=3 ARCL:3 -ARCL3 CCL=4 ARCL:4 -ARCL4 4.18 Introduction to the 3M™ Codefinder™ Software 07/09 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) Tag Example CMD: CMD:004 Description HL7 segment (not available at present) I/P/O I/P/O Command. Mandatory Specifies the function and coding product to be used. The data element is three digits in the format CXX The C represents the function code and the XX represents the coding product. The Function (C) codes are: 0 - Initiates a standard coding session. This is the most commonly used option. 1 - Prompts the coder for a principal diagnosis 2 - Allows the coder to add a diagnosis only. 3 - Allows the coder to add a procedure only. 4 - Computes a DRG without user interaction when diagnosis and procedure codes are passed. It displays the final coding screen. 5 - Computes a DRG without user interaction when diagnosis and procedure codes are passed. This code should be used when batch grouping multiple records. 7 - Allows the coder to only code the admit diagnosis. 8 - Produces an output packet listing the installed products and groupers. The coding product (XX) options are: 03 - Codefinder only 04 - Codefinder and Grouper COD: Code All Tags input Legacy input COD:T.D569 COD:T.I10 COD:2 T.D569 T.I10 Code All Tags output COD:R.Q61C COD:T.D569 COD:T.I10 COD:MDC.16 COD:PCCL.0 Description I/O Legacy output COD:5 R.Q61C T.D569 T.I10 MDC.16 PCCL.0 Code. Identifies Diagnosis and Procedure codes in the input packet, and the Diagnosis codes and Procedure codes, DRG, MDC, DRG version, Code Edition and PCCL values in the output packet. There are two formats: Legacy or Code All Tag. The format to be used is set in the CODEFIND.INI file. Code All Tags must be used for all new interfaces. Code All Tags display format input: COD: is followed by the actual code. Every code has a COD: tag. Each COD: tag must be separated by a line feed or carriage return/line feed <CR/LF> . Note: Codes preceded by an alpha character are considered codes and must be preceded by the COD: tag. 07/09 Creating a tagged format file4.19 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) HL7 segment Tag Example COD Description (continued) Codes input through the interface are verified for accuracy if the Validate Codes option is enabled. This is done in the Configuration Utility. Refer to the Configuration Utility online help for details. (not available at present) I/P/O Codes that are invalid are not used but passed to the output packet as is unless they are deleted by the coder Code All Tags display format output: The COD: is followed by the actual code. This includes Diagnosis codes and Procedure codes, DRG, MDC, DRG version, Code Edition and PCCL values. Each COD: tag could be followed by other data, such as code text, procedure date, and physician ID, code modifier data, each with its own tag if these items of data are enabled. See page4.37 for information on the format and prefixes used to send codes in the COD: tag.Legacy is only maintained for compatibility with old interfaces. Code All Tags must be used for all new interfaces. It is recommended that Legacy interfaces be converted to Code All Tags when they require modification to accommodate new elements of data. Legacy display format input: The COD: tag is followed by a value that indicates the number of codes being sent. Each code must be separated by a line feed. Note: Codes preceded by an alpha character are considered codes and must be counted in the COD: value. Legacy display format output: The value sent with the COD: tag indicates the number of codes sent in the output packet. It includes all codes that have an alpha character, DRG, and MDC. If COD: is preceded by the TXT: tag in the input packet, the returned codes are followed by other data, such as code text, procedure date, and physician ID. Important: If you use the TXT: tag in order to return text, procedure date, and physician ID, you must include the correct number of hard returns after each code. See the TXT: description for more information. DATE: COD:ACHI.3564302 DATE:08/05/2003 Description Date of procedure I/P/O This follows a procedure code and normally the physician name tag (PHYS). The date can be sent in the input packet or if entered in Codefinder, passed in the output packet. Note: The date in the Legacy display format is on its own line, following the code and code text. It does not have a separate tag. Code All Tags example: COD: ACHI.3564302 TEXT:[1267] Dilation and evacuation of uterus [D&E] DATE:04/07/2003 PHYS:Dr Smith Legacy example: ACHI.3564302 [1267] Dilation and evacuation of uterus [D&E] 04/07/2003 Dr Smith 4.20 Introduction to the 3M™ Codefinder™ Software 07/09 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) HL7 segment Tag Example DBG: DBG:0 Description Debug Display. (not available at present) I/P/O I/O INTERNAL USE ONLY Specifies whether the reimbursement output to the DBG display is standard or detailed. Values are: 0 = Standard 1 = Detailed The default value is 0 if no value is sent. DDT: DDT:01/10/2000 Description Discharge or Separation date. I/P/O Required for grouping and reimbursement.Used in both Legacy and Code All Tags display formats. The data element contains the patient’s date of separation. The default date format for Australia is European (DDMMYYYY). The software accepts any of the following date formats (examples use the European format): DDMMYY, DD MM YY, DD/MM/YY, DD-MM-YY, DDMMYYYY, DD MM YYYY, DD/MM/YYYY, or DD-MM-YYYY. Interactive processing: If the DDT: is not sent or sent with no data, Codefinder will display the Patient Information window with the separation Date field displaying todays date and highlighted. Batch processing: If the DDT: is not sent or sent with no data, the software generates an error message and the record is not processed. The date format can be set to U.S. (MMDDYYYY), European (DDMMYYYY) or International (YYYYMMDD). This is done using the Configuration Utility as also is the setting for the two or four digit year. Refer to the Configuration Utility online help for details. 07/09 Creating a tagged format file4.21 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) HL7 segment Tag Example DSP: DSP:03 Description Separation Mode (Discharge Disposition). (not available at present) I/P/O I/P/O Sends the patient’s Separation Mode code. Valid data is the AR-DRG Separation Mode values. If there is no DSP: in the input packet, Codefinder stops at the Patient Separation mode screen for the user to choose a separation mode. Batch processing: If there is no DSP: in the input packet, the software generates an error message and the record is not processed. AR-DRG Separation Mode Values: 01 = discharge/transfer to an acute hospital 02 = discharge/transfer to a residential ageing service 03 = discharge /transfer to a psychiatric hospital 04 = discharge/transfer to other health care accommodation 05 = statistical discharge type change 06 = left against medical advice 07 = statistical discharge from leave 08 = died 09 = home/other The numbers next to the Separation Modes displayed at the Codefinder Patient Separation mode screen are selection numbers and not AR DRG Separation Mode values. So only send the values in the table above and not the item numbers in the Codefinder screen as shown below 1: Home/other 2: discharge/transfer to an acute hospital 3: discharge/transfer to a residential ageing service 4: discharge /transfer to a psychiatric hospital 5: discharge/transfer to other health care accommodation 6: statistical discharge type change 7: left against medical advice 8: statistical discharge from leave 9: died DTX: Legacy format: Code All Tags format: Returns the codes and associated information in a single block. DTX:1 AR Cost Wt 0.53 ALOS 2.48 FMT:2 AR Cost Wt| AR Cost Wt | 12 | 3 | 2 ALOS | ALOS | 26 | 3 | 2 Normal format I Returns the codes and associated information in a single block South Australia output example: SAwgt Cf 10.34 Cp 10.33 LOS Av 24.36 Lo .12 Hi 73.09 New South Wales output example: NSW wgt 2.52 ALOS 7.9 Ltrim 1 Htrim 27 S/D wgt 0.72 Code All Tags format DTX All Tags format: Uses a tag before each separate piece of information in the weight line. DWGT:0.53 ALOS:2.48 4.22 Introduction to the 3M™ Codefinder™ Software 07/09 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) Tag Example Description DRG text. HL7 segment (not available at present) I/P/O Causes the information contained in the cost weight line and any text added with the Modify utility that is displayed on the Coding Summary screen to be passed in the output packet. The tag must be sent in the input packet for this data to be returned. Legacy display format: The data element after DTX contains the number of lines in the text. Subse quent lines contain the text under the DRG title on the DRG Summary screen. This includes the reimbursement line and any text entered using the Modify utility program (see example above). It is always accompanied by the Format field (FMT:). Code All Tags Display Format: With DTX ALL TAGS set to blank or “NO” in the Codefind.INI file, acts the same as Legacy display format. With DTX ALL TAGS set to “YES” in the Codefind.INI file, the DTX and FMT tags do not appear in the output packet. The weight data is separated into individual tagged data elements if the elements are defined in the DRGTAGS.TXT file found in the 3MHIS\ENCODER directory. EOR: EOR: with Longitudinal Redundancy Check number # Description End of record. I Identifies the end of each individual record. See page 4.36 for more information. ERR: ERR: 0 ERR:382 Description Error Code. O This is always the first tag in the output the output packet. The data element contains an error number. An error number of zero (ERR:0) indicates no errors occurred during processing. The text corresponding to the error code appears in the error text field (ETX:), described below. The ERR tag may appear in one or two places in the output packet: 1. Always at the beginning of the record and indicates the error status of the record (Packet error). If an error is encountered during processing, an error numbers is returned in the ERR: tag and no codes will be returned in the output packet. 2. An ERR: tag can also be returned after the RCS: tag. This indicates that the coding session encountered a reimbursement error. If no errors are encountered then there is no ERR: tag after the RCS: tag. Most reimbursement errors will cause reimbursement calculation to terminate, so no reimbursement fields will be passed to the output packet. If the ERR tag does not appear after the RCS tag, no reimbursement errors occurred. If there is a Reimbursement error and no coding errors the packet ERR: tag will still show “0”. Note: It is adviseable when programming to service the packet ERR; tag ( the first ERR: tag ) and not service it again till an EOR: tag is encountered Note: Error codes have different meanings, depending on where the ERR tag appears. For example, an ERR:49 at the top of the record does not have the same meaning as an ERR:49 in the RCS section. ETX: 07/09 ETX:Invalid or no age in input packet ETX:Unable to load statistics table for this date O Creating a tagged format file4.23 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) Tag Example Description Error text. HL7 segment (not available at present) I/P/O Text description of the error code (ERR:). The data element contains the text that corresponds to the error code. The error numbers and text descriptions for packet errors (i.e., the very first ERR: tag in the output packet) are listed below. 0 No error 1 Backup at Keyword prompt 2 Abort at Keyword prompt 3 No entry at Keyword prompt 4 Next at Keyword prompt 6 Invalid command in input packet 11Incomplete coding session by operator request 12Invalid codes passed to Codefinder 15DATABASE stack overflow 17DATABASE unknown instruction 18DATABASE unresolved external 19DATABASE code buffer overflow 22DATABASE could not open 26DATABASE revision mismatch 28DATABASE divide by zero 29CT TABLE could not open 32CFG FILE product information 35CFG FILE hospital grouper information 36CFG FILE Code3 grouper information 37Invalid or no age in input packet 38Invalid or no gender in input packet 39Invalid or not integrated in input packet 40Invalid or no state in input packet 41Invalid or no payer in input packet 42Invalid discharge date in input packet 43Invalid admit date in input packet 44Admit date is after discharge date 45Invalid charges in input packet 46Invalid product in input packet 47Invalid environment setting 48Invalid demographic data 49Invalid environment setting or demographic data 50No codes in packet for batch processing 51LRC number following EOR: is incorrect for packet 52Invalid or missing TAGS.TXT file 53No codes were returned 54CT TABLE corrupted 4.24 Introduction to the 3M™ Codefinder™ Software 55CFG FILE incorrect version 56CFG FILE not authorized 57CFG FILE bits not set 58CFG FILE missing data 59CFG FILE setup info 60CFG FILE system info 61CFG FILE state info 62CFG FILE reimbursement information 63 CFG FILE Key map 64CFG FILE prefixes 65CFG FILE template array 66CFG FILE template 67DATABASE corrupted 68DATABASE no gateway framecan’t enter database 69DATABASE no grouping cleanup frameoutdated database (Your codes and groupings may be incorrect) 70REFERENCE could not open 71NOTES could not create 72NOTES semaphore file 73NOTES table file 74NOTES data file 75EXCLUDES can’t open flat file 76EXCLUDES can’t open index file 77EXCLUDES can’t read index file 78NWSECURE cannot connect to 79NWSECURE user license count exceeded 80NWSECURE bad CEDIT checksum 81PREFERENCES could not update 82CACHE out of memory 83CACHE size invalid 84Grouper interface number not found 85Grouper not valid with product 86System out of memory 87DLL file not found 88DLL path not found 89DLL corrupted 07/09 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) Tag Example ETX: Description (continued) 90Unknown DLL error 91DLL version mismatch 92Resource not found or misused 93Buffer overflow while parsing packet 94Buffer overflow while building packet 95Invalid tag information in input packet HL7 segment (not available at present) I/P/O 96Invalid data in input packet 97Invalid number of codes passed in input packet 98Disposition not passed in input packet 99Other Codefinder error The error numbers and text descriptions for reimbursement errors (i.e., those that would appear after the RCS tag) are listed below. 49 - Invalid DRG value or no statistics available for this DRG 99 - Unable to open reimbursement knowledge base 222 - Unable to load facility data 291 - Error loading stat key 297 - Missing stat key 382 - Unable to load statistics table for this date Note: Error codes have different meanings, depending on where the ERR tag appears. For example, an ERR:49 at the top of the record does not have the same meaning as an ERR:49 in the RCS section. FMT: O Legacy DTX:1 AR Cost Wt 0.53 ALOS 2.48 FMT:2 AR Cost Wt | AR Cost Wt | 12 | 3 | 2 ALOS | ALOS | 26 | 3 | 2 Description Format. Legacy display format and with DtxAllTags set to “NO” or blank in the Codefind.INI file in Code All Tags display format. Specifies how the cost weight information under the DTX: tag in the output packet, is formatted. It is returned when the DTX: tag is sent in the input file. The data area contains the number of format information lines that follow. The first two segments in each line contains the title of the costweight field. The remaining three segments contain the starting position of the cost data in the line, the number of digits to the left of the decimal place and the number of digits to the right of the decimal place. Segments are separated with a vertical bar (|). GS: COD:GS:1 TEXT:Invalid PDX Description Grouper Status. O Contains errors generated during the grouping process. The text returned with the GS code will describe what the error was. If no errors are found (GS = 0), the COD:GS: tag will not be included in the output. 07/09 Creating a tagged format file4.25 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) Tag Example HMV: HMV:2 Description Hours of Mechanical Ventilation. HL7 segment (not available at present) I/P/O I/O Valid Value: HMV hours The HMV is required if grouping in AR-DRG V4.1 or V4.2, but not for AR-DRG V5.0 or V5.1 or 5.2 . The HMV field is requred for reimbursement regardless of the AR-DRG version used. If not sent and required Codefinder will be prompt for it. If entered in Codefinder it can be be passed to the output packet by enabling the HMV: tag for output using the Tag.exe Editor. INT: INT:0 Description Integrated Encoding. I/O Valid values: 0 = Off 1 = On Overrides the setting for Intergrated Encoding in the Configuration Utility. With Integrated Encoding turned on Codefinder prompts for procedure codes during the coding of diagnoses rather than having to coding them separately, ISD: ISD:0 Description Sameday I/O Valid values: 0 = not same-day 1 = same-day Required for grouping when certain diagnoses and procedure codes associated with a same day separation from the hospital, are entered or sent to Codefinder. If not sent sameday is calculated from valid admit and separation dates in the input. (The “Sameday” field was originally the “Intended Sameday” field in AN-DRG and there were three disparate variables not two as shown above . In AN-DRG it referred to the intention. In AR-DRG it is the actual) LEV: LEV:10 Description Leave Days I Passes the number of patient leave days from a health establishment for the current episode of care. The DRG grouper subtracts the number of leave days from the total LOS and passes this to the grou per. The data element identifies the number of days (0 999) and must be less than the acute LOS. 4.26 Introduction to the 3M™ Codefinder™ Software 07/09 Tags for the Coding and Reimbursement System Table 4–2. Tag MOD: Description Codefinder interface tags (continued) HL7 segment Example (not available at present) Code All Tags output Legacy output COD: T.C549 MOD:00 TEXT:Malignant neoplasm of corpus uteri, unspecified COD: TM.M80103 MOD:00 TEXT:Carcinoma NOS COD: T.C7988 MOD:01 TEXT:Secondary malignant neoplasm of other specified sites COD: TM.M80106 MOD:01 TEXT:Carcinoma, metastatic NOS T.C549-00 Malignant neoplasm of corpus uteri, unspecified TM.M80103-00 Carcinoma NOS T.C7988-01 Secondary malignant neoplasm of other specified sites TM.M80106-01 Carcinoma, metastatic NOS I/P/O I/P/O Modifier. Code All Tags display format only: MOD: tags follow COD: tags where required. Passes additional data about a code. There could be multiple MOD: tags for each COD: code. Is used to pass Morphology / Diagnosis pairing numbers as shown in example above. Other data associated with a code may be passed in additional MOD: tags in the future MDC: MDC:2 I or MDC:3 Description Returned MDC length. Input packet Valid values: 2 – Returns two digit MDC 3 – Returns three digit MDC The default is 3 digit MDC if the tag is omitted or if no value or an invalid value is sent. MDC. Code All Tags COD:MDC.16 COD:MDC.016 Description Legacy O MDC.16 MDC.016 Diagnostic Category (MDC) Identifies the Major Diagnostic Category (MDC) returned in the output packet.The MDC as determined by the DRG grouper. Legacy Display Format: Returned as a code under the COD:xx tag CodeAllTags Display Format: Returned as a code in a COD: tag 07/09 Creating a tagged format file4.27 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) Tag Example MLS: MLS:2 Description Mental health legal status. HL7 segment (not available at present) I/P/O I Required for grouping in AR-DRG with certain codes Valid values 1 - Involuntary 2 - Voluntary MRP: Description Code All Tags Legacy Input Input ..... MRP:1 ..... MRP:1 OUTPUT ..... COD: T.C341 MOD:00 COD:TM.M81403 MOD:00 COD: T.C787 MOD:01 COD: T.C793 MOD:01 COD:TM.M81406 MOD:01 COD:T485 MOD:02 COD:TM.M88211 MOD:02 ..... OUTPUT ..... COD:7 T.C341-00 TM.M81403-00 T.C787-01 T.C793-01 TM.M81406-01 T.D485-02 MTM.M88211-02 EOR: I/O Morphology code pairing Valid Values 0 = Return codes without pairing numbers 1 = Return codes with pairing numbers The MRP tag is sent in the input packet to turn on Morphology/Diagnosis Code numbers to be passed in the output packet. This links diagnosis codes to the associated morphology codes. Legacy Display Format: The pairing numbers are passed as a suffix to the Diiagnosis \ Morphology code pair seperated by a hypen. Code All Tags Display Format: The pairing numbers are passed in the MOD: tag for the Diiagnosis \ Morphology code pair. Refer Morphology/Diagnosis pairing on page 4.51 4.28 Introduction to the 3M™ Codefinder™ Software 07/09 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) Tag Example NLS: NLS:5 Description Non-acceptable Length of Stay HL7 segment (not available at present) I/P/O I Used in grouping to AR-DRG Versions 4.1 and 4,2 only Passes a patient’s non-acceptable length of stay. When a valid number of days (less than the acute length of stay) is passed, the software subtracts the NLS days from the Total LOS giving the Acute LOS. PAY: PAY:11 Description Payor. I/P/O Sets the grouper setup to be used. The data element contains the 3M grouper setup code.3M Groupers code and grouper setups are listed below . Interactive processing: If the PAY: is not sent the default grouper setup in the configuration file is used. If the default is set to “Prompt User” or if the PAY: tag with a value of “1” is sent, the software displays the Encoding Options window to allow the user to select a grouper. Batch processing: If there is no PAY: tag, sent the default grouper setup in the configuration file is used. If the default is set to “Prompt User” the software generates an error message and the record is not processed. Note: If user defined grouper setups have been added, run the Configuration Utility to determine the grouper setup interface number. 3M payor codes Default Payor: 11 Australian Refined Pre-configured Payors with Reimbursement configured: 33 Victoria WIES 300 New Zealand Pre-configured Payors: 310 New South Wales 320 QLD Teaching hospitals, Group A 321 QLD Children’s hospitals, Group P 322 QLD Women’s hospitals, Group X 323 QLD Other hospitals without ICU, Group T 324 QLD Other hospitals with ICU, Group B 330 SA Metropolitan hospitals ‘Full weights’ 331 SA Metropolitan paediatric hospitals 332 SA Country hospitals ‘Full weights’ 333 SA - Country Paediatric hospitals 340 Tasmania 350 Victoria (AR) 360 Western Australia 380 Private Hospitals 381 Australian Capitol Territory User Defined Payors: 900 to 999 User Defined Groupers. 07/09 Creating a tagged format file4.29 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) Tag Example PHYS: Code All Tags PHYS:Morris, D. Or Code All Tags format: COD: ACHI.9203800 TEXT: CPAP Ventilation less than 80 hrs DATE:01/10/04 PHYS:DR654987 Description HL7 segment (not available at present) Legacy : I/P/O I/P/O ACHI.9203800 CPAP Ventilation less than 80 hrs 01/10/04 PHYS:DR654987 Physician name or number. Passes the Physician name or number entered against a procedure code in the output packet. PID: PID:123-45-6789 JOHN JENSEN Description Patient ID. I/P/O Sends patient identification or other free text. This information is displayed in the Codefinder “Patient Identification” window. It appears on all prints generated in Codefinder. The data element has a maximum of 251 characters. Only 198 characters displayed on the Patient Information screen. Interactive processing: If there is no PID: in the input packet, the software displays the Patient Infor mation window so one can be entered. Click Add/View codes to continue. You can send the tag with no value to bypass the Patient Information window. Batch processing: Does not require a PID: tag, but could be included for audit purposes. PRFX Code All Tags Legacy sample input sample input … COD:T.K351 PRFX:P COD:ACHI.3057200 COD:ACHI.9251529 … … COD:4 T.K351-PRFXP ACHI.3057200 ACHI.9251529 … sample output … COD: T.K351 PRFX:P ARE:0 ARCL:2 TEXT:Acute appendicitis with peritoneal abscess COD: ACHI.3057200 ARE:5 TEXT:[926] Laparoscopic appendicectomy COD: ACHI.9251529 ARE:0 … sample output … T.K351-PRFXP-ARE0- ARCL2 Acute appendicitis with peritoneal abscess ACHI.3057200-ARE5 [926] Laparoscopic appendicectomy ACHI.9251529-ARE0 … 4.30 Introduction to the 3M™ Codefinder™ Software I/P/O 07/09 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) HL7 segment Tag Example Description Code Prefixes or Modifiers (not available at present) I/P/O Passes Code Prefixes or Modifiers (also referred to as Diagnosis Onset Types ) entered in Codefinder. Modifiers can be one or two characters in length. These prefixes could also be sent back with codes to Codefinder via the interface. To disable the code prefix use: [Miscellaneous] CodePrefixes=NO PRFX Prefix format within the CODEFIND.INI file and function: I/P/O Description) There are three segments to creating a CodePrefix entry in the INI file ( Refer to CodePrefixes example above). 1.Each prefix can have one or two characters or numbers, followed by a description. 2.The prefix and description are both framed by the < and > symbols. 3.Each prefix/description combination is separated from the next prefix/description combinations by a pipe (|) character. Duplicate prefixes though possible are not recommended, as Codefinder only tracks the first occurrence of that prefix. The CodePrefixes entry if set to NO, disables the feature within Codefinder but allows prefixes to be sent to Codefinder via the host interface. Codefinder will preserve them and pass them through to the output providing the user does not delete the code. The user does not have the ability to modify existing or add new prefixes. NOTE: Prefixes sent into Codefinder via the interface do not currently need to match a prefix listed in the CodePrefixes setting. RCS: RCS:ON Description RCS. I Turns reimbursement on or off, overriding the setting in the Configuration Utility. The output tags for reimbursement values follow the RCS: tag In the output packet. Blank Uses the reimbursement setting in the Configuration Utility. ON Turns reimbursement on if the setting is On in the Configuration Utility. If the setting is off in the Configuration Utility, this tag has no effect. OFF Turns reimbursement off if the setting is On in the Configuration Utility See appendix A for an explanation of the tags that follow the RCS: tag. 07/09 Creating a tagged format file4.31 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) Tag Example SEX: SEX:1 Description Sex. HL7 segment (not available at present) I/P/O I/P/O Sends the patient’s gender. Required by all coding and grouping products. The data element contains the gender code. The default value is Female. The options are: 0 or 9 or u or U 1 or m or M 2 or f or F 3 or i or I Unknown Male Female Indeterminate Interactive processing: If there is no SEX: tag in the input packet, the software displays the Encoding Options window so one can be chosen. Batch processing: If there is no SEX: in the input packet, the software generates an error message and the record is not processed. SYS: SYS:0 I/O Description System. The default is System 0 if the tag is not sent. Calls the appropriate Codefinder product system setup. Each system can have different product menus or user authorisations. For example, a different system can be setup for each hospital in a hospital group that is using a central sever installation of Codefinder. Systems are set up in the Configuration Editor using the System menu located in “Edit Systems”. Sys tem 0 is the default HIS system installed with the product. Each additional system is assigned a number sequencially. The value sent in the SYS: tag determines which system is to be used. For a description of the system menu and how it is used, see appendix A of the 3M™ Coding and Reimbursement System User’s Guide. Note: It is recommended that you allow the System tag to default to 0 unless you know the numbers associated with the user’s systems. Codefinder has a limit of 20 Systems setups. TEXT: Code All Tags only I/P/O COD: T.K359 TEXT: Acute appendicitis, unspecified Description Text for codes. Returns the text for a code Only used with Code All Tags display format. Generally the returned code text is not stored in the PMI system. 4.32 Introduction to the 3M™ Codefinder™ Software 07/09 Tags for the Coding and Reimbursement System Table 4–2. Tag TXI: Description Codefinder interface tags (continued) HL7 segment Example (not available at present) Legacy Code All Tags with TXTWithAllTags=Yes TXT:4 TXI:4 COD:4 AT.794 <hard return> <hard return> <hard return> T.T3120 <hard return> <hard return> <hard return> ACHI.1388201 <hard return> <hard return> <hard return> TXT:4 TXI:4 COD:AT.794 COD:T.T3120 COD:ACHI.1388201 I/P/O I Code All Tags with TXTWithAllTags=No does not require TXI: tag Text input. Indicates the number of text lines being returned after each code in an input packet. Legacy display format: After an episode is first coded and sent back to the PMI system, patient records are often sent back into Codefinder for changes or additions. Including the TXI: tag in the input file allows the code-related values sent back to the PMI system, to be returned to Codefinder so that do not have to be re-entered. The tag and the value sent indicates that the input packet will include any or all of the following with each code: text, date and/or physician identification for each code. The value passed with the TXI: indicates the combination of code related values being returned. Code All Tags display format: Not used with Code All Tags display format. Code releated values are returned with their own tags. The TXI: tag and it’s value is a single entry in the input file before the COD:xx tag. The TXI: tag is used only if the TXT: tag is also included in the input file and generally both should have the same value and before the COD:xx tag. Specific circumstances could call for a different values. The LegacyTXT= setting in the codefind.ini file affects the values for the TXI: tag. See page 4.41 for a more detailed discussion of how the TXI: tag interacts with the LegacyTXT= setting. Values for LegacyTxt=No 1Resends code with a procedure date. Add one hard return after code with no date. 2Resends code with modified text 3Resends code, modified text, and procedure date 4Resends code, physician ID 5Resends code, procedure date, and physician ID 6Resends code, modified code text and physician ID 7Resends code, modified code text, procedure data, and physician ID Values for LegacyTxt=Yes 2Code and text (same as leaving it blank) 3Code, text, and procedure date 4Code, text, procedure date, and physician ID 07/09 Creating a tagged format file4.33 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) HL7 segment Tag Example TXT: Legacy Code All Tags with TXTWithAllTags=Yes TXT:4 TXI:4 COD:4 AT.294 <hard return> T.T3120 <hard return> ACHI.1388201 <hard return> TXT:4 TXI:4 COD:AT.294 COD:T.T3120 COD:ACHI.1388201 Description (not available at present) I/P/O I Code All Tags with TXTWithAllTags=No does not require TXT: tag Text. Sent in the input packet to tell the Codefinder program what code-related information (text, procedure date, or physician ID) should be returned in the output packet. It is also used when codes, text, procedure date, and/or physician ID are returned in the input packet to Codefinder. The TXT: (text input) tag is generally paired with the TXI: tag. Legacy display format: No text, date, or ID is returned if you omit this field. If you are sending codes in the input packet but not sending the actual text, procedure date, or physician, you must also add the indi cated number of hard returns in the input packet after each code sent. Hard returns are required for all codes, both diagnosis and procedure, even though procedure date and physician are only associated with procedures. Code All Tags display format: TXT: is only used if you want to override the default setting , which returns text, date, and physician. The override function is enabled by changing the TXTWithAllTags=No setting in the codefind.ini file to TXTWithAllTags=Yes. If you send in text, physician ID, or procedure date, the values must be preceded by the TEXT:, PHYS:, and DATE: tags. You do not need to send hard returns. The LegacyTXT= setting in the codefind.ini file affects the values for the TXT: tag. See page 4.41 for a more detailed discussion of how the TXT: tag interacts with the LegacyTXT= setting. Values for LegacyTxt=No 1Returns code with procedure date. Legacy: Add one hard return in the input file after code if no date is sent. 2Returns code with text. Legacy: Add one hard return in the input file after code if no text is sent. Sending the TXT: tag without a value produces the same results as TXT:2. 3Returns code, text, and procedure date. Legacy: Add two hard returns in the input file after code if no text and date are sent. 4Returns code and physician ID. Legacy: Add one hard return in the input file after code if no ID is sent. 5Returns code, procedure date, and physician ID. Legacy: Add two hard returns in the input file after code if no date and ID are sent. 6Returns code, text, and physician ID. Legacy: Add two hard returns in the input file after code if no text and ID are sent. 7Returns code, text, procedure date, and physician ID. Legacy: Add three hard returns in the input file after code if no text, date, and ID are sent. Values for LegacyTxt=Yes 2Code and text (same as leaving it blank) 3Code, text, and procedure date 4Code, text, procedure date, and physician ID 4.34 Introduction to the 3M™ Codefinder™ Software 07/09 Tags for the Coding and Reimbursement System Table 4–2. Codefinder interface tags (continued) Tag Example VSN: VSN:0 HL7 segment (not available at present) I/P/O I or VSN:1 Description Code Edition, Grouper Version Sent in the input packet to turn on the return of the code edition and grouper version used for the coding session, in the output packet. Values: VSN:0 or not sent = Code edition and grouper version used returned in output packet VSN:1 VSN. = Code edition and grouper version used not returned in output packet Code All Tags Legacy COD:VSN.ICD10E4 COD:VSN.AR50 _VSN.I10E4 <hard return> _VSN.AR50 <hard return> O Note: the ‘_’ indicates the one char space (for the ‘H’ symbol) Description Code Edition, Grouper Version The code edition and grouper version used for the episode returned in the output packet. Legacy display format: The VSN. is a field marker under the COD:xx tag Code All Tags display format: Preceded by the COD: tag WGT: WGT:500 Description Admission weight. I/P/O Sends the admission weight. Required by the AR-DRG Grouper if age is less than one Year. The data element contains the admission weight in grams. Valid values: 400 to 9999 grams. - AR-DRG 4.1 , 4.2 , 5.0 , 5.1 400 to 9999 grams or 100 to 399 with Dx codes P0701,P0724,P0722 - AR-DRG 5.2, 6.0 Batch processing: If no admit weight is passed, the AR-DRG grouper default value of 2500 grams is used. 07/09 Creating a tagged format file4.35 End of record The EOR: tag signals the end of each individual record. After reading the EOR: tag, the software passes the focus to the coder’s screen in the 3M Codefinder. The Longitudinal Redundancy Check (LRC) number indicates the length of the input and output packets. It is located after the EOR: tag (EOR:156). The software calculates the LRC by comparing the first byte of the packet with the second byte of the packet. Suppose that the first three bytes of the packet begin with CMD:. The interface software then compares C and M. C M Results Decimal 067 077 014 Binary 1000011 1001101 0001110 The comparison is made one bit at a time. If both bits are zero, the result is zero. If both bits are 1, the result is zero. If one bit is zero and the other is one, the result is one. After comparing C with M, the software compares the results with D. Results D Results Decimal 014 068 074 Binary 0001110 1000100 1001010 The process continues until the EOR: tag is reached at the end of the packet. The EOR: tag is not included in the calculation. The final result is converted into a decimal number. It is then located after the EOR: tag. When the input packet is sent to the coding software, the cfparse.dll program calculates an LRC and compares it with the one being sent. If the results are different, an error message is displayed. An LRC number always follows the EOR: tag in the input packet. The following formula calculates the LRC using C programming language. int Result while(*Packet) Resultˆ =*Packet++; 4.36 Introduction to the 3M™ Codefinder™ Software 07/09 How codes and code information are sent and returned New interfaces must use the Code All Tags Display format. This section discusses how codefind.ini settings and specific tags control the way codes and code information are handled by the Codefinder software interface: ◆ How the codes are identified and displayed in the output packet: Legacy Display format or Code All Tags Display format. the format in use is determined by settings in the codefind.ini file. See page 4.38. Legacy display format, was developed for the original Codefinder Software and is maintained for these dated interfaces only. It is advised that these interfaces be changed to the Code All Tags display format when they require to be modified to accommodate a new data elements. ➤ 07/09 ◆ What code information (text, physician, procedure date) is returned in the output packet: With Code All Tags Display format, a codefind.ini file setting (TXTWithCODAllTags=) controls whether or not code-related information is returned in the output packet. With Legacy Display format the TXT: and TXI: tags in the input packet tell the software which code-related items are to be returned in the output packet. See pages 4.38 and 4.41. ◆ How the grouper information (Cost weights, ALOS, etc.) is identified and displayed in the output packet: The DTX: tag in the input packet tells the software to return the grouper data information. With Code All Tags Display format the codefind.ini file DTXAllTags= can be set to present this data in the old format or each item in it’s own tag. See pages 4.38 and 4.49. Note: Input and output display formats must be matched to avoid incompatibilities in the future. Generally the input display format and the output display format do not have to match. If the codefind.ini file is set up to specify Code All Tags for the output, the input file can be in Legacy format, and vice versa. However, the TXT: and TXI: tags do not work properly if the input and output display formats do not match. Creating a tagged format file4.37 How codes and code information are sent and returned Codefind.ini settings Code All Tags DRG Text All Tags Text with Code All tags Legacy Text The Interface section of the codefind.ini file below highlights the settings that control the Display format of the returned codes. The default is Code All Tags Display format. LegacyTxt= parameter may be added to the Interface section set to YES, if Legacy Display format is required. See page 6.4 in the Utilities chapter for instructions on using the Intredit tool to change the codefind.ini settings. [Interface] CODAllTags=YES DTXAllTags=YES DecorateCodes=NO PcktProcessorExe= PassThroughSize=0 ReturnDeleteIndicators=NO TagTxtPath=D:\3MHIS\ENCODER\TAGS.TXT TXTWithCODAllTags=NO Splashexe=D:\3MHIS\WINCODER\CDFSTART.EXE NOEXEC CodefindExe=D:\3MHIS\WINCODER\CODEFIND.EXF SaveBeforeModifyPckt=NO ParseDLLPath=D:\3MHIS\WINCODER\INTERFAC\CFPARSE.DLL CfInt32DllPath=D:\3MHIS\WINCODER\INTERFAC\CFINT32.DLL CfIntDLLPath=D:\3MHIS\WINCODER\INTERFAC\CFTHUNK.DLL LegacyTxt=NO The LegacyTxt= setting and the CodAllTags= setting control the display format of the codes and related information in the output packet. LegacyTXT=Yes allows old DOS interfaces to continue to work with Codefinder for Windows™. CodAllTags also controls the choice between Legacy and Code All Tags formats. The DTXALLTags= setting controls the display format of the data items such as code, text, cost weight, A/LOS, and outliers associated with the grouper. These are the items that appear along with the DRG and MDC on the Codefinder code Summary screen after grouping. The TXTWithCODALLTags= setting controls whether or not code-related items, such as Code descriptions (Text), date and physician ID are displayed in the output file when Code All Tags Display format is being used. These four settings interact with each other in specific ways. See tables 4–3, 4–4, and 4–5 on pages 4.46, 4.47, and 4.49 for detailed information. 4.38 Introduction to the 3M™ Codefinder™ Software 07/09 How codes and code information are sent and returned Legacy and Code All Tags display formats Though codes can be set to display in the output packet in one of two formats: Legacy and Code All Tags all new Interfaces must be developed using the Code All Tags Display format. Legacy display format, was developed for the original DOS Codefinder Software and is maintained for these dated interfaces only and covered here for reference only. The input and output display formats should be matched. Legacy display format This format must not be used for new interfaces and is covered here for reference only. In this display format, in the input and output packets contain the COD: tag with a value that indicates the number of codes being sent. The tag and value are followed by the codes one to a line. In the input packet this would include Diagnosis codes (P.), Procedure codes (ACHI.) and Morphology codes (TM). Code text, physician ID, and procedure date could also be sent, positioned under each code. Morphology / diagnosis code pairing numbers could also be sent back concatenated with the code and separated by a hyphen In the output packet, the COD: tag indicates the number of codes generated by the coding session, including those that could have been sent in the input packet. This number includes the following code types; Diagnosis codes (P.), Procedure codes (ACHI.), Morphology codes (TM), DRG (R.), MDC (MDC.), Code edition (VSN.), DRG version (VSN.) and PCCL (PCCL.). If enabled Code text, physician ID, and procedure date are positioned under each code but not included in the count. DRG flags are concatenated with the code, separated by hyphens as are morphology / diagnosis code pairing numbers. The values -ARE1 -ARCL0 in the sample output file are DRG flags and are the results of the AR-DRG grouper. DRG flags is enabled or disabled via Codefinder’s Configuration Editor using the “Edit Systems” and the “DRG Flag Interface” menu options. If the TXT: tag is sent in the input packet, each code in the output packet is followed by data related to it such as code text, procedure date, and physician ID. Legacy input example 07/09 TXT: COD:3 T.C341 ACHI.9016300 ACHI.9251419 Creating a tagged format file4.39 How codes and code information are sent and returned Legacy output example COD:6 R.E71B RESPIRATORY NEOPLASMS W/O CC T.C341-ARE1-ARCL2 Malignant neoplasm of upper lobe, bronchus or lung ACHI.9016300-ARE8 [545] Other endoscopic excision of bronchus ACHI.9251419-ARE8 [1910] General anaesthesia, a normal healthy patient, non-emergency or not known PCCL.0 PCCL 0 - SDX is not a CC, or is included in ADRG definition, or is excluded MDC.004 DISEASES & DISORDERS OF THE RESPIRATORY SYSTEM EOR:122 ➤ Note: The tagging of codes with an asterisk (*) or hash (#) identifying their significance in the assignment of the DRG, has been phased out and replaced with the DRG flags ARE and ARCL. Code All Tags display format With the Code All Tags display format each code in the input and output packet is preceded by a COD: tag. In the input packet the COD: tag would prefix the following code types; Diagnosis codes (P.), Procedure codes (ACHI.) and Morphology codes (TM). Code text, physician ID, and procedure date could also be sent, positioned under each code but with their own tag. In the output packet the COD: tag would prefix the following code types; Diagnosis codes (P.), Procedure codes (ACHI.), Morphology codes (TM), DRG (R.), MDC (MDC.), Code edition (VSN.), DRG version (VSN.) and PCCL (PCCL.). Code text, physician ID, and procedure date could also be sent, positioned under each code but with their own tag. DRG flag values are sent under each diagnosis or procedure code with their own tags (ARE: and ARCL:). Morphology / diagnosis code pairing numbers are sent using the MOD: tag. DRG flags is enabled or disabled in the Codefinder Configuration Editor. If TXTWithAllTags in the interface section of the codefind.ini file is set to “NO”, code text, procedure date, and physician ID are returned in their own tags TEXT:, DATE:, and PHYS: under each COD: tag. If it is set to “YES” they are not sent. If TXTWithAllTags is set to Yes the TXT: tag could be sent in the input packet to over ride this. The value sent in the TXT: controls the functionality (refer to the table covering the TXT: tag below). 4.40 Introduction to the 3M™ Codefinder™ Software 07/09 How codes and code information are sent and returned Code All Tags output example Returning code-related information (TXT: and TXI:) COD: R.E71B TEXT:RESPIRATORY NEOPLASMS W/O CC COD: T.C341 ARE:1 ARCL:2 TEXT:Malignant neoplasm of upper lobe, bronchus or lung COD: ACHI.9016300 ARE:8 TEXT:[545] Other endoscopic excision of bronchus COD: ACHI.9251419 ARE:8 TEXT:[1910] General anaesthesia, a normal healthy patient, non-emergency or not known COD: PCCL.0 TEXT:PCCL 0 - SDX is not a CC, or is included in ADRG definition, or is excluded COD: MDC.004 TEXT:DISEASES & DISORDERS OF THE RESPIRATORY SYSTEM EOR:92 The TXT: tag is used in the input packet if code-related data items are wanted in the output packet. The value for TXT: specifies which code-related items are to be returned. The items are: ◆ ◆ ◆ Text for each code Date for each procedure code Physician identification for each procedure code With interactive processing, the text for a code is generated by the Codefinder software. The date and physician identification are entered by the coder from the Patient Summary window. If you are sending in a record that has already been coded and these data elements are present, they can be included the input packet so they do not have to be added again. If you are using batch processing and want the date and physician ID in the output packet, they must be included in the input packet. Depending on the value of the TXT: tag, the Codefinder software will add the code text if it is not input. Text input and output works differently depending on the choice of Legacy or Code All Tags format. Legacy format The TXT: tag and the TXI: tag are used to control the input and output of code-related data elements in the Legacy format. The TXT: tag is used in the input packet if code-related items are wanted in the output packet. The value for TXT: specifies which code-related items are to be returned. It must be positioned above the codes in the input packet. The TXI: (Text input) tag accompanies the TXT: tag in the input packet if any of the code-related items are present in the packet. The tag notifies the interface program that the input 07/09 Creating a tagged format file4.41 How codes and code information are sent and returned packet will include the codes and any or all associated data elements. It must be positioned above the codes in the packet. The TXI: tag is used only if the TXT: tag is also included in the input file. They must both have the value of the TXI: tag. Hard returns in input packet If you are using Legacy format and sending the text, procedure date, or physician along with the codes, you must also add a specified number of blank lines in the input packet after each code sent. If you don’t, the software cannot parse the incoming codes correctly. These blank lines are required for all codes (diagnosis, procedure, group, MDC, etc.), because all codes need to take up the same number of lines in the file. See table 4–4 for examples. You do not need hard returns if you are not sending in code-related information or if you are using Code All Tags format. “Block” number prefix to procedure code description These numbers are displayed or passed in square brackets in the text description line for each ACHI procedure code. For data analysis purposes, block numbering provides a means of readily aggregating certain types of procedures. COD: ACHI.9016300 ARE:8 [Block number] prefix Legacy input example showing hard returns TEXT:[545] Other endoscopic excision of bronchus In this example of a Legacy input packet, the TXT: and TXI: value is 7, which tells the software to expect four elements for each code (code, text, date, physician) and to return the text associated with the code as well as the date and physician for the procedure codes. Because the diagnosis code doesn’t have associated date and physician, two blanks are required after the code. TXT:7 TXI:7 COD:3 T.C341 Malignant neoplasm of upper lobe, bronchus or lung <blank> <blank> ACHI.9016300 Other endoscopic excision of bronchus 20040305 JD Morris ACHI.9251419 General anaesthesia, a normal healthy patient, non-emergency or not known <blank> <blank> EOR: 4.42 Introduction to the 3M™ Codefinder™ Software 07/09 How codes and code information are sent and returned Hard returns in output packet With the Legacy format, if you specify that you want procedure date and/or physician ID in the output packet, the software adds blank lines after codes that are not procedure codes because all codes need to take up the same number of lines in the output file. In this example of Legacy input and output packets, the TXT: value sent in the input packet is 7, which returns the text, date, and ID associated with the procedure code. There is no code-related information being sent in, so the TXI: tag is not required and you do not need to include hard returns. Note that in the output file, the non-procedure codes have blank lines where the date and ID would be if they were procedure codes. Legacy input Legacy output 07/09 TXT:7 COD:3 T.C341 ACHI.9016300 CHI.9251419 EOR: TXT:4 COD:6 R.E71B RESPIRATORY NEOPLASMS W/O CC <blank> <blank> T.C341-ARE1-ARCL2 Malignant neoplasm of upper lobe, bronchus or lung <blank> <blank> ACHI.9016300-ARE8 [545] Other endoscopic excision of bronchus <blank> <blank> ACHI.9251419-ARE8 [1910] General anaesthesia, a normal healthy patient, non-emergency or not known <blank> <blank> PCCL.0 PCCL 0 - SDX is not a CC, or is included in ADRG definition, or is excluded <blank> <blank> MDC.004 DISEASES & DISORDERS OF THE RESPIRATORY SYSTEM <blank> <blank> EOR:78 Creating a tagged format file4.43 How codes and code information are sent and returned CodeAllTags format with all code-related items returned The setting of the TXTWithAllTags in the interface section of the codefind.ini file, turns the function of sending code descriptions (code text), procedure date and physician ID on or off. With it set to “NO” the output packet will contain this information if sent in as well as if it were entered during the coding session. The TXT: tag is not required in the input packet if you are using Code All Tags display format and do not want to control which code-related items are returned. The TXT: tag could be used in the input packet if you are using Code All Tags display format and want to have specific combinations of code-related items returned in the output packet. This will require TXTWithAllTags to be set to YES. The table below lists the values to be sent with the TXT: tag and the various combinations of code information that will be returned. Code-related items are preceded by the tags: TEXT:, DATE:, PHYS: and MOD: in the input and output packet. The output packet additionally will contain the ARE: and ARCL: grouper tags if grouper flags are turned on. Examples of Code All Tags input and output packets Code All Tags input In this example, two codes are sent in the input packet. The TXT: tag is not used and no hard returns are necessary. The text for the codes will be returned automatically, as will the date and physician ID for the procedure code if they are added in the coding session. The output file does not contain blank lines. CMD:004 PID:12345687 PAY:11 SYS:0 DDT:10/07/02 ADT:07/07/02 DSP:9 AGE:70 SEX:1 HMV:12 COD:T.C341 COD:ACHI.9016300 EOR: 4.44 Introduction to the 3M™ Codefinder™ Software 07/09 How codes and code information are sent and returned Code All Tags output Setting display formats and text return ERR:0 ETX:(3M CF) No Error PID:12345687 COD: R.E71B TEXT:RESPIRATORY NEOPLASMS W/O CC COD: T.C341 TEXT:Malignant neoplasm of upper lobe, bronchus or lung COD: ACHI.9016300 TEXT:[545] Other endoscopic excision of bronchus DATE:08/07/2002 PHYS:Dr Smith COD: PCCL.0 TEXT:PCCL 0 - SDX is not a CC, or is included in ADRG definition, or is excluded COD: MDC.004 TEXT:DISEASES & DISORDERS OF THE RESPIRATORY SYSTEM EOR:14 The choice of display format type--Legacy or Code All Tags-controls which TXT and TXI values can be used and how they are returned. There are three settings in the Codefind.ini file that work with the TXT: tag: - LegacyTXT= - CodAllTags= TXTWithAllTags= This has been replaced by the CodAllTags setting (CodAllTags=NO sets the legacy text format) Default setting is YES Default setting is blank To control the code-related output in the Code All Tags display format, you change the values of CodeAllTags= and TXTWithAllTags= to YES. If you don’t want to control the text output, the TXTWithAllTags= should be set to NO. Table 4–3 illustrates the relationship of the settings in the Codefind.ini file and the code-related elements controlled by the TXT: and TXI: tags. 07/09 Creating a tagged format file4.45 How codes and code information are sent and returned Table 4–3. Relationship of display formats, .ini settings, and TXT:/TXI: values Format returned Setting in .ini Input with code items sent Output example Returns Legacy format LegacyTxT=No Uses values 1–7 for TXT: and TXI:. TXT:1Code and procedure date TXT:2Code and text TXT:3Code, text, and procedure date TXT:4Code and physician ID TXT5:Code, procedure date, and physician ID TXT6:Code, text, and physician ID TXT7:Code, text, procedure date, and physician ID or TXT:7 TXI:7 <number of codes> <code> <text> <hard return> <hard return> <procedure code> <text> <procedure date> <doctor ID> COD: T.C341 Malignant neoplasm of upper lobe , bronchus or lung hard return hard return ACHI.9016300 Other endoscopic excision of bronchus 05/03/2005 Dr Morris Returns Legacy format LegacyTxt=Yes TXT:3 TXI:3 <number of codes> <code> <text> <hard return> <procedure code> <text> <procedure date> COD: T.C341 Malignant neoplasm of upper lobe , bronchus or lung hard return ACHI.9016300 Other endoscopic excision of bronchus 05/03/2005 CodAllTags=Yes <code> <code> COD: T.C341 TEXT:Malignant neoplasm of upper lobe, bronchus or lung COD: ACHI.9016300 TEXT:[545] Other endoscopic excision of bronchus TXT:7 <diagnosis code> <procedure code> COD: T.C341 TEXT:Malignant neoplasm of upper lobe, bronchus or lung COD: ACHI.9016300 TEXT:[545] Other endoscopic excision of bronchus DATE: 05/03/2005 PHYS:Dr Morris CodAllTags=blank or No This is the default setting. Allows DOS sites to keep the same input and output tags when they move to Codefinder for Windows. Only values 2–4 can be used. TXT:2Code and text (same as leaving it blank) TXT:3Code, text, and procedure date TXT:4Code, text, procedure date, and physician ID Returns Code All Tags format. TXTWithAllTags=No Returns text for all codes and any procedure dates and physician IDs entered in input packet or in Codefinder. Returns Code All Tags format. CodAllTags=Yes Returns code-related items specifed by TXT: value. Each item has its own tag. TXTWithAllTags=Yes Uses values 1–7 for TXT:/TXI:. TXT:1Code and procedure date TXT:2Code and text TXT:3Code, text, and procedure date TXT:4Code and physician ID TXT5:Code, procedure date, and physician ID TXT6:Code, text, and physician ID TXT7:Code, text, procedure date, and physician ID 4.46 Introduction to the 3M™ Codefinder™ Software or <diagnosis code> <text> <procedure code> <text> <procedure date> <doctor ID> 07/09 How codes and code information are sent and returned Examples of Legacy TXT: tag input and output Table 4–4. Table 4–4 illustrates the input and output associated with each TXT/TXI value using the Legacy format with LegacyTXT= set to NO. Remember that the TXI: tag is required if you are sending in actual values for code- related information. For additional TXT: tag information, refer to page 4.41 of this chapter. TXT choices with Legacy display format Choice Input with no codes sent (interactive) Input with codes only, no data elements sent (batch or interactive) Input with data elements sent (batch or interactive) Output (assumes code items were either sent in or added interactively) No TXT: tag. COD: COD:2 T.C341 ACHI.9016300 COD:2 T.C341 Malignant neoplasm of upper lobe, bronchus or lung ACHI.9016300 [545] Other endoscopic excision of bronchus COD: T.C341 COD:ACHI.9016300 TXT:1 COD: TXT:1 COD:2 T.C341 ACHI.9016300 TXT:1 TXI:1 COD:2 T.C341 hard return ACHI.9016300 05/03/2005 COD:2 T.C341 hard return ACHI.9016300 05/03/2005 TXT:2 COD: TXT:2 COD:2 T.C341 ACHI.9016300 TXT:2 TXI:2 COD:2 T.C341 Malignant neoplasm of upper lobe, bronchus or lung ACHI.9016300 [545] Other endoscopic excision of bronchus COD:2 T.C341 Malignant neoplasm of upper lobe, bronchus or lung ACHI.9016300 [545] Other endoscopic excision of bronchus TXT:3 COD: TXT:3 COD:2 T.C341 ACHI.9016300 TXT:3 TXI:3 COD:2 T.C341 Malignant neoplasm of upper lobe, bronchus or lung hard return ACHI.9016300 [545] Other endoscopic excision of bronchus 05/03/2005 COD:2 T.C341 Malignant neoplasm of upper lobe, bronchus or lung hard return ACHI.9016300 [545] Other endoscopic excision of bronchus 05/03/2005 No code info returned TXT: 1 Code and date TXT:2 or TXT:blank Code and text TXT:3 Code, text, and date 07/09 Creating a tagged format file4.47 How codes and code information are sent and returned Table 4–4. TXT choices with Legacy display format Choice Input with no codes sent (interactive) Input with codes only, no data elements sent (batch or interactive) Input with data elements sent (batch or interactive) Output (assumes code items were either sent in or added interactively) TXT:4 TXT:4 COD: TXT:4 COD:2 T.C341 ACHI.9016300 TXT:4 TXI:4 COD:2 T.C341 hard return ACHI.9016300 Dr Morris COD:2 T.C341 hard return ACHI.9016300 Dr Morris TXT:5 COD: TXT:5 COD:2 T.C341 ACHI.9016300 TXT:5 TXI:5 COD:2 T.C341 hard return hard return ACHI.9016300 Dr Morris COD:2 T.C341 hard return hard return ACHI.9016300 05/03/2005 Dr Morris TXT:6 COD: TXT:6 COD:2 T.C341 ACHI.9016300 TXT:6 TXI:6 COD:2 T.C341 Malignant neoplasm of upper lobe, bronchus or lung hard return ACHI.9016300 [545] Other endoscopic excision of bronchus Dr Morris COD:2 T.C341 Malignant neoplasm of upper lobe, bronchus or lung hard return ACHI.9016300 [545] Other endoscopic excision of bronchus Dr Morris TXT:7 COD: TXT:7 COD:2 T.C341 ACHI.9016300 TXT:7 TXI:7 COD:2 T.C341 Malignant neoplasm of upper lobe, bronchus or lung hard return hard return ACHI.9016300 [545] Other endoscopic excision of bronchus 05/03/2005 Dr Morris COD:2 T.C341 Malignant neoplasm of upper lobe, bronchus or lung hard return hard return ACHI.9016300 [545] Other endoscopic excision of bronchus 05/03/2005 Dr Morris Code and physician TXT:5 Code, date, and physician TXT:6 Code, text, and physician TXT:7 Code, text, date, and physician 4.48 Introduction to the 3M™ Codefinder™ Software 07/09 How codes and code information are sent and returned Returning DRG text The DTX: tag requests that information contained in the grouper weight line displayed on the Codefinder Summary screen and any text added with the Modify Utility be included in the output packet. The tag must be sent in the input packet for text to be returned in the output packet. The weight line usually contains several data items, such as weight, GLOS, and ALOS. You can choose to request the data in the Legacy display format (as a single block) or Code All Tags display format (with a specific tag for each data item) by changing the DTXAllTags= setting in the Codefind.ini file. See the DTX: description on page 4.22 in table 4–2 for a list of the possible DRG text line data items and tags that are returned from different groupers. Table 4–5 shows how the DTXAllTags= setting interacts with the LegacyTXT= and CodAllTags= setting. Basically, regardless of the Legacy or CodAllTags setting, if DTXAllTags is set to Yes, the output is in tagged format. If DTXAllTags is set to No or blank, the output is in Legacy display format. Table 4–5. Relationship of DTXAllTags and Legacy/Code All Tags Setting in .ini file Output CodAllTags=YES DTXAllTags=YES DWGT:1.22 ALOS:2.92 CodAllTags=NO DTXAllTags=YES LegacyTxt=YES DTXALLTags=YES LegacyTxt=NO DTXALLTags=YES CodAllTags=YES DTXAllTags=NO DTX:1 AR Cost Wt 1.22 ALOS 2.92 FMT:2 AR Cost Wt|AR Cost Wt|12|3|2 ALOS|ALOS|26|3|2 DTXAllTags=NO DTXAllTags=NO CodAllTags= DTXAllTags= LegacyTxt=YES DTXALLTags=NO LegacyTxt=NO DTXALLTags=NO LegacyTxt= DTXALLTags= 07/09 Creating a tagged format file4.49 Code formats Input and output packet for Codefinder can include many types of codes besides the diagnosis and procedure codes. For example, morphology codes and DRG codes are all part of the Codefinder output and may be input as well, particularly when batch grouping. Each type of code must be input and output in a specific code format. Some code types have an identifying prefix followed by a period before the actual code. ➤ Note: Codes located in the interface packet have no periods by default. If codes with periods are required in the output packet, change the value of the DecorateCodes line in the interface section of the Codefinder.ini file to Yes. [Interface] CODAllTags=YES DTXAllTags=YES DecorateCodes=YES The format of inpatient codes Table 4–6. Table 4–6 shows the formats for different types of inpatient codes. In general, each type of code is identified by a prefix, which is a letter or letters and a period (T., ACHI., M., etc.). Keep in mind that when using the Code All Tags display format, codes with prefixes are preceded by the COD: tag, while with the Legacy display format, the COD: tag specifies the number of codes being sent or returned and the individual codes follow without using tags. Inpatient code formats Type of code Description Example ICD-10-AM ICD-10-AM codes appear in the code format xxx.nnnnnnn. Diagnosis #T.O049 Procedure ACHI.3564302 MorphologyTM.M80001 The first character position of the code contains a blank space. The second set of characters indicates the type of code. The code type prefixes are: T. ICD-10-AM diagnosis code. 3 to 5 characters. TM. ICD-10-AM morphology code. 6 characters. ACHI. ACHI procedure code. 7 characters. GS. (Grouper Status) Identifies the errors generated during the grouping process. The text returned with the GS code will describe what the error was. If no errors are found (GS = 0), the GS prefix will not be included in the output. This is not reutrned if the episode grouped correctly The actual code (nnnnnnn) follows the period. 4.50 Introduction to the 3M™ Codefinder™ Software 07/09 Code formats Table 4–6. Inpatient code formats Type of code Description Example DRG DRG values are 4 characters, alphanumeric and the prefix is R. R.O40Z ABORTION W D&C, ASPIRATION CURETTAGE or HYSTEROTOMY MDC Major Diagnostic Category indicator identifies the major diagnostic cat- T.D569 MDC.16 egory into which the DRG falls. The prefix is MDC. 01Diseases and disorders of the nervous system 02Diseases and disorders of the eye 03Diseases and disorders of the ear, nose, mouth, and throat 04Diseases and disorders of the respiratory system 05Diseases and disorders of the circulatory system 06Diseases and disorders of digestive system 07Diseases and disorders of the hepatobiliary system and pancreas 08Diseases and disorders of the musculoskeletal system and connective tissue 09Diseases and disorders of the skin, subcutaneous tissue, and breast 10Endocrine, nutritional, and metabolic diseases and disorders 11Diseases and disorders of the kidney and urinary tract 12Diseases and disorders of the male reproductive system 13Diseases and disorders of the female reproductive system 14Pregnancy, childbirth, and the puerperium 15Newborns and other neonates 16Diseases and disorders of blood and blood forming organs and immunological disorders 17Neoplastic disorders (haematological and solid neoplasms) 18Infectious and parasitic diseases 19Mental diseases and disorders 20Alcohol/drug use and alcohol/drug induced mental disorders 21Injuries, poisoning, and toxic effects of drugs 22Burns 23Factors influencing health status and other contacts with health services Morphology/Diagnosis code pairing 07/09 3M Codefinder sequences Morphology codes next to their relevant site code in the interface output packet. It also has the ability to send two-digit pairing sequence numbers to assist an interface program to group Site and Morphology codes. Morphology / Diagnosis code sets being returned to Codefinder required the PMI interface to pass them with these pairing sequence numbers so Codefinder could maintain the relationship. Codefinder has additional logic to pair up site and Morphology codes sent via the interface sequenced next to the Creating a tagged format file4.51 Code formats the site code or randomly sequenced with no pairing sequencing numbers. Site and Morphology codes which are paired properly by their sequence are easily identified, grouped and numbered with pairing sequence numbers by the Codefinder software. If site and Morphology codes are not in the proper sequence the software will attempt to group, like site and Morphology codes, together. If there are multiple site codes that could be paired with one or more out-of-sequence Morphology code(s), the software will group the site codes together sequentially with the Morphology code(s) following and assign a common sequence number to all related codes in the group. If a dagger/asterisk relationship has been identified, the Morphology codes will be sequenced after the dagger/site code with the asterisk code(s) following. The following scenarios cover the logic 3M Codefinder now uses to pair up site/Morphology code pairs in the interface output packets. Condition Outcome M codes and site codes have Pairing Sequence numbers Maintains relationship M code sequenced under its Site code Maintains relationship M code not sequenced under its site code or M codes random in sequence to site codes site codes together followed by the M codes. Paired if no multiple relationships Else multi relationship sets are sequenced Orphan M codes Sequenced next to first M code in a valid M codes/site code pair Orphan site codes If a site code has no morphology code immediately following it, the software will attempt to group it with a site/Morphology code pair that has similar characteristics. 4.52 Introduction to the 3M™ Codefinder™ Software 07/09 Code formats 1. Initial coding session with no MRP: tag or MRP:0 or MRP:[blank] sent in input packet When Morphology codes are assigned in an initial coding session the pairing logic will position the Morphology code next to the matching site code in the output packet. If the MRP: tag is not sent in the input packet or sent set to 0 (MRP:0) or blank (MRP:), then two digit pairing sequence numbers will not be included with the codes to identify code sets. If two site codes have the same Morphology code and as duplicate Morphology codes are deleted, the two site codes will be paired followed by the common Morphology code. Example: LegacyText ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #1 COD:9 R.J67A T.C440 TM.M80703 T.C780 TM.M80706 MDC.009 PCCL.2 VSN.I10E5 VSN.AR52 EOR:7 ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #2 COD:14 R.N60A T.C549 TM.M80103 T.C7988 TM.M80106 T.C434 T.C435 TM.M87203 T.C773 TM.M87206 MDC.013 PCCL.3 VSN.I10E4 EOR:0 CodeAllTags ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #1 COD:R.J67A COD:T.C440 COD:TM.M80703 COD:T.C780 COD:TM.M80706 COD:MDC.009 COD:PCCL.2 VSN.I10E5 VSN.AR52 EOR:7 07/09 ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #4 COD:R.N60A COD:T.C549 COD:TM.M80103 COD:T.C7988 COD:TM.M80106 COD:T.C434 COD:T.C435 COD:TM.M87203 COD:T.C773 COD: TM.M87206 COD:MDC.013 Creating a tagged format file4.53 Code formats COD:PCCL.3 VSN.I10E4 VSN.AR52 EOR:0 2. Initial coding session with MRP:1 sent in input packet When Morphology codes are assigned in an initial coding session the pairing logic will position the Morphology code next to the matching site code in the output packet. As the MRP:1 tag is sent in the input packet two digit pairing sequence numbers will be included with the Morphology/Site code sets to identify the pairs. If two site codes have the same Morphology code, as duplicate Morphology codes are deleted, the two site codes will be paired followed by the common Morphology code and share the same pairing sequence number. Example: LegacyText ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #1 COD:9 R.J67A T.C440-00 TM.M80703-00 T.C780-01 TM.M80706-01 MDC.009 PCCL.2 VSN.I10E5 VSN.AR52 EOR:7 ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #4 COD:14 R.N60A T.C549-00 TM.M80103-00 T.C7988-01 TM.M80106-01 T.C434-02 T.C435-02 TM.M87203-02 T.C773-03 TM.M87206-03 MDC.013 PCCL.3 VSN.I10E4 EOR:0 CodeAllTags ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #1 COD:R.J67A COD:T.C440 MOD:00 COD:TM.M80703 MOD:00 COD:T.C780 MOD:01 COD:TM.M80706 4.54 Introduction to the 3M™ Codefinder™ Software ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #4 COD:R.N60A COD:T.C549 MOD:00 COD:TM.M80103 MOD:00 COD:T.C7988 MOD:01 COD:TM.M80106 07/09 Code formats MOD:01 COD:MDC.009 COD:PCCL.2 VSN.I10E5 VSN.AR52 EOR:24 3. MOD:01 COD:T.C434 MOD:02 COD:T.C435 MOD:02 COD:TM.M87203 MOD:02 COD:T.C773 MOD:01 COD: TM.M87206 MOD:01 COD:MDC.013 COD:PCCL.3 VSN.I10E4 VSN.AR52 EOR:55 Coded episode returned to Codefinder with no Pairing sequence numbers with no MRP: tag or MRP:0 or MRP:[blank] sent in input packet When a pre-coded episode that contains Morphology and site codes that do not have pairing sequence numbers is returned to Codefinder in the interface input packet, the pairing logic in Codefinder will identify the Morphology and site codes sets and pair them together. As the MRP: tag identifies that pairing sequence numbers are not to be returned, Morphology and site codes pairs will be returned sequenced next to each other in the output packet with no pairing sequence numbers, irrespective of the order these code sets were sent in, in the output packet. Example: LegacyText CMD:004 SYS:0 PID:Morphology Test Record #1 PAY:11 DDT:08/10/07 ADT:06/10/07 DSP:9 AGE:45 SEX:2 MRP:1 HMV:0 COD:4 T.C440 TM.M80703 T.C780 TM.M80706 EOR: 07/09 ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #1 COD:9 R.J67A T.C440-00 TM.M80703-00 T.C780-01 TM.M80706-01 MDC.009 PCCL.2 VSN.I10E5 VSN.AR52 EOR:7 Creating a tagged format file4.55 Code formats CodeAllTags CMD:004 SYS:0 PID:Morphology Test Record #4 PAY:11 DDT:08/10/03 ADT:06/10/03 DSP:9 AGE:45 SEX:2 RSQ:0 MRP:1 HMV:0 COD:9 T.C549 TM.M80103 T.C7988 TM.M80106 T.C434 T.C435 TM.M87203 T.C773 TM.M87206 EOR: 4. ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #4 COD: R.N60A COD: T.C549 MOD:00 COD: TM.M80103 MOD:00 COD: T.C7988 MOD:01 COD: TM.M80106 MOD:01 COD: T.C434 MOD:02 COD: T.C435 MOD:02 COD: TM.M87203 MOD:02 COD: T.C773 MOD:03 COD: TM.M87206 MOD:03 COD: MDC.013 COD: PCCL.3 COD: VSN.I10E5 COD: VSN.AR52 EOR:35 Coded episode returned to Codefinder with Pairing sequence numbers in the input packet with no MRP: tag or MRP:0 or MRP:[blank] sent in input packet When an already coded episode that contains Morphology and site codes that have pairing sequence numbers to identify code pairs, is returned to Codefinder in the interface input packet, the pairing logic in Codefinder will identify the Morphology and site codes sets based on the pairing sequence numbers in the input packet. As the MRP: tag identifies that pairing sequence numbers are to be returned, Morphology and site codes pairs will be returned sequenced next to each other in the output packet with no pairing sequence numbers, irrespective of the order that these code sets were sent in. 4.56 Introduction to the 3M™ Codefinder™ Software 07/09 Code formats Example: LegacyText CMD:004 SYS:0 PID:Morphology Test Record #1 PAY:11 DDT:08/10/07 ADT:06/10/07 DSP:9 AGE:45 SEX:2 MRP:1 HMV:0 COD:4 T.C440-00 TM.M80703-00 T.C780-01 TM.M80706-01 EOR: ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #1 COD:9 R.J67A T.C440 TM.M80703 T.C780 TM.M80706 MDC.009 PCCL.2 VSN.I10E5 VSN.AR52 EOR:7 CodeAllTags CMD:004 SYS:0 PID:Morphology Test Record #4 PAY:11 DDT:08/10/03 ADT:06/10/03 DSP:9 AGE:45 SEX:2 RSQ:0 MRP:1 HMV:0 COD:9 T.C549 MOD:00 TM.M80103 MOD:00 T.C7988 MOD:01 TM.M80106 MOD:01 T.C434 MOD:02 T.C435 MOD:02 TM.M87203 MOD:02 T.C773 MOD:03 07/09 ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #4 COD: R.N60A COD: T.C549 COD: TM.M80103 COD: T.C7988 COD: TM.M80106 COD: T.C434 COD: T.C435 COD: TM.M87203 COD: T.C773 COD: TM.M87206 COD: MDC.013 COD: PCCL.3 COD: VSN.I10E5 COD: VSN.AR52 EOR:123 Creating a tagged format file4.57 Code formats TM.M87206 MOD:03 EOR: 5. Coded episode returned to Codefinder with Pairing sequence numbers with MRP:1 sent in input packet When a precoded episode that contains Morphology and site codes that do not have pairing sequence numbers is returned to Codefinder in the interface input packet, the pairing logic in Codefinder will identify the Morphology and site codes sets and pair them together. As the MRP: tag identifies that pairing sequence numbers are to be returned, Morphology and site codes pairs will be returned sequenced next to each other in the output packet with pairing sequence numbers, irrespective of the order these code sets were sent in, in the output packet. Example: LegacyText CMD:004 SYS:0 PID:Morphology Test Record #1 PAY:11 DDT:08/10/07 ADT:06/10/07 DSP:9 AGE:45 SEX:2 MRP:1 HMV:0 COD:4 T.C440 TM.M80703 T.C780 TM.M80706 EOR: ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #1 COD:9 R.J67A T.C440-00 TM.M80703-00 T.C780-01 TM.M80706-01 MDC.009 PCCL.2 VSN.I10E5 VSN.AR52 EOR:7 CodeAllTags CMD:004 SYS:0 PID:Morphology Test Record #4 PAY:11 DDT:08/10/03 ADT:06/10/03 DSP:9 AGE:45 SEX:2 RSQ:0 4.58 Introduction to the 3M™ Codefinder™ Software ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #4 COD: R.N60A COD: T.C549 MOD:00 COD: TM.M80103 MOD:00 COD: T.C7988 MOD:01 07/09 Code formats MRP:1 HMV:0 COD:9 T.C549 TM.M80103 T.C7988 TM.M80106 T.C434 T.C435 TM.M87203 T.C773 TM.M87206 EOR: 6. COD: TM.M80106 MOD:01 COD: T.C434 MOD:02 COD: T.C435 MOD:02 COD: TM.M87203 MOD:02 COD: T.C773 MOD:03 COD: TM.M87206 MOD:03 COD: MDC.013 COD: PCCL.3 COD: VSN.I10E5 COD: VSN.AR52 EOR:35 Coded episode returned to Codefinder with Pairing sequence numbers with MRP:1 sent in input packet When an already coded episode that contains Morphology and site codes that have pairing sequence numbers to identify code pairs, is returned to Codefinder in the interface input packet, the pairing logic in Codefinder will identify the Morphology and site codes sets based on the pairing sequence numbers in the input packet. As the MRP: tag identifies that pairing sequence numbers are to be returned, Morphology and site codes pairs will be returned sequenced next to each other in the output packet with no pairing sequence numbers, irrespective of the order that these code sets were sent in. The returned pairing sequence numbers will not necessarily be the same as that sent in the input packet Example: LegacyText CMD:004 SYS:0 PID:Morphology Test Record #1 PAY:11 DDT:08/10/07 ADT:06/10/07 DSP:9 AGE:45 SEX:2 MRP:1 HMV:0 07/09 ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #1 COD:9 R.J67A T.C440 TM.M80703 T.C780 TM.M80706 MDC.009 PCCL.2 Creating a tagged format file4.59 Code formats COD:4 T.C440-00 TM.M80703-00 T.C780-01 TM.M80706-01 EOR: VSN.I10E5 VSN.AR52 EOR:7 CodeAllTags CMD:004 SYS:0 PID:Morphology Test Record #4 PAY:11 DDT:08/10/03 ADT:06/10/03 DSP:9 AGE:45 SEX:2 RSQ:0 MRP:1 HMV:0 COD:9 T.C549 MOD:00 TM.M80103 MOD:00 T.C7988 MOD:01 TM.M80106 MOD:01 T.C434 MOD:02 T.C435 MOD:02 TM.M87203 MOD:02 T.C773 MOD:03 TM.M87206 MOD:03 EOR: 4.60 Introduction to the 3M™ Codefinder™ Software ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #4 COD: R.N60A COD: T.C549 COD: TM.M80103 COD: T.C7988 COD: TM.M80106 COD: T.C434 COD: T.C435 COD: TM.M87203 COD: T.C773 COD: TM.M87206 COD: MDC.013 COD: PCCL.3 COD: VSN.I10E5 COD: VSN.AR52 EOR:123 07/09 Code formats 7. Orphan Morphology codes returned in the interface packet If the input packet contains a orphan Morphology code(A Morphology code with no matching site code) the orphan code will be sequenced next to the first morphology code. Or at the end of the list of Diagnosis codes if there are no other Morphology codes. Example: 07/09 SYS:0 CMD:004 PAY:11 PID:Morphology Test Record #7 ADT:24/07/2007 DDT:25/07/2007 SEX:2 AGE:44 MRP:1 DSP:9 COD:T.D695 COD:T.C189 COD:TM.M81406 < (Orphan code) COD:TM.M81403 COD:ACHI.1391500 EOR: ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #7 COD:10 R.Q62Z T.D695 T.C189-00 TM.M81403-00 TM.M81406 < (Orphan Morphology code. P.1391500 Not associated with site code.) MDC.016 PCCL.2 VSN.I10E5 VSN.AR52 EOR:91 SYS:0 CMD:004 PAY:11 PID:Morphology Test Record #7 ADT:24/07/2007 DDT:25/07/2007 SEX:2 AGE:44 MRP:1 DSP:9 COD:T.D695 COD:T.J540 COD:TM.M81406 < (Orphan code ) COD:TM.M81403 < (Orphan code ) COD:ACHI.1391500 EOR: ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #7 COD:10 R.Q62Z T.D695 T.J540 TM.M81403 < (Orphan Morphology code.) TM.M81406 < (Orphan Morphology code.) P.1391500 MDC.016 PCCL.2 VSN.I10E5 VSN.AR52 EOR:91 Creating a tagged format file4.61 Code formats 8. Orphan Site Code returned in the interface input packet If a site code has no morphology code immediately following it, the software will attempt to group it with a site/Morphology code pair that has similar characteristics Example: 9. CMD:004 SYS:0 PID:Morphology test record #5 PAY:11 DDT:25/07/2007 ADT:24/07/2007 DSP:9 AGE:44 MRP:1 SEX:2 COD:8 T.D464 T.Z511 T.C787 T.C786 < Orphan code T.C189 TM.M99803 TM.M81406 TM.M81403 T.D759 ACHI.1391500 EOR: ERR:0 ETX:(3M CF) No Error PID:Morphology test record #5 COD:13 R.R61B T.D464-00 T.C189-00 TM.M99803-00 TM.M81403-00 T.Z511 T.C787-01 T.C786-01 < Orphan code TM.M81406-01 T.D759 ACHI.1391500 MDC.017 PCCL.3 VSN.I10E5 VSN.AR52 EOR: Multiple Site / Morphology codes that are interrelated If two site and two Morphology codes that have a cross relationship such that the pairing logic cannot match them, it will assign the same pairing sequence number to the four codes. In the example below D464 could be matched to either M99803 or M81403 as could C189 Example: CMD:004 SYS:0 PID:Morphology test record #5 PAY:11 DDT:25/07/2007 ADT:24/07/2007 DSP:9 AGE:44 MRP:1 SEX:2 COD:8 T.D464 T.Z511 4.62 Introduction to the 3M™ Codefinder™ Software ERR:0 ETX:(3M CF) No Error PID:Morphology test record #5 COD:13 R.R61B T.D464-00 T.C189-00 TM.M99803-00 TM.M81403-00 T.Z511 T.C787-01 T.C786-01 TM.M81406-01 07/09 Code formats T.C787 T.C786 T.C189 TM.M99803 TM.M81406 TM.M81403 T.D759 ACHI.1391500 EOR: Sequencing of † and * codes pairs and Morphology Codes T.D759 ACHI.1391500 MDC.017 PCCL.3 VSN.I10E5 VSN.AR52 EOR: Codes pairs sent in input and output packets via the interface are not identified as Dagger/Asterisk codes. If codes are direct entered or they are coded through the Codefinder pathways they may have Dagger/Asterisk relationships identified. When Dagger/Asterisk relationships are identified, the pairing logic will place the asterisk code after the Dagger code in the interface output packet. Example: ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #35 Legacy COD:5 R.R62A T.D489 † T.M360 * MDC.017 PCCL.2 EOR: (Note: † and * are only shown to identify the codes pairs ) When Dagger/Asterisk relationships are identified along with a related Morphology (site) code, the pairing logic will place the asterisk code after the morphology code in the interface output packet. The Diagnosis/Morphology code set will also include the set matching numbers if the MRP: tag is sent in the input packet set to 1 (MRP:1) 07/09 Creating a tagged format file4.63 Code formats Example: MRP:1 in input packet ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #35 Legacy COD:6 R.R62A † T.D489-00 TM.M80001-00 * T.M360 MDC.017 PCCL.2 EOR: MRP:0 or MRP:[blank] or no MRP: tag in input packet ERR:0 ETX:(3M CF) No Error PID:Morphology Test Record #35 Legacy COD:6 R.R62A † T.D489 TM.M80001 * T.M360 MDC.017 PCCL.2 EOR: (Note: † and * are only shown to identify the code pair ) Inpatient packet examples This section shows examples of packets that contain the various types of inpatient codes. See appendix A, WIES Reimbursement, for an explanation of the tags that appear below the RCS tag. 4.64 Introduction to the 3M™ Codefinder™ Software 07/09 Code formats ICD-10-CM and AR-DRG Legacy input packet Product is Codefinder Reimbursement is Australian Grouper is Victoria State MDC output to be 2 chars wide Show ICD, DRG Ver. in output Hospital in home LOS Pair morphology codes with dx Intended Same-day status Mental heath legal status Hours of mechanical ventilation Length of stay Leave days Number of codes sent Diagnosis Secondary diagnosis Procedure 07/09 Codefinder. AR-DRG Victorian State Pre-defined Grouper. Three codes sent in and configuration set for WIES Reimbursement calculation. CMD:004 AUR:CTYPE=4|CROLE=A|ACLS=MP|ATSI=2 PID:Test Patient PAY:33 MDC:2 VSN:1 RV3:0 SEX:2 AGE:40 DSP:09 DDT:12/01/2005 ADT:01/01/2005 MRP:1 TXT: DTX:1 ISD:0 MLS:2 HMV:5 LOS:11 LEV:2 COD:3 T.D569 T.I10 ACHI.1250000 EOR: Creating a tagged format file4.65 Code formats Output packet examples ICD-10-CM and AR-DRG Legacy output packet Number of codes returned DRG Patient Clinical Complexity Level Major Diagnostic Category ICD–10-AM Edition number AR-DRG Version number Normative Average LOS Victorian reimbursement information Packet showing DRG, principle and secondary diagnosis, procedure, PCCL, MDC, text descriptions and Victorian WIES Reimbursement scheme. ETX:(3M CF) No Error PID: Test Patient TXT: COD:8 R.Q61C RED BLOOD CELL DISORDERS W/O CATASTROPHIC or SEVERE CC T.D569 Thalassaemia, unspecified T.I10 Essential (primary) hypertension ACHI.1250000 [1863] Blood volume nuclear medicine estimation PCCL.0 PCCL 0 - SDX is not a CC, or is included in ADRG definition, or is excluded MDC.16 DISEASES & DISORDERS OF BLOOD, BLOOD FORMING ORGANS, IMMUNOLOG DISORD VSN.I10E4 <hard return> VSN.AR50 <hard return> ALOS:2.3 RCS: TREIMB:4131.55 DRGWT:1.4154 TOTWT:1.4154 ATSICP:0.0000 BWIES:1.1506 BRATE:2919.00 PAYER:Public RURISO:0.00 VICDRG:Q61C LOSCAT:M MVCP:0.0000 AAACP:0.0000 ASDCP:0.0000 THALCP:0.2648 COLONCP:0.0000 STN:2 STX:High Outlier EOR:34 4.66 Introduction to the 3M™ Codefinder™ Software 07/09 Chapter 5 Creating an HL7 format packet 5 5.2 Introduction to the 3M™ Codefinder™ Software 07/09 Chapter 5 Creating an HL7 format packet Please note: 3M™ Codefinder™ software can accommodate HL7 formatted data. This chapter is currently under revision, and will be included in its entirety with the next release. THE 3M™ CONNECTIONS SOFTWARE USES VERSION 2.3 and higher of the HL7 (Health Level Seven) standard for interfacing with PMI systems. HL7 standards provide structure for non-proprietary communication between interfaces of different systems that send or receive patient admissions/registration, discharge or transfer data, patient scheduling, orders, results, billing, medical records, and patient care. The primary goal of HL7 is to provide standards for the exchange of data among health care computer applications and eliminate or substantially reduce the custom interface programming and program maintenance that may otherwise be required. The 3M™ Codefinder software does not process the HL7 format directly. 3M Connections software includes programs that translate the HL7 format to the 3M proprietary tagged format required by Codefinder and back to HL7 again. Both the Basic (DLL) and TCP/IP communications modes can be used with HL7 format input packets. 5.3 Introduction to the 3M™ Codefinder™ Software 07/09 HL7 processing in 3M Connections Software The following steps describe the processing procedure when you use HL7 format. 1. The PMI application sends a data packet in HL7 format containing patient demographic information to CFINT32.DLL directly or via the TCP/IP server if this interface option is used. 2. The CFINT32.DLL file calls the HL723M32.EXE file. The HL723M32.EXE file stores the MSH (Message Header) segment. 3. The pre-post processor (PP32.EXE) processes the packet and converts the HL7 formatted data to the tagged format. 4. The CFINT32.DLL then sends the data to the coding application. 5. After the coding is done and the “Complete” button is pressed, the entire process is reversed. PMI System Input packet data (usually demographics but can be anything) 3M Codefinder and Reimbursement System Vendor interface CFINT32.DLL Coding and grouping session output packet Data from output packet HL7 only PrePost Processor HLT23M32.EXE PrePost Processor PP32.EXE Figure 5–1. Basic interface data flow HL7 uses the Code All Tags display format only. Refer to the chapter 4 for further details. 5.4 Introduction to the 3M™ Codefinder™ Software 07/09 Chapter 6 Utilities 6 6.2 Introduction to the 3M™ Codefinder™ Software 07/09 Chapter 6 Utilities T HIS CHAPTER CONTAINS information about the tools and programs located in the 3MHIS\wincoder\interfac directory. These tools are: ◆ IntrEdit.exe, used to modify the codefind.ini or registry settings as necessary ◆ IPKTST32.EXE - Interface Test Packet tool, used to test the input and output packets ◆ UNLOAD32.EXE - Unload tool, used to unload the Codefinder and DLL programs ◆ Debug32.exe - Debug Display tool, displays function calls, input and output packets passed to and from CFINT32 ◆ CFWINFIL.exe - Batch Interface program, run Codefinder in batch mode ◆ TAGS.EXE - Tags.Txt Editor utility, used to modify the default output packet You have access to the different utilities depending on the type of 3M™ Connections Software interface option you purchased. 07/09 Utilities6.3 Intredit tool The Intredit tool allows you to: ◆ View and edit codefind.ini file entries. The codefind.ini file is created in the “Windows” directory if your operating system is Windows XP, or in the “WinNT” directory if your operating system is Windows 2000. ◆ View and edit 3M values in the Windows registry. These values are added to the registry during the installation of the interface. It is safer to use this utility than Regedit as it only allows you to modify the Codefinder registry settings. ❑ Double-click the Intredit.exe tool located in the 3MHIS\ wincoder\interfac directory. The Intredit Editor window appears. The directory structure on the left panel of the Intredit Editor window has two main headings: My Computer Registry and CODEFIND.INI. 6.4 Introduction to the 3M™ Codefinder™ Software 07/09 Intredit tool Modifying the codefind.ini file ❑ To modify the interface section of the codefind.ini file, double-click on the CODEFIND.INI folder, in the left panel of the Intredit Editor window. Then click on the Interface folder from the folders that drop down.For a discussion of codefind.ini settings for the interface, see pages 4.38 and 4.46 in chapter 4 (Tagged Format). Click CODEFIND.INI, then click Interface. The right-hand pane shows the Interface Section of the .ini file. ❑ Click the icon next to the value you want to change. The Edit String window appears. ❑ Enter any edits to the string and click OK — or —– If the value is an executable, click Browse to locate the new executable. 07/09 Utilities6.5 Intredit tool Modifying the Registry To modify the Registry: ❑ From the 3MHIS\wincoder\interfac directory, launch intredit.exe. ❑ Click on the + sign by the My Computer Registry folder in the left panel of the Intredit Editor window. ❑ From the folders that drop down, select HKEY_LOCAL_MACHINE, and in turn select SOFTWARE > 3M > HIS > INTERFACE. The right-hand pane shows the Registry values for the interface. Each value has a name and a data value. Adding a new value ❑ To add a new entry to the list in the right pane, Right click in the blank area of the right pane. A small New prompt appears. ❑ Click New, then String Value. The Edit String window requests the name and data for the new value. 6.6 Introduction to the 3M™ Codefinder™ Software 07/09 Intredit tool ❑ In the Value Name box, enter the name for the value. ❑ In the Value Data box, enter the specifications — or — If the value is an executable, click browse to locate the executable. ❑ Click OK. The new entry appears in the right pane in alphabetical order. Editing an existing value ❑ To edit an existing value, In the right pane, click the icon of entry with the value you want to change. The Edit String window opens, showing the current name and data. The Data Value is highlighted. ❑ In the Edit String window, enter any edits to the string and click OK — or — If the value is an executable, click Browse to locate the new executable. 07/09 Utilities6.7 Interface Test Packet tool (IPKTST32) The 3M Connections Software includes a 32-bit interface test program (IPKSTS32.EXE). This program tests the Basic Interface (CFINT32.DLL) and is used to examine the operation of different constructs of input data packets with Codefinder before writing code for the PMI interface program. It provides the facility to open existing input files and to create new ones. The Connections Software installs a selection of sample files in tagged format in the 3M HIS\WINCODER\INTERFAC directory. Chapter 4 contains several additional examples of input packets that can be used as a basis for writing your own. Saved Input packet files can be used for ongoing testing during development. ❑ In the 3MHIS\WINCODER\INTERFAC directory, IPKTST32.EXE. The Interface Test Program window appears. This also launches Codefinder. There are two communication modes in the interface test program: DLL or Winsock. The DLL mode is the default option. Use the DLL mode to experiment with tagged formatted input data packets. Select the Winsock option to test the TCP/IP interface. 6.8 ❑ Click the Connection option located in the top bar of the window. ❑ From the drop-down window, choose DLL or Winsock, as required. Introduction to the 3M™ Codefinder™ Software 07/09 Interface Test Packet tool (IPKTST32) New input files ❑ If the sample input packet files do not meet your needs, you can create your own for development and testing. On the Interface Test Program window, type the packet data in the Input Packet section or copy and paste sections from another source and edit them as required. This packet must match the specifications outlined in Chapter 4. ❑ Make sure the discharge date matches the grouper version you want to use. ❑ Click the Write Packet button. This launches the Codefinder software. Depending on the data and the value sent in the CMD: tag, Codefinder could start at the Patient Information window, the Principal Diagnosis Keyword prompt, or the Patient Code Summary window. The example shows an input packet for a previously coded episode being sent back for interactive coding (CMD:004) with the codes from that session, so Codefinder would start at the Patient Code Summary window. If the batch command (CMD:504), with all the required information for batch grouping is sent, the results will be returned and Codefinder will not display on the screen. 07/09 ➤ Note: If interactive coding is being used and Codefinder does not display when you click the Write Packet button, you may need to run the Unload program. See page 6.13 for information. ❑ Code or Edit the record as necessary. ❑ On the Patient Code Summary window, click Compute. ❑ To end the coding session, click Complete. Utilities6.9 Interface Test Packet tool (IPKTST32) The Interface Test Program displays the data returned from Codefinder in the Output Packet window. ❑ Saving test packets ❑ Examine the output packet for errors, messages, and expected format. Input packets created can be saved for future use. The saved input packets must have the extension .vi so they can be retrieved and opened inside the ipktst32 utility. Output packets can also be saved. Click File and then Save Input. The Save Interface File window opens. Though the input packet files can be saved anywhere, they are best saved in the 3MHIS\WINCODER\INTERFAC directory. ❑ In the Save In box, browse to and select the location where the packet is to be saved. ❑ In the File Name box, enter a file name—with an extension of .vi—for the packet. ❑ Select Interface in the Save as type box. ❑ Click Save to finish. 6.10 Introduction to the 3M™ Codefinder™ Software 07/09 Interface Test Packet tool (IPKTST32) Using existing input packets ❑ It is convenient to have a library of saved test packet files of various types to assist with testing during development. To use these example or saved input packet files: From the File option at the top on the Interface Test Program window choose Open. The Open Interface File window is displayed showing the last location a file was opened from and any files that have a .vi extension. Generally, this is the INTERFAC directory. ❑ If the files are saved elsewhere, browse to the location. ❑ Click on the required file from the list. The selected file appears in the File name field. ❑ Click Open. The data for the input file appears in the Input Packet section. 07/09 Utilities6.11 Interface Test Packet tool (IPKTST32) ❑ Ensure the discharge date matches the grouper version you want to use. ❑ Click the Write Packet button. ➤ Note: If interactive coding is being used and Codefinder does not display when you click the Write Packet button, you may need to run the Unload program. See page 6.13 for information. The Codefinder window displays with the patient data from the selected input packet. ❑ Code or edit the record as required. ❑ To end the coding session, click the Complete button. The Interface Test Program displays the data returned from Codefinder in the Output Packet window. ❑ Examine the output packet for errors, messages, and expected format. 6.12 Introduction to the 3M™ Codefinder™ Software 07/09 Unload program (UNLOAD32.EXE) This program allows you to unload program files that are left orphaned in memory following a fatal error during testing. For example, if you are using the Interface Test Packet tool and it doesn’t launch Codefinder when you click Write Packet, there could be to many instances of CFINT32.DLL orphaned in memory. Perform the following procedures to unload the files: ❑ Close all running instances of IPTST32 and Codefinder ❑ In the 3MHIS\WINCODER\INTERFAC directory, launch the UNLOAD32.EXE program. The Unload window appears. The window may show files that are in memory. ❑ In the upper right, ensure that only the Codefinder box is ticked. this will display the files associated with Codefinder that will need to be unloaded. If other boxes are checked, you will see an extremely large list of files. ❑ First, if CODEFIND.EXF is displayed, highlight it, then click Unload. ➤ Note: Always select the CODEFIND.EXF file first, before you unload any other files. The selected file is unloaded from memory and disappears from the window. This process may have to be repeated if more than one instance of the program is in memory. ❑ 07/09 Repeat the step above until all the files are unloaded. Utilities6.13 Debug Display tool (debug32.exe) The Debug Display tool is used to diagnose or troubleshoot interface problems. The tool is installed with the interface software. Input and output packets only reside in memory and are not stored in files. The Debug Display tool allows examination of the function calls and the data that is passed between the interface program and Codefinder. This Debug Display tool program must be invoked first, before calls to Codefinder are made either from the interface being developed or from the interface test utility. The Debug Display tool is slightly different depending on whether or not you are testing tagged format or HL7 packets. Debug Display for tagged format packets ❑ To run the Debug Display tool for tagged format. In the 3MHIS\WINCODER\INTERFAC directory, select the DBG32.EXE tool. The Debug Display window appears. The Instance Information section in the left pane displays the function calls that have been initiated. This information will assist software engineers when troubleshooting interface problems. Error messages are also displayed here. 6.14 Introduction to the 3M™ Codefinder™ Software 07/09 Debug Display tool (debug32.exe) The right pane of the window has two tabs for the display of the input and output packet data. The byte quantities for each packet appear at the bottom of each section. ❑ Launch the Interface Test Packet program, select an input file, and click Write Packet — or — Launch Codefinder from the PMI system. The Debug Display window now shows the function calls in the left pane and the input packet in the right pane. 07/09 ❑ After coding is done click on the complete button. ❑ In the Debug Display tool click on the Output Packet tab to view the output packet. Utilities6.15 Debug Display tool (debug32.exe) ➤ Note: If interactive coding is being used and Codefinder does not display when you click the Write Packet button, you may need to run the Unload program. See page 6.13 for information. Debug Display for HL7 format packets Some changes to the registry are needed before running Debug Display with an HL7 format input packet. ❑ From the 3MHIS\WINCODER\INTERFAC directory, launch INTREDIT.EXE. ❑ Choose HKEY_LOCAL_MACHINE > SOFTWARE > 3M > HIS > INTERFACE. ❑ Click on the PcktProcessExe2 line and modify it to read C:\3MHIS\RIP\BIN\PP32.EXE pre=-h post=-h. ❑ Click on the SaveBeforeModifyPckt line and change the (0) to (1). ❑ Exit INTREDIT. To run the Debug Display tool with HL7: ❑ In the 3MHIS\ WINCODER\INTERFAC directory, select the DBG32.EXE tool. The Debug Display window appears. ❑ Launch the Interface Test Packet program, select an input file, and click Write Packet — or — Launch Codefinder from the PMI system. The data generated appears in the Debug Display tool window. When a HL7 packet is sent to Codefinder, the HL7 segments are translated to tagged format as required by Codefinder. When coding is completed the tagged output packet from Codefinder is then translated back into HL7 format. The right pane of the Debug Display tool window has four tabs. Although they have a certain order on the screen, it is easier to understand them in the order in which they are processed. ◆ PrePacket. Displays the original HL7 format input file. 6.16 Introduction to the 3M™ Codefinder™ Software 07/09 Debug Display tool (debug32.exe) P 07/09 ◆ Input Packet. Displays the HL7 format input file translated to tagged format. ◆ PostPacket. Displays the Codefinder output file in tagged format. Utilities6.17 Debug Display tool (debug32.exe) ◆ Output Packet. Displays the tagged format output file translated into HL7 format. ➤ Note: If interactive coding is being used and Codefinder does not display when you click the Write Packet button, you may need to run the Unload program. See page 6.13 for information. Debug Display with TCP/IP The Debug Display tool with the TCP/IP interface functions the same as for the Basic interface. With a modification to the Target statement for the TCP server icon, additional information regards function calls and CPU time can be collected in the TimeInfo.log file. ❑ Right-click the 3M TCP server icon and choose Properties. The default statement should read: c:\3mhis\rip\bin\tcps.exe -p 8000 -i-l -cfint32.dll 6.18 Introduction to the 3M™ Codefinder™ Software 07/09 Debug Display tool (debug32.exe) The components within the statement are: -p -l cfint32.dll -i -D ❑ Port number Start Codefinder Run Codefinder (minimized) Create Debug information in TimeInfo.Log file To enable the debug mode, add -D to the Target statement c:\3mhis\rip\bin\tcps.exe -p 8000 -i-l -cfint32.dll -D TimeInfo log file 07/09 When you add the -D to the target statement, a TimeInfo.log file is created in the INTERFAC directory. In addition to the instance information in the Debug Display tool the TimeInfo.log file also lists the function calls and CPU time. The log is useful in trouble shooting any problems with function calls. ❑ Add a string value named TimeFile in the Registry. Give it the value 1. ❑ Follow the instructions for Basic Interface, tagged format (page 3.9), or Basic Interface, HL7 format (page 3.10) to test the function calls. ERRLOG.TXT The ERRLOG.TXT file, created in the interface directory, contains a list of interface error messages from the CFINT32.DLL program describing problems that occurred during the interface processes. This is enabled by the entry “ShowErrors” in the Registry being set to 0, or if “ShowErrors” does not exist in the Registry. ➤ Note: If you want error messages to appear on the interface software window, the ShowErrors string must have a value of 1. Utilities6.19 Batch processing (CFWINFIL.EXE) The 3M Connections Software Batch program CFWINFIL.EXE processes records sequentially from an input file. Records in the input file can be set up for interactive coding and grouping or grouping automatically without user intervention. To group records automatically without user intervention, all the data required by the grouper must be in the input record. When coding and grouping interactively, data omitted from the input record and required by Codefinder will be prompted for during the coding session. ➤ Creating an input file for batch processing Note: If this option is required please call 3M Customer Support to assist with installation during normal business hours. The input file for batch processing is a text file. For testing it can be created using Notepad, Wordpad, or some other text creation software. The records in the file must be tagged formatted according to the conventions outlined in Chapter 4. It is up to the site or the vendor to develop the facility to create the input files, run the batch process and process the output from Codefinder. To batch process the records automatically (with no user intervention), the CMD: tag should begin with a 5 (CMD:504). To process the records interactively (with user intervention), the CMD: tag should begin with a 0 (CMD:004). Each record must end with the EOR: tag. If the EOR: tag is not included, the interface software treats all the records as a single record. A new input file could be created for each or a group of episodes to be processed or the same input file used and the data over written. Using the same input file eliminates the need to change the file name in the command line, each time the batch process is run. ❑ Name the input file for the batch process appropriately and place it in the \3MHIS\WINCODER\INTERFAC directory. CFWINFIL.EXE by default, looks for the input file and writes the output file to the \3MHIS\WINCODER\INTERFAC directory. It is recommended to set a path so the files are placed in a user folder. If the files are located in a directory other than the 6.20 Introduction to the 3M™ Codefinder™ Software 07/09 Batch processing (CFWINFIL.EXE) default, the entire path to the input and output files will need to entered in the command line for the batch process to work. Configuring the batch option Configuring the batch option involves creating a shortcut from which to launch the batch processing. ❑ In the 3MHIS\wincoder\interfac directory, right-click on cfwinfil.exe. ❑ Choose Create Shortcut. ❑ Drag the shortcut to the desktop. ❑ The shortcut could be renamed appropriately to indicate the type of job. If several different batch jobs are being run regularly, a shortcut for each job could be created Running the batch file ❑ To run the batch file, you add the input and output file names to the Target command in the shortcut properties window. Right-click the shortcut and choose Properties. The Batch Interface Properties window opens. The Target statement includes cfwinfil.exe. 07/09 Utilities6.21 Batch processing (CFWINFIL.EXE) ❑ Place the cursor at the end of the target line field and click the mouse to establish a starting point for the configuration command. ❑ Enter a space after the program name and type the following command, using your input and output file names: CFWINFIL Interface=input_file_name Batchout=output_file_name If the input and output files are not located in the same directory as cfwinfil.exe, the complete path must be included with the file names. CFWINFIL Interface=Drive/Path/input_file_name Batchout= Drive/ Path/output_file_name ❑ Click OK to close the Properties window. ❑ Double-click the shortcut to process the records. Automatic batch processing When batch processing is complete, an exit window showing the number of records processed and the name of the input and output files is displayed on screen. A second small window also displays, indicating that the processing has completed. ❑ Click OK to exit and complete the process. 6.22 Introduction to the 3M™ Codefinder™ Software 07/09 Batch processing (CFWINFIL.EXE) Turning off the Exit window display To inhibit the display of the exit windows displayed by the CFWINFIL program the following string value must be added to the registry in the HKEY_LOCAL_MACHINE\ SOFTWARE\3M\HIS\Interface folder: CfWinFilJustExit “YES” When the value is set to “YES” CFWINFIL will terminate without stopping to display the exit windows. This is useful in automating a batch process. ➤ Interactive batch processing Note: For instructions on adding a value to the registry, see page 6.6. With interactive batch processing (CMD:004) Codefinder is opened for the user interaction, for each episode in the input file. This could be at the Separation Mode window, Patient Information window, Diagnosis prompt or Summary window depending on the information in the input file. ❑ Double-click the shortcut to process the records. ❑ Complete the coding session. ❑ Group the episode if coding and grouping is set in the CMD tag. ❑ Click Complete to proceed to the next record. The next episode in the input file is displayed. ❑ Repeat these steps until all the records in the batch file are coded and grouped. After the last episode in the input file is processed the exit windows are displayed or if the exit windows are inhibited with the entry in the registry, the batch process will terminate. Additional parameters View the data in the input and output packets ❑ 07/09 The parameters “INPUT”, “OUTPUT” and “-d” can be added to the target command line to assist with troubleshooting. The “INPUT” and “OUTPUT” will display the input and output packets for each episode. The “-d” will create a file that will log all episodes that end in error while in Codefinder. These parameters can be used separately or together and must be separated by spaces. To examine data in the input and output packets for an episode: In the Shortcut Properties window, add INPUT OUTPUT to the target command line. Utilities6.23 Batch processing (CFWINFIL.EXE) The parameters must be separated by spaces. They can also be used individually. CFWINFIL Interface=input_file_name Batchout=output_file_name input output ❑ Double-click the Batch shortcut to start the processing. A window showing data for the packet being processed is displayed. Packet number Command line Input packet ❑ In the command line, click Continue to send the packet to the Codefinder software. When Processing in Codefinder is completed, a window displays the data in the output packet. Packet number Command line Output packet 6.24 Introduction to the 3M™ Codefinder™ Software 07/09 Batch processing (CFWINFIL.EXE) ❑ Click Continue to move to the next episode in the input file or complete the processing. ❑ If you don’t want to see subsequent packets, click Don’t Show Packets Anymore. The interface finishes processing the batch file. Creating an error log file The command line option “-d” creates an error log file called CFWINFIL_ERROR_FILE.txt in the INTERFAC directory. When an input packet causes an error in Codefinder, the packet and the corresponding Codefinder output error message is copied into this log file. The log file is over written with each batch run so examine the file immediately after. 3M recommends that this option be used permanently. The error log file allows you to track and troubleshoot interface failures. The error messages logged are the same as sent to the output file. However, in the output file there they are mixed in with all the correctly processed records. ❑ In the Shortcut Properties window, add -d to the target command line. CFWINFIL Interface=input_file_name Batchout=output_file_name -d The -d stands for “debug.” It must be preceded by a space. ❑ Double-click the Batch shortcut to start the processing. When the processing has finished, go to the interface directory and double-click the CFWINFIL_ERROR_FILE.txt to see the error log. Two sample error logs are shown below. 07/09 Utilities6.25 Batch processing (CFWINFIL.EXE) ***************INPUT PACKET #1*************** CMD:504 PAY:15 INT:ON PID:1~29 TXT: SEX:M AGE:08181961 01042004 DDT:01042004 ADT:01042004 WGT: COD:2 T.I10 ACHI.9613900 EOR: ***************OUTPUT PACKET #1*************** ERR:98 ETX:(3M CF) Disposition not passed in input packet PID:1~29 ***************INPUT PACKET #2*************** CMD:504 PAY:15 INT:ON PID:2~29 TXT: AGE:02061931 01042004 DDT:01042004 ADT:01042004 DSP:09 WGT: COD:2 T.I10 ACHI.9613900 EOR: ***************OUTPUT PACKET #2*************** ERR:38 ETX:(3M CF) Invalid or No Gender in Input packet PID:2~29 6.26 Introduction to the 3M™ Codefinder™ Software 07/09 Tags.txt Editor utility The TAGS.TXT file is used by the interface program to identify the data fields and the conditions that will determine they be returned in the output packet. 3M Connections software installs a default list of tags based on the grouper and reimbursement. The TAGS.TXT file can be edited using the Tags.txt Editor utility (TAGS.EXE) in the INTRFAC directory. TAGS.TXT file The TAGS.TXT file contains four elements separated by semicolons for each tag: ◆ Tag number identifies the data element in the Encoder in which the data will be stored. The first seventy numbers, 0–69, correspond to the variable numbers in the database system file. ◆ Tag or field marker that precedes each field and indicates the type of data that follows. ◆ Return/Delete indicator shows information that is only applicable when the Codefinder software is installed with another 3M product, such as the 3M™ Audit Expert Software. The indicator shows if the tag should appear in lower case in the output packet from Codefinder. Lower case tags are routinely used within 3M software. 0 Allows the Return Tag Indicator to determine if it is blank, whether or not a tag will be returned in the Codefinder output packet. 1 Indicates that the tag with data be returned in the output packet. The tag should always be entered using lower case letters. However, if the Return Tag indicator indicates that the data should be returned, the software defers to the Return/Delete indicators and the tag will be returned in upper case letters. If the tag appears in lower case, it will not be returned by the 3M Audit Expert Software or 3M™ Coder Productivity Software after the data packet is processed. These two software products are not applicable to AR-DRG grouping and therefore are not available locally. ➤ Note: The Return/Delete Indicator is ignored unless the following line appears in the interface section of the codefind.ini file: ReturnDeleteIndicators=Yes 07/09 Utilities6.27 Tags.txt Editor utility ◆ Return Tag indicator. Specifies whether the tag and data will be returned in the output packet. 0 Never return. 1 Returns if data value of -1 in the input packet. 2 Always return or special case. 4 Return the value for this field if its tag is not in the input packet. 8 Used to determine internal buffer size for any tag associated with information about codes. Also used to determine internal buffer sizes. The following table shows the results of the two indicator settings. Return/Delete Return Tag indicator Indicator Results 0 0 Tag is not returned. 1 0 Lower case tag is returned. 0 1 Upper case tag is returned if input data equals -1. 1 1 Upper case tag is returned if input data equals -1. Lower case tag is returned if input data is not equal to -1. 0 2 Upper case tag is returned. 1 2 Upper case tag is returned. 0 4 Upper case tag is returned if the tag is missing, blank, or has a value of -1. 1 4 Upper case tag is returned if the tag is missing, blank, or has a value of -1. Lower case tag is returned if the tag has a value other and -1. 0 8 Upper case tag is returned if data exists. 1 8 Upper case tag is returned if data exists. 6.28 Introduction to the 3M™ Codefinder™ Software 07/09 Tags.txt Editor utility Default TAGS.TXT values ➤ Table 6–1. Tag Number 07/09 The following table displays the default values for the TAGS.TXT file. Note: The default setting for Return Tag may need to be changed relative to the data required by your patient administration system. Default TAGS.TXT values Tag Ret/ Del Return Tag 0 SEX: 1 Always return or special case 1 AGE: 1 Always return or special case 2 DSP: 1 Always return or special case 4 INT: 0 Always return or special case 11 WGT: 1 Always return or special case 12 PAY: 0 Always return or special case 13 LOS: 0 Always return or special case 14 LON: 0 Always return or special case 22 ALS: 0 Always return or special case 24 NLS: 0 Always return or special case 25 LEV: 0 Always return or special case 26 MLS: 0 Always return or special case 27 RV3 0 Always return or special case 30 NEC: 0 Always return or special case 31 AWT: 0 Always return or special case 32 ISD: 0 Always return or special case 34 HMV: 0 Always return or special case 45 MDC: 0 Always return or special case 46 VSN: 0 Always return or special case 47 RSQ: 0 Always return or special case 51 AUR: 0 Always return or special case 57 MRP: 0 Always return or special case 70 CMD: 1 Always return or special case 71 DDT: 1 Always return or special case 72 PID: 0 Always return or special case 73 TXT: 0 Always return or special case 74 COD: 0 Used by code to determine internal buffer size 75 ADT: 1 Always return or special case 76 CHG: 0 Always return or special case 77 SYS: 0 Always return or special case 78 RCS: 0 Always return or special case Utilities6.29 Tags.txt Editor utility Table 6–1. Tag Number Default TAGS.TXT values (continued) Tag Ret/ Del Return Tag 79 HOS: 0 Always return or special case 80 DBG: 0 Always return or special case 81 TXI: 0 Always return or special case 82 TEXT: 0 Used by code to determine internal buffer size 83 DATE: 0 Used by code to determine internal buffer size 84 PHYS: 0 Used by code to determine internal buffer size 85 EOR: 0 Always return or special case 86 ERR: 0 Always return or special case 87 ETX: 0 Always return or special case 88 DTX: 0 Always return or special case 89 MOD: 0 Used by code to determine internal buffer size 92 VAR 0 Never return 116 ARE: 0 Always return or special case 117 ARCL: 0 Always return or special case 131 PRFX 0 Used by code to determine internal buffer size Using the Tags.txt Editor (TAG.EXE) ❑ The values in the TAGS.TXT file can be modified using the Tags.txt Editor utility, TAG.EXE, that is installed with the Connections Software and resides in the WINCODER/INTERFAC directory. In the 3MHIS\WINCODER\INTERFAC directory, double-click TAG.EXE to launch the Tags.Txt Editor program. The Editor window displays the list of output tags. The condition that determines when each tag is to be returned, or if it is never to be returned in the output packet, is set using the Editor. 6.30 Introduction to the 3M™ Codefinder™ Software 07/09 Tags.txt Editor utility ❑ Find the tag you want to edit and click the text in the Return Tag column, then click the down arrow to display all the options. A drop-down window offers five options for controlling the returned tag: ◆ ◆ ◆ ◆ ◆ ❑ Always return or special case Never return Return if input packet = -1 Return if a tag is not in the input packet Used by code to determine internal buffer size Click the desired Option under which the Tag is to be Returned in the drop-down. The drop-down close and the field displays the option selected for the Tag. ❑ Repeat the step for each of the Tags that needs to be changed. ❑ When the options are set for the required Tags, Select File then Exit. A window with the option to save or ignore the modification is displayed. 07/09 Utilities6.31 Tags.txt Editor utility 6.32 Introduction to the 3M™ Codefinder™ Software 07/09 Appendix A Reimbursement options A A.2 Introduction to the 3M™ Codefinder™ Software 07/09 Appendix A Reimbursement options T HIS APPENDIX DISCUSSES the specific input and output tags used by the 3M™ Codefinder™ Software used with the Reimbursement Calculation Software (RCS). When RCS is turned on, during the grouping process Codefinder passes data for the episode coded, to the Reimbursement Calculation Software. RCS calculates and assigns the Reimbursement values. These values are passed back to Codefinder where it becomes part of the Codefinder output packet for the patient episode, under the RCS: tag. RCS is turned on or off using the Codefinder Configuration Editor (CRSConfig). RCS can also be turned on or off by passing a RCS: tag with a value of ON or OFF in the input packet. The value in RCS: tag overrides the Configuration file setting for Reimbursement (see page 4.23 for details). The Reimbursement calculation is based on the region and the grouper being used. Discussed are the reimbursement options for New Zealand and for the Australian state of Victoria: Victoria New Zealand begins on page A.4 begins on page A.13 Please refer to the appropriate section for your region. 07/09 A.3 Australian State of Victoria—WIES reimbursement Victoria WIES reimbursement overview The basic funding formula and information used for Victoria reimbursement calculations comes from the Metropolitan Health & Aged Care Services Division of the Victorian State Government Department of Human Services, Australia. Since 1993, the Department of Human Services (DHS) has used a casemix system to fund Victoria hospitals. This means that, rather than reimbursing hospitals based upon the resources they use, payment is based upon the number and types of patients a hospital treats (i.e., its casemix). Each patient’s WIES score is determined based on two factors: 1. How long did a patient stay in hospital compared to other patients with similar conditions (i.e., inlier equivalents)? 2. How do the typical treatment costs for the patient’s condition compare to typical treatment costs for other conditions (i.e., the cost weight)? In general, the more resource-intensive a condition is—whether due to how complicated the condition is or how long the patient stayed—the higher the WIES score. For example, a patient who is in hospital 3 days for an appendicectomy might receive a WIES score of 1.06, while the WIES value for a liver transplant patient who died after 3 days would be 7.51. Likewise, a liver transplant patient who was discharged alive after 40 days would be allocated 30.02 WIES. The DHS funds hospitals at a standard rate per WIES. Because fixed costs are more expensive for small hospitals, country hospitals receive a slightly higher rate than metropolitan hospitals. 3M Codefinder uses these standard rates to calculate WIES reimbursement. A.4 Introduction to the 3M™ Codefinder™ Software 07/09 Australian State of Victoria—WIES reimbursement Data requirements for reimbursement Reimbursement has three input tags, one output tag, and sub-tags that contain values that reside under these tags. The tags are: Input Tags Output Tags RV3: RCS: AUR: RCS: If valid values are available for the RV3: and the sub tags in the AUR: tag for the episode in the PMI system, they must be passed in the input packet for an accurate calculation of Reimbursment. If valid values are not passed, default values will be used making the outcome approximate. Hours of mechanical ventilation (HMV) HMV is a co-payment in the reimbursement calculation. If it available in the PMI system this value must be passed in the HMV: tag of the Codefinder input packet, for an accurate calculation of Reimbursement. Example Explanation HMV:55 55 hours of mechanical ventilation (Please refer to the HMV: tag in chapter 4 for more details.) 07/09 A.5 Australian State of Victoria—WIES reimbursement Input tags The table below covers the details for input tags and sub-tags. See http://www.health.vic.gov.au/pfg/index.htm for variable definitions. Table A–1. Input tags HL7 Segment Tag Example RV3: RV3:23 Description The hospital in the home length of stay value will be passed in via the RV3: reimbursement tag. This will be the number of days of hospital care in the home. (not available at present) The example shows a Hospital in the home length of stay of 23 days. AUR: AUR:CTYPE=4|CROLE=A|ACLS=MP|ATSI=5 Description The AUR: tag is a container for several sub-tags (CTYPE, CROLE, ACLS, and ATSI). Each sub-tag is followed by an equals (=) sign followed by the value for the item. Sub-tags are separated by the pipe (|) character. CTYPE= CTYPE=4 Description Care Type describes the nature of the clinical service provided to a patient during an episode of care. Hospitals are eligible for WIES funding only if the Care Type is 4 or U. Possible Values: F, E, 1, 2, 6, 7, K, 8, 5E,5T,5K,5G,5S,5A, 9, 0, 4, U, P Default Value if not sent in input packet: 4 and U Interpretation: Eligible for WIES funding. CROLE= CROLE=A Description Contract Role. The contracted hospital is not eligible for WIES funding; only the contracting hospital is eligible. Possible Values: A = contracting hospital B = contracted hospital Default value if not sent in input packet: A Interpretation: Eligible for WIES funding. ATSI= ATSI=5 Description Aboriginal and Torres Strait Islander Loading. See ‘Indigenous Status’ in VAED Data Definitions. The hospital is eligible for co-pay if the patient qualifies as ATSI. Possible values prior to July 2008: 2, 5, 6, 7 8, 9 Possible values since July 2008: 1 = Aboriginal but not Torres Strait Islander origin 2 = Torres Strait Islander but not Aboriginal origin 3 = Both Aboriginal and Torres Strait Islander origin 4 = Neither Aboriginal nor Torres Strait Islander origin 8 = Question unable to be asked 9 = Patient refused to answer Default value if not sent in input packet: 2 Interpretation: Not indigenous (Not eligible for ATSI co pay) A.6 Introduction to the 3M™ Codefinder™ Software 07/09 Australian State of Victoria—WIES reimbursement Table A–1. Input tags (continued) HL7 Segment Tag Example ACLS= ACLS=MP Description The Account Class determines the responsible party and rate for payment. (not available at present) Possible Values: NT, MP, ME, MR, MN, M5, MA, PA, PB, PC, PD, PE,PF, PG, PH, PI, PJ, PK, PL, PM, PN, PO, PP, PQ, PR, PS, PT, PU, PV, PW, PX, PY, VX, VN, V5, WC, WN, TA, TN, AS, AN, SS, SN, CL, CN, OO, ON, JP, JN, XX, XN (See http://www.health.vic.gov.au/pfg/pfg2005/pfg0506.pdf for definitions.) Default value if not sent in input packet: MP Interpretation: Public (Eligible for WIES funding.) RCS: RCS:0 or RCS:1 Description May be used in the Input file to override the setting in the Configuration Utility that enables the reimbursement calculation. RCS:0 RCS:1 Turns off reimbursement Turns on reimbursement Output tags ➤ The table below covers the details for output tags. Note: If an error occurs during the calculation of reimbursement RCS will terminate and reimbursement will not be calculated. A second ERR: tag and error number, will be passed under the RCS: tag in the Codefinder output packet and there will be no reimbursement fields. All tags whose value evaluates to zero are not presented on screen or passed in the output file 07/09 A.7 Australian State of Victoria—WIES reimbursement Table A–2. WIES reimbursement output tags Tag Example HL7 Segment (not available at present) RCS: RCS:<no value> Description When reimbursement is enabled, the RCS: tag is passed in the Codefinder output packet. All tags following the RCS: tag carry data from the reimbursement calculation. These tags are covered and follow in this table. ERR: ERR:382 Description Reimbursement error code. If the ERR and ETX tags are not present, it is assumed that no errors were detected. Most errors are the result of the inability to calculate reimbursement values. In most cases, if the ERR and ETX tags are present, the rest of the WEIS reimbursement and copay tags listed in this table will not appear in the output. Note: With reimbursement enabled it is likely that the output packet could contain two ERR: tags. When writing code ensure that the primary ERR: tag (at the start of the packet) is serviced once and not again till an EOR: tag has been encountered. The ERR: tag under the RCS: tag must be serviced separately. ETX: ETX:Unable to load statistics table Description Reimbursement error text. Describes the error associated with the corresponding reimbursement error code (ERR:). The significant error flags are listed below. 49 - Invalid DRG value or no statistics available for this DRG 99 - Unable to open reimbursement knowledge base 222 - Unable to load facility data 291 - Error loading stat key 297 - Missing stat key 382 - Unable to load statistics table for this date Note: With reimbursement enabled it is likely that the output packet could contain two ERR: tags. When writing code ensure that the primary ERR: tag (at the start of the packet) is serviced once and not again till an EOR: tag has been encountered. The ERR: tag under the RCS: tag must be serviced separately. TREIMB: TREIMB:3492.65 Description Total reimbursement dollar value. If TREIMB = 0, no reimbursement tags will be included in the output. DRGWT: DRGWT:1.3805 Description WIES value used for the DRG. TOTWT: TOTWT:1.3805 Description Total WIES score used for calculation (at present time, same as DRGWT) ATSICP: ATSICP:0.3186 Description Aborginal/Torres Strait Islander co pay included in the total WIES. If this amount = 0, the ATSICP tag will not be included in the output. A.8 Introduction to the 3M™ Codefinder™ Software 07/09 Australian State of Victoria—WIES reimbursement Table A–2. WIES reimbursement output tags (continued) Tag Example HL7 Segment (not available at present) BWIES: BWIES:1.0619 Description Base WIES without any of the co-pays added in. BRATE: BRATE:2496.00 Description Base rate dollar value. PAYER: PAYER:Public PAYER:Private PAYER:DVA PAYER:TAC PAYER:Non-WIES Description Description of base rate used. RURISO: RURISO:47.00 Description Rural / Isolated dollar value added per episode VICDRG: VICDRG:G07B Description The DRG allocated for the episode. The base grouper is AR-DRG that includes some Victorian DRG splits. ALOS: ALOS:2.8 Description The average length-of-stay for the DRG. LOSCAT: LOSCAT:S Description Length of stay category S = Same day O = One day or Overnight M = Multi-day MVCP: MVCP:0.0000 Description Mechanical ventilation co-pay weight add to TOTWT. If this amount = 0, the MVCP tag will not be included in the output. AAACP: AAACP:0.0000 Description AAA stent co-pay weight add to TOTWT. If this amount = 0, the AAACP tag will not be included in the output. ASDCP: ASDCP:0.0000 Description ASD device co-pay weight add to TOTWT. If this amount = 0, the ASDCP tag will not be included in the output. THALCP: THALCP:0.0000 Description Thalassemia co-pay weight add to TOTWT. If this amount = 0, the THALCP tag will not be included in the output. 07/09 A.9 Australian State of Victoria—WIES reimbursement Table A–2. WIES reimbursement output tags (continued) Tag Example HL7 Segment (not available at present) COLONCP: COLONCP:0.0000 Description Colonoscopy co-pay weight add to TOTWT. If this amount = 0, the COLONCP tag will not be included in the output. (Valid 2003/04 only.) STN: STN:2 Description Length of stay status 1 = Inlier 2 = High Outlier 3 = Low Outlier STX: STX:Inlier Description Text description for length of stay status. Inlier High Outlier Low Outlier A.10 Introduction to the 3M™ Codefinder™ Software 07/09 Australian State of Victoria—WIES reimbursement Sample data packet for reimbursement Input packet in Code All Tags format Output packet in Code All Tags format with Text with Code All Tags activated 07/09 Sample input and output packets for the Code All Tags format are provided below. CMD:004 AUR:CTYPE=4|CROLE=A|ACLS=MP|ATSI=2 PID: Sample data required to initiate 3M Codefinder with reimbursement. PAY:33 MDC:2 VSN:1 RV3:0 SEX:2 AGE:40 DSP:09 DDT:12/01/2005 ADT:01/01/2005 ISD:0 MLS:2 HMV:5 LOS:11 LEV:2 COD:T.D569 COD:T.I10 MRP:1 TXT: DTX:1 EOR: ERR:0 ETX:(3M CF) No Error PID: Sample data required to initiate 3M Codefinder with reimbursement. COD: R.Q61C TEXT:RED BLOOD CELL DISORDERS W/O CATASTROPHIC or SEVERE CC COD: T.D569 ARE: 1 ARCL: 2 TEXT:Thalassaemia, unspecified COD: T.I10 ARE: 0 ARCL: 0 TEXT:Essential (primary) hypertension COD: MDC.16 TEXT:DISEASES & DISORDERS OF BLOOD, BLOOD FORMING ORGANS, IMMUNOLOG DISORD COD: PCCL.0 TEXT:PCCL 0 - SDX is not a CC, or is included in ADRG definition, or is excluded COD: VSN.I10E4 COD: VSN.AR50 DTX: 1 VIC INL WT 0.6790 ALOS 2.3 LT 1 HT 9 MTDRG N FMT:5 VIC INL WT|VIC INL WT|13|2|4 ALOS|ALOS|27|3|1 LT|LT|37|3|0 HT|HT|44|3|0 MTDRG|MTDRG|55|1|0 RCS: TREIMB:4131.55 A.11 Australian State of Victoria—WIES reimbursement DRGWT:1.4154 TOTWT:1.4154 BWIES:1.1506 BRATE:2919.00 PAYER:Public RURISO:0.00 VICDRG:Q61C ALOS:2.3 LOSCAT:M THALCP:0.2648 STN:2 STX:High Outlier EOR:34 Output packet in Code All Tags format with Text with Code All Tags activated if reimbursement error occurred ➤ A.12 ERR:0 ETX:(3M CF) No Error PID: Sample data required to initiate 3M Codefinder with reimbursement. COD: R.Q61C TEXT:RED BLOOD CELL DISORDERS W/O CATASTROPHIC or SEVERE CC COD:*T.D569 TEXT:Thalassaemia, unspecified COD: T.I10 TEXT:Essential (primary) hypertension COD: PCCL.0 TEXT:PCCL 0 - SDX is not a CC, or is included in ADRG definition, or is excluded COD: MDC.16 TEXT:DISEASES & DISORDERS OF BLOOD, BLOOD FORMING ORGANS, IMMUNOLOG DISORD COD: VSN.I10E4 COD: VSN.AR50 ALOS:2.3 RCS: ERR:99 ETX:Unable to open reimbursement knowledge base EOR:34 Note: With reimbursement enabled it is likely that the output packet could contain two ERR: tags. When writing code ensure that the primary ERR: tag (at the start of the packet) is serviced once and not again till an EOR: tag has been encountered. The ERR: tag under the RCS: tag must be serviced separately. Introduction to the 3M™ Codefinder™ Software 07/09 New Zealand—WIES reimbursement New Zealand (NZ) uses Weighted Inlier Equivalent Separations (WIES) with amendments for reimbursement. Codefinder has the ability to calculate a NZ WIES and pass the reimbursement values via the interface. Data requirements for WIES With reimbursement enabled, the following values are displayed on the Patient Summary screen after grouping: NZ DRG WIES Score Base WIES Mechanical Ventilation co-payment AAA stent co-payment ASD co-payment Scoliosis co-payment WIES is only calculated for episodes discharged after July 1st 2005. Modifications to the AR-DRG grouping logic is used to assign NZ split DRGs. Only a WIES score is calculated. WIES calculation and display may be turned on or off using the Codefinder Configuration Utility or by sending the RCS: tag in the input packet There are five variables that affect the WIES score: ◆ ◆ ◆ ◆ ◆ Eligibility for ASD co-payment Eligibility for AAA co-payment Eligibility for Scoliosis co-payment The rate for mechanical ventilation co-payment The rate for one off mechanical ventilation co-payment These five variables are set and maintained in the Configuration Utility by each facility. In order to receive the ASD, AAA and Scoliosis co-payment, the eligible facilities are required to turn these co-payments on in the Configuration Utility. They are not turned on automatically with Codefinder updates. Future updates of reimbursement will be advised by 3M HIS. The values entered for these variables are specific to tertiary and non-tertiary hospitals. Data passed from facility’s patient database 07/09 In addition to all the information required for grouping and passed via the interface, for more accurate calculation of WIES score the following information could be passed if the data is available on the PMI system. A.13 New Zealand—WIES reimbursement ◆ ◆ HMV – Hour of Mechanical Ventilation LEV – Total leave days For tag format and examples of passing these values, refer to the chapter entitled Tags for the Coding and Reimbursement System. Input tags The Table below covers details of the input tags and sub-tags. Table A–3. WIES reimbursement input tags Tag Example Mandatory HL7 Segment (not available at present) RCS: RCS:YES Optional RCS:NO Description Reimbursement Calculation Software Used in the Input file to override the setting in the Configuration Utility that enables the reimbursement calculation. RCS:0 Turns off the reimbursement RCS:1 Turns on the reimbursement LEV: LEV:10 Description Leave days Yes The number of days a patient is allowed away from the facility. This is subtracted from the length of stay to arrive at the acute length of stay. If not passed, the software uses the length of stay for calculation. HMV: HMV:55 Description Hours of Mechanical Ventilation Yes Required for an accurate calculation of WIES score. Output tags ➤ A.14 The table below covers details for the reimbursement tags the follow the RCS: tag in the Codefinder output packet. Note: If an error occurs during the calculation of reimbursement RCS will terminate and reimbursement will not be calculated. A second ERR: tag and error number, will be passed under the RCS: tag in the Codefinder output packet and there will be no reimbursement fields. Introduction to the 3M™ Codefinder™ Software 07/09 New Zealand—WIES reimbursement Table A–4. WIES reimbursement output tags Tag Example HL7 Segment (not available at present) RCS: RCS:<No Value> Description Reimbursement Calculation Software When reimbursement is enabled, the RCS tag identifies that all tags following contain data from the reimbursement calculation DRGWT: DRGWT:3.7465 Description DRG Cost weight STN: STN:2 Description Length of stay status 1 = Inlier 2 = High Outlier 3 = Low Outlier STX: STX:High Outlier Description Text description for length of stay status Inlier High Outlier Low Outlier TOTWT: TOTWT:3.7465 Description Total weight - to be discontinued BWIES: BWIES:2.6005 Description Base WIES WIES excluding co-payments NZDRG: NZDRG: F19Z Description NZ DRG ALOS: ALOS:2.0 Description Acute length of stay Length of stay minus leave days 07/09 A.15 New Zealand—WIES reimbursement Table A–4. WIES reimbursement output tags Tag Example HL7 Segment LOSCAT: LOSCAT:M Description Length of stay category (not available at present) S = Same day O = One day or Overnight M = Multi-day MVCP: MVCP:0.0000 Description Mechanical Ventilation co-payment AAACP: AAACP:0.0000 Description Abdominal Aortic Aneurysm co-payment ASDCP: ASDCP:1.1460 Description Atrial Septal Defect co-payment ScoliosisCP: ScoliosisCP:1.1460 Description Scoliosis co-payment ERR: ERR:382 Description Reimbursement error code. If the ERR and ETX tags are not returned, reimbursement was calculated without an error. Most errors result in the inability to calculate reimbursement. Therefore, if the ERR and ETX tags are present, there will be other reimbursement tags listed in the output packet. ETX: ETX:Unable to load statistics table Description Text for the reimbursement error code. Describes the error associated for the corresponding reimbursement error code (ERR:). The significant error flags are listed below. 49 - Invalid DRG value or no statistics available for this DRG 97 - Missing stat key 99 - Unable to open reimbursement knowledge base 222 - Unable to load facility data 291 - Error loading stat key 382 - Unable to load statistics table for this date A.16 Introduction to the 3M™ Codefinder™ Software 07/09 New Zealand—WIES reimbursement Sample data packet for reimbursement Input packet in Code All Tags format Output packet in Code All Tags format Sample input and output packets for the Code All Tags format are provided below. CMD:004 PID: Sample data required to initiate NZ WIES with 3M Codefinder via host interface for test use only showing AAA value PAY:300 MDC:2 VSN:1 MRP:1 TXT: DTX:1 SEX:2 AGE:40 DDT:12/07/2005 ADT:01/07/2005 DSP:09 ISD:0 MLS:2 HMV:5 LOS:11 LEV:2 COD:T.I714 COD:ACHI.3311600 EOR: Text With Code All Tags, DRG Flags and DRG Cost Weight options turned on. NZ WIES data starts after the RCS: ERR:0 ETX:(3M CF) No Error PID: Sample data required to initiate NZ WIES with 3M Codefinder via host interface for test use only showing AAA value. COD: R.F08B TEXT:MAJOR RECONSTRUCT VASCULAR PROCEDURES W/O CPB PUMP W/O CATASTROPHIC CC COD:*T.I714 ARE:0 ARCL:0 TEXT: Abdominal aortic aneurysm, without mention of rupture COD:*ACHI.3311600 ARE:5 TEXT:[762] Endovascular repair of aneurysm COD: MDC.05 TEXT:DISEASES & DISORDERS OF THE CIRCULATORY SYSTEM COD: PCCL.0 TEXT:PCCL 0 - SDX is not a CC, or is included in ADRG definition, or is excluded COD: VSN.I10E3 COD: VSN.AR50 DWGT:3.71 ALOS:7.3 LOWT:2 HIGT:21 07/09 A.17 New Zealand—WIES reimbursement RCS: DRGWT:6.9829 TOTWT:6.9829 BWIES:3.7143 NZDRG:F08B ALOS:7.3 LOSCAT:M MVCP:0.0000 AAACP:3.2686 ASDCP:0.0000 STN:1 STX:Inlier EOR:81 Output packet in Code All Tags format showing a reimbursement error ➤ A.18 ERR:0 ETX:(3M CF) No Error PID: Sample data required to initiate NZ WIES with 3M Codefinder via host interface for test use only showing AAA value. COD: R.F08B TEXT:MAJOR RECONSTRUCT VASCULAR PROCEDURES W/O CPB PUMP W/O CATASTROPHIC CC COD:*T.I714 ARE:0 ARCL:0 TEXT: Abdominal aortic aneurysm, without mention of rupture COD:*ACHI.3311600 ARE:5 TEXT:[762] Endovascular repair of aneurysm COD: MDC.05 TEXT:DISEASES & DISORDERS OF THE CIRCULATORY SYSTEM COD: PCCL.0 TEXT:PCCL 0 - SDX is not a CC, or is included in ADRG definition, or is excluded COD: VSN.I10E3 COD: VSN.AR50 DWGT:3.71 ALOS:7.3 LOWT:2 HIGT:21 RCS: ERR:99 ETX:Unable to open reimbursement knowledge base EOR:81 Note: With reimbursement enabled it is likely that the output packet could contain two ERR: tags. When writing code ensure that the primary ERR: tag (at the start of the packet) is serviced once and not again till an EOR: tag has been encountered. The ERR: tag under the RCS: tag must be serviced separately. Introduction to the 3M™ Codefinder™ Software 07/09 Index Numerics 3M Codefinder and Reimbursement System how the interface works, 1.8 A AAACP, A.9 ACLS, A.7 Admit date, tag for, 4.17 ADT: tag, 4.17 Age, tag for, 4.17 AGE: tag, 4.17 ALOS, A.9 APC version number, tag for, 4.35 APC version number, tag for, 4.35 ASDCP, A.9 ATSI, A.6 ATSICP, A.8 AUR, A.6 Automatic batch processing, 6.21 Codefind.ini settings, 2.8 file descriptions, 2.8 flowchart, 1.10 how the interface works, 1.9 overview, 1.9 Batch processing automatic, 6.21 input packet requirements, 4.10 configuring the batch option, 6.22 interactive, 1.19, 4.7, 6.21 input packet requirements, 4.10 sample input packets, 4.8 running the batch option, 6.22 automatic batch, 6.23 error log file, 6.26 interactive batch, 6.24 turning off Program Will Exit window, 6.24 setting up, 6.21 Birth weight, tag for, 4.35 BRATE, A.8 BWIES, A.8 C B Basic option CFINT.DLL function calls, 3.6 CFINT32.DLL function calls, 3.6 07/09 C/C++, 1.13 Casemix, A.4 CFINT.DLL (basic option) function calls, 3.6 link library, 3.4 CFINT32.DLL (basic option) function calls, 3.6 Index I.1 link library, 3.4 CFPARSE.DLL program, 4.36 cfwinfil.exe configuring, 6.22 running, 6.22 automatic batch, 6.23 error log file, 6.26 interactive batch, 6.24 turning off Program Will Exit window, 6.24 Client application for TCP/IP, 1.11 CMD: tag, 4.19 COD: tag, 4.19 with Code All Tags format, 4.39 with Legacy format, 4.39 Code All Tags display format example, 4.44 Code All Tags format, 1.16, 4.5 and TXT: tag, 4.45 COD: tag, 4.39 Codefind.ini setting, 4.38 setting for HL7 format, 1.14 Code formats decimals, 4.11, 4.50 inpatient, 4.50 DRG, 4.51 examples, 4.51, 4.64 MDC, 4.51 Code formats and TXT:/TXI: values, 4.46 Code text and TXT:/TXI, 4.39, 4.41 Code text sent, tag for, 4.32 Codefind.ini settings basic option, 2.8 CODAllTags=, 4.38 DTXAllTags=, 4.38 modifying with Intredit, 6.5 TXTWithCODAllTags=, 4.38 Codefinder interface overview, 1.8 Codefinder input and output tags, table of, 4.16 Code-related data elements in Code All Tags display format example, 4.44 in input file, 4.41 Codes, number sent, tag for, 4.19 COLONCP, A.10 Command, tag for, 4.19 Configuring the batch option, 6.22 Connections Software communication modes, 1.9 installing, 2.4 interface overview, 1.8 Cost weights, A.4 CROLE, A.6 CTYPE, A.6 I.2 Introduction to the 3M™ Codefinder™ Software D Date format, 4.17, 4.21 DATE: tag, 4.20 DBG: tag, 4.21 DDT: tag, 4.21 Debug Display tool, 6.15 ERRLOG.TX, 6.20 registry setting, 6.20 launching, 6.15, 6.17 tabs, 6.16 uses, 6.15 Debug reimbursement tag for, 4.21 Designing the input packet (tagged format), 4.7 Discharge date, tag for, 4.21 Disposition tag for, 4.22 DRG code format, 4.51 DRG Text with Code All Tags Codefind.ini setting, 4.38 DRG text, tag for, 4.22 DRGfinder output packet exampl.e, 4.15 DRGWT, A.8 DSP: tag, 4.22 DTX: tag, 4.22 E End of record and longitudinal redundancy check, 4.36 End of record, tag for, 4.23, 4.36 EOR: tag, 4.23 ERR, A.8, A.16 ERR: tag, 4.23 ERRLOG.TX, 6.20 registry setting, 6.20 Error Code, tag for, 4.23 Error log file (batch processing), 6.26 Error text, tag for, 4.24 Errors, list of, 4.24 ETX, A.8, A.16 ETX: tag, 4.24 Examples of inpatient code packets, 4.51, 4.64 F File descriptions basic option, 2.8 Flowchart Basic interface data flow, 1.10 Flowshoart Data flow into and out of Codefinder, 1.8 FMT: tag, 4.25 07/09 Function, specifying, 4.19 Funding, A.4 G Gender, tag for, 4.32 Grouper, tag for, 4.29 Groupers input packet requirements, 4.12 H HL7 format Code All Tags setting, 1.14 line feed or carriage return/line feed, 2.5 overview, 5.3 processing in Connections software, 5.4 host interface component overview, 1.13 Hours of mechanical ventilation WIES reimbursement, A.5 How the interface works basic option, 1.9 I Inlier equivalents, A.4 Inpatient codes, formats for, 4.50 DRG, 4.51 examples, 4.51, 4.64 MDC, 4.51 Input files for testing creating, 6.9 saving, 6.10 Input packet automatic batch requirements, 4.10 interactive batch requirements, 4.10 tab in Debug Display, 6.16 Input packet, tagged format, 4.7 general requirements, 4.9 Input tags ADT:, 4.17 AGE:, 4.17 CMD:, 4.19 COD:, 4.19 DATE:, 4.20 DBG:, 4.21 DDT:, 4.21 DSPD:, 4.22 DTX:, 4.22 EOR:, 4.23 INT:, 4.26 07/09 ISD:, 4.26 -LOGVER (APC), 4.35 MOD:, 4.27 PAY:, 4.29 PHYS:, 4.30 PID:, 4.30 RCS:, 4.31 SEX:, 4.32 SYS:, 4.32 TEXT:, 4.32 TXI:, 4.33 TXT:, 4.34 WGT:, 4.35 Installation prerequisites, 2.5 NetWare server, 2.5 NT server, 2.5 stand-alone, 2.5 Installing installation prerequisites, 2.5 software security, 2.4 INT: tag, 4.26 Integrated Encoding tag for, 4.26 Interactive batch processing, 4.7, 6.21 sample input packets, 4.8 Summary screen, 6.24 interactive batch processing, 1.19 Interface edit (Intredit) tool, 6.4 codefind.ini, 6.5 launching, 6.4 registry, 6.6 uses, 6.4 Interface overview, 1.8 Interface responsibilities 3M, 1.22 interface developer, 1.22 Interface Test Packet, 6.8 creating input file, 6.9 DLL and WInsock modes, 6.8 launching, 6.8 saving test packets, 6.10 testing procedure, 6.11 intftest tool, 6.8 Intredit, 6.4 launching, 6.4 ipktest32 tool, 6.8 DLL and Winsock modes, 6.8 ISD: tag, 4.26 J Java, 1.13 Index I.3 L Launching Debug Display tool, 6.15, 6.17 Interface edit tool, 6.4 Interface Test Packet, 6.8 Tags.txt Editor, 6.31 Legacy display format, 1.15 hard returns in input packet, 4.42 hard returns in output packet, 4.43 example, 4.43 Legacy format, 4.4 COD: tag, 4.39 TXT: tag, 4.39 Legacy format and TXT: tag, 4.45 LOGVER: tag (APC), 4.35 Longitudinal Redundancy Check (LRC), 4.36 LOSCAT, A.9 M Major Diagnostic Category code format, 4.51 MOD: tag, 4.27 MVCP, A.9 N NetWare server installation prerequisites, 2.5 NT server installation prerequisites, 2.5 Number of codes in input packet, tag for, 4.19 O Output errors, list of, 4.24 Output fields (tagged format), 4.13 Output packet example, 4.15 tab in Debug Display, 6.16 Output tags ADT, 4.17 AGE, 4.17 COD, 4.19 DATE, 4.20 DBG, 4.21 DDT, 4.21 DSP, 4.22 ERR:, 4.23 ETX:, 4.24 FMT, 4.25 INT, 4.26 I.4 Introduction to the 3M™ Codefinder™ Software ISD, 4.26 LOGVER: (APC), 4.35 MOD, 4.27 PAY, 4.29 PHYS, 4.30 PID, 4.30 RCS, 4.31 SEX, 4.32 SYS, 4.32 TEXT, 4.32 Overview host interface component, 1.13 TCP/IP interface option, 1.11 P Patient Code Summary screen interactive batch processing, 6.24 Patient Code Summary screen see Summary screen, 1.6 Patient ID, tag for, 4.30 Patient Summary screen entering date and physician ID, 4.41 PAY: tag, 4.29 PAYER, A.8 Payer tag for, 4.29 Payment, A.4 PcktProcessorExe2 line in registry for HL7, 2.5 PHYS: tag, 4.30 Physician ID entering from Summary screen, 4.41 Physician ID, tag for, 4.30 PID: tag, 4.30 PostPacket (HL7) tab in Debug Display, 6.16 PrePacket (HL7) tab in Debug Display, 6.16 Procedure date entering from Summary screen, 4.41 Procedure date, tag for, 4.20 Processing options automatic batch, 6.21 interactive batch, 1.19, 4.7, 6.21 sample input packets, 4.8 single-record, 4.7 sample input packets, 4.8 Product, specifying, 4.19 Program Will Exit window (batch processing), 6.24 programming languages, 1.13 R RCS, A.7 RCS: tag, 4.31 Registry settings 07/09 for ERRLOG.TX, 6.20 modifying with Intredit, 6.6 PcktProcessorExe2 line in registry for HL7, 2.5 Reimbursement, A.4 Reimbursement Calculation Software tag for, 4.31 Reimbursement error, 4.23, A.8 Reimbursement error text, 4.24 Reimbursement line format tag for, 4.25 Requirements for input packet automatic batch, 4.10 interactive batch, 4.10 Requirements for tagged format input packet general, 4.9 Return DRG weight line text, 4.22 Return text for recoding, 4.33 tag for, 4.34 RURISO, A.9 RV3, A.6 S Security, 2.4 Sex, tag for, 4.32 SEX: tag, 4.32 Single-record and batch processing, 1.19 Single-record processing, 4.7, 4.8 Software security stand-alone, 2.4 Stand-alone installation prerequisites, 2.5 Stand-alone installation, software security, 2.4 STN, A.10 STX, A.10 Summary screen, 1.6 entering date and physician ID, 4.41 interactive batch processing, 6.24 SYS: tag, 4.32 System, tag for, 4.32 T Tagged format designing the input packet, 4.7 output packet description, 4.13 table of tags, 4.16 Tagged format defined, 1.14, 4.3 Tags, table of, 4.16 Tags.txt Editor utility, 6.28 launching, 6.31 TAGS.TXT file, 6.28 TAGS.TXT file 07/09 default values, 6.30 editing with Tags.txt Editor utility, 6.28 elements, 6.28 use, 6.28 TCP/IP interface option overview, 1.11 TCP/IP option client application, 1.11 interface files, 1.11 TCP/IP Server, 1.11 terminal emulator, 1.11 TimeInfo log file, 3.12, 6.19 Terminal emulator TCP/IP, 1.11 Text input, tag for, 4.33 Text tag for code text, 4.34 Text with Code All Tags Codefind.ini setting, 4.38 TEXT: tag, 4.32 THALCP, A.9 TimeInfo log file, TCP/IP, 3.12, 6.19 TOTWT, A.8 TREIMB, A.8 TXI: tag, 4.33 hard returns in Legacy input packet, 4.42 example, 4.42 uses of, 4.41 TXT: tag, 4.34 and Legacy format, 4.39 hard returns in Legacy output packet, 4.43 hard returns in output packet example, 4.43 input and output examples, 4.47 TXT:/TXI: tag and formats, 4.45 U Uniform Billing Codes, 4.22 Utilities batch processing, 6.21 additional parameters, 6.24 configuring, 6.22 running the batch file, 6.22 Debug Display tool, 6.15 ERRLOG.TX, 6.20 registry setting, 6.20 launching, 6.15, 6.17 tabs, 6.16 uses, 6.15 Interface edit (Intredit) tool, 6.4 codefind.ini file, 6.5 launching, 6.4 registry, 6.6 uses, 6.4 Index I.5 Interface Test Packet, 6.8 creating input file, 6.9 DLL and Winsock modes, 6.8 launching, 6.8 saving test packets, 6.10 testing procedure, 6.11 Tags.txt Editor, 6.28 launching, 6.31 V VICDRG, A.9 Victoria reimbursement, A.4 Visual Basic, 1.13 W WGT: tag, 4.35 WIES reimbursement, A.4 input packet sample, A.11 output packet sample, A.11 I.6 Introduction to the 3M™ Codefinder™ Software 07/09 3 Health Information Systems Division Headquarters 575 West Murray Boulevard Salt Lake City, UT 84123 800-367-2447 www.3Mhis.com 3M Australia Pty Limited 950 Pacific Highway Pymble NSW 2073 1800 029 706 within Australia 0800 444 639 within New Zealand www.3m.com/intl/au/ Please recyle. 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