Cumulative list of changes to CHAMP TouchPoint
Overview of December 2008 Release
NOTE: THERE IS A VERSION UPDATE FOR THIS RELEASE
Until you complete the Version Update in Step #6 in the Installation Instructions, which is a separate document, some features will not be available and/or you may get an “Invalid Subscript Reference error.” Updates included:Snapshot of Changes/New Features
TouchPoint Clinical
Overview of September 2008 Release
NOTE: THERE IS A VERSION UPDATE FOR THIS RELEASE
Until you complete the Version Update in Step #6 above, some features will
not be available and/or you may get an “Invalid Subscript Reference
error.
• 170 – New TouchPoint Flowsheet Reports
•
171 – Multiple Federal Tax IDs
•
172 – Restore Health Promotion Modifier
•
173 – Create Setup Files for SQL Server 2005
•
174 – Update TouchPoint Vitals Report
•
175 – New Scheduler Reports
•
176 – ICD 2009 Update
•
177 – Multiple Taxonomy Codes
NOTE: THERE HAVE BEEN INTERIM UPDATES FOR HOSPICE AND WISCONSIN FORWARDHEALTH
TESTING that some of you received since the last major update in May. The
September Release is a cumulative update that includes these changes as well
as other changes. If you received one or both of the interim updates, some
of the Version Updates and other changes may have already been applied.
Diagnosis Codes
Version 2.03 Grouper Files
CMS has updated the grouper files used to generate HIPPS codes for your OASIS assessments. You will need to download these from our website, http://www.champsoftware.com/support/grouper.html, and install them to the C:\Windows\System32 folder on each workstation.
When you first begin submitting assessments with HIPPS codes generated by the new grouper files, you may receive warning messages about the version number and the HIPPS code. As long as you are using the more current version, you can ignore these warnings. Similarly, if you do not implement the corrected GROUPER.DLL by the time the state system does, you may receive these warning messages until you install the new software.
In addition to the new grouper file, CMS issued updated grouper logic on September 22nd, which did not give us sufficient time to incorporate changes in the logic used with the Validate/Calculate button on the OASIS PPS tab. We need to know if you are actively using that function, so that we can send you an update when it is ready. Please email support@champsoftware.com, indicating you use the PPS Validate/Calculate feature, and would like to receive the update.
Medications
• Epocrates Online - There is now a button on the Client Medications screen that will link you to Epocrates Online. We made this change in response to requests from our customers for a medications database. After discussing the options in detail with a couple of our customers, rather than implement an expensive built-in database requiring frequent updates, we have elected to provide a link to a free and widely-recognized service provided by Epocrates. We trust you will find this valuable.
Billing
• Added 2009 Diagnosis/Procedure codes
•
New hospice requirements for July 1st
•
Changes for Wisconsin Medicaid – to permit testing for ForwardHealth
before November deadline
•
Changes for Wisconsin Birth to Three billing
•
Created Wisconsin Medicaid PCA payer, which will retain legacy ID’s
•
Changes to permit using 2.6 runtime
•
Federal Tax ID by payer (optional)
•
Taxonomy Code by payer (optional)
•
Changes for MN ICF/MR billing
•
837 file name change
•
Fixed row count and page count issues
•
PLEASE NOTE: If you currently have a Pay Code Setup for Insurance/ Medicare
HMO, you will need to change the Payer to Medicare HMO
Daily
• New feature: at the request of one customer, there is a new option on the custom menu to “Default to Load My Dailies for Today.” Clicking this menu option will flip the view of the daily list for everyone in the agency. When this is unchecked, it will show dailies for all employees since the 1st of the last month. When it is checked, it will show dailies for “me” (the logged in employee) for today only.
OASIS
• Additional validation on M0450 requiring all blank or none blank
•
Batch file for M0450 sends missing items as blank rather than zeros
•
Changed alert for M0826 to: “Is client's current payment source Medicare
or Medicare HMO? Please note that there are no HHRG/HIPPS when M0110 or M0826
rating is NA.”
ClickNotes
• Restored Health Promotion modifier on problem lists
•
Added validation to help ensure the Actual modifier is used with signs/symptoms
•
Added additional Vitals fields
Reports
• Changed flowsheets back to require the user to enter a range of visit
dates, and added a new set of flowsheets with “Complete” in the
title which cover the entire admission
•
Three new Scheduler “mini” reports
•
Added Pharmacy to Medications List report
System
• TouchPoint Pathways screen – new button to switch to/from traditional
Omaha System category terms: Surveillance, Treatments & Procedures, Teaching,
Guidance & Counseling, and Case Management
•
Employees screen – took License out and added Taxonomy to button with
UMPI, so that employee taxonomy can be used when needed for billing
•
Physicians screen – replaced License with Taxonomy
SQL Server
CHAMP now supports migrations and installations of SQL Server 2005.
Files with this Release
• Release_September_2008_Full.zip – this zip file is installed
as usual, into the network BINSQL folder
•
Grouper.dll – this file needs to be saved to the C:\WINDOWS\system32
folder of every PC that will be used to do OASIS assessments.
•
Samples of new Scheduler reports
Details of Major Changes
General
• ICD Update for 10/1/2008
o This update includes changes to the ICD diagnosis and procedure codes effective
October 1, 2008.
o With regard to Medicare, you will need to use 2008 ICD codes for an episode
with dates of service prior to October 1st, and 2009 ICD codes for an episode
with a first date of service on or after October 1st. This applies to both
the RAP and Final Claim, regardless of when you actually submit the RAP or
Final Claim. Please remember that diagnosis codes are pulled from the 485,
which supports up to 8 secondary diagnoses, not from the OASIS.
o Since you must use 2009 codes when the first date of service is on or after
October 1st, please be sure that this update is applied in a timely manner.
You may find the documents at the CMS website helpful to insure correct coding:
http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/07_summarytables.asp
Billing
• New hospice requirements for July 1st (If you are interested in purchasing
this feature, let us know.)
•
Changes for Wisconsin Medicaid – to permit testing for ForwardHealth
before November deadline
o To test for ForwardHealth, go to A/R -> Pay Code Setup (Medicaid pay code)
and change your State/Service from Wisconsin to ForwardHealth. Change Electronic
File Status from P – Production to T – Test. Create a claim and
follow the instructions at https://www.forwardhealth.wi.gov/WIPortal/Default.aspx?srcUrl=Trading%20Partner%20Profile.htm&tabid=41
NOTE: You will need to change your Pay Code Setup back to Medicaid/ Wisconsin
and your Electronic File Status back to P – Production before you send
in your regular Medicaid claims. Several of the Updates on the Medicaid website
say, “Providers should only use these instructions for claims received
following implementation of ForwardHealth interChange. Following these procedures
prior to implementation will result in the claim being denied.”
•
Federal Tax ID by payer (optional)
o If your agency has multiple Federal Tax IDs, you can enter the additional
Tax IDs in the Pay Code Setup screen by payer; then this will be the Tax ID
that will appear in the claims you produce for that payer. If your agency has
only one Federal Tax ID, you can disregard the Federal Tax ID field in Pay
Code Setup.
•
Taxonomy Code by payer (optional)
o This works like the Federal Tax ID above. If your agency has multiple Taxonomy
Codes, you can enter them in the Pay Code Setup screen by payer and they will
appear on your claims. If your agency has only one Taxonomy Code, you can disregard
the Taxonomy field in Pay Code Setup.
•
837 file name change
o New file name structure is:
[agency NPI]_837P or 837I_[date file created]_[pay code]_[end date].dat
Example:
1234567890_837P_20080922_11_20080831.dat
Daily
• New feature: Default to Load My Dailies for Today”
Instructions: To use, go to Dailies -> Custom Menu and check “Default
to Load My Dailies for Today”
OASIS
• Additional validation on M0450 requiring all blank or none blank
o This will prevent Integument skip problems
Overview of May 2008 Release
NOTE: THERE IS A VERSION UPDATE FOR THIS RELEASE
Some features will not be available without completing the Version Update, as noted in Step #6 above.
For the past year we have all been dealing with changes caused by adding the NPI to claims. In this next season, we will deal with omitting legacy identifiers from claims. Legacy identifiers include your agency provider number, physician provider numbers, and rendering provider numbers (for personal care and other specialized services).
What makes this difficult is that some payers want legacy identifiers omitted starting this month, while others will continue to require legacy identifiers. In addition, some payers have different requirements for paper than for electronic claims submission. We have done our best to research requirements and implement them in this release. The simplest explanation is that legacy identifiers are omitted for Medicare and MN Medicaid, and included for other payers.
In this season we recommend that you aggressively implement electronic claims submission. It will help with this transition, and should offer significant time savings. CHAMP actively supports electronic claims submission for many payers, including Medicare, Medicaid, and insurance. For insurance claims, we recommend you use a free service clearinghouse www.ClearConnect.com.
Billing Changes
Scheduler Change
Clinical Changes
Details of Major Changes
Billing Changes
NPI Only - No Legacy Identifiers
Other Legacy Identifiers will be omitted or put in claims as listed below:
Payer Information Now on Website
There is now a new area on our website with setup information for many of our payers. To the best
of our knowledge, the information on each of these Pay Code Setup screens is correct. If you find out
that the setup is incorrect, please let us know so that we can make the appropriate changes. You can
find this payer information here:
http://www.champsoftware.com/support/index.html
Overview of Release Y
NOTE: THERE IS A VERSION UPDATE FOR THIS RELEASE
Some features will not be available without completing the Version Update, as noted in Step #7 above. This Version Update includes two updates for PPS/OASIS.
This update is almost entirely oriented to changes in billing requirements, particularly for Medicare PPS/OASIS. If you use CHAMP for billing, we recommend installing this update well before the December 27th deadline. If you do not use CHAMP for billing, you are free to skip this update, since it will be incorporated in the next update, probably in the summer or fall of 2008.
Billing Changes
Files with this release
Details of Major Changes
Billing Changes
Late-Breaking News
On December 18, 2007, CMS posted guidance to home health agencies at http://www.cms.hhs.gov/center/hha.asp. This notice indicates that there are still errors in the grouper file and pseudo-code at this late date. We are shipping this update with the current grouper, and will offer an update in January within a week of receiving notice from CMS that they have fixed their system.
Version 2.01 PPS Grouper Files
CMS has updated the grouper files used to generate HIPPS codes for your OASIS assessments. You will need to download these from our website, http://www.champsoftware.com/support/grouper.html, and install them to the C:\Windows\System32 folder on each workstation.
When you first begin submitting assessments with HIPPS codes generated by the new grouper files, you may receive warning messages about the version number and the HIPPS code. As long as you are using the more current version, you can ignore these warnings. Similarly, if you do not implement the corrected GROUPER.DLL by the time the state system does, you may receive these warning messages until you install the new software.
Medicare PPS/OASIS
These notes do not attempt to cover the extensive information provided by CMS and others about the changes for PPS Reform effective January 1, 2008. It is merely a summary of how the software implements those changes.
When to Install. The latest date to install this update is 12/27/07, to permit you to do 2008 recert/follow-up assessments. However, we encourage agencies to install this update at least one week earlier, by 12/20/07, to permit staff to do some trial assessments before new regulations take effect (see suggestions below). The new Grouper.dll provided by CMS is able to generate HIPPS codes for older OASIS assessments as well as the new 2008 assessments.
Although new TouchPoint-ClickNotes modules shipped over two years ago, we understand that a handful of agencies may still be using the older clinical module. Therefore we have also updated those routines as well.
The 5-Day Transition Window. Prior to 12/27/07, any OASIS assessment you create will include the same M00 items you have been using all year. Between 12/27/07 and 12/31/07, this will continue to be true for all assessments except RFA 04 (recert) and RFA 05 (follow-up). During this 5-day window, when you create a recert/follow-up assessment, you will be asked this question: “Does this episode begin in 2008?” If you respond No, then the assessment will contain 2007 items. If you respond Yes, the assessment will contain 2008 items.
For a detailed CMS discussion of transition issues, please read “Answers Regarding Transition Episodes,” which can be found at http://www.cms.hhs.gov/HomeHealthPPS/03_coding&billing.asp. As indicated in this CMS document, you will have to deliberately use an artificial effective date, M0090, on recert/follow-up assessments in this 5-day window between 12/27/07 and 12/31/07. The CMS Grouper was written in such a way that it will consider a M0090 date on or after 12/27/07 as a 2008 episode, regardless of how you responded to the above question in CHAMP. If the recert/follow-up assessment in this 5-day window is for a 2007 episode, you need to use 12/26/07 for M0090 (Date Completed). Otherwise the grouper will return a blank HIPPS code (because it is expecting a M0110 rating, and you are not sending one). The state system is designed to accept your artificial M0090 date of 12/26/07.
There are other transition issues with regard to SOC/ROC assessments for episodes that start between 12/27/07 and 12/31/07; for these you should enter M0090 of 12/31/07 if you complete the assessment in 2008. A similar case occurs for ROC assessments for episodes that start early in 2008; for these you should enter M0090 of 1/1/08 if you complete the assessment in 2007. These special cases are described in much more detail in the CMS document TransitionEpisodesQA.pdf.
CHAMP PPS Tab Information. The OASIS screen in CHAMP incorporates logic from the new grouper, to a much greater degree than we have done since 1999. The PPS tab still show the HHRG score and points in the clinical, functional, and service domains, as well as the “gap” in points to reach the next level. The PPS tab also has a new box on the right side of the screen. When you click Validate/Calculate on the PPS, CHAMP will run the 1448-byte OASIS data string through the CMS code, and do the same validation the grouper would do. The grouper returns a one-digit validation code, which indicates whether there are errors with the manifestation code sequencing, or with the clinical, functional, or service domains. By incorporating the CMS pseudo-code, CHAMP will indicate which diagnosis code has the manifesting code sequencing problem. In the case of domain errors, CHAMP will indicate which M00 item(s) contain the error. This should be helpful in validating and optimizing OASIS ratings before locking and sending the assessment to the state.
Billing Changes. There are relatively few changes on the PPS (billing) side. PPS calculations will include new case-mix adjusters, new wage index factors, and new standard rates and per visit amounts. The calculation will include the LUPA add-on, and the new supplies payment.
The billing system includes one additional error message regarding the 5th digit of the HIPPS code, which is a rating for non-routine supplies. When you run the Medicare Billing Report, or invoices for Medicare, CHAMP will check whether you have entered supplies in the charges screen. If not, you will see an error message indicating that you need to change the final digit in that client’s HIPPS code from a letter to a numeric value. The error message will tell you what numeric value to use. For more information, consult MM5746.pdf, which can be found at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5746.pdf.
A final note: I was asked by one agency how much the charge for this update would be. This is anything but a “small” update. There are 10,000 new lines of code, and many changes to existing code. Even so, this update is included in your annual support, at no extra charge.
Suggestions for Trial Assessments
We are shipping this update early to permit you to generate some trial assessments, as an aid to training staff in the new M00 items, particularly M0230/240/246. We suggest you create some hypothetical assessments.
To permit future-dated assessments, we have changed the validation to tell you that the completion date is a future date, but allow you to save the assessment anyway.
Of course if you see problems, please bring them to our attention as early
as possible. With thousands of lines of new and changed software code, it is
likely that there is a bug or two hiding in there somewhere. We want to know
about any bugs and fix them quickly. There may be a patch release in January
incorporating any important changes.
Overview of Release X
NOTE: THERE IS A VERSION UPDATE FOR THIS RELEASE
Some features will not be available without completing the Version Update, as noted in Step #7 of the Installation Instructions.
General
ICD update for 10/1/07
Client List – now has:
Daily
Scheduler
Query
Billing (additional changes not included in Release W++ in August)
Clinical
ClickNotes
General
ICD update for 10/1/07
This update includes changes to the ICD diagnosis and procedure codes effective October 1, 2007.
With regard to Medicare, you will need to use 2007 ICD codes for an episode with dates of service prior to October 1st, and 2008 ICD codes for an episode with a first date of service on or after October 1st. This applies to both the RAP and Final Claim, regardless of when you actually submit the RAP or Final Claim. Please remember that diagnosis codes are pulled from the 485, which supports up to 8 secondary diagnoses, not from the OASIS.
Since you must use 2008 codes when the first date of service is on or after October 1st, please be sure that this update is applied in a timely manner. You may find the documents at the CMS web site helpful to insure correct coding. http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/07_summarytables.asp
Billing
Child and Teen Checkups claim feature
To use this feature:
Advanced Practice Billing claim feature
To use this feature:
Overview of Release W+
Release W shipped last December, primarily to implement billing changes for
NPI requirements. Our W+ patch in March corrected minor errors with old paper
claim forms. This W++ release is a 2nd patch to Release W, intended solely
to make minor changes in the new claim forms. If you do not need these changes,
or have already worked through the changes with our support staff, you do not
need to install this release.
Changes
Future Updates
For those wondering about future updates, there will be an update in mid-September
with ICD changes for October 1st, and another update in December with Medicare/
OASIS changes. New clinical features will be bundled with these updates.
Overview of Release W+
Release W included several significant changes, notably billing changes for
NPI requirements. This was a very complex change, and we have discovered
a small number of software errors that have been corrected. Release W+ is
a patch to our December 2006 Release W primarily for the purpose of correcting
these errors. If you are not experiencing these errors, or have already worked
through the error with our support staff, you do not need to install this
release. Of course if you want some of the enhancements bundled with this
patch, please install this release.
Errors Corrected
SUMMARY OF RELEASE W:
This update includes several significant changes, particularly to meet new
billing requirements. You should install this update even if you do not use
CHAMP for billing.
NOTE: THERE IS A VERSION UPDATE FOR THIS RELEASE
Some features will not be available without completing the Version Update,
as noted in Step #7 of the Installation Instructions.. This release includes
5 separate updates. Some create new reports.
General
Reports
• New Employee Caseload – Visited Report that shows all clients visited
by an employee, not just the one’s assigned to that employee. Sample below.
• New Scheduler report for “today’s schedule”
• Corrected a problem with Scheduler reports spanning 2006-7
Query
• You can now query data from all ClickNotes screens. The query master
table list will now include: TouchPoint Interventions, Problems, Signs/Symptoms,
Visits, Vitals
• New “contains” filter logic to find a word or phrase “within” a
field.
• Corrected minor issues caused by Release V
Billing
NPI
• The National Provider Identifier (NPI) is being phased in between now
and May 22, 2007. This impacts both electronic 837 files, and paper forms. This
release supports two new paper forms, the UB-04, and Revised CMS-1500. Legacy
forms will be supported until they are obsolete.
• Editable claims. Because new information is still arriving, and there
may be changes between now and May 22, 2007, the electronic claims feature in
the software is now capable of letting you make changes to any locator on the
UB-04 or Revised CMS-1500 form, and printing the revised claim. This release
does not include the ability to revise an electronic claim file, because the
837 format includes information that does not translate to a paper form. But
for all payers for which you submit paper claims, the ability to revise the claim
before submission should help during the NPI transition period.
PPS Rate Changes Effective 1/1/07
• The transition to CBSA codes will be complete in 2007. A 3.3% funding
increase takes affect 1/1/07. The 5% rural add-on expires 12/31/06. These changes
are described in greater detail below.
Clinical
TouchPoint
• Removed Not Home/Not Found and Note/Other as exceptions for pathways – now
any type of visit may include pathways and interventions;
• Pathways are now selected AFTER you key a new visit date, in order to
find the most recent visit.
• We’d like to remind you that Release V included a pathway import/export
feature. CHAMP Software, Inc. has launched a website which you may use to share
TouchPoint pathways with other agencies. Additional information will be sent
this month.
Details of Major Changes
NPI
Note: information presented here is current to the best of our knowledge. We are in the stage 2 transition period for implementing the National Provider Identifier (NPI). The NPI changes dictate corresponding changes in 837 electronic forms, and have introduced two new paper claim forms, the UB-04 and Revised CMS-1500.
The software will produce legacy UB-92 and CMS-1500 forms until they become obsolete in May 2007. This is our understanding of timelines for implementing changes, and how best to use the software. By May 23, 2007 at the latest, you will need to have NPIs in place for your agency, and for physicians.
Electronic 387 Claim Files
The software will include NPIs in appropriate segments at such time as you enter NPIs into the system. You will enter one or more agency NPIs in the A/R->Pay Code Setup screen (some agencies have multiple NPIs, so entering them by pay code is necessary). You will enter physician NPIs in the System->Physician screen. If you provide MN PCPO services, CHAMP is prepared to submit NPIs (or UMPIs) for your employees. For PCPOs, we will make additional changes as we know more about DHS policy.
Once a particular NPI is installed, the 837 file for that claim will include the NPI in the appropriate segment. This means that if you have NPIs for some physicians and not for others, some claims will include the physician NPI, and others will not. The 837 claim file will include BOTH the NPI (if it can find one) and the legacy identifier. MM4023 indicates that at some point Medicare may suggest that legacy identifiers not be submitted.
Paper UB-04
On March 1, 2007, you may begin using the UB-04, which replaces the UB-92. You must use the new form by May 23, 2007. Although the UB-04 is capable of including both legacy identifiers and NPIs, because of this short window of time, CHAMP will only include NPIs on the UB-04.
Revised CMS-1500
On January 1, 2007, you may begin using the Revised CMS-1500. You must use the new form by April 1, 2007. Although the Revised CMS-1500 is capable of including both legacy identifiers and NPIs, because of this short window of time, CHAMP will only include NPIs on the Revised CMS-1500.
Editable Claims
In previous releases you could see an 837 claim file on a screen similar to the UB-92 or CMS-1500 paper form. These screens could not be printed. With this release, the paper claim printing screens are completely revised, to accommodate the numerous layout changes in the UB-04 and Revised CMS-1500. To make changes in a paper claim form and reprint the form, use the A/R->Electronic Claims screen as before. Select the file (which are now listed in reverse date order), and click the Edit button. Use the Navigate menu to find the claim you want, make the changes in the appropriate locators, and click the Print button at the top of the claim form.
For flexibility during this transition period, the A/R->Pay Code Setup
screen will include options for the old CMS-1500, the Revised CMS-1500, UB-92,
and UB-04. Selecting HIPAA Institutional will display a UB-04 screen, and selecting
HIPAA Professional will display a Revised CMS-1500 screen.
January 1, 2007 PPS Update
This update reflects the 3.3% increase approved for January 1, 2007. In addition to the increase in the national standard rate, there are new wage indexes for each CBSA, which are incorporated in code. You will no longer have to enter PPS Standard Rates on the A/R->Billing Data screen. These have been incorporated in code, for both 2006 and 2007.
The 3.3% increase applies to episodes which end on or after 1/1/2007.
CBSA Changes
Any agency that was in a blended transition MSA/CBSA for 2006 will have to switch to a new CBSA code for 2007. Examples of agencies that need to deal with this change are Carlton Co, MN – 50070 to 20260, and Bexar Co, TX – 50322 to 41700.
If you need to deal with this change, enter the 2006 Blended Code as well as the new CBSA Code on the A/R->Billing Data screen. Then click the Custom menu, “Update Medicare 2006 MSA/CBSA Blended Code to 2007 CBSA Code.” This will go to the value code box on the Billing UB-92/UB-04 screen for every client, remove the Blended Code, and replace it with the new CBSA Code. This is necessary for claims ending on or after 1/1/2007, so make this change when you have finished claims ending in 2006.
Rural Add-On
In 2006 there is a 5% rural add-on, which ends on 12/31/06. However, this
change applies to episodes which start before 1/1/2007. This means that rural
agencies will have three sets of rates:
1. episodes starting and ending in 2006 – earn 2006 rates plus the rural
add-on
2. episodes starting between 11/3/06 and 12/31/06, which end between 1/1/07
and 2/28/07 – earn 2007 rates because they end in 2007, plus the rural
add-on because they start in 2006
3. episodes ending after 2/28/07 – earn 2007 rates without the rural
add-on
Updating Data
To update dollar calculations for episodes that are already in the software, go to the A/R->Billing Data screen, and click the Custom menu, “Update Client HHRG Rates for 2007 Episodes.” This procedure will recalculate amounts due for episodes that end on or after 1/1/2007, based on new wage index values and rural add-on.
New Employee Caseload – Visited Report
This report, which was requested by two agencies in Wisconsin, shows all clients visited by an employee, not just the clients assigned to that employee. This report is under Agency Reports, Client Management. Here is a sample. Note that employee 006 visited 4 clients, 3 of which were assigned to other staff.
SUMMARY OF RELEASE V:
This update includes 20 significant changes. Most are enhancements.
As you read about the new features in TouchPoint and ClickNotes, we think you’ll
agree, that: We’ve been listening to you!
NOTE: THERE IS A VERSION UPDATE FOR THIS RELEASE
Some features will not be available without completing the Version Update,
as noted in Step #7 above. This release includes 5 separate updates. Some create
new reports, and one will install ICD code changes.
General
Compliance Changes
• ICD update for 10/1/06 (see notes below)
• Version 1.06 PPS Grouper Files (see notes below)
All Screens
• New screen resizing for widescreen notebook computers
• Auto-logoff screen beeps, and waits 2 minutes longer before logging off
Reports
• New TouchPoint Assessment Report (see notes below)
• New TouchPoint Interventions Report (see notes below)
• Print TouchPoint Care Plan for selected visit only
• TouchPoint Visit Report – avoiding duplicate header on page 2
• Old Contact Report – wider center margin
Query
• Simplified logic when combining Daily with Client Admission info, which
should reduce errors and increase stability
System
• Employee list screen - changed to default isActive = true on an add
• Transfer Check-Out Chart list is now alphabetic order
Billing
Medicare
• Fixed bug which missed recerts on day 56, or when discharged in days
1-5
MN Medicaid
• adding SSN for PCA Services through PCPO
• changes for MSHO and Medicare HMO billing (requires feature password)
• PrimeWest through ClearConnect (requires feature password)
• UCare through ClearConnect
Clinical
OASIS
• As of June 21st, CMS removed the requirement to lock within 7 days. You
are now required to lock within 30 days and before submitting a RAP. After discussing
options with customers, the software has been changed to no longer calculate
lock date or show it in red. Instead, when the user fills in the completion date,
it automatically locks the assessment, with the lock date being the same as the
completion date.
TouchPoint
• User-defined Omaha System Intervention Categories (see notes below)
• Improved ordering visits by time of day
• New pathway export and import function, designed so you can easily share
pathways with other agencies (see notes below)
Details of Major Changes
ICD update for 10/1/06
This update includes changes to the ICD diagnosis and procedure codes effective October 1, 2006. As last year, there is no longer a grace period for the changes. For further information: http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM3094.pdf
With regard to Medicare, you will need to use 2006 ICD codes for an episode with dates of service prior to October 1st, and 2007 ICD codes for an episode with a first date of service on or after October 1st. This applies to both the RAP and Final Claim, regardless of when you actually submit the RAP or Final Claim. Please remember that diagnosis codes are pulled from the 485, which supports up to 8 secondary diagnoses, not from the OASIS.
Since you must use 2007 codes when the first date of service is on or after October 1st, please be sure that this update is applied in a timely manner. You may find the documents at the CMS web site helpful to insure correct coding. http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/07_summarytables.asp#TopOfPage
Version 1.06 PPS Grouper Files
CMS has updated the grouper files used to generate HIPPS codes for your OASIS assessments. You will need to download these from our website, http://www.champsoftware.com/support/grouper.html, and install them to the C:\Windows\System32 folder on each workstation.
When you first begin submitting assessments with HIPPS codes generated by
the new grouper files, you may receive warning messages about the version number
and the HIPPS code. As long as you are using the more current version, you
can ignore these warnings. Similarly, if you do not implement the corrected
GROUPER.DLL by the time the state system does, you may receive these warning
messages until you install the new software.
SUMMARY OF RELEASE U:
This update serves primarily two purposes: (1) roll back Medicare PPS changes,
and (2) incorporate many changes suggested for the ClickNotes clinical software.
As you read about the new features in TouchPoint and ClickNotes, we think
you’ll agree, that: We’ve been listening to you!
NOTE: THERE IS A VERSION UPDATE FOR THIS RELEASE
• Update ID 136 – renamed Scheduler by Aide report to Scheduler by
Employee
• Update ID 137 – changed Omaha System signs/symptoms for family
planning from: inappropriate/insufficient knowledge about preconceptual health
practices to: inappropriate/insufficient knowledge about preconception health
practices
• Update ID 138 – new auto-lock feature
• Update ID 139 – added print date to visit list grid
• Update ID 140 – New Essential Activities Report for MN Public Health
• Update ID 141 – New TouchPoint Maternal and Child Reports
• Update ID 142 – customizable Visit Type
• Update ID 143 – PCPO feature, and setting employees inactive for
the scheduler
Comment for System Administrator who installs this update: This version update includes two “alter table” commands. After installing the version update, please exit CHAMP and return. This step is only necessary one time on one machine, immediately after the version update. This step is not necessary on any other workstations.
General
All Screens
• Added an Edit menu, with Cut, Copy, Paste, and Undo
• Included the spell-checker on the edit menu
Client List
• Now has search by birth date
Scheduler
• Restricting edit and delete functions to (1) visits associated with the
employee who is logged in, or (2) an employee with level 3 in form privileges.
• Stopped copying verified, exported, and miles on copied visit.
• New “active” flag on employee list to restrict dropdown list
to active employees.
Reports
• New Essential Activities Report for MN Public Health (setup for this
report is on the System -> Agency Variables screen, the Cost Center tab)
• Finally corrected problem duplexing old Contact Detail Report.
Billing
Retroactive PPS Rate Changes
The federal government has rolled back Medicare PPS rate changes. Final notifications
of implementation details arrived in late March. This update reverts to the
2005 standard rate, and incorporates the 5% rural add-on.
To implement this change, you should repeat 2 of the 4 steps included in our
Release U notes. These steps are:
1. On the A/R menu, Billing Data screen, click the Custom menu, and click Update
PPS Standard Rates. This will reinstate the 2005 standard rates on tab 2 of
the Billing Data screen.
2. On the A/R menu, Billing Data screen, click the Custom menu, and click Update
Client HHRG Rates for 2006 Episodes. This procedure will recalculate amounts
due for episodes that end on or after 1/1/2006, based on the 2005 standard
rate and the 5% rural add-on.
Pay Code Setup
• Added an option for group supplies of “Itemize - Do Not Group”
• HIPAA Institutional electronic claims now include Remarks from client
Billing UB-92 screen.
Client Billing UB-92 (and System Comboboxes)
There is a new combobox option for source of admission. The change we made
in Release U to link "source of admission" on the UB-92 screen
to the "admit from" codes on the admission-physician screen caused
serious problems for some of our Wisconsin customers, and this updates creates
a new combobox option for source of admission. It will be blank unless you
go into the System Combobox Codes screen, and install the standard set of
codes, which are:
1 Physician Referral 2 Clinic Referral 3 HMO Referral 4 Transfer from a Hospital
facility 5 Transfer from a SNF 6 Transfer from another health care facility
7 Emergency Room 8 Court/Law enforcement 9 Information not available A Transfer
from a Critical Access Hospital (CAH) B Transfer from another HHA C Readmission
to same HHA.
Personal Care Provider Organizations
Effective March 1st Personal Care Provider Organizations are required to report
the rendering provider number for PCA services. This has been implemented in
the electronic file, but not on paper. To enable this feature, select Minnesota
PCPO as the State in pay code setup. You must also submit visits as one per
line, because there is no provision to group visits by employee in the software.
There is a new box on the employee screen for their PCA provider number.
Clinical
OASIS
• Fixed skip problem for M0450, M0460, M0476, M0488, and M0530 when the
copied rating is skip = yes because the original was skip = yes, but the skip
needs to be no so you can edit the rating.
• To get correct skip patterns, Integument items must now be done on the
Integument tab rather than the PPS tab.
ClickNotes Visit List
• The combobox for Visit Type is now customizable. You may drop “HHA
Supervison” if you don’t need it, or add “PRN” or other
options you might want. Use the System -> Combobox Codes screen, and select
Visit Type on the left to set up desired options.
• Omaha System documentation is now available on Visit Type of Case Conference,
HHA Supervision, Phone Call, and any new types you install. Omaha System documentation
is not available for the Visit Type of Not Home/Not Found, or Note/Other.
• New buttons to insert the current time.
There is a new auto-locking feature.
• The feature is controlled on the System Variables screen, where someone
with supervisor rights on that screen can check or uncheck "Chart Auto-Locking."
• With auto-locking turned on, visits will be automatically locked after
7 days, when they the user goes to the ClickNotes visit list screen.
• When a visit is auto-locked, a message will be inserted at the beginning
of the Visit Summary saying 'Auto-Locked on 99/99/9999' with today's date.
• Unlocking can only be done by someone with supervisor rights on the ClickNotes
visit list screen, and only if the chart has been auto-locked.
• Normal locking, wherein a user locks visit notes when they are complete,
is still in place. When a chart is locked this way, no one can unlock that visit.
• When a chart is unlocked, it remains so for that day and the next day
only, so charting can be completed. After 1 day, it will be auto-locked again.
• This cycle can be repeated as needed.
ClickNotes Vitals Screen
• Simplified labels for BP and pulse. Added cm and lbs where missing. Now
carry forward pre-preg weight and due date. Now pre-filling weight gain.
• Added 2nd Lung Sounds to Vitals tab, and dropped 2nd blood sugar.
• Added Live Births to Antepartum tab.
• New MCH and Child History tabs and reports.
• Two new customizable tabs (see separate document for setup details).
ClickNotes Problem Screen
• Increased limit on Problem Notes to 500 characters.
ClickNotes Intervention Screen
• Default view coming into this screen is now “selected” interventions
• Now permit Notes to be added to pathway interventions. Click Edit to
enable the Free Text box in the lower right corner. These notes will be inserted
after pathway interventions on the Visit Report.
TouchPoint Visit Report
• Added Aide Supervision notes to the report.
• Corrected date order problem.
TouchPoint Care Plan Report
• Now available for all visits, not just Assessment visits.
SUMMARY OF RELEASE T:
PPSBILLING
OASIS
OTHER
In past years, CHAMP upgrades for PPS have replaced a system lookup table that contained dollar amounts per HHRG per MSA. Because of the complex changes effective 1/1/2006, CHAMP will retain the 2005 lookup table, but implement a new 2006 calculation per HHRG per CBSA.
There are two aspects to the PPS changes. The dollar amounts associated with the HHRG generated by the OASIS assessment will increase based on the new national standard rate of $2,327.68, as wage-adjusted for your county. But claims after 1/1/2006 will be required to have in the value amount locator a 5-digit CBSA code, rather than the 4-digit MSA code you have been using. As stated in the December 8th email from Palmetto GBA: The CY 2006 Home Health wage index is effective for HH episodes ending on or after January 1, 2006. To receive the CBSA wage index, there must be at least one line item date of service (LIDOS) for January 1, 2006 or after on the Final Claim.
These are the steps to implement the PPS changes in CHAMP. See the comments
below on when to do these steps.
1. On the A/R menu, Billing Data screen, enter your 5-digit CBSA code in the
new box on the right side of the screen. For example, rural MN is 99924, and
San Antonio, TX is 41700. There is a short list of CBSA codes below, but the
final authority is you finding your county on the list at http://www.champsoftware.com/support/cms1301f_fr.pdf.
Minnesota
50070 Carlton Co, MN
33460 Twin Cities Metro, MN
50071 Dodge Co, MN
41060 St Cloud Metro, MN
99924 Rural MN
Texas
12420 Austin, TX
41700 San Antonio, TX
36220 Odessa-Midland, TX
50125 Big Spring, Howard County, TX
Wisconsin
11540 Appleton/Calumet Co, WI, Outagamie Co, WI
20740 Eau Claire/Eau Claire Co, WI, Chippewa Co, WI
29100 LaCrosse Metro, WI
99952 Rural WI
2. On the A/R menu, Billing Data screen, click the Custom menu, and click Update
PPS Standard Rates. This will place the new standard rates on tab 2 of the
Billing Data screen. Those rates are:
Skilled Nursing $101.62
Occupational Therapy $111.86
Physical Therapy $111.11
Speech-Language Pathology $120.73
Medical Social Services $162.89
Home Health Aide $46.01
3. On the A/R menu, Billing Data screen, click the Custom menu, and click Update
Medicare Value Codes from MSA to CBSA Code. This will go to the value
code box on the Billing UB-92 screen for every client, remove the MSA code,
and replace it with the new CBSA. This is necessary for claims ending on or
after 1/1/2006.
4. On the A/R menu, Billing Data screen, click the Custom menu, and click Update
Client HHRG Rates for 2006 Episodes. Because CMS published these changes
in late November, and notified you in early December, these changes were not
ready when you saved OASIS assessments in November and December for episodes
that end on or after 1/1/2006. This procedure will recalculate amounts due
for episodes that end on or after 1/1/2006, based on new CBSA-based wage index
values.
When to Do these Steps
You should do the above steps for the PPS changes when you have claims ready
to send that end on or after 1/1/2006. This may be January 2nd, or January
10th, or January 20th, depending on when you do Medicare claims. Ideally you
will finish all claims that end before 1/1/2006, then make the switch, and
continue with 2006 PPS rates and CBSA codes.
However, after switching to 2006 rates and CBSA codes, you may still need to
do a 2005 PPS claim. In such a situation, you will have to manually
go to the UB-92 screen, and enter the old MSA code in the value amount box.
Then, run your claim. Finally, put the CBSA code back.
Likewise, after switching to 2006 rates and CBSA codes, you may need to unlock
and relock a 2005 OASIS assessment. In such a case, even though the
UB-92 screen has a CBSA code, CHAMP will use the MSA code on your A/R Billing
Data screen to calculate the rate for the HHRG.
There are a number of additional changes in the P0PS reports in CHAMP. Note
the new drop-down that lets you separate RAPs from Final Claims. Most of the
PPS reports will run better if you select only Final Claims. Please try the
new Case Mix Report.
This is fairly complicated. If you have questions, please email support@champsoftware.com.
SUMMARY OF RELEASE S:
2006 DIAGNOSIS CODING CHANGES
This update includes changes to the ICD diagnosis and procedure codes effective October 1, 2005. See the CMS web site for details regarding changes: http://www.cms.hhs.gov/medlearn/icd9code.asp
With regard to Medicare, you will need to use 2005 ICD codes for an episode with dates of service prior to October 1st, and 2006 ICD codes for an episode with a first date of service on or after October 1st. This applies to both the RAP and Final Claim, regardless of when you actually submit the RAP or Final Claim. Please remember that diagnosis codes are pulled from the 485, which supports up to 8 secondary diagnoses, not from the OASIS.
Since you must use 2006 codes when the first date of service is on or after October 1st, please be sure that this update is applied in a timely manner. You may find the documents at the CMS web site noted above helpful to insure correct coding.
BILLING
New Feature – there is now a dropdown box on the invoice screen to let
you make a choice for Medicare claims between RAPs only, Final Claims only,
or both together.
Fixed Medicare bill type when user runs an entire episode range of dates to
get one claim (even though normally you should run one date to get one claim)
Fixed bug with Medicare HMO - total $ was coming out zero
Fixed Hierarchical Level codes for TPL claims to Medica
TOUCHPOINT – Final Release for Fall Training
General corrections to ClickNotes/TouchPoint screens
Fixed problems in TouchPoint Visit Report with incomplete data, added a signature
in 2nd column, and added underlines for easier reading
Added several new reports
New TouchPoint Care Plan Report
New TouchPoint Comprehensive Assessment Report
New TouchPoint Discharge Report
New TouchPoint Wound Flow Sheet