This patch introduces additional ICD-10 implementation-related
modifications into the VistA Registration V5.3 package. The
enhancements being made support the existing business processes
in the Admission Transfer Discharge (ADT) & Patient Treatment File
(PTF) modules. The scope of this effort supports implementation of
ICD-10 within the Veterans Health Administration (VHA). The conversion
from ICD-9 to ICD-10 requires that all VistA connected applications,
back-end processes, databases and the Patient Treatment File (PTF)
support twenty-five (25) ICD Diagnosis, Present on Admission (POA)
indicators, and Procedure and Surgical Codes.

Functional Overview:

* System enhancements and modifications are being made to the existing
software components in the ADT & PTF modules.

- The 501 transactions will allow one principal diagnosis with a POA
indicator and up to 24 secondary diagnoses with POA indicators for
a total of 25 diagnosis codes and 25 POA Indicators.

- The 401 Surgeries and 601 Procedures transactions will allow up to
25 Procedure codes each.

- The 701 transaction will allow one principal diagnosis with a POA
indicator and up to 24 secondary diagnoses with POA indicators
(data stored in 702 record) for a total of 25 diagnosis codes and
25 POA Indicators.

* System enhancements and modifications are being made to the existing
software interface between the VistA PTF module and the Austin
Information Technology Center (AITC). VistA PTF collects diagnosis
and procedure information on inpatient episodes of care and based on
a user defined trigger event, transmits the data to the AITC for
inclusion in the PTF Master File (Data Store). Additionally, VistA
PTF collects census data (diagnosis/POA and procedure/surgery)
quarterly on current inpatients and transmits that data to the AITC.

- Modifications are being made to the content of PTF Transmission (VistA
Mailman) messages to accommodate the inclusion of up to twenty-five
(25) ICD-10 Diagnosis and associated Present on Admission (POA)
indicators and up to twenty-five (25) ICD-10 Procedure and Surgical
codes that could be included in a record for transmission.