# Keeping Diagnostic and Procedure Codes Current

Code set versioning (CSV) modifies VistA to comply with the Health Insurance Portability and Accessibility Act (HIPAA) stipulations that diagnostic and procedure codes used for billing purposes must be the codes that were applicable at the time the servic e was provided. Because the codes change, CPRS currently checks ICD and CPT code validity as of a specified date when codes are entered, when a new code set is implemented, and whenever Clinical Application Coordinators (CACs) or IRM personnel choose to ru n the option.

CPRS GUI users will see indicators for inactive codes on the Cover Sheet, Problems tab, Encounter form, and in Clinical Reminders (although the Clinical Reminders changes may be less apparent).

In these GUI locations, any diagnosis or procedu re codes that are inactive or will become inactive by a specified date because a new code set has been installed display with the "#" symbol in front of them as shown in the following examples.

Cover Sheet Displays

On the Cover Sheet, the active problems display. Users can quickly see if the patient has any inactive codes for the active problems. The "#" symbol shows the user that this active problem has an inactive code.

If the user tries to get a detailed display of the problem, the user first gets a warn ing about the inactive code.

The warning message instructs the user to correct the inactive code from the Problems tab. When the user closes the warning dialog, the detailed display then comes up. The "#" symbol in the detailed display also shows that the code is inactive.

Problems Tab Display

On the Problems tab, users are alerted to inactive codes in two ways. The first time the user goes to the Problems tab if there are problems with inactive codes, a dialog displays that tells how many problems wi th inactive codes have been found.

Note: This dialog appears only the first time the user goes to the problems tab for that patient in a session. When the user closes the dialog, the Problems tab display. Problems with inactive codes have the "#" symbol in the status column.

The detailed display of a problem also indicates that the current code is inactive. Users should use the Change feature to associate the problem with an active code.

Encounter Form Display

The Diagnoses tab of the Encounter dialog disp lays a "#" next to the code if the code is inactive.

If the user tries to select that diagnosis the following warning displays that tells users about codes that need to be updated through the Problems tab.

Consults Tab Displ ay

For Consults and Procedures, only active codes will be allowed for the following functions:

· Lexicon look up for provisional diagnosis as of the ordering date

· Copying or changing existing orders (the consult or procedure will not be accepted until a valid code is selected)

· Edit/Resubmit, the original code will be checked to see if it is active, if it is inactive an active code will need to be entered before CPRS will accept it

Clinical Reminders

CPRS GUI will only display codes that were active in the reminder date range.