Which Executables Work With Which Masks Files?

QUESTION:
Which Executables Work With Which Masks Files?

ANSWER:
Our code base is effectively split into the original branch which supports ICD9cm codes and the new branch which supports ICD10 codes.

The original branch has version numbers which begin with f (for "federal") while the new branch has version numbers which start with v. The original branch starts with f2 and ends with f32. The new branch starts with v33 and is currently up to v36.

In order to assign a DRG, you need both the logic (which we encode in the software) and the attributes or "masks" (which we encode in masks files).

The original branch is backwardly compatible: f32 has all the logic for some early version (f6, I believe) up and including f32. (The versions are internally designated with letters, so each executable can only support 26 versions. We have an executable and masks which support f2-f5 but that combination is a special order item).

The new branch is not backwardly compatible: v33 only supports v33, v34 only supports v34, etc. So v36 cannot use v34 masks because it does not have v34 logic in it.

We have a project on the books to combine all the logic into a backwardly compatible super-set, but currently this project is inactive.

Backward Compatibility in ICD10 Versions

QUESTION:

Hello, we have used your grouper for several years now, but v35 is the first one that hasn't seemed to be backward compatible to old masks. It groups fine under 35, but if we try to use the 34 mask with the cdrgv35a binary it doesn't return anything. Is this a known issue or something others have dealt with?

ANSWER:

Alas, this is a feature: starting with v32 (our first ICD10-based production release), we gave up backward compatibility for the logic component.

(Note that versions which begin with 'f' are ICD9-based while those that begin with 'v' are ICD10-based. Those that begin with 'x' are experimental.)

The CMS release process changed dramatically, so our release process had to change dramatically as well. In order to assign v34 DRGs you will need the v34 DLL.

I10 Progress Report #9: Windows Version Validated

We have used the new DRGFilt10 to validate our DRG Assignment Engine (DAE) under windows (our reference platform is Windows 7 in order to avoid leading edge syndrome).

So we are hard at work putting together our Windows products for v33; we expect them to be available by mid-October at the latest.

This also gave us more experience with the new control file format, which we love. As part of the port to Windows, we added a feature to  DRGFilt10:  if you do not specify the "crlf" parameter, which controls the end of line (EOL) format, then DRGFilt10 does the environment-specific usual thing (Unix EOL under Unix, Windows EOL under Windows).

In other words, leaving the "crlf" parameter out of the control file means that output lines end with just line feed (LF) under Unix and carriage return (CR) + LF under Windows.

If you need to force CRLF under both environment, set crlf=1.

If you need to force LF under both environments, set crlf=0.

I10 Progress Report #8: V33 Support Validated

Hurray, our DRG Assignment Engine (DAE) correctly handles the CMS test set with ICD10 codes and v33 code attributes and logic.

Now we just have to roll out the DAE into our pared-down product catalog and overhaul our web sit and on-line store and we will be all set.

Next stop: CSV support for the new DRGFilt.

I10 Progress Report #8: Masks File Has Been Built

We have built and validated the v33 masks file, so we are ready for integrated testing as soon as the logic module has been updated. We expect the logic upgrade to be done by midday tomorrow.

I10 Progress eport #7: So Far, So Good

We have finished our assessment of the v33 upgrade and we have started the work:

• the attributes seem to be only minor different between v32 and v33
• the logic seems somewhat different between v32 and v33

We expect to have have masks file built first thing tomorrow, so that when the software update is done mid-day tomorrow, validation can begin.

Currently, our goal is to have our DRG Assignment Engine (DAE) will be upgraded to support v33 by end the of the day on October 1, 2015.

I10 Progress Report #6: on to V33

We are hard at work on support for v33, which currently is moving along three different tracks:

DRGFilt Upgrade
We are upgrading DRGFilt to handle CSVs as well as fixed-width input. (We may also get to adding support for the very simple equation format: one line per column, each line of the form "col_name=value")

V33 Masks File
To support v33, we need to support logic and the ICD10 code attributes, which we call "the masks" and some people call "the tables." We encode the logice in our software and we create a database of attributes which we call "the masks file." We are hard at work creating the masks file.

V33 Logic Support
Of course we are upgrading our logic module to match the v33 logic module so that our software can work in conjunction with the v33 attributes to assign v33 DRGs.

I10 Progress Report #5: Success

At last, x32 has been validated, confirming that our new ICD10-based development path is working:

Processing version X32...ICD10 config
9187 records read with 0 errors.
All done.

So we are immediately starting work on v33, which will be our first production version for ICD10.

We are also changing our DRGFilt control file from its very 1980s fixed-width format to a very 1990s .INI file. (We hope to have support for a very 2000s XML format very soon.)

I10 Progress Report #4

Yesterday we finished porting the attributes handling subsystem to our new development environment. We validated x32 against the CMS test data and x32 matches 97% of the time.

We are chasing that 3% but since I10 v32 was not an official release, we think that some of the discrepancy is due to last-minute changes. We are looking into running the official Grouper software so we can confirm their results.

We expect to be done with x32 no later than the end of the week and to start v33 Monday.

I10 Progress Report #3

We almost got the code attribute data file building process ported from our old environment to our new one.

We are grateful to have our out-going guru's help today and we are confident that he will be able to get us over the final hump: if not today, then tomorrow.

I10 Progress Report #2

We did not quite meet our goal of building x32 yesterday; we completed the logic part but not the code attribute part (which we call "the masks" and which many other organizations call "the tables").

We expect to finish the basic x32 DRG Assignment Engine (DAE) today, build DRGFilt x32 on top of the DAE and then start on v33.

I10 Progress Report #1

Many of you have enquired about the status of our support for the upcoming grouper release. This post is intended to answer those questions.

This coming October 1st we are due to release v33, which will be the first version which is only ICD10 (i10). Starting with v33, we will no longer provide ICD9-based (i9-based) grouping support, so v33 is our first non-experimental release which is i10-based.

Up to now, our versions have all been i9-based except for the experimental i10-based products. We designated the experimental versions with an 'x' instead of a 'v', so v31 was the i9-based grouper and x31 was the i10-based grouper.

Last year's grouper was the last grouper with both, so v32 is the last i9-based grouper and x32 is the last time that i10-based grouping is considered 'experimental.'

On top of the very large shift from i9-based to i10-based grouping, our in-house grouper guru retired, which forced us to revamp our development process.

This is our plan to migrate us from the i9-based to i10-based development:

1. Technology turn over from departing guru to new team
2. Re-create x31 with the new process and new team
3. Create x32 with the new process and new team
4. Create v33 with the new process and new team

We are happy to report the step (1) was completed in early June and that step (2) was completed yesterday.

We expect to complete step (3) today and have an x32 DRGFilt available for evaluation by first thing Monday morning.

Currently, we feel that we are on track to be ready to provide our DRG Assignment Service for v33 on October 1st.

We are currently reviewing our product line to see which products we want to port from i9 to i10. As soon as we can we will put up an on-line survey to allow our customers to weigh in on which products to keep and which to leave behind.

ICD10 Support in 2015

2015 should be a banner year for DRG Groupers; we are taking advantage of the impending shift to ICD10 to knock some items off of our to-do list:

• We are going to change our web site to improve the on-line shopping experience.
  
• We changed our URL to DRGGroupers.net to go with our web site overhaul.
  
  
• We are going to try to streamline our upload and download pathways for our DRG Assignment Service (DAS).
  
• We are going to review our product definitions to make sure that we are offering what people want to buy.
  
• We are trying out a streamlined development process by creating an ICD10 version of v32 DRGs--and we are looking for beta testers.

This is an ambitious slate to get done by the end of the year, but so far we are on track and appreciate your patience with any issues that arise.

DRGFilt Control File Change for V30: dxc & sgc

The ancient and venerable DRGFilt control file syntax has changed slightly for v30, released in October of 2012. The change is the addition of two new keywords, "dxc" and "sgc" and they stand for "diagnosis count" and "surgery/procedure count" respectively.

The problem they solve are records with 15 dx or 15 procedures. Since drgfilt's cntl file mechanism only has a two-digit length, it cannot directly specify all 15 when they are spaced as on these test records.

When these values are present, they are multiplied in drgfilt by the dxl and/or sgl and override the lengths on the dx and sg cards.

For example, our internal control file to process the Federal test data now looks like this:

age  000 03
sex  003 01
ds   004 02
dxl  000 08
dxc  000 15
poa  000 07
dx   023 96
sgl  000 07
sgc  000 15
surg 223 98
#drg  603 03
#mdc  600 02
#rc   598 02
exmp 006 01
# these are written out by us
drg  607 03
mdc  610 02
rc   612 02
dflg 614 15
sflg 629 15

New in V30

The DRG definitions were finalized early this year, allowing us to ship products on September 28, 2012 instead of our usual target of the first week in October.

This is a quiet year for DRG version change. The only real DRG change we have to report is the addtion of two new HACs (see glossary), 13 and 14.

Probably also because of the impending switch from ICD9 to ICD10, there are no new or revised or deleted ICD-9-CM diagnosis codes for V30. There are also no revised or deleted ICD-9-CM procedure codes for V30 and only one new procedure code:

00.95    Injection or infusion of glucarpidase

For details, visit the CMS site:

https://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/

Conversion from ICD9 codes for diagnoses and procedures to ICD10 codes is still coming, but it isn't here yet. We will continue to produce ICD10 versions of our products as an aid to cutting over.

V30 for ICD10

We have a pre-release of V30 for ICD10 codes in the works. We expect CMS to release a definitions manual in the next few weeks, at which point we can ensure that our implementation is correct.

We expect CMS to release their V30 ICD10 grouper early next year, 2013. We intend to release ours on or before February 1st, 2013.

V30 Release Early

Since there were no changes to V30 in the past few weeks, our pre-release V30 is being promoted to a full release today. While the official release date will be October 1st this year, we expect to finish our internal validation and distribution today, at which point we will fill our standing orders. We will update our website and on-line store tomorrow.

Thanks for your patience.

F30 Pre-Release

We have received a pre-release of F30 from our development group to accommodate a DRG Assignment Service (DAS) client who wanted to try out F30 ahead of its official release on October 1st, 2012.

We put the pre-release F30 through our basic validation process, upgraded our DAS system and have used it successfully.

We are in the process of finishing the internal F30 roll-out.

Barring changes from CMS or bug reports, this will become our official F30 release on October 1st, 2012.

Question About DRG27

QUESTION

Hey there I currently have your v27 software and we recently put this into production for the current year.

My question is if it's backward compatible ?  I need to go back 3  years in my dataset and assign a drg value.  Can I use your software version to do this ? will it look at the service dates and assign a previous version ?  Or, must I buy a previous version or versions and apply based on the year ?

Thanks for your help.

ANSWER

(Before we start, I should point out the current version is F29, not F27; you can see the complete list of versions here:

http://www.drggroupers.com/grouper.html

For the purposes of this answer, I will assume that you knew this already and that you wanted F27.)

In order to assign DRGs for a given version, you need two things:

1. Logic, which we encode in software
2. Code attributes, which we encode in masks files

The software is always for a given version; in your case, that is F27. The software is backwardly compatible, provided that you have the masks files for previous vesrions.

So if  you have software for F27 and want to assign DRGs for F24, then all you would need to do is to buy the masks file ($100 from our on-line store at the above link) for F24. In fact, you can buy masks files for any version before F28 and then be able to assign DRGs for that version.