Ascend Release Notes

2859

NCPDP Billing - allow option to remove Patient ID and ID Qualifier, in other words, to suppress sending the CX and CY fields under certain circumstances.

Notes from the person testing:
I tested these scenarios:
1). In Payers screen, E-Bill NCPDP tab, I selected "Do Not Send" for Patient Id Field. There is a value in Patient ID field on the patient's record. No CX or CY fields were formatted on the AM01 segment. Cardholder ID still shows in C2 field of AM04 segment.

2). In Payers screen, E-Bill NCPDP tab, I selected Patient ID for Patient ID Field. I then removed Patient ID from the patient record. No CX or CY fields were formatted on the AM01 segment. Cardholder ID still shows in C2 field of AM04 segment.

3). Same as (2) above, but I added back the value in Patient ID field of patient record. CX field shows "99" and CY field shows value from Patient ID field on AM01 segment. The AM04 segment shows the cardholder ID from insurance record.

In my testing, I did not encounter multiple CX segments being built.

2931

Find Claim found the claim but did not load the profile. This has been fixed.

3013

Added NCPDP E1 Enhanced Support

The Processor Control Number (PCN) is now set to 2222222222 for all transactions that are of the type 'Medicare Eligibility Part D'.

The Software Vendor Id still contains the TROOPELIG text and this is expected for RelayHealth.

3037

Added utility to parse ANSI X12 transmission batch text.

New menu item under Financials / E-Bill :
"View Parsed 837P"

A File Selection screen will appear. Select an X12 output file and click the Open button.

The selected file is parsed and a Microsoft Notepad window is opened to display the text.

The Notepad window remains open until you manually close it.

3049

Added Eligibility Verification to NCPDP Transaction Log

3054

Performance Improvement: Financials / E-Bill / NCPDP Transaction Log

Charging

2963

Create Option To Uncharge Non-Transmitted Doses Upon Discharge/Discontinue

Inpatient orders can be charged manually, by running the Fill List Report, by printing an IV label, or by an automated dispensing system sending a charge to Ascend through the interface. In the first three methods, the charge can be posted to the order in advance of the patient receiving the medication.

In those cases, if there are future charges on an order where the patient has not received those doses, and either the order is Discontinued, or the patient is Discharged, with this option checked, those charges will be removed.

The charges must not have been already transmitted to the hospital billing system to be removed. The Ascend billing interface only sends charges from the previous day, so future charges will not have been transmitted.

The option is added as a checkbox under the Utilities / Options / Billing tab.

The checkbox is located on the lower left side of the screen labeled "Automatically uncharge scheduled doses when patient/order is DC'd.

Both the program and interface will use the setting. Interface will need to be greater than 3.2.29 to work.

The program will uncharge any scheduled doses after the discharge/discontinue date.

This option controls if charges for scheduled doses should be uncharged when one of these actions is performed:
A patient is Discharged.
An order is Discontinued.

Charge type must be scheduled to be uncharged.

Example:
Patient has been charged for one dose on 4/15/2009 08:00.

In the General Tab of the Order, in the Scheduled Times / Charges section, you can see the
Dose Date = 4/15/2009 08:00,
Qty = 1,
Charged = Yes,
Transmitted = blank,
Type = Scheduled.

Patient gets Discharged on 4/14/09 15:00.

With this option checked, the Scheduled dose shown above will be Uncharged, and if you opened the Order after 4/14/09 15:00, you will not see the charge for this scheduled dose.

Dose Date = 4/15/2009 08:00,
Qty = 1,
Charged = No,
Transmitted = blank,
Type = Scheduled.

Charging

3066

ER/Misc Charge/Credit: The screen has been redesigned.

It has two functions.

1. Add a Charge or Credit to an existing order
2. Create a new order on an existing patient and place a charge on that order. The new order will have a status of Discontinued, and will display a status of "D".

On the Orders menu, choose ER/ Misc Charge / Credit.

The screen is divided into 3 sections:

Charge Method.

You can choose to charge by Order Ref, or Patient and Inventory List.

When you charge by Order Ref, you choose the Charge Date, the Order Ref and the number of Doses to charge and click the Charge/Credit button.

When you charge by Patient and Inventory List, you need to choose the following:

Order Type: Choose Order Type from the list. If you have an order type that you want to use specifically for ER/Misc/Charge/Credits, then choose that one, or create one using Utilities / Order Types.

Include discharged patients for how many days? Enter a numeric value to limit the number of patients that appear on the list.

The second section is where you enter the information, and click the Charge/Credit or Close buttons.

Charge Date: This is the date of service for the charge
Patient: Choose by ID, Name or Medical Record Number.

Ordering Doctor: If the Utilities / Options / Order Entry tab setting for Default Attending Dr as Order Dr is checked, then the patient's Attending Dr. is selected by default. You may choose another Dr. from the list. Otherwise, you may select a Dr. from the list.

Order Info: Choose by Description, Charge Code, Alternate Charge Code, NDC, or Inventory ID.

Doses: Number of doses to charge for.

Floor Stock: Choose a Floor Stock area from the list, and the order will use a Charge Method of Floor Stock. Otherwise, the Charge Method will be Manual.

The third section is a display list of the orders that have been charged for the current ER/Misc Charge/Credit session. If you dismiss the screen, and later return to it, the list will start out blank.

2247

Clinical Reviews are now filtered by Admission. (See Note 1, below.)

2252

“Inactivate” button on Clinical Reviews screen is now Active.

The Clinical Review form allows the user to Accept, DC or Cancel the new order. Inactivate was disabled. Now, it is Active.

Inpatient users may need to get more information about the problem or consult with the physician before knowing whether to Accept or DC the order.

In some cases Inactivate would be the desired action, preventing the order from being included with batch IV labels, Fill List report and outbound orders interface when set to exclude transmission of Inactive orders to systems such as Pyxis.

2795

New Clinical Alert: "Invalid NDC".

Turn this Clinical Intervention Check on in the Utilities / Options / First Databank tab. The option is "Invalid NDC Warnings". It will be on by default.

Whenever an Order is saved for an item with an Invalid NDC, a clinical alert will be generated to notify pharmacy that no other clinical checking is available.

An invalid NDC number is defined by an Inventory record whose NDC number does not match any NDC number in First Databank.

Ascend uses the NDC number to do all First Databank clinical checking, and if the NDC number is invalid, no clinical checking can occur.

Note: When an Ascend program update or a First Databank update is applied, the NDC numbers from First Databank get updated. This may cause some of your Inventory records that previously had valid NDC numbers to now have invalid numbers.

When the update is complete, run the Report "Inventory with Invalid NDC" to get a list of all the Invalid NDC numbers in your Inventory.

It is good practice to run that report after each update.

If the inventory record has no NDC, no warning will be produced. This is by design.

2950

Clinical Documents - Disabled Cut option when Clinical Doc is locked. This prevents users from cutting (deleting) any of the contents of the locked document.

3011

Clinical Review screen now has a link to the order.

For an existing Clinical Review, the screen has a link to the order that generated it at the upper right corner. Click on the link and the Order will open.

For a new Clinical Review, there is no link, but if you view the Clinical Review and choose Save or Cancel, it brings you back to the Clinical Reviews list, where you can click on the button "Edit Order" and the order will open.

Codes

2256

HCPC screen can now sort by Code and Description headings. Click on the heading you would like to sort by.

Codes

2923

Performance Improvement: Pricing Rule screen.

Interfaces

2899

ASAP.XML TotalRecords and TotalSegments now use segment delimiter.

Since the segment delimiter is now defined in the XML file, the program will use the file delimiter when counting segments and not assume the delimiter will be \.

The ASAP.XML file, under the version 3.0 and 4.0 headings, the entry:

<TH09 name="Data Segment Terminator Character">\</TH09>

was added to define the terminator character to use as the segment delimiter (in this example it is the \ character).

Change the value to use a different segment delimiter.

Interfaces

2901

ASAP.XML - do not create CDI segment if order is not compound.

For the version 4 of ASAP, a line has been added to CDI segment to exclude non compound orders.

Note from the Hann's On Software Support Representative:

In order to have the CDI segment be built only on compound orders, I found I had to edit the orders and, on the Other tab, set the Compound indicator to YES. If that indicator was either NO or NOT SPECIFIED, the CDI segment was not built.

With this change made to all the orders, I ran the Export Narcotics function and CDI segments built only for orders marked as compounds.

2261

Inventory screen - Added a link next to HCPC code to allow you to bring up the Utilities / HCPC Codes screen from the Inventory screen.

The link is an icon that looks like a file folder. Click the file folder, and the HCPC Codes screen comes up for your reference.

It is for your reference, and clicking on a code in the screen does NOT have any affect on your Inventory record.

2842

Inventory : Scrollbars for MAR Notes have been added.

In the MAR section, there is a new list with Dose Text and Notes as your choices.

Dose Text is text that can print on the MAR under the Dose Time. The Dose Text can be up to 15 characters.

Mar Notes is a Text field and can be any amount of characters. Therefore, when typing in MAR Notes, scrollbars may be enabled, if needed.

2973

HCPC code list in Inventory is now sorted. You may type the first few characters of the code you are looking for, and it will jump to that code.

3001

Add Option to specify which Inventory Description field holds Brand Name.

This option applies to New Inventory records where an item from the First Databank screen is imported into the Inventory screen.

Hospital pharmacies almost always want the drug name, aka generic name, loaded into Inventory Description1. If the selected NDC is for a branded drug item, the brand name would then go into Inventory Description2.

Given the way Ascend has accessed the FDB tables, whenever a user imported an item with a true brand name the brand name was imported into Description1. The user then had to copy and paste to flip the brand name to Description2.

These new options will control the Import process so it will place the brand name of branded items in their Description field of choice.

For example, Tylenol is a brand name. The drug or generic name is Acetaminophen. Hospital pharmacies almost always want to have Acetaminophen show up in Inventory.Description1 and Tylenol show up in Inventory.Description2. Ascend's Import process, however, always loaded Tylenol in Description1 and Acetaminophen in Description2, which is the exact opposite of what the user wants.

These new options will allow the import to place Tylenol in Description2 and Acetaminophen in Description1.

Go to Utilities / Options / Inventory tab.

Near the left bottom are two new choices, Description1 and Description2. The choices are:
No Definition
Generic Name
Brand Name

To specify that the Generic name gets imported to Description1, and the Brand name to Description2, set the options accordingly.

Description1: Generic Name
Description2: Brand Name

3072

Inventory Pricing Rule: Changed the word "Markup" on Pricing Rule screen to avoid confusion with the definition of "Markup".

The Inventory Pricing Rule screen calculates the price the same way. Only the wording on the screen has changed.

The Inventory Pricing screen, with the list of rules, still refers to the word "Markup" in the column headings. This will be changed in a future release.

167

IV Label and Compound Sheet now uses the Inventory Precision fields.

Previously, the precision was set to 2 decimal places, and the printed Compound Sheet or IV Label strength or per may have been rounded, eg. 3.375 GM may have printed 3.38 GM. Now that the IV Label and Compound Sheet use the precision fields, the 3.375 GM will print, as long as the precision was set to 3 or 4.

To setup Strength and Per Precision defaults, go to Utilities / Options / Inventory tab, and set the number of decimals for each.

To override the default setting, an item in Inventory can have it's own precision.

436

New Option to Prompt for number of labels.

Utilities / Options / Printing

There is a new checkbox
"Always prompt for quantity when printing this label/form"

Choose the label or form from the list. Then, check the checkbox.

After clicking Print or Preview for an order, you will be prompted to "Enter the number of copies to print". You can choose to change the default value, or keep it the same.

2903

New: Patient Admission Label

A new form was added: Patient Admission Label.

This label can be used as a Cassette or Admission label for Inpatient use.

It is designed to fit a 3.5 in. x 1 in. label.

2988

Outpatient Label: Suppress Mix Date for Outpatient Oral Category Order

Mix Date will no longer print on the Outpatient label when the category of the order is "Outpatient Oral Prescription".

Mix Date will still print on the Outpatient label when the category of the order is simply "Outpatient Prescription".

The Category is set by the Order Type in Utilities / Order Types. Each Order Type is linked to a Category. An Order Type may be set for an Inventory record. Every Order requires an Order Type.

Menus

2684

Customized Orders View Columns Will Remember Last Columns Selected.

Choose the menu Orders / Orders View. Click on the link for Customize Columns.

Add or remove columns that will display on the Orders tab.

These columns will be remembered, so next time you login, the same columns will display.

Options

2797

Inpatient : Option to specify length of Clinical Checking period for Other Medication Orders

Utilities / Options / First Databank tab, enter a number where it says "Days from admit date to include other medication orders in clinical reviews checking". Fill in the number of days, greater than or equal to 0. 0 days (or leave the field blank) will result in no checking.

Other Medication orders for inpatients are used to enable clinical checking between medications the patient was taking prior to Admission and anything they will receive during their stay. Cross checking Other Medication orders against Inpatient orders only have value within the first day or so after Admission.

Enter a value greater than or equal to 1 day will include clinical checking Other Medication orders with Inpatient orders for that amount of days.

After the number of days have passed, no clinical checking with the Other Medication orders will occur.

Options

3074

Order Entry tab : Can enter the Interface Route Code when adding or editing a Route.

An Ascend interface that sends outbound orders with the administration times will send a Route Code as part of the interface message.

Previously, there was no way to enter this code.

Now, when a Route is edited or added, the first window displays the Description, the next window displays the First Databank Route code, and the final window will display the Interface Route Code.

The Interface Route Code is optional.

Currently, the Route Code is limited to 2 characters.

1763

Verify Orders will now list only Inactive orders.

In prior versions, it would display Other Medication Orders and DC'd charge orders inserted by the interface.

2224

Renew Orders: changed algorithm calculating number of days.

The Renew Orders function changes the Stop Date of the order to a new date. A window prompts for number of days to renew the order. The system suggests a value based on the default number of stop days for the order.

Ascend calculates the stop date based on:
Inventory record number of Stop Days from the Stop Date List linked to the Patient Location, or the Default Stop Days from Utilities / Options / Order Entry Tab.

For an Order with multiple ingredients, Ascend suggests the number of stop days based on the ingredient with the shortest number of default stop days, or, to the system wide setting from the Utilities / Options / Order Entry Tab.

1. A note about Admissions

A number of CSR's are based on the fact that in Ascend, one patient can have many admissions.

In prior versions, one patient had one admission. The next admission would create a new patient record. Therefore, each patient record had it's own Admit date and Discharge Date.

Ascend now uses one patient record and links the patient record to an Admission record. One patient record can be linked to many Admission records.

The Admission record now holds the Admit date and Discharge date.

You will see some CSR's stating that a function needs to look at an Admission. This means, in prior versions, it was looking at the Patient record and it now needs to look at the Admission record.

2960

Warning message when refilling an order between the start and stop dates.

The same prescription number already exists for this patient that falls within the Fill Start Date and/or Fill Stop Date of this order.

Previous Order
Rx Number: 86
Entered Date 4/28/2009
Fill Start Date: 4/28/2009
Fill Stop date: 5/01/2009

New Order
Fill Start Date: 4/30/2009
Fill Stop Date: 5/1/2009

If you are billing per diem then you may be billing the same day more than once. Are you sure you want to continue?

You can choose Yes or No. If you choose No, you will return to the Order screen where you can make changes or choose Cancel.

2961

Use of the Enter key in Instruction and Comments fields creates a Carriage Return / Line Feed. Use the Tab key or click on a new field to leave the field.

The Order screen’s Physician’s Instructions, Patient Instructions, Mix Instructions and Comments fields are affected.

Now, when when the user enters any of these fields, the software places the focus at the end of the field’s text, and the existing text is NOT highlighted.

These fields do NOT allow the use of the Enter key to leave the field.

Now, the user must use the Tab key or the mouse to leave the field.

Also, if a user highlights a section (or all) of the text in one of these fields, and then presses the Enter key, the highlighted text is replaced by a carriage return/line feed. Use CTRL-Z to undo, if needed.

The tab order for these fields is:

After the user adds an order item, the ‘Add’ key for the order’s items retains the focus.

Starting at the ‘Add’ key for the order’s items, if the user presses the Tab key, the focus goes to:

Edit Item button,
Delete button,
Quantity button,
down-arrow button,
Physician’s Instructions,
Patient Instructions,
Mix Instructions,
Comments,
New Order button.

2989

This Patient is Discharged warning needs to look at Admission (See Note 1.)

2998

Performance Improvement for New Orders when bringing up the Inventory List

3047

Order Item Selection: Added Charge Code to Display
The Charge Code now displays below the NDC number at the top of the screen.

2796

Alternate Shipping Address - New indicator in Patient Information section when active. "Alt Ship".

When a patient has an Active Alternate Shipping Address, the patient's home address is displayed in the Patient Information section of the profile, with the phrase "Alt Ship" to the left of that address field.

Click on "Alt Ship" and a screen appears that shows the current, active Alternate Shipping Address.

2886, 2906

Select A Patient Admission: Added new Search By fields.

You can now search for a patient by one of the following:

Last Name, First Name
Last Name
First Name
Patient ID
Medical Record Number
Social Security Number
HICN
Insured ID
Room
Phone *
PatientRef

*Note: Phone searches all phone number fields; home, work, cell and other.

2939

Select A Patient Needs To Search Admissions (See Note 1.)

The screen is now called Select A Patient Admission.

2946

Select A Patient Admission: Duplicate Name Warning modification required (See Note 1.)

2984

Select Patient Admission Filters Need to Use PatientAdmissions Table (See Note 1.)