V2.57 (Jan 2025)

V2.57.9116.0 Released 01/08/25

The notes below indicate changes and additions to the software. Please review these release notes carefully when deciding to apply a software update to an installation.

Each note is related to an issue tracking assignment number (starting with CACTWO) in the heading. Please refer to the change with this tracking assignment number when communicating questions or issues.

The heading also contains a parenthesized "Change Type", indicating the severity or importance of the change. The severities used are:

• Critical - Recommended that this application be upgraded as soon as possible at all sites running previous versions.
• Conditionally Critical - Recommended that this application be upgraded as soon as possible at all sites running previous versions matching the stated conditions.
• Important - Recommended upgrading the application if the customer is experiencing the issue denoted or currently applying a work-around for a specific non-functional feature.
• Enhancement - Recommended upgrading only if the specific functionality is desired.

Allow PCS/CPT Codes to be Configured per Category

CACTWO-4897 (Enhancement)

A new configuration will allow outpatient accounts to show PCS codes along with CPT, and inpatient accounts to show CPT codes along with PCS, for specific account categories.

Allow Users to be Assigned to Managers

CACTWO-5140 (Enhancement)

A new field will display within User Management that can be used by administrators and managers to assign users to a manager. The manager field is a dropdown that will only display for users with a manager role. Clicking the blue button next to the field will allow you to associate users to a manager. When a manager has users assigned when that manager runs User Reports, they will only see the users that are assigned to them. A new manager column has been added to the User Management grid.

Add the Ability to Bulk add Columns in Grid Column Configuration

CACTWO-5520 (Enhancement)

A new button has been added to Grid Column Configuration that will enable the user to bulk add columns. When the button is clicked, a box will open showing only available columns. User can check as many columns as needed and click OK to have them added to Grid Column Configuration.

Allow Drilldown Column Names to be Changed in Account Search

CACTWO-5678 (Enhancement)

In Account Search, for drilldowns other than Accounts, administrators and users with the privilege will see an edit button next to the drilldown field.

Clicking the edit button will bring up an edit pane, listing all columns associated with that drilldown. The user can then change the name in the ‘new name’ column.

Please note that any changes made will be seen in ALL searches that use that drilldown.

Split Form Designer: Worksheet & Query Designer to Accommodate Separate Queries for CDI vs Coding

CACTWO-6400 (Enhancement)

Form Designer has been split into two menu items: Worksheet Designer and Query Designer. This will allow query templates to be split up by user type, just like worksheets. Current queries will initially be in the Shared Query folder, but can be changed via the Type field at the top right of the query. Users can be assigned a new set of privileges within role management for creating/editing templates as needed. When creating a query in an account, the user will only see the templates that are assigned to them by their profile type, with the ability to have access to more templates by setting the above privileges.

Lock Down Certain Sections of a Shared Worksheet

CACTWO-6363 (Enhancement)

A new dropdown has been added to the Add Field box in Worksheet Designer. displayed as “Editable”, it allows the creator of the worksheet to set what type of user can edit that particular field. It defaults to All Users. If a field is set as Coders Only, then a CDI or Auditor looking at that worksheet will not be able to alter that field. This will appear in Shared Worksheets only.

Create new Worksheets for Auditor Only

CACTWO-6364 (Enhancement)

Worksheet Designer now has a pane for Auditor worksheets. These worksheets, once created, will only appear in an auditor’s worksheet drop down when the Add button in the Navigation Tree is clicked. Only auditors, admins and managers can create a form in Worksheet Designer for Auditors. A new privilege has been created in Role Management to assign that ability to other types of users.

New Fields Added to the Account Fields List in Worksheet Designer

CACTWO-6387 (Enhancement)

New field options have been added to the Worksheet Designer when using Account Fields. These fields will be ‘stamped’ onto the form so that they do not change even if changes occur on the account details.

Add Coder Scorecard to Coder Personal Dashboard

CACTWO-6389 (Enhancement)

If enabled, the Coder Personal Dashboard will display the Coder Scorecard report at the bottom of the dashboard screen. The data can be drilled down by clicking on any number other than 0 in the Open Audits and Closed Audits columns.

Allow User to Change the ‘Reason’ Once the Query has Been Sent or Closed

CACTWO-6404 (Enhancement)

The reason field on a physician query can now be changed after being sent or closed. If a user makes a change in that field, a Save Edit button will appear at the bottom to save the change.

Add Charge CPT Code Section to Audit Viewer for Certain Revenue Codes

CACTWO-6440 (Enhancement)

CAC now has the ability to audit Charge CPT/HCPCS codes from the Charges Viewer will now be added to the Pre/Post Outcome section of the audit. A new Audited Charges section will show beneath the Pre and Post Outcome sections of the Audit. At the bottom of the list will be an Add button for the auditor to add a hard charge if needed. The charge CPT codes will will show in the the Pre and Post Outcome lists. Further down the Audit, a section called Charge Codes will be showing beneath the CPT codes section and will show all of the totals and error rates. To enable this feature contact CAC support and provide a list of revenue codes you wish to audit.

Add an Escalation Section for Audit Worksheet

CACTWO-6441 (Enhancement)

If a coder chooses to rebuttal an audit and the auditor does not agree, a new section line for escalation will open in the audit. If an escalation is marked as requested, the auditor can add his details, and manually assign the acct to another auditor. Workflow can also be used to assign to another auditor who has escalation privileges.

Add APC Changes for CPT Codes to Audit Worksheet

CACTWO-6443 (Enhancement)

Auditors can audit APC changes on outpatient accounts, which are automatically created upon Computing an APC. In Account Search, the Audits drilldown will now have 3 more columns; APC Changes, APC Error Rate, APC Accuracy. APC columns have also been added to the Outpatient user reports.

Allow When Recording a ‘Physician Response’ on a Query to Expand

CACTWO-6486 (Enhancement)

In a physician query, the physician response field block was static. It has been fixed so that it can become larger as more text is added.

Create a Return to Query Button in the Shift Reason Window

CACTWO-6487 (Enhancement)

A ‘Return to Query’ button has been added to the bottom right of the Shift Reason window. When clicked, user will be taken back to the query to make any change necessary, including recomputing a drg. Clicking the cancel button at this point will remove any work done on that query. Selecting a closing reason will again pop the Shift Reason window, where the query can be updated and closed.

Allow for Tertiary Grouper in Audit, With a Billing tag on Inpatient Accounts

CACTWO-6516 (Enhancement)

If a tertiary grouper is present on an inpatient account, then all 3 DRGs will be presented in the Pre and Post Outcome panels of the Audit Worksheet. If a billing grouper is indicated, the billing grouper will receive a Billing tag.

Allow Billing Grouper Data in the CDI Metric Scorecard Report

CACTWO-6609 (Enhancement)

If an account has a billing grouper with anof APR-DRG, the CDI Metric Score Card report will separate reviews and case mix index between MS-DRG and APR-DRG.

Update Denial Management to act Like Audit Worksheet

CACTWO-6795 (Enhancement)

The Denial Management viewer has been changed to match how Audit Worksheet is opened. Upon opening Denial Management, the user will see a button called Add Denial. Clicking this will open the Denial worksheet, and will allow for multiple worksheets to be open. Each Denial will open from its own button, with the original Denial date.

Add Setting to Control Mandating a Pre Query DRG on Queries

CACTWO-6818 (Enhancement)

This update addresses challenges encountered with pre-query DRGs during the query process. Initially, a pre-query DRG is determined based on existing diagnosis codes.

However, as new diagnoses are added before closing the query, the post query DRG may not accurately reflect these updates. This discrepancy often requires manual adjustments by removing or modifying diagnoses to capture the intended impact accurately. Additionally, updates to the pre-query DRG can inadvertently change the account-level DRG instead of just the query DRG, leading to further manual corrections to re-enter the accurate account information. To streamline this process, we are introducing four configuration settings for the “PreDrgQueryRequirement” site configuration, which can be adjusted by CAC Support as needed.

1. Default Behavior: The current system behavior continues, where the pre-query DRG is automatically populated from the account and required when sending a physician query. If the pre-query DRG is not included, a validation error will prompt correction before proceeding.
2. Open: When a query is opened, the pre-query DRG is automatically populated from the account (similarly for the post-query DRG, which will initially match the pre-query DRG). Both DRGs must be edited and confirmed by the user before the query can be closed.
3. Manual: This setting gives full control to the user by not auto populating the pre-query DRG, but it remains a required field to close the query. This option suits sites preferring complete manual entry of both pre and post-query DRGs without auto-population.
4. Never: Neither the pre-query nor post-query DRG is auto-populated under this setting, and neither is required to close the query. This setting is suitable for sites that do not require tracking of pre and post-query DRG calculations. (Uncommon) These new settings are designed to reduce the manual workload and improve accuracy in DRG documentation during the query process.

Add a PCS to CPT Crosswalk to TruCode™

CACTWO-6829 (Enhancement)

A new section will appear in the Research tab of the TruCode™ reference tab called CPT to PCS Crosswalk if a CPT code is clicked, or PCS to CPT Crosswalk if a PCS code is clicked.

Allow Pending Accounts to be Hidden for Autoload Users

CACTWO-6838 (Enhancement)

A new configuration setting will hide the Pending Accounts grid for all forced autoload dashboard page.

Retain Highlighting of Text When Using ‘Add Code’

CACTWO-6841 (Enhancement)

When a user highlights text and chooses either Add Code or Add Code From Encoder from the right click menu, the text will remain highlighted while the dialog is open, previously there was no highlight.

Add Ability to Edit Codes for Query Pre/Post DRG Without Changing Account Level DRG

CACTWO-6861 (Enhancement)

In a query, a new dialog will open if the Compute button is clicked for the Pre or Post DRG. In the dialog, the user can change the codes to compute for a new DRG by clicking on the plus sign it will add the code from assigned codes to either the pre/post query DRG codes the x button will remove them and to add all codes from assigned code tree you can click on the button “Overwrite All Codes”, but the main account DRG will not be updated.

Add New Columns to the Audit Report

CACTWO-6862 (Enhancement)

Two new columns, Principal Diagnosis Error and Accuracy Rate have been added to 4 Audit user reports: • Inpatient Auditor Productivity • Outpatient Audit Scorecard • Outpatient Auditor Productivity • Outpatient Coder Scorecard

Create New Workgroup Assignment Report

CACTWO-6864 (Enhancement)

A new user report called Current Workgroup Assignment per User has been created. This will display the workflow assignment for each active user from the user’s profile. Only active users with at least one assigned workgroup appear on this report. A Forced Autoload user will show an asterisk to the right of the workgroup name if autoload was launched on that day.

Allow Customization to Medical Necessity in TruCode™

CACTWO-6867 (Enhancement)

This feature adds a configuration setting “SendChargesToEncoder” is set to false to prevent charges from importing into Solventum CRS, but their new custom “charges-filter.js” will inject the charges into the input packet for TruCode’s medical necessity calculations.

Error Occurring With use of Short Token Highlight

CACTWO-6869 (Important)

When text that is only a couple characters long is selected for adding a code, an error was occurring if that text occurred in the HTML style attributes earlier in the document. This has been corrected.

Created by Dropdown in Physician Query has Been Updated

CACTWO-6883 (Enhancement)

The Created By dropdown in a physician query showed all available users in the list. This has been changed so that only administrators or users with the privilege from role mangement to create/edit physician queries are listed.

Add Comment Fields in Denial Management Viewer

CACTWO-6884 (Enhancement)

A comment field has been added to each of the three appeals in the Denial Management viewer.

Change the Coder of Record Dropdown to Only Allow Coders on the Audit Worksheet

CACTWO-6890 (Important)

The drop down for ‘coder of record’ in the Audit Worksheet viewer had all users show up. CDI should not be included in this dropdown, so this has been corrected to only show Coders and Auditors.

Prevent ‘Coder of Record’ on a new Audit From Being a CDI Specialist

CACTWO-6890 (Important)

Previously, the Audit Worksheet was applying the last user to save the account to the Coder of Record field. This could include a CDI, which it shouldn’t. Now, the coder of record will be decided by this process:

1. If the account was submitted, default the “Coder of Record” to the last submitter. Otherwise…
2. If the account’s Owner is not a CDI Specialist, default the “Coder of Record” to the owner. Otherwise…
3. If the account’s Last Saver is not a CDI Specialist, default the “Coder of Record” to the last saver. Otherwise…
4. Leave the “Coder of Record” blank for the user to fill in.

Display Issue is Happening When a Physiciain Query Form Uses Sections

CACTWO-6903 (Important)

Using a physician query form with dynmaic sections, if sections were removed via the red X on the form, they were scaling in green across the screen horizontally instead of vertically. This has been corrected.

Add Comments to Shift Reason Panel

CACTWO-6905 (Enhancement)

In a physician query, when a query is closed, a shift reason panel is presented. A new comment box has been added to the panel. This field is available in account search. Even if no shift reasons are selected, the comment will still show back in the query.

A new column for shift reason comments can be added to the Physician Queries grid.

For any shift reasons created prior to this upgrade, the column will appear blank.

Create an Impact Queries Viewer

CACTWO-6908 (Enhancement)

An Impact Queries viewer will show in the Navigation Tree whenever a billed account has a CDI created query in place. This will give the CDI a quick look at impacts among queries without opening each one. Clicking on the envelope will open that specific query for investigation. The field for Assigned Impact % is manually filled in by the CDI, and the total of all fields should not be more than 100%. To ensure that doesn’t happen, a validation rule should be implemented. Three new columns and fields have been added to Grid Maintenance, Validation Manager, Account Search and Workflow: • CDI Query Impact Dollars • CDI Query Impact Percent • CDI Query Impact Weight

Buttons not Working if Audit Worksheet is Popped Out

CACTWO-6910 (Important)

Several button options have been enabled to work from a popped out audit worksheet: Route to Coder, Return to Auditor and Mark as Reviewed.

1. “Route to Coder,” when logged in as an auditor to forward an open audit to the Coder of Record
2. “Return to Auditor,” when the coder rebuts the open audit assigned from the auditor
3. “Mark as Reviewed,” when the coder is assigned an account with a closed audit and hasn’t marked the audit as reviewed previously

Force Autoload is Skipping an Account Assigned to the Workgroup

CACTWO-6917 (Important)

An account that was being added to a workgroup that was being worked on by a forced autoload user was not being triggered. This corrects the following problem: If an account was skipped in the forced autoload process due to various reasons (locked in use, reassigned to a different user or workgroup, has an open audit for a different coder), it does not appear for the forced autoload later if the account appears again in the forced autoload user’s workgroup.This has been corrected.

Add Strength Fields to Each Appeal on Denial Worksheet

CACTWO-6919 (Enhancement)

In Denial Management, strength fields have been added to each of the appeals in the Denial Management. Strengths are low, medium and high. These are also now showing as columns in the Denials drilldown in Account Search.

‘Encoder Not Detected’ pops up Sporadically in Solventum™

CACTWO-6921 (Important)

If a user was accessing Solventum™ but not via the website, the ‘Core Encoder not detected’ message was popping up in various places. This has been fixed.

Created ‘CDI Activity Detailed Report’

CACTWO-6923 (Enhancement)

New user report ‘CDI Activity Detailed Report’ has been created. Its similar to the CDI Activity Report but, adds account numbers.

Ignore new Codes Added by Coder Post Audit

CACTWO-6927 (Important)

If an auditor submits an account with an open audit, the “post-audit” codes will change to reflect what the auditor submitted. If any other user submits an account with an open audit, the “post-audit” codes will not change.

Add Audited by Field to Denials Management

CACTWO-6935 (Enhancement)

An ‘Audited By’ field has been added to every denial in Denial Management. This field will also show as a column in the Denials drilldown in Account Search.

Audit and Denial Worksheets Should Verify Deletions

CACTWO-6936 (Enhancement)

When deleting an audit or a Denial Management, an ‘are you sure you want to delete’ window will pop to verify the user wishes to delete.

Allow Secondary DRG to be Expanded by Default on Shift Reasons Dialog

CACTWO-6944 (Enhancement)

By default, the first DRG on the Shift Reason dialog is always expanded. If a customer wants a secondary DRG to also auto expand, an updated shift-reason-calculator.js will be needed.

Popped out Audit Worksheet is Losing Fields and Minimizing

CACTWO-6945 (Important)

In some circumstances, a popped out Audit Worksheet will be minimized and may lose the Recommendations box when changes are being made on the main account detail page. This has been corrected.

Edit Procedure Details in not Allowing Deletion of Modifiers

CACTWO-6946 (Important)

On the assigned codes tree, if you right click on a CPT code and select Edit Procedure Details, the modifier could not be removed. This has been corrected.

Allow Physician Coders to Edit and Delete Code Suggestions

CACTWO-6952 (Enhancement)

Physician coders can now edit and delete code suggestions from documents.

Calculations on CDI Query Detail Report are Incorrect

CACTWO-6957 (Important)

The calculation of the two ‘chart impact’ columns in the CDI Query Detail report were comparing Working DRGs with Final DRGs, which it should have been comparing Baseline DRGs with Final DRGs. This has been corrected.

Correct CDI Review Counts in two CDI Reports

CACTWO-6966 (Important)

In both the CDI Activity and the CDI Activity Detail reports, a reconciled account was showing as both a followup and a Recon touch causing a discrepancy between the CDI Dashboard and the reports. This has been changed so that a reconciled account will only show in the Recon touch columns.

Workflow is not Moving Charts if the Stage is X for Physician Coders

CACTWO-6978 (Important)

Workflow will now process accounts with a Stage of X and a physician coding stage that is other than X.

Discharge Disposition Data in Audit Reports are Incorrect

CACTWO-7001 (Important)

Two of the audit user reports, Audit Abstract Report and Inpatient Auditor Productivity were reporting the opposite result for Disposition changes. This has been corrected.