Allergy Immunotherapy Shot Plan Toggles And Options

Office Medicine

Toggles

Shot Room Toggles - program SPMAINT, toggles stored under SHOTROOM
Toggle	Program behavior
ALLOW_RAPID_IT=Y	With it you can record multiple shots of the same extract for the same patient on the same day Without it you can only record one set of injections per patient per day.
ALTERNATE_SIDES=Y	First letter of location alternates between L and R by default. User can change it. Without toggle, location defaults to same as previous shot?
COMBINE_VENOM_CODES=N	Separates venom extract billing codes based on the number of insects in the extract. Example: Pt gets 3 shots - Honey Bee (IHC=VX1), Wasp (IHC=VX1), and a Mixed Vespid (3 species of Hornet, IHC=VX3). Without the toggle these would be added together and the IHC for billing would be VX5. With the toggle set, the single insects are added for an IHC=VX1-2 and the mixed vespid is billed separately as VX3. NOTE: In-house procedure codes for venom are stored as LAB_CHG in the patient's Immunization Plan Builder screen.
CUTSPOOL=Y	Closes label printer between labels to force immediate printing. Only needed is windows print manager holds print jobs too long.
DEFAULT_LOC=NO	Disables copying the last injection location forward from the last IT injection to the current injection.
MAILING_LABEL=ASK MAILING_LABEL=NO	Displays a prompt asking whether you want to print mailing labels when printing vial labels. Don't print from and to address labels when printing labels for vial. If neither of these toggles (MAILING_LABEL=NO, or MAILING_LABEL-ASK) are present, the program will always print address labels to go with vial labels.
SCREENLINES=27	Adds 2 extra lines to screen to display comments from both previous shots in G-ive shot screen.
VIAL_EXPIRATION=xxx	For calculating default expiration date for extract vials. Expiration date = current date + xxx days. User can change date. Without this toggle, expiration date is calculated from shot interval as follows: If Interval>=28 days Expiration = 11 months + current day If Interval>=14 days Expiration = 6 months + current day Else Expiration = 4 months + current day
Toggles for Order Vial program - program SPLABQ, toggles stored under SPLABQ
Toggle	Program behavior
CUTSPOOL=Y	Closes schedule printer between patients so the schedule prints immediately. Only needed is windows print manager holds print jobs too long.

Toggles for Shot List by Service Date - program SPLIST1, toggles stored under SHOTROOM
Toggle	Program behavior
ALLOW_RAPID_IT=Y	Program asks whether you want to print all visits for patients with more than one visit per day. Without the toggle, only one visit per patient per day prints.

Toggles for Waiting List by Service Date - program SPWLIST1, toggles stored under SPWLS + job code
Toggle	Program behavior
START=xx	Default starting hour for report (military time). Without this toggle, default starting hour is 1.
END=xx	Default ending hour for report (military time) Without this toggle, default ending hour is 24.

Toggles for Shot History Report - program SPHSTLST, toggles stored under SHOTROOM
Toggle	Program behavior
ALLOW_RAPID_IT=Y	Prints a cleaner format for patients with multiple shots of the same extract in the same day.

Toggles for Edit Unbilled Extract - program SPUNBEXE, toggles stored under SPUBNEXE
Toggle	Program behavior
PROCLOOKUP=BYJOB	Changes Tab-search for procedure codes to a job-specific search. Without the toggle, procedure code search is global codes only.

Medical Record Forms

The shot programs use the following forms from the Medical Records Entry Form Library

Form	Purpose
RXN	Local reactions
SRXN	Systemic reactions
SRMP	Shot room mini-physical
OINJ	Other injections
VIAL	Used by vial queue programs

In-house Procedure Codes for Billing

The shot room program can automatically send procedure codes for extracts and shot administration if you set up special procedure codes as follows.

In-house Code	Purpose	Explanation
IT1	Administration fee for 1 shot
IT2	Administration fee for 2 shots
IT3	Administration fee for 3 shots	Most insurance companies use the same billing code for 3 or more shots as for 2 shots. The program simply counts the number of shots and uses that as part of the In-house code. You should set up procedure codes for IT2 through the maximum number of shots a patient might receive in a single visit.
IT4	Administration fee for 4 shots
IT5	Administration fee for 5 shots
EX1	Extract fee for a single dose	These are the charge codes for extract taken from a stock vial at the time of the injection, not for patients that have their own vial. The program counts the number of injections and uses that number as part of the code. You should set up procedure codes for EX1 through the maximum number of shots a patient might receive in a single visit
EX2	Extract fee for 2 doses
EX3	Extract fee for 3 doses
EX4	Extract fee for 4 doses
EX5	Extract fee for 5 doses
VX1	Venom extract for a single insect.	The nurses must enter VX1 as the LAB_CHG in the patient's Shot Plan Builder screen if you want to bill this code.
VX3	Venom extract for 3 insects.	The nurses must enter VX3 as the LAB_CHG in the patient's Shot Plan Builder screen if you want to bill this code.
VX1-2	Venom extract for 2 injections, each with a single insect	If you set the toggle, COMBINE_VENOM_CODES=N, you will need these codes to bill single-insect venom for multiple injections. You may need other codes if you give more than 3 vemon injections in a single visit. The pattern is VX1 for single visit, followed by -2 for quantity 2, --3 for quantity 3, etc. The shot program will count the number of injections with VX1 as the lab charge. If there are more than one, the program will add a - and the quantity to the code.
VX1-3	Venom extract for 3 injections, each with a single insect
VX2	Venom extract, 2 insects.	If you don't set the COMBINE_VENOM_CODES=N toggle, the shot program will look for any injections where the lab charge starts with VX. The quantities after VX will be added. For example a VX1 and a VX3 will be combined and billed as VX4.
VX4	Venom extract, 4 insects.
VX5	Venom extract, 5 insects.
EXT5	Fee for a patient's own vial of extract, 5 doses	These are only examples. The EXT part of the code indicates a vial of extract. The number is the number of doses. You will need to enter a code for every possible dose quantity that your office might need to bill. For example, if your standard vial has 10 doses and a patient could have up to 5 vials, you would set up codes for EXT10, EXT20, EXT30, EXT40, and EXT50.
EXT10	Fee for a patient's own vial of extract, 10 doses
EXT15	Fee for a patient's own vial of extract, 15 doses

Merge Codes for Custom Label Format

There are three labels that can be customized. The custom formats for these labels are each stored in a separate file. Filenames are:

SPFLABEL.TXT – From address label (Your office).

SPTLABEL.TXT – To address label (The patient’s address).

SPVLABEL.TXT – Vial label (Should specify vial contents)

These files must be save as plain text not a word-processing document. The files should be stored in the same folder as your route slip templates.

Field names for mergable text should be typed in upper-case letters and surrounded by square brackets.

The following is a list of field names that can be used in custom labels:

[SP_LOT_NO]	Lot-number or vial location for the first active mixture.
[EXP_DATE]	Expiration date in MM/DD/YYYY format.
[DILUTION]	Strength of the mixture taken from the starting sequence number (SEQ_xx).
[EXTRACTS]	List of extract components from field AG_1 through AG_12 for the current mixture.
[COMMENT_TEXT]	COMMENT_TEXT field for current mixture.
[FLAG_1] [FLAG_2]	FLAG_1or FLAG_2 field from the second page of the extract plan.
[SP_INTERVAL]	Recommended interval between shots. Field name ‘SP DAYS’ in the Allergy Immunization Plan Builder screen.
[HM_*] [SP_*] [AG_*] [SEQ_*]	Miscellaneous fields from the Allergy Immunization Plan Builder. Any field name that starts with one of these 3-4 character sequences will print exactly as it appears on the screen. Simply enter the field name from the Plan Builder screen.
[JB_ST_ZIP]	State and ZIP code from the Job Code Definition table. Formatted as XX XXXXX XXXX.
[JB_*]	Other fields from the Job Code Definition table can be used by entering the field name exactly as it appears on the screen in the Job Definition Module.
PFN	Patient’s first name.
PTN	Patient’s name.
PLN	Patient’s last name.
PTA	Patient’s address.
PTC	Patient’s city.
PTZ	Patient’s state and ZIP code.
FT	Patient’s title (Mr. Or Ms.)
SFN	Insurance Subscriber’s first name.
SLN	Insurance Subscriber’s last name.
RFN	Referring Dr.’s name.
RFF	Referring Dr.’s first name.
RFL	Referring Dr.’s last name.
RFA	Referring Dr.’s address.
RFC	Referring Dr.’s city.
RFZ	Referring Dr.’s state and ZIP code.
RFT	Referring Dr.’s telephone number.
DRN	Assigned provider (PROV0) name.
DRF	Assigned provider (PROV0) first name.
DRL	Assigned provider (PROV0) last name.
DRA	Assigned provider (PROV0) address.
DRC	Assigned provider (PROV0) city.
DRZ	Assigned provider (PROV0) state and ZIP code.
DRT	Assigned provider (PROV0) telephone number.
DATE	Current system date.

Merge Codes for Custom Shot Schedule Format

The standard Shot Schedule uses a text file called drins.txt to print the instructions. You may edit drint.txt to reflect the needs of your office. The file must be saved in plain text format. The format of the schedule cannot be changed without custom programming. The recommended way to print a custom schedule is through a Microsoft Word document using bookmark merge codes as described below.

Custom schedules are printed through Microsoft Word via dynamic data exchange (DDE)

The document name is SPEXTRACT.DOC. Field names to merge are entered as bookmarks in Word. The bookmark names should be A through Z. If you need more than 26 bookmarks, use AA, AB, through AZ then BA through BZ, etc.

Since you can print up to three extract mixtures on each page of the schedule, you will need to designate which mixture to print. The way to do this is enter a colon and a number after the field name. For example, [EXP_DATE:1] will print the expiration date for the first mixture in the set while [EXP_DATE:2] will print the expiration date for the second mixture. For dose volume (ml) you need to specify both the mixture number and the dose (shot) number. [DOSE:1,1] is the first dose from the first vial, [DOSE:1,2] is the second dose from the first vial, and [DOSE:2,1] is the first dose of the second mixture. Fields that require a number are designated below with ‘:#” or “:#,#” at the end of the field name.

[SP_LOT_NO]	Lot-number or vial location for the first active mixture.
[EXP_DATE:#]	Expiration date in MM/DD/YYYY format.
[DILUTION:#]	Strength of the mixture taken from the starting sequence number (SEQ_xx).
[EXTRACTS:#]	List of extract components from field AG_1 through AG_12.
[COMMENT_TEXT:#]	COMMENT_TEXT field for current mixture.
[SP_INTERVAL:#]	Recommended interval between shots. Field name ‘SP DAYS’ in the Allergy Immunization Plan Builder screen.
[DOSE:#,#]	Dose from the Shot Plan formatted as X.XXml. The first number after the colon (:) specifies which mixture (1-3). The number after the comma (,) indicates which shot (1-15?) If you ask for more shots than the plan specifies at the current dilution, the top dose will repeat.
[REVISED]	If you enter a ‘Y’ in response to the REVISED: prompt when you print the schedule, this bookmark will print ‘* REVISED *’. Otherwise this bookmark will be cleared (removed from the printout).
[FLAG_1:#] [FLAG_2:#]	FLAG_1or FLAG_2 field from the second page of the extract plan.
[HM_*:#] [SP_*:#] [AG_*:#] [SEQ_*:#]	Miscellaneous fields from the Allergy Immunization Plan Builder. Any field name that starts with one of these 3-4 character sequences will print exactly as it appears on the screen. Simply enter the field name from the Plan Builder screen.
[JB_ST_ZIP]	State and ZIP code from the Job Code Definition table. Formatted as XX XXXXX XXXX.
[JB_*]	Other fields from the Job Code Definition table can be used by entering the field name exactly as it appears on the screen in the Job Definition Module.

In addition to the shot plan fields (above) the Custom Shot Schedule can include nearly any field than can be used on a route slip. A partial list of these merge codes follows:

PFN	Patient’s first name.
PTN	Patient’s name.
PLN	Patient’s last name.
PTA	Patient’s address.
PTC	Patient’s city.
PTZ	Patient’s state and ZIP code.
FT	Patient’s title (Mr. Or Ms.)
SFN	Insurance Subscriber’s first name.
SLN	Insurance Subscriber’s last name.
RFN	Referring Dr.’s name.
RFF	Referring Dr.’s first name.
RFL	Referring Dr.’s last name.
RFA	Referring Dr.’s address.
RFC	Referring Dr.’s city.
RFZ	Referring Dr.’s state and ZIP code.
RFT	Referring Dr.’s telephone number.
DRN	Assigned provider (PROV0) name.
DRF	Assigned provider (PROV0) first name.
DRL	Assigned provider (PROV0) last name.
DRA	Assigned provider (PROV0) address.
DRC	Assigned provider (PROV0) city.
DRZ	Assigned provider (PROV0) state and ZIP code.
DRT	Assigned provider (PROV0) telephone number.
DATE	Current system date.

Any field from patient information can be included by using the exact field name from the Patient Information screen.

To activate the custom format you must use the program FMFILE to define the directory containing Microsoft Word and the directory containing the SPEXTRACT.DOC file. Type FMFILE at the main menu and enter the following two records:

CODE	PATH
WORDPATH	The full pathname where WINWORD.EXE exists on your computer, for example: C:\program files\microsoft office\office\
SPDOCPATH	The full pathname to the folder where you saved SPEXTRACT.DOC, for example: C:\om8\wp\

The pathname is field #1 in FMFILE. Note you must include the backslash ( \ ) at the end of the path.