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Military Medical Treatment Facilities to Implement Updated DHA COVID-19 Medical Coding Policy

Policy

The Defense Health Agency (DHA) Memorandum, based on the authority of References (a) and (b), and in accordance with the guidance of References (c) and (d), establishes the DHA’s procedures to standardize the coding for Coronavirus 2019 (COVID-19) Military Medical Treatment Facilities (MTFs). This memorandum cancels and replaces DHA- Policy Memorandum 20-003 of (13 April 2020). A change was issued since the cancelled Memorandum 20-003 of (13 April 2020), the Attachment titles were updated to reflect that Attachments 1, 2, and 4 are considered Policies as opposed to Guidance.

  • Identification #: 20-003
  • Date: 5/13/2020
  • Type: Memorandums
  • Topics: N/A

DHA IPM 19-004: Utilization of the Case Management (CM) Registry (Active and Screening) for Military Health System (MHS) Beneficiaries

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), establishes the Defense Health Agency’s (DHA) procedures to: Outline responsibilities for MHS and Service Department CM personnel to utilize the CM Screening Registry; Identify requirements to utilize CM coding in alignment with current MHS CM coding guidance; and Require the use of standardized Adult and Pediatric Tri-Service Workflow (TSWF) forms for CM documentation (inclusive of telephonic, virtual, or face to face screening) located within AHLTA system and future Electronic Health Record MHS GENESIS

DHA IPM 18-012: The DoD Medical Ethics Program (DoDMEP) in the Military Health System (MHS) - Extended

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), based on the authority of References (a) through (c), and in accordance with the guidance of References (d) through (k), establishes Defense Health Agency’s (DHA) procedures that: • Apply to Active Duty Service members, namely Active Component members and Reserve Component members on active duty for a period of more than 30 days, who, hereafter, are referred to collectively as Active Duty Service members (References (e) and (f)). • Establish a set of common guidelines, standards, and procedures governing the DoDMEP for military health care personnel in all locations. • Outline implementing procedures for DHA collaboration with the DoDMEP office, to be known as the DoD Medical Ethics Center (DMEC), which is to operate under the direction of the President of the Uniformed Services University of the Health Sciences (USUHS). • Implement guidance for the DoD mission, vision, guiding principles of the DoDMEP (DMEC) as set forth in Reference (g) and delineate areas of responsibility between the DHA and USUHS, including: o The provision of medical ethics education and training (E&T) to health care providers and other health care personnel; o Creation and maintenance of a DMEC portal; and o Medical ethics consultation services to MHS health care personnel across all settings. • This DHA-IPM is effective immediately and will expire effective 12 months from the date of issue.

DHA IPM 18-016: DHA IPM 18 016 Medical Coding of the DoD Health Records

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (s): • Establishes the Defense Health Agency’s (DHA) procedures for centralized oversight, standardized operations, and ensured quality and performance for the coding of DoD Health Records. • This DHA-IPM is effective immediately; it will be converted into a DHA-Procedural Instruction. This DHA-IPM will expire 12 months from the date of issue.

DHA-IPM 20-003: DoD Procurement of Ruminant Products from Overseas Origin

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), establishes the Defense Health Agency’s procedures to authorize the procurement of all ruminant meat (beef, sheep, goat, bison, etc.) and edible products from ruminants of overseas origin. DoD procurement of ruminant meat and meat products will align with current United States Department of Agriculture (USDA) restrictions and residual risk mitigation measures for Bovine Spongiform Encephalopathy (BSE).

  • Identification #: 20-003
  • Date: 4/10/2020
  • Type: DHA Interim Procedures Memorandum
  • Topics: N/A

Elective Surgical, Invasive, and Dental Procedures in Military Treatment Facilities

Policy

This memorandum directs all Military Treatment Facility (MTF) and Dental Treatment Facility (DTF) Commanders and Directors to immediately postpone all elective surgeries, invasive procedures, and dental procedures performed on beneficiaries of the MTFs and DTFs with the exceptions outlined below. This includes aerosol-producing procedures, such as endoscopies, bronchoscopies, pulmonary function tests, and sleep continuous positive airway pressure (CPAP) titrations. This policy is effective March 31, 2020, and will remain in place for 60 days.

  • Identification #: N/A
  • Date: 3/24/2020
  • Type: Memorandums
  • Topics: N/A

DHA IPM 20-002: Southern Hemisphere Influenza Vaccination Program

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), establishes the Defense Health Agency’s (DHA) procedures to implement instructions, assign responsibilities, and prescribe procedures for the Southern Hemisphere Influenza Vaccination Program. All Active Duty, Selected Reserve, and National Guard members receive an annual influenza vaccination. Personnel who are traveling to, conducting a permanent change of station to, or are located in the Southern Hemisphere will receive the Southern Hemisphere influenza vaccine or obtain an exemption (e.g., medical or administrative) in accordance with guidance in paragraph 6.a. of Attachment 2. Military personnel residing in the Southern Hemisphere who have received the Southern Hemisphere influenza vaccine in accordance with Appendix 1, meet the annual influenza immunization requirement.

(DTM)-19-004 -Military Service by Transgender Persons and Persons with Gender Dysphoria (Change 1)

Policy

Implements the policy in the February 22, 2018 Secretary of Defense Memorandum and the February 2018 DoD Report and Recommendations on Military Service by Transgender Persons, assigns responsibilities, and prescribes procedures regarding the standards for accession, retention, separation, in-service transition, and medical care for Service members and applicants with gender dysphoria, as applicable. This DTM is effective April 12, 2019. This DTM will be incorporated into DoDIs1300.28, 1332.14, 1332.30, and 6130.03, and supersedes any contradictory guidance in those publications. This DTM will expire effective September 12, 2020.

DHA-PI 6025.32: MHS GENESIS Medical Device

Policy

This DHA-PI establishes Defense Health Agency’s (DHA) procedures to provide key stakeholders’ responsibilities for connecting medical devices to MHS GENESIS; establish clinical expectations for connecting medical devices to MHS GENESIS; provide references for MTFs to use in procuring medical devices that will be connected to MHS GENESIS; and provide process for MTFs to elevate medical device connection issues related to MHS GENESIS.

DHA-PI 5020.01: New Integrated Capabilities Portfolio

Policy

This DHA-PI ensures alignment of the Integrated Capabilities Portfolio (ICP) process with the National Military Strategy, support the Quadruple Aim , and ensure every resource is supporting the critical initiatives of the DHA. This effort ensures that every dollar spent provides value back to the Military Health System (MHS), improves efficiency and effectiveness, and supports readiness and health.

  • Identification #: DHA PI 5020.01
  • Date: 3/11/2020
  • Type: DHA Procedural Instruction
  • Topics: N/A

DHA-PI 8400.01: CyberLOG MDE Risk Management

Policy

This DHA-PI establishes centralized processes and procedures to implement and maintain RMF authorization and cybersecurity for MDE across the Military Health System (MHS) through the Defense Health Agency (DHA) CyberLOG. This DHA-PI develops the standard DHA cybersecurity requirements process to translate and identify MTFs MDE planning requirements; implements a standard cybersecurity approach to analyze, evaluate, and manage MDE planning, procurement, and sustainment to meet cybersecurity requirements through the RMF process; executes the DHA RMF authorization process within DHA activities for MDE purchased with DHP funds; and maintains an acceptable security baseline for MDE.

  • Identification #: DHA PI 8400.01
  • Date: 3/2/2020
  • Type: DHA Procedural Instruction
  • Topics: N/A

2019 Billing Rates for Care Provided to Other Than Foreign Nationals

Policy

DHA-PI 6040.04: Guidance for Amendment and Correction of Entries in Garrison Electronic Health Records (EHRs)

Policy

This Defense Health Agency-Procedural Instruction (DHA-PI), establishes the Defense Health Agency’s (DHA) procedures to remove erroneously entered information in the EHRs. In general, these procedures should be limited to Personally Identifiable Information (PII) or Protected Health Information (PHI) pertaining to one person or persons, but entered inadvertently into the record of a different person. These procedures may also be applied to other information (e.g., incorrect adverse diagnosis), as deemed necessary after appropriate review. All efforts to correct documentation errors at the user level should be expended prior to requesting a correction. Patient-initiated requests to correct the EHR must be completed within 60 days of the request being received by the covered entity (the Military Medical Treatment Facility (MTF)), or 90 days if applicable extension requirements are met.

DHA-PI 6025.28: Standard Processes and Procedures for Communication of Laboratory and Radiology Results

Policy

This Defense Health Agency-Procedural Instruction (DHA-PI), provides procedures for implementing uniform accountability and business rules for communicating clinical laboratory and radiology results. This DHA-PI establishes uniform processes, measures, workflows, and business rules which include documentation requirements and performance metrics for standardized notification of patients (or personal representatives), of laboratory and radiology results.

  • Identification #: DHA PI 6025.28
  • Date: 2/21/2020
  • Type: DHA Procedural Instruction
  • Topics: N/A

DHA-PI 6025.33: Acupuncture Practice in MTFs

Policy

The purpose of this DHA-PI is to comply with Presidential Memorandum for the Heads of Executive Departments and Agencies, to support the clinical practice of acupuncture by designated clinical staff throughout the DoD, as a complement to existing pharmacologic and non-pharmacologic therapies. This DHA-PI establishes the DHA’s procedures to expand the availability and utilization of acupuncture as a non-pharmacologic therapy for acute and chronic pain as an essential element of the Military Health Service (MHS) Pain Management Campaign.

  • Identification #: DHA PI 6025.33
  • Date: 2/20/2020
  • Type: DHA Procedural Instruction
  • Topics: N/A

Military Medical Treatment Facilities to Implement Updated DHA COVID-19 Medical Coding Policy

Policy

The Defense Health Agency (DHA) Memorandum, based on the authority of References (a) and (b), and in accordance with the guidance of References (c) and (d), establishes the DHA’s procedures to standardize the coding for Coronavirus 2019 (COVID-19) Military Medical Treatment Facilities (MTFs). This memorandum cancels and replaces DHA- Policy Memorandum 20-003 of (13 April 2020). A change was issued since the cancelled Memorandum 20-003 of (13 April 2020), the Attachment titles were updated to reflect that Attachments 1, 2, and 4 are considered Policies as opposed to Guidance.

  • Identification #: 20-003
  • Date: 5/13/2020
  • Type: Memorandums
  • Topics: N/A

DHA IPM 19-004: Utilization of the Case Management (CM) Registry (Active and Screening) for Military Health System (MHS) Beneficiaries

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), establishes the Defense Health Agency’s (DHA) procedures to: Outline responsibilities for MHS and Service Department CM personnel to utilize the CM Screening Registry; Identify requirements to utilize CM coding in alignment with current MHS CM coding guidance; and Require the use of standardized Adult and Pediatric Tri-Service Workflow (TSWF) forms for CM documentation (inclusive of telephonic, virtual, or face to face screening) located within AHLTA system and future Electronic Health Record MHS GENESIS

DHA IPM 18-012: The DoD Medical Ethics Program (DoDMEP) in the Military Health System (MHS) - Extended

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), based on the authority of References (a) through (c), and in accordance with the guidance of References (d) through (k), establishes Defense Health Agency’s (DHA) procedures that: • Apply to Active Duty Service members, namely Active Component members and Reserve Component members on active duty for a period of more than 30 days, who, hereafter, are referred to collectively as Active Duty Service members (References (e) and (f)). • Establish a set of common guidelines, standards, and procedures governing the DoDMEP for military health care personnel in all locations. • Outline implementing procedures for DHA collaboration with the DoDMEP office, to be known as the DoD Medical Ethics Center (DMEC), which is to operate under the direction of the President of the Uniformed Services University of the Health Sciences (USUHS). • Implement guidance for the DoD mission, vision, guiding principles of the DoDMEP (DMEC) as set forth in Reference (g) and delineate areas of responsibility between the DHA and USUHS, including: o The provision of medical ethics education and training (E&T) to health care providers and other health care personnel; o Creation and maintenance of a DMEC portal; and o Medical ethics consultation services to MHS health care personnel across all settings. • This DHA-IPM is effective immediately and will expire effective 12 months from the date of issue.

DHA IPM 18-016: DHA IPM 18 016 Medical Coding of the DoD Health Records

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (s): • Establishes the Defense Health Agency’s (DHA) procedures for centralized oversight, standardized operations, and ensured quality and performance for the coding of DoD Health Records. • This DHA-IPM is effective immediately; it will be converted into a DHA-Procedural Instruction. This DHA-IPM will expire 12 months from the date of issue.

DHA-IPM 20-003: DoD Procurement of Ruminant Products from Overseas Origin

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), establishes the Defense Health Agency’s procedures to authorize the procurement of all ruminant meat (beef, sheep, goat, bison, etc.) and edible products from ruminants of overseas origin. DoD procurement of ruminant meat and meat products will align with current United States Department of Agriculture (USDA) restrictions and residual risk mitigation measures for Bovine Spongiform Encephalopathy (BSE).

  • Identification #: 20-003
  • Date: 4/10/2020
  • Type: DHA Interim Procedures Memorandum
  • Topics: N/A

Elective Surgical, Invasive, and Dental Procedures in Military Treatment Facilities

Policy

This memorandum directs all Military Treatment Facility (MTF) and Dental Treatment Facility (DTF) Commanders and Directors to immediately postpone all elective surgeries, invasive procedures, and dental procedures performed on beneficiaries of the MTFs and DTFs with the exceptions outlined below. This includes aerosol-producing procedures, such as endoscopies, bronchoscopies, pulmonary function tests, and sleep continuous positive airway pressure (CPAP) titrations. This policy is effective March 31, 2020, and will remain in place for 60 days.

  • Identification #: N/A
  • Date: 3/24/2020
  • Type: Memorandums
  • Topics: N/A

DHA IPM 20-002: Southern Hemisphere Influenza Vaccination Program

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), establishes the Defense Health Agency’s (DHA) procedures to implement instructions, assign responsibilities, and prescribe procedures for the Southern Hemisphere Influenza Vaccination Program. All Active Duty, Selected Reserve, and National Guard members receive an annual influenza vaccination. Personnel who are traveling to, conducting a permanent change of station to, or are located in the Southern Hemisphere will receive the Southern Hemisphere influenza vaccine or obtain an exemption (e.g., medical or administrative) in accordance with guidance in paragraph 6.a. of Attachment 2. Military personnel residing in the Southern Hemisphere who have received the Southern Hemisphere influenza vaccine in accordance with Appendix 1, meet the annual influenza immunization requirement.

(DTM)-19-004 -Military Service by Transgender Persons and Persons with Gender Dysphoria (Change 1)

Policy

Implements the policy in the February 22, 2018 Secretary of Defense Memorandum and the February 2018 DoD Report and Recommendations on Military Service by Transgender Persons, assigns responsibilities, and prescribes procedures regarding the standards for accession, retention, separation, in-service transition, and medical care for Service members and applicants with gender dysphoria, as applicable. This DTM is effective April 12, 2019. This DTM will be incorporated into DoDIs1300.28, 1332.14, 1332.30, and 6130.03, and supersedes any contradictory guidance in those publications. This DTM will expire effective September 12, 2020.

DHA-PI 6025.32: MHS GENESIS Medical Device

Policy

This DHA-PI establishes Defense Health Agency’s (DHA) procedures to provide key stakeholders’ responsibilities for connecting medical devices to MHS GENESIS; establish clinical expectations for connecting medical devices to MHS GENESIS; provide references for MTFs to use in procuring medical devices that will be connected to MHS GENESIS; and provide process for MTFs to elevate medical device connection issues related to MHS GENESIS.

DHA-PI 5020.01: New Integrated Capabilities Portfolio

Policy

This DHA-PI ensures alignment of the Integrated Capabilities Portfolio (ICP) process with the National Military Strategy, support the Quadruple Aim , and ensure every resource is supporting the critical initiatives of the DHA. This effort ensures that every dollar spent provides value back to the Military Health System (MHS), improves efficiency and effectiveness, and supports readiness and health.

  • Identification #: DHA PI 5020.01
  • Date: 3/11/2020
  • Type: DHA Procedural Instruction
  • Topics: N/A

DHA-PI 8400.01: CyberLOG MDE Risk Management

Policy

This DHA-PI establishes centralized processes and procedures to implement and maintain RMF authorization and cybersecurity for MDE across the Military Health System (MHS) through the Defense Health Agency (DHA) CyberLOG. This DHA-PI develops the standard DHA cybersecurity requirements process to translate and identify MTFs MDE planning requirements; implements a standard cybersecurity approach to analyze, evaluate, and manage MDE planning, procurement, and sustainment to meet cybersecurity requirements through the RMF process; executes the DHA RMF authorization process within DHA activities for MDE purchased with DHP funds; and maintains an acceptable security baseline for MDE.

  • Identification #: DHA PI 8400.01
  • Date: 3/2/2020
  • Type: DHA Procedural Instruction
  • Topics: N/A

2019 Billing Rates for Care Provided to Other Than Foreign Nationals

Policy

DHA-PI 6040.04: Guidance for Amendment and Correction of Entries in Garrison Electronic Health Records (EHRs)

Policy

This Defense Health Agency-Procedural Instruction (DHA-PI), establishes the Defense Health Agency’s (DHA) procedures to remove erroneously entered information in the EHRs. In general, these procedures should be limited to Personally Identifiable Information (PII) or Protected Health Information (PHI) pertaining to one person or persons, but entered inadvertently into the record of a different person. These procedures may also be applied to other information (e.g., incorrect adverse diagnosis), as deemed necessary after appropriate review. All efforts to correct documentation errors at the user level should be expended prior to requesting a correction. Patient-initiated requests to correct the EHR must be completed within 60 days of the request being received by the covered entity (the Military Medical Treatment Facility (MTF)), or 90 days if applicable extension requirements are met.

DHA-PI 6025.28: Standard Processes and Procedures for Communication of Laboratory and Radiology Results

Policy

This Defense Health Agency-Procedural Instruction (DHA-PI), provides procedures for implementing uniform accountability and business rules for communicating clinical laboratory and radiology results. This DHA-PI establishes uniform processes, measures, workflows, and business rules which include documentation requirements and performance metrics for standardized notification of patients (or personal representatives), of laboratory and radiology results.

  • Identification #: DHA PI 6025.28
  • Date: 2/21/2020
  • Type: DHA Procedural Instruction
  • Topics: N/A

DHA-PI 6025.33: Acupuncture Practice in MTFs

Policy

The purpose of this DHA-PI is to comply with Presidential Memorandum for the Heads of Executive Departments and Agencies, to support the clinical practice of acupuncture by designated clinical staff throughout the DoD, as a complement to existing pharmacologic and non-pharmacologic therapies. This DHA-PI establishes the DHA’s procedures to expand the availability and utilization of acupuncture as a non-pharmacologic therapy for acute and chronic pain as an essential element of the Military Health Service (MHS) Pain Management Campaign.

  • Identification #: DHA PI 6025.33
  • Date: 2/20/2020
  • Type: DHA Procedural Instruction
  • Topics: N/A
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