In 2013 the United States will convert from the use of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to the use of the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS). This study compares the approximately 5,000 terms in the July 2009 Clinical Observations Recording and Encoding (CORE) Problem List subset of the Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) terminology produced by the National Library of Medicine with terms found in the January 2009 versions of ICD-10-CM/PCS. The comparison was done by a single individual and used the internally defined concepts of "Exact," "Inexact," "Model" (one SNOMED CT term to many ICD-10-CM/PCS terms), "Not Elsewhere Classified," "Not Otherwise Specified," "Synonym," and "Not Found" to classify the CORE Problem List terms according to the quality of the match. Among the CORE Problem List terms, 6.0 percent were not found in ICD-10-CM/PCS, and 69.1 percent had equivalent ICD-10-CM/PCS terms. The 13.0 percent of terms classified as "Inexact" could also be used directly assuming some acceptable loss of clinical precision. The 11.9 percent of terms classified as "Model" represent differences that require rule-based mapping. The results of this study suggest that ICD-10-CM/PCS meets the intended design goal of increased clinical precision but studies are needed to precisely define the depth of coverage.
{"title":"A comparison between a SNOMED CT problem list and the ICD-10-CM/PCS HIPAA code sets.","authors":"Steven J Steindel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In 2013 the United States will convert from the use of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to the use of the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS). This study compares the approximately 5,000 terms in the July 2009 Clinical Observations Recording and Encoding (CORE) Problem List subset of the Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) terminology produced by the National Library of Medicine with terms found in the January 2009 versions of ICD-10-CM/PCS. The comparison was done by a single individual and used the internally defined concepts of \"Exact,\" \"Inexact,\" \"Model\" (one SNOMED CT term to many ICD-10-CM/PCS terms), \"Not Elsewhere Classified,\" \"Not Otherwise Specified,\" \"Synonym,\" and \"Not Found\" to classify the CORE Problem List terms according to the quality of the match. Among the CORE Problem List terms, 6.0 percent were not found in ICD-10-CM/PCS, and 69.1 percent had equivalent ICD-10-CM/PCS terms. The 13.0 percent of terms classified as \"Inexact\" could also be used directly assuming some acceptable loss of clinical precision. The 11.9 percent of terms classified as \"Model\" represent differences that require rule-based mapping. The results of this study suggest that ICD-10-CM/PCS meets the intended design goal of increased clinical precision but studies are needed to precisely define the depth of coverage.</p>","PeriodicalId":40052,"journal":{"name":"Perspectives in health information management / AHIMA, American Health Information Management Association","volume":" ","pages":"1b"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329199/pdf/phim0009-0001b.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40193909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The International Classification of Diseases, Tenth Edition, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) has been mandated as the new code set to be used for medical coding in the United States beginning on October 1, 2013, replacing the use of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). To assist in the transition from ICD-9-CM to ICD-10-CM/PCS, the National Center for Health Statistics developed bidirectional general equivalent mappings (GEMs) between the old and new code sets. This article looks at how the GEMs have been leveraged by Health Care Service Corporation (HCSC) to achieve the goal of transition to ICD-10-CM/PCS. The analysis examines the questions asked and lessons learned in the practical application of the GEMs for the translation of business rules and processes in order to promote a deeper understanding of the data issues involved in the transition from ICD-9-CM to ICD-10-CM/PCS from a payer's perspective.
国际疾病分类第十版临床修改/程序编码系统(ICD-10-CM/PCS)已被授权为2013年10月1日起在美国用于医疗编码的新代码集，取代国际疾病分类第九版临床修改(ICD-9-CM)的使用。为了协助从ICD-9-CM向ICD-10-CM/PCS过渡，国家卫生统计中心在新旧代码集之间开发了双向一般等效映射(GEMs)。本文将介绍卫生保健服务公司(Health Care Service Corporation, HCSC)如何利用GEMs实现向ICD-10-CM/PCS过渡的目标。该分析考察了GEMs在翻译业务规则和流程方面的实际应用中提出的问题和吸取的经验教训，以便从付款人的角度促进对从ICD-9-CM向ICD-10-CM/PCS过渡所涉及的数据问题的更深入理解。
{"title":"Preparing for ICD-10-CM/PCS: one payer's experience with general equivalence mappings (GEMs).","authors":"Sydney V Ross-Davis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The International Classification of Diseases, Tenth Edition, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) has been mandated as the new code set to be used for medical coding in the United States beginning on October 1, 2013, replacing the use of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). To assist in the transition from ICD-9-CM to ICD-10-CM/PCS, the National Center for Health Statistics developed bidirectional general equivalent mappings (GEMs) between the old and new code sets. This article looks at how the GEMs have been leveraged by Health Care Service Corporation (HCSC) to achieve the goal of transition to ICD-10-CM/PCS. The analysis examines the questions asked and lessons learned in the practical application of the GEMs for the translation of business rules and processes in order to promote a deeper understanding of the data issues involved in the transition from ICD-9-CM to ICD-10-CM/PCS from a payer's perspective.</p>","PeriodicalId":40052,"journal":{"name":"Perspectives in health information management / AHIMA, American Health Information Management Association","volume":" ","pages":"1e"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329202/pdf/phim0009-0001e.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40193912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Carroll, T. Cullen, Stewart C. Ferguson, Nathan Hogge, M. Horton, J. Kokesh
The US Indian health system utilizes a diverse range of health information technology and innovative tools to enhance health service delivery for American Indians and Alaska Natives. This article provides an overview of efforts and experience using such tools to achieve health equity for American Indian and Alaska Native communities. Specific attention is given to the Indian Health Service Electronic Health Record and to two examples of telehealth innovation.
{"title":"Innovation in Indian healthcare: using health information technology to achieve health equity for American Indian and Alaska Native populations.","authors":"M. Carroll, T. Cullen, Stewart C. Ferguson, Nathan Hogge, M. Horton, J. Kokesh","doi":"10.13016/70DO-8U6F","DOIUrl":"https://doi.org/10.13016/70DO-8U6F","url":null,"abstract":"The US Indian health system utilizes a diverse range of health information technology and innovative tools to enhance health service delivery for American Indians and Alaska Natives. This article provides an overview of efforts and experience using such tools to achieve health equity for American Indian and Alaska Native communities. Specific attention is given to the Indian Health Service Electronic Health Record and to two examples of telehealth innovation.","PeriodicalId":40052,"journal":{"name":"Perspectives in health information management / AHIMA, American Health Information Management Association","volume":"8 1","pages":"1d"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66541881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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