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Changing diagnosis codes will challenge emergency medicine

Date:
May 26, 2015
Source:
University of Illinois at Chicago
Summary:
Emergency medicine faces special challenges during this fall's changeover in how medical diagnoses are coded. Nearly a quarter of all ER clinical encounters could pose difficulties, authors of a new report state.
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FULL STORY

Andrew Boyd, assistant professor of biomedical and health information sciences.
Credit: Roberta Dupuis-Devlin

Emergency medicine faces special challenges during this fall's changeover in how medical diagnoses are coded. Nearly a quarter of all ER clinical encounters could pose difficulties.

In addition to the problems it may pose for reimbursement and proper clinical documentation, the coding change will complicate tasks faced by emergency physicians, such as justifying hospital admissions and reporting certain diseases to public health departments, say researchers at the University of Illinois at Chicago. Their study is published in the May issue of American Journal of Emergency Medicine.

The researchers found that 27 percent of the 1,830 commonly used emergency room ICD-9 codes had convoluted mappings that could create problems with reporting or reimbursement. Further, they found that when they looked at more than 24,000 actual clinical encounters in the ER, 23 percent could be assigned incorrect codes if recommendations of the Center for Medicare and Medicaid Services were followed.

The new international disease classification system, known as ICD-10, is to be fully implemented Oct. 1. It includes more than 68,000 diagnostic codes -- compared to 14,000 in its predecessor, ICD-9.

During the past two years researchers have extensively reviewed how ICD-9 codes map to ICD-10 codes, not only for emergency medicine, but for other problematic areas, including pediatrics, patient safety reporting and long-term research. Some ICD-9 indicator codes translate well, but many more have convoluted mappings -- and some simply don't map at all.

In their latest study, the UIC researchers looked specifically at the codes used most often by emergency physicians, to see where problems may arise.

"Despite the wide availability of information and mapping tools, some of the challenges we face are not well understood," says Dr. Andrew Boyd, assistant professor of biomedical and health information sciences at UIC and principal investigator on the study.

The UIC team developed a free tool, available online, that reports the ICD-9 to ICD-10 code mappings: http://lussierlab.org/transition-to-ICD10CM

Jacob Krive, clinical assistant professor of biomedical and health information sciences, is first author on the paper. Mahatkumar Patel, also of UIC biomedical and health information sciences; Drs. Lisa Gehm and Mark Mackey of UIC emergency medicine; Erik Kulstad of UIC emergency medicine and Advocate Christ Medical Center; and Jianrong "John" Li and Dr. Yves Lussier of the University of Arizona were co-authors on the study.


Story Source:

Materials provided by University of Illinois at Chicago. Original written by Jeanne Galatzer-Levy. Note: Content may be edited for style and length.


Journal Reference:

  1. Jacob Krive, Mahatkumar Patel, Lisa Gehm, Mark Mackey, Erik Kulstad, Jianrong “John” Li, Yves A. Lussier, Andrew D. Boyd. The complexity and challenges of the International Classification of Diseases, Ninth Revision, Clinical Modification to International Classification of Diseases, 10th Revision, Clinical Modification transition in EDs. The American Journal of Emergency Medicine, 2015; 33 (5): 713 DOI: 10.1016/j.ajem.2015.03.001

Cite This Page:

University of Illinois at Chicago. "Changing diagnosis codes will challenge emergency medicine." ScienceDaily. ScienceDaily, 26 May 2015. <www.sciencedaily.com/releases/2015/05/150526171900.htm>.
University of Illinois at Chicago. (2015, May 26). Changing diagnosis codes will challenge emergency medicine. ScienceDaily. Retrieved February 20, 2017 from www.sciencedaily.com/releases/2015/05/150526171900.htm
University of Illinois at Chicago. "Changing diagnosis codes will challenge emergency medicine." ScienceDaily. www.sciencedaily.com/releases/2015/05/150526171900.htm (accessed February 20, 2017).