July 29, 2010
What Are EMR Vendors Planning for ICD-10?
Written by: John
I remember when I first started my job at a healthcare facility 5+ years ago, I ran into these codes they called ICD-9. Yes, this was all very foreign to me, but I learned quickly the meaning of ICD-9. I also learned quickly that the EMR vendor which had been selected (before I was there) didn’t provide a list of ICD-9 as part of their EMR software (they do now). They did provide an upload feature and so we exported a list out of our old PMS, cleaned them up a little and then uploaded them into the new EMR. Not a fun or effective process even that way.
Obviously, we’ve come a long way in five years. There are plenty of free lists of ICD-9 codes around the net that people can use, manipulate and add to their EMR software pretty easily.
However, I couldn’t help but wonder what solutions were being offered for EMR vendors planning for ICD-10. Yes, EMR vendors do have until October 1st, 2013 (which has been moved back a bunch of times so let me know if it’s been changed again) and so maybe EMR vendors aren’t concerned about it yet. Although, I’m guessing that many have already put a lot of thought into preparing for ICD-10.
My question for EMR vendors is, how are you planning to handle the ICD-10 codes? We’re talking about going from 14,315 diagnosis codes to 69,101 diagnosis codes. The National Center for Health Statistics (NCHS), the Centers for Medicare and Medicaid Services (CMS), AHIMA, the American Hospital Association, and 3M Health Information Systems have put together some General Equivalence Mappings (GEMs) that I believe try to do some mapping between ICD-9 and ICD-10. However, like translating a language there’s rarely a one to one match. With 4+ times as many codes there couldn’t be. So, certainly there’s the question of how you’re going to make the transition from ICD-9 to ICD-10 coding?
Although, at a simpler level, how are you planning to get the almost 70k ICD-10 codes in your system? Does anyone know of a database of these codes that’s available for EMR vendors? Is each EMR vendor going to try and create their own? What’s happening in this regard?
And maybe the answer is….ask us once we’re done dealing with stage 1 meaningful use. ICD-10 isn’t until stage 2 or stage 3 meaningful use.
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6 responses to "What Are EMR Vendors Planning for ICD-10?"
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Huh! I was on the World Health Organization (the ICD publisher) site a couple of hours ago looking for exactly this information. The only relevant information I found was this, in the ICD10 FAQ:
— quote from http://www.who.int/classifications/help/icdfaq/en/index.html —
Q: How can I translate between ICD-10 and ICD-9?
A: It is not possible to convert ICD-9 data sets into ICD-10 data sets or vice versa.
ICD-9 has 6,969 codes while there are 12,420 codes in ICD-10 (14,199 with the fourth-character place of occurrence codes in Chapter XX (External Causes of Morbidity and Mortality)…
…In order to provide users with details of the exact changes between ICD-9 and ICD-10 WHO has published detailed tables in electronic form. This five diskette set can be ordered from here.
— end quote —
Frustratingly, the last word, “here”, is a dead link to bookorders.who.int, and it is not the only dead link on the WHO site. Attempts to get to the current electronic ICD-10 from links at http://www.who.int/classifications/icd/en/ also were in vain. Maybe their web-store is temporarily down. It was the same story yesterday.
Also, you must have better search logic than I because I cannot find ANY free ICD-9 data sets on the web. There are some commercial ones, but nothing free.
A followup to my previous post. Here is the link to WHO’s US publication outlet:
http://www.whopress.us/books/Books.aspx?type=pubWHO&id=795
I also found a way into the WHO store:
http://apps.who.int/bookorders/anglais/home1.jsp?sesslan=1
but the catalog doesn’t include anything that would make it easy to extract the codes and descriptions and I couldn’t find the published tables mentioned in the FAQ I quoted above. Perhaps it is buried somewhere that I did not think of looking.
I wrote to the publications office. We’ll see what kind of response I get.
By the way, CDC and CMS are making a General Equivalency Mapping (GEM) tool available to all players to assist with the transition. Because of the lack of one-to-one correspondence, I guess we all may end up incorporating the GEM into our products in some fashion to assist providers with coding. For a given ICD-9 dx the GEM provides possible ICD-10 codes, along with some flags that could be translated as remarks in each case. See:
http://www1.cms.gov/ICD10/Downloads/GEMs-CrosswalksBasicFAQ.pdf
Thanks for the links Seth. It’s an interesting thing, no? Everyone’s going to need the codes, but how are they going to get them? I had one EMR vendor say that he pulled down the ICD-10 list from the CMS website. I’m asking for more details.
OpenEMR handles the ICD-9 and will handle the ICD-10 codes very well. It is just a matter of importing the codes into the program. There are scripts that will allow the program to import all the codes. The codes can be purchased from the AMA directly in the format for uploading.
http://www.openmedpractice.com
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