It's been a few very busy days and so I haven't had a chance to put together a post lately. I, along with many others, did some testing of the Enhanced View during the week and have found it to be as promised: lots of new features, a cooler and more intuitive interface, and some improvements of longstanding tools.
I'm in the midst of working on the new Diagnosis/Problem List feature. It appears to be a lot cleaner and easier to move a dx to problem and vice versa. There is even a code converter that anticipates out launch of charging and billing at the closing of a note.
Maybe a quick word on available code nomenclature:
SNOMED CT - Systematized Nomenclature of Medicine -- Clinical Terms - this is our preferred choice for entry into the Problem and Diagnosis Lists. The two primary reasons are that they are vastly more inclusive and descriptive, and this system is more amenable to data mining and capture for the purposes of builiding registries and other data management tools. To the first point, SNOMED encompasses most areas of clinical information such as diseases, findings, procedures, microorganisms, pharmaceuticals etc.
I'm in the midst of working on the new Diagnosis/Problem List feature. It appears to be a lot cleaner and easier to move a dx to problem and vice versa. There is even a code converter that anticipates out launch of charging and billing at the closing of a note.
Maybe a quick word on available code nomenclature:
SNOMED CT - Systematized Nomenclature of Medicine -- Clinical Terms - this is our preferred choice for entry into the Problem and Diagnosis Lists. The two primary reasons are that they are vastly more inclusive and descriptive, and this system is more amenable to data mining and capture for the purposes of builiding registries and other data management tools. To the first point, SNOMED encompasses most areas of clinical information such as diseases, findings, procedures, microorganisms, pharmaceuticals etc.
ICD-9 - The International Classification of Diseases, Ninth Revision - this is the codification system used for billing and charging, though more broadly defined as the code used to classify morbidity data from inpatient and outpatient records, and physician records. Its chief advantage is its universal role in billing schedules.
CPT - Current Procedural Terminology - this code set describes medical, surgical, and diagnostic services and procedures. It is used for billing purposes as an adjunct to the ICD-9 code.
DSM - Diagnostic and Statistical Manual of Mental Disorders - this is the code set that provides diagnostic criteria for mental disorders. As many of you know, it consists of a 5 axis system related to the various aspects of a patient's disorder, from affective to physical to functional. The ICD-9 and DSM use the same diagnostic code numbers, enabling this system to be used for billing and charging.
BOTTOM LINE: Use SNOMED diagnostic codes in your note. The conversion from SNOMED to ICD will be a snap when we are ready to roll out associated charging and billing processes.
I hoped I helped you to sleep if you too are awake at the wrong hour of day.
CPT - Current Procedural Terminology - this code set describes medical, surgical, and diagnostic services and procedures. It is used for billing purposes as an adjunct to the ICD-9 code.
DSM - Diagnostic and Statistical Manual of Mental Disorders - this is the code set that provides diagnostic criteria for mental disorders. As many of you know, it consists of a 5 axis system related to the various aspects of a patient's disorder, from affective to physical to functional. The ICD-9 and DSM use the same diagnostic code numbers, enabling this system to be used for billing and charging.
BOTTOM LINE: Use SNOMED diagnostic codes in your note. The conversion from SNOMED to ICD will be a snap when we are ready to roll out associated charging and billing processes.
I hoped I helped you to sleep if you too are awake at the wrong hour of day.
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