[News release] As diagnosis codes change, data lost in translation – both ways

From the 16 March 2015 UIC news release

Changes in how medical diagnoses are coded under the latest international disease classification system – known as the ICD-10 codes – may complicate financial analysis, research projects and training programs that depend on look-back comparisons of health care data, report researchers at the University of Illinois at Chicago.

The report, a collaboration of researchers at UIC and at the University of Arizona, is online in the Journal of the American Medical Informatics Association (JAMIA).

Codes for diagnoses – used to justify payments, among other things – may not translate from ICD-10 back to ICD-9 in a simple way, says Andrew Boyd, assistant professor of biomedical and health information sciences at UIC and first author of the paper.

Boyd and his colleagues have been looking at issues that could come up as physicians and hospitals change from one system to the other. Previously they found that some ICD-9 codes map well to ICD-10, but many more have highly convoluted mappings, and some don’t map at all. This forward-mapping is needed for continuing payments of ongoing medical conditions.

“Now, we are taking the same methodology and looking backward,” Boyd said. Reverse-mapping from ICD-10 back to ICD-9 will be important for all sorts of retrospective analyses, he said, “because we have 30 years of data that we want. We don’t want to lose all this information.”

Clinical researchers and analysts conducting studies across datasets – and hospital administrators who manage growth and watch trends for strategic planning – will need to pull data under both the new and the old codes. Mapping back from ICD-10- to ICD-9 is just as complex as mapping from ICD-9 to ICD-10.

The researchers created a web portal tool and translation tables designed to provide guidance on ambiguous and complex translations and to reveal where analyses may be challenging or impossible. The tool lists all ICD-9-CM diagnosis codes related to the input of ICD-10-CM codes and classifies their level of complexity, which can be a one-to-one “identity,” or reciprocal (the simplest); class-to-subclass; subclass-to-class; “convoluted”; or “no mapping.”

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AMA: New policies that will impact the future of medicine

 

From the 14 December article at KevinMD.com by PETER W. CARMEL, MD

The AMA adopted new policy that, among other things, supports legislation that would require manufacturers of all drugs and biologics to notify the FDA of any discontinuance, interruption or adjustment in the manufacture of a drug that may result in a shortage. The AMA will also advocate for the FDA and/or Congress to require drug manufacturers to establish a plan for continuity of the supply of vital and life-sustaining medications and vaccines to avoid production shortages whenever possible.

With the implementation of the Affordable Care Act underway, health insurance exchanges have received significant attention as a new way for millions of Americans to obtain health insurance coverage from private insurers. New AMA policy supports using the open marketplace model for exchanges to increase competition and maximize patient choice. The policy also asks the AMA to advocate for the inclusion of actively practicing physicians and patients in health insurance exchange governing structures and for developing systems that allow for real-time patient eligibility information.

In addition to promoting the open marketplace model for health insurance exchanges, the AMA continued to endorse giving Medicare patients greater choice in seeing the physicians they want and need to see. The AMA reaffirmed support for the Medicare Patient Empowerment Act, which would eliminate current restrictions on private contracting with Medicare patients. New policy calls on the AMA to initiate and sustain a well-funded grassroots campaign to secure passage of the bill in Congress. This legislation ensures that if patients choose to see a physician that is not in the Medicare system they can still receive the benefits they have earned.

AMA delegates also recognized that onerous administrative burdens can divert a physician’s attention away from patient care. New policy calls on the AMA to work vigorously to stop implementation of ICD-10, a new code set for medical diagnoses. Currently, physicians use 14,000 diagnosis codes under ICD-9, but under ICD-10 the number of codes would grow by about 55,000.

Physicians are already working to integrate electronic health records into their offices, and the implementation of ICD-10 will place significant and costly burdens on the practice of medicine with no direct benefit to patients. At a time when we are working to get the best possible value for our health care dollars, this massive and expensive undertaking will add administrative expense and create unnecessary workflow disruptions….

 

 

Related articles

• AMA Adopts New Policies During Final Day of Semi-Annual Meeting (AMA news release)

Items included

• Guidelines for Health Insurance Exchanges
• Virtual Medical IDs
• Stop the Implementation of ICD-10
• Stop Legal Prohibition of Male Circumcision
• AMA Votes To Work ‘Vigorously’ To Stop ICD-10 Implementation (listahit.wordpress.com)

• AMA hoping to stop ICD-10 use in billing (listahit.wordpress.com)
• The AMA Finally Takes A Stand Against ObamaCare Thinking In Washington (forbes.com)
• AMA Wants To Put Brakes On ICD-10 Implementation (informationweek.com)
• ICD-10: Why Bother? (3mhealthinformation.wordpress.com)
• Doctors vs. the AMA (reason.com)