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Any code requests that do not meet the criteria will be evaluated for implementation within ICD on and after October 1, once the partial freeze has ended.
Examples of proposals can be found in the minutes from the March 5, Agenda and Handouts. If the reader has attempted data extraction utilizing the ICDCM system, you have probably encountered difficulty obtaining the exact diagnosis for which you were searching. For many research purposes, the ICDCM diagnosis codes can be very broad, and lack the specificity to narrow the search.
ICDCM is running out of code capacity to expand and keep up with advances in technology. Another reason for the switch is the growing need for precise quality data. As many of you are already aware, payment systems are requiring quality measure collection for all venues of healthcare.
It has become increasingly difficult to compare costs and outcomes of different procedures, treatments, and technologies. The ability to obtain access to very specific data is vital to the success of many treatments. Clinical trials require specific information on comorbid conditions, adverse events, and past medical, surgical, and social histories.
By converting to the new ICDCM system, we will expect to obtain better data for 1 measuring the quality, safety, and efficacy, 2 researching, and 3 gaining more efficiency in our healthcare system. The new ICDCM system will allow for future expansion to accommodate the rapid introduction of new technologies into the healthcare system.
In addition, we will finally be able to align the United States data with other ICD coding systems worldwide. There is an anticipated reduction in coding errors due to the specificity of the codes, and an overall lowering of costs and improving efficiencies in the healthcare system.
Increased granularity in the diagnosis coding will allow for better medical necessity justification, accurate reimbursement, and easier monitoring of quality data for outcomes. The specificity of the new codes will allow researchers access to more specific data for their research purposes.
ICDCM diagnosis codes will tell the story of each patient encounter, describe etiologies of the disease process, explain the complications of care, provide a basis for medical necessity, support coverage for payment purposes, identify incidence of disease, and support statistical tracking for healthcare practices, as well as provide disease state information on medical practices across the continuum of care.
The new system's granularity will play an important role in determining the severity of the patient's condition and contribute to research on treatment outcomes.
What are general equivalence mappings GEMs? The most common users of the GEM files include, but are not limited to, professionals working in health information, medical research and informatics. Some terms to be familiar with while working with the GEM files are as follows. This is known as a One-to-One code link. This is known as One-to-Many code mapping. Often times, it takes more than one code to satisfy all of the meaning contained in one code in the other system.
An example of a One-to-Many mapping might be coding nonpressure ulcers. In the ICDCM system, ulcer codes contain more information such as laterality, specification of skin breakdown, fat exposed, muscle necrosis, bone necrosis, or unspecified severity.
The anatomic sites are also much more specific. Mapping is not a straightforward correlation between the codes. The user is responsible to evaluate the documentation in the medical record, the coding choices provided, and to reference the ICDCM code book to verify the ultimate code selection.
The GEM files give the most likely choice or best compromise between codes. However, please be aware that the GEMs are not crosswalks. They are reference mappings, designed to help the user navigate the complexity of translating meaning from one code set to the other.
Researchers should pay special attention to the GEM files. For instance, if clinical studies were initiated before October 1, , researchers should be able to map from one coding system to the other for continuity of data collection.
The new ICDCM coding system set for implementation on October 1, will provide users of clinical healthcare data the ability to get more specific with morbidity data. Now is the time to begin this important transition process by performing an assessment of your currently collected coded data in ICDCM, and plan the education, system training, system integration, and documentation improvement that must be accomplished. Accurate and detailed documentation will assist in the transition and will assist coders in determining the correct code based on the documentation contained in the medical record.
Scientists, manufacturers, and qualified healthcare professionals who are conducting clinical research should identify research projects that will overlap the two coding systems based on the October 1, mandatory compliance date. Additional information can be found on the NCHS website: 5. No competing financial interests exist. The content of this article was expressly written by the author listed. No ghostwriters were used to write this article. Donna J. Cartwright can be reached at for questions or by email at donna.
National Center for Biotechnology Information , U. Advances in Wound Care. Adv Wound Care New Rochelle. Author information Article notes Copyright and License information Disclaimer. The single selected cause for tabulation is called the underlying cause of death, and the other reported causes are the nonunderlying causes of death. The combination of underlying and nonunderlying causes is the multiple causes of death. The ICD has been revised periodically to incorporate changes in the medical field.
To date, there have been 10 revisions of the ICD. The years for which causes of death in the United States have been classified by each revision are as follows:. The U. The ICD-9 is no longer available in print. Volume I , modified for U. In addition, the most detailed tabulation list of causes used in the U. A related classification, the International Classification of Diseases, Clinical Modification ICDCM , is used in assigning codes to diagnoses associated with inpatient, outpatient, and physician office utilization in the U.
Volume 3 procedures is used in assigning codes associated with inpatient procedures. National Center for Health Statistics. Section Navigation.
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