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

Jacob Krive, Mahatkumar Patel, Lisa Gehm, Mark Mackey, Erik Kulstad, Jianrong John Li, Yves A. Lussier, Andrew D. Boyd

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Beginning October 2015, the Center for Medicare and Medicaid Services will require medical providers to use the vastly expanded International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) system. Despite wide availability of information and mapping tools for the next generation of the ICD classification system, some of the challenges associated with transition from ICD-9-CM to ICD-10-CM are not well understood. To quantify the challenges faced by emergency physicians, we analyzed a subset of a 2010 Illinois Medicaid database of emergency department ICD-9-CM codes, seeking to determine the accuracy of existing mapping tools in order to better prepare emergency physicians for the change to the expanded ICD-10-CM system. We found that 27% of 1830 codes represented convoluted multidirectional mappings. We then analyzed the convoluted transitions and found that 8% of total visit encounters (23% of the convoluted transitions) were clinically incorrect. The ambiguity and inaccuracy of these mappings may impact the workflow associated with the translation process and affect the potential mapping between ICD codes and Current Procedural Codes, which determine physician reimbursement.

Original languageEnglish (US)
Pages (from-to)713-718
Number of pages6
JournalAmerican Journal of Emergency Medicine
Volume33
Issue number5
DOIs
StatePublished - Jan 1 2015

ASJC Scopus subject areas

  • Emergency Medicine
  • Medicine(all)

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