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10/29/15
 
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Anatomy of ICD-10 Codes

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The leap from ICD-9 to ICD-10 is significant, but you can more easily transition to the new ICD10 codes if you understand their structure.

Comparison ICD-10 (7 characters) to ICD- 9 CM (5 digits)

Again, the ICD-10 code expands up to 7 characters with the extension code indicating additional information. Thus, S91.322 describes a laceration with foreign body of the foot, the sixth character indicates the right foot and the “A” represents it is the first encounter. The ICD-9 code of 892.1 is described as a complicated open wound of the foot with no mention of right or left side of the body. For example:

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All ICD-10 codes will begin with one of the following letters of the alphabet; the alpha characters are not case sensitive. The most commonly reported diagnoses for chiropractic are likely to begin with an "M" or an "S".

A & B: Infectious and Parasitic Diseases L: Skin and Subcutaneous Tissue
C: Neoplasms M: Musculoskeletal and Connective Tissue
D: Neoplasms, Blood, Blood-forming Organs N: Genitourinary System
E: Endocrine, Nutritional, Metabolic O: Pregnancy, Childbirth and the Puerperium
F: Mental and Behavioral Disorders P: Certain Conditions Originating in the Perinatal Period
G: Nervous System Q: Congenital Malformations, Deformations and Chromosomal Abnormalities
H: Eye and Adnexa, Ear and Mastoid Process R: Symptoms, Signs and Abnormal Clinical and Lab Findings
I: Circulatory System S: Injury, Poisoning, Certain Other Consequences of External Causes
J: Respiratory System T: Injury, Poisoning, Certain Other Consequences of External Causes
K: Digestive System U: no codes listed, will be used for emergency code additions


V, W, X, Y: External Causes of Morbidity (homecare will only have to code how patient was hurt; other settings will also code where injury occurred, what activity patient was doing).

In case you missed it – New and Improved Referral Management System (RMS)

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Meaningful Use Reminder – Family and Social History

As a reminder, to ensure the capture of proper information in the Family History form for Meaningful Use, patients must have at least one Family History item in the checklists options available, documented on a first degree relative using the FH-SH-CCC form.

Important items to note:
  • The first degree relatives that will count for the Meaningful Use measure are the first six listed in the relatives drop down (Arrow 1 below).
  • Items in the General Comments section will not count toward MU.
  • If there is FH documented using the old form, prior to July 23rd, this will not count for MU. At least one item will need to be re-entered using the current form. It will also not count for MU to click the “reviewed no changes required” box in this situation.
  • To document an item:
    • Select a first degree relative from the drop down list (Arrow 1) and click refresh.
    • Check off applicable items from the checklist
    • Click the Save button (Arrow 2)
We are continuing to work with GE to request improvements on the efficiency and ease of use of the GE FH form. We will provide updates as improvements become available.

Screenshot-FH-SH-CCC form

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Users Impacted: - Clinic Staff, Providers

Level of Impact: High - New Process/New Form

***Please contact the any member of the CIS (EMR) Team if you have any questions or concerns at IT-Clinical Systems Support 915.215.4111 Option 3

In case you missed it – CareManager Expansion into Cardiology Clinic 20 Bizarre new ICD-10 codes

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EMR Announcements

There is currently 1 EMR Announcement(s):
    MU Workshop 2015 FAQ

    CVS (Clinical Visit Summary)
    • If I regenerate the CVS – would it still count towards MU?
      Yes
    • If I Save to Chart & Close – would it still count towards MU?
      No, it must be printed
    • If I’m not done with my note and I print the CVS after the patient leaves the clinic – would it still count towards MU?
      Yes
    • What if I don’t want a certain allergy or medication to show on the CVS?
      You can customize sections on the CVS by clicking on the customize button. Sections and entries are automatically checked off to be included on the CVS – uncheck box to exclude section from CVS.
    • Can I print the CVS after the note has been signed?
      Yes - go to documents, highlight the note, right click on the note, scroll down to create clinical visit summary and print


    Patient Education

    • If a patient has more than two listed problems or medications, we have to print Patient Education for each of them?
      No, you have to print patient education only one per problem or medication on each office visits.
    • If we do not find a specific problem, can we print a Handout from the actual Handout button, it will count towards MU?
      No unfortunately, we must print patient education from Patient Education button.


    ICD-10 and Family History

    • If the diagnosis I am searching for doesn’t show in the smart list what do I do?
      If it doesn’t show in the smart list, then the diagnosis you are searching for has more specific codes to choose from. These codes can be found by searching in the reference list and choosing the most specific applicable code.
    • How many family members do I need to document family history on?
      One family history item needs to be documented on at least one first degree relative.


    • We’ve been working diligently to correct the issue of labs not showing in flow sheets.

      Please report any issues regarding these particular labs not crossing over from the report to your flowsheet.

    • Please dial 215-4111 Option 3 to reach us.

    • To request to file an EMR document in error please send an e-mail to elpasoemr@ttuhsc.edu. Please do not send alerts or flags for this type of request.

    • For any feedback or requests for this newsletter please e-mail us at elpasoemr@ttuhsc.edu

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EMR Known Issues

There are 2 EMR Known Issues:
    • Rotating residents do not have access to printers or computers in clinic
    • Clinic must notify EMR department of any residents rotating through their clinic in order for them to be granted access.
    • Please report any lab values not showing in flowsheets after signing the lab report to the EMR, Labs proxy box in EMR.
    • To report any issues please e-mail us at elpasoemr@ttuhsc.edu or contact us at our new number 215-4111 option 3.
As always we are working to resolve these issues in a timely fashion and will keep you updated on their status.

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El Paso, Texas, USA