Tools tackle complexity of translating codes to ICD-10

Researchers studying the difficulties of mapping between ICD-9 and ICD-10 have created tools to deal with the complexity, according to an article published in the Journal of the American Medical Informatics Association.

The researchers, from the University of Illinois at Chicago and the University of Arizona, describe the majority of translations between the two code sets as "complex and nonreciprocal, creating convoluted representations and meanings." In creating their tools, they sought to categorize the mappings by their level of complexity: "identity" (reciprocal), "class-to-subclass," "subclass-to-class," "convoluted," or "no mapping."

They found in ICD-10, an additional 536 class-to-subclass relationships, 7,478 subclass-to-class translations, plus a substantial number of convoluted relationships (57,013). In all, they identified 669 codes that had no mapping.

External causes of morbidity, injury and poisoning  presented the largest percentage of convoluted diagnosis codes, while diseases of the blood and conditions that occur during the perinatal period had the smallest percentage of convoluted diagnosis codes.

The more complex and convoluted the codes, the more time and resources will be needed to conduct queries and analytics using them, the authors said. Their tools are designed to help organizations evaluate the financial and compliance risks with complex codes where reporting on them proves difficult.

A study from Vanderbilt University found the general equivalence mappings (GEMs) and reimbursement mappings (RMs) created by the Centers for Medicare & Medicaid Services and the Centers for Disease Control and Prevention didn't provide the promised consistency between the two code sets. Those authors urged healthcare organizations to perform their own analysis with their most commonly used codes to determine how that will affect reimbursement and care statistics.

While the transition reportedly could hit pediatricians particularly hard, a new survey suggests ICD-10 implementation costs for small physician practices are significantly lower than the American Medical Association estimated last year.

Meanwhile, lawmakers on both sides of the aisle this week made clear that they don't want the transition to ICD-10 delayed again.

To learn more:
- read the article
- check out the web portal
- find the translation tables

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