Conversion from our old diagnosis schema to ICD10/CCI: Difference between revisions

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This article outlines how we will transition from the [[:Category:Diagnosis Coding|old diagnosis schema]] to [[ICD10]] and [[CCI]]. Process has been in the works since at least 2016.
This article outlines how we will transition from the [[:Category:Diagnosis Coding (old)|old diagnosis schema]] to [[ICD10]] and [[CCI]]. Process has been in the works since at least 2016.
   
   
As of 18:59, 2017 September 16 (CDT), some of the discussion about this continues in [[Task Team Meeting - Rolling Agenda and Minutes]].
== Timeline ==
== Timeline ==
Current Timeline is this:
* 2018-May-ish: request to collect ICD10 and CCI data for at least two patients per week
* in progress now:  
* 2018-08-01 implementation of CCMDB.accdb cross-checks starts  
** groupings for reports
* 2010-10-18:  [[Primary Admit Diagnosis]] needs to be entered for all patients, old style DX
** Groupings for Charlson, Apache Dxs, Alert score, Overstay
* 2018-10-01 all initial cross-checks implemented
* 2018-03-01 implementation of cross-checks starts (incl TISS, CFE)
* 2018-12-01 implementation of CFE/TISS cross checks complete; suggestion of full ICD10/CCI coding for pts expected to be discharged after 2019-01-01
* 2018-03-15 all initial cross-checks implemented
* 2019-01-01 - enter complete [[ICD10 collection]] and [[CCI Collection]] for patients with [[Dispo DtTm]] >= 2019-01-01
* 2018-03-15 start full double-coding for all patients is expected
* 2022-03-28 - deleted all test ICD10 entered up to Dec 31,2018.
* 2018-04-01 earliest possible date to only code ICD10; this might be later if double coding shows problems


== Data ==
== Data ==
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* [[R Filter Field]]
* [[R Filter Field]]


* Code mapping Excel workbook from Allan Garland, used by Tina, can be found on X:ccmdb\!ICD10_Mapped
Dx Code mapping was not possible:
* [[Translation of Dx Data from CCMDB schema to ICD10/CCI]]


=== Procedures  / [[CCI]] ===
=== Procedures  / [[CCI]] ===
See [[CCI Data Structure]].
See [[CCI Data Structure]].
Special consideration will need to be given to:
* [[Registry Patient Type#Conversion from our old diagnosis schema to ICD10/CCI]]


== Collection Interface ==
== Collection Interface ==
[[Patient viewer tab ICD10]] will be added in [[Patient Viewer]].
[[Patient Viewer Tab ICD10]], [[Patient Viewer Tab CCI_Pick]] and [[Patient Viewer Tab CCI_Comp]] have been added in [[Patient Viewer]].


Need to address [[Facilitating diagnosis entries]].
Completion of new items for CCI/ICD10 in [[CCMDB.accdb Data Integrity Checks]].


== Documentation / wiki ==
== Documentation / wiki ==
Articles for each new DX are available on the wiki. Where possible the new article will contain a link to the related old article(s).
=== [[ICD10 collection]] ===
 
Articles for each new DX are available on the wiki. Where possible the new article will contain a link to the related old article(s). See [[ICD10 Diagnosis List]].
All will need to be [[ICD10 diagnosis article reconciliation|reconciled with the old diagnoses articles]].
 
The following link will take you to a Semantic Mediawiki table that lists articles for ICD10 diagnoses that have been added to the wiki, and the degree to which their article integration has been completed:
* {{#ask:[[Category:ICD10 Diagnosis]]
|?#
| ?Has ICD10TransitionStatus
| ?Has ICD10OldArticleLink
| ?Modification date
|sort=Has ICD10TransitionStatus
|order=asc
|format=broadtable
|link=all
|limit=0
|headers=show
|searchlabel=IDC10 Transition
|intro= This is a list of articles for ICD10 diagnoses that have been added to the wiki, and the degree to which their article integration has been completed..
|default=No locations found.
|class=sortable wikitable smwtable
}}
 
If the old article has no additional instructions Most of the conversions will be straightforward, just do a reality check and then change the status. Articles with explanations and links will take a little more time and effort. See [[Diagnoses that likely have criteria]] for a list.
 
=== Left to plan/set up ===
{{discussion}}
The following still need to be set up
* accommodate multiple alternate dxs as links drawn from [[:Category: ICD10 Diagnosis]]
* accommodate likely bug entries depending on how we code those...
 
== Decisions made ==
=== Task Elements ===
* What will we do with [[:Category:Task Elements]]; they don't fit into ICD10/CCI (or do they)? emailed [[p:Dr. Allan Garland|Dr. Allan Garland]]. Ttenbergen 20:17, 2017 September 18 (CDT)
** Leave them in the [[L_Dxs table]]. Rename tab to "Tasks"
** some tasks ''look'' like they would correspond to CCI codes but we use specific collection instructions for them so they would not be equivalent, so we can't change this to using CCI codes.
 
=== Future CCI/Procedure/[[Previous Location]] Cross Check ===
All we will have for xcheck is: if from OR or PACU, must have at least 1 CCI. Ttenbergen 16:26, 2017 September 19 (CDT)
 
=== optional dates for dx or px that isn't an acquired ===
* Don't allow dates unless in acquired dx/px Ttenbergen 16:44, 2017 September 19 (CDT)
 
=== Charlson Comorbids ===
Allan has provided a table of which ICD10s contribute to which Charlson score. Tina has added a column for Charlson condition to [[s_ICD10 table]] and added [[S ICD10 Charlson Como conditions table]] to contain possible values and corresponding points.
'''We will need a query to group conditions found per patient, and a query to give total Charlson score. '''
 
=== ICD10 / CCI Groupings for Reports ===
We need ways to group ICD10 codes for reports.
 
Allan has provided a listing.
 
Tina has set up structure so that any dx can be part of any number of groupings (like wiki categories):
* [[S ICD10 Blocks table‎]]
* [[S ICD10 Block Dxs table]]
'''need to populate'''
 
== Decisions to be made ==
=== Flagging additional info available for dxs in CCMDB to look up on wiki ===
[[p:Dr. Allan Garland|Dr. Allan Garland]]'s table combines DX name and other information.
* Take the extra info out of the dx name; add a column that says "important extra info", make wiki link more visible in ccmdb when that is the case.
** Added a column to [[s_ICD10 table]] that would be set to true/checked if there is important wiki info.
*** {{discussion}} This approach will be misleading. There will be more additional info on the wiki from the start than just the extra info Allan added in the setup of ICD10. Using this tag will only lead people ''not'' to look things up. Should we really use this? Ttenbergen 18:07, 2017 October 14 (CDT)
 
=== CCI vs remaining manually collected labs ===
[[:Category:Manually_collected_labs]]
* {{discussion}} CCI - should we move the imaging labs collection in with this? Emailed Allan... Ttenbergen 19:51, 2017 September 18 (CDT)
** Allan pointed out that the blood products etc also have procedures. Tina to send list. Ttenbergen 16:17, 2017 September 19 (CDT)
*{{discussion}} It is much simpler and faster to count the number of CXR's, ABGs, and other tests in our lab counts than to put a CCI entry for each every day they are done.  Also,  anything that is currently on the tiss sheet should not have to be included in CCI at least for ICU.  For example, CRRT and IHD is clearly marked on the tiss and which days are clearly shown. To have to enter in CCI all tests and procedures every single day they are done is not feasible within the time constraints of our EFT's in my opinion.--[[User:LKolesar|LKolesar]] 08:12, 2018 January 31 (CST)


=== significant complications ===
=== [[CCI Collection]] ===
*[[Significant_complications]]
Articles are now on wiki, see [[CCI Picklist]] and [[CCI Component]].
* {{discussion}} Important complications - emailed list to Allan for consideration. Ttenbergen 16:10, 2017 September 19 (CDT)


== Related Articles ==
== Related Articles ==

Latest revision as of 11:14, 2022 April 7

This article outlines how we will transition from the old diagnosis schema to ICD10 and CCI. Process has been in the works since at least 2016.

Timeline

  • 2018-May-ish: request to collect ICD10 and CCI data for at least two patients per week
  • 2018-08-01 implementation of CCMDB.accdb cross-checks starts
  • 2010-10-18: Primary Admit Diagnosis needs to be entered for all patients, old style DX
  • 2018-10-01 all initial cross-checks implemented
  • 2018-12-01 implementation of CFE/TISS cross checks complete; suggestion of full ICD10/CCI coding for pts expected to be discharged after 2019-01-01
  • 2019-01-01 - enter complete ICD10 collection and CCI Collection for patients with Dispo DtTm >= 2019-01-01
  • 2022-03-28 - deleted all test ICD10 entered up to Dec 31,2018.

Data

Diagnoses / ICD10

Diagnosis data will be stored in the L_ICD10 table. The codes will be provided by the s_ICD10 table.

Special consideration will need to be given to:

Dx Code mapping was not possible:

Procedures / CCI

See CCI Data Structure.

Collection Interface

Patient Viewer Tab ICD10, Patient Viewer Tab CCI_Pick and Patient Viewer Tab CCI_Comp have been added in Patient Viewer.

Completion of new items for CCI/ICD10 in CCMDB.accdb Data Integrity Checks.

Documentation / wiki

ICD10 collection

Articles for each new DX are available on the wiki. Where possible the new article will contain a link to the related old article(s). See ICD10 Diagnosis List.

CCI Collection

Articles are now on wiki, see CCI Picklist and CCI Component.

Related Articles

Related articles:
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