Controlling Dx Type for ICD10 codes

Many of the items on the ICD10 Diagnosis List are not suitable as certain Dx Types.

Examples:

• Severe sepsis should never be a Comorbid Diagnosis
• Past history, removal of breast (mastectomy) should never be an Acquired Diagnosis / Complication or Admit Diagnosis
• many more

We would like a way to detect when such inconsistencies happen.

Proposed Solution 1

• Add three columns to the s_ICD10 table:
  • como_not_allowed
  • admit_not_allowed
  • acquired_not_allowed
    • Template:Discussion it might be possible to combine the admit and acquired columns; can someone think of a dx that would only be allowed in one of them, or prohibited in one of them?
• populate the columns
  • Template:Discussion there are 1814 ICD10 codes on our list. Who would do this?
• put cross checks into CCMDB.mdb to prevent bad entries

Solution 2

• Add three columns to ICD10 DX template the following:
  • como_allowed - default YES
  • admit_allowed - default YES
  • acquired_allowed - default NO
    • reason above is:
      • work is done in central location and exported to the s table. Is that still the plan that DX to be exported from Wiki?
      • work done on wiki instead on in a table and others can work on it too.
      • default answers: NO in comorbid and YES in Admit, Acquired
        • the thought perhaps less changes because more NO in comorbids and more YES in admit and acquired, so less to change??

Should we do this?

Template:Discussion Is this worth the effort? It would take someone not insignificant time.

Template:Discussion Is that a reasonable solution?

If we do this, should we do more?

• if we are going to go through this review of all codes, are there other things we would want to review this way at this time? (I would likely need to find a way to get this info imported into the wiki when done, so this might be a good time to fix some other data that can be imported. Also, are there other checks we anticipate doing? Any other fields these dxs might interact with? Things we allow or prohibit based on where they are from? Prevent dudes from having Ovary, torsion? There is a risk of making this a bottomless pit, but if we are going to do anything like that it would be easier to do at the same time as this than separately later.
  • No, not going to start looking at gender vs types of DX. That could be done later, unless Allan wants to take the time on this one. Then it becomes and issues of checking if gender and name makes sense, as we cannot always tell if there is gender coding error from the name. Gender error is common entry error too. We don't catch it unless there are other encounters. If there are few males with hysterectomies and a few females with prostate issue, it evens things out over the big picture.