Reasoning around moving to ICD10 and our subset of it: Difference between revisions
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===Diagnosis issues=== | ===Diagnosis issues=== | ||
==== Diagnoses without specific codes missing in ICD10 ==== | ==== Diagnoses without specific codes missing in ICD10 ==== | ||
Might help resolve these: [[ICD10_Diagnosis_List]] | Might help resolve these: [[ICD10_Diagnosis_List]]; moved to [[List of ICD10 Diagnoses we don't code]]. | ||
==== Diagnoses where it is questionable whether we need them ==== | ==== Diagnoses where it is questionable whether we need them ==== | ||
Revision as of 10:01, 2018 June 20
This article explains our choice of ICD10 as a coding schema and of the subset of codes we include.
Why are we moving to a new diagnostic coding schema?
Our old diagnosis list was made in-house designed mostly for the Critical Care setting where our database started out. We are moving to a new diagnosis set primarily to make our data set more comparable to other data sets, and to include more diagnoses that are relevant to Internal Medicine physicians outside of the ICU setting.
Why are we moving to ICD10 rather than a different coding schema?
ICD10 is one of the most widely used diagnosis coding standards. It is the diagnosis coding schema used in all hospitals in Canada, including those in Manitoba. Using the same system as used elsewhere means that diagnoses don't need to be translated to another system, where often a 1-to-1 translation is not possible. It also means that our definitions are more likely to be equivalent to those used by other data sets.
Another benefit of moving to ICD10 will be that it should eliminate diagnoses for which we don't have a code, since ICD10 includes codes for diagnoses that have no specific code.
Why are we including the subset of diagnoses that we do
We are seeing increased interest by Internal Medicine physicians in our data set. Since they fund our program to a large extent, we need to make sure our data includes what they are interested in, in a format that is usable for them.
Why are we including some codes that are not part of ICD10-CA
Non-standard ICD10 Diagnoses lists these and provides reasons.
Why do we not include the entire set of ICD10 codes
The full ICD10 includes over 16000 diagnosis codes. We decided to only use a subset of this to make it easier to learn the new list. Any diagnoses whose codes we omitted can be assigned to the next more general NOS code.
Should we remove some?
Some diagnoses such as Alopecia (nonscarring hair loss), Albinism (albino), disorder of the nails do not initially seem significant enough to code. However, they should be retained so that they can be used as comorbidities, especially for medicine patients. For example, albinism is a condition associated with other genetic abnormalities.
Concerns
Pathogen issues
see Pathogens
Diagnosis issues
Diagnoses without specific codes missing in ICD10
Might help resolve these: ICD10_Diagnosis_List; moved to List of ICD10 Diagnoses we don't code.
Diagnoses where it is questionable whether we need them
Please put those right into the offending dxs. That way if we decide to keep them we can put the reason there, and if we decide to remove them we are already there.
APACHE/Charlson in ICD10
- We currently put in a level of severity in our comorbids. Ie COPD- mild, mod or severe. Is it OK to not have this information? Without the severe designation we may miss the chronic history component of apache (severe liver, lung, etc.)
- according to Allan, the ICD10 Codes can be translated to give you Charlson and Apache. Do you have specific concerns? See the following: