That would be an advantage if "Hand, Foot and Mouth Disease" or "Fell, Scaped Knee" were a problem. But, they aren't. They are diagnoses on a face sheet. Personally, I don't want them in the problem list. I want problems, i.e. Asthma, Chronic otitis media, ADHD, in the problem list.
Well, you've got to do whatever works for you in your practice. I respect your right to set up a system that is personally satisfying to you.
I gather you have devised a "face sheet" system for yourself, external from Amazing Charts, which demonstrates that you appreciate the value of having a problem list. You apparently just don't care for Amazing Charts way of doing it, and obviously don't mind doing double-entry to maintain it to your personal standards. There is absolutely nothing wrong with that; I just see an opportunity to automate that process here, and Amazing Charts is soooo.... cloooooose to perfection.
This inability to define each code with multiple descriptions may seem like a small thing, but in fact I believe it is a MAJOR OBSTACLE to proper use of the Problem List in the Summary Sheet, and limits users from realizing the full potential of this feature.
I SKINNED MY KNEE (ON THE ICD-9 DATABASE) Take the "Skinned Knee" example that you offered above. To create an ICD-9 for that, you would have to find "ABRASION HIP/LEG" (916.9), and redefine it as "SKINNED KNEE" (916.9).
Well, what happens when the patient comes in with a "SKINNED HIP"? There is no clue left in the program as to which ICD-9 might correspond to that code. You wrote over it!
Well, you could just lookup 916.9 every time, and then type "SKINNED KNEE" next to it, but that doesn't save time, and it doesn't populate the Problem List.
The easier solution for many, as you say, is to just type "Skinned Knee" and have done with it.
MISSED OPPORTUNITYWell, if it was a quick and painless process, and didn't obliterate the original code description, you might not mind doing a quick ICD-9 lookup for "ABRASION HIP/LEG" (916.9) and adding an alternate entry for "SKINNED KNEE" (916.9).
Now, did that save you any time in this encounter? Probably not.
However, next time a kid comes in with a skinned knee, you click on the ICD-9 button, start typing "SKINN", and up pops "SKINNED KNEE" (916.9), which gives you a happy feeling. The amount of time saved is marginal, but consider that a lot of the words we type are hard to spell, and not all the folks typing in diagnoses are brilliant physicians like me and you.
With this system, they only need to be spelled right ONCE.
That is not all the benefit that accrues from using the ICD-9 code, however. I will not go into how having the physician select the ICD-9 code helps the person doing the billing (which may be
ourselves in some cases).
The most important benefit accrues from the fact populates the Problem List in the Health Summary, and in the Assessment section of your Encounter Form.
WHO CARES ABOUT A SKINNED KNEE?Now, you may say that "SKINNED KNEE" does not constitute much of an addition to the Problem List, but if you're scanning the Problem List, and "SKINNED KNEE" is joined by "SKINNED NOSE", "FIRST DEGREE BURN", "SCALP LACERATION", that may be a jumping-off point for a conversation about child safety, or something even more serious. It's good to have that kind of overview of past diagnoses.
I also hear your objection that the problem list could become cluttered with unimportant details, but of course these can be set as "Inactive" or even deleted, and they won't show up on the printed list or can be hidden in the display.
Lest anyone be distracted by the seeming-frivolity of skinned knees, remember that there are ICD-9 codes for "Other disorders" of the ear, brain, cervix, synovium with much more useful sub-diagnosis categories.
p.s. - Also, as you have indicated, using the ICD-9 codes creates one less "panic button" to click through when you're trying to sign your charts (admittedly this feature could be disabled for diehard non-coders).
