Home Forums Discussions Problems ICD-9 and CPT warning messages

Someone please help me. Please! Is this a bug or am I doing something wrong?

In preferences, you can choose to turn off warnings for leaving off ICD-9 codes and CPT codes. The first patient works perfectly. No error messages. From then on, you always get an error message on the CPT code (the second one).

The preferences still have the check mark for not having messages.

I wish I could fix this, and I wish I could turn off every single error message in the program.

It worked okay for me, and I just tried again. Unsure what the issue is. I have not upgraded to version 4.0.6 yet, still on 4.0.45.

I don't do this, but you really should try to go to AC 4.0.62 - seems very stable.

Wish it would work for me. Paul are you talking about the same thing? Not using the ICD-9 code and just typing in the diagnosis?

Okay, I see. It is not working for me either. I did not realize it was automatically entering the ICD9's for me. I took them out and have the same issue you have. I would like to know what the reason would be for not adding in the ICD9 code though.

Thanks Paul. Well for starters, it takes longer rather than just tabbing down and writing one.

Two, you don't have to delete 20 ICD-9 codes when you print an order.

But, three, the ICD-9 codes are so lame. Type in:

Dermati
Pharyng
Oti
Injury
Headache

The first four help you not at all.

The last one does give you headache, but it also gives you,

"Headache Associated With Sexual Activity"

Ummm....I may have it wrong, but isn't a headache the classic way of getting OUT of sexual activity?

The problem is that ICD 9 or the new ICD 10 codes are LAME -- unfortunately we have to use it to get paid. I hate putting in lumbago when I really want back pain, but that is what works - numbness in the feet is "change in sensation". Unfortunately particularly in adult medicine the push is to more and more statistics and disease management which will require us to be able to search for all pt. with diagnosis XXX.XX and pull them up and that is why most of us have to use the ICD 9 in the chart. Occasionally I can't figure it out and when I just write it in my coder gives me the right code later.

The ICD 9 coder is why I have to finish most of my notes after clinic. I just type the diagnosis in words and then go back and code when I get the chance and sign off the note. My understanding is you have to use the ICD9 code in order to search the data for diagnoses (i.e. generating a list of all my Type 2 diabetic patients vs. my Type 1 diabetics) Am I correct?

To me the coder remains a weakness for AC. For instance the coding engine in the Epocrates Pro package will give much more intuitive descriptive terms, and you can search it based on combos of words (i.e. leg+pain. Interestingly no code came up for sex+headache. Guess you have to use postcoital) .

(Unfortunately the coder program only comes with the ultra deluxe Epocrates Pro suite, and not with the free program or the lower cost versions. I however feel that this version is well worth the money for my needs)

I can see your issues with that guys, and I do know that the ICD-9's and 10's are terribly set up and the search function in AC is not very easy to use. I have had my docs complain quite a bit about it because when they cannot find the code they are looking for they spend forever and usually end up putting something close and passing a note on to our billing staff coder that will correct it. Where you you type the code in? It won't let me type in a code in the ICD-9 field.

You can just go under the diagnosis list and just type whatever you want - just won't be coded and can't search later.

Unfortunately if you look in a real ICD 9 book you find that the codes are really that dumb - terms we use all the time are nowhere to be found in the actual ICD 9 code list.

I agree with all. Of course, we still use paper Superbills, and my coder changes what I write to a diagnosis and code. Back in the day, when the coding database was a bit more accessible, I kind of used the Praxis EMR method (Bell shaped curve). After two years of using the program, I went through and found the 200 most used codes and put them in the database along with the proper code. When the Dx and ICD-9 wasn't there, I would type it in a notepad and add them weekly.

You're correct about searching with ICD-9 codes. Can the Epocrates Pro package be revers engineered to Access. I could then change it to SQL. Of course, it is probably licensed.

It would be interesting to try to reverse engineer the Epocrates package and see. I have also had trouble searching for patients with certain CPT codes as well. I can go into Advanced Search and put in the encounter type as 80101 and it brings up 3 patients, yet I can find other patients with the CPT that are not coming up. Any suggestions?

This is why I have always questioned the Practice Management program. It's sort of like if you don't know how to put on a saddle, how do you learn to ride a horse.

I don't get the gist of your post. Do you mean that because of the functionality that is currently missing in AC that when the PM program comes along it will not be complete enough to rely on? Or do you mean that many users do not understand how to use AC effectively as it is, and so adding a PM module will be another hurdle that causes erroneous entry or hinder effective usage in the office?

As you state in your own post, although I am not sure why you can't type the ICD-9 code in, the coding database has issues. Therefore, if it is difficult to code in the program we have now, it will be difficult to have a PM that is based on that.

So, no, I do not mean what you say in the first question, and I certainly wouldn't be so arrogant as to suggest what other users can and cannot understand. The beauty of AC is its simplicity.

Bert,

About that saddle analogy. I think leslie knows how to put saddles on...but I think she rides mules. I try and use the coder...it does take time.

Tom

LOL, I was going to make a reference to Leslie.

Hey, hang on here pardners! Even knowing how to put a saddle on does not mean one knows how to ride, and vice versa. And sometimes, one will find a better way to put a saddle on only after they learn how to ride. Ok, finished with the analogies. I rarely get to ride anymore anyway. I spend most of my time feeding the damned things!!

Leslie