Home Forums Searching the ICD 10 database

I do not know if the ICD database in AC was written by AC or whether it is a third party program that was imported into AC. However, one very nice feature for this database (which it sorely lacks) would be a direct lookup of the ICD-10 code when the code is entered in the search field. For example, say I want to replace the ICD-10 code for pinguecula that was arbitrarily generated in my problem list by AC. The code was converted to H11.159, which is pinguecula, but UNSPECIFIED. It needs to be documented and specified as bilateral. The code for that is H11.153. However, if I type H11.153 (which I can quickly look up using an internet ICD-10 search engine)into the ICD-10 database search field, nothing comes up. If I back-space 2 spaces and enter H11.1, it comes up as a yellow highlighted category of conjunctival deposits and degenerations. If I click refine selection, then H11.153 finally shows up in the list as H11.153 - pinguecula, bilateral. Now I can enter the proper code description into the chart. So the code is in the database, but cannot be directly accessed (!?!) This doubles or triples the time I need to update my problem list. Add this to the long list of things that need to be addressed. BTW, the two search engines I have used with good success are I-Magic (http://imagic.nlm.nih.gov/imagic/code/map) and (http://icd10.nuemd.com/icd-10/codes).

I also vote for a throw-back to the database featured in AC 6.3.3. We could edit codes and descriptions.

You have just said beautifully what I have been trying to get across the past two days. Unless direct entry of all codes is possible, my cheat sheet of common codes will not work. The extra clicks of refinement are maddening.

I agree!! We must have the ability to directly enter any icd10 code. I have spent weeks establishing a DERMATOLOGY cheat sheet for my office and we simply must be able to enter the codes. AC is NOT generating codes with sufficient granularity, thats for sure!

Sandy

I will second that. AC, please let us add a specific code and description when one is not available in AC database. A lot of the codes are there when we look them up by clicking on the menu bar at the top but not when working inside a chart. Some of the conditions have all "yellowed out" codes.

https://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html

I don't think the database was made by AC. That would be like making the medication list. An arduous task. I believe there are two databases. AC uses SNOMED. That is all I know.

I have just been having a long discussion with another user. He brings up a point that I have wondered about.

Please don't jump all over me on this. But, what does it matter if you put acute otitis media vs left acute otitis media vs right acute otitis media vs bilateral acute otitis media. They are all ICD-10 codes, and they should all get you paid. Now, I guess it would be nice four our sake to have it documented. And, I suppose acute otitis media would mean that it has to be one of the other three.

First point: There are two different ICD-10 database searches in AC, and they yield different results. I don't know that this is a good or bad thing; I do know that it is important to understand the difference between the two because as EyeGuy, Bert and others have noticed, the two give different results.

In the patient's chart, the box is called "Lookup diagnosis" and you are right: type in the code (e.g. H11.153), and you may get no answer.

But tn the main page of AC, under View...diagnosis codes, the box that opens up is entitled "Search billing codes". This is designed to enter a known code. In the example above, typing H11.153 yields the description you want, "pinguecula, bilateral".

So when looking up by code look on the main screen and when searching by diagnosis look in the patient's chart.

Second point, and Bert alludes to this above: Ed, can you point to ANY documentation from an insurance company that says, "if your patient has a pinguecula and you code "H11.159" which does not specify that it is bilateral, then you will not get paid"?
I understand that ICD-10 permits a higher level of specificity. I also know that we want to do what we can to avoid non-payment, but do we know that the insurers will be this crazy? Keep in mind that to do so, they will have to look at your note to find out which eye(s) did or did not have the problem.

Jon,
It is wonderful that the search engine under the main view page directly accesses the ICD-10 code that I type in. However, that doesn't help me when the search engine that appears when you click Add diagnosis on the summary page does not allow you to do that. Would it be a stretch to link the everything to the most comprehensive database and search engine? Does that make too much sense? I don't know about you, but our carriers in NY State are constantly auditing charts, likely looking for ways to deny a claim. I would rather give them as few reasons as possible to keep my money.

AC's response to that request is that it would often lead to an extremely long list of "hits", so that is why the search results are pared down.

Hopefully the fix Cathy@AC mentioned on Friday will arrive soon. It would simplify the coding for Z23 and Z00.12x
She didn't mention dermatology codes but maybe they'll be fixed too.

Agreed, Josue.
Anyone who has specific issues or questions about ICD-10 coding should post them here (or contact AC directly). They are monitoring concerns and requests, and have promised to make changes. These are not changes that require a new version of AC; the ICD-10 database can apparently be updated much more easily and quickly.

Why in the world would AC include 2 different ICD10 databases??
And not be able to enter the ICD10 code directly in the one for charting??

At the moment, I am quite happy that I have hung back with 6.3.3.
I love being able to enter my ICD10 codes and description any way I want them.
Lots of folks here are using cheat sheets and other search tools anyway since they are finding AC's search cumbersome.

I would be happy if AC would just include 2 codes in their database, so they convert to ICD10 automatically, instead of listing as (000):
Hyperlipidemia - 272.4 to E78.5
Vitamin D deficiency - 268.9 to E55.9

Would save me a few minutes a day for the next few months.

I think it may be a good idea to ask all of the ICD-10 questions in one thread. I posted under Catherine Lehmann's Post at:

http://amazingcharts.com/ub/ubbthreads.php/topics/67190#Post67065

This may allow us to develop our own FAQs, and allow her to answer questions when she can. Obviously, there will be some threads that are very specific. I don't think I have ever tried anything like this. But, I don't think we have had to adjust to anythinig so confusing before. At least it is confusing for me.

Hi, Both hyperlipidemia E78.5 and Vitamin D deficiency E55.9 are in the current vocabulary. It sounds as though the problems on your problem list were mapped from ICD 9 to ICD 10 incorrectly (to "000" codes). Mapping is complex. Unfortunately you may have to re-enter those problems as you see them. Thank You for your patience.