Home Forums Discussions General Discussion ICD-10 "and AC question

Is anyone else having the problem of ICD-10 codes in the problem list "zeroing out?"

For almost every patient I have seen since October 1, the codes look like they are OK- no request to be more specific. Yet, the next time I see the patient the Assessment box has many of the diagnoses coded as "000". I get an error message saying the codes are not acceptable for inclusion in the superbill. Yesterday I had to redo the problem list on every patient I saw! In one case I couldn't order an imaging study till the whole note was written and coded.


Is there a way to prevent this? It would be a lot easier to get a request for more specificity when you do the initial entry. Some of them do that, but it seems that most do not.

For me, the zeroed codes are the ones that have not been mapped from 9 to 10. Sometimes they have the same name. Sometimes they were transferred sometimes not, I'm not sure why
Ex: allergic rhinitis is sometimes 000 sometimes transfers over.

Usually once I put the ICD10 code it will always be there. I usually go back and remove the 000 codes from the summary, but most of the time if I am not running to the next patient.Sometimes if they have multiple 000 codes I will hold that chart over for removal of 000 codes.

I have not seen 000 codes return after the correct ICD10 code is put in. Perhaps you are seeing the old code because you did not remove it, but the new code is somewhere in the mix.

What version of AC?

Dear Dr. Bergman,

There is an issue with forwarding charts from the Check in screen. This screen is changing ICD10 codes to 000 on the assessment when you pull the forwarded chart from your inbox. You can update to 8.3.0 to fix this. In the meantime you can either not use the clinical check in screen or delete the 000 codes from the assessment than re-add them from the problem drop down.

Sorry this got past us,

Claire

how can I get 8.3?

I am also noticing ICD-10 codes entered after October 1st have showed up "000" in subsequent encounters. Most annoying is hyperlipidemia E78.5, which always zeroes out. But many other common codes have the same behavior. I am now trying to use a different code "Endogenous hyperlipidemia E78.1" (whatever that is) which doesn't seem to zero out.

Whether intentional or not, the mapping from ICD-9 to ICD-10 has plenty of bugs, and so does the ICD-10 coding in AC 8.24.

John, there actually was a V97.33 on the Incredibles. And, I always recommend a follow-up appointment for any patient struck by a killer whale. (which by the way is in the dolphin family). So you may see W56.22 Struck by a dolphin.

I, too, have some issues with the .000s.

Appropriate for this time of year-
z63.1
Problems in relationship with in-laws.

Now that it is a legitimate diagnosis, is there an effective treatment. I have tried large doses of Cabernet but that only seems to exacerbate the symptoms.

did you administer the Cabernet to yourself or the in-laws, never mind thinking about it Cabernet not likely to improve character faults in the in-laws and unless you drank enough to get sh_tfaced you probably suffered from the thought....now that was a waste of good Cabernet!

You noticed I wrote:

Having trouble with 000 too. I am really not, just didn't want to be accused of hijacking. LOL.

I am not saying you guys are.

Who knew there was a whole line of humor that can be built around ICD10 coding?

I'm thinking maybe National Lampoon was given the duty to develop ICD 10.

I don't know. I actually like ICD-10. The diagnoses pop up easily. I haven't seen a TB result yet. Maybe just a bit of refining.

John and I just want to get feedback from CMS as to what they are allowing now and what they may not allow next year.

Agree I like the way ICD-10 codes come up when I do a lookup pushing the Lookup Dx button, just wondering why conditions such as Dolphin attacks and In-Law issues made it in; hence the National Lampoon insinuation.

Actually, in ICD-9, there were quite a few funny ones like falling form an airplane without a parachute, which I see weekly and falling from a train on an employee or falling on a train onto a passenger, etc.

I suppose even in the ICD world the "...Publish or Perish Rule..." applies.

Seriously --
Can you imagine a career in "medical coding services" --
8 hours a day, 5 days a week, for 25 years??
Personally, I would die of suffocation in a job like that.

Wouldn't you be just a little tempted to slip in a few outrageous codes just to lighten up the day?

From a practical point of view, I can't see any difference.
I just use the Google search or the CMS search to find a reasonable code, then I put it in the Add Code list in AC.

The fact that there are multiple codes that can describe the same condition, or that infinite degrees of precision are possible (presumably, you could specify the pod from which the killer whale that struck you came---) is largely irrelevant to a general family practice.

Just like you don't have to know the entire Oxford English Dictionary or know a gerund from a past participle to make yourself understood in ordinary English.

Tom, I enjoy when you get on a roll

I love the ICD-10 codes in AC.

And, I do wish more people understood gerunds; half noun, half verb.

Like the running of AC is interesting to say the least.