Cross reference from ICD 9 to ICD 10 Diagnosis Codes
We would like to List ICD 9 and show corresponding ICD 10 code
As of 8/11/2015, we have deployed ICD-10 coding for Practice Fusion superbills in all PF practices to make sure you are prepared for the October 2015 CMS ICD-10 deadline.
We have also incorporated ICD-10 diagnosis coding directly in the clinical and lab ordering workflows.
To learn more, you can visit our ICD-10 Center here: http://www.practicefusion.com/icd-10/
Additionally, there are 3 helpful knowledge base articles available:
It was great to have ICD9 and ICD10 cross-referenced in the beginning.
The problem is that several of the of the insurance carriers, denied claims/superbills with both ICD9 and ICD10 codes listed.
To improve this, ICD9 codes should be deleted from the superbills.
I love the new system!!!!! It has worked really well. Rarely my ICD 9 cannot be linked to ICD 10, so I have to discontinue it and retype a better match. I love that I can keep old diagnosis and all medications, comments that have been associated with it. Great work!
Janet Schaffel commented
Thanks. This is great functionality.
Leo G. Pepa commented
we need ICD9 to interchange to ICD10
This feature needs, to come, if at all possible, before October 1st. It seems to me that 1) The diagnoses attached to the visit need to be ICD 10 after October 1st, 2) the problem list needs to be ICD 10 - and there needs to be a way that the current problem list can be transformed into ICD 10 (this also needs to be one Dx at a time at the user's request or it will bog everything down) 3) the superbill needs to be able to pull from the ICD 10 chart assessment and ICD 10 problem list - otherwise the provider needs to do all the work of finding the codes each time they bill. I think I am going to put ICD 10 codes into the comments of the ICD 9 problem list until there is clinical integration with ICD 10. I hope it doesn't come to that.
As we've been working to meet our state guidelines for this, we are coming across ICD-10 codes that don't exist in the DSM V and/or in the WHO. Is anyone else having this issue?
Hi Dr. Gilmer--we have begun working on ICD10 for the clinical workflow as well.
what is the status of providing the ICD9 to ICD 10 mapping and search functions into the clinical note i.e. Summary: Diagnosis table and assessment sections?
Dra Margarita Collazo commented
Agree need icd 10 conversion in SOAP diagnosis
I am thankful that PF has put in place a system for ICD-9/ICD-10 conversion. However, we’re running to quite a problem. It seems that when the providers are entering the dx codes in the summary tab or in the encounter it only does the ICD-9 code. But when the biller goes to complete the superbill, they have the ICD-9 that the provider entered but some codes prompt for a more specific ICD-10 code. The biller is not going to know what this should be as the provider is the one diagnosing the patient. We don’t have time to get with the provider on all of these instances to clarify but we need the correct information. Can you please make that prompt at the provider level when they enter diagnosis codes in the encounter? We need this ASAP!!!
Dr Rahul Gor commented
Just a few more suggestions for the new superbill:
When selecting an item: light blue as a highlight is tougher to see especially since alot of us work in spaces with horrible fluorescent bulbs that are reflective.
The modifier section though excellent in terms of the user interface, is very slow. Something is taking very long to load up from your end, you would think that the codes would take longer but they are instantaneous.
Date of service: should be changeable on the top. If you create and sign a note with the wrong dos, you have to scroll down after you pick everything to change it.
Font needs to be a little larger (not much) and more bold. Not an issue on a larger monitor but tougher to see on a tablet.
Once we finish the transition could we have the option to have the note and the bill side by side so you can see the note as you enter the bill...though I can see how with less real estate on a tablet this might not be very viable.
Good work on the transition! It's going to be tough but I think the 1st version is a great start.
Agree completely with Rgorg and Amy Yu.
the clinician is responsible for the diagnosis code that will associate with the procedure or E&M code billed.
Thank you for reassuring me that ICD 10 coding and crosswalks will be operational in the clinical note.
Hope it is functional long before Oct 1, 2015 deadline to allow us to learn, use and work out bugs before Oct 1.
Dr Rahul Gor commented
I think this is a good first step. It is a chaotic transition and it is apt to get everyone upset. I would strongly recommend getting out your armor as the ehr is going to be the scapegoat for all the issues related this mandate.
Either way here are some suggestions:
I think the clinical note under assessment should be the place that you do the coding and crosswalking.
Reason: The clinician makes the most accurate decision at the pt encounter and should not be sending bills without finishing the note.
When it's time to bill, you just click on the diagnosis already in the chart (crosswalked already) and click send. You can always change it something else but at least you are gong to get things such as laterality and cause right since you clicked in the codes during the encounter.
2. Assessment section:
Should be able to enter multiple diagnosis with as little lag as possible and with the fewest clicks.
Reason: Assessment/diagnosis is the key to everything. This is the section that generates the superbill and will be used as a reference for any icd 10/icd9 crosswalk issues. A doctor with a pt in front of them will want to be able to enter the avg of 3-4 diagnosis quickly and the push to the plan/treatment/rx section. They can also skip the plan section and go straight to the bill which is crosswalked already.
Kudos to the fact that you have reduced the "click and scroll" interface with a search and click (faster) and better for keyboards and tablets w/ smaller screens
Hi Dr. Gilmer--no reason to be disturbed. We are also working on ICD10 coding in the clinical workflows. More updates as we near release of this functionality.
This is Disturbing!!, please tell me I misunderstand:
"we have deployed ICD10 coding for Practice Fusion superbills to 60% of PF practices" and "We are currently working on ensuring the Practice Fusion EHR is ready for the CMS ICD10 BILLING DEADLINE"
The billing code is TAKEN FROM the clinical dx code. Not the other way around. We need rollout of ICD-10 coding selection and crosswalks in THE CLINICAL NOTE - BEFORE - or simultaneous to - deployment on superbills.
The billing code placed on a superbill is taken from the clinical diagnosis code that the physician specifies in their clinic note, not the other way around. In out-patient practices, billers see the clinical dx code chosen by the physician - and place that DX CODE on the superbill to send for payment.
Only a hospital or perhaps a huge group practice would have a coder chose the ICD10 code instead of the physician. Your users are small practices, not hospitals. I am the coder.... You must make it easy and functional for me to select the Dx code from within my clinical note. Getting it onto a superbill is the easy part.
We MUST have full seamless easy ICD-10 code selection ability and crosswalk in the CLINICAL NOTE - (and also by the way a functional way to update the existing ICD-9 codes already in patient notes).
It is Much More Important to have the clinical side rolled out than the superbill itself. It is not a question of what CMS mandates (only the billing code), the point is that the billing code is determined by the diagnosis code, that must be selected by ME the physician provider, in real time, at the time of the encounter, before I can sign my note.
If I do not have the specifics captured in my note, before the patient leaves, it is too late to select the correct ICD-10 code after the patient is gone. I need to be sure I have can select the proper specific ICD-10 code while the patient is there.
Please tell me that PF is prepared for this and is already beta testing the clinical note dx code portion of the program and will have it up and running for the all of us well before the October 1 2015 deadline!!! We users will need some time to adjust to a new clinical workflow and you will need time to work out the bugs.
This is absolutely critical for us practitioners.
Hi Dr. Matheson--we're going to see about having someone reach out to you directly to see if they can help with the issues you've raised. Thanks for keeping the feedback coming!
I am so glad you are working on ICD 10! I would love a way to change over the old ICD 9 to ICD 10 codes. It would be best if it wasn't mandatory. The codes are different enough for some that it would take some human involvement - so I would want it when I choose to not happening as soon as I opened at chart. I am playing the the superbill ICD 10 - and I'm not getting some codes I will need - DIabetes only gets me the E11.9 diabetes without complication and I could't find a way to select the options to select the complications like E11.43 - gastroparesis, or E11.319 Diabetes with reinopathy. Same thing with ear infection - it goes to unspecified (H66.9 - but does get the right or left with is great) without option for things like suppurative H66.4. The experts we are listening too say it is going to be very important to be specific in the future. So when we start using it for clinical, and billing after the first year, it would be great to be able to get the most specific ICD 10 code.
Dr Michael Wingren commented
We need to be able to pull up ICD-10 codes as we currently pull up ICD-9 codes to create an accurate progress note and show our biller on staff what ICD-10 code to use. Please get the ICD-10 codes into the charts section (not just the billing section) ASAP.
Hi Shirin--we will be adding ICD10 to the clinical workflows very soon as well.