Introduction to Mapping Tool 2015 ICD 9 CM and ICD 10 CM/PCS
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1 MapIT (developed by AHRQ*) Introduction to Mapping Tool 2015 ICD 9 CM and ICD 10 CM/PCS * Introduction Ginger Cox, RHIT, CCS, ICD-9/10 Coding and Conversion Analyst, University of California, Davis Center for Health Care Policy and Research Denise Love, Executive Director/Project Manager, National Association of Health Data Organizations (NAHDO) Patrick Romano, MD, MPH, FACP, FAAP, Professor of Medicine and Pediatrics, University of California, Davis Center for Health Care Policy and Research 2 1
2 Overview Introduction About the Tool Short Review of Mapping Logic Understanding the GEM Flags Mapping Examples Mapping Changes FY 2014 and FY 2015 Single and Batch Mode, and Output Demonstration Summary 3 About the Tool Mapping tool MapIT based on General Equivalence Mapping (GEMs), FY 2014 and FY 2015 Provide all plausible translation alternatives with forward, backward, reverse forward, and reverse backward translations ICD-9-CM to ICD-10-CM (diagnosis and external causes) ICD-9-CM to ICD-10-PCS (procedures) Enhancements Two Panes: Single Lookup and Batch Lookup. Output will reflect if it is mapping from 9-to-10 or 10-to-9 Mapping Tool is FREE and offered by AHRQ Tool is available on AHRQ website 4 2
3 Output: Your list of codes 6 3
4 Stage 1: Map Original ICD-9 Codes to ICD-10 Code 7 Stage 2: Map new ICD-10 Codes from Stage 1 to find more ICD-9 Codes Stage 3: Map new ICD-9 Codes from Stage 2 to find more ICD-10 Codes 8 4
5 Example: Proper Direction 9-to-10 Forward Map ICD-9 Description Map ICD-10 Description Phlebitis and thrombophlebitis, iliac vein 10-to-9 F Map I Phlebitis and thrombophlebitis, unspecified iliac vein ICD-10 Description Map ICD-9 Description I Phlebitis and thrombophlebitis, unspecified iliac vein Backward Map B Map Phlebitis and thrombophlebitis, iliac vein Match in general description 9 Example: Reverse Direction Reverse Map ICD-10 Description Map ICD-9 Description I Phlebitis and thrombophlebitis, right iliac vein I Phlebitis and thrombophlebitis, left iliac vein I Phlebitis and thrombophlebitis bilateral iliac veins RB Map Phlebitis and thrombophlebitis, iliac vein RB Map RB Map Reverse Backward mapping logic 10-to-9 Use the backward map and reverse the lookup Provide more specific codes
6 GEM Flags: What do they tell you? 11 GEM Flag: Exact Match ICD-9 Desc ICD10 Desc Approx No Map Thrombo -phlebitis migrans I82.1 Thrombo -phlebitis migrans Comb Scenario Choice The Approximate Flag: code 0 means exact match. Business rule: Do you take them as face-value? Do you want to evaluate these exact-matches as well? 12 6
7 GEM Flag: Approximate Match ICD-9 Desc ICD10 Desc Approx No Map Acute and chronic resp failure following surgery J96.20 Acute and chronic resp failure with hypoxia Comb Scenario Choice The Approximate Flag: code 1 means approximate match in descriptions. Business rule: How will these descriptions affect your project or study? 13 GEM Flag: No Map ICD-9 Desc ICD10 Desc Approx No Comb Scenario Choice Map Pressure NoDx No Dx ulcer, unstageable The No Map Flag: code 1 means there are no codes to match the description (often found in the proper direction). Business rule: Are there any other codes to consider? Consider reverse map to find additional codes? 14 7
8 GEM Flag: Example of No Map ICD9 Description Map ICD10 Description Pressure Ulcer, unstageable F Map No DX No DX RB Map L Pressure ulcer, unstageable, unspec. elbow RB Map L Pressure ulcer, unstageable, right elbow RB Map L Pressure ulcer, unstageable, left elbow RB Map L Pressure ulcer, unstageable, unspec. back RB Map L Pressure ulcer, unstageable, rt.upper back RB Map L Pressure ulcer, unstageable, lt.upper back RB Map L Pressure ulcer, unstageable, rt.lower back RB Map L Pressure ulcer, unstageable, lt.lower back RB Map L89.1xx Many, many more! 15 GEM Flag: Combination Source: Iatrogenic pulmonary embolism and infarction ICD10 Target T80.0xxA Description Approx No Map Air embolism following infusion, transfusion, therapeutic injection, initial encounter I26.90 Septic pulmonary embolism without acute cor pulmonale I26.99 Other pulmonary embolism without acute cor pulmonale Comb Scenario Choice The Combination Flag: code 1 means it takes more than one target code to satisfy all the meaning of the source code. Business rule: Do you want to capture all choices or are you limited to one choice? 16 8
9 GEM Flag: Example of Combination Clusters Scenario Choice ICD-10 Description 1 1 T80.0xxA Air embolism following infusion, transfusion, therapeutic injection, initial encounter 1 2 I26.90 Septic pulmonary embolism without acute cor pulmonale Scenario Choice ICD-10 Description 1 1 T80.0xxA Air embolism following infusion, transfusion, therapeutic injection, initial encounter 1 2 I26.99 Other pulmonary embolism without acute cor pulmonale Source: Iatrogenic pulmonary embolism and infarction 17 Diagnosis Mapping Example Severe Sepsis with septic shock 3 codes ICD-9-CM Unspecified septicemia (Infection) Severe sepsis (Condition) Septic shock (Condition) 2 codes ICD-10-CM A41.9 Sepsis, unspecified organism (Infection) R65.21 Severe sepsis with septic shock (Condition) ICD-10-CM has more combination codes. Condition + Site/Symptom + Attribute about the diagnosis. 18 9
10 Procedure Mapping Example Partial Gastrectomy with anastomosis to jejunum 1 code ICD-9-CM (volume 3) 43.7 Partial gastrectomy with anastomosis to jejunum 2 codes ICD-10-PCS 0DB60ZZ 0D160ZA Excision of stomach, open approach Bypass stomach to jejunum, open approach ICD-10-PCS will not have combination codes. Every objective and approach must have a separate code for each site. 19 Vague ICD-9-CM Procedure Procedure on single vessel Beware! 1 code ICD-9-CM Procedure on single vessel Codes ICD-10-PCS (1,156 distinct codes on every vessel) Dilation on vessels in heart and aorta (left, right, bilateral) Dilation on arteries in upper extremities & upper diaphragm Dilation on arteries in lower extremities & below diaphragm Dilation on veins in upper extremities & upper diaphragm Dilation on veins in lower extremities & below diaphragm More.. More codes for extirpation and excision on every vessel 20 10
11 Mapping Result: Will require team discussion Mapping did not result in ICD-10-CM codes with coma. ICD-9-CM Description ICD-10-CM Description Hepatitis delta with hepatic coma Hepatitis E with hepatic coma Chronic hepatitis C with hepatic coma B17.0 Acute delta (super) infection of hepatitis B carrier B17.2 Acute Hepatitis E B17.8 Chronic viral hepatitis C Look up in ICD-10-CM codebook for codes with coma. ICD-10-CM Look up in the ICD-10-CM for hepatic coma K72.01 Acute & subacute hepatic failure with coma K72.11 Chronic hepatic failure with coma K72.91 Hepatic failure, unspecified with coma 21 MapIT New Changes: FY 2014 (effective 10/1/2013) Actions Diagnosis or Procedure How many? 83 New codes Diagnosis 0 Deleted codes Diagnosis 9 Description changes Diagnosis 28 Mapping changes - GEM Diagnosis 15 New codes Procedure 7 Deleted codes Procedure 3 Description changes Procedure 8 Mapping changes - GEM Procedure
12 MapIT New Changes: FY 2015 (effective 10/1/2014) Actions Diagnosis or Procedure How many? 211 Mapping Changes Diagnosis Mapping Changes Diagnosis Mapping/Cluster Changes Diagnosis Mapping/Cluster Changes Diagnosis Mapping Changes Procedure Mapping Changes Procedure Mapping/Cluster Changes Procedure Mapping/Cluster Changes Procedure
13 MapIT Output See below You can add rows for your output. 13
14 How to Download MapIT Under Toolkits, go to MapIT Tool MapIT Tool Zip File: Open or Drag and Drop into your folder MapIT_FY_Comp_2_1_120 Click on the above folder and the following will appear MapIT_FY12_2_1_120 (old with three panes) MapIT_FY13_2_1_120 (old with three panes) MapIT_FY15_2_1_120 (new with two panes friendly) 27 How to Run the Application 14
15 Easy Access Wizard create program file name Or Create your own icon 29 Demonstration of MapIT We will map the codes you are most familiar with in your program. Single Lookup You can look up by word or code Batch Lookup I will create text file in the demo Output Excel, Word, PDF 30 15
16 Summary Tool is available and FREE. Easy to map legacy to new codes. Easy to map new codes to legacy. After mapping, it is important To refer to the codebook instruction, coding guidelines and Coding Clinic frequently asked questions, and clinical advisement. To discuss which code(s) would capture the information for your project Allow your team to focus on discussions on which code(s) needed for the project. Allow your program to move forward to other activities: Upgrading system format. Testing ICD-10 codes in the test environment. Create report and compare to the legacy reports. 31 Questions? Mapping Tool is available at: 16
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