SNOMED CT Patient Diagnosis Map inoperative codes to the operative codes with the crosswalk parameter off Map inoperative codes to

Transcription

1 IMS Build September 2015

2 Contents ICD-10 User Guide for EMR... 1 Introduction... 5 Parameters... 5 Set up the Crosswalk parameter... 5 Set the ICD-10 compliance date... 6 Set the default ICD search tab and code type... 8 Set up the display for an ICD code in the diagnosis drop down... 9 Setup Set up the ICD-10 compliance date for an insurance carrier Add the employer insurance Set up the most used ICD-10 codes Add an ICD-10 code Create an ICD-10 template Link a question template with an ICD code Visit Note Global Template Setup Changes in the Diagnosis Window Add ICD codes in the Diagnosis window Add ICD codes from the ICD template Set up ICD codes for Monitor If Visit Note Dashboard Apply the diagnosis code in the Search ICD-9 window Visit Note Check for diagnosis codes compliance Edit visit note from the action toolbar Edit visit note using Allow Edit Enter diagnosis from question templates Copy from template Copy from the previous visit Show Link Visit Note Forms... 41

3 SNOMED CT Patient Diagnosis Map inoperative codes to the operative codes with the crosswalk parameter off Map inoperative codes to the operative codes with the crosswalk parameter on Show the ICD code type in Patient Diagnosis New ICD Search Windows Enhanced Crosswalk Superbill Bill Copy Functionality in Superbill Swap diagnosis codes in Superbill Prescription Copy prescription Add diagnosis codes in Prescription NDC Drug Education View indicated medications based on the current diagnosis code Lab and Interface Diagnostic/Lab on Visit Note Diagnostic/Lab Order Letter Templates Add ICD fields in Letter Template General Modules Changes After the ICD-10 Compliance Date View the ICD codes in the patient chart Check In/Out View the ICD type in Bill Selection from the Reminder screen Referral Tracking Patient Special Search Audit Log Operating Room Record Activities Add ICD codes in Sales Invoice View the ICD codes with ICD types in Dashboard Health Maintenance

4 Utilities CCD, CCDA, and CCR Patient Merge CHDP Form Add ICD codes in PM 160 (CHDP) Cancer Immunotherapy Billing Template Setup Billing Template link with Insurance Patient Information Patient Vaccine/Shot Setup Generate a super bill for a given shot Generate a super bill for Skin Test Reports

5 The International Classification of Diseases (ICD) provides a system for assigning codes to diagnoses and procedures. These codes are used by providers to track health conditions, signs, symptoms, abnormal findings, complaints, and other causes and indicators of injury or disease. The ICD codes have two versions: the ICD-9 and the ICD-10. Everyone who is covered by the Health Insurance Portability Act (HIPAA) needs to transition to ICD-10 diagnosis codes on October 1, 2015, which is the new compliance date. For visits or service offers after October 1, 2015, providers and billing professionals will be required to only use the ICD-10 codes for their diagnoses coding and inpatient procedures coding. IMS supports both ICD-9 and ICD-10 codes and includes a Crosswalk feature for your transition from ICD-9 to ICD-10. This document shows you how to set up the ICD-10 codes and use the Crosswalk feature. To facilitate your transition from ICD-9 to ICD-10, you can set up and use the Crosswalk feature. This feature allows you to display the mapped ICD-9 codes and ICD-10 codes when applying the codes before and after the compliance date. To set the Crosswalk parameters, follow these steps: 1. On the menu bar, click Setup, and then click System Parameters. 5 I C D E M R U p d a t e s

6 2. In the Parameters window, type icd-10 on the filter bar, and then click Filter. 3. From the Value list for the Enable Crosswalks for diagnosis codes in search screens (ICD9 to ICD10 and ICD10 to ICD9) parameter, select Yes. 4. Click Save. Figure 1 In the Parameters window, set up the Enable Crosswalks for diagnosis codes in search screens (ICD9 to ICD10 and ICD10 to ICD9) parameter to enable ICD-10 Crosswalk. In IMS, the default ICD-10 compliance date is 10/01/15. To set the ICD-10 compliance date to one that is different from the default, follow these steps: 1. On the menu bar, click Setup, and then click System Parameters. 2. In the Parameters window, type compliance on the filter bar, and then click Filter. 3. In the ICD-10 Compliance Date (ICD-10 Transition Date) (Modules/Features) parameter Value box, enter your desired date for ICD-10 compliance. 6 I C D E M R U p d a t e s

7 Figure 2 In the ICD-10 Compliance Date (ICD-10 Transition Date) (Modules/Features) parameter Value box, enter your desired date for ICD-10 compliance to set the compliance date. 4. Click Save. Do not change the default date for the ICD-10 Compliance Date (ICD-10 Transition Date) (Modules/Features) parameter. You can only update the ICD-10 compliance date 10/01/15 in testing environments or when the value does not follow the ICD-10 compliance date of CMS. 7 I C D E M R U p d a t e s

8 The ICD-10 Clinical Modification (CM) and ICD-10 Procedure Coding System (PCS) codes will replace the ICD-9-CM codes. You will use ICD-10-CM for diagnoses coding in all your healthcare settings and ICD-10-PCS for coding inpatient procedures in hospital settings. When you search for an ICD-10 code, click a search tab and select either CM, PCS, or Both from the ICD-10 Code Type list. To set up a default search tab and code type that appears in the ICD-10 Search window, follow these steps: 1. On the menu bar, click Setup, and then click User Parameters. 2. In the Parameters window, type icd-10 in the filter box, and then click Filter. 3. From the Value list for the Default value of ICD-10 Search screen while applying diagnosis code (Other) parameter, select the applicable type of ICD tab. Figure 3 In the Parameters window, click the Value list for the Default value of ICD-10 Search screen while applying diagnosis code (Other) parameter to select a default tab type. 4. From the Value list for the Default option for ICD-10 code type (Other) parameter, select the applicable type of ICD code. 8 I C D E M R U p d a t e s

9 5. Click Save. Figure 4 In the Parameters window, click the list for the Default option for ICD-10 code type (Other) parameter to select a default code type. You can set up a notification that allows you to automatically include a diagnosis code in Most Used ICD-ICD 9 Code and display the code in Charge Posting and Charge Posting(Multi.). To do this task, follow these steps: 1. On the menu bar, click Setup, and then click System Parameters. 2. In the Parameters window, type display in the filter box, and then click Filter. 3. Select Yes from the list for the Ask to display the diagnosis in the Most Used ICD list? (Charge Posting) parameter. 9 I C D E M R U p d a t e s

10 4. Click Save. Figure 5 In the Parameters window, click the list for the Ask to display the diagnosis in the Most Used ICD list? (Charge Posting) parameter to set up the display notification for ICD codes. To set up the ICD-10 compliance date for the insurance carrier, follow these steps: 1. On the menu bar, click Setup, and then click Payer/Medical Service/Reference. 2. In the left pane of the Setup Center window, double-click Insurance Carrier. 3. On the Insurance Carrier screen, enter 10/01/15 in ICD-10 Transition Dt. 10 I C D E M R U p d a t e s

11 Figure 6 On the Insurance Carrier screen, set the date in the ICD- 10 Transition Dt* box to 10/01/15 to set up the compliance date of the insurance carrier. 4. Click Columnar View in the right pane. 5. In the Insurance Carrier Columnar View window, set the compliance date in the box under the ICD 10 compliance column, and then click Save. To set the ICD-10 compliance date of multiple insurances, click the Columnar View on the Insurance Carrier screen. Figure 7 You can set up the compliance date in the boxes under the ICD 10 compliance column of the Insurance Carrier Columnar View window. To add an insurance for an employer in IMS, follow these steps: 1. On the menu bar, click Setup, and then click Payer/Medical Service/Reference. 11 I C D E M R U p d a t e s

12 2. In the left pane of the Setup Center window, double-click Employer. 3. On the Employer screen, enter the company details. 4. Select Bill Employer or Both from the Type list. 5. On the action toolbar, click the Save symbol. The system automatically creates an insurance plan for the employer. You can also search for the insurance plan in the Search Insurance Plan window. Figure 8 On the Employer screen, select Bill Employer or Both to create an insurance for an employer. When you select the insurance in the Case Insurance window, the system verifies the ICD-10 transition date of the employer insurance. Figure 9 When you select the employer insurance during charge posting, the system verifies the ICD-10 transition date in the Employer screen. You cannot edit the insurance plan created for an employer. 12 I C D E M R U p d a t e s

13 To create a list of your most used ICD codes, follow these steps: 1. On the menu bar, click Setup, and then select Bill. 2. In the left pane of the Setup Center window, double-click Most Used ICD-10 Code. 3. In the Most Used ICD-10 Code window, enter the ICD code details on the gold bar. To filter codes by description, select Description from the Search list, and then enter the description on the gold bar. 4. Select a code in the left pane, click the right arrow symbol. 5. Select the check box in the D column. 13 I C D E M R U p d a t e s

14 Figure 10 In the Most Used ICD-10 Code window, select the box under the D column to display the code in Charge Posting and Super Bill. Only the selected codes automatically appear in the diagnosis code list. 6. Click Save. You can also select the box in the D column of Most Used ICD-9 Code. 14 I C D E M R U p d a t e s

15 Figure 11 To display the codes from your most used ICD- 9 codes list, select the box under the D column. The ICD-9 Code window and ICD-10 Code window also have the D column. Figure 12 You can also set up to display the code for quick selection in the ICD-10 Code window. To add an ICD-10 code in the Setup Center window, follow these steps: 1. On the menu bar, click Setup, and then click Bill. 2. In the left pane of the Setup Center window, double-click ICD-10 Code. 3. In the ICD-10 Code window, click Add. 15 I C D E M R U p d a t e s

16 Figure 13 You can add an ICD-10 code in the ICD-10 Code window. 4. Enter the ICD-10 code details in the box in the ICD-10 and Description columns. 5. To link the ICD-10 code with an IMS feature, click the Link with symbol. 6. In the Link with window, click the feature that you want to link with the code, and then set up the details in the right pane. 7. Click Save, and then Close. Figure 14 In the left pane of the Link with window, click the IMS feature to set up and link the feature with the ICD-10 code. 8. In the ICD-10 Code window, click Save. 16 I C D E M R U p d a t e s

17 You can use an ICD-10 template to organize your ICD-10 codes. To create an ICD template, do the following: 1. On the menu bar, click Setup, and then select Bill. 2. In the left pane of the Setup Center window, double-click ICD-10 Template. 3. In the ICD-10 Template window, click Add. 4. In the upper-right pane, enter the details of the new template. 5. In the lower-right pane, enter the details of the ICD-10 code, and then click Save. Figure 15 In the ICD-10 Code Template window, fill out the forms in the right pane to create a template for ICD-10 codes. 17 I C D E M R U p d a t e s

18 To associate the code with a patient diagnosis, link an ICD code with the question template of the visit note. To do this task, follow these steps: 1. On the menu bar, click Setup, and then click Visit Note. 2. In the left pane of the Setup Center window, double-click the question template that you want to link with the code. 3. In the left pane of the template window, select a question, and then click Link with. 4. In the left pane of the Link with window, select either ICD-9 or ICD-10. Figure 16 In the template window, select an entry in the left pane, and then click the Link with button to open the Link with window. 5. In the right pane, click the search ICD symbol beside ICD-9 or ICD I C D E M R U p d a t e s

19 Figure 17 In the Link with window, select the ICD code version, and then click the search ICD symbol to open the Search ICD window. 6. In the Search ICD window, enter the ICD details in the Search box, and then click Search. 7. In the Results pane, select an ICD code, click Ok, and then click Save. You can also link an ICD code with a question template in Visit Note. To do this, click the question template in the left pane of Visit Note, and then click Edit Template in the template window. Figure 18 In the template window, click Edit Template to open the setup window of the template and link the template with an ICD code. 19 I C D E M R U p d a t e s

20 There is now an option to add both ICD-9 and ICD-10 codes in the Visit Note Global Template setup. In the Diagnosis window, you can now select ICD-9 or ICD-10 from the list in the ICD Code Type column. Click the red question mark to open the ICD search window, where the default tab lets you access whatever ICD type was selected. To add the most used ICD codes in the Diagnosis window, do the following: 1. On the menu bar, click Setup, and then click Visit Note. 2. In the left pane of the Setup Center window, double-click Global Template. 3. In the left pane of the Global Template screen, click Diagnosis. 4. In the Diagnosis window, click Allow Edit. 5. Click Add to view the Add options: Add Dx Add from Most Used ICD - 9 Add from Most Used ICD I C D E M R U p d a t e s

21 Figure 19 In the Diagnosis window, click Add to view the Add options. 6. Select either Add from Most Used ICD - 9 or Add from Most Used ICD In the Select ICD - 9 or the Select ICD - 10 window, select the ICD codes that you want to add, and then click Ok. 21 I C D E M R U p d a t e s

22 Figure 20 In the Select ICD - 10 window, select the ICD code that you want to add, and then click Ok to add the code in the Diagnosis window. 8. In the Diagnosis window, click Ok. To add ICD codes from the ICD template, do the following: 1. On the menu bar, click Setup, and then click Visit Note. 2. In the left pane of the Setup Center window, double-click Global Template. 3. In the left pane of the Global Template screen, click Diagnosis. 4. In the Diagnosis window, click Allow Edit. 22 I C D E M R U p d a t e s

23 5. Click Add from Template to view the Add from Template options: Add from ICD 9 Template Add from ICD 10 Template Figure 21 In the Diagnosis window, click Add from Template to view the Add from Template options. 6. Select either Add from ICD - 9 Template or Add from ICD -10 Template. 7. In the left pane of the ICD-9 Templates or the ICD-10 Templates window, click the plus sign to expand the template categories, and then click the template that you want to add. 8. In the right pane, select the check box of the ICD codes that you want to add, and then click Ok. 23 I C D E M R U p d a t e s

24 Figure 22 In the right pane of the ICD-10 Templates window, select the check box of the ICD codes that you want to add to the Diagnosis window. 9. In the Diagnosis window, click Ok. To set up ICD codes to monitor in Monitor If, do the following: 1. On the menu bar, click Setup, and then click Visit Note. 2. In the left pane of the Setup Center window, double-click any of the question template options. 3. In the left pane of the question template window, select a question template. 4. Click Monitor If. 5. In the Diagnosis tab of the Monitor question template if window, select ICD-9 or ICD-10 in the ICD Code Type column, and then do any of the following: Enter the operative ICD code in the ICD & Description column. 24 I C D E M R U p d a t e s

25 Figure 23 In the Monitor question template if window, enter the operative ICD code in the ICD & Description column. Click the question mark in the column header to open the Search operative ICD code type window and search for the ICD code. 6. Click Save, and then click Close. The following are changes in the Dashboard window of Visit Note: In Dashboard, the compliant ICD type appears in the bracket beside the Active Diagnosis dashlet header. Figure 24 In Dashboard, the compliant ICD type appears in the bracket beside the Active Diagnosis dashlet header. 25 I C D E M R U p d a t e s

26 In the Flowsheet Category window, you can click the Dx symbol to use the ICD Type filter and select All, ICD-9, ICD-10 CM, or ICD-10 PCS in the Search Diagnosis window. To access the Flowsheet Category window, click Setup > click Visit Note > double-click Flowsheet > click Add/Edit Category. When applying the diagnosis code for Visit Note, SuperBill, and Charge Posting, the system checks the service date and ICD-10 compliance date, and then displays the compliant diagnosis code. To apply a code, do the following: 1. Search for the applicable ICD code in any of the following: Patient Diagnosis. In the Patient Diagnosis window, click the red question mark beside ICD & Description. Figure 25 In the Patient Diagnosis window, click the search ICD symbol beside ICD & Description to open the Search ICD-9 window. 26 I C D E M R U p d a t e s

27 To open the Patient Diagnosis window, click Visit Note > Diagnosis. Superbill. In the Superbill window, click the red question mark beside Diagnosis (ICD). Figure 26 In the Super Bill window, click the search ICD symbol beside Diagnosis (ICD) to open the Search ICD-9 window. Charge Posting. On the Charge Posting screen, click the red question mark beside Diagnosis* (ICD). Figure 27 On the Charge Posting screen, click the search ICD symbol beside Diagnosis* (ICD) to open the Search ICD-9 window. 2. In the Search ICD-9 window, click the ICD 9 to 10 tab. 3. Select the type of code from the ICD-10 Code Type list. 27 I C D E M R U p d a t e s

28 You can set the default code type in Setup. For instructions about how to set the default code type, see Set the default ICD search tab and code type. 4. In the search box, enter the comma and ICD-9 code. To search by description, enter the backslash and ICD-9 description. 5. Click Search. 6. In the left pane, select an ICD-9 code. The Crosswalk window appears only if the Enable Crosswalks for diagnosis codes in search screens (ICD-9 to ICD-10 and ICD-10 to ICD-9)? (Modules/Features) parameter is set to Yes. 7. In the right pane, select the corresponding ICD-10 code, and then click Ok. 28 I C D E M R U p d a t e s

29 Figure 28 In the Search ICD-9 window, click the ICD-9 code and the corresponding ICD-10 code to apply the code. If you manually enter the ICD-9 code or select the code from the list under ICD, the Select ICD-10 window appears. Figure 29 In the Select ICD-10 window, select the ICD-10 code to apply the diagnosis code. To apply the code, select the corresponding ICD-10 code, and then click Ok. If you enter a diagnosis code that is not in the database, the ICD-9 Code window appears. Add the code, click Save, and then apply the new code in the Search ICD-9 window. 29 I C D E M R U p d a t e s

30 Figure 30 You can add the diagnosis code in the ICD-9 Code window. If you enter an ICD-9 code that is not included in your list of most used ICD-9 codes, a notification appears. Click Yes to include the diagnosis code in Most Used ICD-9 Code and set the code for automatic display in Charge Posting. Click No to include the diagnosis code in Most Used ICD-9 Code without setting it up for automatic display. Figure 31 If you entered an ICD-9 code that is not included in the Most Used ICD-9 Code, the display notification appears. 30 I C D E M R U p d a t e s

31 The system now checks the visit note records for ICD-10 compliance. Specific details are mentioned in the sections that follow. The following are checks that the system performs with compliance dates for diagnosis codes in the Visit Note screen: First check case insurance. The system checks if the case attached to the visit note has an insurance, compares the compliance date of the active case insurance with the visit date, and then sets the compliance diagnosis code type of the visit note. When you select an employer in the case insurance, and the employer insurance is selected as the case insurance, then the check will happen with the transition date of the employer. Second check patient insurance. If no case insurance is found for a patient, the system checks for the active primary insurance of the patient, compares the transition date of the insurance with the visit note date, and then sets the compliance diagnosis code type of the visit note. Third check system parameter. If case insurance and patient insurance does not exist, the system compares the value of the ICD-10 Compliance Date (ICD-10 Transition Date) (Modules/Features) parameter with the visit note date, and then sets the compliance diagnosis code type of the visit note. 31 I C D E M R U p d a t e s

32 The system checks for the compliance of the diagnosis when the following situations happen: A new visit note is created. An existing visit note is retrieved from the system and is already in Edit mode. The Edit symbol opened. is clicked from the action toolbar after a visit note is You click Allow Edit in a question template, in the Note window, or any place other than the Visit Note menu or toolbar. You enter the correct sign-off password while signing off a visit note. You change the visit note date in the General window. Figure 32 In the General window, change the date in the Date box for the system to check for the compliance of the diagnoses. 32 I C D E M R U p d a t e s

33 When you click the Edit symbol on the action toolbar, the following situations happen: If the existing operative codes and compliant diagnosis are the same, then the operative and inoperative diagnosis codes are shown as they are in the applicable locations in the interface. If the existing operative codes and compliant diagnosis are not the same, and if the compliant diagnosis codes exist as inoperative codes for the visit note, a confirmation message appears with the option to open the Diagnosis window. If the existing operative codes and compliant diagnosis are not the same, and if the compliant diagnosis code does not exist as inoperative diagnosis for the visit note, a confirmation message appears with the option to open the Diagnosis window. The message Warning: Non compliant diagnosis codes found in Patient Diagnosis. The compliant diagnosis code type for the selected visit note is ICD-10 where the type of current active code is ICD-9. Please open the Diagnosis window to set proper diagnosis codes. appears. Select Yes, Open Diagnosis Window to change the diagnosis codes or select No, I will do it later to leave the action for a later time and continue working on the visit note. The scenarios mentioned above also happen in the following cases: When the date is changed in the General window. If a signed off visit note is made editable and the correct password is entered. 33 I C D E M R U p d a t e s

34 In the left pane of the Visit Note screen, if you click any of the question templates, and then click Allow Edit, the following scenarios happen: If the existing operative codes and compliant diagnosis are the same, then the operative and inoperative diagnosis codes are shown as they are in the applicable locations in the interface. If the existing operative codes and compliant diagnosis are not the same, and if the compliant diagnosis codes exist as inoperative codes for the visit note, then the message Warning: Non compliant diagnosis codes found in Patient Diagnosis. The compatible diagnosis code type for the selected visit note is ICD- 9 where the type of current active diagnosis is ICD-10. Please open the Diagnosis window to set proper diagnosis codes. appears. Click Ok to continue working on the visit note. The applicable lists loads the patient diagnosis of only the current operative code type of the visit note in the following: Patient diagnosis Multi. Patient diagnosis Referral diagnosis 34 I C D E M R U p d a t e s

35 To use the Copy Template option, do the following: 1. In the right pane of the Visit Note screen, click Copy Template. 2. In the left pane of the Select Template window, select the template that you want to copy. Figure 33 In the left pane of the Select Template window, select the template that you want to copy. 3. Click Deselect All. 4. In the right pane, select the Diagnosis check box. 5. Click Copy. 35 I C D E M R U p d a t e s

36 6. In the Select Dx, Rx, Careplan, Lab, CPT, Immunization or Followup window, select the ICD codes that you want to add in the visit note. Figure 34 In the Select Dx, Rx, Careplan, Lab, CPT, Immunization or Followup window, select the ICD codes that you want to add in the visit note. In the Select Dx, Rx, Careplan, Lab, CPT, Immunization or Followup window, only the compliance ICD codes will appear in the selection. 7. Click Ok. 8. When the window for mapping inoperative ICD codes appear, select the appropriate ICD codes, and then click Ok. 36 I C D E M R U p d a t e s

37 The crosswalk parameter should be on for the ICD mapping window to appear. In Visit Note, the previous visit can have either ICD-9 or ICD-10 codes in Diagnosis, Pt. Dx, Mult. Pt. Dx, and Ref. Dx. If operative and inoperative codes of the current visit and the previous visit are the same, then the system only copies the data as they are and does not process anything else. Figure 35 In the right pane of Visit Note, click Copy Prv. Visit to open the Copy From Previous Visit Note window. 37 I C D E M R U p d a t e s

38 If the operative diagnosis code of the current visit is ICD-10, then the following scenarios occur: If the previous visit has ICD-9 as operative codes and ICD-10 as inoperative codes, then the system copies both ICD-9 and ICD-10 codes, but it will set ICD- 10 as operative and ICD-9 as inoperative. If the previous visit has ICD-9 as operative and has no ICD-10 selected as inoperative codes, then the system copies the ICD-9 codes as inoperative. The following are the changes in the Show Link option: In the Link with question name setup window, ICD-9 and ICD-10 are in the Linked To pane. Figure 36 In the Link To pane of the Link with question name window, select ICD- 9 or ICD-10 to link the questions to. 38 I C D E M R U p d a t e s

39 Basing on the Link with setup, the system checks for the compliant diagnosis codes of the visit note and shows the said diagnosis only in the window that you open using the Show Link option. In the Select Suggested Options window, only the compliant diagnosis of the visit note appears. Figure 37 In the Select Suggested Options window, only the compliant diagnosis of the visit note appears. In the Show Link window, the label for diagnosis appears according to the operative diagnosis codes. 39 I C D E M R U p d a t e s

40 When you select a diagnosis and click Ok while the crosswalk parameter is enabled, then the following situations will happen: o The window where you can map codes appears, where you can access the list of mapping inoperative codes for each of the operative ones that will be added to the diagnosis in the visit note. o The mapping list window shows the mapping list only with the diagnoses that you selected in the Show Link window. You can select one or more inoperative codes from the list for the operative diagnosis. If the current operative codes are ICD-9 and the inoperative codes are ICD-10, then CM and PCS appear as options in the ICD-10 Code Type list. If you click Cancel, then no inoperative codes are set for the visit note. If you click Ok, then the system copies the selected inoperative codes of the operative ones in the visit note. In the (N)on-Compliant Diagnosis tab of the Patient Diagnosis window, selected inoperative codes are saved for the visit note along with corresponding operative ones in the (A)ctive Diagnosis tab. Billing priority for the inoperative codes are set on a first-come-first-served basis, which means that the first inoperative code is the primary, second inoperative code is secondary, and so on. 40 I C D E M R U p d a t e s

41 The following are changes in the Visit Note forms: On the Visit Note screen, when users open any visit note form, the system loads the operative diagnosis codes of the visit note; and the diagnosis code, description, and type fields are selected. The system then replaces the appropriate data on the forms. Inoperative codes will not be displayed anywhere in the forms. The system now displays the code type of the operative diagnosis. Figure 38 In the Visit Note forms, the system now displays the code type of the operative diagnosis. 41 I C D E M R U p d a t e s

42 The following are changes in the features related to the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT): In the Patient Snomed CT window, the Dx symbol box. is added beside the ICD When you click Dx, you can select either ICD-9 or ICD-10. You can only select one operative and one inoperative diagnosis code for SNOMED CT. You can now link operative and inoperative diagnosis codes for a single SNOMED CT. The operative diagnosis appears in the Patient Snomed CT window based on the compliance date of the visit note. If you try to override the operative or inoperative diagnosis, a message appears; and based on your selection, the system overrides or keeps the diagnosis as it is for SNOMED CT. In the Patient Snomed CT window, the selected operative diagnosis appears in the ICD box of the (A)active Snomed CT tab. 42 I C D E M R U p d a t e s

43 Figure 39 In the Patient Snomed CT window, the selected operative diagnosis appears in the ICD box of the (A)ctive Snomed CT tab. In the Patient Diagnosis window, the mapped ICD codes added from SNOMED CT appears in the (N)on-Compliant Diagnosis tab. In the SnomedCT tab of the Reconciliation window, the Dx symbol beside the ICD box. appears 43 I C D E M R U p d a t e s

44 Figure 40 In the SnomedCT tab of the Reconciliation window, the Dx symbol appears beside the ICD box. The following are changes in Patient Diagnosis: In the Patient Diagnosis window, the templates for the operative diagnosis codes now appear in the left pane. 44 I C D E M R U p d a t e s

45 Figure 41 In the Patient Diagnosis window, the left pane now displays the templates for operative diagnosis codes. In the (A)ctive Diagnosis tab, only the operative codes appear. Based on the operative codes, either ICD-9 & Description or ICD-10 & Description appears as a new column header. Figure 42 In the (A)ctive Diagnosis tab, based on the operative codes, ICD-9 & Description or ICD-10 & Description are the new column headers. The Dx symbol is for mapping the inoperative codes to the operative codes. They appear in the (N)on-Compliant Diagnosis tab. 45 I C D E M R U p d a t e s

46 In the lower pane of the Patient Diagnosis window, the (N)on-Compliant Diagnosis tab is added. It shows the inoperative diagnosis codes mapped to the operative diagnosis codes in the (A)ctive Diagnosis tab. Figure 43 In the lower pane of the Patient Diagnosis window, the (N)on-Compliant Diagnosis tab is added to show the inoperative diagnosis codes mapped to the operative diagnosis codes in the (A)ctive Diagnosis tab. When the compliance date of a visit note changes, the operative and inoperative codes are swapped. If there are no inoperative codes mapped for one or more operative diagnosis codes in the visit note after the date changed, then the window appears where you can select the appropriate codes. 46 I C D E M R U p d a t e s

47 Figure 44 In the Select ICD-10 Mapping Code(s) window, select the appropriate ICD-9 codes to map with the ICD-10 codes, and then click Ok to show the diagnosis codes in the Patient Diagnosis [Patient: name Age: age] window. For example, if a visit note is created before the compliance date, you can change the creation date to a date on or after the compliance date. When the Diagnosis window is opened, the message Non compliant diagnosis codes found in active diagnosis list. The compatible diagnosis code type for the selected visit note is ICD-10 while the type of current active diagnosis codes in the visit is ICD-9. The existing diagnosis codes will be made non-compliant. The codes which already had mapping codes selected will be replaced by already mapped compatible diagnosis codes and for the remaining you will have to select ICD-10 codes from the list of mapping to add them as active diagnosis. Please review the diagnosis codes and their priorities after they are updated to the list active diagnosis codes. Press Yes to continue or No to cancel the action. appears. Click Yes to swap the codes. Click No to return to the Visit Note screen. The message consistently appears until the codes are swapped. 47 I C D E M R U p d a t e s

48 In the Type column of the (A)ctive Diagnosis tab, if Problem is selected instead of ICD, the Dx symbol does not appear. In the Billing column of the (A)ctive Diagnosis tab, the priorities for billing are Primary, Secondary, Tertiary, Quaternary, and Other. The billing priority values cannot be duplicated, except when you select Other. In the Patient Diagnosis History window, the ICD Type column shows either ICD- 9 or ICD-10 as types of ICD codes. When you click Mark as No Known Problem in the Patient Diagnosis window, all the operative and inoperative diagnosis codes become inactive. In the (T)his Visit tab of the Patient Diagnosis window, the operative ICD code type & Description column appears and only displays the operative diagnosis. The Link SnomedCT symbol appears only in the (A)ctive Diagnosis and the Non-compliant Diagnosis tabs. If you click the Link SnomedCT symbol, the Select SnomedCT for ICD-operative code type ICD code window that has all of the mappings for that particular ICD code appears. 48 I C D E M R U p d a t e s

49 Figure 45 In the Patient Diagnosis window, click the Link SnomedCT symbol to open the Select SnomedCT for ICD-operative code type ICD code window. To map the operative codes to the inoperative codes with the crosswalk parameter off, follow these steps: 1. In the left pane of the Visit Note screen, click Diagnosis. 2. In the (A)ctive Diagnosis tab of the Patient Diagnosis window, click Add. 49 I C D E M R U p d a t e s

50 Figure 46 In the (A)ctive Diagnosis tab of the Patient Diagnosis [Patient: name Age: age] window, click Add to add a new diagnosis code row. 3. In the ICD-9 & Description column, click the red question mark beside the column header to search for and select the appropriate ICD-9 codes. 4. Click the Dx symbol. 5. In the Mapped ICD-10 Code(s) window, select the operative code from the drop-down list in the ICD-9 Code column. Figure 47 In the Mapped ICD-10 Code(s) window, select the operative code from the drop-down list in the ICD-9 column to designate the diagnosis code for mapping. 50 I C D E M R U p d a t e s

51 6. Enter the inoperative code in the ICD-10 Code column or click the red question mark to search for and select the ICD-10 codes. If ICD-10 is the inoperative code, then the Search ICD - 10 window opens and will only let you search for ICD-10 codes. 7. Click Ok. To map the operative codes to the inoperative codes with the crosswalk parameter on, follow these steps: 1. In the left pane of Visit Note, click Diagnosis. 2. In the (A)ctive Diagnosis tab of the Patient Diagnosis window, click Add. 3. In the ICD-9 & Description column, click the red question mark beside the column header to search for and select the ICD-9 codes. Figure 48 In the ICD-9 & Description column, click the red question mark beside the column header to search for and select the ICD-9 codes. 51 I C D E M R U p d a t e s

52 4. In the ICD 9 To 10 tab of the Search ICD-9 window, enter the ICD-9 code in the ICD-9 (, ) box on the gold bar, and then click Search. 5. In the left pane, select the operative code, select the corresponding inoperative code in the right pane, and then click Ok. Figure 49 In the left pane of the Search ICD-9 window, select the operative code, and then select the corresponding code in the right pane, and then click Ok to add the codes to the diagnosis. The same process applies if ICD-10 is the operative code and ICD-9 is the inoperative code. To show the ICD code type in the middle pane of Visit Note, do the following: 1. On the menu bar, click Setup, and then click Visit Note. 52 I C D E M R U p d a t e s

53 2. In the Setup Center window, double-click Options (Left Frame). 3. In the Visit Note Options (Left Frame) window, click the Layout symbol in the Diagnosis row. 4. In the Layout for Visit/Letter (Diagnosis) window, click Column. 5. Click ICD Code Type, and then click Save. Figure 50 In the Layout for Visit/letter (Diagnosis) window, click Column, then click ICD Code Type, and then click Save to add the ICD code type in the middle pane of Visit Note. 6. In the Visit Note Options (Left Frame) window, click Save, and then click Close. You can use the following ICD search windows when selecting a diagnosis code: Search ICD-9. A single search tab appears on the Search ICD-9 window if the crosswalk parameter is not enabled. 53 I C D E M R U p d a t e s

54 Figure 51 If the crosswalk parameter is not enabled, the Search ICD-9 window only displays the ICD 9 tab. Search ICD-9. The ICD 9 and ICD 9 To 10 tabs appear on the Search ICD-9 window if the crosswalk parameter is enabled. Click ICD 9 tab to search ICD-9 codes, and click the ICD 9 To 10 tab to view the mapped ICD codes. Figure 52 If the crosswalk parameter is enabled, the Search ICD-9 window displays the ICD 9 and ICD 9 To 10 tabs. Search ICD-10. The Search ICD-10 window allows you to search only ICD-10 codes if the crosswalk parameter is not enabled. Figure 53 If the crosswalk parameter is not enabled, the Search ICD-10 window displays the ICD-10 tab only. Search ICD-10. The ICD 10, ICD 9 To 10, and ICD 10 To 9 tabs appear on the Search ICD-10 window if the crosswalk parameter is enabled. 54 I C D E M R U p d a t e s

55 Figure 54 If the crosswalk parameter is enabled, the Search ICD-10 window displays the ICD 10, ICD 10 To 9, and ICD 9 To 10 tab. Click the ICD 10 tab to search only the ICD-10 codes, or click either ICD 9 To 10 or ICD 10 To 9 to search the mapped ICD codes. For instructions about how to enable the Crosswalk feature, see Set up the Crosswalk parameter. Click Save. The following are changes related to the enhanced crosswalk for diagnosis codes: The following windows are affected with the enhanced crosswalk: o ICD-9 To 10 diagnosis search window tab. o Select ICD-10 window that appears when ICD-9 codes are applied manually or selected from the drop-down list. o ICD-10 To 9 diagnosis search window tab. o Select ICD-10 window that appears when ICD-10 codes are applied manually or selected from the drop-down list. o ICD-9 To 10 mapping Tree View window. 55 I C D E M R U p d a t e s

56 o ICD-10 To 9 mapping Tree View window. o ICD-10 Setup Utility select diagnosis window. The results for equivalent mapping codes are enhanced by collating the results for both forward and backward mapping. If the same result is available for forward and backward mapping, then only one and not two records are shown in the results pane. The following are changes related to Superbill: When the system retrieves the operative codes from the Patient Diagnosis window of the Visit Note into Superbill, it also retrieves the mapped inoperative codes from the Patient Diagnosis window. The priority field of the inoperative diagnosis codes are also included. If the bills require a different version of operative codes from where you are copying, a confirmation message appears. If you click Yes, only the CPT codes are copied but not the diagnosis codes. If you click No, then you need to manually add the CPT codes. If you successfully copy the CPT codes, then the mapped inoperative and operative codes are also copied. 56 I C D E M R U p d a t e s

57 The following are changes related to the bill copy functionality in Superbill: In the Billed pane of the Super Bill window, the ICD Type column is added. The ICD Type column shows the operative version of the diagnosis code selected in the bill. To open the Super Bill window, click Activities > Visit Note > Super Bill. If you right-click an entry in the Diagnosis (ICD) column, the options Copy Bill and Copy Service Date appear. When you select either of these options, the system retrieves both the operative version and the inoperative mapped ICD codes. If the operative version of the diagnosis code in the super bill does not match with the operative version that you are about to add to the new bill, the message IMS has detected that ICD-operative ICD version codes are required in the superbill based on the Visit Date and Insurance/System ICD-10 compliance date. The ICD-inoperative ICD version codes will not be copied into the superbill. Click Ok to continue. appears. To avoid copying the ICD to the new bill, click Ok. To avoid copying the whole charge, click Cancel. In the Billed window, the ICD Type column is added. To open the Billed window, click Activities > Visit Note > Super Bill > Copy. In Billed, if you select an entry, and then click Select, then the system retrieves both the operative version and the inoperative mapped ICD codes, and then applies them in the super bill. 57 I C D E M R U p d a t e s

58 If the operative version of the diagnosis code in the bill does not match with the operative version of the diagnosis code to be added to the super bill, then the message IMS has detected that ICD-operative ICD version codes are required in the superbill based on the Visit Date and Insurance/System ICD-10 compliance date. The ICD-inoperative ICD version codes will not be copied into the superbill. Click Ok to continue. appears. Click Ok so that the ICD codes of the bill are not retrieved from the Charge Posting window. Click Cancel to return to the Billed window. IMS can now swap the mapped inoperative codes with the operative version of the diagnosis codes in any screen or window that supports the mapping of inoperative diagnosis codes. You can still swap the codes even if the compliant version of the diagnosis code does not match with the operative one. Diagnosis code swapping is also enabled in Case master, UB Options, Charge Posting, and CHDP. The following are the conditions to swap the operative and inoperative codes in Superbill: You open any window that is in the editable mode and supports the inoperative diagnosis. The current compliant version of the diagnosis code does not match the operative version already selected in the current window. 58 I C D E M R U p d a t e s

59 If the conditions mentioned above are met, then the following scenarios apply: When you map one operative diagnosis code: o The operative code is moved into the inoperative code mapping window. The priority of the moved code is set to Primary. o The mapped inoperative code with the highest priority is moved into the operative code field. o The operative code column of the Mapped ICD-operative code type Code(s) window shows the current operative code that is moved out of the inoperative code mapping window. o If there is no inoperative diagnosis code that was mapped before the swap, then the operative code column of the Mapped ICD-operative code type Code(s) window shows None after the swap. The previous operative code is added in the inoperative code field. The operative diagnosis code field is left blank. When you map multiple operative diagnosis codes: o All of the operative diagnosis codes are moved into the inoperative code mapping window. o The priority of the moved operative code is based on its position in the operative code field. The first operative code is Primary, the second operative code is Secondary, the third operative code is Tertiary, the fourth operative code is Quaternary, and the next succeeding operative codes are Other. o The priority field of the mapped diagnosis codes affects the priority and positions of the diagnosis codes that are moved in the operative code field. 59 I C D E M R U p d a t e s

60 o The mapped inoperative code with the highest priority is moved into the highest position of the operative code field. o The mapped codes in addition to n is not considered while moving into the operative code field. N is the maximum number of diagnosis codes in Super Bill and Charge Posting. Currently, n is equal to eight diagnosis codes. When swapping diagnosis codes, only the first eight inoperative diagnosis codes will go into the operative field based on priority set for the inoperative codes. o Duplicate mapped inoperative codes are not moved into the operative code field. o The current operative code is moved to the inoperative code filed. The operative code with the highest position is assigned with the highest priority. o If no operative diagnosis code is mapped before the swap, then the operative code column of the Mapped ICD Code window shows None after the swap. The operative diagnosis code field is left blank. When the confirmation message related to the swap of the diagnosis code appears and you proceed with the swap, the crosswalk window opens and shows the list of applicable ICD-10 codes for each ICD-9 code. You need to meet the following conditions before this window can be accessed: o The total number of unique inoperative diagnosis codes that are already mapped are less than eight. 60 I C D E M R U p d a t e s

61 o There is at least one operative code without an inoperative code mapped to it. o The operative code that does not have an inoperative code mapped to it has at least one mapping code in the crosswalk mapping file. The requirements mentioned above are also applicable to swapping in PM 160 (CHDP) and UB Options. If there are n inoperative codes already mapped for a diagnosis code, then the crosswalk window will allow the user to select only eight minus n number of codes. In the crosswalk window, the diagnosis codes of multiple CPTs are swapped together from Superbill. The diagnosis codes are grouped by CPTs. The point mentioned above also applies to the diagnosis code swap on Charge Posting, Case master, and when fetching super bills into Charge Posting. If the diagnosis codes entered are ICD-9 codes and the active primary insurance does not support ICD-9 codes based on the ICD-10 transition date, then the message Non compliant diagnosis codes found in the superbill. The compliant diagnosis code type is ICD-current compliant version while the type of selected operative diagnosis codes in the superbill is ICD-current operative code. The existing ICD-current operative version codes will be moved into the inoperative diagnosis mapping window. The ICD-current operative version codes which had mapping codes selected will be replaced by already mapped ICD-current complaint codes. Please review the diagnosis codes and their priorities after they are updated. Click OK to continue or Cancel to proceed without any 61 I C D E M R U p d a t e s

62 changes. appears. Click OK to swap the diagnosis codes selected for the charges. Click Cancel to avoid swapping the diagnosis codes already entered in the super bill. For partially or completely billed super bills, the message does not appear and no diagnosis code swap is required. The following are changes in Prescription: Prescription is now compatible with ICD-10. Surescripts considers the Written Date in the XML message as the Prescribe date in IMS. So, if the Written Date on the prescription message is on or after the compliance date, then ICD-10 codes will be used. ICD-10 diagnosis codes can now be sent in the XML message. Only two ICD-9 and two ICD-10 codes can be sent in the XML message. The prescription s code type depends on the prescribe date and the system parameter for the compliance date. If the prescribe date is before the compliance date, ICD-9 will be the operative diagnosis code type in Prescription. On or after the compliance date, the diagnosis code type becomes ICD-10. The checks are done in the following scenarios: o A new Add Rx window is opened. o The prescription is copied using the Copy function in the right pane of Prescription. o Prescribe date is changed manually. 62 I C D E M R U p d a t e s

63 o The prescription is changed using Chg. in the right pane of Prescription. In the Prescription screen, the compliant ICD code will depend on either the date in Prescribe or the date in the Last Appr. section, whichever is the most recent one. To view the Prescription window, click Activities > Prescription > Entry. If you select ICD-9 diagnosis codes for the prescription and if the compatible code type of the diagnosis is also ICD-9 after the check, then no change is needed. This is also applicable if the operative diagnosis code type is ICD-10. If you select ICD-9 diagnosis codes for the prescription and if the compatible code type of the diagnosis is ICD-10 after the check, then the message The selected Prescription requires ICD-10 codes as diagnosis codes. The existing ICD-9 codes in the diagnosis section will be removed from diagnosis list, and you will be required to enter ICD-10 codes manually appears. The content in the Dx box is removed, and you are required to enter the operative ICD codes. Click OK. 63 I C D E M R U p d a t e s

64 Figure 55 In the message window, click OK to begin entering the operative codes in the Dx box. If you approve a selected prescription in the Prescription window, and the compliant diagnosis codes do not match with the diagnosis code selected, the message The selected prescription consists of ICD-non-compliant diagnosis code type codes while the late approval date (written date) has been set to a date on or after the ICD-compliant diagnosis code type compliance date. We recommend you to edit the prescription and select ICD-compliant diagnosis code type codes to be added and sent in the prescription. Name of drug appears. Click OK. 64 I C D E M R U p d a t e s

65 Figure 56 In the message window, click OK to go back to the Prescription window. In the Approve/Deny Refill window, if you click either Approve & Print, Approve & Fax or Approve & esend, and the compliant diagnosis codes do not match with the diagnosis code selected, the message The selected prescription consists of ICD-non-compliant diagnosis code type codes while the late approval date (written date) has been set to a date on or after the ICD-compliant diagnosis code type compliance date. We recommend you to edit the prescription and select ICD-compliant diagnosis code type codes to be added and sent in the prescription. Name of drug appears. Either click OK to be return to the Prescription screen and add new diagnosis codes or click Cancel to return to the Approve/Deny Refill window. Figure 57 In the message window, click OK to go back to the Prescription screen and add new diagnosis codes. 65 I C D E M R U p d a t e s

66 When you copy a prescription, the system checks the compatible diagnosis code of the new prescription. The diagnosis codes are also copied only if the compatible diagnosis codes of the new prescription are the same as the one that is being copied. To add diagnosis codes in Prescription, follow these steps: 1. On the menu bar, click Activities, and then click Prescription. 2. In the upper pane of the Prescription screen, do any of the following: Enter the diagnosis code in the Dx box. Click the question mark beside Dx to search for and select the appropriate code in the Select Patient Diagnosis (operative ICD type) window. Figure 58 In the Select Patient Diagnosis (operative ICD type) window, select the diagnosis that you want to add, and then click Ok for the codes to appear in the Dx box. 66 I C D E M R U p d a t e s

67 3. On the action toolbar, click Save. In the Rx Summary window, the ICD codes that were added from Prescription appears in Patient Dx. Figure 59 In the Rx Summary window, the ICD codes that were added from Prescription appears in Patient Dx. The following are changes in NDC Drug Education: In the Indication and Contra Indication windows, you can click the links in the ICD-9 and ICD-10 columns to open the ICD-9 Codes and the ICD-10 Codes windows. 67 I C D E M R U p d a t e s

68 Figure 60 In the Indication window, click the link in the ICD-9 or ICD-10 column to view the ICD codes lists. In the ICD-9 Codes and the ICD-10 Codes windows, there are two columns: o ICD code column. The ICD code column shows the ICD code. o ICD description column. The ICD description column shows the detailed description of the ICD code. Any module in the system that shows Drug Education Indication and Contra- Indication has separate ICD-9 and ICD-10 columns that are linked with the ICD information windows. 68 I C D E M R U p d a t e s

69 Figure 61 In the ICD-9 Codes window, the ICD-9 information is shown in the ICD-9 and ICD-9 Description columns. View the drug information while writing a prescription. To view the drug information while writing a prescription, follow these steps: 1. On the menu bar, click Activities, and then click Visit Note. 2. In the left pane of the Visit Note screen, click Prescription. 3. In the Add Drug pane of the Add Prescription window, enter the name of the drug in the Drug column. 4. Click the Drug Education symbol beside Drug. 69 I C D E M R U p d a t e s

70 Figure 62 In the Add Drug tab of the Add Prescription [Patient: name Age: age] window, click the Drug Education symbol to open the Drug Information (drug name) window. 5. In the left pane of the Drug Information (drug name) window, click either Indication or Contra-indication. 6. In the Indication and Contra-Indication tabs, click the links in the ICD-9 or ICD-10 columns to view the ICD codes lists. 70 I C D E M R U p d a t e s

71 To view indicated medications based on the current diagnosis code, do the following: 1. On the menu bar, click Activities, and then click Visit Note. 2. In the left pane of the Visit Note screen, click Prescription. 3. In the Prescription window, click Add. 4. In the Add Prescription window, click Show Drug By Patient Dx. 5. In the Indicated Medication (operative ICD code type) window, you can now view the indicated medication based on the current operative diagnosis code. The following are the changes related to Diagnostic/Lab on Visit Note: In the Diagnostic/Lab Order window, the system checks the Date box when you open the window. To open the Diagnostic/Lab Order window, click Activites > Visit Note > Diagnostic/Lab. 71 I C D E M R U p d a t e s

72 Figure 63 In the Diagnostic/Lab Order [Patient: name Age: age] window, IMS checks the Date field when you open the window. When the date that you set in the ICD-10 Compliance Date (ICD-10 Transition Date) (Modules/Features) parameter is before the ICD-10 compliance date, then the ICD values in Dx (1), Dx (2), etc., columns are ICD-9. When the date that you set in the ICD-10 Compliance Date (ICD-10 Transition Date) (Modules/Features) parameter is on or after the ICD-10 compliance date, then the ICD values in Dx (1), Dx (2), etc., columns are ICD-10. If ICD-9 is the operative code type, the following scenarios happen: o When dual diagnosis is disabled, only the operative diagnosis search windows are open and only operative codes are added. o When dual diagnosis is enabled, the diagnosis search windows with Crosswalk are opened. The search window have ICD 9 To 10 and ICD 9 tabs. You can select more than one ICD-10 code with a single ICD-9 code, and the selected ICD-10 codes are shown in the Mapped ICD-10 Code(s) window. 72 I C D E M R U p d a t e s

73 Figure 64 In the Search ICD-9 window with Crosswalk enabled, if dual diagnosis is enabled, you can select more than one ICD-10 code with a single ICD-9 code. If ICD-10 is the operative code type, the following scenarios happen: o When dual diagnosis is disabled, the ICD-10 search windows appear. o When dual diagnosis is enabled, the search window with ICD 9 To 10, ICD 10 To 9, and ICD 10 tabs appears. You can select the corresponding inoperative ICD-9 codes, and the selected codes are shown in the Mapped ICD-9 Code(s) window. o The Dx symbol is available regardless of how you set up the Crosswalk parameter. The Dx symbol has a selection of corresponding mapped inoperative codes connected to each and every selected operative code. 73 I C D E M R U p d a t e s

74 In the lower portion of the Diagnostic/Lab Order window, these labels indicate operative and inoperative codes: o If the codes available for selection are ICD-9 codes, then ICD - 9 are Operative Codes and ICD - 10 are Non - Operative Codes appears. o If the codes available for selection are ICD-10, then ICD - 10 are Operative Codes and ICD - 9 are Non - Operative Codes appears. If an existing visit note has a lab order with a To be Ordered/Ordered/Received status, the system checks either the date of the visit note or the date in the Diagnostic/Lab Order window, and then it generates the appropriate codes. If the date is before the compliance date in the ICD-10 Compliance Date (ICD-10 Transition Date) (Modules/Features) parameter, then you can select ICD-9 codes in the Dx columns and also in the search window. If the date is on or after the compliance date in the ICD-10 Compliance Date (ICD-10 Transition Date) (Modules/Features) parameter, then you can select ICD-10 codes in the Dx columns and also in the search window. If you edit a lab order with a To be Ordered status, the Date box shows the date when the order was originally created, and when adding a new test you can select the ICD code version that was used in the previously entered test. If Date shows a date that is before the compliance date in the ICD-10 Compliance Date (ICD-10 Transition Date) (Modules/Features) parameter, and you enter a date that is on or after the compliance date, then the message The selected codes in the Lab order window are ICD-9 and if you change the date, then the codes will be changed to ICD-10. appears. If Date shows a date that is on or after the compliance date in the ICD-10 Compliance Date (ICD-10 Transition Date) (Modules/Features) parameter, and 74 I C D E M R U p d a t e s

75 you enter a date that is on or after the compliance date, then the message The selected codes in the Lab order window are ICD-10 and if you change the date, then the codes will be changed to ICD-9. appears. Enter ICD codes in Visit Note Diagnostic/Lab Order. To enter ICD codes in the Visit Note Diagnostic/Lab Order window, follow these steps: 1. In the left pane of the Visit Note screen, click Diagnosis/Lab. 2. In the upper-right pane of the Diagnostic/Lab Order window, select the diagnostic or lab order from the Order For drop-down list. 3. In the lower-right pane, select a lab test in the Lab Test column. 4. In the Dx (1) and Dx (2) columns, do any of the following: Click the box to select the operative ICD code from the drop-down list. Click the red question mark beside the column header to search for and select operative ICD codes. Click the arrow symbol is the tooltip for the arrow symbol. in the Dx column to add more diagnosis boxes. Additonal Dx(s) 5. In the Dx column, click the Dx symbol to open the Mapped Inoperative Code Type Code(s) window. Figure 65 In the Dx column, click the Dx symbol to open the window to map the inoperative ICD codes. 75 I C D E M R U p d a t e s

76 6. In the first column, either select an operative ICD code or select None. 7. In the second column, do any of the following: Enter the inoperative ICD code. Click the question mark in the column header to search for and select inoperative ICD codes. 8. Click Ok. 9. In the Diagnostic/Lab Order window, click Save. If the crosswalk parameter is on when you select an operative ICD code from the dropdown list, the window for the corresponding mapped inoperative ICD code automatically appears. The following are changes related to the Diagnostic/Lab Order screen: In the right pane of the Diagnostic/Lab Order screen, you can click Requisition to print the requisition order that have ICD codes based on the compliance date. Figure 66 In the right pane of the Diagnostic/Lab Order screen, users can click Requisition to print the requisition order that will have the ICD codes based on the compliance date. 76 I C D E M R U p d a t e s

77 In the Diagnostic/Lab Order window from the Visit Note and Diagnostic/Lab Order screens, the diagnosis codes in the Dx (1), Dx (2), etc. columns appear based on the Date field. If the date is before the compliance date, then you can select ICD-9 codes from the list. If it is on or after the compliance date, then you can select ICD-10 codes from the list. At the lower portion of the Diagnostic/Lab Order window, ICD - 9 are Operative Codes and ICD - 10 are Non - Operative Codes or ICD - 10 are Operative Codes and ICD - 9 are Non - Operative Codes appears to indicate the operative and inoperative codes. This message is based on the compliance date. If you change the Date in the lab order, and the new lab order date is not in the same phase as the existing date, then the message The selected operative Diagnosis codes will be replaced by the respective inoperative codes. appears. Click Yes to replace the operative codes with the inoperative codes. Click Cancel to return to the Diagnostic/Lab Order window. No action happens if both the old and new dates are in the same phase. On the Diagnostic/Lab Order screen, View Order appears when you right-click a lab order with any of the available status. If you click View Order, a window opens where you can view all of the tests that are selected in the order along with the selected diagnosis for each test. In the lower portion of the Ordered Diagnostic/Lab Test window, either The Operative codes are ICD-9 or The Operative codes are ICD-10 indicates the ICD code type of the diagnosis codes shown in the window. When there is no document linked with an order, the Lab Result window opens. The Lab Result window has a Quick Info window similar to the one in Patient Documents. Quick Info appears automatically after the Lab Result window 77 I C D E M R U p d a t e s

78 opens. In the Lab Result window, you can also click Quick Info. to open the Quick Info window. Figure 67 In the Lab Result window, click the Quick Info. button to open the quick info window. When you send a lab order, the system compares the current system date with the compliance date entered in the system parameter. When the current system date is before the compliance date, then IMS checks if the diagnosis entered are ICD-9, and the following occurs: o If the diagnosis codes that you enter are not ICD-9, then the HL7 Pre- Generate Check window appears for all of the orders. The message Dx should be ICD-9. appears, and you need to correct the diagnosis codes. o If you click the Fix Error symbol, the Diagnostic/Lab Order window appears. You are required to change the Date as the current system date 78 I C D E M R U p d a t e s

79 and update the diagnosis accordingly. When you click Save, the HL7 Pre- Generate Check works according to its functionality. If the current system date is on or after the compliance date set in the system parameter, then the system checks if all of the diagnosis entered are ICD-10, and the following occurs: o If the diagnosis codes entered are not ICD-10, then the HL7 Pre-Generate Check window appears for all of the orders. The message Dx should be ICD- 10. appears, and you need to correct the diagnosis codes. o If you click the Fix Error symbol, the Diagnostic/Lab Order window appears. You are required to change the Date as the current system date and update the diagnosis accordingly. When you click Save, the HL7 Pre-Generate Check works according to its functionality. Figure 68 In the HL7 Pre-Generation Check window, click the Fix Error symbol to change the date as the current system date and update the diagnosis accordingly. 79 I C D E M R U p d a t e s

80 View the operative ICD codes in Diagnostic/Lab Order. To view the operative ICD codes in the Diagnostic/Lab Order screen, do the following: 1. On the gold bar of the Diagnostic/Lab Order screen, enter the appropriate filter criteria, and then click Retrieve. 2. Right-click your selected diagnostic/lab order, and then click View Order. 3. In the Ordered Diagnostic\Lab Test window, view the ICD codes in the second column and view the operative code type in the lower left. Figure 69 In the Ordered Diagnostic\Lab Test, view the ICD codes in the second column and view the operative code type in the lower left. Letter Template now supports the setup, data loading, and printing of both ICD-9 and ICD-10 diagnosis codes. You can now add more ICD information using new ICD 80 I C D E M R U p d a t e s

81 fields in the Field List pane. All the windows or screens that can generate the letter template will show not just the ICD code but also the ICD type. No new fields are added for ICD-10 codes and descriptions. All existing ICD fields for codes and descriptions populate the operative diagnosis codes only. So, if the operative diagnosis code of the visit note is ICD-10, then IMS prints the ICD-10 codes and descriptions. To add ICD fields in Letter Template, do the following: 1. On the menu bar, click Setup, and then click Other. 2. In the left pane of the Setup Center window, double-click Letter Template. 3. On the gold bar of the Letter Template window, select the module of the letter template from the Type list. 4. Click New. To edit an existing letter template, click the Edit symbol on the gold bar. 5. In the right pane, enter icd in the Search box, and then click Search. 81 I C D E M R U p d a t e s

82 Figure 70 In the right pane of the Letter Template window, enter icd in the Search box, and then click Search to see the available ICD fields. 6. Double-click the ICD type fields that you want to include in the letter template. 7. Click Save. After the ICD-10 compliance date, you can directly search, select, and apply ICD-10 codes on your patients records. When you search diagnosis codes on or beyond October 1, 2015, the Search ICD-10 window appears instead of the Search ICD-9 window. 82 I C D E M R U p d a t e s

83 Figure 71 When you search a diagnosis code on or beyond the compliance date, the Search ICD-10 window appears. You can set the default ICD search tab and code type that will display in the Search ICD-10 window. For instructions about how to set the default search tab and code type, see Set the default ICD search tab and code type. ICD-10 codes will be applied to the charges that you post, and the corresponding claims will contain the ICD-10 codes. The ICD lists in Visit Note, SuperBill, and Charge Posting will show the most used ICD-10 diagnosis codes. Figure 72 After the ICD-10 compliance date, the ICD list will only show ICD-10 codes. 83 I C D E M R U p d a t e s

84 When the super bill requires you to select the ICD-9 code and the insurance allows you to only use the ICD-10 code when posting the charge for the super bill, a notification message appears. Figure 73 If the system detects that the insurance does not support the ICD-9 code and requires you to select the ICD-10 code instead, a notification message appears. When you apply codes after the ICD-10 compliance date and you have not enabled the Crosswalk parameter, only a single tab will appear in the Search ICD-10 window. Figure 74 When you apply codes after the compliance date with an inactive Crosswalk parameter, a single tab appears in the Search ICD-10 window. To view the ICD codes in the patient chart, follow these steps: 1. On the IMS main toolbar, click the Chart View symbol. 84 I C D E M R U p d a t e s

85 2. In the Chart View window, click the Dx tab. Figure 75 You can view the ICD codes in the Dx tab of the Chart View window. 3. In the Chart View window, click the Sheet tab. 4. View the ICD codes in the DIAGNOSIS(S) table. Figure 76 In the Sheet tab of the Chart View window, you can view the ICD codes. 5. Scroll down to verify the ICD code version that is compatible for the insurance. 85 I C D E M R U p d a t e s

86 Figure 77 In the INSURANCE(S) table in the face sheet, you can view the compatible ICD code for an insurance. The Bill tab in the Chart View window also shows the ICD codes. To view the ICD codes in the face sheet of the patient, click Utilities > Patient > Face Sheet. Figure 78 In the Bill tab of the Chart View window, you can view the ICD codes. View the ICD codes from Chart View. To view the ICD codes sent from Chart View, do the following: 1. On the menu bar, click Utilities, then click Patient, and then click Chart View. 2. In the Document tab of the Chart View for patient name window, double-click your selected entry in the lower-right pane. 3. In the upper right of the Patient name (document number of total number of patient documents) document window, click Quick Info. 86 I C D E M R U p d a t e s

87 4. In the Diagnosis tab of the patient name window, view the list of all the ICD codes that are associated with the patient. In the Patient Letter window, you can view ICD code and ICD code type information. Figure 79 In the Patient Letter window, you can view the ICD code and ICD code type information. Once a patient is checked in or checked out, users can now open the letter template in the following locations: Letter in the Check In - patient name window. Forms (To be Signed) in the right-click options. Forms (To be Filled) in the right-click options. 87 I C D E M R U p d a t e s

88 Superbill on Visit Note. In Bill Selection from the Reminder screen, the ICD Type column is added to identify the ICD codes included in the reminders. To view the ICD Type in Bill Selection from the Reminder screen, do the following: 1. On the menu bar, click Activities, and then click Reminder. 2. In the right pane of the Reminder screen, right-click your selected reminder, and then click Edit. Figure 80 In the right pane of the Reminder screen, right-click an existing reminder to view the right-click options, and then click Edit to open the Reminder Task window. 88 I C D E M R U p d a t e s

89 3. In the Reminder Task window, select Bill from the Link To list, and then click the document symbol beside Link To. 4. In the Bill Selection window, review the ICD types that appear in the ICD Type column. Figure 81 In the Bill Selection window, check the ICD Type column to view the ICD type of the diagnoses included in the reminder. The following are changes in Referral Tracking: On the Referral Tracking screen, the ICD Type column now identifies whether the diagnosis codes are ICD-9 or ICD-10. To sort the ICD types, click the ICD Type column header. Figure 82 In the Referral Tracking screen, click ICD Type from the top of the column to sort the ICD types. 89 I C D E M R U p d a t e s

90 In the Add Referral window, you can now add ICD codes in the Diagnosis box by doing any of the following: o Click the box to select an ICD code from the drop-down list of existing codes. o Enter the ICD code in the Diagnosis box, press Tab to view the ICD-9 Code or ICD-10 Code window, add the applicable ICD code the users want to add, and then click Save. Figure 83 In the Add Referral window, click the Diagnosis box to select an ICD code from the drop-down list of existing codes. In the Edit Referral window, if you try to edit a referral that has ICD-9 codes as active codes on or after the ICD compliance date, then the message Current referral requires ICD-10 codes as active diagnosis codes. Currently selected ICD- 9 code will be REMOVED. Please select a compatible Diagnosis code again. appears. Add referral from Visit Note. To add a referral from Visit Note, do the following: 1. In the left pane of the Visit Note screen, click ROS. 90 I C D E M R U p d a t e s

91 Adding referrals can be done in all of the question templates on Visit Note. 2. In the ROS patient name window, click Edit Template. 3. In the left pane of the ROS Questions (Specialty) window, click the ROS that you want to add a referral to. 4. In the Main tab in the middle pane, select the Enter Value check box. 5. From the Type list select Ref. Doctor, Pt. Dx, or Pt. Dx (Multi.). 6. Click Save. 7. In the ROS patient name window, select REFERRAL in the + column. 8. In the Select Referral Doctor window, select the referral doctor from the upper pane. 9. In the lower pane, enter the ICD code in the Diagnosis box or click the red question mark beside the label to search for and select the diagnosis code. 10. Select the Show in Referral Tracking check box to show the entry in the Referral Tracking screen. 91 I C D E M R U p d a t e s

92 Figure 84 In the Select Referral Doctor window, select the Show in Referral Tracking check box to show the entry in the Referral Tracking screen. Diagnosis referral date compared with the compliance date. The diagnosis that appears in the list is dependent on the comparison of the referral date with the compliance date. The comparison is based on the following priorities: Priority 1: Comparison with patient case active insurance compliance date. In the Referral Tracking window, if the case insurance of a patient is selected, then the system compares the referral date with the active insurance compliance date of the case. 92 I C D E M R U p d a t e s

93 Priority 2: Comparison with patient active insurance compliance date. In the Referral Tracking window, if the case is not selected, then the system compares the referral date with the active insurance compliance date of the patient. Priority 3: Comparison with system parameter ICD-10 compliance date. If neither case insurance nor patient insurance is found, then the system compares the referral date with the ICD-10 compliance date specified in the system parameter. In all scenarios mentioned above, the following situations occur: o ICD-9 appears in the list if the referral date is before the compliance date. o ICD-10 appears in the list if the referral date is on or after the compliance date. Checks for the diagnosis codes. There are checks for the diagnosis codes if the following scenarios occur in the Referral Tracking screen: The Referral Tracking screen is opened for editing. The referral date is changed. The case of the patient is changed. The insurance of the patient is changed. The patient case insurance compliance date is changed. The patient active insurance compliance date is changed. 93 I C D E M R U p d a t e s

94 In the left pane of the Patient Special Search, you can now select All, ICD-9, or ICD- 10 from the Dx list. Figure 85 In the left pane of the Patient Special Search screen, click the Dx box to select All, ICD-9, or ICD-10 from the dropdown list. Select any of the following values to search for default ICD types: All. Select All to open the Search Diagnosis window where you can search for all of the available ICD codes. ICD-9. Select ICD-9 to open the Search Diagnosis window where you can only search ICD-9 codes. ICD-10. Select ICD-10 to open the Search Diagnosis window where you can only search ICD-10 CM, ICD-10 PCS, or both. The left pane of the Chart Audit window also has the same change with the Dx values. In the right pane of Patient Special Search, the Diagnosis/Problem column now displays the ICD code type with both operative and inoperative codes. Figure 86 In the right pane of the Patient Special Search window, the Diagnosis/Problem column now displays the ICD code type with both operative and inoperative codes. 94 I C D E M R U p d a t e s

95 When you print or export the search results, ICD-9 and ICD-10 details are shown in different columns in the document. When you double-click a selected entry in the Audit Log window, the Table name Columns (Insert) window appears. In the Field column, icd9 is now changed to diagnosis and the ICD type appears in the New Value column. The ICD type now indicates whether the ICD code is ICD-9 or ICD-10 in the bracket. Figure 87 In Table name Columns (Insert) window, icd9 in Field is now changed to diagnosis while the ICD type is now indicated beside the ICD code in New Value. 95 I C D E M R U p d a t e s

96 In the Field column, diagnosis_id_tran_id, primary_code_tran_id and sec_code_tran_id are some of the new entries that also identify the correct ICD type in the bracket. The following are changes related to Operating Room Record: For diagnosis codes in the Diagnosis: Dx1, Dx2, etc., the following scenarios occur: o If the surgery date is before the compliance date, then you can select ICD-9 codes from the Diagnosis list. o If the surgery date is on or after the compliance date, then you can select ICD-10 codes from the Diagnosis drop-down list. o You can select only one set of diagnosis codes at a time from the Diagnosis list. Figure 88 In the Operating Room Record & Surgical Supply window, only one set of diagnosis codes at a time are available in the Diagnosis drop-down list. 96 I C D E M R U p d a t e s

97 For diagnosis codes passed with Generate SuperBill, the following scenarios occur: o If you click Generate SuperBill, a super bill is generated that can then be used in Charge Posting. The super bill contains selected diagnosis codes from the Operating Room Record. o In the Operating Room Record & Surgical Supply window, there is no Dx symbol, so only the operative codes are passed in the super bill. The default ICD type of ICD codes that can be added on the Sales Invoice screen is based on the invoice date. Currently, ICD-9 codes can be added but ICD-10 codes will be the default selection on or after the ICD compliance date. To add ICD codes on the Sales Invoice screen, do the following: 1. On the menu bar, click Activities, point to Point of Sale, and then click Sales Invoice. 2. In the upper-right pane on the Sales Invoice screen, enter the name of the patient in the Patient box. 3. Enter the name of the seller in the Sold By box. 4. In the left pane, select a product that you want to include in the sales invoice. 97 I C D E M R U p d a t e s

98 You can also use the Category filter on the gold bar to easily select the product that you want. 5. In the middle pane, click the Other Info. symbol in the O column. 6. In the upper pane of the Product Discount & Other Information window, click the red question mark beside Dx to search for and select the applicable ICD codes. Figure 89 In the upper pane of the Product Discount & Other Information window, enter the ICD codes in the Dx boxes to add ICD codes to the product sold. 7. Click Ok. 8. On the action toolbar, click Save to open the Check Out window for the payment process. You can also click any of the options in the Payment Mode pane to access the Check Out window for the payment process. 98 I C D E M R U p d a t e s

99 If the Invoice Date of a sales invoice that has ICD-9 codes is changed to a date on or after the ICD compliance date, the message As the Invoice date has been changed to a value on-or-after the ICD-10 compliance date, diagnosis code(s) selected in Product Discount & Other Information will be removed. You have to select ICD- 10 code(s) again. Do you want to continue? appears. Click Yes to proceed and enter the ICD-10 codes in the Product Discount & Other Information window. To view ICD codes with ICD types in the Dashboard, do the following: 1. On the menu bar, click Setup, then click Admin. 2. In the left pane of the Setup Center window, double-click Dashboard. 3. In the row for This Week Visits, click the Select Dashlets symbol. 99 I C D E M R U p d a t e s

100 Figure 90 In the Dashboard window, click the Select Dashlet symbol to open the Select Dashlets window. 4. In the Select Dashlets window, click the Select symbol of Visit By Diagnosis (D) (T). 100 I C D E M R U p d a t e s

101 Figure 91 In the Select Dashlets window, click the Select symbol of Visit Note Diagnosis (D) (T). 5. In the Search Diagnosis window, enter the keyword in the Description ( \ ), ICD Code (, ), or Search box. 6. Select All, ICD - 9, ICD - 10 CM, or ICD - 10 PCS from the ICD Type list, and then click Search. 101 I C D E M R U p d a t e s

102 Figure 92 Enter the keyword that you want to use in the appropriate search boxes, select All, ICD - 9, ICD - 10 CM, or ICD - 10 PCS from the ICD Type filter, and then click Search to search for ICD codes. 7. In the Results pane, select the ICD codes that you want to add, and then click the arrow symbol 8. Click Ok. 9. In the Select Dashlets window, click Save. to move the codes to the Selected Diagnosis pane. When you go to Activities > Dashboard, the ICD types appear in the brackets beside the ICD codes. 102 I C D E M R U p d a t e s

103 Figure 93 In Dashboard, you will see the ICD type shown in the brackets beside the ICD codes. The following are changes on Health Maintenance: In the (C)riteria tab of the Setup and the Health Maintenance (Special Search) windows, you can now select ICD-10 in the Filter column of the Advance pane. When you select ICD-10, click the search symbol beside Set Priority to view the Search Diagnosis window, where only ICD-10 codes can be searched. After you select the codes, they will appear in the lower pane. 103 I C D E M R U p d a t e s

104 Figure 94 In the Advance pane, select ICD-10 in the Filter column to open the Search Diagnosis window. To access reminders, right-click an entry in the right pane, and then click Edit. When the Reminder Task window appears, select Bill from the Link To list, and then click the document symbol beside the box to view the ICD. The system has a feature that allows users to open multiple search windows to search for diagnosis and CPTs. To activate this the feature, you need to contact Meditab. The Continuity of Care Document (CCD), Consolidated Clinical Document Architecture (CCDA), and Continuity of Care Record (CCR) export and import are now ICD-10 compatible. In Patient Merge, when information of the patients are merged, the operative and inoperative codes are also merged. 104 I C D E M R U p d a t e s

105 To go to Patient Merge, click Utilities > Patient > Patient Merge. You can now use ICD-10 codes or select the mapped codes when you apply an ICD code in the CHDP screen. The following are the functionalities in the CHDP Form: The PM 160 (CHDP) window automatically retrieves the active diagnosis codes of the specific visit. If any new diagnosis codes are entered in the PM 160 (CHDP) window, then the new ICD codes are automatically entered into the (A)ctive Diagnosis tab in the patient diagnosis. Any new diagnosis codes added in PM 160 (CHDP), Superbill, or Charge Posting are automatically added in the patient diagnosis of the visit note. It appears in the (T)his Visit tab. When you send the diagnosis codes of the CHDP claims, their priority is based on the service from date and the ICD compliance date. Only one version of the diagnosis codes can be submitted on one CHDP claim form. Before swapping diagnosis codes in PM 160 (CHDP), the following message appears based on these scenarios: o If ICD-10 becomes the compliant code and the current diagnosis codes are ICD-9, the message The Date of Service and Insurance/System ICD-10 Compliance date combination requires ICD-10 codes to be submitted on 105 I C D E M R U p d a t e s

106 claims. The operative ICD-9 codes which had mapped ICD-10 codes selected will be replaced by already mapped ICD-10 codes. Please review the diagnosis codes and their priorities after they are updated. Do you want to continue. appears. o If ICD-9 become the compliant code and the current diagnosis codes are ICD-10, the message The Date of Service and Insurance/System ICD-10 Compliance date combination requires ICD-9 codes to be submitted on claims. The operative ICD-10 codes which had mapped ICD-9 codes selected will be replaced by already mapped ICD-9 codes. Please review the diagnosis codes and their priorities after they are updated. Do you want to continue. appears. To add ICD codes in the PM 160 (CHDP) window, do the following: 1. On the menu bar, click Activities, and then click Visit Note. 2. In the right pane of the Visit Note screen, click CHDP. 3. In the right pane of the PM 160 (CHDP) window, enter the operative diagnosis codes in the ICD-9 Codes or ICD-10 Codes boxes. 106 I C D E M R U p d a t e s

107 Figure 95 In the right pane of the PM 160 (CHDP) window, enter the operative diagnosis codes in the ICD-9 Codes or ICD-10 Codes boxes. 4. Click the Dx symbol to open the Mapped inoperative code type Code(s) window. 5. In the first column, select the operative ICD code from the list. 6. In the second column, do any of the following: Enter the inoperative ICD code. Click the question mark in the column header to search for the inoperative ICD code. 7. Click Ok. 107 I C D E M R U p d a t e s

108 8. In the PM 160 (CHDP) window, click Save. The following are changes on in the Cancer module screens and features: In the (A)ctive Diagnosis tab of the Patient Diagnosis window, the Cancer Detail symbol that open the Cancer Diagnosis Detail (ICD code) window only appears when the following ICD codes are entered: o Codes 140 to 239 of ICD-9. o Codes C00 to D48 of ICD-10. To open the Patient Diagnosis window, click Activities > Visit Note > Diagnosis. Both the operative and inoperative cancer ICD codes have their own Cancer Diagnosis Detail (ICD code) window. There is no automatic mapping between the cancer details of the operative and inoperative codes. In the Cancer Diagnosis Detail (ICD code) window, the Dx symbol beside Primary Site is removed, and the Copy From button is added. To retrieve the diagnosis codes based on the current ICD type in the visit note, click the red question mark beside Primary Site. 108 I C D E M R U p d a t e s

109 Figure 96 In the Cancer Diagnosis Detail (ICD code) window, the Copy From button is added to open the Copy From Cancer Diagnosis window. In the Cancer Diagnosis Detail (ICD code) window, the Copy From button only appears when the ICD code is selected from the (A)ctive Diagnosis tab. In the Copy From Cancer Diagnosis window, if you select a diagnosis, and then click Ok, then the system copies all of the information aside from the primary site if the primary site and the ICD code for which you are copying it for are not of the same ICD type. 109 I C D E M R U p d a t e s

110 Figure 97 In the Copy From Cancer Diagnosis window, select a diagnosis, and then click Ok to copy the cancer diagnosis. In the Copy From Cancer Diagnosis window, if you point to cancer diagnosis, a window with detailed information of the cancer diagnosis appears. When you click the red question mark beside Histologic Type, the Search Histologic Code Type window appears. In this window, you can search for ICD-9 and ICD-0-3 codes. The Code Type column is also added. In Export Cancer Registry window, only the compliant cancer diagnosis information is exported. To open the Export Cancer Registry window, click Utilities > Export/Import > Export Cancer File. 110 I C D E M R U p d a t e s

111 In Diagnosis Selection, the Type column is added to determine the ICD code type. In the Export Cancer Registry window, the system only filters the visit note if the ICD code selected is a compliant ICD and selected in the Diagnosis Selection window. In the Cancer CDA template, the system exports the diagnosis codes in the Active Problem Section where the ICD-9-CM column header is now changed to ICD. The following are changes in Immunotherapy Billing Template setup: The following are options in the Immunotherapy setup: o Billing Template (ICD-9) o Billing Template (ICD-10) Billing Template (ICD-10) looks similar to Billing Template (ICD-9) but with the Copy from ICD-9 Template option. 111 I C D E M R U p d a t e s

112 Figure 98 In the Billing Template (ICD-10) window users can click Copy from ICD-9 Template to copy ICD-9 templates into the window. You can either add templates manually or copy the information from the ICD-9 template. When you click Copy from ICD-9 Template and any billing template for ICD-9 is still in the system, then a list of all of those templates appear in one window. You can select any template from the list and copy all of the information except ICD-9 codes from the selected ICD-9 template and include them in the current ICD-10 template. In the ICD-9 template, if any ICD-9 codes are selected when the template is copied, then the system shows the mapped ICD-10 codes for the ICD-9 codes in a tree view. Click Click here to view list if ICD-9 code(s) without mapping to view a list of ICD-9 codes without mapping. 112 I C D E M R U p d a t e s

113 Figure 99 In the Select ICD-10 Mapping Code(s), select the ICD-9 codes, and then click Ok to map the codes. You can select a single ICD-10 code for each ICD-9 code, and the system replaces the ICD-9 codes with one from ICD-10. You can search for ICD-9 or ICD-10 diagnosis codes in the appropriate setup screens or windows. In the Billing Template (ICD-10) window, if you click Copy from ICD-9 Template without clicking Add button, the system automatically replaces the information of the billing template that is already created. The following are changes in Billing Template link with Insurance: The Template Type column now has ICD-9 and ICD-10 as two of its options. 113 I C D E M R U p d a t e s

114 Figure 100 In the Billing Template link with Insurance window, select ICD-9 or ICD-10 in the Template Type column. Based on your selection in the Template Type column, the appropriate billing template whether ICD-9 or ICD-10 appears in the Billing Template column. You can set up ICD-9 and ICD-10 templates by insurance, plan, or patient. All of the existing entries will have ICD-9 as the default template type before the compliance date. If you click Add before the compliance date, the default value in the Template Type column is ICD-9. On or after the compliance date, this changes to ICD-10. If you point to the Template Type column, the Changing Template Type value will remove selected Billing Template. tooltip appears. The following are changes in Patient Information: In Patient Information, you can now select different ICDs. ICD-9 and ICD-10 tabs are added. 114 I C D E M R U p d a t e s

115 Figure 101 In the Patient Information window, click the ICD-9 tab to view the ICD-9 information. You can select or search for the appropriate diagnosis codes from the related tabs. In the Patient Information window, the tab that is open by default is based on the operative diagnosis. To open the Patient Information window, click Activities > point to Immunotherapy > click Immunotherapy > click the Patient Information symbol. You can also open the Patient Information window in other screens or windows where the Patient Information symbol appears. The system compares the current system date with the transition date parameter, and it focuses on the appropriate ICD tab of the window. 115 I C D E M R U p d a t e s

116 The following are changes in Patient Vaccine/Shot setup: The ICD Type column is added beside the Diagnosis column. The system matches the current system date with the system parameter for the compliance date and shows only a single type of diagnosis on the list. While generating a super bill for a given shot, the system retrieves the ICD codes in the following scenarios: First preference is given to the Patient Information window. If no data is found, then the system checks in Billing Template link with Insurance. If there is no billing template found for a specific patient in Billing Template link with Insurance, then the system checks Billing Template (ICD-9) or Billing Template (ICD-10), and then retrieves the appropriate CPT and ICD codes. When giving a shot to the patient, the system compares the shot given date to the case insurance. If the case insurance has an employer, then it takes the transition date of the employer if the employer type is Bill Employer or Both. If there is no employer, then the system checks for the transition date of the active primary case. If the case does not have any insurance, then the system checks the compliance date of the insurance of the patient, and then compares it with the date the shot was given. 116 I C D E M R U p d a t e s

117 If the case insurance and the patient insurance are not found in the records, then the system checks the system parameter compliance date, and then compares it with the date the shot was given. If the shot given date is before the compliance date, then the system fetches the ICD-9 code from Billing Template (ICD-9). If the shot given date is on or after the compliance date, then the system fetches the ICD-10 codes from Billing Template (ICD-10). When the system generates a super bill for Skin Test, it compares the skin test date with the different compliance dates with the priority as explained in Generate superbill for a give shot. Based on the comparison, appropriate ICD codes are added from setup into Superbill. The following are changes related to Reports: In the Parameters window of Visit Note Reports, the Dx Range section is added where you can enter the date range for ICD-9, ICD-10 CM, and ICD-10 PCS. 117 I C D E M R U p d a t e s

118 Figure 102 In the Parameters window, the Dx Range is added to the direct filters From and To with the ranges ICD-9, ICD-10 CM, and ICD-10 PCS. To view the Parameters window, click Reports > click EMR > click the Visit Note plus symbol > double click Visit Note By Diagnosis, Patient Visit Summary By Diagnosis, Prescription By Diagnosis, or Patient Visit Detail By Diagnosis. The codes for ICD-10 CM have the following validation requirements: o A minimum of three letters. o A maximum of eight letters (including the decimal dot). o Alphanumeric datatype. o The first digit is alpha. o The second digit is numeric. 118 I C D E M R U p d a t e s

119 o The third to seventh digits are alpha or numeric (not considering the decimal dot). The codes for ICD-10 PCS have the following validation requirements: o No decimals. o The minimum and maximum length are both seven characters. o An alphanumeric datatype. o A zero digit is allowed on the left. There are check boxes for the ICD-9, ICD-10 CM, and ICD-10 PCD ranges. If you select a check box, its corresponding ICD code is included in the reports. If you clear a check box, then the corresponding range option becomes unavailable. At least one of the check boxes need to be selected for proper validation to occur. The check boxes are all selected by default. If multiple code types are selected, the system runs all of the selected codes in the specified ranges. If the ICD-9 and ICD-10 CM and PCS ranges are selected, then the report runs for all of the codes in those ranges, and the results are there for all of the criteria that have either of those ICD codes. The template flow remains the same for the new Dx Range options. 119 I C D E M R U p d a t e s

120 Figure 103 In the Visit Note by Diagnosis report from EMR Reports, Primary Dx From: ICD code To: ICD code appears in the upper part, and the operative code type appears in a bracket beside the diagnosis codes in the headers. In the Sort pane of the Group/Sort tab, ICD Type is added in the parameters windows of the reports that have ICD codes. 120 I C D E M R U p d a t e s

121 Figure 104 In the Sort pane of the Group/Sort tab, ICD Type is added in the parameters windows of the reports that have ICD codes in All Reports. When reports are generated, the ICD Type column appears if it is selected in the Columns tab. 121 I C D E M R U p d a t e s

122 Figure 105 In the Columns tab of the Diagnostic/Lab By All Options Report Parameters window, select the ICD Type check box for the ICD Type column to appear in the report. ICD Type is added in the following paths: o Click Reports > click Diagnostic/Lab > click the General plus symbol > doubleclick By all options. o Click Reports > click EMR > click the Prescription plus symbol > double-click By all options. 122 I C D E M R U p d a t e s

123 o Click Reports > click EMR > click the Prescription plus symbol > double-click By provider (Ohio state). o Click Reports > click EMR > click Case plus symbol > double-click patient By Admission Date. In the Diagnosis column of Visit Note Detail By All Options, the ICD code type appears inside the brackets beside the diagnosis codes. Figure 106 In the Diagnosis column of Visit Note Detail By All Options, the ICD code type appears inside the brackets beside the diagnosis codes. Add the ICD Type column in a template. To add the ICD Type column in a template, do the following: 1. On the menu bar, click Reports, and then click EMR. 123 I C D E M R U p d a t e s

124 2. In the Report Center, click the plus symbol beside Prescription, and then double-click By All Options. 3. On the Prescription By All Options screen action toolbar, click the Design symbol. 4. Right-click the table body, and then click Add Column. Figure 107 On the table body, right-click, and then select Add Column from the right-click menu options to open the Add Column window. 5. In Formula of the Add Column window, enter icd_type, and then click Verify. 6. In the Expression window, click OK. 7. In the Add Column window, click OK. 8. On the Prescription By All Options screen, drag the Compute number column header to your preferred location among the columns. 9. Right-click the Compute number column header, and then click Properties. 10. In the Attributes window, enter ICD Type in the Label box. 11. Click Apply, and then click OK. 124 I C D E M R U p d a t e s