Platinum System ICD-9 to ICD-10 Converter

Transcription

1 Platinum System ICD-9 to ICD-10 Converter Overview The ICD-9 to ICD-10 converter is based on the General Equivalency Mapping (GEM) files published by CMS, and is not intended to be used as a final ICD-10 conversion, ICD-10 mapping, or ICD-9 to ICD-10 crosswalk tool. Keep in mind that while many codes in ICD-9-CM map directly to codes in ICD-10, in some cases, a clinical analysis may be required to determine which code or codes should be selected for your mapping. The ICD-9 to ICD-10 converter is not intended to provide a perfect mapping. It is used as a guidance tool. You have the responsibility of reviewing mapping results in the insurance cases before submitting your first ICD-10 claims. You also have to know how to use the ICD-10 codes to meet the insurance companies standards. Platinum System C.R. Corp. takes no responsibility for the results of the conversion and denials that may result from an invalid mapping. There is no obligation to use the ICD-9 to ICD-10 Converter. You can do a customized ICD10 mapping directly in individual insurance cases. The converter can be used as often as needed. Only the ICD-9 codes that have not been converted in the insurance cases will be converted whenever the converter runs. A - INSTALLATION You must update your Platinum System with the PsAutoUpdate.exe utility program to get the ICD-9 to ICD-10 converter. The version or a more recent will auto download the converter. If you do not know how to install an update, go on and click on Documentation and Download Platinum Auto Update utility program and read the selfexplained document (3) Install the Platinum System Auto Update Utility Program. B ACCESS THE ICD-9 TO ICD-10 CONVERTER You will find the ICD-9 to ICD-10 converter in the PROCESS tab. 1 Page

2 C - USER AGREEMENT You must accept the Disclaimer for processing the ICD-9 to ICD-10 conversion. Click on I AGREE to accept. 2 Page

3 D - ICD-9 to ICD-10 Conversion (Window explanation) One to one mapping The One to one mapping tab shows all ICD-9 codes that can be converted directly to a unique ICD-10 code. The total number of such ICD-9 codes in your database is indicated in brackets. The ICD-9 codes are listed in the field ICD-9 with their description and the corresponding ICD10 code is indicated in the field ICD-10 with its description. The Description of the ICD code shows Invalid ICD-9 code if the code is nonexistent in the ICD-9-CM code set. Such codes cannot be converted. The clearing house Gateway/TriZetto systematically denies claims having such ICD codes. So you can replace in the insurance cases the invalid ICD-9 codes with a valid code and re-run the conversion tool to get them converted. Otherwise you could manually select a valid ICD-10 code in the insurance cases if you don t want to worry about the ICD-9 code. Multiple choice 3 Page

4 The Multiple choice tab shows all ICD-9 codes having multiple ICD-10 codes possibilities. A clinical analysis may be required to determine which code should be selected for your mapping. If more than one ICD-10 code must be selected in your mapping for a unique ICD-9 code, or if the same ICD-10 code cannot be selected for all of your insurance cases, you must do a specific ICD-10 mapping directly in the insurance cases. You should not use the converter for that particular ICD-9 code. If the same ICD-10 code can be used for all (or vast majority) of your insurance cases, you can select the one that fulfill your mapping as follow: 1) Move the cursor in the ICD-10 field of the ICD-9 code to convert. You can click in the field or use the Up and Down arrow keys. The ICD-10 (Alt+0) drop-down box displays the very first ICD-10 code available. 2) Press on the Plus (+) key on your keyboard to open the ICD-10 code options for the selected ICD-9 code. The list displays under the drop-down box ICD-10 (ALT+0): 3) Click on the code you want to select and press on the Plus (+) key on your keyboard or on the ENTER to choose it. The ICD-10 code will show in the field ICD Page

5 As you see it is a straight forward process. You can move quickly through the codes using these keys combination: Down arrow key to move down in the list Plus (+) key to open code options Down / Up arrow key to move the cursor on the chosen code ENTER or Plus (+) key to select the code. No need to use the mouse. Be aware that if further investigation is needed, you can skip an ICD-9 code and proceed with its conversion at another time. No Mapping The No mapping tab shows all ICD-9 codes that have no equivalent ICD-10 code. However, we give you the capability to select an ICD-10 code for the conversion. You select an ICD-10 code as you do for your Multiple Choice. Proceed with the conversion To apply the conversion to all the insurance cases, click on the Proceed button. You will be asked if you are sure. Click on Yes to convert the ICD-9 codes in the insurance cases. Only the ICD-9 codes that have not been converted in the insurance cases will be converted whenever the converter runs. If you return in the converter, the ICD-10 codes selected last time in the Multiple Choice and No mapping tabs will display. E - Reports 5 Page

6 You have access to three PDF reports to ease the conversion and quickly identify the mappings that need to be reviewed. 1) Click on the Reports button located at the bottom of the ICD-9 to ICD-10 Conversion window: 2) Select the report by clicking on the corresponding button: Insurance Cases ICD-9 Codes report Information on the report: ICD-9 code, patient name and insurance case. This report will be useful to get a list of all ICD-9 codes in your database and the insurance cases where they appear. It gives you an overview before you proceed with the conversion. You can quickly identify which ICD-9 codes cannot be converted by the ICD-9 to ICD-10 Converter because the mapping is specific to the insurance case or use it to research which patient as an ICD-9 code. Converted ICD-9 Codes report Information on the report: ICD-9 code, ICD-10 code used for the conversion, patient name and insurance case This report will be useful to get a list of the ICD-9 codes that have been converted and the ICD-10 code used for the conversion. You can use it to validate the new mappings and to point out the insurance cases that have to be reviewed and updated following a clinical analysis. Unconverted ICD-9 Codes report Information on the report: ICD-9 code, patient name and insurance case. The information is grouped in two sections: Invalid ICD-9 codes and Unconverted ICD-9 Codes. This report will be useful to get a list of the ICD-9 codes that have not yet been converted or cannot be converted (Invalid ICD-9 Codes). 3) A PREVIEW is generated for the selected report. You can print or save it. If you do not select a folder to save the report, it will be saved in \\platinum\data\edi\ folder. 6 Page

7 Tip When the PDF file is open, you can search specific information like an ICD-9 or ICD-10 code or a patient name. You open the Find box doing Ctrl + F or selecting Edit then Find. Enter in the Find box the information you are looking for then click on the Previous/Next button. Very important: do not insert a dot in the diagnosis codes because it was dropped on the reports. Example: If you seek the ICD-9 code , you type in the Find box Page

8 F ICD-9 TO ICD-10 CROSSWALK TOOL An ICD-9 to ICD-10 crosswalk tool was added to the insurance case. It provides the ICD-10 codes mapped to the selected ICD-9 code. This tool can be used to view the codes or to add an ICD-10 code to the insurance case ICD-10 mapping. This is an alternative to the ICD-9 to ICD-10 Converter which converts all ICD-9 to ICD-10 regardless the insurance case and the clinical analysis. You can use it or not when you do the mapping directly in the insurance cases. How to use it 1) Access the insurance case; Type the ICD-9 code (with no dot) in the ICD-9 Codes field or click on the dropdown arrow to select an ICD-9 code. The ICD-10 Codes box displays instantly the very first ICD-10 code available in the list; 2) Click on the drop-down arrow next to the ICD-10 Codes box to view all the ICD10 codes mapped to the selected ICD-9 code; 3) 8 Page

9 If you want to use an ICD-10 code into your mapping, click on it. The selected code will show in the ICD-10 Codes field and will be moved in the Windows clipboard. In our example, we clicked on M21769: 4) 5) Click on the ICD-10 tab Click in the field where you want to copy the ICD-10 code [1) to 12)] and do Ctrl + V to paste it. In our example, we pasted the ICD-10 code in the field 6): 6) 9 Page