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Abstract: The transition of procedure coding from ICD-9-CM-Vol-3 to ICD-10-PCS has generated problems for the medical community at large resulting from the lack of clarity required to integrate two non-congruent coding systems. We hypothesized that quantifying these issues with network topology analyses offers a better understanding of the issues, and therefore we developed solutions (online tools) to empower hospital administrators and researchers to address these challenges. Five topologies were identified: “identity”(I), “class-to-subclass”(C2S), “subclass-to-class”(S2C), “convoluted(C)”, and “no mapping”(NM). The procedure codes in the 2010 Illinois Medicaid dataset (3,290 patients, 116 institutions) were categorized as C=55%, C2S=40%, I=3%, NM=2%, and S2C=1%. Majority of the problematic and ambiguous mappings (convoluted) pertained to operations in ophthalmology cardiology, urology, gyneco-obstetrics, and dermatology. Finally, the algorithms were expanded into a user-friendly tool to identify problematic topologies and specify lists of procedural codes utilized by medical professionals and researchers for mitigating error-prone translations, simplifying research, and improving quality.

Learning Objective 1: To illustrate the implications of the transition between the ICD-9-CM-Vol3 and the ICD-10-PCS coding platforms and to showcase a systematic approach (online tools) to standardizing bi-directional relationships and mappings across ICD-9-CM-Vol3 and ICD-10-PCS to mitigate error-prone translations, simplify research, and improve quality of care.

Authors:

Andrew Boyd (Presenter)
University of Illinois at Chicago

Jianrong Li, University of Arizona
Colleen Kenost, University of Arizona
Samir Rachid Zaim, University of Arizona
Jacob Krive, University of Illinois at Chicago
Manish Mittal, University of Illinois at Chicago
Richard Satava, University of Washington Medical Center
Michael Burton, University of Illinois at Chicago
Jacob Smith, University of Arizona
Yves Lussier, University of Arizona

Presentation Materials:

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