For the past month or so, I’ve been looking for ICD-10 coding tools; preferably an app that runs on handheld devices like smartphones and tablets. And specifically an app which could be used by physicians and coders alike to code ICD-10 diagnoses.
What I’ve found are three general types of applications:
1. Simple text search apps
The most common ICD-10 apps I’m finding are simple text search utilities where the developer took the ICD-10 data files and added some simple text searching. Many don’t even allow wildcard operators and I didn’t find any that have very advanced searching capabilities.
2. Code assignment modules embedded into an EHR
Some EHR vendors have sophisticated ICD-10 code assignment functionality that do in fact address many of what I believe are core requirements of the ideal ICD-10 coding tool. But this is not what I’m looking for. Who’s going to license an EHR just to do code assignment?
3. Sophisticated computer-assisted code assignment tools utilizing artificial intelligence and/or natural language processing
There are some vendors out there that offer standalone, sophisticated ICD-10 code assignment functionality – usually via some sort of API and not via a handheld device. They're very expensive and not something most physicians and coders would use.
So what should a “Good” ICD-10 Coding be Able to Do?
One Size That Fits All
Has a user interface, logic rules and “workflow” that support the competencies and idiosyncrasies of both coders and physicians
A user interface that minimizes the need to key in search terms but is driven from a point and click method – or touch screen
Incorporates medical-specialty specific functionality to filter out anything not related to the specialty of the provider whose claims are being coded
Minimizes the need for coders to know anatomy and physiology
Allows the user to begin a code assignment session by selecting a part of the body
Speaks the Lingo and Holds Your Hand
Incorporates clinical terminologies that reflect more current clinical terminology and standardization of the terms used to diagnose certain conditions and disorders that clinicians and health care personnel use today for patient care and data reporting
Incorporates ICD-10’s coding conventions, general guidelines, and chapter-specific guidelines that must be followed to classify and assign the most appropriate code
Identifies and automatically assists the user with proper handling of “combination code” scenarios
Identifies and automatically assists the user with proper handling of “code first” scenarios
Automatically applies “excludes” rules that specify conditions that cannot occur together
Allows the assignment of manifestation codes
Assists the user with ensuring that laterality is considered when applicable
Assists the user with ensuring that seventh character extension for episode of care is considered when applicable
Uses patient age and gender to automatically preclude inappropriate diagnoses from be selected/assigned. These would include:
- Newborn/Neonate Diagnoses (0 years)
- Pediatric Diagnoses (0-17 years)
- Maternity Diagnoses (12-55 years)
- Adult Diagnoses (15-124 years)
- Female Only Diagnoses
- Male Only Diagnoses
Accommodates identification of Present On Admission exempt codes
Flags any codes that are questionable as admission diagnosis
Prevents assignment of codes that are unacceptable as principal diagnosis
Flags duplicate codes
Assists with applying coding conventions and guidelines that reflect more current clinical terminology and standardization of the terms used to diagnosis mental, behavioral and substance use disorders.
Allows the user to identify most commonly coded diagnoses to create a virtual super-bill
Simple and Not Fancy – This is Real Work!
Doesn't contain fancy graphics that slow down performance
Displays a bread crumb/trail of the pathway the user took to arrive at a diagnosis
Retains a history of all patients and diagnoses selected on a user-specific basis and allows the user to browse code assignments made in the past
Runs on a smartphone or tablet
Can operate offline without an internet connection
Can receive software and ICD-10 code updates without the user having specialized technical knowledge
Provides an XML based or other “standardized” output that contains all coding information needed for downstream EHR storage and billing processes
Eliminates or at least minimizes the tension between coders and physicians that can result from excessive coder queries to the physician
Where are these ICD-10 Coding Tools?
What else should a good ICD-10 coding tool do? Send me your ideas. And if you know of any tools that do most or all of what I've listed above, please contact me so I can share with others. Thanks!