In 2015, insurance payers stopped accepting ICD-9 for most claims and began to require ICD-10. Meanwhile, PCMH programs and Meaningful Use standards used to qualify for the ARRA programs shifted from using ICD-9 to preferring SNOMED-CT.
How does PCC software support ICD-9, ICD-10, and SNOMED-CT?
- In the patient’s chart, clinicians record all diagnoses with SNOMED-CT. SNOMED is a detailed vocabulary that is ideal for charting and is required by industry standards.
- When billing, clinicians and other staff will use ICD-9 codes for all claims prior to October 1st, 2015, and ICD-10 codes thereafter. Physicians select SNOMED diagnoses, and PCC EHR automatically sends billers the associated ICD-9 or ICD-10 codes. Users can configure the mapping between SNOMED-CT and ICD-9/ICD-10.
PCC has built support for the new taxonomies into PCC EHR, Partner and our other software and services. We’ve created special tools and conversion reports to help you handle the interaction between the different taxonomies, and we provide training opportunities to make ICD-9’s phase out as smooth as possible. Read below to learn more.
The Migration from ICD-9 to ICD-10 for Billing
PCC software fully supports both ICD-9 and ICD-10. During 2014 and 2015, we continue to add new tools and feature to expand and improve our coding tools.
During each software release, PCC will publish our progress and provide training on ICD-10 tools in Partner.
In addition to software tools, PCC is offering a series of online training opportunities on ICD-10. You can learn about anatomy and physiology in ICD-10, along with other billing guidance.
Read the ICD-10 Resources article to learn more.
Other Special Software Considerations
As your office prepares for ICD-10, here are some configuration and migration topics you should consider. Feel free to contact PCC Support to discuss any of these issues.
Billing Configuration: PCC EHR includes a diagnosis billing code mapping for common pediatric codes, but your practice can configure which diagnosis descriptions map to which ICD-10 billing codes with the Billing Configuration tool.
Reports: PCC is expanding and adapting all report output to make extra space for ICD-10 codes. You may need to adjust favorite reports with saved criteria to include new codes in addition to legacy ICD-9 codes.
Charge Screens and Posting Charges: PCC’s charge posting software, including
oops, are ready for ICD-10. The Charge Screen Editor (
csedit) will allow the creation of charge screens using the ICD-10 list. Snapcodes and other billing tools also support ICD-10. You can review your configuration and even “practice” posting visits with the ICD-10 code set.
Custom Diagnoses: Some offices create custom entries in the current ICD-9 diagnosis table, or alter the descriptions in order to use diagnoses as an office communication tool or for other reasons. The ICD-10 table can not be edited and will instead be kept up-to-date-with the published standard. Contact PCC Support or attend one of our Web labs to talk about your office’s workflow and how to adjust to the new code set.
The Migration from ICD-9 to SNOMED-CT for Diagnosis Descriptions in the Chart
As of the January 2014 PCC software update, all diagnosis charting in PCC EHR uses SNOMED descriptions.
Your office can use the Diagnosis Configuration tool to customize your practice’s diagnosis descriptions and the Billing Configuration tool to map billing codes for orders and diagnoses. PCC EHR includes all diagnoses in SNOMED-CT, along with a subset of around 1000 “Favorite” diagnosis descriptions that are most suited for pediatric use. Your office can edit the Favorites list to improve diagnosis searching, select alternate descriptions that are part of the SNOMED-CT standard, and adjust the mapping to your ICD-9 billing codes. Read the Diagnosis Configuration article to learn more.
PCC Support is working with each PCC EHR practice to discuss the shift to SNOMED-CT. We can provide special reports and assistance in preparing diagnosis tables and configuring your SNOMED options.
During the January 2014 software update, PCC EHR automatically migrated diagnoses that appeared on chart note protocols to SNOMED descriptions. Physicians now see SNOMED descriptions in the Diagnosis component on chart notes, when they add new items to Problem Lists, and elsewhere where diagnoses appear. ICD-9 codes from before the update will be untouched.
When SNOMED-CT descriptions are selected on chart notes and the Bill function is used, PCC EHR will display the mapped ICD-9 code for review and send the ICD-9 to Partner for billing. After October of 2015, ICD-10 codes will appear instead.
Training and Learning More About SNOMED-CT and PCC
PCC hosts Web labs on each software update. We also contact each office to discuss major updates and review the changes. We can provide additional lists, tools, and support as needed.
You may find the following resources useful:
- Diagnosis Configuration Tool
- Billing Configuration Tool
- 6.19 Release Video
- 6.19 Migration Considerations
As always, contact PCC to talk about any changes or other concerns.
Unavailable or Unusual SNOMED-to-Billing Mapping
Some SNOMED-CT descriptions may not have an associated ICD-9 billing code in your office’s diagnosis table.
In addition, if your office uses non-standard ICD-9 descriptions, or you have entered custom text for general ICD-9 codes, you may notice some unusual billing mapping.
To correct unusual mapping, you can add new diagnoses entries with the standard ICD-9 description to your diagnosis table in Partner, and then adjust the SNOMED mapping using the Diagnosis Configuration tool. This work is optional, however, as payors only require the correct diagnosis billing code. As you adjust your table and workflow, remember that the text description is irrelevant for insurance billing purposes.
PCC Support can prepare a special list of common SNOMED-CT to ICD-9 mapping for your review. We can also analyze your most frequently used ICD-9 codes and provide common related SNOMED-CT descriptions, to help familiarize your practice with the new vocabulary. You can run and re-run these lists yourself using a special Partner report,
Call or e-mail PCC Support at any time to talk about SNOMED, ICD-10, and the specific needs of your practice.
We can work with your office to create custom solutions, provide additional training, and work with you to get your practice ready for the changes.