Our compliance department has notified us that, according to the auditors, we must not allow providers to change the description on a problem code from the standard ICD-9 description. In other words, when the provider selects a problem from the custom problem list, or the smart list, or the reference list, whatever ends up in the patient's chart must be the exact description from the ICD-9 specification. No deviation from that description is permissible.
Clearly this is something that GE not only allows, but encourages. And frankly, we're not the least bit convinced that our compliance department is correct about this.
But I've been charged with asking as many fellow Centricity users as possible two questions:
1. Are you aware of any such restriction?
2. If so, how are you dealing with it, given that Centricity does not recognize this restriction?
Last month I saw a demo of the 'add problem' and search changes that are due out in SP10, and I believe one thing mentioned was that users will no longer be able to change the descriptions of the problem when they add it to the chart. I believe that SP is expected out in July.
Our providers change them all the time , more so to their "laymans" terms for easier search ability. With that said I could see where this could be a problem moving into ICD-10
I truly wish there was a way to stop providers from changing problem descriptions.
They are not coders and will pick the first code that looks right-enough.
For example, I've seen situations where the provider picked the code for diabetes 250.00 and typed in the complications into the description.
Or added "family history" or "FH of" to the description of a problem like cancer, which makes it look to all computers and interfaces that read code and not english, that the patient has cancer.
Worse, the providers can then add it to a custom list and off it propagates to all providers in the organization.
As we switch over from ICD-9 to ICD-10 I am re-training them specifically on this topic and dumping all custom lists.
I wish I could clear out the SmartList and force it to start again on 10/1.
I am unaware of this but also see where this could create problems come ICD-10
You can control who can edit custom lists in security.
We've locked them down from editing the descriptions, but another problem arises in that the Smart List is chock-full of non-standard ICD-9 descriptions. We'd have to prohibit access to the Smart List, and ensure that all entries on the custom lists are standard. I haven't even looked into the Reference List yet.
@ronmoses - how do you lock down users from editing the description?
From our GE representative:
I haven’t yet found any customers that have run into this issue. Our internal teams haven’t heard of it either, even one of our consultants who used to do audits for the OIG. She recommended that you ask your auditors for their official source.
I also don’t think there are any plans to lock down the field in SP10 either but I am verifying that.