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VFE Problem list for ICD 10

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ntaylor

(@ntaylor)

Posts: 79

Estimable Member

Topic starter

Does anyone know how GE is identifying the orange (less specific) ICD codes in the GE Orders module, and do you know of a way in VFE, similar to PROB_AFTER, that would return the list of the patients Active Problems, but exclude the orange/less specific diagnosis from the list? We have a custom Assessment form, and would like to prevent the provider from assessing the less specific Diagnosis codes, and force them to go to the problem list and update these codes to the more specific ICD10 before they can assess it.

thanks.

Posted : September 24, 2015 4:23 am

mjharunk

(@mjharunk)

Posts: 191

Reputable Member

From what I can tell GE has created "logic" to indicate (orange) when a diagnosis is uncoded, lacking an ICD10 code, or is an injury code without encounter type (7th digit).

However, it doesn't indicate whether a diagnosis is the most specific available. There are many "unspecified" diagnoses which are technically valid for billing (not orange), but may not be reimbursed. I can't fathom a logic set that would be able to make the clinical decision based on information provided.

It is going to take vigilance on the part of the providers and billing departments to ensure that the codes being used are at the necessary level of specificity. It really comes down to a clinical decision by the provider coupled with the oversight of back office staff.

Posted : September 24, 2015 4:38 am

JenWagaman

(@jenwagaman)

Posts: 74

Trusted Member

I started to look for the same thing a few weeks ago by pulling up the crystal report GE provides for 'unbillable' problem list items. (this is a report that you can run by provider/appt schedule, which essentially shows all the 'orange' problem codes for each patient with an upcoming appt). There is a table view that is called unbillable codes (or something similar).. but I haven't drilled into it deep enough to figure out the logic and to see if it can be utilized in an encounter form... so we just have our assessment/plan section alert the providers if they pick a problem to assess that doesn't have a 10 code at all. Would be interested to see if anyone comes up with a way to do this...

Posted : September 24, 2015 5:23 am

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