Is my custom problem list a problem for ICD-10?

Guest blog by Charlie Bernstein

Remember when your Electronic Health Record (EHR) system was first implemented? Taking advantage of all of the new productivity tools, your organization probably built some customized problem lists. These custom problem lists made it possible to standardize on the codes you use for various departments, conditions, and regulatory submissions.

Now that the ICD-10 clock is ticking down, think back to the hours spent creating those custom lists in ICD-9. Since you developed the lists yourself, expecting an EHR vendor to convert them to ICD-10 for you isn’t really possible. Custom problems lists are just that, custom. How would they know what codes you want on the list for ICD-10?

Most EHR custom problem lists can be exported in ICD-9 and there are tools out there that can take your list of ICD-9 codes and translate them to ICD-10. Great, problem solved. Or is it? You now know which ICD-10 codes you want in each custom problem list, but how do you get them back into the EHR?

You could update each list manually. It’s not unreasonable to consider this approach since that is how the original list was created, but let’s crunch the numbers: ICD-9 has around 17,000 codes; ICD-10 has more than 140,000. That’s eight times as many codes. In reality, you are looking at about four times the number of codes going from a list of ICD-9 to ICD-10 codes because only a handful of ICD-9 codes have over 100 alternatives. Even so, this seems like a daunting task. Certainly more work than when you created the list in the first place.

How much time will it take to convert custom problem lists? Even with a simple example of converting 100 custom problem lists created in the span of one year, you should expect to devote about 5,000 man hours. Sound over the top? Not really when you consider each list could have an average of 75 entries, so for 100 lists you are looking at 7,500 ICD-9 codes. So, accounting for the 4 to 1 ratio of ICD-10 codes to ICD-9 codes, we’re looking at 30,000 codes to program into the EHR. If each of those codes takes 10 minutes to create, that’s 300,000 minutes or 5,000 man hours.

There is some good news. Some EHR systems have the ability to import back a custom problem list with both the ICD-9 and ICD-10 codes in it. Using tools that support the EHR’s custom list import format, lists of ICD-9 codes can be exported from the EHR, translated to ICD-10, and then re-imported back into the EHR with the same problem list attributes as before.

If you have custom problem lists that need to be translated to ICD-10, now is the time to do your research and look for solutions that support this approach. It should save you time, resources, and allow you to meet the October 1, 2014 deadline.

Charlie Bernstein is a Product Marketing Manager with 3M Health Information Systems.

Problem lists ready for ICD-10? Join Charlie for a webinar where he will demonstrate how hospitals and physician practices can speed ICD-10 code conversion of their problem lists.

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