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I-MAGIC and the SNOMED CT to ICD-10-CM Map

I-MAGIC and the SNOMED CT to ICD-10-CM Map. Dr. Kin Wah Fung, MD, MS, MA, FRCSEd U.S. National Library of Medicine, Bethesda, MD, USA kwfung@nlm.nih.gov. Datapalooza 2012 “Data Lab Session”. Health Data Standards.

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I-MAGIC and the SNOMED CT to ICD-10-CM Map

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  1. I-MAGIC and the SNOMED CT to ICD-10-CM Map Dr. Kin Wah Fung, MD, MS, MA, FRCSEd U.S. National Library of Medicine, Bethesda, MD, USA kwfung@nlm.nih.gov Datapalooza 2012 “Data Lab Session”

  2. Health Data Standards • NLM is the central coordinating body for clinical terminology standards within the Department of Health and Human Services (HHS). NLM works closely with the Office of the National Coordinator for Health Information Technology (ONC) towards the nationwide implementation of an interoperable health information technology infrastructure. • The NLM Long Range Plan for 2006-2016 recommends that the Library continue and enhance its standards efforts “in response to specific US government priorities and feedback from those attempting to implement standards in current electronic health records and personal health records, regional health information exchanges, clinical research systems, and public health applications.”

  3. Two Government Health IT Priorities • The incentives for Medicare/Medicaid providers to implement and demonstrate “meaningful use” of “certified” EHRs • NPRM (2/12) for Stage 2 EHR Certification Criteria (effective 2014) – problem list data to be encoded in SNOMED CT • Migration to ICD-10-CM /PCS for HIPAA transactions • NPRM (4/12) – proposed implementation date 2014 (postponed from 2013)

  4. SNOMED CT to ICD-10-CM Map • Clinical data coded in SNOMED CT can be used to generate ICD-10-CM codes (“code once, use multiple times”) • Implementation of SNOMED CT in the EHR will not only improve the quality of data, but can also help the transition to ICD-10-CM • A rule-based map (vs. one-to-one crosswalk) • One SNOMED CT concept may need more than one ICD-10-CM codes to fully represent its meaning e.g. etiology and manifestation, injury codes • One SNOMED CT concept may possibly map to multiple alternative ICD-10-CM target codes, depending on patient context and other factors e.g. episode of care

  5. Scope of the map • SNOMED CT concepts suitable for the problem list: clinical findings, events and situation • Commonly used SNOMED CT concepts are mapped first • CORE Problem List Subset • Donated content from Kaiser Permanente’s Convergent Medical Terminology (CMT) • Preview publication released in February - covers 7,000 concepts • Final release in June – about 15,000 concepts

  6. Possible uses of the map data • The I-MAGIC (Interactive Map-Assisted Generation of ICD Codes) use case • Embedded in the EHR to help healthcare providers find ICD-10-CM codes in real-time, as they update a SNOMED CT-encoded problem list • In coding applications - to assist coding professionals by suggesting ICD codes based on SNOMED CT-encoded problems • Others: • In a computer-assisted coding program to generate ICD-10-CM codes from narrative medical notes • Stand-alone app to look up ICD-10-CM codes • Educational tool for coding professionals – to show the difference between SNOMED CT and ICD-10-CM

  7. To download the Map • http://www.nlm.nih.gov/research/umls/mapping_projects/snomedct_to_icd10cm.html • UMLS license required, can be applied on-line (free-of-charge) http://uts.nlm.nih.gov • SNOMED CT and ICD-10-CM can be used freely in the U.S. • I-MAGIC demo tool http://imagic.nlm.nih.gov/imagic/code/map

  8. NLM SNOMED CT resources • CORE Problem List Subset http://www.nlm.nih.gov/research/umls/Snomed/core_subset.html • Convergent Medical Terminology Subsets http://www.nlm.nih.gov/research/umls/Snomed/cmt.html • Nursing Problem List Subset http://www.nlm.nih.gov/research/umls/Snomed/nursing_problemlist_subset.html • Route of Administration Subset http://www.nlm.nih.gov/research/umls/Snomed/roa_subset.html • SNOMED CT to ICD-10-CM Map http://www.nlm.nih.gov/research/umls/mapping_projects/snomedct_to_icd10cm.html • SNOMED CT to ICD-9-CM Map http://www.nlm.nih.gov/research/umls/mapping_projects/snomedct_to_icd9cm_reimburse.html • ICD-9-CM to SNOMED CT Map http://www.nlm.nih.gov/research/umls/mapping_projects/icd9cm_to_snomedct.html • US Extension http://www.nlm.nih.gov/research/umls/Snomed/us_extension.html • US SNOMED CT Content Request System https://uscrs.nlm.nih.gov/ • UMLS-enhanced SNOMED CT browser https://uts.nlm.nih.gov/snomedctBrowser.html

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