Chapter 8: ICD-10 Enhancements in Avalon This chapter describes how ICD-10 specific workflows have been incorporated in the different components of the Avalon application to ensure that the users transition to ICD-10 seamlessly. ICD-10 Mapping Tool Avalon users have the option to map a patient s existing ICD-9 diagnosis codes to ICD-10. To do this, they need to follow the steps discussed below: 1. Go to the Patient s Demographics, click on the Settings icon at the top right corner of the screen and select ICD-10 Mapping option from the drop-down menu. FIGURE 134: ICD-10 MAPPING OPTION 2. The ICD-10 Mapping screen appears. Here, the patient s current and past diagnosis codes are listed. All the ICD-9 codes and their corresponding ICD-10 codes can be seen. The users can click on the Current or the Past tab to map the respective diagnoses.
FIGURE 135: MAPPING SCREEN The ICD-9 diagnoses that have been mapped appear as green while the unmapped diagnoses appear as red in color. In case you are unable to find the appropriate ICD-10 code in the dropdown menu populated on the basis of General Equivalence Mapping, you can click on the map the right ICD-10 code. icon to manually search and FIGURE 136: CHANGE CURRENT MAPPING You don t have to do the entire mapping in one go. You can map some of the diagnoses and click on Continue. The system saves the mapping you ve done so far and allows you to continue from that point later on. However, once the ICD-10 compliance date is effective for the practice, you will be unable to proceed to the Clinical Review sheet or the e-superbill component of the patient profile if the ICD-10 mapping is not complete for all Current ICD-9 codes. Note: Prior to the effective date, the ICD-10 codes are only visible on the mapping screen and cannot be seen elsewhere in the application. Post ICD-10 effective date, the mapping screen can be accessed via Patient Demographics. If there are any unmapped ICD-9 codes, the mapping screen appears for the Clinical Review Sheet and e- Superbill as well. 2
ICD-10 impact on e-superbill Before the effective date, only ICD-9 codes are visible on the e-superbill screen. Post effective date, you get the option to view both ICD-9 and ICD-10 codes. There is a button that allows you to turn the visibility on or off for the ICD-9 codes on the e-superbill as per your needs. FIGURE 137: DIAGNOSIS CODES ON ESUPERBILL SCREEN 3
To add diagnosis, click on the plus icon to open the ICD-10 search library. Here, you can search for the required ICD-10 code by ICD-9 or ICD-10 description or code. FIGURE 138: SEARCH FOR A DIAGNOSIS When you attach the diagnosis pointers with each CPT, it shows the ICD-10 code along with their description in a pop-up window. Since the procedure points to the first diagnosis, you can see a tick mark against that diagnosis in the pop-up window. FIGURE 139: DIAGNOSIS POINTERS You can also view e-superbill templates that show both ICD-10 codes and their corresponding descriptions. 4
FIGURE 140: ESUPERBILL TEMPLATES 5
ICD-10 workflow enhancements in Diagnosis Component To view the Diagnosis component, select a patient profile, open an existing Provider Note or create a new one. You can drag and drop the Diagnosis component on the note from the components panel on the right side of the screen. Post ICD-10 effective date, the ICD-10 codes and descriptions are also displayed along with the ICD-9 codes. FIGURE 141: DIAGNOSIS COMPONENT- PN You can also move a Current diagnosis to Past by clicking on this diagnosis. icon next to the You can view both Current as well as Past diagnoses by clicking on the respective buttons at the top right corner of the Diagnosis window. 6
FIGURE 142: PAST DIAGNOSIS- PN ICD-10 IMPACT ON DIAGNOSIS SEARCH LISTS Master Search You can add a diagnosis by searching for it by browsing through the master search using the ICD- 9/ ICD-10 code or description. The system populates both ICD-9 and ICD-10 codes and descriptions that match your search query. You have the option to browse through the master list to get the appropriate code. 7
FIGURE 143: MASTER SEARCH Custom Lists Many practices define their preferred sets of diagnosis codes for faster documentation. This preferred list of diagnosis codes often pertains to the practice specialty or contains codes that are more frequently used by the practice and is called Custom List. To access the Custom List, please click on button. FIGURE 144: CUSTOM LIST 8
Hot Lists Lastly, you can document the appropriate diagnosis code by searching through the Hot List. You can access the Hot List by clicking on. FIGURE 145: HOT LIST Now that we ve searched for and added the required diagnosis code, you can click on the blue diagnosis tab to expand it to show the corresponding ICD-9 and ICD-10 code descriptions. FIGURE 146: CODE DESCRIPTION 9
The description also entails specifics of the patient s medical condition such as Severity, Onset, Type, Progress and Significance. These details enhance documentation and help avoid non-specific codes. SOAP Text After making the appropriate selection, you can click on Save button. The diagnosis codes that you select here will appear on the SOAP text as well. FIGURE 147: DIAGNOSIS COMPONENT SOAP TEXT Clinical Review Sheet Clinical Review sheet also reflects the diagnosis codes that you selected in the Diagnosis tab in both the Detailed as well as Summary view. 10
Summary View shows the ICD-10 codes. FIGURE 148: CLINICAL REVIEW SHEET- DETAILED FIGURE 149: CLINICAL REVIEW SHEET- SUMMARY 11
ICD-10 impact on Prescriptions The prescription screen shows the ICD-10 codes along with their descriptions in the Diagnosis tab. FIGURE 10: PRESCRIPTION SCREEN Here, you need to fill out the details of the prescription such as daily dose, number of refills, diagnosis and severity of the medical condition. You can select the ICD-10 diagnosis code that you want to associate with the prescription. 12
FIGURE 151: SELECT DIAGNOSIS When you select the diagnosis and click on Done, you will be redirected to the pharmacy screen. Once you select the pharmacy and the provider, the prescription preview screen opens up. FIGURE 11: PRESCRIPTION PREVIEW 13