scholarly journals Entropic measures of complexity in a new medical coding system

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jerome Niyirora
Keyword(s):  
Longitudinal Data ◽  
Coding System ◽  
Medical Coding ◽  
Coding Systems ◽  
The Us ◽  
Icd 10 ◽  
New Codes

Abstract Background Transitioning from an old medical coding system to a new one can be challenging, especially when the two coding systems are significantly different. The US experienced such a transition in 2015. Objective This research aims to introduce entropic measures to help users prepare for the migration to a new medical coding system by identifying and focusing preparation initiatives on clinical concepts with more likelihood of adoption challenges. Methods Two entropic measures of coding complexity are introduced. The first measure is a function of the variation in the alphabets of new codes. The second measure is based on the possible number of valid representations of an old code. Results A demonstration of how to implement the proposed techniques is carried out using the 2015 mappings between ICD-9-CM and ICD-10-CM/PCS. The significance of the resulting entropic measures is discussed in the context of clinical concepts that were likely to pose challenges regarding documentation, coding errors, and longitudinal data comparisons. Conclusion The proposed entropic techniques are suitable to assess the complexity between any two medical coding systems where mappings or crosswalks exist. The more the entropy, the more likelihood of adoption challenges. Users can utilize the suggested techniques as a guide to prioritize training efforts to improve documentation and increase the chances of accurate coding, code validity, and longitudinal data comparisons.

scholarly journals Entropic Measures of Complexity in a New Medical Coding System

2021 ◽  
Author(s):  
Jerome Niyirora
Keyword(s):  
Longitudinal Data ◽  
Coding System ◽  
Medical Coding ◽  
Coding Systems ◽  
The Us ◽  
Icd 10 ◽  
New Codes

Abstract BackgroundTransitioning from an old medical coding system to a new one can be challenging, especially when thetwo coding systems are significantly different. The US experienced such a transition in 2015.ObjectiveThis research aims to introduce entropic measures to help users prepare for the migration to a newmedical coding system by identifying and focusing preparation initiatives on clinical concepts with morelikelihood of adoption challenges.MethodsTwo entropic measures of coding complexity are introduced. The first measure is a function of thevariation in the alphabets of new codes. The second measure is based on the possible number of validrepresentations of an old code.ResultsA demonstration of how to implement the proposed techniques is carried out using the 2015 mappingsbetween ICD-9-CM and ICD-10-CM/PCS. The significance of the resulting entropic measures is discussed inthe context of clinical concepts that were likely to pose challenges regarding documentation, coding errors,and longitudinal data comparisons.ConclusionThe proposed entropic techniques are suitable to assess the complexity between any two medical coding systems where mappings or crosswalks exist. The more the entropy, the more likelihood of adoptionchallenges. Users can utilize the suggested techniques as a guide to prioritize training efforts to improve documentation and increase the chances of accurate coding, code validity, and longitudinal data comparisons.

Basic Principles and Benefits of Various Classification Systems in Health

2011 ◽  
pp. 51-58
Author(s):  
Dimitra Petroudi ◽  
Athanasios Zekios
Keyword(s):  
Information Systems ◽  
Health Professionals ◽  
International Classification Of Diseases ◽  
Classification Systems ◽  
Coding System ◽  
Basic Principles ◽  
Medical Coding ◽  
Coding Systems ◽  
Classification Of Diseases

The introduction of information systems in health progressively led tï coding systems. The purposes of these systems are: recording causes of death, coding diseases and procedures, etc. The most important medical coding system in our days is ICD (International Classification of Diseases). Other coding systems that health professionals use are: SNOMED, LOINC, MeSH, UMLS, DSM, DRG and HCPCS. There are also many Nursing Classification Systems, such as: NANDA, NIC, NOC, ICNP, Omaha and HHCC. This chapter describes these coding systems and their advantages.

Is the firearm epidemic in the US getting worse?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Tedesco ◽  
K Y C Adja ◽  
F Rallo ◽  
C Reno ◽  
M P Fantini ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
National Level ◽  
Gun Violence ◽  
Public Health Issue ◽  
Western World ◽  
Diagnostic Code ◽  
The Us ◽  
Icd 10 ◽  
Ed Visits ◽  
Annual Decline

Abstract Background The US is the least regulated firearm market in the Western world and firearm violence is a major public health issue. Firearms account for 40,000 deaths in the US annually, which is higher than other high-income countries. Although most of the gun-related deaths in the US are the result of suicide attempts and self-inflicted injuries, nearly 40% of them come from accidents, assaults, or police intervention. Methods We measured the number of non-self-inflicted firearm-related ED visits, by including patients discharged with diagnostic ICD-9-CM (ICD-10 for 2016) codes of accidents, assaults or legal intervention resulting in firearm injuries between 2006-2016. We used data from the Healthcare Cost and Utilization Project (HCUPnet). From the CDC Wide-ranging Online Data for Epidemiologic Research we obtained data on non-suicidal firearm-related deaths over the period 2006-2017. To identify the cause of death we used the ICD-10 codes. Temporal changes of rates of ED visits and deaths were evaluated using Joinpoint Software. Results In 2006 there were a total of 79,998 ED visits with a diagnostic code of firearm-related injury, and this number showed a non-significant 2.7% annual decline between 2006-2013 (p = 0.06) followed by a significant 19.4% annual increase between 2013-2016 (p < 0.05), resulting in 111.305 visits in 2016. The number of non-suicidal firearm-related deaths showed a significant 2.2% annual decline between 2006-2014 (p < 0.05), followed by a significant 10.3% APC (p < 0.05) between 2014-2017. Conclusions Data showed steady rates until 2013 and a striking increasing trend starting from 2013. Firearm-related deaths followed the same trends. Our data show that in the last four detectable years there has been a new concerning wave of gun violence and consequently a higher number of fatalities. Analysis limitations: we used national-level aggregate data and coding accuracy may be not consistent nationwide. Key messages In the last four detectable years there has been a new concerning wave of gun violence and consequently a higher number of fatalities nationwide. The US firearm related deaths epidemic urges for new policies and preventive measures, such as stricter background checks and restrictions on guns ownership.

Validation of ICD-10 codes shows intracranial venous thrombosis incidence to be higher than previously reported

2018 ◽  
Vol 49 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Joel D Handley ◽  
Hedley CA Emsley
Keyword(s):  
Positive Predictive Value ◽  
Cerebral Infarction ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
International Classification Of Diseases ◽  
Coding System ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
In Pregnancy

Background: Intracranial venous thrombosis (ICVT) accounts for around 0.5% of all stroke cases. There have been no previously published studies of the International Classification of Diseases, Tenth Edition (ICD-10) validation for the identification of ICVT admissions in adults. Objective: The aims of this study were to validate and quantify the performance of the ICD-10 coding system for identifying cases of ICVT in adults and to derive an estimate of incidence. Method: Administrative data were collected for all patients admitted to a regional neurosciences centre over a 5-year period. We searched for the following ICD-10 codes at any position: G08.X (intracranial and intraspinal phlebitis and thrombophlebitis), I67.6 (non-pyogenic thrombosis of intracranial venous system), I63.6 (cerebral infarction due to cerebral venous thrombosis, non-pyogenic), O22.5 (cerebral venous thrombosis in pregnancy) and O87.3 (cerebral venous thrombosis in the puerperium). Results: Sixty-five admissions were identified by at least one of the relevant ICD-10 codes. The overall positive predictive value (PPV) for confirmed ICVT from all of the admissions combined was 92.3% (60 out of 65) with the results for each code as follows: G08.X 91.5% (54 of 59), O22.5 100% (4 of 4), I67.6 100% (1 of 1), I63.6 100% (1 of 1) and O87.3 100% (1 of 1). There were 40 unique cases of ICVT over a 5-year period giving an annual incidence of ICVT of 5 per million. Conclusions: All codes gave a high PPV. Implications for practice: As demonstrated in previous studies, the incidence of ICVT may be higher than previously thought.

scholarly journals Reimbursement of Apps for Mental Health: Findings From Interviews

10.2196/14724 ◽  
2019 ◽  
Vol 6 (8) ◽  
pp. e14724 ◽  
Author(s):  
Adam C Powell ◽  
Matthias B Bowman ◽  
Henry T Harbin
Keyword(s):  
Mental Health ◽  
Care Delivery ◽  
Coding System ◽  
Reimbursement Mechanisms ◽  
Common Procedure ◽  
The Us ◽  
Varied Range ◽  
Potential Channels ◽  
Physician Work ◽  
Shed Light

Background Although apps and other digital and mobile health tools are helping improve the mental health of Americans, they are currently being reimbursed through a varied range of means, and most are not being reimbursed by payers at all. Objective The aim of this study was to shed light on the state of app reimbursement. We documented ways in which apps can be reimbursed and surveyed stakeholders to understand current reimbursement practices. Methods Individuals from over a dozen stakeholder organizations in the domains of digital behavioral and mental health, care delivery, and managed care were interviewed. A review of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCSPCS) codes was conducted to determine potential means for reimbursement. Results Interviews and the review of codes revealed that potential channels for app reimbursement include direct payments by employers, providers, patients, and insurers. Insurers are additionally paying for apps using channels originally designed for devices, drugs, and laboratory tests, as well as via value-based payments and CPT and HCSPCS codes. In many cases, it is only possible to meet the requirements of a CPT or HCSPCS code if an app is used in conjunction with human time and services. Conclusions Currently, many apps face significant barriers to reimbursement. CPT codes are not a viable means of providing compensation for the use of all apps, particularly those involving little physician work. In some cases, apps have sought clearance from the US Food and Drug Administration for prescription use as digital therapeutics, a reimbursement mechanism with as yet unproven sustainability. There is a need for simpler, more robust reimbursement mechanisms to cover stand-alone app-based treatments.

scholarly journals PENGKODEAN DALAM PEMBELAJARAN PENULISAN SASTRA

2020 ◽  
Vol 12 (2) ◽  
pp. 161-171
Author(s):  
Tsalits Abdul Aziz Al farisi
Keyword(s):  
Design Patterns ◽  
Model Design ◽  
Coding System ◽  
Student Activities ◽  
Learning Pattern ◽  
Coding Systems ◽  
Literary Writing ◽  
Literary Learning

The purpose of this research is to describe it 1) how is the coding system for creating poetry. 2) how can  student understand objects in the ward then applied to the text of diction. 3) how can students create certain diction in relation to what one imagines. The methods in this research are using quantitatif methods with model design patterns using media as a basis for finding a purpose the study of literature at SMA Kanjeng Sepuh school X class. The result of this study is the observation table of assessments stuents interest in literature especially the poem. On other side of the observation of teacher and student activities carrying out the study of poetry is also a focus quantitatif data results. The conclusion of this study is to find a point of literary learning accuracy through quantitatif measures in coding systems. It needs to be used to find the concrete steps the literary writing learning pattern that currently is of little interest to students.

scholarly journals Evaluation of Audio Compression Artifacts

10.14311/906 ◽  
2007 ◽  
Vol 47 (1) ◽  
Author(s):  
M. Herrera Martinez
Keyword(s):  
State Of The Art ◽  
Subjective Evaluation ◽  
Audio Coding ◽  
Coding System ◽  
Audio Compression ◽  
Coding Systems ◽  
Wide Range ◽  
Different Types ◽  
Processing Techniques ◽  
Signal Processing Techniques

This paper deals with subjective evaluation of audio-coding systems. From this evaluation, it is found that, depending on the type of signal and the algorithm of the audio-coding system, different types of audible errors arise. These errors are called coding artifacts. Although three kinds of artifacts are perceivable in the auditory domain, the author proposes that in the coding domain there is only one common cause for the appearance of the artifact, inefficient tracking of transient-stochastic signals. For this purpose, state-of-the art audio coding systems use a wide range of signal processing techniques, including application of the wavelet transform, which is described here. 

A Systematic Review of Coding Systems Used in Pharmacoepidemiology and Database Research

2018 ◽  
Vol 57 (01/02) ◽  
pp. 01-42 ◽  
Author(s):  
Yong Chen ◽  
Marko Zivkovic ◽  
Su Su ◽  
Jianyi Lee ◽  
Edward Bortnichak ◽  
...  
Keyword(s):  
Real World ◽  
Clinical Setting ◽  
English Language ◽  
Data Extraction ◽  
Therapeutic Area ◽  
Coding System ◽  
Clinical Coding ◽  
Real World Data ◽  
Coding Systems ◽  
Database Research

Summary Background: Clinical coding systems have been developed to translate real-world healthcare information such as prescriptions, diagnoses and procedures into standardized codes appropriate for use in large healthcare datasets. Due to the lack of information on coding system characteristics and insufficient uniformity in coding practices, there is a growing need for better understanding of coding systems and their use in pharmacoepidemiology and observational real world data research. Objectives: To determine: 1) the number of available coding systems and their characteristics, 2) which pharmacoepidemiology databases are they adopted in, 3) what outcomes and exposures can be identified from each coding system, and 4) how robust they are with respect to consistency and validity in pharmacoepidemiology and observational database studies. Methods: Electronic literature database and unpublished literature searches, as well as hand searching of relevant journals were conducted to identify eligible articles discussing characteristics and applications of coding systems in use and published in the English language between 1986 and 2016. Characteristics considered included type of information captured by codes, clinical setting(s) of use, adoption by a pharmacoepidemiology database, region, and available mappings. Applications articles describing the use and validity of specific codes, code lists, or algorithms were also included. Data extraction was performed independently by two reviewers and a narrative synthesis was performed. Results: A total of 897 unique articles and 57 coding systems were identified, 17% of which included country-specific modifications or multiple versions. Procedures (55%), diagnoses (36%), drugs (38%), and site of disease (39%) were most commonly and directly captured by these coding systems. The systems were used to capture information from the following clinical settings: inpatient (63%), ambulatory (55%), emergency department (ED, 34%), and pharmacy (13%). More than half of all coding systems were used in Europe (59%) and North America (57%). 34% of the reviewed coding systems were utilized in at least 1 of the 16 pharmacoepidemiology databases of interest evaluated. 21% of coding systems had studies evaluating the validity and consistency of their use in research within pharmacoepidemiology databases of interest. The most prevalent validation method was comparison with a review of patient charts, case notes or medical records (64% of reviewed validation studies). The reported performance measures in the reviewed studies varied across a large range of values (PPV 0-100%, NPV 6-100%, sensitivity 0-100%, specificity 23-100% and accuracy 16-100%) and were dependent on many factors including coding system(s), therapeutic area, pharmacoepidemiology database, and outcome. Conclusions: Coding systems vary by type of information captured, clinical setting, and pharmacoepidemiology database and region of use. Of the 57 reviewed coding systems, few are routinely and widely applied in pharmacoepidemiology database research. Indication and outcome dependent heterogeneity in coding system performance suggest that accurate definitions and algorithms for capturing specific exposures and outcomes within large healthcare datasets should be developed on a case-by-case basis and in consultation with clinical experts.

Coding for Pediatrics 2018, 23rd Ed

2017 ◽  
Author(s):  
Keyword(s):  
American Academy ◽  
Behavioral Health ◽  
Health Care Professionals ◽  
Care Management ◽  
Chronic Care ◽  
Icd 10 ◽  
New Codes ◽  
Therapeutic Services ◽  
Essential Resource ◽  
Management Services

For beginners and advanced coders alike, this is the first place to look for pediatric-specific coding solutions! A widely used American Academy of Pediatrics (AAP) exclusive, this essential resource complements standard coding manuals with proven documentation and billing solutions. This year's completely updated 23rd edition includes all changes in Current Procedural Terminology (CPT) codes -- complete with expert guidance for their application as well as ICD-10-CM updates for pediatric-related conditions. There is also an increased focus on compliant electronic health record administration. The book's many clinical vignettes and examples, as well as the many coding pearls throughout, provide added guidance needed to ensure accuracy and payment. This great resource continues to be approved for 4 continuing education units from the American Academy of Professional Coders. New in this edition: New chapters on Telemedicine, Common Surgical Procedures and Sedation, and Common Testing and Therapeutic Services Discussion of new codes for primary care management of behavioral health conditions Division of anesthesia and surgery coding from testing and therapeutic services for easier reference Discussion of options for reporting chronic care management services by physician or qualified health care professionals in 2018 New codes for common chest and abdominal radiologic services, pulmonary services updates to vaccines New codes for several unique care management services including: physician-performed chronic care, psychiatric collaborative care, and behavioral health integration care

On Educating about Medical Data Management

2007 ◽  
Vol 46 (01) ◽  
pp. 74-79 ◽  
Author(s):  
P. Knaup ◽  
F. Leiner ◽  
R. Haux
Keyword(s):  
Data Management ◽  
Clinical Data ◽  
Medical Data ◽  
Patient Data ◽  
Management Systems ◽  
Multiple Use ◽  
Data Management Systems ◽  
Medical Coding ◽  
Medical Data Management ◽  
Coding Systems

Summary Objectives: To summarize background, challenges, objectives, and methods for the usability of patient data, in particular with respect to their multiple use, and to point out how to lecture medical data management. Methods: Analyzing the literature, providing an example based on Simpson’s paradox and summarizing research and education in the field of medical data management, respectively health information management (in German: Medizinische Dokumentation). Results: For the multiple use of patient data, three main categories of use can be identified: patientoriented (or casuistic) analysis, patient-group reporting, and analysis for clinical studies. A so-called documentation protocol, related to study plans in clinical trials, supports the multiple use of data from the electronic health record in order to obtain valid, interpretable results. Lectures on medical data management may contain modules on introduction, basic concepts of clinical data management and coding systems, important medical coding systems (e.g. ICD, SNOMED, TNM, UMLS), typical medical documentation systems (e.g. on patient records, clinical and epidemiological registers), utilization of clinical data management systems, planning of medical coding systems and of clinical data management systems, hospital information systems and the electronic patient record, and on data management in clinical studies. Conclusion: Usability, the ultimate goal of recording and managing patient data, requires, besides technical considerations, in addition appropriate methodology on medical data management, especially if data is intended to be used for multiple purposes, e.g. for patient care and quality management and clinical research. Medical data management should be taught in health and biomedical informatics programs.

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