I’ve been working in healthcare, in one capacity or another, my entire career. I put myself through college working as a hospital unit coordinator, a women’s clinic assistant, and a medical biller. For the last 10 years, I’ve been in the healthcare IT side of the business. I have taken part in development, implementation, and maintenance projects, always trying to make sure that healthcare terminology standards were used effectively. When I tell people what I do, there is always some level of confusion. What do you mean by healthcare terminology? Do you maintain the medical dictionary? Well, not exactly, but sort of. Terminology is an overloaded term used to describe a lot in the healthcare industry. The truth is that terminology means different things to different people. It depends on what type of organization you work for, your role, and what you are trying to accomplish.
There are many different healthcare terminology standards. Quality reports try to take advantage of these terminology standards, but there is not a single, widely accepted standard to use. Clinical codes are needed for CMS reports, but ACOs commonly use claims data instead. There are many solutions to the multi-terminology problem, including mapping or paying a vendor to reconcile the standards. These solutions are not flexible or adaptable enough and rarely succeed. A healthcare data warehouse creates a single solution that allows for all terminology standards to exist in one place to be pulled out for reporting purposes when needed.
ICD-10 will increase the number of diagnosis codes from 13,000 (in ICD-9) to roughly 68,000. Only 24% of these codes will map one-to-one. The switch from ICD-9 to ICD-10 is mandated for October 2014, which is soon considering all the change happening in healthcare right now. However disruptive the change to ICD-10 may seem, the new codes will increase specificity, allowing faster billing and better healthcare analytics. Embracing the switch now will allow organizations to realize the benefits sooner.
“SNOMED, HL7, ICD-9 , ICD-10, CPT codes: With so many healthcare terminology standards available, which one should you be using? Well, it really depends on what you’re trying to accomplish. Different healthcare terminology standards were developed to fulfill distinct purposes. Each one generally does a good job meeting its purpose. Match your purpose to your standard, and you probably have a winner. There are billing, clinical, laboratory, and pharmacy terminologies. Health Catalyst’s expert shows you the trick to picking the one that’s right.