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Jornada Técnica sobre CIE-10Introducción Conceptual | Conceptual Briefing
15-16 de septiembre de 2009Escuela Nacional de Sanidad
Agencia de Calidad del Sistema Nacional de SaludInstituto de Información Sanitaria
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Datos de contacto | Contact data• Arturo Romero Gutiérrez• Médico de Admisión y Documentación Clínica• Complejo Hospitalario de Toledo• Miembro de la Unidad Técnica de la
CIE-9-MC para el Sistema Nacional de Salud• [email protected]
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Hechos clave | Key facts• Desarrollo ICD-10-CM y PCS | Development
– Proceso largo | Long time in process– Respuesta crítica de proveedores | Provider criticism– Apoyo moderado de AHIMA* | Moderate support– Estado borrador | Draft status– Efecto “poda” | Pruning effect– Plazo en EE.UU. 1 oct 2013 | Deadline in USA– Sistemas de mapeo | Mapping systems– “Complejidad” de PCS | PCS “complexity”
• Agotamiento de CIE-9-MC | Run off codes• Terminología pobre | Poor terminology• Taxonomía anticuada | Obsolete taxonomy
* AHIMA: American Health Information Management Association
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Versiones | Versions
• CIE-9-MC 2008 (ICD-9-CM FY2007)• CIE-10 (2003, 2008)• ICD-10-CM Clinical Modification (2009)• ICD-10-CA Canada Enhancements• ICD-10-AM Australian Modification• PCS Procedure Coding System (2009)• Other procedure classificatios
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Actividades | Activities
• Mantenimiento continuado de CIE-9-MC| Continued CIE-9-MC updating
• Observación de limitaciones CIE-9-MC| Observing limitations
• Seguimiento de publicaciones ICD-10 (+CM)| Publications monitoring & follow-up
• Diseño de eCIE10 y sistema de mapeo| Web application design + mapping system
• Ensayo de prototipos eCIE10MC & PCS| Prototype testing
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Fuentes de información | Info sources
• eCIE9MC (base de datos | database)MSPS – IIS España
• CIE-10 (PDF) OPS – Washington…
• ICD-10-CM (PDF) CDC• ICD-10-AM NCCH• ICD-10-CA CIHI/ICIS• PCS (.mdb) CDC
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CDC
Fuentes de información | Info sources
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Fuentes de información | Info sources
ICD-10-CM 2009
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ICD-10-PCS 2009
Fuentes de información | Info sources
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Material formativo
ICD-10-PCS 2009
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Borradores ICD-10-CM | Drafts
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Borradores | Drafts
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ICD-10-AM
ICD-10-AM
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Mapeo ICD10-ICD10AM | Mapping
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Fuentes de información | Info sources
CIHI/ICIS
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Características ICD-10-CA | Features
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Observación de ICD-10-CA | Observed
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Mantenimiento CIE-9-MC | Editing
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Mantenimiento CIE-9-MC | Editing
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Mantenimiento CIE-9-MC | Editing
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Mantenimiento CIE-9-MC | Editing
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CIE-10 2003 | ICD-10
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En esquema… | ICD-10-CM outline
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En esquema… | PCS Outline
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Instrumentos | Tools
• Navegación de clasificaciones | Browsing– eCIE9MC Aplicación Web | Web Application– eCIE10 | Web Application– Sistema de mapeo | Mapping system– Navegador ICD-10-CM | Browser– Navegador PCS | Browser
• Comparador de contenido | Contents comparator• Estadísticas comparadas | Comparative stats
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Comparador | Comparator
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Navegador PCS | Browser
PCS: Procedimientos
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PCS: Sección 0
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PCS: Taxonomía multiaxial
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PCS: Ayuda
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PCS: Descriptores
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PCS: Indice alfabético
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PCS: Mapeo
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Características principales | Main features
Criterios CIE-10-MC
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Diferencias | Differences
ICD-10-CMCIE-9-MCCriterios
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Mejoras | Improvements
EfectosCIE-10-MCCriterios
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Para discusión … | To be discussed …
• Críticas | Criticism• Interoperabilidad | Interoperability• Estrategia de formación | Training strategy
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Críticas | Criticism
ICD-9-CMCIE-9-MC• …• …
ICD-10-CMCIE-10-MC• …• …• …• …• …• …• …• …• …
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Críticas | Criticism
Facturación | Billing
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Respuesta a críticas | Answering Criticism
• Ulceras por presión y localizaciones anatómicas– Pressure ulcers are a common condition in elderly Medicare beneficiaries with
chronic illnesses. Under the current ICD-9-CM system, health care practitionerscan identify the severity or location of a pressure ulcer but the coding systemcannot link those elements if the patient has more than one ulcer. Under a single ICD-10 code, a patient’s medical history will identify the severity and location of each pressure ulcer;
• Angioplastia y procedimientos en general– ICD-9 has only one code for angioplasty, the widely used procedure for widening
a narrowed or obstructed blood vessel. ICD-10 provides 1,170 codeddescriptions, with a granularity that pinpoints the location of the blockage and the device used for each patient;
• Lateralidad– ICD-9 codes do not provide sufficient detail to distinguish whether a condition
occurred on a patient’s left or right side. ICD-10 will improve care by providing thatbasic type of information;
• Códigos de combinación– ICD-9 includes separate codes for medication errors and other external causes of
injury, which are reported separately from the actual condition. Under ICD-10, information about medication errors and external causes of injury will be embedded in the code for the condition. Therefore a single, more informative codewill provide a ready source of information to help medical professionals preventmedical errors and improve quality of care."
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Interoperabilidad | Interoperability
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Estrategia de formación | Training strategy
• Aprovechar conocimiento existente| Take advantage from existing knowledge
• Instrumentos óptimos (navegación, mapeo)| Optimized tools (browsing, mapping)
• Inmersión progresiva| Progressive immersion
• Multimodal (presencial+e-formación)| Multimodal (presence & e-learning)
• Momento óptimo| Optimum timing
• Acreditación| Accreditation
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Inmersión progresiva | Progressive immersion
• Uso de los recursos de terminología| Use of terminology resources
• Doble codificación| Double coding
• Armonización de índices| Alphabetic index harmonisation
• Mapeo semántico y de referencia| Reference & semantic mapping
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Muchas gracias …
• thank you very much• merci beaucoup• go raibh maith agat• moltes gràcies• eskarrik asko• moitas grazas