Ask Joy: This Week – Transition to SNOMED in 2014
There’s no question—2014 is going to be a confusing year, with the transition to Stage 2, new EHR certification requirements, changes to quality reporting programs, and the implementation of new coding requirements.
Last week, we reviewed the Summary of Care measures for both Stage 1 and Stage 2 of Meaningful Use. However, there’s more to take into consideration for this objective. In order to successfully meet the 2014 Summary of Care requirements, you’ll have to change how you maintain an up-to-date problem list. So, the question:
When maintaining an up-to-date problem list, can both SNOMED-CT as well as non-SNOMED-CT (i.e. ICD-9 or ICD-10) elements be included to meet the Summary of Care measure?
The requirements state that for each transition of care or referral, patient problems must be included in the Summary of Care Record. Furthermore, CMS explains how code sets need to be mapped to SNOMED-CT in your certified EHR. Although Stage 1 recommends using SNOMED or ICD-9 codes for recording patient problems, Stage 2 requires the problems to be coded using SNOMED only.
Today, most providers use ICD-9 for coding patient problems, and all providers use ICD-9 for billing, as that is the CMS requirement. But, no matter which stage you’re in next year, the coding requirements will change. If you don’t have a plan in place, I offer a simple outline to ensure you’re following guidelines to meet Meaningful Use in 2014, no matter which stage you are attesting.
From January 1 – October 1, 2014
If you are attesting for Stage 1
- You can use ICD-9 or SNOMED for adding patient problems
- You will continue to use ICD-9 for billing
If you are attesting for Stage 2
- You must use SNOMED codes for patient problems
- You must use ICD-9 for billing
After October 1, 2014
If you are attesting for Stage 1
- You can use ICD-9 or SNOMED for adding patient problems
- You must use ICD-10 for billing
If you are attesting for Stage 2
- You must use SNOMED codes for patient problems
- You must use ICD-10 for billing
| Now | Jan 1 – Sep 30, 2014 | Oct 1 2014 onwards | |||
| Stage 1 | Stage 2 | Stage 1 | Stage 2 | ||
| Clinical | ICD-9 /SNOMED | ICD-9 /SNOMED | SNOMED | ICD-9 /SNOMED | SNOMED |
| Billing | ICD-9 | ICD-9 | ICD-9 | ICD-10 | ICD-10 |
Moving to SNOMED should ease your transition to ICD-10, mainly because mapping ICD-9 to ICD-10 is much more complicated than mapping SNOMED to ICD-10.
Providers should start using SNOMED codes for coding patient problems as soon as possible, even if you will be attesting for Stage 1 in 2014.
And remember, if you need further support, understanding, or guidance, 4Med offers a full program on bridging the gap between ICD-9 to ICD-10.
About the Author: Joy Rios has worked directly with multiple EHRs to develop training programs for both trainers and practice staff. She has successfully attested to Meaningful Use for multiple ambulatory practices in both Medicare and Medicaid. She also authored the Certified Professional Meaningful Use course for www.4Medapproved.com. Joy holds an MBA with a focus in sustainability. She is Health IT certified with a specialty in Workflow Redesign, holds HIPAA security certification, and is a great resource for information regarding government incentive programs.Ask Joy is a regular column on 4Medapproved HIT Answers.