An order diagnosis originates from a clinical system and eventually makes its way into one of the two billing systems (Hospital or Professional). Typically the physician needs to sign for an order, so you shouldn't trust a diagnosis on an order unless it was signed.
In the revenue cycle for professional billing (this normally means outpatient visits), you will find diagnoses on charges that originated from one of the many clinical systems. Many would assume these all show up on professional billing claim types, but that isn't always the case if the charges are not billed to insurance. -----Original Message----- From: [email protected] [mailto:[email protected]] On Behalf Of Dan Connolly Sent: Tuesday, November 18, 2014 10:52 AM To: Phillip Reeder; [email protected]; [email protected] Cc: [email protected] Subject: RE: [gpc-informatics] #90: Diagnoses Modifiers for data attribution I just realized this proposal doesn't facilitate the main distinction our users are accustomed to: billing vs. clinical diagnosis. They'd have to know to choose the union of Enounter, Order, Problem list, and Professional. In HERON at KUMC, the union of Problem List and Encounter is represented as a Clinical folder. And we don't (yet?) support Professional Diagnosis nor Order Diagnosis. What are those? I'd appreciate somebody filling me/us in on what workflows those represent. -- Dan ________________________________________ From: Phillip Reeder [[email protected]] Sent: Wednesday, November 12, 2014 2:13 PM To: [email protected]; [email protected]; Dan Connolly Cc: [email protected] Subject: Re: [gpc-informatics] #90: Diagnoses Modifiers for data attribution Based on the emails I found, and what is on babel, this is what I think the modifiers should be. The only difference from Babel is in the Billing Diagnosis modifiers where I tried apply what was in the various emails. Cerner had Inactive and Canceled modifiers for the Problem List Diagnosis in one of the emails. I¹m unsure if they need to be added or if they could be mapped to the three modifiers from Epic. For consistency, is there a preference for Principle vs Primary? Does it make a difference? Modifier Modifier Code Clarity Table Billing Diagnosis Admit Diagnosis Principle DX|BILL:ADMIT PRINCIPLE HSP_ACCT_ADMIT_DX Admit Diagnosis Secondary DX|BILL:ADMIT SECONDARY HSP_ACCT_ADMIT_DX Discharge Diagnosis Principle DX|BILL:PRINCIPAL HSP_ACCT_DX_LIST Discharge Diagnosis Secondary DX|BILL:SECONDARY HSP_ACCT_DX_LIST Discharge Diagnosis Present on Admis.. DX|BILL:POA HSP_ACCT_DX_LIST Encounter Diagnosis Admit Encounter Diagnosis DX|ENC:ADMIT HSP_ADMIT_DIAGNOSIS Discharge Encounter Diagnosis DX|ENC:DISCHARGE HSP_DISCH_DIAGNOSIS Primary Encounter Diagnosis DX|ENC:PRIMARY PAT_ENC_DX Secondary Encounter Diagnosis DX|ENC:SECONDARY PAT_ENC_DX Medical History Diagnosis DX:HISTORY MEDICAL_HX Order Diagnosis Order Medication Diagnosis DX|ORDER:MED ORDER_DX_MED Order Procedure Diagnosis DX|ORDER:PROC ORDER_DX_PROC Problem List Diagnosis Active Problem DX|PROB:ACTIVE PROBLEM_LIST Deleted Problem DX|PROB:DELETED PROBLEM_LIST Resolved Problem DX|PROB:RESOLVED PROBLEM_LIST Professional Diagnosis Primary Professional Diagnosis DX|PROF:PRIMARY ARPB_TRANSACTIONS Secondary Professional Diagnosis DX|PROF:SECONDARY ARPB_TRANSACTIONS On 11/12/14, 1:33 PM, "GPC Informatics" <[email protected]> wrote: >#90: Diagnoses Modifiers for data attribution >--------------------------+---------------------------- > Reporter: campbell | Owner: preeder > Type: design-issue | Status: assigned > Priority: major | Milestone: data-domains2 >Component: data-stds | Resolution: > Keywords: | Blocked By: > Blocking: 70, 91, 120 | >--------------------------+---------------------------- >Changes (by dconnolly): > > * cc: gpc-dev@Š (added) > * owner: dconnolly => preeder > * status: reopened => assigned > > >Comment: > > Phillip, I re-opene this because your question (Wednesday, November 12, > 2014 12:44 PM) shows we clearly didn't carry out the recorded decision. > > Do you have a preference on what the modifiers actually should be? > >-- >Ticket URL: ><http://informatics.gpcnetwork.org/trac/Project/ticket/90#comment:7> >gpc-informatics <http://informatics.gpcnetwork.org/> >Greater Plains Network - Informatics ________________________________ UT Southwestern Medical Center The future of medicine, today. _______________________________________________ Gpc-dev mailing list [email protected] http://listserv.kumc.edu/mailman/listinfo/gpc-dev _______________________________________________ Gpc-dev mailing list [email protected] http://listserv.kumc.edu/mailman/listinfo/gpc-dev
