title: Identifying clinically disruptive International Classification of Diseases 10th Revision Clinical Modification conversions to mitigate financial costs using an online tool.
abstract: OBJECTIVE
  To quantify coding ambiguity in International Classification of Diseases Ninth Revision Clinical Modification conversions (ICD-9-CM) to ICD-10-CM mappings for hematology-oncology diagnoses within an Illinois Medicaid database and an academic cancer center database (University of Illinois Cancer Center [UICC]) with the goal of anticipating challenges during ICD-10-CM transition.
  
  
  METHODS
  One data set of ICD-9-CM diagnosis codes came from the 2010 Illinois Department of Medicaid, filtered for diagnoses generated by hematology-oncology providers. The other data set of ICD-9-CM diagnosis codes came from UICC. Using a translational methodology via the Motif Web portal ICD-9-CM conversion tool, ICD-9-CM to ICD-10-CM code conversions were graphically mapped and evaluated for clinical loss of information.
  
  
  RESULTS
  The transition to ICD-10-CM led to significant information loss, affecting 8% of total Medicaid codes and 1% of UICC codes; 39 ICD-9-CM codes with information loss accounted for 2.9% of total Medicaid reimbursements and 5.3% of UICC billing charges.
  
  
  CONCLUSIONS
  Prior work stated hematology-oncology would be the least affected medical specialty. However, information loss affecting 5% of billing costs could evaporate the operating margin of a practice. By identifying codes at risk for complex transitions, the analytic tools described can be replicated for oncology practices to forecast areas requiring additional training and resource allocation. In summary, complex transitions and diagnosis codes associated with information loss within clinical oncology require additional attention during the transition to ICD-10-CM.
authors: University of Illinois at Chicago, Chicago, IL.
authors: Neeta K
authors: NK
authors: Venepalli
authors: Yusuf
authors: Y
authors: Qamruzzaman
authors: Jianrong John
authors: JJ
authors: Li
authors: Yves A
authors: YA
authors: Lussier
authors: Andrew D
authors: AD
authors: Boyd
mesh_terms: D003365:Costs and Cost Analysis; D016208:Databases, Factual; D017048:Health Care Costs; D006801:Humans; D007087:Illinois; D038801:International Classification of Diseases; D020407:Internet; D008484:Medicaid; D008491:Medical Informatics Applications; D008495:Medical Oncology; D014481:United States