Patient Problem and Problem Type records currently allow you to add an ICD-9 diagnosis code to them so that you may relate the Problem to an ICD-9 code. This update (6.1) retains that capability and also allows you to add an ICD-10 diagnosis code record to Problem and Problem Type records.
If you use Problems then you have a special tool to assist you in your ICD-10 transition. By coding an ICD-10 code alongside the corresponding ICD-9 code for a problem, you now have a quick and easy cross reference to the correct ICD-10 code that you can use for subsequent encounters for the same problem. Even better, if you show problems in your Encounter Dashboard, you can easily see both the ICD-9 and ICD-10 codes directly in the Encounter as you create it. You will have to click back and forth between the encounter and dashboard tabs, but the information you need to code ICD-10 for an encounter can be just a mouse click away, at least for existing problems.
You can also create this same ICD-9 to ICD-10 relationship on your Problem Type records so that anytime you use the Problem Type for any patient you will automatically have the ICD-10 code mapping available for new Problems of that type. Since some ICD-9 codes cannot be mapped to a single ICD-10 code, a Remarks field has been added to both the Problem and Problem Type records. Just like ICD-9 and ICD-10 codes, Remarks placed on a Problem Type record will automatically populate the Remarks field for a Problem that uses that Problem Type. Remarks can contain additional information related to ICD-10 (or anything else). When multiple ICD-10 codes are required they can be entered into the remarks field. You will have to open the Problem Editor to see the Remarks, but you can open the editor from the dashboard. In these cases it is suggested that you leave the ICD-10 code on the Problem or Problem Type empty so that you will know that further investigation is required. If your next step is always to open the Problem Editor you can then see if Remarks exist describing how to proceed with ICD-10 coding. If there are no remarks (and no ICD-10 code) you can edit the Problem (or Problem Type) record and add the relevant information so that it will be available for the next time (you have to determine the ICD-10 codes anyway; you might as well do it in a way that prevents you from having to do it over and over again every time you code for this problem).
The following examples show opening Problems from the EMR tab, but there is no fundamental difference when opening Problems from the EMR or Encounter Dashboards.
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