WO2016149670A1 - Medical classification coding software - Google Patents

Abstract

A new method of obtaining an ICD-10 code for a condition or disease has the steps of providing a preprogrammed medical computing device with input and output display, signing into the medical diagnostic system; and selecting a start of the search by anatomical or verbal method. The anatomical method provides an anatomical model. It also enables selection of an affected anatomical part, selecting a layer of the human body and answering a series of questions to pinpoint the ICD-10 code. The verbal model provides a hardware or virtual keyboard, typing medical terms and answering a series of questions to pinpoint the ICD-10 code. The system also enables reverse look-up to find information about a code.

Description

MEDICAL CLASSIFICATION CODING SOFTWARE

TECHNICAL FIELD

[0001] This invention is in the field of medical coding of diseases and conditions and more specifically, in coding to the new ICD-10 system, using touch screens and more specific and correct codes.

BACKGROUND

[0002] The field of medical coding has grown up in the last decade, as the information requirements have become more intense, due to insurance companies and governmental authorities working to increase specificity, automate processing for Medicare and insurance companies, and detect fraud. Medical coding had steadily moved away from health care providers to specialists in finding the correct codes among the tens of thousands that are available. More recently, many institutions have cut staff and expect the health care professional to not only diagnose and treat but also detect and correctly enter the codes enabling payment.

[0003] The medical coding systems have been strictly numerical, with a string of numbers classifying medical conditions and treatments. The left end of the number string codes for more general information, with additional digits on the right end providing more specific information. Different conditions, associated with particular procedures could eventually be memorized by intelligent health care professionals. Expert coders are able to maximize billings by adjusting the particular codes to be sure to demonstrate the value of the procedure(s). Now that has abruptly changed with the addition of two more right-end digits to an already complicated system.

[0004] The new ICD-10 expands the previous number of codes from about 17,000 to about 141,000 codes. There are additional columns of numbers in the new codes that require more detail. There are almost no direct translations from ICD-9 to ICD-10, although providers of coding programs are attempting to perform just such steps. There are no direct translations because the new ICD-10 codes have two additional digits, not found in ICD-09. In other words there is the capability for 100 times as many codes. Now using numbers and 26 alphabet letters in the two digits, there are as many as 1296 times the number codes available in ICD-10. A translation program can at best get the coder to a family of 100 codes.

Additional detail not provided in ICD-9 involves a variety of types, including visit number, more detail on the medical problem and code, such as month of pregnancy, etc. The more detailed coding will enable automation at the insurance company, with "adequate" numerical detail, rather than narratives.

[0005] It should not be a surprise that implementation of ICD-10 with its expanded data requirements has been delayed. The delayed implementation of ICD-10 is simultaneous with new stresses on the healthcare system, including millions more patients under the Affordable Health Care Act, and more regulations thereunder. New health care professionals are needed and many are coming from non-English speaking countries. Besides US use, other countries are considering implementation of ICD-10, as it will provide more data and international comparisons.

SUMMARY

[0006] In one embodiment of this invention, there is provided an improved method of obtaining an ICD-10 code for a condition or disease that provides input by either verbal entry or selection of body parts on 3D model. The method starts with providing a preprogrammed medical computing device with input and output display. The next steps are signing into the medical diagnostic system and selecting a start of the search by anatomical or verbal method. The anatomical method has the steps of providing an anatomical model; touching an area of a touch screen closest to an affected anatomical part; selecting a layer of the anatomical model; and answering a series of questions to pinpoint the code. The verbal method has the steps of providing a keyboard in the form of hardware or touch screen functions; entering at least one word describing the condition or disease; and answering a series of questions to pinpoint the code.

[0007] Optionally, the model of the human is presented as three-dimensional. In another embodiment, the model of the human body is rotated. In yet another embodiment, there is the step of zooming the human model to make it larger or smaller. In yet another embodiment there is a step of accessing deeper layers of the body. Optionally, the method of verbal searching also has the step of touching an area of a touch screen closest to the affected anatomical part. In yet another embodiment, there is the step of displaying at least the left digits of the ICD-10 code as more information is selected.

[0008] To the accomplishment of the foregoing and related ends, certain illustrative aspects of the invention are described herein in connection with the following description. These aspects are indicative, however, of but a few of the various ways in which the principles of the invention is intended to include all such aspects and their equivalents. Other advantages and novel features of the invention may become apparent from the following detailed description of the invention when considered in conjunction with the drawings.

DETAILED DESCRIPTION

[0009] As an experienced and multiply certified "coder" (expert at interpreting other health care professionals' observations and actions into the medical codes that are used for billing), I have personally shared the problems healthcare professionals and insurance providers have in mastering the preceding versions of the ICD system. In particular, new professionals, such as medical students, devote many hours to master the organization of the ICD-9 in order to find and memorize the correct codes for procedures on which they assist. Health care providers are hiring new as well as experienced employees to handle the influx of newly insured patients. New employees may have to learn the basics of coding for the first time.

Experienced employees are struggling to master the new coding system.

[0010] People for whom English is a second language struggle, at least initially, with providing a clear narrative, both for choice of terms and different writing styles. Selecting a wrong term can send the healthcare professional down a time-wasting and fruitless coding path.

[0011] I have discussed these coding challenges with health care providers and other coders who experience on a daily basis the depth of frustration with current solutions. In an effort to come up with a solution, I synthesized various ideas to solve these problems and devised a new method for arriving at correct and effective ICD-10 codes. My new method is designed to save professionals time, increase their productivity, and provide institutions greater efficiency. Even if my system only decreased the frustration level of healthcare professionals, that would be highly beneficial, as they would be in a better frame of mind to focus on their foremost personal and professional goal of helping people.

[0012] The present invention arose out of a desire to create a system that not only addresses the increased complexities of ICD-10, but also makes it easier to enter and select the correct data to arrive at the exact, appropriate coding for ICD-10. As a certified coder, I have been studying versions of ICD-10 for years. Even before that, I was facile at finding the most appropriate ICD-9 codes in coding books and computer applications.

[0013] I have also examined ICD-10 "crosswalks," which are software applications that purport to translate ICD-9 codes into ICD-10 codes. As mentioned above, they can only point to a family of ICD-10 codes because there are additional factors required to produce a correct and complete ICD-10 code. I continued to search for software or a web-based system but did not find anything better.

[0014] Thus I decided to design my own new system. I have spoken to many people in various aspects of the industry (including but not limited to physicians, professional coders, billing personnel, insurance company employees), all of whom recognized that such a product was missing and sorely needed. Even more importantly, people entering the industry, such as new coders, billers, nurses and medical students, have a serious need to get up to speed on not just coding but particularly the new more complex ICD-10 system.

[0015] My new software uses words (verbal) as well as graphics (anatomical) to assist the coder in finding the correct code. No other software cues the coder with specific questions to get the correct code (see below for details). There are code "crosswalks" from ICD-9 to ICD- 10. However, because more information - in more digits of information - is required for ICD-10, there often is not a direct code correlation. Consider that the two new digits populated by numbers 0-9 provide up to 100 more choices for the coder. In addition, my method provides for efficient updates as new versions of ICD-10 codes are released.

[0016] My software accepts not only words to start determining the correct code, it also accepts touch to access anatomical illustrations. For example, the coder can select by touch to a touch screen the particular location of a broken bone. The coder can enter keywords for body location or use the body graphic to choose a part of the affected body part. Next the coder enters the problem (e.g., fracture) or views a queue of possible choices. If more information is needed to complete a correct code, the software is programmed to cue the coder until a correct code is obtained. For example, the left or right side is needed in many codes, and the coder is required to provide the information. Also when the first or subsequent visit is needed (as required for many codes), the coder is cued to provide that information.

[0017] We have also devised warnings by blinking lights and sounds emitted by speakers when the professional selects an unacceptable code. This aids coders and alerts them to examine the alternatives available - on screen or nearby. For example, some codes should not be used if a certain disease is causing the symptom. A specific example is toxic maculoplasty H35.38 for a first poisoning due to drug or toxin, which cannot be used for an adverse effect of a properly administered drug.

[0018] My new software uses words as well as graphics to assist the coder in finding the correct code. No other diagnostic software cues the coder with specific questions to get the correct code. Both are essential elements of my invention.

[0019] In addition, the software was designed from the start to be readily updated.

[0020] My invention operates by the use of keyboards, touch screens and microphones for input via a mobile software application ("mobile app"), a web service/cloud application ("web application") and a marketing website with content management system ("Website"). The website is preferably optimized for the smaller screens of mobile devices and is run on a server. The website provides basic company information (landing page, company information and a consolidated contact information page), as well as links to the web application for logging in and/or signing up. Visitors to the site preferably complete a contact form with at least some of the following information: name, email address, phone number (optional), and comments and/or messages.

[0021] The website is secured with user names and corresponding passwords for everyone seeking access. An administrative user manages staff login functions such as creating, updating, disabling and deleting users. General access to the website is tracked by an analytics program, such as GOOGLE ANALYTICS.

[0022] The web application is designed to enable visitors to the website to sign up for and subscribe to the service. After a visitor has registered and confirmed a new account and billing information, the visitor becomes a registered user. Each user has access to the account information and can update billing details and basic profile information as needed, including but not limited to name and password. Fingerprints and retina scans are optionally used to sign in securely. The web application also allows users with administrative privileges to login, view, and/or deactivate descriptions for all or a subset of users. For example, a hospital has an application administrator who can add new personnel or delete departing personnel from the hospital's set of users.

[0023] The web application provides an endpoint to facilitate communication with the mobile app, known as the web service. The web service provides additional help for coding and decoding with at least two options: 1) a code lookup with which to submit criteria for searching and obtaining a valid ICD-10 code; and 2) a reverse lookup with which to submit an ICD-10 code and obtain the description and other details about the code.

[0024] The mobile app provides users a main screen to select one of the two options (code lookup or reverse lookup). Upon selecting a reverse lookup, the user's screen displays an input field to submit the ICD-10 code and retrieve information about the code from the web service. Upon selecting the lookup code, the user is asked for a preference to search by anatomical model or by circumstance. Searching by anatomical model opens a new screen with a three-dimensional model of the human body. The user can rotate the model, zoom in or out, and/or select layers, including but not limited to surface/skin, muscular system, skeletal system, and organs. The user makes selections by touching a point on the model to indicate the location or action. This information is combined with basic circumstance information and submitted to the web service to obtain the correct ICD-10 code.

Circumstances include but are not limited to symptoms, accident or injury, bacteria, diagnostic tests, and mental health issues.

[0025] Health care professionals include but are not limited to physicians, psychiatrists, medical students, medical residents, counselors, therapists, medical assistants, medical secretaries and even medical receptionists - all of whom are called upon to select medical codes.

[0026] A wide variety of devices are used for medical computing, including but not limited to tablet computers, laptops, smart phones, specialized devices, and wearable computers, such as watches.

[0027] These medical computing devices interface with networks via cables, WI-FI, and Bluetooth® wireless technology connections. The medical computing devices require input methods, such as touch screens and pointer devices for selecting body locations, microphones for stating the terms, keyboards and keyboard displays, etc.

[0028] These medical devices can be used within many different settings, including but not limited to hospitals of various types, clinics, offices or specialized facilities such as imaging facilities. The devices can be used bedside, hallways, nursing stations, waiting rooms, examining rooms, etc.

EXAMPLE 1. Head Injury

[0029] Of course, the health care professional first examines the patient. Finding a "head injury," the doctor enters those words (which begin with S00-S009). [0030] The software asks whether the injury affects the face or scalp. (S00 for scalp).

[0031] Next the software asks whether the injury is superficial, a wound or a fracture, upon which the doctor enters wound SOI.

[0032] Next the software asks if there is an open wound, laceration without foreign body, a laceration with a foreign body, a puncture without a foreign body, a laceration with a foreign body, or an open bite. The doctor enters open bite - queued SO 1.05.

[0033] The software asks if the visit is an initial encounter, subsequent encounter, or sequel encounter. The doctor enters "initial" for a code of SO 1.05 A (with the decimal also being considered a digit) is now described with reference to the drawings, wherein like reference numerals are used to refer to like elements throughout. In the following description, for purposes of explanation, numerous specific details are set forth in order to provide a thorough understanding of the present invention. It may be evident, however, that the present invention may be practiced without these specific details. In other instances, well known material processes are shown in flow diagram form in order to facilitate describing the invention.

[0034] As can be seen from the foregoing examples, it is possible to connect the various steps in a variety of ways that still represent the invention. Furthermore, as can be seen from the foregoing examples, some of the steps can be omitted or routed around.

[0035] Any alterations and further modifications of the inventive features illustrated herein, and any additional application of the principles of the invention as illustrated herein, which would occur to one skilled in the relevant art and having possession of this disclosure, are to be considered within the scope of the invention.

[0036] Reference throughout this specification to an "embodiment," an "example" or similar language means that a particular feature, structure, characteristic, or combinations thereof described in connection with the embodiment is included in at least one embodiment of the present invention. Thus, appearances of the phrases an "embodiment," and "example," and similar language throughout this specification may, but do not necessarily, all refer to the same embodiment, to different embodiments, or to one or more of the figures. Additional, reference to the words "embodiment," "example" or the like for two or more features, elements, etc., does not mean that the features are necessarily related, dissimilar, the same, etc.

[0037] Each statement of an embodiment or example is to be considered independent of any other statement of an embodiment despite any use of similar or identical language characterizing each embodiment. Therefore, where an embodiment is identified as "another embodiment," the identified embodiment is independent of any other embodiments characterized by the language "another embodiment." The features, functions and the like described herein are considered to be able to be combined in whole or in part one with another as the claims and/or art may direct, either directly or indirectly, implicitly or explicitly.

[0038] As used herein, "comprising," "including," "containing," "is," "are," "characterized by," and grammatical equivalents thereof are inclusive or open-ended terms that do not exclude additional un-recited elements or method steps. "Comprising" is to be interpreted broadly and including the more restrictive terms "consisting of and "consisting essentially of."

[0039] Reference throughout this specification to features, advantages, or similar language does not imply that all of features and advantages that may be realized with the present invention should be or are in any single embodiment of the invention. Rather, language referring to the features and advantages is understood to mean that a specific feature, advantage or characteristic described in connection with an embodiment is included in at least one embodiment of the present invention. Thus, discussion of the features and advantages, and similar language, throughout this specification may, but does not necessarily, refer to the same embodiment. [0040] Furthermore, the described features, advantages, and characteristics of the invention may be combined in any suitable manner in one or more embodiments. One skilled in the relevant art will recognize that the invention can be practiced without one or more of the specific features or advantages of a particular embodiment. In other instances, additional features and advantages may be recognized in certain embodiments that may not be present in all embodiments of the invention.

Claims

1. A method of obtaining an ICD-10 code for a condition or disease, the method comprising a. providing a preprogrammed medical computing device, with input and output display; b. signing into the medical diagnostic system; and c. selecting a start of the search by anatomical or verbal method.

2. The method of claim 1, wherein the anatomical method comprises a. providing an anatomical model; b. touching an area of a touch screen closest to an affected anatomical part; c. selecting a layer of the human body; and d. answering a series of questions to pinpoint the code.

3. The method of claim 1, wherein the verbal method comprises a. providing a keyboard in the form of hardware or touch screen functions; b. entering at least one word describing the condition or disease; and c. answering a series of questions to pinpoint the code.

4. The method of claim 1 wherein the model of the human is three-dimensional.

5. The method of claim 1 wherein the step of touching the anatomical model enables rotating the anatomical model.

6. The method of claim 1 wherein the step of touching the anatomical model enables zooming to enlarge of minimize the anatomical model.

7. The method of claim 1 wherein the method of searching by a verbal method also comprises displaying and accessing an area of a touch screen closest to the affected anatomical part.

8. The method of claim 1 further comprising displaying at least left digits of the ICD-10 code when enough information is selected.

9. The method of claim 8 further comprising displaying more digits of the ICD-10 code, as more questions are answered and a condition or disease category is particularized.