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April 02, 2014

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Agree with sound argument. ICD-11 and the ICD-11CM version for the US whether it is available makes sense to adopt rather than ICD-10. According to WHO, ICD-11 will not be available until 2017 (they have enjoyed their own series of delays) and we could, and must use SNOMED-CT for meaningful use anyway. Question: how does one convert SNOMED-CT to ICD-10? The NLM crosswalk is available (last update July 2013) to map diagnosis across nomenclatures, but what about laterality and "initial" vs "subsequent" encounter? There is no component of the SNOMED-CT code that speaks to encounters.

Those are good examples of how SNOMED alone would not be able to support the detail that is currently expected to be required for billing in the future. From the physician perspective I believe we should use SNOMED in our EHRs and that we will learn to enter somewhere in our documentation enough information (laterality et al) for the coders to be able to enter the right ICD-x codes. Pick your version of ICD-x, and I will still enter the same documentation notes and SNOMED codes. And an opinion for another post is that the amount of detail that is going to be expected for billing is actually more important to address than what coding set is going to be used for billing.

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