Tuesday, April 23, 2013

What The World Needs Now .... is Codes, Sweet Codes, It's The Only Thing Theres Just Too Little Of........

This is without a doubt my favorite ICD-9 codes. Imagine the granularity of clinical description possible with the additional codes that will be found in ICD-10!

""ICD-10-CM codes are the ones designated for use in documenting diagnoses. They are 3-7 characters in length and total 68,000, while ICD-9-CM diagnosis codes are 3-5 digits in length and number over 14,000. The ICD-10-PCS are the procedure codes and they are alphanumeric, 7 characters in length, and total approximately 87,000, while ICD-9-CM procedure codes are only 3-4 numbers in length and total approximately 4,000 codes.""

As it is the numbers and complexity of codes seen with ICD beggars the imagination. Furthermore, the use of those codes is by necessity rudimentary and poorly descriptive of the actual events surrounding the patient's hospital or clinical course. The time pressures of clinical practice often result in the practitioner using the 1st plausable code for the clinical scenario rather than the best or most descriptive for the scenario.

In the final analysis the reality of clinical work is that creating is a more intellectually gratifying and intrinsically more rapid process than choosing. WIth respect to a previous post in which I mentioned the supercomputer Watson, analysis of free text by such an artificial intelligence will come much closer to mirroring the reality of clinical work than trying to train the practitioner in the nuances of translation of clinical thought into structured data. Ultimately as so famously captured in the quote from Alfred Korzybski, 'The Map is not the territory.'


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