MU Stage1 Final Rule - Maintain Up-To- Date Problem List

SECTION #  Section 170.302(b)—Maintain Up-To- Date Problem List

MU OBJECTIVE Maintain an up-to-date problem list

MU STAGE 1 MEASURE More than 80% of all unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have at least one entry or an indication that no problems are known for the patient recorded as structured

CERTIFICATION CRITERION Final Rule Text: §170.302(c). Final rule text remains the same as Interim Final Rule text, except for references to adopted standards, which have been changed.

STANDARDS N/A

TEST CRITERIA # §170.302(c) http://healthcare.nist.gov/docs/170.302.c_problemlist_v1.1.pdf

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ICD9 is currently the coding used for the problem list, but ICD 10 will be required in the future. Fortunately for us this is something the VA will have to tackle as they bill. The concern is that there will be a delay in releasing the code for this but since WorldVistA had finally managed to negotiate the release of the lexicon files from the VA in a timely fashion, hopefully there is a mechanism permanently in place for this to be done smoothly. This is not the whole story, however, as there is a one to many relationship between ICD9 and SNOMED and ICD10.

In addition, there is a problem list coding effort going on between Kaiser Premanante and the VA so it is possible they will come up with their own standard for coding problems and will not follow what is required by Meaningful Use. However, considering that they bill the insurance companies and Medicare as well (?), presumably the VA will need to conform.

DEVELOPMENT STATUS Step by step documentation for how problems are entered and edited and coded is needed. Most will need to install the ICD9, CPT and SNOMED codes and the recommended method for doing that by the VA is to update the Lexicon files and the CPT code files with ICD 9 codes included all at once. Problem coding with SNOMED is not done in VistA at this time. WorldVistA has an agreement with the VA and AMA that allows purchase of the CPT codes from the AMA and a kit from WorldVistA. The kit contains the VA files. Contact Nancy Anthracite for more information. nancy at worldvista dot org.

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