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Networked ICD-9 Coding System for a Radiology Department

¹ Both authors: Department of Radiology, P.O. Box 100374, University of Florida School of Medicine, 1600 S.W. Archer Rd., Rm. G387, Gainesville, FL 32610.

View larger version (49K): [in a new window]   Fig. 1. —Main screen of code finder client. Case has been coded for "ascites" and "liver failure" with appropriate code string shown at bottom. String "ICD-9 Code: 571.5, 789.5" is automatically placed in Windows copy buffer for pasting in dictation.

View larger version (54K): [in a new window]   Fig. 2. —Code finder client after keyword search on "kidney." Drop-down selection list of matching codes ordered by descriptor is activated.

View larger version (35K): [in a new window]   Fig. 3. —Adding new code. "ADD A NEW CODE" button on the finder screen activates this screen. Code for "fecal incontinence" (787.6) is being added. It has been tagged as useful in body imaging and fluoroscopy (gigu) areas. Data checking ensures that user has entered code number, description, and checked at least one practice area.

View larger version (73K): [in a new window]   Fig. 4. —Moving code from full code set to departmental list. "MOVE THIS CODE" button on the finder screen activates this screen. Code for "secondary malignant neoplasm of kidney" (198.0) will be moved. It has been tagged as useful in body imaging and fluoroscopy (gigu) areas. If code already exists in departmental set, user is notified. Radiologist can alter descriptive text if desired. At least one practice area is required.

View larger version (44K): [in a new window]   Fig. 5. —Code Manager client. Data sheet type view is presented on startup. Double-clicking on descriptor text field activates modify, delete, and duplicate functions (Fig. 6). Double-clicking on code field activates sorting and search functions (Fig. 7).

View larger version (49K): [in a new window]   Fig. 6. —"Edit Single code." This feature allows changing code, descriptor, and practice area designation. Entry can be duplicated or deleted. Duplication facilitates giving single numeric code more than one meaningful description by altering text string in duplicate. This code might be duplicated and changed to "Muscular pain" to allow same code to be found under either designation.

View larger version (38K): [in a new window]   Fig. 7. —"Recorder and Search." This feature allows ordering by code, descriptor, or date of entry. Search function positions record pointer to first or next matching code in data sheet. User has entered both code number (123.1) and text (Cysticercosis) search strings. Typically, either code number or text search is done.

View larger version (30K): [in a new window]   Fig. 8. —Integration of code finder and manager clients into departmental work flow. As shown by dotted connecting lines, we plan to eventually integrate coding functions with our order entry, online medical record, and reporting systems.

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