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Potential ICD 10 Codes Prompt

AIM's Potential ICD 10 Codes feature analyzes data points from the patient care report in order to offer a selection of potential codes.

Thank you for your interest in the ICD 10 Prediction feature. Currently this feature works with bills that are posted from AIM ePCR or ones that are manually imported and contain the appropriate elements from the patient care report such as Primary Symptom, Impression, Chief Complaint, and/or contain a Narrative. If the feature is not working as expected, please contact AIM Support.

Any Billing user with access to editing bills will be able to utilize the Potential ICD-10 Codes feature once it is enabled. Users can find the button for the feature within the Diagnosis Tab of the Billing Module:

Clicking on the Potential ICD-10 Code button can only be done while the bill is in edit mode. Once clicked, a pop up will appear providing the following details:

If the associated PCR did not contain enough data points to be able to provide potential ICD-10 codes, this screen will be mostly blank with an alternate description:

"There are no suggestions that can be made for this bill. This could be because of missing data points in the ePCR (see PCR Data section below) or due to the ePCR vendor. Contact AIM Support for more information."  

PCR Data Section

2024-07-15_9-32-35

The PCR Data section is a collapsible section that relays the information that was factored-into the ICD-10 code results. This is an important reference for the biller that helps with code assignments. It shows the following data from the associated ePCR:

  • Chief Complaint
  • Primary Symptom
  • Primary Impression
  • Other Symptom
  • Secondary Impression
  • CMS Service Level
  • Narrative

This section will also show the current payer of the bill for context.

Potential ICD-10 Grid Columns

Select Column

Users can click anywhere in the row to select codes they would like to apply to the bill.

Code Column

Contains the ICD-10 code for the value.

At times, a code may appear highlighted in orange. When hovering the mouse over this code, it will suggest that the code might be invalid or outdated. Since the ICD-10 Code List is continually updated, certain codes will eventually be replaced by more accurate and specific ones. The Potential ICD 10 Code feature may occasionally provide recommendations based on outdated bills, which are marked in this way to help users avoid using codes that are unlikely to be accepted.

Description Column

Contains the ICD-10 description for the value.

Confidence Column

This metric represents that particular code's use frequency as it pertains to the patient care report data points used. The higher the Confidence percentage for a value, the more commonly-used that code is for the representing data points. The lower the Confidence percentage, the less commonly-used that code is for the data points provided on the patient care report.

2024-07-15_9-37-21If the user selects any code from the Potential ICD-10 Codes grid, they may then select 'Add To Bill' at the bottom of the prompt to add those codes to the bill. Otherwise, users can simply use the pop up for reference and use the Cancel button to return to the Diagnosis Tab to continue coding manually. 

THIS TOOL PROVIDES ICD-10 SUGGESTIONS BASED ON THE HISTORY OF PCR DATA POINTS MAPPING TO BILLING. IT IS STILL THE BILLERS RESPONSIBILITY TO DETERMINE THE CORRECT CODE.