PracticalDermatology

If you have been reading any medical news of late, you certainly are aware that we are approaching the October 1 deadline for transition to ICD-10 coding system and how this transition may adversely impact your practice. So, you may ask: Why do I need to know about yet another confusing acronym, such as SNOMED-CT?

WHAT IS SNOMED-CT?

SNOMED-CT stands for Systemized Nomenclature of Medicine Clinical Terms and represents a systemically organized collection of more than 311,000 clinical concepts. It was initially developed in 1965 by the American College of Pathology, and in 2003 it was adopted by the National Library of Medicine on behalf of the US Department of Health and Human Services. It serves as an ontological basis for the upcoming ICD-11 that is scheduled to be endorsed in 2017.

SNOMED-CT is not an alternative to ICD-10, but rather a Meaningful Use Initiative requirement. Many Electronic Health Record (EHR) systems do not have a fully integrated SNOMED-CT structure, and instead focus on ICD-10 rather than addressing this regulatory requirement.

SNOMED-CT and ICD-10

The ICD-10 system represents a flat table of more than 68,000 complex alpha-numeric codes that are primarily designed for billing and government reporting. As such, it is not designed to be physician-friendly. It not only lacks the clinical specificity necessary to accurately document a patient encounter, but it has no clinical logic built into it. For example, there are eight billable ICD-10 diagnosis codes for atopic dermatitis. Nevertheless, if you specifically document atopic dermatitis (AD) in your note, you are left with only two non-specific choices: Other atopic dermatitis (L20.89) or atopic dermatitis, unspecified (L20.9).

On the other hand, SNOMED-CT represents a structured dictionary of medicine that has been developed for clinical data input with a built-in clinical logic behind it.

This makes it an intuitive and physician-friendly system that most of us are familiar with. For the diagnosis of AD, for example, it gives you 32 different specific AD diagnoses, including diagnoses of infantile and adult atopic dermatitis; atopic dermatitis of eyelid, face, hands and scalp; photoaggravated atopic dermatitis; impetiginized atopic dermatitis— to name a few. Moreover, all of these concepts are logically connected with other parts of the SNOMED-CT logic-based database.

Although SNOMED-CT doesn't take the place if ICD-10, a SNOMED-CT integrated EHR can benefit from the transition to ICD-10. SNOMED-CT and ICD-10 have been successfully used in EHRs worldwide for almost two decades. Sophisticated integration between the two systems has resulted in a seamless integration of clinically orientated SNOMED-CT and billing reporting accomplished by ICD- 10. For instance, EZDERM has developed a patent-pending three-dimensional body map with SNOMED-CT database in its core. This gives EZDERM an ease of use and accuracy of ICD-10 coding.

DO NOT FEAR AN ICD-10 ARMAGEDDON

I have been developing an ICD-10-compliant Electronic Health Record (EHR) for several years now. During this process, I have discovered that solely focusing on ICD-10 is a fundamentally flawed approach. Understanding the importance of having a well-designed EHR is quintessential for a practice to endure the future changes in healthcare, whether it is ICD-10 or any other transition. It certainly allows for “business as usual transitions” of practices that use a well-designed system to bypass increasingly complex government regulatory roadblocks. It also gives users piece of mind to face any perceived threat of upcoming ICD-10 Armageddon or any other confusing regulation our government may fancy

Srdjan Prodanovich, MD, FAAD is a full-time practicing dermatologist and CEO of EZDERM.