SynapseDirect

Duplicates are not allowed.

ie.

Essentially what I want is to be able to use the terms *I* like, and map them to the closest ICD code.

I'll make a list of the edit I do here, for the benefit of other primary care doctors.

 

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= ICD9 coding for depression = 

from aafp.org 

In either case, the appropriate diagnosis code will depend on the nature of the patient's depression. For example, the diagnosis code for

a single episode of acute depression is 296.2X,

for a recurrent episode is 296.3X,

for neurotic depression is 300.4 and for

postpartum depression is 648.4X.

The code for depression not elsewhere classified or otherwise specified is 311.

(A fifth digit is required when an "X" appears; a list of fifth digits can be found in the ICD-9 manual.)

The following fifth-digit subclassification is for use with categories 296.0-296.6:
0 unspecified
1 mild
2 moderate
3 severe, without mention of psychotic behavior
4 severe, specified as with psychotic behavior
5 in partial or unspecified remission
6 in full remission

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In the US, there are many tricky minute details regarding what's a proper code to use - this has a lot to do with reimbursement.  Certain code categories require 5 digits, for example, migraine headaches.  You will not get paid if you use 4 digits.  If you use a depression code for a patient with depression and tension-type headache that you think is secondary to depression, you will not get paid.  But if you use a headahe variant code first and use depression as a secondary code, guess what, you will get paid.  It will take some time to compile a good list but it certainly worth the effort to save time in the future - you do need to pay attention to updates each year for new rules.  Hopefully one day I will get to it.

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Important info, thanks qilin.

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Does each client have it's own ICD9.r file ?

 

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Yes, I never bothered to put it on the server.

 

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Graham Chiu
Beta Downloads and Documentation Wiki

I want to make some additions and edits.

It'll be a challenge to do it on every PC.

 

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Copy it to a network directory and copy it to each  PC from there.

 

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Graham Chiu
Beta Downloads and Documentation Wiki

Graham:

Copy it to a network directory and copy it to each  PC from there.

lol. I know *how* to do it.

I guess I could write a .bat file and have that bat file send it to each PC.   

It will be hard for the less nerdy user.  I can't think of any good reason to have local icd9.r files though.

 

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If you never change them, then it's not a problem.

 

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Graham Chiu
Beta Downloads and Documentation Wiki

Graham:

If you never change them, then it's not a problem.

Yea, but it is great that you CAN change them. :)

 

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How does one add more ICD codes to the existing icd file? Does it require the knowledge of any program ?

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kgmamman:

How does one add more ICD codes to the existing icd file? Does it require the knowledge of any program ?

No, you just need a Text File editor like Notepad to do the editing ( I use a program called TextPad).

the file icd9.r is a ONE LINE ! Text file with 76882 characters (you can use Word Wrap to put it on one screen or hit the [end] character to get to the end of the line).

Hopefully this diagram I made will help you.

 

 

 

 

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It changed a while ago.

Bring up the ICD9 popup, select a class to add to, and then enter the ICD9 code, diagnosis and then click on the [Add New ICD9] button.

This only affects the icd9.r file on your workstation.

 

 

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Graham Chiu
Beta Downloads and Documentation Wiki

To see the fruits of your edits, you need to reload synapse as the icd files are loaded upon client (synapse.exe) startup. 

All the codes will be unavailable if you make a wrong edit.  It is a good idea to have backup copies of your icd9 files.

I store all my icd9.r edits in a file called:  icd9.r.edits.txt

I make the changes there and then just copy them into the icd9.r file.

 

 

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