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NLM Releases Draft SNOMED CT to ICD-9-CM Rules-Based Map To Support Reimbursement

Map Available Now—NLM Seeks Users to Test, Evaluate

The U.S. National Library of Medicine (NLM) has released a draft rules-based mapping from SNOMED Clinical Terms® (SNOMED CT®) to the International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM). The map was designed to support semi-automated administrative reporting and reimbursement for healthcare services within U.S. healthcare organizations. The NLM seeks users to “test drive” and provide feedback for the map—which will guide the development of related maps.

The draft map consists of approximately 5,000 mappings representing the SNOMED CT terms most commonly used by Kaiser Permanente and the University of Nebraska. It is designed to support administrative reporting and reimbursement processes originating with data sets where SNOMED CT is the core terminology for clinical descriptive purposes. It provides a validated concept-based mapping to ICD-9-CM, recognizing that in some selected cases, further processing of ICD-9-CM codes may be required for specialized business applications.

Users can evaluate and test the map now by downloading it from the NLM Web site at http://www.nlm.nih.gov/research/umls/mapping_projects/snomedct_to_icd9cm_reimburse.html. Starting December 1, 2009, through February 1, 2010, users will be able to provide feedback to the NLM and CAP STS. More details about the feedback process will be posted on the same Web page by December 1, 2009.

“We strongly encourage testing by people who intend to use the map for the billing use case,” said Betsy Humphreys, deputy director, NLM. “The results from this test will inform and influence the development of related maps including SNOMED CT to ICD-10-CM [International Classifications of Diseases, 10th revision, Clinical Modification] and ICD-10-PCS [International Classification of Diseases, 10th revision, Procedure Coding System].”

SNOMED Terminology Solutions™ (STS), a division of the College of American Pathologists (CAP), developed the map on behalf of the NLM. CAP STS, and the American Health Information Management Association Foundation (AHIMA Foundation), on behalf of the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS), completed a collaborative review and validation of the draft map to ensure that the result accurately reflects the meaning and usage of ICD-9-CM. James Campbell, MD, at the University of Nebraska, was also instrumental in the development of this draft map.

The mapping is provided for the benefit of software vendors and the information technology community at large on the assumption that they will employ the data to create functionality to support semi-automated administrative and reimbursement reporting from a clinical data record that uses SNOMED CT.

“The final map will become a critical component for healthcare IT systems in the United States, linking SNOMED CT and ICD-9-CM for streamlined reimbursement and administrative reporting,” said Kevin Donnelly, vice president and general manager, CAP STS.

For additional details contact Vivian Auld, Senior Specialist for Health Data Standards, National Library of Medicine, at (auld@nlm.nih.gov).