Loading up DSM-IV Codes

michaelsheridan wrote on Thursday, December 17, 2009:

All,

Newbie Mike here again.  I’m making pretty good process on getting this system customized to meet my needs.  I just finished loading all the CPT codes I’m likely to use via the superbill.  Next:

I need to load DSM-IV codes into the system.  They generally correspond quite well with the ICD-9 codes, and I realize that I can enter them one-by-one through the superbill, pretending that they really are ICD-9.   I began that way, but quickly found it quite tedious.

Next,  I loaded  the DSM-IV codes  into an Excel spreadsheet,  so  I can export  them into most any common  file format.   At this point,  I seem to have two options:

1.  To upload them as a group into the database as ICD-9 codes.  I suspect there is some utility available to accomplish this, but haven’t yet found it.   I have gleaned from other forum posts that there is a method for uploading an ICD-9 file.   Can you help?
2. Add them as custom codes via custom/code_types.inc.php, and putting them into a custom codes table (as I understand it).

Which is the preferred option, #1 or #2? I suspect #1 is the cleanest method.   Or, is there perhaps a third, better option that I have not found?  Whichever option is recommended, what is the procedure for implementing it?  Again, if you can point me to the appropriate documentation, that would be grand.

By the way, kudos to those of you who developed and are maintaining this package. It runs very smoothly, is more intuitive and feature-laden than some commercial packages I have used,  plus  I keep finding little unexpected “goodies” that really do make a lot of sense.  So far, I’m very impressed with your work.

Mike

ideaman911 wrote on Thursday, December 17, 2009:

Hi, Mike;

My wife is a Psyche provider, who has just confirmed your statement.  At present there is not a “DSM-IV” category of code in the Superbill area.  It would not be a major issue to change the relative PHP code to add the type, but there are some concerns about how that will be dealt with.  For example, in the Fee Sheet, the current search setup has selectable for CPT, ICD & HCPCS codes, so you would have to add the radio selection there as well as the logic to find them correctly.  Once you do, I believe the Billing would also have to be changed to assure the DSM-IV would handle correctly to place proper values in the CMS 1500 and X12 outputs locations.  Not a trivial pursuit.

My wife has simply followed the approach of manually loading the DSM codes as ICD codes, and let OpenEMR handle the rest as per normal ICD.  In fact, I have similarly made the HCPCS “G” codes used by Medicare for the e-Rx incentive program show as CPT instead, for simplicity in handling and setting up the Fee Sheet via Admin - Lists, since there is no problem doing so at any payer, other than that they indicate it is “not payable”.  Medicare simply gives them the N365 code on their EOBs.  Just an FYI on that - you must use a value of $0.01 for that, as a zero will not work in OpenEMR.

The Codes database is one of the few which have no linkages INTO it, so can be loaded using the Admin - Databases and manually uploading, if you have an Excel file and import.  But I would still urge you to verify it completely using a duplicate setup before you go anywhere near your “real” data, and I would suggest you call them ICD9 still, since that will be the default in the search, so will prevent errors in usage.  Hope that helps.

Joe Holzer    Idea Man    315-622-9241     im@holzerent.com
http://www.holzerent.com

sunsetsystems wrote on Thursday, December 17, 2009:

You could add a code type to custom/code\_types.inc.php and the Fee Sheet *would* pick up the new type, but then you’d need significant changes to the billing system to make them work with claims.  Offhand it sounds like you’ll be much better off if you can treat them as ICD9 codes.

As for loading them, you could modify one of the scripts in contrib/util/ for that purpose, or perhaps import a spreadsheet as Joe suggests.

Rod 
(http://www.sunsetsystems.com/)

blankev wrote on Thursday, December 17, 2009:

If you know to find the right file ( …\openemr\customcode-info.php) around line 37 //US Clinics, it is easy to change ICD9 into DSM IV (Diagnosis code).

Be sure during upgrade of OpenEMR to keep the right file with the right Field names.

But if your wife uses both ICD and DSM IV it will be more difficult although you can add a line extra with the right permissions.

Change the lines around  #37:

//US Clinic and of you go. Import the relevant codes and make connection through Administrations => FeeSheet => and make the wanted connections (Once you know how its easy form here). Rather slow but it works for my ICPC2 codes and local billing system. (You also might have to change the name of ICP4 into the wanted billing fees for psyche consultations.)

Import through CSV-files is straight forward, making the connections was rather trial and error, but it works once understood.

Pimm

michaelsheridan wrote on Friday, December 18, 2009:

I’m perfectly happy to simply enter the DSM codes as ICD’s.  Ulitmately, DSM-IV is nothing but a subset of ICD-9 anyway.   I’ll futz around with admin/databases and see if I can’t figure out how to upload it as a .csv.

Thanks again, folks!

Mike

michaelsheridan wrote on Friday, December 18, 2009:

OK, I see how that is supposed to work.

But rather than learning phpMyAdmin, populating the index field, figuring out padding for the fields I don’t really need, uploading it and thoroughly testing it, I think I could buckle down and manually enter the codes more quickly, one-by-one.   So, I believe that’s what I will do.

Then, on to the next challenge!

Thanks, all

Mike

blankev wrote on Friday, December 18, 2009:

Mike,

do yourself and your supporters a pleasure! Learn how to upload and download CSV files (comma seperated files) in phpMyAdmin. It saves so much time and that s why you want to use the digital highway.

Learning this little trick is no effort and can be done from within OpenEMR working versions.

If you want some practical instructions, please let me know. I should have some kind of manual somewhere in preparation for the OpenEMR manual department.

Pimm

blankev at attglobal dot net

michaelsheridan wrote on Saturday, December 19, 2009:

OK, Pimm,

You’ve convinced me.  I’ll need to download .csv’s shortly, anyway, in order to transfer the data to an electronic reminder call system (by the way, is an integrated reminder call system on the enhancement list?  It should be).   I assume that myphp will be the way to do that…

But first, I’ll have to visit the backup utility and get it working.  I’m sure I’ll screw up my first upload, and will feel much better with a backup to keep me from reentering all of those CPT codes I’ve already done.

Thanks,

Mike