Need to update ICD 10 codes - Suggestions needed

Management and Administration
#48

It’s interesting that this is still a problem after all these years.
The ICD10 import utility did briefly work on some of the version 5 releases.
Now on Version 6.1, it’s broken again.

“The number of staged files is incorrect. Only place the files that you wish to install/upgrade to.”

There is of course only 1 ICD10 Code Description zip file in place. I have to say, as someone who’s been building and deploying OpenEMR installs in medical practices for over a decade now, it’s pretty dang embarrassing that we can’t get something as basic and fundamental as an ICD10 data load to work.

ETA: I went back and checked on a 6.0 test install, the ICD10 import works there. Apparently somebody decided to “upgrade” it for the 6.1 release.

#49

need 2 files in there @Penguin8R

#50

What if the practice doesn’t want the PCS codes?
(Since 99.9% of them will only ever need or use the CM codes)
I mean, I love OpenEMR, but let’s be realistic, it’s not being used in hospitals…

#51

ICD10-PCS has to be activated in Admin->Forms->Lists->Code Types so the load just needs it’s zip file to the load the DX and PCS tables in case at some point someone would like to use the PCS.

#52

So, am I understanding this correctly, we have to load both ICD10-CM and ICD10-PCS simultaneously, even though the ICD10-PCS will never be used? So then all future ICD10 updates will have to include both as well?
I will spin up another 6.1.1 install & test if that’s the case, just making sure we know what to expect.

#53

I don’t recall us having to add that for FHIR support, but we may have needed it to handle the receiving of CCD-A imports when we are receiving a file that is referred to a clinical installation from a hospital.

We’ve had to add a lot more code set supports in order to meet ONC certification. There will be some additional code-sets that that will have to be executed for the 7.0 release. 6.1 was a stepping stone to the 7.0 ONC certified release so that’s possibly the problem you are running into.

As for things breaking, as volunteers we are trying to do the best we can, we’d love to have more development help as it sounds like you and your team have experience in this space. Feel free to help us fix some of these bugs :slight_smile:

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#54

The code loader in 6.1.0 is broken.
One awkward workaround is to use a temporary installation of 6.0 to load the current CMS ICD-10 release, then dump the table and import it into the working 6.1.0 environment.

Importing 2022 ICD-10 codes in latest OpenEMR
#55

hi @Penguin8R , it’s working on the demos. You’re having an issue upgrading them?

#56

Doesn’t work on a local test installation of 6.1.0. A version 6.0 installed on the same LAMP stack has no trouble loading the ICD-10 CM codes.
Ran into the same issue twice in the last month helping 3rd party sites set up laboratory interfaces.
Most labs require DX codes as part of the order requisition, so it’s a critical component.
I have a dev working on a LOINC code loader, so I’ll see if he can fix the ICD10 bugs too.

ETA: The 2 lab installs were on brand new 6.1 OpenEMR environments that were being prepped for first use, with no existing ICD10 data present, so it’s not just updates that don’t work, even the initial load of the ICD10 codes on a clean system can’t be executed.

#57

Ok, good luck, am unable to reproduce the fail on my local tests and the demos.

#58

It just hit me, is this a new feature for ONC, so the system will recognize ICD10-PCS codes when receiving data from a hospital or HIE in future? If that’s the reason, then it would make some sense, but that is the only logical explanation I can think of for defaulting to loading both code sets…

#59

Stephen, thanks for the tips, I understand how it works now, after creating a clean 6.1.1 environment to test in.
I have been updating ICD10s the same way for over a decade, this change definitely caught me by surprise, have never even bothered to download the PCS code sets before.

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#60

There’s another OpenEMR user @mdsupport who is looking at integrating a LOINC code importer. See this github issue. The two of you may want to coordinate: LOINC codes · Issue #5411 · openemr/openemr · GitHub

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#61

It’s not a new feature. When you upgrade to a new version of OpenEMR the files are moved in seamlessly but when you manually upgrade just the code set you have to do some custom work.

#63

Not as relevant to the folks but as I was upgrading for 5.0.0 (patch 8) to 5.0.2 (patch 5), when I tried to push new ICD-10 codes (19 and 22), I discovered that the ICD-10 shows an error that it can’t find the folder. Turns out its a temp folder. Was able to satisfy that and even through code and successfully loaded 19 and 22 ICD codes (tried both from scratch). It was mentioned by @stephenwaite – but just to reiterate 22 codes need you to edit 2022-ICD-10-CM-Code-Descriptions.zip and remove that silly folder – moving the files to the root. It succeeds to “run” but still don’t load properly as we would see N18.3 instead of N18.30. Could there be issues? If this is not related to this thread but it seemed very similar to: the uploader is broken.

update: I was able to upload the 22 codes (succesfully) on 5.0.8 patch 8, which is very odd!

#64

Hopefully someone is monitoring this thread.
We’re on v6.1.0 (1) and need to update ICD10 to the 2023 release.

According to this thread (as of Jun 22) the v6.1 external data loader is broken, has this been fixed?

I’ve downloaded the following zip folder;
2023 Code Descriptions in Tabular Order - updated 01/11/2023 (ZIP)
(https://www.cms.gov/files/zip/2023-code-descriptions-tabular-order-updated-01/11/2023.zip)

And, is the correct file in the zip folder; icd10cm_order_2023.txt ?

#65

hi @hitechelp , you have to follow the steps that have been described here and in other threads.

  1. move the 2 zip files into the contrib/icd10 folder and the 2 older files out
  2. run the sql commands to load the new checksums into the db
  3. run the upgrade script

this also hinges on having the php mysql local infile allow set to true which you should then turn back off for security

#66

Stephen,
Please elaborate; there are eight files in the CMS download. Which 2 files are you talking about? And, what sql commands you are referring to?

#67

hi @hitechelp , here are the files and sql statements

#68

Thank you Stephen
Looks like this was written for v7.0 to 7.1 upgrade.
Is this ok to run on 6.1.0 (1)?

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