BILLING
- This table is one of the most useful tables for determining patient diagnoses and/or reasons for a primary care encounter.
- Not all diseases and conditions are coded – only 75% of the code and text is coded to a calculated field.
- Diagnostic codes and text are standardized to ICD-9 ontology. It should be noted that, in some provinces (namely Ontario), only three-digit ICD-9 codes are used (no decimal places) which limits the specificity of the code. Keep this in mind when searching for ICD-9 codes.
- Patients may have more then one record for a single encounter if the provider billed for multiple services – however, these multiple records for a single encounter will only be present in the database if the services/diagnostic codes were input as separate records. If a provider put multiple codes into one record or field (which happens often) CPCSSN only takes the first code it encounters in the orig field and that is what populates the calculated field.
- Another thing to note about how the code_calc field is derived is that the CPCSSN processing tools will first take the original code (code_orig) to populate the code_calc field, and if empty the tool will then look at the text (name_orig) to derive a code_calc. Not all text strings are recognized by the CPCSSN tools – in these instances the code_calc field will be empty.
- Further work is needed to understand how often the name_orig and the code_orig align.
- Date variables: use Service Date, but if missing use Date Created.
