How AngelTrack handles ICD-10 codes in the PCR, as well as the implications on the rest of the system
ICD-10 Codes in the PCR
AngelTrack collects the ICD10 codes representing the crew's impression of the patient, plus any acute symptoms and injury causes the patient is experiencing.
The codes are set by the attending, and then reviewed (and perhaps revised) by QA. Afterward, they are used for these purposes:
- Information for the billers performing the coding,
- Uploads to a state trauma registry, and
- Additional medical justification in the run reports in the unfortunate event you receive an ADR.
Code Determination by the Crew
On the PCR Assessment page, AngelTrack collects these ICD10 codes:
- One code for the primary impression, required if you so choose;
- One or more codes for a secondary impression, optional; and
- One or more codes for acute symptoms required for emergent and ALS calls if you so choose.
If a patient has prior transports, a blue ↯ icon appears which will fetch the ICD10 code list from the patient's most recent non-emergent transport; likewise a red ↯ icon for the most recent emergent transport. Using these icons, once a patient has an accurate ICD10 code list in place, it can be easily carried forward to future dispatches.
Requiring Codes from the Crew
If you wish, AngelTrack can require crews to provide ICD-10 codes before submitting their report to QA. On the "Preferences" page under Settings you can enable these options:
☑ A primary impression (ICD-10 code) must be recorded for all BLS+ calls.
☑ Acute symptoms (ICD-10 codes) must be recorded for emergent and ALS+ calls.
When those options are not checked, then the crew can -- if they wish -- submit their report to QA without providing the codes.
The Built-In Code Lists
AngelTrack has built-in lists of high-level (mostly .XXX) ICD-10 codes that are relevant for an EMS PCR:
- 250 codes for the impressions on the PCR Assessment page
- 340 codes for the acute symptoms on the PCR Assessment page
- 240 codes for the cause on the PCR Injury report
- 190 codes for the origin location type on the PCR Followup page
These code lists are recommended by NEMSIS…, but the lists can be edited and expanded at any time from the Settings page, by anyone who has Administrator, Captain, or HR privileges.
Use During Billing/Coding
Your billers/coders may choose to make use of the codes chosen by the attending and during QA review. Although the PCR's code lists are very general (most are .XXX) so as to be suitable for use by the crew, they may nevertheless be useful as starting points for coding the dispatch for insurance.