June 1, 2011

ODG Embraces ICD-10 Codes to Maximize the Diagnostic Accuracy of Its Treatment and Return-to-Work Guidelines

Encinitas, CA – Work Loss Data Institute (WLDI) announces a new parallel version of Official Disability Guidelines (ODG) and ODG Treatment in Workers’ Comp using the ICD-10 diagnostic coding system, with guideline recommendations and data converted from ICD-9 to ICD-10.

The alphanumeric ICD-10 medical diagnostic coding system is mandated for use in the United States by October 1, 2013, replacing the current numeric ICD-9 coding system. The ICD-10 system is also the predominant medical diagnostic coding system used in the rest of the world. ICD-10 provides a much more complex hierarchy for specifying a medical condition compared to ICD-9, and there are approximately 68,000 ICD-10 codes, versus approximately 13,000 ICD-9 codes.

As with ICD-9 in the past, ODG has used the official coding manual for ICD-10, converting it to a database along with proprietary links for ease of use, and presenting guidelines for use in workers’ compensation, non-occupational disability, automotive liability, and group health. Among the guidelines integrated into the ICD-10 coding hierarchy are the following:

·        Return-To-Work Summary Guidelines

·        Return-To-Work "Best Practice" Guidelines

·        Capabilities & Activity Modifications for Restricted Work

·        Medical Procedure Summaries, with all possible procedures that might be considered for each condition, along with a recommendation for appropriate use and a summary of the supporting medical evidence, with links to the cited references, which are ranked and weighted alphanumerically

·        ODG Treatment UR Advisor, aligning procedure codes with diagnosis codes with normative utilization data and recommendations for approval

·        Causality Likelihood (for workers' comp)

·        Hospital Costs

·        Hospital Length Of Stay

·        Case Management Triage levels

·        Physical Therapy Guidelines

·        Chiropractic Guidelines

·        Workers' Comp Costs per Claim (Indemnity versus Medical)

·        Disability Duration Adjustment Factors by Age

·        Charts and graphs of actual workers’ comp and disability data

The online ODG will contain both versions, ICD-9 and ICD-10, running parallel through the transition date and beyond.

Phil Denniston, President of Work Loss Data Institute, publisher of ODG, said, “I am pleased that ODG has embraced the new ICD-10 coding system. The success of evidence-based guidelines for both return-to-work and medical treatment depends on having an accurate and definitive diagnosis. The ICD-10 coding system has been created to allow much more specificity in assigning the correct diagnosis. We have always said that ODG is not ‘cookbook’ medicine and does not recommend the same treatment for each patient. Hundreds of alternative treatments are discussed in ODG for each type of injury or illness, summarizing the high quality medical evidence for each one. Going forward with the ICD-10 coding system, we will be able to narrow the indications for each treatment, by identifying those patients most likely to benefit from each. Plus, because treatment is the primary predictor of return-to-work, and ODG is the only guideline that integrates medical treatment and return to work, ODG will be able to recommend more definitive disability durations as well.”

Dr. Charles W. Kennedy, MD, Senior Medical Editor for ODG, said, “ODG has become the pre-eminent medical guideline used in workers’ compensation, both for medical treatment and for disability duration. Converting ODG to ICD10 codes will take it to the next level. There are no other guidelines available in this format.”

WLDI is an independent database development company focused on workplace health and productivity based in Encinitas, California. Currently in its 16^th annual edition and available in Web-based, textbook and Systems Integration formats, ODG 2011 provides evidence-based medical treatment, UR and disability duration guidelines to improve as well as benchmark outcomes in workers’ comp and non-occupational disability.