The first step to preparing your SMARText Dx items for the ICD-10 transition is to ensure that your most commonly used diagnoses codes have been updated to SMARText Dx items that contain ICD-9 and related ICD-10 based on clinical coding.  To obtain a list of your most commonly used Dx items, follow the steps below.  This report will also provide you with a list of ALL SMARText Dx items that are downloaded to your system.

Open the SMARText Items Manager by going to Docutainers > SMARText Items (or hit F10 on your keyboard).

1. Click the List - By Type tab.
2. Un-check the "Include Cloud Library Items" box.
3. Using the drop-down menu, click the + next to Generic, + next to Structured Items, and then select Assessment Item.  If you receive a message stating "This operation can take many minutes to complete. Continue?", click Yes.  This will prohibit you from using SOAPware on the workstation you are running the report on, so please ensure you do this at a time that will not interrupt clinic operations.
4. After the search completes, results will be displayed and will be automatically sorted by the Usage column.  Dx items that are most used will be displayed at the top.  

Next, we suggest that you print or export the list of Dx items so that you can work from your external list on updated the codes that need to be updated.

After clicking the print button, SOAPware will display a print preview of the SMARText items report.  This report can either be (1) printed or (2) exported using the Export To button.  The Export To button will allow the user to export the report to Excel and work from a spreadsheet report while updating items.

The report will list all Dx items that are downloaded to your local database sorted with the most used items at the top.  The user can then review the Description column of the report to locate Dx items that need to be updated to the new ICD-9/ICD-10 SMARText items.

Notice, in the screenshot above, that the code for Asthma (nonspecific - 493.10) does not contain an ICD-10 code in the description, whereas the code for Intrinsic asthma, acute does.  This indicates that the Asthma code is an out-of-date code and needs to be re-downloaded and replaced with the updated and ICD-9/ICD-10 item. If the diagnosis items you are using have billable ICD-10 codes, then both the ICD-9 and ICD-10 codes will be present in the item description of the SMARText item.

To download the updated item click the Search tab.  

1. Check the box at the bottom to "Include Cloud Library Items".
2. In the Find box, type the ICD-9 code (ex: 493.10) and click the Find button.

The search results will display all items on your local database, as well as the items on the Cloud Library that contain the keyword entered into the Find box (ex: 493.10).

Notice that the item displayed with an upwards facing green arrow is the item on the local database and does not contain the ICD-10 code.  Several other items are displayed on the Cloud Library (indicated by a downward facing green arrow), including the item of the same description that includes the ICD-10 code (ex: Asthma, intrinsic, stable ICD493.10- J45.909).

1. Highlight the ICD-9/ICD-10 Dx item that you wish to download.
2. Click the Download button.

Confirm that you wish to overwrite the existing Dx item by clicking Yes.

This will replace the Dx item on your local database with the updated ICD-9/ICD-10 item that can now be inserted into documentation.

When entering new Dx items into documentation, ensure the items are ICD-9/ICD-10 Dx items.  These will display with both the ICD-10 and ICD-9 code as shown in the screenshot above.

Because the Diagnosis SMARText items in SOAPware can contain both ICD-9 and ICD-10 (and SNOMED-CT), this should allow for a smoother shift from ICD-9 to ICD-10 on October 1, 2015 as well as meeting the requirements for 2014 Meaningful Use, Stage 2. Phase 1 of our ICD-10 release also contains a toggle to send either the ICD-9 or the ICD-10 over to billing systems. SOAPware's ability to support multiple coding systems in the background of what you are now using should greatly ease the confusion that most (i.e. non-SOAPware clients) are attempting to address with these transitions.

It is important that you remove all obsolete non ICD-9/ICD-10 Diagnoses from your local SMARText library. Failure to remove these items will clutter your search results that are presented when searching for the proper ICD-10 coded item. It also open the opportunity for clinicians to insert the incorrect code, resulting in a denial of a claim or inaccurate documentation.

To delete an obsolete item from the local SMARText Library, open the SMARText Items Manager (F10 or Tools > SMARText Items Manager).  Search for and highlight the obsolete Dx item, then click the Delete button.