“Graphical User Interface Apparatus for Searching and Displaying Medical Codes in an Electronic Anesthesia Record” in Patent Application Approval…

"Graphical User Interface Apparatus for Searching and Displaying Medical Codes in an Electronic Anesthesia Record" in Patent Application Approval Process

By a News Reporter-Staff News Editor at Politics & Government Week -- A patent application by the inventor Glenn, David Michael (Menlo Park, CA), filed on October 15, 2014, was made available online on May 28, 2015, according to news reporting originating from Washington, D.C., by VerticalNews correspondents.

This patent application is assigned to Glenn; David Michael.

The following quote was obtained by the news editors from the background information supplied by the inventors: "In the United States the use of medical codes are primarily used to file healthcare claims. The code vocabularies most relevant the practice of anesthesiology are the American Medical Association (AMA) copyrighted Current Procedural Terminology (CPT), the World Health Organization's copyrighted International Classification of Diseases (ICD), and the Relative Value Scale (RVS), established by the federal government in 1992. For the anesthesiologist, a subset of the RVS published by the American Society of Anesthesiologists termed the ASA-RVS is most relevant because of its focus on anesthesia and non-anesthesia procedures including pain management services, invasive monitoring and transesophageal echocardiography procedures. Currently, the United States is transitioning from ICD-9 having approximately 16,000 codes, to ICD-10 having approximately 68,000 codes. An excellent discussion of the problems with CPT codes can be found in the background discussion of U.S. Pat. No. 5,325,293 to Dorne and U.S. Pat. No. 8,606,594 to Stern, et al.

"Every medical insurance payer recognizes CPT codes as the standard by which medical procedures are described. In anesthesiology, as other medical disciplines, to completely bill for services rendered, the anesthesiologist must properly specify the one or more CPT codes, ICD codes and RVS codes. CPT codes work in tandem with ICD codes to create a comprehensive picture of medical services rendered. ICD codes describe the symptoms, area, and type of injury or disease in a patient. When listed together, ICD and CPT codes present a picture of both the diagnosis and the type of service provided to the patient by the anesthesiologist. As such it is necessary to convert CPT codes to ICD codes, and vice-versa. However, this is often difficult. The following examples are illustrative of challenges often encountered; The CPT code for two doses of Hepatitis A vaccine, of pediatric or adolescent dosage, for intramuscular use is 90633. The ICD code for that same vaccine is V05.3. In general, CPT codes provide more specificity than their ICD counterparts. Three doses of the above vaccine are coded in CPT as 90634, while in ICD it is still coded as V05.3. Medical coders must familiarize themselves with the equivalencies between these two code systems, and be able to freely translate one into the other. In converting between CPT and ICD codes, medical coders must ensure that the CPT code they enter for a medical procedure makes sense with the ICD code. If a claim is submitted for a Human Papilloma Virus vaccine (CPT 90650), but list the diagnosis as acute appendicitis with generalized peritonitis (ICD-9-CM 540.0), a health insurance company would catch this error, deny the claim, and return it for correction. Today's consolidated health care environment is creating conflicts between the two systems. Many hospitals operate outpatient facilities in which CPT coding is used instead of ICD-9-CM procedural coding. With the advent of ambulatory surgical centers and physician office surgical suites, many procedures that were once performed exclusively for inpatient services now can be performed as either inpatient or outpatient services. Consequently, two coding systems are in use for the same procedures. Medical coders have difficulty tracking frequencies or costs when the facility data contains both ICD and CPT codes.

"To help alleviate these translational issues, an efficient means of bridging or commonly referred to, as crosswalking between ICD and CPT codes is required. Crosswalk databases are widely available.

"Matters are further complicated by the use of RVS codes. As briefly discussed above, the RVS is a scheme used to determine how much money medical providers should be paid. It is partially used by Medicare in the United States and by nearly all Health Maintenance Organizations (HMOs). RVS assigns procedures performed by a physician or other medical provider a relative value that is adjusted by geographic region (so a procedure performed in Manhattan is worth more than a procedure performed in Dallas). This value is then multiplied by a fixed conversion factor, which changes annually, to determine the amount of payment. The RVS for each CPT code is determined using three separate factors: physician work, practice expense, and malpractice expense. The average relative weights of these are: physician work (52%), practice expense (44%), malpractice expense (4%). In the development of the RVS, the physician work (including the physician's time, mental effort, technical skill, judgment, stress and an amortization of the physician's education), the practice expense and the malpractice expense are factored into the result. The calculation of the fee includes a geographic adjustment. The RVS does not include adjustments for outcomes, quality of service, severity, or demand. For anesthesiologists, the American Society of Anesthesiology annually publishes a focused set of RVS codes, referred to as the ASA-RVS (and heretofore referred to as simply 'RVS'), and a CPT-RVS crosswalk. These RVS codes are the codes most commonly used by anesthesiologists. The power of the crosswalk is that it defines the set of CPT codes most commonly required by anesthesiologists. RVS codes are very oriented to regions of the body. One of the predominate drivers of how an anesthesiologist is compensated is based on what region(s) of the body the surgeon(s) is (are) operating on. So if an RVS code is known, the CPT codes derived through the crosswalk are usually very focused to a region of the body.

"Often the task of assigning proper and complete medical codes falls to accounting or clerical personnel. These individuals often lack the understanding of medical procedures to completely enumerate the services rendered by the anesthesiologist. Consequently, numerous systems and processes that help either the doctor or staff to select medical codes have been and are being developed. Some of these systems analyze patient data to derive CPT codes, while others attempt to use anatomical images or anatomical user interfaces to derive CPT codes. For example, US 2003/0200119 A1 to Lewis, et al., 2008/0273774 A1 to Mikhail, et al., 2009/0070140 A1 to Morsch, et al, and 2010/0328235 A1 to Taute, each use some type of anatomical visualization means to derive medical codes. However, each lack the 4-way correlation between CPT, ICD, RVS and anatomical acceleration needed by the anesthesiologist. Additionally, some prior art pertains to novel ways of searching for medical codes. For example, U.S. Pat. No. 6,393,404 to Waters, et al., and U.S. Pat. No. 5,483,443 to Milstein, et at., both focus on searching or deriving CPT codes and fail to recognize the utility of the ICD and RVS correlation and the need to present search results in a way useful to the anesthesiologist. A comprehensive solution particularly suitable to anesthesiology is lacking primarily because the anesthesiologist is required to provide CPT, ICD and RVS codes whereas other practitioners may only need CPT codes."

In addition to the background information obtained for this patent application, VerticalNews journalists also obtained the inventor's summary information for this patent application: "A novel graphical user interface apparatus for displaying and selecting CPT, ICD and RVS medical codes derived through the cooperative interaction of a first, second, third and fourth sub-views. The apparatus uses a full-body anatomical representation of a human to accelerate the selection of CPT codes and additionally makes use of medical lingo terms to further enhance the quality of search results. It further correlates search results and CPT-ICD and CPT-RVS crosswalk databases to derive contextually relevant medical codes. The apparatus has the added novelty of ordering search results in a non-obvious manner to provide the anesthesiologist with the most accurate medical codes in the electronic anesthesia record. Although, the apparatus was developed within the context of the electronic anesthesia record, the concepts are broadly applicable to other practices of medicine.

BRIEF DESCRIPTION OF THE DRAWINGS

"The following drawings form part of the present specification and are included to further demonstrate certain aspects of the present invention. The invention may be better understood by reference to one or more of these drawings in combination with the detailed description of specific embodiments presented herein.

"FIG. 1 is the graphical user interface for an electronic anesthesia record application of a multi-function gesture sensitive device in accordance with an embodiment of the present invention.

"FIGS. 2a, 2b and 2c are the graphical user interface for selecting procedure, diagnosis, RVS values and a full-body representation of a human in accordance with an embodiment of the present invention.

"FIG. 3 is the entity-relationship model used by the present invention in accordance with an embodiment of the present invention.

"FIG. 4 is a flow diagram detailing how CPT in-memory search results are prioritized in accordance with an embodiment of the present invention.

"FIG. 5 is a flow diagram detailing how ICD in-memory search results are prioritized in accordance with an embodiment of the present invention.

"FIG. 6 is a flow diagram detailing how RVS in-memory search results are prioritized in accordance with an embodiment of the present invention."

URL and more information on this patent application, see: Glenn, David Michael. Graphical User Interface Apparatus for Searching and Displaying Medical Codes in an Electronic Anesthesia Record. Filed October 15, 2014 and posted May 28, 2015. Patent URL: http://appft.uspto.gov/netacgi/nph-Parser?Sect1=PTO2&Sect2=HITOFF&u=%2Fnetahtml%2FPTO%2Fsearch-adv.html&r=1129&p=23&f=G&l=50&d=PG01&S1=20150521.PD.&OS=PD/20150521&RS=PD/20150521

Keywords for this news article include: Patents, Anesthesia, Legal Issues, Pain Medicine.

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