ICD-10 and Bridge Tables

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ICD-10 and Bridge Tables

Post  dmjk2011 on Mon May 09, 2011 11:46 am

I am designing the changes to our existing datawarehouse for ICD-10 diagnosis and procedure code changes. We already have a bridge table that sits between the claim and claim line fact tables and the diagnosis table that has the following structure...

DIAG_CD_GRP_BRDG table:
diag_cd_grp_SK
diag_cd_SK
diag_cd_pos_num
diag_tp_SK

Is it just a matter of adding a ICD_version_flag in the bridge table to handle the new version codes? (assuming both ICD-9 and ICD-10 codes will be in the diagnosis dimension - tied using the diag_cd_SK)

The source data also has a provision to send us cross-reference data for providers who might not be ready by 2013 or for early adoptors who can send ICD-10 before Oct 2013. So now we have claims that could have a corresponding ICD-9 AND an ICD-10 in each line..only one of which is used for claim adjudication. The other is just for reference. Would I create a new bridge table that stores the cross-reference diagnosis/procedure codes? I wouldnt want to increase the size of the bridge table unnecessarily.

Any suggestions are welcome. Thank you for your time!!
-J






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Re: ICD-10 and Bridge Tables

Post  ngalemmo on Mon May 09, 2011 9:19 pm

If the intent of the bridge is to carry the codes used for adjudication (ie. one or the other), you do not need to change the bridge. This assumes the ICD-10 codes will appear as new rows in the dimension. The dimension should include the coding system as part of the natural key, which would be sufficient to identify the coding system that applies.

A cross-reference would be best handled by another bridge, however, I would suspect that the cross-reference will be a bit dicey as the correlation between 9 and 10 codes will diverge over time.

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