April 10, 2018 — This bulletin provides an overview of changes that are being made to the business process and outlines new criteria requirements for questions submitted to the Classifications eQuery coding question service.

Questions received via Classifications eQuery can be of great value to CIHI. They can lead to improved data quality and better products. Your questions identify emerging health issues of national concern, potential data quality issues and potential gaps or errors in CIHI’s products. And certainly many clients already provide us with well-worded and well-researched questions.

Why the changes?

  • We conducted a detailed review of submitted questions and our responses to them. This review highlighted the need to reinforce the focus of the service and revealed that many of the questions can be answered using existing resources or by consulting peers.
  • New key health priorities have emerged, such as medical assistance in dying (MAID) and opioids. Questions on these topics need to be answered in a thorough and comprehensive manner.

To address both of these needs, we are communicating clear and concise question submission criteria to our clients.

What’s changing?

As of October 1, 2018, only coding questions that meet one or more of the following criteria will be answered:

  • A disease, condition or intervention appears not to have an applicable ICD-10-CA or CCI code.
  • A possible error is identified in ICD-10-CA/CCI, the Canadian Coding Standards or related resource content (e.g., bulletins, Tip for Coders, education products).
  • A perceived gap is identified in the classifications (ICD-10-CA or CCI), Canadian Coding Standards or related resource content that could improve data collection if addressed. 
  • The question suggests a potential major/systemic data quality issue.
  • An issue of significant public interest or strategic policy issue emerges (e.g., MAID, opioids).

We will not provide answers to questions that

  • Are based on hypothetical clinical scenarios;
  • Do not include the pertinent clinical documentation to put the diagnosis/intervention into context;
  • Ask for validation of code assignment without a specific issue identified;
  • Can be answered using the clients’ resources. Answers will not expand on information that should be acquired through training and/or by consulting available resources, such as ICD-10-CA and CCI, the Canadian Coding Standards, CIHI’s education products, bulletins and Tips for Coders;
  • Are related to incomplete, illegible or ambiguous documentation; and/or
  • Are not within the scope of the Classifications and Terminologies expertise (e.g., questions that are clinical in nature or that belong to another program area).

Phased implementation

The change will take place in 2 phases in order to assist you with the strategic direction, and equip you with the knowledge, resources and tools required.

Soft launch: May 1 to September 30, 2018

During this phase, we will respond to all questions and make you aware if your question aligns with the new criteria. We will direct you to existing resources, and provide information on how to apply the iCODE Strategy. This will prepare you for the formal launch in October 2018, when questions that require more information or that can be answered using existing resources will be returned to the client.

Formal launch: October 1, 2018

From this point forward, we will respond to questions that do not meet the above criteria with an explanation as to why they were not answered. We will invite you to submit another coding question with complete information.

Resources

A job aid (Resolving a Coding Challenge) has been created to help you in this transition. Please follow the steps set out in the job aid. If a solution cannot be found, a coding question can be formed using the steps outlined in the job aid.

Resolving a Coding Challenge

Clients should use these resources:

  • Folio software (ICD-10-CA/CCI classifications);
  • iCODE Strategy;
  • CIHI classification resources (e.g., education modules, Canadian Coding Standards, Tips for Coders);
  • Internet research;
  • Informal consultation with coding colleagues or a formalized coding community of practice; and
  • Communication with health professionals within your own facility.

Streamlined resources

If you have questions about these changes, please email classifications@cihi.ca.