HCC Best Practice: Emphysema

To assist you in identifying patients with a potential emphysema (HCC 111) diagnosis, OHN’s Clinical Documentation Excellence (CDE) team, in collaboration with clinical leaders, have created a logic model within the HCC Best Practice Advisory (BPA) tool. The model uses natural language processing (NLP) in EPIC to identify potential diagnoses and present these within the BPA to you, the clinicians.

You can find information regarding suspected diagnoses within the EPIC “probable condition logic” hyperlink in the BPA, including the information listed below. In cases where NLP is used, a smart link will give you specific information concerning the suspected diagnosis, including the type of radiologic study, the date of the study, and a quote from the study which includes the word or statement that triggered the BPA tool.

HCC 111 Emphysema Logic Process Explained

If the radiologist’s reading of a CT image of the lungs includes words such as “emphysema” or “emphysematous,” a suspected diagnosis will be triggered.

Since this logic is based on string-matching algorithms of the imaging result, there could be a limited number of false positives if the radiologist’s reading contains the word “no” prior to the trigger words mentioned above.

If a patient meets both the emphysema and COPD logic, a suspected emphysema diagnosis will appear within the HCC BPA.