# Pro blem List

The problems list on the Problems tab displays a patient's current and historical health care problems entered by clinicians. The problems list allows each identified problem to be traced through the VISTA system.

Service Connected Conditions

If a problem is service connected, the problem's service connected status is displayed in parentheses in the Description column.

Service Connected Condition Abbreviations

· SC - Service Connected Condition

· AO - Agent Orange Exposure

· IR - Ionizing Radiation Exposure

· SWAC - Southwest Asia Conditions

· SHD Shipboard Hazard and Defense

· MST - Military Sexual Trauma,

· HNC - Head or Neck Cancer

The problems list on the Problems tab can be configured to show active, inactive, both active and inactive combined, or removed problems. Treatment factors, SNOMED CT codes, and ICD codes display right after the problem text.

Codes to Classify Problems

Pr oblems in CPRS are classified using two kinds of codes: International Classification of Diseases (ICD) codes and Systematized Nomenclature of Medicine concept terms (SNOMED CT). ICD codes are primarily used for billing purposes while SNOMED CT codes defin e problems in ways that health care provider would use. Previously, only ICD codes were used to define problems. The availability should help providers better define problems, while also mapping to ICD codes in the background.

ICD codes are still used on th e Encounter form to define a problem. And SNOMED-CT may be mapped to ICD codes. There are many codes that are not mapped however. So, how do additional codes get added to the list of possible terms?

There are three key types of updates:

· Every time a new and unmapped problem is selected from the Extended Search, a request is made for the problem to be added to the Problem List Core Set and the unmapped problems updated from the 799.9 to the appropriate ICD-9-CM code by the New Term Rapid Turnaround (NTRT) process. The NTRT deployment process, adds the term to the core set so that it is available for future searches as well as it updates the patient's record with the new ICD-9-CM code (s). The Problem List Audit History Log captures the update and can be viewed in the Problem List tab in the detail view of the problem. This takes place without the need for any further input from users or CAC's involvement.

· When new terms are requested following an Extended Search or the user applies for a new term, a request is made for those terms to be found within SNOMED-CT. If there are already suitable terms in SNOMED-CT, then such a problem can be added quickly to the core. If the terms do not exist in SNOMED-CT, then the requested term(s) are forwarded to SNOMED-CT's curators at IHTSDO. If or when SNOMED CT has incorporated the term into the SNOMED CT release, new terms will be added to the core set.

· Standards Development Organizations (SDO) make updates to their terminologies on a regular basis, and these changes are transmitted to the Problem List core set by the NTRT process. The SNOMED CT subset is updated through the Lexicon Utility Quarterly update process. Such updates require no input from users.

Related Topics

Adding a Problem

Annotating a Problem

Changing a Problem

Customizing the Problems List

Making a Problem Inactive

Removing a Problem

Verifying a Problem