Patent ID: 8265952
Filing Date: 2012-09-11
Classification: G16H

Abstract:
1. A method implemented on a suitably programmed computer comprising a processor and a display, the method comprising: receiving at least one transaction in an International Classification of Diseases (ICD) 9 format or an ICD 10 format; determining whether the received transaction is in the ICD 9 format or the ICD 10 format; when the received transaction is in the ICD 10 format, identifying at least one transaction in the ICD 9 format that matches the received transaction in the ICD 10 format; processing, via the processor, the identified transaction in the ICD 9 format, wherein processing the identified transaction comprises one of processing an eligibility query, processing a claim, and performing claims management; providing processing results in the ICD 10 format by associating the processed identified transaction in the ICD 9 format with the ICD 10 format; and transmitting the processing results of the processed transaction, wherein identifying at least one transaction in the ICD 9 format that matches the received transaction in the ICD 10 format further comprises: mapping an ICD 10 code from the received transaction to an ICD 9 code selected from a group of at least one ICD 9 code; identifying whether the group of ICD 9 codes are in a priority order; and selecting at least a highest priority code from the group of ICD 9 codes for the ICD 9 format, and wherein when the received transaction is in the ICD 9 format, processing, via the processor, the received transaction, providing processing results in the ICD 9 format, and transmitting the processing results of the processed transaction.