# Problem 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-9-CM codes display right after the problem text. If they have been specified by the provider, ICD-10-CM codes can be seen in the detailed display.

## Coding Systems Used to Represent Problems

Problems in CPRS are represented using two systems: Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) codes and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. SNOMED CT terminology is the designated national standard for Problem List for clinically expressing problems and to support interoperability and data exchange within VA, DoD, and external partners. ICD-10-CM codes are primarily used for reimbursement purposes. Previously, only ICD codes were used to define problems. SNOMED CT should help providers better define problems, while also mapping to ICD codes in the background.

Depending on the method for documenting a problem, the problem represented in SNOMED CT may or may not be linked to an ICD-10-CM code(s). If the user selects a problem from the National Problem Selection List, the problem will be linked to ICD-10-CM code(s). If the user selects a problem from within the Lexicon Utility, the problem will be linked to an R69 code (an unspecified problem).

## Using Problems for Encounter Information

The Problem List application passes all patients’ problems to the Encounter Form. These problems can be viewed under the Problem List Item section of the Diagnosis tab and may be utilized for Encounter check out. However, if the problem is linked to an inactive code or represented in ICD-9-CM, the system requires the user to update the problem. Updates may require the user to link the problem to an active SNOMED CT or ICD-10-CM code.

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