A closer look at core capabilities
Deterministic rules backed by 715K+ authoritative concepts
Legacy EHRs rely on static code lookups that miss the complexity of wound care terminology. Integrium CORE's terminology service spans 6 code systems (SNOMED CT, ICD-10-CM/PCS, CPT, HCPCS, and LOINC), with deterministic SNOMED-to-ICD-10 complex map evaluation that resolves wound diagnoses to the correct billing codes.
Every terminology decision is traceable and repeatable. No machine learning, no black boxes. The same input always produces the same output, giving your billing and clinical teams full confidence in every code assignment.
- 715K+ concepts across 6 authoritative code systems with wound care focus
- SNOMED-to-ICD-10 complex map evaluation for accurate wound diagnosis coding
- Deterministic, repeatable results: same input, same output, every time
- CMS quarterly refresh keeps all code systems current automatically
Deterministic rules, every decision auditable
Integrium CORE's billing rules engine runs deterministic rules covering CPT calculation, NCCI edit validation, LCD compliance, medical necessity checks, and pre-submission sign-and-lock validation. Every rule fires the same way every time. No probabilistic models, no unexplainable outputs.
The RuleTrace audit trail captures the full decision chain for every billing validation: which rules fired, what data was evaluated, and what the outcome was. When payers question a claim, you have a complete, timestamped record of every validation that occurred before submission.
- NCCI edit pair validation and LCD compliance checks at point of care
- Pre-submission sign-and-lock validation catches errors before claims go out
- RuleTrace audit trail with full decision chain for every validation
- State-specific payer rules (e.g., Ohio MCO SA modifier logic)
Built on Medplum, FHIR R4 from the ground up
Integrium CORE is built natively on Medplum's FHIR R4 platform, not retrofitted with a FHIR facade. Five purpose-built profiles (WoundCondition, WoundObservationPanel, WoundProcedure, Encounter, and Claim) model the full wound care lifecycle from assessment through billing, aligned with the HL7 wound assessment implementation guide.
Native FHIR means interoperability is built in, not bolted on. Clinical data flows directly into billing workflows through structured resources, and the CMS quarterly refresh pipeline keeps NCCI edits, MPFS fee schedules, ICD-10 updates, and LCD policies current, with SHA-256 integrity verification, dry-run validation, and audit logging on every cycle.
- 5 FHIR R4 profiles purpose-built for wound care documentation and billing
- CMS quarterly refresh with SHA-256 verification and dry-run validation
- Native Medplum platform with no FHIR translation layer or middleware
- A dual-reviewed scenario validation suite ensures data integrity across updates
