CHAPTER
18
Diagnostic Coding
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-2
Learning Outcomes (cont.)
18.1 Recall the six ways that ICD codes are used
today.
18.2 Describe the conventions used by
ICD-9-CM.
18.3 Outline the steps to code a diagnosis using
ICD-9-CM.
18.4 Explain the purpose and usage of V codes
and E codes.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-3
Learning Outcomes (cont.)
18.5 Name the appendixes found in ICD-9-CM.
18.6 Compare ICD-9-CM and the ICD-10-CM.
18.7 Summarize the ICD-10-CM general coding
guidelines.
18.8 Illustrate unique coding applications for
neoplasms, diabetes mellitus, fractures, R
codes, poisonings, and Z codes.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-4
Introduction
• Diagnosis – translated into ICD codes
• Reimbursement is based on codes
entered so you must
– Understand what the codes mean
– Know how to chose correct codes
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-5
The Reasons for Diagnostic Codes
• Chief complaint (CC)
– Diagnosis (DX)
• Proves medical necessity of treatment
• Diagnostic code
– Coexisting conditions
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-6
The Reasons for Diagnostic Codes
• International Classification of Diseases
– 9th edition ~ ICD-9-CM
– 10th edition ~ ICD-10-CM
• Original purpose of ICD-9-CM
– Classification of morbidity and mortality
statistics
– Medical research, education, and
administration
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-7
The Reasons for Diagnostic Codes (cont.)
• Current uses
– Facilitation of payment
– Evaluation of utilization patterns
– Study healthcare costs
– Research
– Prediction of trends
– Planning for future
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-8
Apply Your Knowledge
How are ICD codes used?
ANSWER: ICD codes are used for:
•
•
•
•
•
•
Facilitation of payment for medical services
Evaluation of utilization patterns
Study of healthcare costs
Research regarding quality of healthcare
Prediction of healthcare trends
Planning for future healthcare needs
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-9
An Overview of the ICD-9-CM
• Diseases and Injuries Tabular List (Volume 1)
– 17 chapters of disease descriptions and codes
– V codes
– E codes
• Alphabetic Index (Volume 2)
• Volume 3 ~ edition for hospitals
• Appendices
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-10
Conventions
NOS – not otherwise specified
NEC – not elsewhere classified
[ ] – brackets
[ ] – slanted bracket
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-11
Conventions (cont.)
( ) Parentheses
Includes
: Colon
Excludes
} Brace
Use additional code
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-12
Conventions (cont.)
• Code first underlying disease
• Code, if applicable, any causal condition
first.
• Be aware of
– Boldface type
– Italicized typeface
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-13
Conventions (cont.)
• Alphabetic Index
– Omit Code
– See Condition
– See Also
• Read Coding Guidelines
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-14
The Alphabetic Index
• Contains terms needed to locate codes
• Organized by condition
• Main terms
• Subterms
• Nonessential terms
• Cross-references
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-15
The Tabular List
• Organized by source or body system
• Code structure - categories
– Rubrics ~ three digit
– Subcategories ~ four digit
– Subclassifications ~ five digit
• Code to highest level of specificity
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-16
The Tabular List (cont.)
• V codes
– Encounters not related to illness or injury
– Primary or supplemental codes
– May not be covered by insurance carrier
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-17
The Tabular List (cont.)
• E codes
– External causes of injuries and poisoning
– “How did that happen?”
– Only a supplemental code
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-18
Apply Your Knowledge
Matching
ANSWER:
___
C contains synonyms or alternative wordings
___
E surround nonessential or supplementary terms
A. NOS
___
F used after an incomplete term
C. [ ]
___
B ICD-9 does not contain a code specific enough
A used if condition cannot be better descriped
___
D. [ ]
___
H a directive; refers you to a different term
F. :
___
D indicates that 2 codes are needed
___
G a suggestion; you might find a better code
G. See Also
B. NEC
E. ( )
H. See Condition
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-19
Coding with ICD-9





Record the code
Read to find the best code
Locate the code from the Alphabetic
Index in the Tabular List
Find the diagnosis in the Alphabetic Index
Locate the patient’s diagnosis
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-20
Coding with ICD-9 (cont.)
• Acute vs. chronic conditions – list acute
code first
• Combination codes – used in place of
single codes
• Multiple coding – more than one code
required to describe diagnosis
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-21
Coding with ICD-9 (cont.)
• Coding unclear diagnoses
• Principal vs. primary diagnosis
– Principal diagnosis
– Primary diagnosis
– Secondary diagnosis
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-22
Apply Your Knowledge
What are the steps to code a diagnosis?
ANSWER:
1. Locate the diagnosis in the medical record
2. Find the diagnosis in the Alphabetic Index
3. Locate the correct code in Alphabetic Index and then
in the Tabular Index
4. Read all instructions to find the best code
5. Record the code
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-23
V Codes and E Codes
• V codes – Supplementary Classification of
Factors Influencing Health Status and
Contact with Health Services
• E codes – Supplementary Classification of
External Causes of Injury and Poisoning
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-24
V Codes
• Outpatient use
• Examples:
– V04.81 Influenza vaccination
– V58.11 (Encounter for) Chemotherapy
treatment
– V14.0 History (personal) of allergy to penicillin
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-25
E Codes
• General use
– Initial treatment only, except fractures
– Use as many codes as required
• Poisonings and Adverse Effects
– Refer to poisoning column then to
how it occurred
– Must be documented in the medical
record to code
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-26
E Codes (cont.)
• Poisoning
• Burns
– Accidental
– Degree of burn
– Therapeutic
– Extent (% of body
burned)
– Suicide attempt
– Assault
– How it occurred (E
code)
E Codes are never the primary code
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-27
Apply Your Knowledge
Determine whether a V code or E code should
be used: ANSWER:
E code
patient required stitches to close a wound from a knife
E code
patient was exposed to a chemical that caused a rash
V code
patient was seen for a shingles vaccination
V code
patient had an annual physical
E code
patient presented with a fractured wrist
V code
child came to office for a sports exam
V code
patient is requesting birth control pills
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-28
Appendices of ICD-9
A. Morphology of Neoplasms
B. Deleted
C. Classification of Drugs
D. Classification of Industrial Accidents
E. List of the Three Digit Categories
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-29
Apply Your Knowledge
List the appropriate Appendix:
ANSWER:
B deleted in 2004
C Classification of Drugs
E Three Digit Categories
A Morphology of Neoplasms
D Classification of Industrial Accidents
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-30
Basic Comparison of ICD-9-CM and ICD10-CM
• Internal List of Causes of Death – 1893
• ICD-9 ~ 1975
– 14,200 codes
– No expansion
– Volume 3 for
hospital codes
• ICD-10-CM
– Over 68,000
diagnostic codes
– Greater specificity
– Provides for expansion
• ICD-10-PCS –
hospital codes
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-31
ICD-10 Information
• Alpha Index
• Tabular (numeric) List
– 21 chapters
– Category ~ 3 characters
– Subcategory ~ 4-5 characters
– Final code ~ up to 7 characters
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-32
Characters and Specificity
•
•
•
•
Codes begin with an Alpha character
Possible characters ~ 3-7
More precise clinical picture
Enhances trending analysis
ICD-9 (limited specificity)
ICD-10 (expanded specificity)
Code: 233.0 Carcinoma in situ Code: D05.01 Lobular carcinoma in situ of
breast (vague as to cancer
right breast
type)
OR
Code: D05.11 Intraductal carcinoma in site
of right breast
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-33
Placeholders
• “x” – placeholder for future expansion of
code’s specificity
• Do not drop placeholder when adding
characters
ICD-9-CM
ICD-10-CM
910.0 Face, neck, and scalp;
abrasion or friction burn
without mention of infection
910.1 Face, neck, and scalp;
abrasion or friction burn,
infected
S00.01 Abrasion of scalp (code noted to √x7th)
S00.01xA Abrasion of scalp, initial encounter
S00.01xD Abrasion of scalp, subsequent
encounter
S00.01xS Abrasion of scalp, sequela
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-34
Combination Codes
• More combination codes available
• Decreased need for multiple codes
ICD-9-CM
ICD-10-CM
995.92 Severe sepsis
R65.21 Severe sepsis with septic shock
and
785.52 Septic shock
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-35
Apply Your Knowledge
List at least two ways that the ICD-10 is an improvement
over the ICD-9.
ANSWER:
The ICD-10 contains many more codes, allows for expansion;
has more combination codes, and incorporates placeholders
all of which enables more precise coding.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-36
Basic Coding Guidelines for ICD-10
Locate term
in Alphabetic
Index
Refer to
notes
Follow
instructional terms
to appropriate code
Assign the appropriate
code with highest degree
of specificity
Read and
follow terms
in ( ) and [ ]
Go to Tabular list
Assign additional code
for s/s not associated
with disease
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-37
Basic Coding Guidelines for ICD-10
(cont.)
• Conventions are similar to ICD-9
• ICD-10
– More detailed documentation by physician
– Never code from the Alpha Index
– Verify codes in Tabular list
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-38
3-38
Apply Your Knowledge
What are the general coding guidelines for the
ICD-10?
ANSWER:
Locate the diagnosis in the Alphabetic Index
Read and follow all notes and conventions.
Locate in Tabular list.
Follow instructions to the appropriate code.
Assign the code with highest degree of specificity.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-39
Synopsis of ICD-10 Coding Guidelines by
Chapter
• Chapter 1 – HIV coding
– R75 ~ inconclusive laboratory evidence
– B20 ~ positive serology
– Z21 ~ HIV positive, asymptomatic
– Z71.7 ~ counseling provided
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-40
Synopsis of ICD-10 Coding Guidelines by
Chapter
• Chapter 2 – Neoplasms
– Type of neoplasm
– Location
– Additional codes
– Primary vs. secondary neoplasms
– Treatments
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-41
Synopsis of ICD-10 Coding Guidelines by
Chapter (cont.)
• Chapter 4 – Diabetes
mellitus
• Chapter 5 – Pain
– Psychological
– Type
– F45.41
– Body system affected
– Complications
– Appropriate code from
G89 category
– Use of insulin
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-42
Synopsis of ICD-10 Coding Guidelines by
Chapter (cont.)
• Chapter 6
– Eye and ear not
included
• Chapter 9 –
Hypertension
– G89 ~ pain diagnoses
– I10 ~ essential
hypertension
– If present, list
underlying cause first
then the pain code
– Code underlying
etiology then code
hypertension
– R030.3 ~ transient
hypertension
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-43
Synopsis of ICD-10 Coding Guidelines by
Chapter (cont.)
• Chapter 10
– Avian or H1N1
influenza
– Other types of
influenza
• Chapter 13 –
Fractures
– Laterality
• Unilateral – 4th digit “1”
• Designated by 5th digit
– Required 7th character
• Initial
• Subsequent
• Sequela
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-44
Synopsis of ICD-10 Coding Guidelines by
Chapter (cont.)
• Chapter 14
– Four stages of chronic kidney disease
– ESRD
• Chapter 15
– 7th digit
– Read instructions carefully
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-45
Synopsis of ICD-10 Coding Guidelines by
Chapter (cont.)
• Chapter 17
– Congenital or chromosomal
– Primary or secondary diagnosis
• Chapter 18 (NEC)
– R codes
– No definitive diagnosis
– Multiple combination codes
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-46
Synopsis of ICD-10 Coding Guidelines by
Chapter (cont.)
• Chapter 19
– Poisoning
• 5th digit – placeholder “x”
• 6th digit – how occurred
• 7th digit – type of encounter
– Burns and Corrosions
• Depth, extent, agent
• Corrosive material sequenced first
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-47
Synopsis of ICD-10 Coding Guidelines by
Chapter (cont.)
• Chapter 20
– Replaces E codes
– Accidents or injuries
– Research and prevention
– Abuse codes take priority
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-48
Synopsis of ICD-10 Coding Guidelines by
Chapter (cont.)
• Chapter 21
– Z codes replace V codes
– Expanded to include
• Chemo, radiation, and immunotherapy
• After care
• Administrative exams
• Family history
• Personal history
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-49
Synopsis of ICD-10 Coding Guidelines by
Chapter (cont.)
• Practice
• Read guidelines carefully
• Ask questions
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-50
Apply Your Knowledge
When a code requires a 7th code, what does it
indicate?
ANSWER: The 7th character of a code indicates
the type of encounter: initial, subsequent, or
sequela.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-51
In Summary
18.1
ICD codes are used to facilitate payment for medical
services; evaluate utilization patterns; study
healthcare costs; research quality of healthcare;
predict healthcare trends; and plan for future
healthcare needs.
18.2
There are conventions used in the ICD.
Bold and italics are used in both the Alphabetic
Index and Tabular List.
Instructions to omit code, see condition, and see
also are found exclusively in the Alphabetic Index.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-52
In Summary (cont.)
18.3
To choose an ICD code, locate all applicable
diagnoses.
Find the key term in the Alphabetic Index and any
applicable subterms.
Verify the code’s description in the Tabular List,
reading all applicable notations for other coding
options and instructions.
Document each code carefully using instructions as
to code sequencing on the CMS-1500 claim form.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-53
In Summary (cont.)
18.4
V codes are used for patients who, though not ill, are
seeking healthcare.
E codes are used to explain how an illness or injury
came about.
18.5
The following appendices are found in ICD-9-CM:
• Appendix A
• Appendix B
• Appendix C
• Appendix D
• Appendix E
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-54
In Summary (cont.)
18.6
ICD-10-CM is intended to provide a more precise
clinical picture of the patient and enhanced trending
analysis for data reporting.
The number of codes increases in the ICD-10 and
the characters change from 3–5 numerical to 3–7
alphanumeric.
Both contain the Alphabetic Index of the diseases,
conditions, and related terms.
The I-10 Tabular List incorporates 21 chapters
Many codes use an “x” as a placeholder for future
expansion; which was not possible with ICD-9.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-55
In Summary (cont.)
18.7
The technique of coding with ICD-10 is very similar
to that of coding with ICD-9-CM.
Locate the diagnosis or symptom in the Alphabetic
Index and consider all notes.
You then move to the Tabular List as instructed in
the Alpha Index.
After following terms, abbreviations and symbols,
the appropriate code with the highest specificity
supported by medical record documentation is
selected.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-56
In Summary (cont.)
18.8
The majority of ICD-10 CM codes follow the general
guidelines.
However, unique coding applications do exist and
chapter guidelines must be followed.
These include but are not limited to the chapters on
neoplasms, diabetes mellitus, fractures, R codes,
poisonings, and the new Z codes.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
18-57
End of Chapter 18
Fraud and
falsehood only
dread
examination.
Truth invites it.
~ Samuel Johnson
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.