ICD-10-CM Made Simple
Prepared Geanetta Agbona CPC, CPC-I, CBCS
AHIMA Approved ICD-10-CM Trainer/AAPC Physician Educator
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Objectives
 Learn
why ICD-10-CM is needed
 Learn some differences & similarities between
ICD-9 & ICD-10
 How does ICD-10-CM affect coding compliance
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Do We Really Need New Codes?
 ICD-10
provides more categories for diseases and other
health-related conditions
 ICD-10 provides clinical language
 ICD-10 will permit us to have more valuable data to help
us improve patient care
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What are the major differences?
ICD-9-CM
ICD-10-CM
17 chapters of ICD-9-CM guidelines
21 chapters of ICD-10-CM guidelines
Classifies injuries by type
Groups injuries by specific site, then by
type of injury
3 to 5 characters in length.
Alphanumeric and can be up to 7
characters in length
No placeholders
Addition of placeholder X
Can’t code laterality
We can code laterality
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Guidelines for Diabetes
Diabetes in ICD-9
Diabetes in ICD-10
If the type of diabetes mellitus is not
documented in the medical record the
default is type II: 250.00
If the type of diabetes mellitus is not
documented in the medical record the
default is: E11 type II diabetes mellitus
For type II patients who routinely use
insulin and the type of diabetes is not
documented use: 250.00,V58.67
For type II patients who routinely use
insulin and the type of diabetes is not
documented use: E11, Z79.4
Whether diabetes is controlled or
uncontrolled is a factor
Whether diabetes is controlled or
uncontrolled is not a factor.
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Guidelines for HIV
HIV in ICD-9-CM
HIV in ICD-10-CM
If a patient is admitted for an HIV related
condition, the principal diagnosis should
be 042
If a patient is admitted for an HIV related
condition, the principal diagnosis should
be B20
Asymptomatic HIV is: V08
Asymptomatic HIV is: Z21
Patients previously diagnosed with any
HIV illness 042 should never be assigned
with 795.71 or V08.
Patients previously diagnosed with HIV
illness B20 should never be assigned with
R75 or Z21
If a patient is being seen to determine
his/her HIV status use V73.89
If a patient is being seen to determine
his/her HIV status use Z11.4
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Personal History
Personal History in ICD-9-CM
When a primary malignancy has been
previously excised or eradicated from its
site and there is no further treatment
directed to that site and there is no
evidence of any existing primary
malignancy, a code from category V10
personal history of Neoplasm should be
used
Personal History in ICD-10-CM
When a primary malignancy has been
previously excised or eradicated from it
site, there is no further treatment of the
malignancy, a code from category Z85,
Personal history of primary malignancy &
secondary malignant neoplasm should be
used to indicate the former site of its
malignancy.
* ICD-10-CM has pregnancy with
neoplasm codes in chapter 15.
* New
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O9A.1
Guidelines for Hypertension
Hypertension in ICD-9-CM
Hypertension in ICD-10-CM
The terms malignant and benign are
important in ICD-9-CM
* The terms malignant and benign are
not important in ICD-10-CM.
Unspecified HTN is 401.9
HTN I10
Hypertensive Heart and CKD code from
categories 404, 428 & 585
Hypertensive Heart and CKD code from
categories I13, I50, N18
*New
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ICD-10-CM & Compliance
There are many things to consider. Here are a few items of
utmost importance:
 How will ICD-10-CM affect the electronic health
records?
 Documents need to be revised. Assist staff by reviewing
the most used ICD-9-CM & ICD-10-CM codes.
 Train the coders well and be sure that they can assist the
physicians when necessary. This will prevent a
decrease in cash flow.
 Be fully compliant by 10/1/2014.
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Review
 Why
do we need ICD-10-CM?
 What are some differences?
 What are some similarities?
 To be compliant what things do we need to do?
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Coding for Fun
Example from AHIMA ICD-10-CM Coding Manual:
Ex. 1.6

This 42 year old HIV positive male has a fever and
shortness of breath. The diagnostic workup, including chest
x-ray and sputum culture, resulted in a diagnosis of
Pneumocystis pneumonia. This was documented as
Pneumocystis pneumonia due to AIDS. What diagnosis
codes are assigned?
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Answers to Coding for Fun


B20
B59
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Questions?
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Who is Geanetta Agbona?

Learn more about me
Click on the link above or go to:
http://geanettajohnsonagbona.weebly.com/
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