ICD-9-CMADOPTED FORHOSPITAL USE

ICD-9-CMADOPTED FOR

PHYSICIAN USE

WORLD HEALTHORGANIZATIONADOPTS ICD-10

HIPAA LEGISLATIONINTERRUPTS US ICD-10 ADOPTION

CMS PROPOSED RULE TO ADOPT ICD-10 OCT 2011

CMS FINAL RULETO ADOPT ICD-10

OCT 2013

CMS DELAYSIMPLEMENTATION

ONE YEAR

CONGRESS DELAYSIMPLEMENTATION

ONE YEAR

IMPLEMENTATIONOCTOBER 1

1979

1988

1994

1996

2008

2009

2013 2015

2014

ICD-10 HISTORY

CODE STRUCTURE

ICD-9-CM CODE FORMAT

X X X X X

CATEGORY ETIOLOGY,ANATOMIC SITE,MANIFESTATION

3 TO 5 CHARACTERSFIRST DIGIT IS NUMERIC OR E OR VALL OTHER DIGITS ARE NUMERIC

ICD-10-CM CODE FORMAT

X X X

CATEGORY

X X X

ETIOLOGY,ANATOMIC SITE,MANIFESTATION

X

EXTENSION

1 TO 7 CHARACTERSFIRST DIGIT IS ALPHAALL DIGITS EXCEPT SECOND ALPHA OR NUMERIC

NUMBER OF CODES

ICD-9DIAGNOSIS CODES

ICD-10DIAGNOSIS CODES

69,00014,000

PERFORMANCE THAT MATTERS

Common Emergency Medicine Diagnoses: ICD-9 to ICD-10 Mapping

AdvantEdge Healthcare Solutions ahsrcm.com info@ahsrcm.com 30 Technology Drive, Warren NJ 07059 877 501 1611

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Contents

Heart Failure ................................................................................................................... 2

Anxiety and Dissociative Disorders ................................................................................. 3

Phobic Disorders ............................................................................................................. 4

Cystitis; Other Urethritis and Urinary Tract Infection ....................................................... 5

Cardiomyopathy .............................................................................................................. 7

Back Sprains and Strains ................................................................................................ 8

Influenza .......................................................................................................................... 9

Acute Pharyngitis and Acute Bronchitis......................................................................... 11

Upper Respiratory ......................................................................................................... 12

Otitis Media, unspecified ............................................................................................... 13

Snycope and Collapse, Convulsions ............................................................................. 13

Chest Pain, Unspecified ................................................................................................ 14

Abdominal Pain ............................................................................................................. 14

Sarcoidosis .................................................................................................................... 15

Ulcerative Proctosigmoiditis .......................................................................................... 15

2

Heart Failure

Diagnoses in shaded areas are titles only and are not billable

DIAGNOSIS ICD-9 ICD-10 ICD-10 Description (if different)

Heart Failure 428 I50 Heart Failure

Congestive heart failure 428.0 I50.9 Heart failure, unspecified

Left heart failure 428.1 I50.1 Left ventricular failure

Systolic heart failure, unspecified 428.20 I50.20

Unspecified systolic (congestive) heart failure

Acute systolic heart failure 428.21 I50.21

Acute systolic (congestive) heart failure

Chronic systolic heart failure 428.22 I50.22

Chronic systolic (congestive) heart failure

Acute on chronic systolic heart failure 428.23 I50.23

Acute on chronic systolic (congestive) heart failure

Diastolic heart failure, unspecified 428.30 I50.30

Unspecified diastolic (congestive) heart failure

Acute diastolic heart failure 428.31 I50.31

Acute diastolic (congestive) heart failure

Chronic diastolic heart failure 428.32 I50.32

Chronic diastolic (congestive) heart failure

Acute on chronic diastolic heart failure 428.33 I50.33

Acute on chronic diastolic (congestive) heart failure

Combined systolic and diastolic heart failure,

unspecified 428.40 I50.40 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure

Acute combined systolic and diastolic heart

failure 428.41 I50.41 Acute combined systolic (congestive) and diastolic (congestive) heart failure

Chronic combined systolic and diastolic heart failure

428.42 I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure

Acute on chronic combined systolic and diastolic heart failure

428.43 I50.43 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure

Heart failure, unspecified 428.9 I50.9 Heart failure, unspecified

3

Anxiety and Dissociative Disorders

Diagnoses in shaded areas are titles only and are not billable

4

Phobic Disorders

Diagnoses in shaded areas are titles only and are not billable

DIAGNOSIS ICD-9 ICD-10 ICD-10 Description

(if different)

Phobic Disorders 300.20 -300.29

F40.00 – F40.9

Phobia, unspecified 300.20 F40.9 Phobic anxiety disorder, unspec.

Agoraphobia with panic disorder 300.21 F40.01

Agoraphobia w/out mention of panic attack 300.22 F40.00 Agoraphobia, unspec.

F40.02

Agoraphobia w/out panic disorder

Social phobia 300.23 F40.10 Social phobia, unspec.

F40.11 Social phobia, generalized

Other isolated or specific phobias

300.29 F40.2 Specific (isolated) phobias

F40.210 Arachnophobia

F40.218 Other animal type phobia

F40.22

Natural environment type phobia

F40.220 Fear of thunderstorms

F40.228 Other natural environment type phobia

F40.23 Blood, injection, injury type

F40.230 Fear of blood

F40.231 Fear of injections & transfusions

F40.232 Fear of other medical care

F40.233 Fear of Injury

F40.24 Situational type phobia

F40.240 Claustrophobia

F40.241 Acrophobia

F40.242 Fear of bridges

F40.243 Fear of Flying

F40.248 Other situational type phobia

F40.29 Other specified phobia

F40.290 Androphobia

F40.291 Gynephobia

F40.8 Other phobic anxiety disorders

F40.9 Phobic anxiety disorder, unspec.

5

Cystitis; Other Urethritis and Urinary Tract Infection

Note: For ICD-10, coders must use codes B95-B97 to identify infectious agent (See specific

codes on the next page)

Diagnoses in shaded areas are titles only and are not billable codes.

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Infectious Agents

Listed Under: Certain infectious and parasitic diseases A00-B99 > Bacterial and viral infectious

agents B95-B97 >

B95 Streptococcus, Staphylococcus, and Enterococcus as the cause of diseases classified

elsewhere (not billable)

B95.0 Streptococcus, group A, as the cause of diseases classified elsewhere

B95.1 Streptococcus, group B, as the cause of diseases classified elsewhere

B95.2 Enterococcus as the cause of diseases classified elsewhere

B95.3 Streptococcus pneumoniae as the cause of diseases classified elsewhere

B95.4 Other streptococcus as the cause of diseases classified elsewhere

B95.5 Unspecified streptococcus as the cause of diseases classified elsewhere

B95.6 Staphylococcus aureus as the cause of diseases classified elsewhere (non-billable)

B95.61 Methicillin susceptible Staphylococcus aureus infection as the cause of diseases

classified elsewhere

B95.62 Methicillin resistant Staphylococcus aureus infection as the cause of diseases classified

elsewhere

B95.7 Other staphylococcus as the cause of diseases classified elsewhere

B95.8 Unspecified staphylococcus as the cause of diseases classified elsewhere

7

Cardiomyopathy

Diagnoses in shaded areas are titles only and are not billable

8

Back Sprains and Strains

Each ICD-10 code must be billed with encounter type in the 7th

digit:

A – initial encounter

D – subsequent encounter

S - sequela

Diagnoses in shaded areas are titles only and are not billable

9

Influenza

Diagnoses in shaded areas are titles only and are not billable

DIAGNOSIS ICD-9 ICD-10 ICD-10 DESCRIPTION (if different)

Influenza 487 J10 - J12 Due to other influenza virus with pneumonia

With pneumonia 487.0 J10.00 Due to unidentified with pneumonia

J10.08 Due to other identified influenza with other pneumonia

J11.00 Due to unidentified influenza with unspecified pneumonia

J12.9 Viral Pneumonia, unspecified

With other Respiratory 487.1 J10.01 Due to other identified influenza with same other identified influenza pneumonia

J10.08* Due to other identified influenza with other specified influenza pneumonia

J10.1 Due to other identified influenza with other respiratory manifestations

J11.1 Due to unidentified influenza with other respiratory manifestations

With other manifestations 487.8 J10.2 Due to other identified influenza with gastrointestinal manifestations

J10.81 Due to other identified influenza with encephalopathy

J10.82 Due to other identified influenza with myocarditis

J10.83 Due to other identified influenza with otitis media

J10.89 Due to other identified influenza with other manifestations

J11.2 Due to unidentified influenza with gastrointestinal manifestations

J11.81 Due to unidentified influenza with encephalopathy

J11.82 Due to unidentified influenza with myocarditis

J11.83 Due to unidentified influenza with otitis media

J11.89 Due to unidentified influenza with other manifestations

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0

DIAGNOSIS ICD-9 ICD-10 ICD-10 DESCRIPTION (if different)

Influenza due to certain identified influenza viruses

488 J09

Due to H1N1 with pneumonia 488.11 J09.X1 Due to identified novel influenza A virus with pneumonia

Due to H1N1 with other respiratory manifestations

488.12 J09.X2 Due to identified novel influenza A virus with other respiratory manifestations

Due to H1N1 with other manifestations 488.19 J09.X3 Due to identified novel influenza A virus with gastrointestinal manifestations

J09.X9 Due to identified novel influenza A virus with other manifestations

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1

Acute Pharyngitis and Acute Bronchitis

Diagnoses in shaded areas are titles only and are not billable

DIAGNOSIS ICD-9 ICD-10 ICD-10 DESCRIPTION (if different)

Acute Pharyngitis 462 J02

Acute Pharyngitis 462 J02.8* Due to other specified organism

J02.9 unspecified

Acute Bronchitis 466 J20

Acute Bronchitis 466.0 J20.0 Due to mycoplasma pneumoniae

J20.1 Due to hemophilus influenza

J20.2 Due to streptococcus

J20.3 Due to coxsackievirus

J20.4 Due to parainfluenza

J20.5 Due to respiratory syncytial (RSV)

J20.6 Due to rhinovirus

J20.7 Due to echovirus

J20.8 Due to other specified organisms

J20.9 unspecified

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2

Upper Respiratory

Diagnoses in shaded areas are titles only and are not billable

DIAGNOSIS ICD-9 ICD-10 ICD-10 DESCRIPTION

(if different)

Deviated Nasal Septum 470 J34.2

Nasal Polyps 471 J33

471.0 J33.0 Polyp nasal cavity

471.1 J33.1 Polypoid Sinus Degeneration

471.8 J33.8 Other

471.9 J33.9 unspecified

Chronic Sinusitis 473 J32

473.0 J32.0 Maxillary

473.1 J32.1 Frontal

473.2 J32.2 Ethmoidal

473.3 J32.3 Sphenoidal

473.8 J32.8 Pansinusitis

473.9 J32.9 Unspecified

Chronic Disease of tonsils and adenoids

474 J35

474.00 J35.01 Tonsillitis

474.01 J35.02 Adenoiditis

474.02 J35.03 Tonsillitis and Adenoiditis

Hypertrophy of Tonsils and Adenoids 474.1 J35

473.10 J35.3 Tonsils with Adenoids

473.11 J35.1 Tonsils alone

473.12 J35.2 Adenoids alone

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3

Otitis Media, unspecified

Diagnoses in shaded areas are titles only and are not billable

DIAGNOSIS ICD-9 ICD-10 ICD-10 DESCRIPTION (if different)

Otitis Media, unspecified 382 H66

Otitis Media, unspecified 382.9 H66.90 Unspecified ear

H66.91 Right ear

H66.92 Left ear

H66.93 Bilateral

Snycope and Collapse, Convulsions

DIAGNOSIS ICD-9 ICD-10 ICD-10 DESCRIPTION

(if different)

Syncope and Collapse 780.2 R55

Syncope and Collapse 780.2 R55

Convulsions 780.3 R56

Febrile convulsions (simple), unspecified 780.31 R56.00

Complex febrile convulsions 780.32 R56.01

Post traumatic seizures 780.33 R56.1

Other Convulsions 780.39 R56.9

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4

Chest Pain, Unspecified Diagnoses in shaded areas are titles only and are not billable

DIAGNOSIS ICD-9 ICD-10 ICD-10 DESCRIPTION (if different)

Chest Pain 786.5 R07

Unspecified 786.50 R07.9

Precordial 786.51 R07.2

Painful respiration 786.52 R07.1 Chest pain on breathing

R07.81 Pleurodynia

Other 786.59 R07.82 Intercostal

R07.89 Other chest pain

Abdominal Pain

DIAGNOSIS ICD-9 ICD-10 ICD-10 DESCRIPTION

(if different)

Abdominal pain 789 R10

Unspecified site 789.00 R10.9

Right upper quadrant 789.01 R10.11

Left upper quadrant 789.02 R10.12

Right lower quadrant 789.03 R10.31

Left lower quadrant 789.04 R10.32

Periumbilic 789.05 R10.33

epigastric 789.06 R10.13

generalized 789.07 R10.84

Other specified site 789.09 R10.10 Upper abdominal, unspecified

R10.2 Pelvic and perineal pain

R10.30 Lower abdominal, unspecified

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5

Sarcoidosis

Diagnoses in shaded areas are titles only and are not billable

DIAGNOSIS ICD-9 ICD-10 ICD-10 Description (if

different)

Sarcoidosis 135 D86 Sarcoidosis of:

Sarcoidosis 135 D86.0 lung

D86.1 lymph nodes

D86.2 lung with sarcoidosis of lymph nodes

D86.3 skin

D86.8 Sarcoidosis of Other Sites

D86.81 Sarcoid meningitis

D86.82 Multiple cranial nerve palsies in sarcoidosis

D86.83 Sarcoid iridocyclitis

D86.84 Sarcoid pyelonephritis

D86.85 Sarcoid myocarditis

D86.86 Sarcoid arthropathy D86.87 Sarcoid myositis

D86.89 Sarcoid of other sites

D86.9 Sarcoid, unspecified

Ulcerative Proctosigmoiditis

Diagnoses in shaded areas are titles only and are not billable

DIAGNOSIS ICD-9 ICD-10 ICD-10 Description

(if different)

Ulcerative Proctosigmoiditis 556 K51

Ulcerative (chronic) proctosignoiditis 556.3 K51.30 Ulcerative (chronic)rectosigmoiditis without complications

K51.311 With rectal bleeding

K51.312

With intestinal obstruction

K51.313 With fistula

K51.314 With abcess

K51.318 With other complications

K51.319 With unspec.complications