Download pdf - ICD-10 Coding Overview

ICD-10 OverviewPrepared by Advanced Billing Consultants

Advanced Billing Consultants, Inc. Copyright 2015

Minimum of 3, maximum of 7 characters

6th and 7th are not optional if required

X may serve as a place holder for 4th and 5th

character for future use

Example of X place holder: other specified

spondylopathies, cervical region is

M48.8X2

Code Structure


Represent the category

1st: Capital Letter (any except U)

2nd: number

3rd: number

Example: The category for pain, not elsewhere classified is

G89

Characters 1-3


Represent the etiology, anatomical site,

severity, or other clinical detail

Can be number or letter- capital or lowercase

Characters 4-6


For obstetrics, musculoskeletal injuries, and

external causes of morbidity

encounter type, or extension, stages,

LT/RT/bilateral/unspecified

OR:

A: initial

D: subsequent

S: Sequela (complications)

Character 7


Collapsed vertebra, not elsewhere classified is M48.50-M48.58, but it requires a 7th digit A= initial encounter for fracture

B= subsequent encounter for fracture with routine healing G= subsequent encounter for fracture with delayed healing S= sequela of fracture

Correct diagnoses for the initial encounter for collapsed vertebra not elsewhere classified, site unspecified is:

M48.50A

Example Character 7


Excludes1: the two codes cannot be billed

together

Excludes2: both codes can be used

Excludes Notes


Many ICD-10 require additional diagnosis

codes

Additional Codes Required


“in diseases classified elsewhere”= a

manifestation code

Can never be listed first

May say: “use additional code” or “code first”

Again, can never be listed first

Code in brackets means it must be coded

also, and second

Etiology/Manifestation Codes


1. Certain Infectious and Parasitic Diseases (A00-B99)

2. Neoplasms (C00-D49)

3. Disease of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)

4. Endocrine, Nutritional, and Metabolic Diseases (E00-E89)

5. Mental, Behavioral, and Neurodevelopmental Disorders (F01-F99)

6. Chronic pain syndrome (G89)

7. Diseases of the Eye and Adnexa

8. Diseases of the Ear and Mastoid Process (H60-H95) **not yet used

9. Diseases of Circulatory System (100-199)

10. Diseases of Respiratory System (J00-J99)

11. Diseases of Digestive System (K00-K95) **not yet used

Chapters


12. Diseases of the Skin and Subcutaneous Tissue (L00-L99)

13. Diseases of Musculoskeletal System and Connective Tissue (M00-M99)

14. Diseases of Genitourinary System (N00-N99)

15. Pregnancy, Childbirth (O00-O9A)

16. Certain Conditions Originating in the Prenatal Period (P00-P96)

17. Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)

18. Symptoms, signs, and abnormal clinical and laboratory findings (R00-R99)

19. Injury, Poisoning, and Certain other Consequences of External Causes (S00-T88)

20. External Causes of Morbidity (V00-Y99)

21. Factors Influencing Health Status and Contact with Health Services (Z00-Z99) ***The new V-codes***

Chapters Cont’d


Use ICD-10 for DOS 10/1/2015 and forward.

Continue use of ICD-9 for DOS 9/30/15 and

before (even for corrected claims)

Date Transition


Many software systems provide crosswalks and

conversions at the encounter or charge entry

level. Ensure you have the most recent

updates for your system.

Specialty specific cheat sheets can be

purchased from many vendors

AAPC offers a free ICD-9 to ICD-10 conversion

tool at: https://www.aapc.com/icd-10/codes/

Conversions and Crosswalks


https://www.aapc.com/icd-10/codes/

We appreciate any feedback. Please contact

us at [email protected]

Thank You!
