Intro to ICD-9 CodingReviewReview

Diagnostic Coding – (Coding I)(Coding I)

Organization of ICD-9 Volume 1Volume 1((17 Chapters Plus E & V CodesE & V Codes)

001-139 Infectious and Parasitic Diseases 140-239 Neoplasms240-279 Endocrine, Nutritional and Metabolic Diseases280-289 Diseases of the Blood and Blood-forming

Organs290-319 Mental Disorders320-389 Diseases of the Nervous System and Sense

Organs390-459 Diseases of the Circulatory System460-519 Diseases of the Respiratory System520-579 Diseases of the Digestive System580-589 Diseases of the Genitourinary System630-676 Complications of Pregnancy, Childbirth, and

the Puerperium680-709 Diseases of the Skin and Subcutaneous Tissue

710-739 Diseases of the Musculoskeletal System & Connective Tissue

740-759 Congenital Anomalies760-779 Certain Conditions Originating in the Perinatal

Period780-799 Symptoms, Signs and Ill-defined Conditions800-999 Injury and PoisoningE800-E999 Supplementary Classification of the

External Causes of Injury and Poisoning

V01-V82 Supplementary Classification of factors influencing Health Status and Contact with Health Services

Organization of ICD-9 Volume 1Volume 1((17 Chapters Plus E & V Codes)

Anatomy of ICD-9 Code

ICD-9 Volume 2 Section 1 - Alphabetic Index to Diseases Section 2 - Table of Drugs and Chemicals Section 3 - Index to External Causes (E-(E-

Codes)Codes) Handy Tables

Hypertension Neoplasms

Using ICD-9 Book

Identify Main TermMain Term in the Diagnostic Statement LocateLocate Main TermMain Term in the Alphabetic IndexAlphabetic Index

(Volume 2 [First])Volume 2 [First]) VerifyVerify Code NumberCode Number in the Tabular ListTabular List

(Numeric Index/Volume 1 [Second]Volume 1 [Second])) Diagnostic Statement – Diagnostic Statement – Chest PainChest Pain

786.5786.5

Using ICD-9 Book

Turn to that ICD code in Volume 1 786.5 Chest pain

786.50 Chest pain, unspecified786.51 Precordial pain786.52 Painful respiration

Pain: Pleurodyniaanterior chest wallpleuritic

epidemic pleurodynia (074.1)

786.59 OtherDiscomfortPressure in chestTightness

EXCLUDES

Using ICD-9 Book

Look up diagnosis in Volume 2 Go to Code # in Volume 1 Pick specific location, type, severity,

complication, and/or manifestation Find appropriate 4th and 5th digits Diagnostic Statement - Diagnostic Statement - Bronchitis, Bronchitis,

acute, probably viral acute, probably viral

466.0466.0

Code the symptom

Abdominal swelling or mass in epigastric area

789.36789.36

Elevated blood pressure

796.2796.2

New Acute or Chronic Problem that you can’t diagnose this visit

Code the symptomCode the symptom

Changes in skin texture

782.8782.8

Abnormal chest sounds

786.7786.7

New Acute or Chronic Problem that you can’t diagnose this visit

Unspecified localized salmonella infection

003.20003.20

Code The Diagnostic Statements Code The Diagnostic Statements

Acute pulmonary manifestations due to radiation

508.0508.0

Three Classifications of V Codes

1. Problem-oriented V Codes – identify circumstances that could affect the patient in the future but are neither a current illness or injury.

Personal history of exposure to radiationPersonal history of exposure to radiation

2. Service-oriented V Code – identify/define exams, aftercare, ancillary services, or therapy.

Follow-up examination following chemotherapyFollow-up examination following chemotherapy

3. Fact-oriented V Code – do not describe a problem or a service; they simply state a fact.

Alcoholism within the familyAlcoholism within the family

V15.3V15.3

V67.2V67.2

V61.41V61.41

Check-up for Chronic Problem, Well Child, Well Adult with No Complaints, Sequelae, or Complications

Use a V Code and/or Code for Chronic Problem

Look up Examination in Volume 2 Diagnostic Statement - Diagnostic Statement - Well ChildWell Child

V20.2V20.2

V70.0V70.0

General Physical

Follow-up for Previous Acute Condition, with no problems

Don’t Code for the acute condition which no longer exists

Use a V Code Look up “History of”“History of” or “Aftercare”“Aftercare”

unless it was an accident

Diagnostic Statement - Diagnostic Statement - Follow-up for pneumonia (fully healed)

V12.6V12.6

Follow-up to Previous Acute Problem, there are complications

Look up “Late Effects”“Late Effects” or the specific condition(s)

Diagnostic Statement - Diagnostic Statement - Patient develops infection in wound on hand you sutured three days ago

906.1906.1

Chronic Problems with Sequelae

Requires two codes:two codes: Code the Chronic Problem firstfirst Code the Complication secondsecond

Diagnostic StatementsDiagnostic StatementsType 2 DM with neurological manifestations

Type 2 diabetic develops peripheral neuropathy

250.60 & 357.2250.60 & 357.2

Peripheral Neuropathy Peripheral Neuropathy

250.6 & 337.1250.6 & 337.1

Table of Drugs and ChemicalsDefining E Codes – Columns 2-5Columns 2-5

Accident codes identify accidental overdose of a drug, wrong substance given or taken, a drug taken inadvertently, accidents that occur in the usage of drugs and biologicals in medical and surgical procedures.

Therapeutic Use codes indicate an adverse effect or reaction to a drug that was administered correctly, either therapeutically or prophylactically.

Suicide Attempt codes identify the effects of drugs or substance taken to cause self-inflicted injury or to attempt suicide.

Assault codes in indicate situations where drugs or substance are “purposely inflicted” by another person with the intent to cause bodily harm, injure, or kill.

Undetermined codes apply when the intent of the poisoning or injury cannot be determined as intentional accidental.

Accidents, Suicides, Poisonings . . . External Causes

Use E codes and/or Injury and Poisoning

Look up injury in Index, circumstances in E-Codes

Diagnostic Statements - Diagnostic Statements - Elderly patient fell, sprained internal collateral ligament in ankle while stepping from curb:

Sprains and strains of ankle and foot Sprains and strains of ankle and foot 845.01845.01

Fall on or from sidewalk curb Fall on or from sidewalk curb E880.1E880.1

Drug Side-Effects

Use Section 2 of Volume 2 Will require 3 codes:

1. the side effectside effect, 2. the code for poisoning for the drugcode for poisoning for the drug and

3. the E-code for the therapeutic use of E-code for the therapeutic use of the drugthe drug.Diagnostic Statements - Diagnostic Statements - Patient develops hives after taking penicillin

Allergic urticaria Allergic urticaria 708.0708.0Penicillin poisoning Penicillin poisoning 960.0960.0Therapeutic penicillin Therapeutic penicillin E930.0E930.0

Look-up “Late Effects”“Late Effects” under:

““Late Effects” or specific condition.Late Effects” or specific condition.

Quiz Quiz

Look-up “E Codes”“E Codes” in:

Section 3Section 3

Look-up “V Codes”“V Codes” in:

History of or :Aftercare, unless an accidentHistory of or :Aftercare, unless an accident

References and Resources

eMD Medical Abbreviation Encoder Pro and Code-i

t-Fast ICD-9-CM online ICD Decoder AHIMA Medi lexion Medical Coding Tips

Medical Conditions & Diseases

RXList Medicine Net Merck Manual American Association

of Medical Biller Tabers Online RN Student