Secret Coding tips for ICD 10 codes


As we have started using ICD 10 codes we would have come across few commonly used ICD 10 codes like hypertension (I10), diabetes (E11.9) etc. which are easy to remember. However, when we have to code for laterality we have to use specific diagnosis ICD 10 code. ICD 10 codes have some new specific coding guideline. The guideline helps us to code the most specific diagnosis in ICD 10. While in ICD 9 we use to follow the same guideline, but the codes were not as specific. For example, in ICD 9 we use to use only one code for upper extremity and lower extremity pain (729.5). However, in ICD 10 we have separate specific ICD 10 code for upper extremity and lower extremity pain. If you want to more specific, we have separate ICD 10 code for left, right and bilateral sides for extremities pain. Therefore, now you can imagine how much specific ICD 10 codes are. There are also few important points to remember while coding ICD 10 diagnosis codes. Let us checkout what are the new changes in ICD 10. These are important for certification exams as well, which will help in clearing CPC exam in future.

Secret Coding tips for ICD 10 codes

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Introduction of Excludes 1 and Excludes 2 in ICD 10


Earlier in ICD 9, we had only includes and excludes for coding diagnosis codes together or ovoid coding together. As I have shown earlier how the V codes of ICD 9 are replaced by Z codes, same way the excludes have been replaced in Excludes 1 and Excludes 2. In ICD 10, excludes 1 and excludes 2  guide us to code correct diagnosis code. Excludes 1 help us not code these codes together since these conditions will not occur together. For example, newborn codes cannot be coded together with adult diagnosis codes. Traumatic and pathological fracture cannot be coded together. Hence, excludes 1 help us not to code the diagnosis codes, which cannot occur together. Coming to Exclude 2 note, they are different for Excludes 1. Excludes 2 note tell to code these codes together because they can occur together. In short, we can use these codes of excludes 2 note and code along with the particular ICD 10 code.

Pregnancy complication codes in ICD 10


Until now, we use to code two or three ICD 10 diagnosis codes for sepsis or septic shock. However, with the introduction of new pregnancy complication codes, we will be using primary (complication with specific trimester) and secondary codes (specific code for week of gestation). In ICD 9 we did not have codes for specific trimester. In ICD 9, the codes are divided on antepartum or postpartum condition. In addition, now with the use of pregnancy complication, we have specific codes for weeks of gestation. So, after coding for pregnancy complication  we have to compulsory code a specific code for number of weeks of gestation. The code series use for pregnancy complication is O00-O9A, followed by specific week of gestation from Z3A category. Therefore, in ICD 10 we have to mandatory code two codes for pregnancy complication.

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