Review Intro to ICD-9 Coding Review (Coding I) Diagnostic Coding – (Coding I)
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Transcript of Review Intro to ICD-9 Coding Review (Coding I) Diagnostic Coding – (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)
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