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ICD-10-CM: An Introduction for Coders

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1 ICD-10-CM: An Introduction for Coders
© Irene Mueller, EdD, RHIA

2 By attending this workshop, participants will
Identify the Reasons for implementing ICD-10-CM in the United States Settings that will require ICD-10-CM Knowledge that coders will need to apply ICD-10-CM Similarities between ICD-9-CM and ICD-10-CM Differences between ICD-9-CM and ICD-10-CM Receive ICD-10-CM Coding Examples and Cases ICD-10-CM Resources Listing for future use

3 Why Change to ICD-10-CM? ICD-9-CM out of space to accommodate new codes Advances in medical knowledge New technology Newly identified diseases Limited space = Lack sufficient clinical detail Severity or complexity of diagnoses

4 Why Change to ICD-10-CM? Updated classification system allows ability to Measure quality of care Initiate pay-for-performance Evaluate resource utilization Track public health threats, such as avian flu Identify medical errors and patient safety issues Exchange meaningful health data with other organizations and government agencies

5 Reasons for ICD-10-CM Implementation
Represents significant improvement Designed to overcome issues & limitations of ICD-9-CM Updates healthcare coding with unambiguous codes for conditions More flexibility in adding new codes Has greater specificity and clinical detail Major improvements in quality & usefulness of coded data

6 Reasons for ICD-10-CM Implementation
Updated Medical terminology & classification of diseases to reflect current clinical practice Improved structure & capacity for capturing technological advances More flexible Accommodates revisions necessitated by medical advances

7 Why Change to ICD-10-CM? ICD-10 first published by WHO 1999 – Australia 1999 – US for death certificate coding 2000 – Canada 2005 – France Thailand 2008 – Korea 25 countries use ICD-10 for healthcare reimbursement & resource allocation ICD-11 – development from now thru 2015

8 ICD-10-CM Implementation
Compliance date = Date of discharge for inpatient claims Date of service for outpatient claims

9 ICD-10-CM Control Cooperating Parties for ICD-10-CM AHA AHIMA CMS NCHS

10 Settings requiring ICD-10-CM
ALL healthcare settings, because ICD-10-CM required for ALL diagnosis coding when implemented Will affect every part of HCOs, not just coders

11 Knowledge Base for ICD-10-CM
CMS Final rule - Recommends 50 hours of training for Inpt Coders (16 for Outpt Coders) PRESUMES coding professionals already possess required knowledge in biomedical sciences needed to correctly apply codes using ICD-10-CM Anatomy Physiology Pathophysiology Pharmacology Medical terminology

12 Knowledge Base for ICD-10-CM
Inpatient coders MUST Have sufficient foundational knowledge of biomedical sciences Learn how to apply ICD-10-CM codes correctly on inpatient encounters Understand how to apply maps and crosswalks between ICD-9-CM and ICD10 systems

13 Knowledge Base for ICD-10-CM
Outpatient coders MUST Have sufficient foundational knowledge of biomedical sciences Learn how to apply ICD-10-CM codes correctly on outpatient encounters Understand how to apply maps and crosswalks between ICD-9-CM and ICD-10-CM

14 Similarities

15 Basic ICD-10-CM Coding Steps
ID all main terms in dx statement ID all modifiers (subterms) in dx statement Locate mainterm(s) in AI Locate subterm(s) (site, etiology, clinical type) Follow any cross-references IF not under 1st code Verify tentative code in TL Follow any instructions Assign codes to highest level of specificity

16 Code Structure Categories Subcategories Codes
Three-character category without any subdivision = Code Codes w/o correct # of characters = INVALID Codes assigned MUST have highest # of characters available/highest level of specificity

17 Structure and Conventions
Much of hierarchical structure similar Many conventions similar Tabular List Chapters Subchapters (Blocks in ICD-10-CM) Alphabetic Index Two parts Index to Diseases and Injuries Neoplasm Table Table of Drugs & Chemicals Index to External Causes

18 Similar AI Conventions
Boldface Mainterms Indented subterms/essential modifiers Non-essential modifiers in ( ) See See Also See Condition

19 Similar Conventions Abbreviations Instructional Notes
NEC (Other Specified) AI and TL NOS (Unspecified) TL only Instructional Notes Includes Examples Location Code first Use add’l code Code Also No Sequencing

20 Instructional Notes Examples

21 Instructional Notes Examples

22 Similar Conventions Punctuation And = And/Or (TL)
Brackets [ ] TL Parentheses ( ) AI and TL Colon : TL Notes And = And/Or (TL) With = Associated with/due to Code Title, AI, TL Subterm sequencing G73. 7

23 Similar Conventions Examples
Brackets Parentheses

24 Differences

25 ICD-10-CM Codes Sub-catergories = 4 or 5 characters
Codes are 3 – 7 characters 1st character is LETTER O IS used; U is NOT used Code format

26 Which of the following is a valid ICD-10-CM code?
428.9 L03.313 T37.0XX1A M12X.58

27 Tabular List TL = 21 chapters Axes of Classification
List of blocks at beginning of each chapter Axes of Classification Body/organ system Etiology/Disease process E & V codes NOT supplemental Order of Chapters – some reordering Some chapters reordered Injuries = 1st by specific site, then type of injury Postop complications moved to procedure-specific body system (mostly)

28 Dashes in AI and TL AI – Dash at end of code = incomplete code
MUST review TL Ex: Fracture, pathologic Ankle M84.47- Carpus M84.44- TL - Dash preceded by decimal point (.-) = incomplete code MUST review referenced code in TL Ex: J43 Emphysema Excludes1: emphysematous (obstructive) bronchitis (J44.-)

29 Exclusion Notes Two types Excludes1 – Pure, NOT CODED HERE!
Located at category, subcategory, or code level Excludes1 – Pure, NOT CODED HERE! NEVER used with code above note Two conditions can’t occur together Congenital and Aquired Excludes2 – Not coded here Condition excluded is NOT INCLUDED HERE Patient may have both at same time Can code both if both present

30 Excludes Notes Examples

31 Morphology Codes No longer listed in AI with descriptors and standard ICD-10-CM codes No longer separate appendix in ICD-10-CM

32 NEC and NOS Separated Other Specified and Unspecified each have their own code Example:

33 Placeholder Character (X)
Two uses Future expansion WITHOUT disturbing overall code structure (5th character for some 6-character codes) Code with less than 6 characters that requires a 7th character extension Obstetrics, Injuries, and External causes of injuries

34 Placeholder Examples T37.0X1A, Poisoning by sulfonamides, accidental (unintentional), initial encounter T56.0X2S, Toxic effect of lead and its compounds, intentional self-harm, sequela W42.0XXA, Exposure to supersonic waves, initial encounter

35 Placeholder Example -TL
Category Code X12 with 7th Character Extension

36 Pregnancy Trimester Coding
Inclusion of trimesters in obstetrics codes Episode of Care 5th Digits Eliminated Examples: O10.012, Pre-existing essential hypertension complicating pregnancy, second trimester O99.013, Anemia complicating pregnancy, third trimester

37 Pregnancy Trimester Example

38 Seventh Character SOME ICD-10-CM categories require 7th character to further specify condition May be number or letter MUST always be 7th character Examples: O65.0XX1, Obstructed labor due to deformed pelvis, fetus 1 S02.110B, Type I occipital condyle fracture, initial encounter for open fracture T17.220D, Food in pharynx causing asphyxiation, subsequent encounter

39 Specificity Laterality Other expanded detail Combining in single code
Etiology and manifestations Poisoning and external cause Diagnosis and symptoms Code titles and language complement accepted clinical practice

40 Specificity Examples RU, LU, RL, LL

41 Specificity Examples

42 Specificity Examples

43 Timeframe Changes for Some Codes
Examples: AMI - Time period changed from 8 wks to 4 wks Abortion vs fetal death – Time period changed from 22 weeks to 20 weeks

44 Timeframe Examples

45 Abortion/Fetal Death - TL

46 ICD-10-CM Coding Guidelines
Section I Structure and conventions of classification General guidelines that apply to entire classification Chapter-specific guidelines that correspond to chapters as arranged in classification Section II Selection of principal diagnosis for non-outpatient settings. Section III Reporting additional diagnoses in non-outpatient settings Section IV Outpatient coding and reporting

47 ICD-10-CM Coding Guidelines
Similar to ICD-9-CM, EXCEPT Laterality (New) Documentation of Complications of Care

48 Laterality Guideline For bilateral sites, final character of codes indicates laterality Unspecified site code also provided if side not identified in medical record If no bilateral code provided and condition bilateral, assign separate codes for both left and right side

49 Documentation of Complications of Care
Code assignment based on provider’s documentation of relationship bet. condition and care or procedure Guideline extends to any complications of care, regardless of chapter where code located Important to note NOT all conditions occurring during/following medical care/surgery are classified as complications There must be cause-and-effect relationship between care provided & condition, and indication in documentation that it is complication Query provider for clarification, if complication not clearly documented

50 Break Time

51 ICD-10-CM Coding Case 1 Pt seen w/ amenorrhea, characteristics of masculinization, and high levels of serum testosterone. Pelvic ultrasound revealed a left discrete ovarian mass. GYN performed laparoscopic unilateral salpingo-oophorectomy as outpatient. Pathologic diagnosis returned as ovarian Sertoli-Leydig cell tumor.

52 Case 1 Coding Process - AI
Tumor —see also Neoplasm, unspecified behavior, by site Sertoli-Leydig cell —see Neoplasm, benign, by site Main Term = Tumor Sub Term = Sertoli- Leydig Cell Neoplasm Site = Ovary

53 Case 1 Coding Process – Neoplasm Table
D What does Dash tell coder???

54 Case 1 Coding Process - TL
D 27 Benign neoplasm of ovary Use additional code to identify any functional activity - ???? Excludes2: corpus albicans cyst (N83.2) corpus luteum cyst (N83.1) endometrial cyst (N80.1) follicular (atretic) cyst (N83.0) graafian follicle cyst (N83.0) ovarian cyst NEC (N83.2) ovarian retention cyst (N83.2)

55 Case 1 Coding Process -TL
D27.0 Benign neoplasm of right ovary D27.1 Benign neoplasm of left ovary D27.2 Benign neoplasm of unspecified ovary Do we need a code for masculinization as a functional activity of the tumor? Per Use Add’l Code note at D27

56 Case 1 ANSWER D27.1 Benign neoplasm of left ovary
Do we need a code for masculinization as a functional activity of the tumor? Per Use Add’l Code note at D27 NO – Mainterm Masculinzation or Virilization goes to D27.-

57 Coding Case 2 Doctor 16-y-o pt w/ myasthenia gravis & adolescent idiopathic thoracic scoliosis. Surgery for spinal fusion cancelled after pt had positive TB skin test during preop workup, suggesting latent TB. Today’s visit – pt started on Isoniazid 300 mg daily & instructed on possible side effects. Will reschedule surgery after two months of INH treatment.

58 Case 2 Coding Process - AI
Findings, abnormal, inconclusive, without diagnosis —see also Abnormal tuberculin skin test (without active tuberculosis) R76.11 Myasthenia G70.9 gravis G70.00

59 Case 2 Coding Process - AI
Scoliosis (acquired) (postural) M41.9 adolescent (idiopathic) —see Scoliosis, idiopathic, juvenile idiopathic M41.20 - - adolescent M41.129 - - - cervical region M41.122 - - - lumbar region M41.126 - - - thoracic region M41.124 - - juvenile M41.119

60 Case 2 Coding Process - TL
M41 Scoliosis Includes: Kyphoscoliosis Excludes1: congenital scoliosis NOS (Q67.5) congenital scoliosis due to bony malformation (Q76.3) postural congenital scoliosis (Q67.5) kyphoscoliotic heart disease (I27.1) postprocedural scoliosis (M96.-)

61 FYI Juvenile vs Adolescent
Juvenile idiopathic scoliosis usu. occurs from about age 4 to puberty-about age 10 or 11 for girls, age 12 for boys. Usu. R thoracic curves. Adolescent idiopathic scoliosis usu. occurs in early puberty, w/ most rapid worsening during early growth spurt. Females more than males – 5:1. Also, usu. R thoracic curves.

62 sequenced in this order?
Case 2 ANSWER R76.11 Findings, abnormal, inconclusive, without diagnosis, tuberculin skin test (without active tuberculosis) G70.00 Myasthenia gravis M Adolescent idiopathic scoliosis, thoracic region Why are codes for this case sequenced in this order?

63 Coding Case 3 62-y-o female visits her family practice physician for annual physical and follow-up on her chronic gout with tophi. She has her annual Pap smear and flu shot for the season.

64 Case 3 Coding Process - AI
Examination (for) (following) (general) (of) (routine) Z00.00- annual (adult) (periodic) (physical) Z00.00 - - with abnormal findings Z00.01 - - gynecological Z01.419 - - - with abnormal findings Z01.411 Can both Z00.- and Z01.- be coded?

65 Case 3 Coding Process - AI
Z01 Encounter for other special examination w/o complaint, suspected or reported diagnosis Includes: routine examination of specific system Note: Codes from category Z01 represent reason for encounter. A separate procedure code is required to id any exam or procedures performed Excludes1:encounter for examination for administrative purposes (Z02.-) encounter for examination for suspected conditions, proven not to exist (Z03.-) encounter for laboratory and radiologic examinations as a component of general medical examinations (Z00.0-) encounter for laboratory, radiologic and imaging examinations for sign(s) and symptom(s) - code to sign(s) or symptom(s) screening examinations (Z11-Z13)

66 Case 3 Coding Process - AI
Z01.4 Encounter for gynecological examination Excludes2: pregnancy examination or test (Z32.0-) routine exam for contraceptive maintenance (Z30.4-) Z01.41 Encounter for routine gynecological examination Encounter for general gynecological examination w/wo cervical smear Encounter for gynecological examination (general) (routine) NOS Encounter for pelvic examination (annual) (periodic) Use additional code: for screening for human papillomavirus, if applicable, (Z11.51) for screening vaginal pap smear, if applicable (Z12.72) to identify acquired absence of uterus, if applicable (Z90.71-) Excludes1:gynecologic examination status-post hysterectomy for malignant condition (Z08) screening cervical pap smear not a part of a routine gynecological exam Z12.4)

67 Case 3 Coding Process - AI
Gout, gouty (acute) (attack) (flare) (see also Gout, chronic) M10.9- - tophi —see Gout by type Gout, chronic (see also Gout, gouty) M1A.9

68 Case 3 Coding Process – AI & TL
Flu Shot Immunization —see also Vaccination encounter for Z23 Z 23 Encounter for immunization Code First: any routine childhood examination Note: procedure codes are required to identify the types of immunizations given

69 Case 3 Coding Process - TL
Persons encountering health services for examinations (Z00-Z13) Nonspecific abnormal findings disclosed at the time of these examinations are classified to categories R70-R94. Excludes1: examinations related to pregnancy and reproduction (Z30-Z36, Z39.-)

70 Case 3 Coding Process - TL
Z00 Encounter for general examination without complaint, suspected or reported diagnosis Excludes1: encounter for examination for administrative purposes (Z02.-) Excludes2: encounter for pre-procedural examinations (Z01.81-) special screening examinations (Z11-Z13)

71 Case 3 Coding Process - TL
Z00.0 Encounter for general adult medical examination Encounter for adult periodic examination (annual) (physical) and any associated laboratory and radiologicexaminations Excludes1: encounter for examination of sign or symptom- code to sign or symptom general health check-up of infant or child (Z ) Z00.00 Encounter for general adult medical examination without abnormal findings Encounter for adult health check-up NOS Z00.01Encounter for general adult medical examination with abnormal findings Use additional code to identify abnormal findings

72 Case 3 Coding Process –Documentation Issue
Gout, chronic drug-induced M1A.20 idiopathic M1A.00 in (due to)renal impairment M1A.30 lead-induced M1A.10 primary —see Gout, chronic, idiopathic saturnine —see Gout, chronic, lead-induced secondary NEC M1A.40 syphilitic (see also subcategory M14.8-) A52.77 tophi —see Gout by type These sub-terms require body part and laterality

73 Case 3 Coding Process - TL
M1A Chronic gout The appropriate 7th character is to be added to each code from category M1A 0 - without tophus (tophi) 1 - with tophus (tophi) M1A.9 Chronic gout, unspecified

74 Case 3 ANSWER Z Examination (for) (following) (general) (of) (routine), annual (adult) (periodic) (physical), gynecological M1A.9XX1 Gout, chronic, with tophi Z23 Vaccination (prophylactic), encounter for

75 Coding Case 4 Office Visit; 36-y-o male pt, primary care physician.
Hx: Pt here for follow-up of lab work from earlier in week. Bitten by tick last month & has had body aches, some swelling to R upper arm, pain & stiffness in R elbow, as well as feeling fatigued. Had + Lyme test; pt to have repeat blood test (Western Blot), as 2ndary follow-up. PE: Alert & in no acute distress. Temp Pulse 108. Resp 20. BP 118/70.

76 Coding Case 4 PE: Weight 296 on a 5’ 9” frame. Up 3 pounds from last week & 22 pounds up since beginning of year. Arm continues to display circular erythematous lesion with 2+ pitting edema. Lesion hasn’t grown outside perimeter markings from first visit. Impression: 1. Localized arthritis, right elbow in Lyme disease due to tick bite 2. Morbid obesity, BMI of 43.7

77 Coding Case 4 Pt has blood drawn & was put on Doxycycline 100 mg b.i.d. × 4 weeks. Additional educational material on Lyme disease given. Should follow-up immediately if affected area grows larger than current, marked area or if any new symptoms develop. We discussed again need for exercise program, when able, & portion control due to over-nourishment status.

78 Case 4 Coding Process - AI
Localized arthritis, right elbow in Lyme disease due to tick bite Arthritis, arthritic (acute) (chronic) (nonpyogenic) (subacute) M19.90 - due to or associated with - - Lyme disease A69.23

79 Case 4Coding Process - AI
Bite (s) (animal) (human) - arm (upper) S41.15- - - lower —see Bite, forearm - - superficial NEC S40.87- - - - insect S40.86-

80 Case 4 Coding Process – AI for External Causes
Bite, bitten by insect (nonvenomous) W57 TL = Exposure to animate mechanical forces (W50-W64) Excludes1: Toxic effect of contact with venomous animals and plants (T63.-)

81 Case 4 Coding Process -TL
W57 Bitten or stung by nonvenomous insect and other nonvenomous arthropods Excludes1: contact with venomous insects and arthropods (T63.2-, T63.3-, T63.4-) The appropriate 7th character is to be added to code W57 A - initial encounter D - subsequent encounter S - sequela

82 Case 4 Coding Process - AI
Morbid obesity, BMI of 43.7 Obesity E66.9 - morbid E66.01 - - with alveolar hypoventilation E66.2 - - due to excess calories E66.01

83 Case 4 Coding Process - TL

84 Case 4 Coding Process – AI
BMI, 43.7 – Use Add’l Note at E66 = Z68.- Body, bodies - mass index (BMI) - - adult or less Z68.1 Z68.20 Z68.21 Z68.22 Z68.23 Z68.24 Z68.25 Z68.26 Z Z Z Z Z Z Z Z Z Z and over Z68.45

85 Coding Case 4 ANSWER A69.23 Arthritis, arthritic, (acute) (chronic) (nonpyogenic) (subacute) due to or associated with Lyme disease S40.861S Bite(s), (animal) (human), arm (upper), superficial NEC, insect.. E66.01 Obesity, morbid Z68.41 Body, bodies, mass index (BMI), adult, 40–44.9 W57.XXXS Index to External Causes, Bite, bitten by, insect, (nonvenomous)

86 Coding Case 5 49-y-o female with CC of painful mouth ulcers over last month. Treated with acyclovir for 10 days and penicillin on two occasions, including tapering doses of steroids on second occasion. Pt states she feels somewhat better but continues to have these ulcers with pain. Denies fever, chills, dysphagia, or lymphadenopathy. No high risk behavior.

87 Coding Case 5 PE: Reveals whitish patches measuring 1 mm × 1 mm on buccal musoca and hard palate; erythematous and inflamed. Assessment: Aphthous ulcers and herpangina Plan: Will start patient on clindamycin orally for buccal cellulitis and Amlexanox 5% as oral paste along with the Xylocaine mouth wash. Patient should follow up with me in 2 weeks.

88 Case 5 Coding Process - AI
Aphthous ulcers Herpangina Is there another diagnosis that needs to be coded?

89 Case 5 Coding Process - TL

90 Case 5 ANSWER Sequencing?
K12.2 Cellulitis (diffuse) (phlegmonous) (septic) (suppurative), mouth (floor) K12.0 Ulcer, ulcerated, ulcerating, ulceration, ulcerative, aphthous (oral)(recurrent) B08.5 Herpangina Sequencing?

91 Documentation for ICD-10-CM
AHA/AHIMA field testing study Much of detail in ICD-10-CM is ALREADY incorporated in MR documentation NOT currently needed for ICD-9-CM coding

92 AHIMA Required CEUs ICD-10-CM/PCS continuing education units (CEUs)
CHPS – 1 CEU CHDA – 6 CEUs RHIT – 6 CEUs RHIA – 6 CEUs CCS-P – CEUs CCS – CEUs CCA – CEUs

93 General Resources Frazier, M. S. & Drzymkowski, J. W. Essentials of Human Diseases and Conditions, 4th ed., Saunders, 2009 Gray, H. Anatomy of the Human Body   Scott, A. S. & Fong, E. Body Structures and Functions, 11th ed., Delmar, 2009 Whonamedit? A dictionary of medical eponyms

94 Pressure ulcer Case A 73 year old male is followed in your clinic Diagnoses Type II Diabetes Mellitus Hypertension Hyperlipidemia CVA 18 mos ago Obesity 54-pack-year smoking history (quit 2 years ago) Diabetic neuropathy Diabetic retinopathy Diabetic gastroparesis Medications 70/30 insulin bid Lisinopril Simvastation Enteric coated aspirin Metoclopramide ac and hs

95 PU Case After stroke 18 months ago, dx w/ depression, tx for 6 months with sertraline, with improvement of mood to normal. Drug discontinued. Most recent functional assessment by visiting RN was that pt needed assistance w/bathing, otherwise independent. HH aide provided assistance w/ bathing & light housework, daughter visited almost every day.

96 PU Case Pt brought into ED by ambulance, after his daughter found him at home lying on floor, unconscious. ED room physician admits him w/ Dx of pneumonia, fall with long lie, dehydration, and altered mental status. By 2nd hospital day, he developed new pressure ulcer over right lateral malleolus. Examination of ulcer shows a round, 3 cm black eschar that is debrided to an ulcer that extends through dermis.

97 ICD-9-CM Codes 486 Pneumonia 401.9 HTN
707.06, Pressure Ulcer R lateral malleolus Dehydration 780.97Altered mental status DM type 2 Neuropathy Retinopathy Gastroparesis 260.60, 357.2, 563.3 250.50, 401.9 HTN 272.4 Hyperlipidemia Obesity V12.54 Hx CVA V15.82 Hx Smoking E888.9 Fall E849.0 At Home

98 ICD-10-CM Codes J18.9 Pneumonia
L Pressure Ulcer R lateral malleolus E86.0 Dehydration R41.82 Altered mental status Altered mental status due to known condition - code to condition DM type 2 E11.40 Neuropathy E Retinopathy -- MUST know w/wo Macular Edema E11.43 Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy Includes: Type 2 diabetes mellitus with diabetic gastroparesis

99 ICD-10-CM Codes I10 HTN - LESS Specific E78.5 Hyperlipidemia
E66.9 Obesity Z86.73 Hx CVA Z Hx Smoking W19.XXXA Fall Y At Home

100 General Resources Frazier, M. S. & Drzymkowski, J. W. Essentials of Human Diseases and Conditions, 4th ed., Saunders, 2009 Gray, H. Anatomy of the Human Body   Scott, A. S. & Fong, E. Body Structures and Functions, 11th ed., Delmar, 2009 Whonamedit? A dictionary of medical eponyms

101 ICD-10-CM Resources AAPC. ICD-10 Connect (e-Newsletter)
AAPC. ICD-10 Implementation AHIMA. ICD-10-CM/PCS Implementation Toolkit CDC. International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) CDC. ICD-10-CM Official Guidelines for Coding and Reporting 2012

102 ICD-10-CM Resources Clinical Documentation Challenges with ICD-10-CM, 11/2011. ICD-10 Taskforce Bulletin. NCHICA. CMS-AAPC ICD-10 Code-a-thon Video. YouTube. One hour and 16 minutes. Endicott, M. ICD-10-CM/PCS codes for musculoskeletal system include greater level of specificity. 8/30/2011 Giannangelo, K. and Hyde, L. ICD-10’s impact on quality measures. Just Coding.

103 ICD-10-CM Resources Grant, C & Wierz, C. An Essential Guide to ICD-10 Implementation. Courtyard Group. Gray, L. ICD-10-CM Coding of Physeal Fractures Using the Salter-Harris Classification System ICD-10 Articles. Just Coding News. HCPro. ICD10Data.com. Free 2012 ICD-10 reference, including all codes, a search engine, ICD-9-CM conversion, all indexes and 10.6 million instant coding notes.

104 ICD-10-CM Resources Kostick, K. M. Coding Diabetes Mellitus in ICD-10-CM Leon-Chisen, N. ICD-10 Overview and How Does ICD-10 Impact Departments? AHA. 11/03/2011 Let's Get The Terms Straight. National Scoliosis Foundation. Role-based Model for ICD-10 Implementation: Inpatient Coders. AHIMA.

105 ICD-10-CM Resources Role-based Model for ICD-10 Implementation: Outpatient Coders. AHIMA. Schraffenberger, L. Basic ICD-10-CM/PCS and ICD-9-CM Coding, 2012 ed. Chicago: AHIMA Schreck, B. Late Effects (Sequela) in ICD-10-CM August 10, 2011 Simmons, C. R. The Musculoskeletal System and ICD-10-CM. ICD TEN, April 2011.AHIMA.

106 ICD-10-CM Resources WHO. International Classification of Diseases (ICD) Zeisset, A. Coding Injuries in ICD-10-CM. Zeisset, A. ICD-10-CM Enhancements: A Look at the Features That Will Improve Coding Accuracy

107 Questions ? ? ? Thank You !


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