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ICD-10-CM Chapter 11-14 CRIHB John Hailes ASC-E/M, CCS, CCS-P, CPC, CPC-H, CIRCC, CPMA, CPC- I, CEMC, CFPC, Trainer 1jhmci.com.

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Presentation on theme: "ICD-10-CM Chapter 11-14 CRIHB John Hailes ASC-E/M, CCS, CCS-P, CPC, CPC-H, CIRCC, CPMA, CPC- I, CEMC, CFPC, Trainer 1jhmci.com."— Presentation transcript:

1 ICD-10-CM Chapter CRIHB John Hailes ASC-E/M, CCS, CCS-P, CPC, CPC-H, CIRCC, CPMA, CPC- I, CEMC, CFPC, Trainer 1jhmci.com

2 Objectives Identify areas in ICD-10-CM that include new terminology for clinical documentation Understanding the coding guidelines that pertain to ICD- 10-CM Chapter Assign the correct ICD-10-CM codes for the case studies involving chapters Define areas in ICD-10-CM that enable improved data capture if more specific conditions are documented – Acuity – Disease type – Site specifity – Disease stage jhmci.com

3 Documentation Matters “If it was not documented, it was not done” “If it was not documented, it was not done” 3jhmci.com

4 XXXX Category. Etiology, anatomic site, severity Added code extensions (7 th character) for obstetrics, injuries, and external causes of injury Coding and 7 th Character Extensions XXX AMS x A Additional Characters Alpha (Except U) 2 Numeric Numeric or Alpha 3 – 7 Characters jhmci.com

5 DISEASES OF THE RESPIRATORY SYSTEM CHAPTER 10 ICD-10-CM National Cancer Institute 5jhmci.com

6 Diseases of the Respiratory System J00-J06 Acute upper respiratory infections J00-J06 J09-J18 Influenza and pneumonia J09-J18 J20-J22 Other acute lower respiratory infections J20-J22 J30-J39 Other diseases of upper respiratory tract J30-J39 J40-J47 Chronic lower respiratory diseases J40-J47 J60-J70 Lung diseases due to external agents J60-J70 J80-J84 Other respiratory diseases principally affecting the interstitium J80-J84 J85-J86 Suppurative and necrotic conditions of the lower respiratory tract J85-J86 J90-J94 Other diseases of the pleura J90-J94 J95-J95 Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified J95-J95 J96-J99 Other diseases of the respiratory system J96-J99 6jhmci.com

7 Respiratory System ICD-9-CM to ICD-10-CM Model Acute Anatomic site of infection Other Severity Pneumonia Cause Chronic Acute, other, then chronic 7jhmci.com

8 Use Additional code to identify Exposure to environmental tobacco smoke (Z77.22)Z77.22 Exposure to tobacco smoke in the perinatal period (P96.81)P96.81 History of tobacco use (Z87.891)Z Infectious agent (B95-B97)B95-B97 Occupational exposure to environmental tobacco smoke (Z57.31)Z57.31 Tobacco dependence (F17.-)F17.- Tobacco use (Z72.0)Z72.0 8jhmci.com

9 Diseases of the Respiratory System Chapter 10 category range = J00-J99 Combination codes = condition and organism – J02.0 Streptococcal pharyngitis J02.0 Other codes require separate reporting of organism – Acute sinusitis J01- – Use Additional code (B95-B97) to identify infectious agent.B95-B97 9jhmci.com

10 New terminology for asthma Respiratory condition in more than 1 site (not specifically indexed) classified to lower anatomic site Additional code notes 10jhmci.com

11 Asthma ICD XX – 4 th Digit Extrinsic Intrinsic Chronic Obstructive Other – 5 th Digit Exacerbation or status asthmatics ICD-10 J45.XXX Extrinsic Intrinsic Chronic Obstructive Other 11jhmci.com

12 J45J45 Asthma J45.2 Mild intermittent asthma J45.2 J45.20 …… uncomplicated J45.20 J45.21 …… with (acute) exacerbation J45.21 J45.22 …… with status asthmaticus J45.22 J45.3 Mild persistent asthma J45.3 J45.30 …… uncomplicated J45.30 J45.31 …… with (acute) exacerbation J45.31 J45.32 …… with status asthmaticus J45.32 J45.4 Moderate persistent asthma J45.4 J45.40 …… uncomplicated J45.40 J45.41 …… with (acute) exacerbation J45.41 J45.42 …… with status asthmaticus J45.42 J45.5 Severe persistent asthma J th Character mano-num system 12jhmci.com

13 Upper Respiratory Infections J00 Acute nasopharyngitis [common cold] J00 J01 Acute sinusitis J01 J02 Acute pharyngitis J02 J03 Acute tonsillitis J03 J04 Acute laryngitis and tracheitis J04 J05 Acute obstructive laryngitis [croup] and epiglottitis J05 J06 Acute upper respiratory infections of multiple and unspecified sites J06 13jhmci.com

14 Upper Respiratory Tract Acute sinusitis by site Acute recurrent sinusitis by site. 14jhmci.com

15 J01J01 Acute sinusitis J01.0 Acute maxillary sinusitis J01.0 J01.00 …… unspecified J01.00 J01.01 Acute recurrent maxillary sinusitis J01.01 J01.1 Acute frontal sinusitis J01.1 J01.10 …… unspecified J01.10 J01.11 Acute recurrent frontal sinusitis J01.11 J01.2 Acute ethmoidal sinusitis J01.2 J01.20 …… unspecified J01.20 J01.21 Acute recurrent ethmoidal sinusitis J01.21 J01.3 Acute sphenoidal sinusitis J01.3 J01.30 …… unspecified J01.30 Anatomical Site Acute Recurrent 15jhmci.com

16 465.9 Acute upper respiratory infection J06 Acute upper respiratory infections of multiple and unspecified sites J06 J06.0 Acute laryngopharyngitis J06.0 J06.9 Acute upper respiratory infection, unspecified J jhmci.com

17 462 Acute Pharyngitis J02.0 Streptococcal pharyngitis J02.0 J02.8 Acute pharyngitis due to other specified organisms J02.8 J02.9 Acute pharyngitis, unspecified J jhmci.com

18 Instructional note When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to J40-J47J40-J47 Chronic lower respiratory diseases 18jhmci.com

19 J40-J47J40-J47 Chronic lower respiratory diseases J41 Simple and mucopurulent chronic bronchitis J41 J42 Unspecified chronic bronchitis J42 J43 Emphysema J43 J44 Other chronic obstructive pulmonary disease J44 J45 Asthma J45 J47 Bronchiectasis J47 19jhmci.com

20 Allergic rhinitis Excludes 1: Allergic rhinitis with asthma (bronchial) – Code to the Asthma code. J J30 Vasomotor and allergic rhinitis J30 – J30.0 Vasomotor rhinitis J30.0 – J30.1 Allergic rhinitis due to pollen J30.1 – J30.2 Other seasonal allergic rhinitis J30.2 – J30.5 Allergic rhinitis due to food Cause and Effect J30.5 – J30.8 Other allergic rhinitis J30.8 – J30.81 Allergic rhinitis due to animal (cat) (dog) hair and dander J30.81 – J30.89 Other allergic rhinitis J30.89 – J30.9 Allergic rhinitis, unspecified J jhmci.com

21 Influenza Influenza may be coded alone or in combination with other codes. Code only confirmed cases: – Exception to Guideline II, H. (Uncertain Diagnoses) J09 – Due to certain identified influenza viruses J10 – Due to other identified influenza viruses 21jhmci.com

22 COPD ICD-9-CM x or 493.2x – Asthma with COPD – Chronic asthmatic (obstructive) asthma – Chronic bronchitis with airway obstruction – Chronic bronchitis with emphysema – Chronic obstructive asthma – Chronic obstructive bronchitis – Chronic obstructive tracheobronchitis ICD-10-CM J44 – J44 Other chronic obstructive pulmonary disease J44 – J44.0 Chronic obstructive pulmonary disease with acute lower respiratory infection J44.0 – J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation J44.1 – J44.9 Chronic obstructive pulmonary disease J44.9 J44 Includes asthma with chronic obstructive pulmonary disease chronic asthmatic (obstructive) bronchitis chronic bronchitis with airways obstruction chronic bronchitis with emphysema chronic emphysematous bronchitis chronic obstructive asthma chronic obstructive bronchitis chronic obstructive tracheobronchitis 22jhmci.com

23 Pneumonia Coded as a combination with the responsible organism Coded as a dual classification J13 and J14 = code first influenza (J09, J10, J11) is applicable J13 Pneumonia due to Streptococcus pneumoniae J13 J14 Pneumonia due to Hemophilus influenzae J14 J15 Bacterial pneumonia, not elsewhere classified J15 23jhmci.com

24 Acute Respiratory Failure Coding Guideline 10.b.1 Acute respiratory failure as the principal diagnosis J96.0 May be assigned as the principal diagnosis when it is the condition established after study to be chiefly responsible for the admission to the hospital. The selection of the code is supported by the Alphabetical and Tabular list. Chapter specific guidelines take precedence. Obstetrics, poisonings, HIV and newborn 24jhmci.com

25 Acute Respiratory Failure Coding Guideline 10.b.2 Acute respiratory failure as a secondary diagnosis Respiratory failure may be listed as a secondary diagnosis if it occurs after admission, or is present on admission, but does not meet the definition of the principal diagnosis. 25jhmci.com

26 Acute Respiratory Failure Coding Guideline 10.b.3 Sequencing of acute respiratory failure and another acute condition. When the patient is admitted with respiratory failure and another condition such as myocardial infarction, CVA or aspiration pneumonia, the principal diagnosis will not be the same in every situation. This applies whether the other acute condition is a respiratory or non-respiratory condition. Principle diagnosis will be dependent on the circumstances of the admission. admission. If two conditions are equally responsible and there are no chapter specific guidelines, the guideline for two or more diagnosisthat equally meet the definition of principal diagnosis may be applied. 26jhmci.com

27 J96J96 Respiratory failure J96.0 Acute respiratory failure J96.0 J96.00 …… unspecified whether with hypoxia or hypercapnia J96.00 J96.01 …… with hypoxia J96.01 J96.02 …… with hypercapnia J96.02 J96.1 Chronic respiratory failure J96.1 J96.10 …… unspecified whether with hypoxia or hypercapnia J96.10 J96.11 …… with hypoxia J96.11 J96.12 …… with hypercapnia J96.12 J96.2 Acute and chronic respiratory failure J96.2 J96.20 …… unspecified whether with hypoxia or hypercapnia J96.20 J96.21 …… with hypoxia J jhmci.com

28 Questions 28jhmci.com


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