1. CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14)
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2. Diseases of Digestive System, Chapter 11
K00-K95
Unspecified GI hemorrhage, K92.2
Combination codes with hemorrhage
Example: K57.21, Diverticulitis of large intestine with perforation and abscess with bleeding
The categories are sequenced in a manner that follows the path of the digestive system from the mouth to the anus, beginning with disorders of the teeth.
For a hemorrhage to be reported active bleeding is not necessary; however, documentation must support the fact that active bleeding has occurred.
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3. Diseases of the Skin and Subcutaneous Tissue, Chapter 12
L00-L99
Also codes to report conditions of the:
Nails
Sweat glands
Hair
Hair follicles
Chapter 12 describes diseases or conditions of the Integumentary System.
Does the integumentary system only include the skin? (No)
What else is included in the integumentary system? (glands, nails, hair and hair follicles)
What are the two glands that are covered in the integumentary system? (sweat and sebaceous)
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4. Infections
Use additional code before L00 directs coder to report the infection with B95-B97
If there isn’t a combination code to describe the diagnosis (cellulitis) and cause (staph infection) then both of these diagnoses would be coded out to fully describe the condition.
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5. Pressure Ulcers Stage 1: erythema (redness) of skin
Stage 2: partial loss of skin (epidermis or dermis)
Stage 3: full thickness loss of skin (up to but not through fascia)
Stage 4: full thickness loss (extensive destruction and necrosis)
Pressure ulcers develop when the circulation is decreased to that area of the body.
Pressure ulcers are graded and reported based on:
Depth of the ulcer
Categorized in stages
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6. Diseases of the Musculoskeletal System and Connective Tissue, Chapter 13
M00-M99
Most codes specify:
Site: Location on the body
Laterality: Right, left, unilateral, bilateral
Some codes include “multiple sites” such as:
M15.-, Polyosteoarthritis including multiple sites
Chapter 13 describes diseases or conditions of the bone, joints, and muscles.
A medical dictionary will always be a handy tool to use when there are medical terms that you may not know. For example, dorsopathies.
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7. Infectious Arthropathies
M00-M02
Direct infections
Invades synovial tissue
Invades the joint
Invasive organism has been identified
Indirect infections
Reactive: Microbial infection identified but not in joint
Postinfective: Microbial antigen present, but not constant and no evidence of multiplication
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8. Pathological Fractures
Also known as (AKA): Spontaneous fracture
Fracture reported in addition to underlying condition responsible for fracture
Never assign a code for a traumatic fracture and pathological fracture of same bone
7th character indicates treatment plans, such as A for initial
The 7th character A (initial encounter) is assigned as long as the patient is receiving active treatment for the fracture.
Other 7th characters:
D (subsequent) is assigned when all active treatment is completed
G, K, and P are assigned subsequent, non-routine encounters
S is assigned for a sequela
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9. Osteoporosis M80 and M81 Systemic condition that affects bones
Fracture sustained with trauma that would not usually cause a fracture
Site is not a component of codes
Category M80, Osteoporosis with current pathological fracture
Age and other osteoporosis codes
Category M81, Osteoporosis without current pathological fracture
Osteoporosis is a systemic condition
Meaning all bones of the musculoskeletal system are affected
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10. CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14)
Conclusion CHAPTER 6
CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14)
Slide 10
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