CHAPTER-SPECIFIC GUIDELINES (ICD-9-CM CHAPTERS 9-17)

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CHAPTER-SPECIFIC GUIDELINES (ICD-9-CM CHAPTERS 9-17) SXS12ierPPT-INTC12_P2

Chapter 9 Diseases of Digestive System Mouth to anus and accessory organs Extensive subcategories 574 Cholelithiasis (10 subcategories) Each has fifth digit subclassification Presence of hemorrhage associated with diseases in this chapter Query provider if documentation is not clear 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 coded, active bleeding is not necessary; however, documentation must support the fact that active bleeding has occurred. SXS12ierPPT-INTC12_P2

Chapter 10 Diseases of Genitourinary System Commonly used codes Urinary tract infection (599.0) Inflammation of prostate (601.X) Disorders of menstruation (626-627) & breast (610-612) Use additional code to identify organism Use additional codes to identify lower urinary tract symptom Chapter 10 includes conditions and diseases of the male and female genital organs and urinary tract and disorders of the breast. An additional code must be used to identify the organism when infections of the urinary tract or genital organs are coded. SXS12ierPPT-INTC12_P2

Chapter 11, Complications of Pregnancy, Childbirth, and the Puerperium Extensive multiple coding with many fifth digit assignments and notes Chapter 11 codes take precedence over codes from other chapters Admission for pregnancy, complication Obstetric complication = first-listed diagnosis This may be the most difficult chapter from which to code: Physicians may overlook documentation of diagnoses that should be coded. Multiple coding is used extensively. Fifth-digit assignment for pregnancy is often difficult to determine. SXS12ierPPT-INTC12_P2

Section I.C.11. Complications of Pregnancy, Childbirth, and Puerperium Chapter 11 codes Mother’s medical record (600 series codes) Not on newborn medical record (Newborn, 700 series codes) Chapter 11 codes are never used on the record of the newborn. Coders may find it helpful to code the mother’s and baby’s records at the same time. Conditions documented on the birth certificate may appear on the newborn’s record but not the mother’s record. Additional documentation to support coding may have to be obtained from the physician. (Cont’d…) SXS12ierPPT-INTC12_P2

Section I.C.11. Complications of Pregnancy, Childbirth, and Puerperium (…Cont’d) Mother’s record Outcome of delivery code (V27.0-V27.9) when delivered Category V27, Outcome of delivery, can be assigned as an additional coding to the mother’s record. An outcome of delivery code should be included on every maternal record when a delivery has occurred. SXS12ierPPT-INTC12_P2

Section I.C.11.a. General Rules for Obstetric Cases Not all encounters are pregnancy related Example, pregnant woman, broken ankle Broken ankle V22.2 Pregnant state incidental, must be documented in medical record as treated condition not affecting pregnancy If an encounter with a pregnant woman is not pregnancy related, code the primary diagnosis first and the pregnancy status (V22.2) second SXS12ierPPT-INTC12_P2

Section I.C.11.a.4. Fifth Digit All categories EXCEPT 650 (Normal delivery) Requires fifth digit for: Antepartum Postpartum Delivery Complications related mainly to pregnancy (640-648) designate fifth-digit subclassifications for antepartum conditions, delivery, and postpartum complications. SXS12ierPPT-INTC12_P2

Codes 640-676.9 Share Fifth-Digit Subclassification Denotes current episode of care 0 Unspecified as to episode of care or not applicable 1 Delivered, with or without mention of antepartum condition 2 Delivered, with mention of postpartum complication 3 Antepartum condition or complication 4 Postpartum condition or complication The fourth digit represents the status of the pregnancy. Which fifth digit would be used if the patient has delivered with no complications? (1) SXS12ierPPT-INTC12_P2

Section I.C.11.b. Selection of Principal Diagnosis—Obstetric No delivery: Principal diagnosis = principal complication >1 complication, sequence any first (Cont’d…) In episodes when no delivery occurs, the principal diagnosis should correspond to the principal complication of the pregnancy that necessitated the encounter. SXS12ierPPT-INTC12_P2

Section I.C.11.b. Selection of Primary Diagnosis (…Cont’d) Routine prenatal visits no complications: V22.0, Supervision, normal first pregnancy or V22.1, Supervision, other normal pregnancy Always primary diagnosis Prenatal outpatient visits for high-risk pregnancies: V23, Supervision of high-risk pregnancy (V23.X) For routine outpatient prenatal visits when no complications are present, codes V22.0 and V22.1 should be used as the first-listed diagnoses. SXS12ierPPT-INTC12_P2

Section I.C.11.c.1. Fetal Conditions Affect Mother Codes from Categories 655 and 656 Assign only if known or suspected fetal or placenta problems affects management of the mother Requires additional diagnostic studies, observation, special care or termination of the pregnancy The existence of a fetal condition alone does not justify reporting these codes SXS12ierPPT-INTC12_P2 12

Section I.C.11.c.2. In Utero Surgery When surgery is performed on the fetus, report a code from Category 655 identifying the fetal condition No code from Chapter 15, perinatal codes, should be used on the mother’s record to identify fetal conditions Surgery performed in utero on the fetus is still coded as an obstetric encounter SXS12ierPPT-INTC12_P2 13

Section I.C.11.d. HIV Infection in Pregnancy, Childbirth, Puerperium Patient admitted during this period because of an HIV-related illness should receive a principal code of 647.6x followed by 042 Patient admitted with asymptomatic HIV status should be reported 647.6x V08 SXS12ierPPT-INTC12_P2 14

Section I.C.11.e. Current Conditions Complicating Pregnancy Assign a code from Category 648.X for patient with current condition that affects management of the pregnancy, childbirth or the puerperium Use additional secondary code from other chapters to identify conditions SXS12ierPPT-INTC12_P2 15

Section I.C.11.f. Diabetes Mellitus in Pregnancy Significant complicating factor in pregnancy Diabetic pregnant patients should be assigned code 648.0X AND A secondary code from Category 250 to identify type of diabetes Code V58.67, Long-term (current) use of insulin should also be reported if appropriate SXS12ierPPT-INTC12_P2 16

Section I.C.11.g. Gestational Diabetes Occurs in second and third trimester in women who were not diabetic prior to pregnancy Can cause complications in pregnancy similar to those of pre-existing diabetes Puts women at greater risk of developing diabetes after the pregnancy (Cont’d…) SXS12ierPPT-INTC12_P2 17

Section I.C.11.g. Gestational Diabetes (…Cont’d) Report 648.8X NEVER report codes 648.0X and 648.8X together Code V58.67, Long-term (current) use of insulin should also be reported if gestational diabetes is being treated with insulin SXS12ierPPT-INTC12_P2 18

Section I.C.11.h. Normal Delivery, 650 No complications, principal diagnosis = 650 With complications = NOT 650 V27.0 (Single liveborn) Only outcome for 650 (Normal Delivery) Normal delivery with resolved antepartum condition = 650 Code 650 is always a principal diagnosis. Code 650 cannot be used if any other code from Chapter 11 is needed to describe a current complication. SXS12ierPPT-INTC12_P2

Section I.C.11.i.1. Postpartum and Peripartum Periods After delivery and continues for 6 weeks Peripartum period Last month of pregnancy to five months postpartum A postpartum complication is any complication that occurs within 6 weeks of delivery. Chapter 11 codes may be used to describe pregnancy-related complications that occur after the 6-week period if the physician documents that the condition is pregnancy related. Postpartum complications that occur during the same admission as the delivery are identified with a fifth digit of “2”; subsequent admissions/encounters for postpartum complications are identified with a fifth digit of “4.” SXS12ierPPT-INTC12_P2

Section I.C.11.i.2.,3.,4. Postpartum Complications Any complication occurring within the 6-week period Complications occurring after the 6-week period may be reported with Chapter 11 codes, if the provider documents they are pregnancy related Complications occurring during the same admission as delivery are reported with fifth digit “2”; subsequent admissions/encounters with fifth digit “4” SXS12ierPPT-INTC12_P2 21

Section I.C.11.i.5. Care following delivery outside hospital If delivered prior to admission In ambulance At home In ED DO NOT CODE delivery Code any postpartum care If a patient delivers outside the hospital, whether at home or in the ambulance on the way to the hospital, do not code the delivery. Only the postpartum care would be coded for. SXS12ierPPT-INTC12_P2

Section I.C.11.j. Late Effect of Complication of Pregnancy Category 677 Reported when an initial complication of pregnancy requires care or treatment at a future date Category reported any time after initial postpartum period Like all late effects, code is sequenced following the complicating condition code SXS12ierPPT-INTC12_P2 23

Section I.C.11.k. Abortions Codes 634-637 require fifth digits: 0: Unspecified 1: Incomplete (POC, product of conception) NOT expelled 2: Complete, all (POC) expelled prior to care A code from categories 640-648 and 651-657 may be used as an additional code with an abortion code to indicate the complication that led to the abortion. Always apply a fifth digit to these codes. What would happen if the fifth digit were not applied? (This would be incorrect coding and it would be denied by the third-party payer.) SXS12ierPPT-INTC12_P2

Section I.C.11.k.1. Fifth-Digits Appropriate fifth-digits listed under each code 640.0, Threatened abortion 0: Unspecified episode 1: Delivered with or without complication 3: Antepartum condition or complication Note that NOT all fifth-digits may be assigned (2 and 4) Not all fifth digits may be reported with every code. Read Notes carefully. SXS12ierPPT-INTC12_P2

Section I.C.11.k.4. Abortion with Liveborn Fetus Attempted abortion results in liveborn fetus: 644.21 (Early onset of delivery) appropriately Use V27 (Outcome of delivery) Attempted abortion procedure code also assigned In this case, three codes are assigned. The three codes would be the early onset of delivery, the outcome of delivery, and an attempted abortion code. SXS12ierPPT-INTC12_P2

Section I.C.11.k.5. Retained Products of Conception Subsequent admissions for retained products of conception following a spontaneous or legally induced abortion are reported with code from: 634 Spontaneous abortion 635 Legally induced abortion With fifth digit “1” (incomplete) Appropriate even if patient previously discharged with diagnosis of “complete” SXS12ierPPT-INTC12_P2 27

Chapter 12, Diseases of the Skin and Subcutaneous Tissue Epidermis Dermis Subcutaneous tissue Infectious Skin/Subcutaneous Tissue Scar tissue ACCESSORY ORGANS Sweat glands Sebaceous glands Nails Hair and hair follicles Other (Cont’d…) 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, and hair follicles) What are the two glands that are covered in the Integumentary System? (sweat and sebaceous) SXS12ierPPT-INTC12_P2

Chapter 12 Multiple codes often necessary (…Cont’d) Multiple codes often necessary Example: Cellulitis due to Staph Cellulitis 682.9 Staph 041.1X If there isn’t a combination code to describe the diagnosis (cellulitis) and cause (staph infection), then both of these diagnoses would be coded to fully describe the condition. SXS12ierPPT-INTC12_P2

Chapter 13, Diseases of Musculoskeletal System and Connective Tissue Ligaments Muscle Synovia Tendons Bone Bursa Cartilage Fascia Chapter 13 describes diseases or conditions of the bone, joints, and muscles. The note at the beginning of the chapter presents important information on fifth-digit subclassifications. SXS12ierPPT-INTC12_P2

Chapter 13 Sections Arthropathies (joint disease) and Related Disorders Dorsopathies (curvature of spine) Rheumatism, Excluding back Osteopathies, Chondropathies, and Acquired Musculoskeletal Deformities Newly Diagnosed Pathologic Fractures Extensive notes and fifth digits Watch fifth digits. Remember you want to code to the highest level of specificity. A medical dictionary will always be a handy tool to use when there are medical terms that you may not know—for example, dorsopathies. SXS12ierPPT-INTC12_P2

Chapter 13, Diseases of Musculoskeletal System and Connective Tissue Refer to the note at the beginning of the chapter regarding fifth-digit sub-classifications Details located there are not repeated in the categories Used for Categories 711-712, 715-716, 718-719, and 730 SXS12ierPPT-INTC12_P2 32

Chapters 14 and 15 Congenital Anomalies (abnormality at birth) (740-759) Conditions Originating in Perinatal Period Perinatal period through 28th day following birth Codes can be used after 28th day if documented that condition originated during perinatal period An anomaly is an abnormality of a structure or organ. Congenital refers to an abnormality with which a person is born. The term perinatal applies only to the baby, and postpartum applies only to the mother. SXS12ierPPT-INTC12_P2

Section I.C.15.b. Use of Codes V30-V39 V30-V39 liveborn infant(s) Example: V30, Single liveborn V31, Liveborn twins Inpatient: Principal diagnosis Note: V30 ONLY used once, hospital where baby delivered When coding the birth of an infant, assign a code from categories V30-V39, according to the type of birth. The code is assigned as a principal diagnosis. Other conditions or congenital anomalies documented, if any, are coded as secondary diagnoses. The code is assigned only once to a newborn, at the time of birth. SXS12ierPPT-INTC12_P2

Section I.C.15.d. Use of Category V29 Assign code when healthy newborn/infant is evaluated for suspected condition not found Do not use when patient has signs/symptoms of a suspected problem, code the signs/symptoms V29 is used secondary to V30 SXS12ierPPT-INTC12_P2 35

Section I.C.15.f. Maternal Causes of Perinatal Morbidity Codes from Categories 760-763 are assigned only when the maternal condition actually affected the fetus/newborn The fact that the mother has a medical condition or experiences a complication does not justify routine reporting of these categories SXS12ierPPT-INTC12_P2 36

Section I.C.15.h. Coding Additional Perinatal Diagnoses Code newborn conditions that require: Treatment Further investigation Additional resource Prolonged length of stay (LOS) Implications for future care All clinically significant conditions noted on a routine newborn examination should be coded. (Cont’d…) SXS12ierPPT-INTC12_P2

Section I.C.15.h. Coding Additional Perinatal Diagnoses (…Cont’d) Insignificant newborn conditions, signs, symptoms Resolve with no treatment Need no code EVEN IF documented When coding perinatal, a resolved condition or one that doesn’t require treatment does not have to be coded. SXS12ierPPT-INTC12_P2

Section I.C.15.i. Prematurity and Fetal Growth Retardation Codes for newborns from categories 764 (Slow fetal growth and fetal malnutrition) and 765 (Disorders relating to short gestation and low birthweight) What is the difference between categories 764 and 765? (Category 764 is for slow fetal growth and malnutrition and 765 is for short gestation and low birthweight.) (Cont’d…) SXS12ierPPT-INTC12_P2

Section I.C.15.i. Prematurity and Fetal Growth Retardation (…Cont’d) Not assigned solely on birthweight or gestational age of newborn Use clinical assessment instead Use physician’s assessment of maturity Use additional code for number of weeks of gestation (765.0 and 765.1) Codes from category 764 and subcategories 765.0 and 765.1 should not be assigned solely on the basis of recorded birth weight or estimated gestational age but on the physician’s clinical assessment of the infant’s maturity. SXS12ierPPT-INTC12_P2

Section I.C.15.j. Newborn Sepsis Code 771.81 should be assigned a secondary code from category 041 to identify the organism Do not report category 038 Do not assign 995.91, Sepsis, assign 771.81 SXS12ierPPT-INTC12_P2 41

Chapter 16, Symptoms, Signs, and Ill-Defined Conditions Do NOT code a sign or symptom if: Definitive diagnosis made (symptoms are part of disease) Only used if no specific diagnosis stated Signs/symptoms are transient or cause not determined Patient fails to return and provisional diagnosis is all that is documented Signs and symptoms codes are used for encounters until a definitive diagnosis can be made. No specific diagnosis can be made after investigation. Signs and symptoms reported as existing at the time of the initial encounter prove to be transient or a cause cannot be determined. A patient fails to return, or is referred elsewhere, and all the coder has is a provisional diagnosis. A more precise diagnosis is not available for any other reason. Certain symptoms that represent important problems in medical care exist, and it might be desirable to classify them in addition to the known cause. (Cont’d …) SXS12ierPPT-INTC12_P2

Chapter 16, Symptoms, Signs, and Ill-Defined Conditions (…Cont’d) More precise diagnosis not available for any other reason Certain symptoms that may represent important problems in medical care exist and might be desirable to classify them in addition to the known cause SXS12ierPPT-INTC12_P2 43

Chapter 17, Injury and Poisoning, Section Examples Fractures Dislocations Sprains and Strains Intracranial Injury Internal Injury Crushing Injury Foreign Body Burns Late Effects Poisoning External causes of injury and poisoning codes are intended to provide data for injury research and evaluation of injury prevention strategies. At the beginning of this chapter, notes provide specific instructions for the entire chapter. SXS12ierPPT-INTC12_P2

Section I.C.17.c. Burns Sequence highest degree burn first Current burns (940-948) classified by Depth (severity) Extent (% body surface) Site And if necessary, agent Sequence first the code that reflects the highest degree of burn when more than one burn is present. (Cont’d …) SXS12ierPPT-INTC12_P2

Section I.C.17.c. Burns Depth of burn is classified as (…Cont’d) Depth of burn is classified as First degree: Erythema Second degree: Blistering Third degree: Full-thickness involvement Nonhealing burns are coded as acute burns. If different degrees of burns are documented at the same site, assign a code to burns of highest degree only. Second-degree burns may also be referred to as “partial-thickness burns.” SXS12ierPPT-INTC12_P2

Section I.C.17.c. Burns Classified According to extent body surface involved Burn site NOT specified Additional data required Burns of different degrees/same local site Report highest degree only Non-healing burns are reported as acute burns Report 958.3 as additional code for infected burn site Assign codes from category 948, Burns, Classified according to the extent of body surface involved, when the site of the burn is not specified or when there is a need for additional data. The coder may use 948 as an additional code. SXS12ierPPT-INTC12_P2

Section I.C.17.c.6. Category 948 Fourth digits = % total body surface involved Fifth digits = % body surface involved in third-degree burns Rule of Nines applies (Cont’d…) The fourth digit represents the amount of body surface involved, and the fifth digit represents the amount that is third degree. The Rule of Nines is used to estimate the body surface involved. SXS12ierPPT-INTC12_P2

Rule of Nines (…Cont’d) Figure: 12.6 SXS12ierPPT-INTC12_P2 For adults: Head and neck are assigned 9%, each arm 9%, each leg 18%, the anterior trunk 18%, the posterior trunk 18%, and genitalia 1%. Physicians may change these percentage assignments when necessary. Figure: 12.6 SXS12ierPPT-INTC12_P2

Section I.C.17.d. Debridement of Wounds, Infection, or Burn Excisional debridement (86.22) Cut away Performed by physician Nonexcisional procedure (86.28) Shaved or scraped (includes water scalpel [jet]) Performed by physician or Nonphysician Excisional debridement involves a cutting away, as opposed to a mechanical debridement, which involves brushing, scrubbing, or washing. SXS12ierPPT-INTC12_P2

Section I.C.17. Injury and Poisoning (800-999) Separate code for each injury Most serious injury first Superficial injuries not reported if in same location as more serious injury Wounds Without mention of complication Complicated Documented delayed healing/treatment, foreign body, primary infection With tendon involvement When coding multiple injuries, assign separate codes for each injury unless a combination code is provided. The code for the most serious injury, as determined by the physician, is sequenced first. Superficial injuries such as abrasions or contusions are not coded when they are associated with more severe injuries of the same site. SXS12ierPPT-INTC12_P2

Section I.C.17.a.2. Vessel and Nerve Damage Code primary injury first Use additional code if nerve/vessel damage minor Primary injury = nerve/vessel damage Code nerve/vessel damage first When a primary injury results in minor damage to peripheral nerves or blood vessels, the primary injury code is sequenced first. SXS12ierPPT-INTC12_P2

Section 1.C.17.b.1. Acute Fracture vs. Aftercare Active treatment of fracture (800-829) may be: Physician evaluation ER encounter Surgical treatment Closed treatment After active treatment completed, use aftercare codes Aftercare involving internal fixation (V54.X) Aftercare for healing traumatic fracture (V54.1X) Other orthopedic aftercare (V54.8X) Unspecified orthopedic aftercare (V54.9) SXS12ierPPT-INTC12_P2 53

Section I.C.17.b.2. Multiple Fractures Same coding principles as multiple injuries Code multiple fractures, by site Sequenced by severity Codes describe accidents, injury, open wounds, etc. Fractures of specified sites are coded individually by site. Combination categories for multiple fractures may be used when there is insufficient detail in the medical record, when the reporting form limits the number of codes, or when there is insufficient specificity at the fourth- or fifth-digit level. (Cont’d …) SXS12ierPPT-INTC12_P2

Fractures Not indicated as closed or open = closed (…Cont’d) Not indicated as closed or open = closed Same bone fractured AND dislocated Code fracture ONLY (highest level of injury) If there is any doubt, check with the physician as to the nature of the fracture (open or closed). If a bone is both fractured and dislocated, you would only code the fracture repair. Fixing the dislocation is included with the fracture repair. SXS12ierPPT-INTC12_P2

Section I.C.17.e. Adverse Effects, Poisoning, and Toxic Effects Properties of some drugs, medicinal, and biological substances, or combinations may cause toxic reactions Classify as Adverse Effect when drug was correctly prescribed/administered Code effect first E-code from therapeutic column for drug (Cont’d…) SXS12ierPPT-INTC12_P2 56

Section I.C.17.e. Adverse Effects, Poisoning, and Toxic Effects (…Cont’d) Poisoning occurs when drugs/chemical substances are not taken as directed Wrong dosage given in error Medication given to wrong person Medication taken by wrong person Medication overdose has occurred Medications (prescription or over-the-counter) taken in combination with alcohol and/or recreational drugs Over-the-counter taken in combination with prescription drugs without provider approval (Cont’d…) SXS12ierPPT-INTC12_P2 57

Section I.C.17.e. Adverse Effects, Poisoning, and Toxic Effects (…Cont’d) Sequencing of Poisoning: Poisoning code from Table of Drugs & Chemicals first Manifestation(s) of the poisoning second Corresponding E code from the Table of Drugs and Chemicals last If intent unknown or questionable, report intent as undetermined (E980-E989) SXS12ierPPT-INTC12_P2 58

E Codes Provides supplemental information Never first-listed diagnosis Identify: Cause of an injury or poisoning, Intent (unintentional or intentional), and Place it occurred E codes are used to supplement basic ICD-9-CM codes. Can E codes be used as the principle diagnosis? (No) What does the E stand for within ICD-9-CM? (External cause) E codes give statistical information. (An example would be, What is the rate of suicides in a given time period? Are suicides on the rise?) SXS12ierPPT-INTC12_P2

General E Code Guidelines Use with any code in Vol. 1 Initial encounter Use E code Subsequent encounter Use late effects E codes An E code may be used with any code in Volume 1 that indicates an injury, poisoning, or adverse effect due to an external cause. No late effect E codes are used for adverse effects of drugs because the effect is immediate. Assign as many E codes as necessary to fully explain each cause. Use an additional code from category E849 to indicate the place of occurrence for injuries and poisonings. SXS12ierPPT-INTC12_P2

Intent Intent Code As Unknown Unspecified Questionable Undetermined* * (E980-E989) If the intent is not confirmed, it should be coded as undetermined from the range of E980-E989. There has to be a definitive diagnosis of intent from the physician in order to use a specific code. SXS12ierPPT-INTC12_P2

Section I.C.19.c. Table of Drugs and Chemicals Alphabetic listing with codes Do NOT code directly from Table Always reference Tabular If the same E code would describe the causative agent for more than one adverse reaction, assign the code only once. SXS12ierPPT-INTC12_P2

Section I.C.19.c. Two or More Substances Involved If two or more substances involved code: Each unless combination code exists Code substance more closely related to principal diagnosis, and Include one code from each category (cause, intent, place) Interaction of a drug(s) and alcohol Using poisoning and E codes for both If two or more drugs or medicinal or biological substances are reported, each should be coded individually unless the combination code is listed in the Table of Drugs and Chemicals. The first-listed E code should correspond to the cause of the most serious diagnosis. SXS12ierPPT-INTC12_P2

Section I.C.19.e. Unknown or Suspected Intent Unspecified Questionable Undetermined E980-E989 You need a definitive cause to code a definitive code. If undetermined, use external cause codes E980-E989. SXS12ierPPT-INTC12_P2

Section I.C.19.f. Undetermined Cause Intent known, cause unknown, use E928.9, Unspecified accident E958.9, Suicide and self-inflicted injury by unspecified means E968.9, Assault by unspecified means These E codes should rarely be used, as the documentation should normally provide sufficient detail to determine the cause of the injury. SXS12ierPPT-INTC12_P2

Section I.C.19.g. Late Effects of External Cause Should be used with late effect of a previous injury/poisoning Should NOT be used with related current injury code Late effect E codes exist for injuries and poisonings but not for adverse effects of drugs, misadventures, and surgical complications. The late effects E codes should never be used with a current injury. SXS12ierPPT-INTC12_P2

CHAPTER-SPECIFIC GUIDELINES (ICD-9-CM CHAPTERS 9-17) Conclusion CHAPTER 12 CHAPTER-SPECIFIC GUIDELINES (ICD-9-CM CHAPTERS 9-17) SXS12ierPPT-INTC12_P2