CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14)

Diseases of Digestive System, Chapter 11 K00-K94 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.

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)

Infections Use additional code before L00 direct 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.

Pressure Ulcers Stage I: erythema (redness) of skin Stage II: partial loss of skin (epidermis or dermis) Stage III: full thickness loss of skin (up to but not through fascia) Stage IV: 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

Disease 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.

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

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 status, 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

Osteoporosis M80 and M81 Systemic condition that affects bones Fracture sustained with trauma that would not usually case 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

CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14) Conclusion CHAPTER 11 CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14)