1. ICD-9-CM, ICD-10-CM, and ICD-10-PCS Coding Systems
Chapter 2
ICD-9-CM, ICD-10-CM, and ICD-10-PCS Coding Systems

2. Disease Classifications
ICD
ICD-9-CM
ICD-10-CM
ICD-10-PCS

3. ICD-10-CM Coding Manual
Permission to reuse granted by Ingenix, Inc.

4. ICD-9-CM Volume 1: Tabular List Volume 2: Index to Diseases
Volume 3: Index to Procedures and Tabular List

5. Oversight of ICD-9-CM National Center for Health Statistics (NCHS)
Centers for Medicare and Medicaid Services (CMS)
Updates
April 1 and October 1 of each year

6. Legislation
Medicare Prescription Drug, Improvement, and Modernization Act (MMA)
Medicare Catastrophic Coverage Act of 1988

7. History of ICD
World Health Organization (WHO) originally intended for use as statistical tool
1955
ICD-7 clinically modified for indexing hospital disease in United States
(continued)

8. History of ICD
1965
ICD-8 lacked depth of clinical data for United States health care delivery system
1968
Two widely accepted modifications published:
ICDA-8
H-ICDA
(continued)

9. History of ICD 1979 2013 ICD-9-CM implemented
ICD-10-CM and ICD-10-PCS implemented

10. Coding Tools Non-automated Automated Coding manuals
Reference materials
Automated
Computer-based encoders
Web-based products
(continued)

11. Coding Tools Updateable ICD-9-CM coding manuals.
Permission to reuse granted by Ingenix, Inc.

12. Medical Necessity
Determination that service or procedure provided is reasonable and necessary for diagnosis or treatment of illness or injury
e.g., patient underwent blood glucose testing (procedure) for hyperglycemia (illness)

13. Tabular List of Diseases Arrangement
Numerical order
17 chapters
Two supplementary classifications
Five appendices

14. Disease and Injury Codes
Category codes
Three digits
e.g., 436
Subcategory codes
Three digits followed by decimal point and one additional digit
e.g., 401.9
(continued)

15. Disease and Injury Codes
Sub-classification code
Three digits followed by decimal point and two additional digits
e.g.,

16. Procedure Codes Category codes Subcategory codes Two digits
e.g., no valid two-digit ICD-9-CM Volume 3 codes
Subcategory codes
Two digits followed by decimal point and one additional digit
e.g., 10.6
(continued)

17. Procedure Codes Sub-classification code
Two digits followed by decimal point and two additional digits
e.g., 82.01

18. Supplementary Classifications
ICD-9-CM V codes
Health status factors
ICD-9-CM E codes
External causes of injury, poisoning, or adverse reaction
(continued)

19. Supplementary Classifications
ICD-9-CM E codes / ICD-10-CM S&T codes
Environmental events, industrial accidents, criminal activity, etc.

20. ICD-9-CM Appendices Appendix A: Morphology of Neoplasms
Appendix B: Glossary of Mental Disorders
Removed from ICD-9-CM effective 2006
Appendix C: Classification of Drugs by American Hospital Formulary Service (AHFS)
(continued)

21. ICD-9-CM Appendices
Appendix D: Classification of Industrial Accidents According to Agency
Appendix E: List of Three-Digit Categories

22. ICD-9-CM Appendix A Morphology of Neoplasms (M codes) M8000/3 Benign
Malignant

23. ICD-9-CM Appendix B Glossary of Mental Disorders Removed from ICD-9-CM
Located in Diagnostic and Statistical Manual of Mental Disorders (DSM)

24. ICD-9-CM Appendix C Classification of Drugs by AHFS
Numerical arrangement
e.g., 76:00 Oxytocics

25. ICD-9-CM Appendix D
Classification of Industrial Accidents According to Agency
Tenth International Conference of Labor Statisticians
Used to classify industrial accidents

26. ICD-9-CM Appendix E List of Three-Digit Categories e.g., 390-392
Acute rheumatic fever

27. ICD-9-CM Index to Diseases and ICD-10-CM Index to Diseases and Injuries
Index of Diseases
Table of Drugs and Chemicals
Alphabetic Index to External Causes of Injury and Poisoning

28. Index to Diseases Arrangement
Alphabetic
Main terms
e.g., conditions
Nonessential modifiers in parentheses
(continued)

29. Index to Diseases Arrangement
Essential modifiers indented
Sub-terms
Qualifiers further indented
Second and third

30. Basic Steps to Coding Diseases
Locate main term in Index to Diseases
Follow directional terms
e.g., see, see also, see category
Review diagnostic statement to locate essential modifiers in Index to Diseases
e.g., sub-terms
Select and verify code in Tabular List of Diseases
(continued)

31. Tabular List of Procedures and Index to Procedures
Volume 3 of ICD-9-CM
ICD-10-PCS
Alphabetic listing of main terms
e.g., procedures
Nouns, adjectives, or eponyms
Use of “with” and “without”
Sub-terms

32. Basic Steps to Coding Procedures
Locate main term in Index to Procedures
Follow directional terms
e.g., omit code
Review procedural statement to locate essential modifiers in Index to Procedures
e.g., sub-terms
Select and verify code in Tabular List of Procedures

33. Guidelines for Coding and Reporting Using ICD-9-CM and ICD-10-CM/PCS
Cooperating parties
CMS
NCHS
Impact of HIPAA
Coding guidelines
Use of terms “encounter” and “provider”
Guidelines for ICD-10-CM/PCS