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

2. 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.

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)

4. 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.

5. 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

6. 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.

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

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 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

9. 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

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