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ICD-10 Overview
Prepared by Advanced Billing Consultants
Advanced Billing Consultants, Inc. Copyright 2015
 Minimum of 3, maximum of 7 characters
 6th and 7th are not optional if required
 X may serve as a place holder for 4th...
 Represent the category
 1st: Capital Letter (any except U)
 2nd: number
 3rd: number
 Example: The category for pain...
 Represent the etiology, anatomical site,
severity, or other clinical detail
 Can be number or letter- capital or lowerc...
 For obstetrics, musculoskeletal injuries, and
external causes of morbidity
 encounter type, or extension, stages,
LT/RT...
 Collapsed vertebra, not elsewhere classified is M48.50-
M48.58, but it requires a 7th digit
 A= initial encounter for f...
 Excludes1: the two codes cannot be billed
together
 Excludes2: both codes can be used
Excludes Notes
Advanced Billing C...
 Many ICD-10 require additional diagnosis
codes
Additional Codes Required
Advanced Billing Consultants, Inc. Copyright 20...
 “in diseases classified elsewhere”= a
manifestation code
 Can never be listed first
 May say: “use additional code” or...
1. Certain Infectious and Parasitic Diseases (A00-B99)
2. Neoplasms (C00-D49)
3. Disease of the blood and blood-forming or...
12. Diseases of the Skin and Subcutaneous Tissue (L00-L99)
13. Diseases of Musculoskeletal System and Connective Tissue (M...
 Use ICD-10 for DOS 10/1/2015 and forward.
 Continue use of ICD-9 for DOS 9/30/15 and
before (even for corrected claims)...
 Many software systems provide crosswalks and
conversions at the encounter or charge entry
level. Ensure you have the mos...
 We appreciate any feedback. Please contact
us at info@abcbilling.net
Thank You!
Advanced Billing Consultants, Inc. Copyr...
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ICD-10 Coding Overview

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An overview of ICD-10 coding for medical physicians by Advanced Billing Consultants.

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ICD-10 Coding Overview

  1. 1. ICD-10 Overview Prepared by Advanced Billing Consultants Advanced Billing Consultants, Inc. Copyright 2015
  2. 2.  Minimum of 3, maximum of 7 characters  6th and 7th are not optional if required  X may serve as a place holder for 4th and 5th character for future use  Example of X place holder: other specified spondylopathies, cervical region is M48.8X2 Code Structure Advanced Billing Consultants, Inc. Copyright 2015
  3. 3.  Represent the category  1st: Capital Letter (any except U)  2nd: number  3rd: number  Example: The category for pain, not elsewhere classified is G89 Characters 1-3 Advanced Billing Consultants, Inc. Copyright 2015
  4. 4.  Represent the etiology, anatomical site, severity, or other clinical detail  Can be number or letter- capital or lowercase Characters 4-6 Advanced Billing Consultants, Inc. Copyright 2015
  5. 5.  For obstetrics, musculoskeletal injuries, and external causes of morbidity  encounter type, or extension, stages, LT/RT/bilateral/unspecified  OR:  A: initial  D: subsequent  S: Sequela (complications) Character 7 Advanced Billing Consultants, Inc. Copyright 2015
  6. 6.  Collapsed vertebra, not elsewhere classified is M48.50- M48.58, but it requires a 7th digit  A= initial encounter for fracture  B= subsequent encounter for fracture with routine healing  G= subsequent encounter for fracture with delayed healing  S= sequela of fracture  Correct diagnoses for the initial encounter for collapsed vertebra not elsewhere classified, site unspecified is: M48.50A Example Character 7 Advanced Billing Consultants, Inc. Copyright 2015
  7. 7.  Excludes1: the two codes cannot be billed together  Excludes2: both codes can be used Excludes Notes Advanced Billing Consultants, Inc. Copyright 2015
  8. 8.  Many ICD-10 require additional diagnosis codes Additional Codes Required Advanced Billing Consultants, Inc. Copyright 2015
  9. 9.  “in diseases classified elsewhere”= a manifestation code  Can never be listed first  May say: “use additional code” or “code first”  Again, can never be listed first  Code in brackets means it must be coded also, and second Etiology/Manifestation Codes Advanced Billing Consultants, Inc. Copyright 2015
  10. 10. 1. Certain Infectious and Parasitic Diseases (A00-B99) 2. Neoplasms (C00-D49) 3. Disease of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) 4. Endocrine, Nutritional, and Metabolic Diseases (E00-E89) 5. Mental, Behavioral, and Neurodevelopmental Disorders (F01-F99) 6. Chronic pain syndrome (G89) 7. Diseases of the Eye and Adnexa 8. Diseases of the Ear and Mastoid Process (H60-H95) **not yet used 9. Diseases of Circulatory System (100-199) 10. Diseases of Respiratory System (J00-J99) 11. Diseases of Digestive System (K00-K95) **not yet used Chapters Advanced Billing Consultants, Inc. Copyright 2015
  11. 11. 12. Diseases of the Skin and Subcutaneous Tissue (L00-L99) 13. Diseases of Musculoskeletal System and Connective Tissue (M00-M99) 14. Diseases of Genitourinary System (N00-N99) 15. Pregnancy, Childbirth (O00-O9A) 16. Certain Conditions Originating in the Prenatal Period (P00-P96) 17. Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99) 18. Symptoms, signs, and abnormal clinical and laboratory findings (R00-R99) 19. Injury, Poisoning, and Certain other Consequences of External Causes (S00-T88) 20. External Causes of Morbidity (V00-Y99) 21. Factors Influencing Health Status and Contact with Health Services (Z00- Z99) ***The new V-codes*** Chapters Cont’d Advanced Billing Consultants, Inc. Copyright 2015
  12. 12.  Use ICD-10 for DOS 10/1/2015 and forward.  Continue use of ICD-9 for DOS 9/30/15 and before (even for corrected claims) Date Transition Advanced Billing Consultants, Inc. Copyright 2015
  13. 13.  Many software systems provide crosswalks and conversions at the encounter or charge entry level. Ensure you have the most recent updates for your system.  Specialty specific cheat sheets can be purchased from many vendors  AAPC offers a free ICD-9 to ICD-10 conversion tool at: https://www.aapc.com/icd-10/codes/ Conversions and Crosswalks Advanced Billing Consultants, Inc. Copyright 2015
  14. 14.  We appreciate any feedback. Please contact us at info@abcbilling.net Thank You! Advanced Billing Consultants, Inc. Copyright 2015

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