This document discusses changes in organization and classification between ICD-9-CM and ICD-10-CM for chapters 15-21. Key points include: - Chapters 15-21 cover pregnancy, perinatal conditions, congenital anomalies, symptoms/abnormal findings, injuries, external causes of injury, and factors influencing health. - Classification changes include more specific codes, terminology updates, and organizational revisions like grouping related codes. - Examples show code title changes and consolidations to improve specificity in ICD-10-CM. - Activities compare ICD-9-CM and ICD-10-CM codes to illustrate classification differences between the systems.

1. ICD-10-CM Training
Kimyatta Turner, MBA, RHIA
LART Consulting Group, Inc.
1LART Consulting Group, Inc. 2015

2. Chapter 6
Session 6: Organization and
Classification of Diseases and Disorders
ICD-10-CM Chapters 15 - 21
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3. • Chapter15:Pregnancy,childbirthandthepuerperium
(O00-O9A)
• Classificationchanges
– ICD-10-CMidentifiestrimester
• Fifth-andsixth-characterlevel
– Nolongerepisodeofcare
Chapter 6
Organization and Classification of
Diseases and Disorders
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4. • Code title changes
– ICD-9-CM
• Inlet contraction of pelvis, 653.2
– ICD-10-CM
• Material care for disproportion due to inlet contractions of
pelvis, O33.2
Chapter 6
Organization and Classification of
Diseases and Disorders
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5. • Other examples of title changes:
ICD-9-CM 654, Abnormality of organs and soft tissues of pelvis
ICD-10-CM O34, Maternal care for abnormality of pelvic organs
ICD-9-CM 664, Trauma to perineum and vulva during delivery
ICD-10-CM O70, Perineal laceration during delivery
Chapter 6
Organization and Classification of
Diseases and Disorders
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6. • Elective abortion
– Legal or therapeutic
• ICD-9-CM, abortion codes
– Elective abortion (without complication)
• ICD-10-CM, Chapter 21
– Z33.2, Encounter for elective abortion of pregnancy
– Complications of induced termination of pregnancy
• Category O04
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Chapter 6
Organization and Classification of
Diseases and Disorders

7. • Example:
O32 Maternal care for malpresentation of fetus
One of the following seventh characters is to be assigned to each
code under category O32.
0 not applicable or unspecified
1 fetus 1
2 fetus 2
3 fetus 3
4 fetus 4
5 fetus 5
6 other fetus
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Chapter 6
Organization and Classification of
Diseases and Disorders

8. • Obstructed labor codes
– ICD-9-CM
• 2 codes
– Obstructed labor due to face presentation
– 660.0X, Obstruction caused by malposition of fetus at onset of labor
– 652.4X, Face or brow presentation
– ICD-10-CM
• 1 code
– O64.2XX-, Obstructed labor due to face presentation
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Chapter 6
Organization and Classification of
Diseases and Disorders

9. Activity–Chapter15OrganizationandClassification
ICD-10-CM ICD-9-CM
O12.1 646.2
O15 642.6
O80 650
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Chapter 6
Organization and Classification of
Diseases and Disorders

10. • Chapter16:Certainconditionsoriginatingintheperinatal
period(P00-P96)
• Newsubchapters
• Respiratoryandcardiovascular disorders
– Groupedtogether,blockP19-P29
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Chapter 6
Organization and Classification of
Diseases and Disorders

11. • Terminology changes
– P00-P04, Newborns affected by maternal factors and by
complications of pregnancy, labor, and delivery
• “Suspected to be”
• Nonessential modifier
• Examples:
P00.3, Newborn (suspected to be) affected by other maternal
circulatory and respiratory diseases
P00.4, Newborn (suspected to be) affected by maternal nutritional
disorders
P00.5, Newborn (suspected to be) affected by maternal injury
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Chapter 6
Organization and Classification of
Diseases and Disorders

12. • Classification revisions
– P05, Disorders of newborn related to slow growth and
fetal malnutrition
• Subclassification for 2500 g
– No longer an option
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Chapter 6
Organization and Classification of
Diseases and Disorders

13. Activity – Chapter 16 Organization and Classification
ICD-10-CM ICD-9-CM
P07.2 765.2
P36 771.81
P76.0 777.1
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Organization and Classification of
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14. • Chapter17: Congenitalmalformations,deformations
andchromosomalabnormalities(Q00-Q99)
• Improvedarrangement
• Up-to-dateterminology
– Example
• Q61 Cystickidneydisease
• Q61.0,Congenitalrenalcyst
• Q61.1,Polycystickidney,infantiletype
• Q61.2,Polycystickidney,adulttype
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Chapter 6
Organization and Classification of
Diseases and Disorders

15. • Classification changes
–Examples:
Q35.1, Cleft hard palate
Q35.3, Cleft soft palate
Q35.5, Cleft hard palate with cleft soft palate
Q35.7, Cleft uvula
Q35.9, Cleft palate, unspecified
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Chapter 6
Organization and Classification of
Diseases and Disorders

16. Activity–Chapter17OrganizationandClassification
ICD-10-CM ICD-9-CM
Q53/Q55.22 752.5
Q65-Q79 754
Q90/Q91 758
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Organization and Classification of
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17. • Chapter18:Symptoms,signsandabnormalclinicaland
laboratoryfindings,notelsewhereclassified(R00-R99)
• Organizationalchanges
– Generalsymptomsandsigns
• Relatedspecificallytoabodysystem
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Organization and Classification of
Diseases and Disorders

18. Examples:
ICD-9-CM (Chapter 7) 427.89, Other specified cardiac dysrhythmias
ICD-10-CM (Chapter 18) R00.1, Bradycardia, unspecified
ICD-9-CM (Chapter 8) 511.0, Pleurisy without mention of effusion or
current tuberculosis
ICD-10-CM (Chapter 18) R09.1, Pleurisy
ICD-9-CM (Chapter 9) 527.7, Disturbance of salivary secretion
ICD-10-CM (Chapter 18) R68.2, Dry mouth, unspecified
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Chapter 6
Organization and Classification of
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19. • Classification change
– Hematuria
• Coded in Chapter 18
–Unless included with underlying condition
»Code in Chapter 14
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Chapter 6
Organization and Classification of
Diseases and Disorders

20. Activity – Chapter 18 Organization and Classification
ICD-10-CM ICD-9-CM
R10 789.0
R41.81 797
R90-R94 793/794
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Organization and Classification of
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21. • Chapter19:Injury,poisoningandcertainother
consequencesofexternalcauses(S00-T88)
• ICD-9-CM
– Typeofinjury,firstaxisofclassification
• ICD-10-CM
– Bodyregioninjured
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Chapter 6
Organization and Classification of
Diseases and Disorders

22. • Conditions that follow site:
– Superficial injury
– Open wound
– Fracture
– Dislocation and sprain
– Injury of nerves
– Injury of blood vessels
– Injury of muscle and tendon
– Crushing injury
– Traumatic amputation
– Other and unspecified injuries
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Chapter 6
Organization and Classification of
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23. • Title changes
• ICD-10-CM descriptors:
– Displaced
– Nondisplaced
– Not used in ICD-9-CM
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Chapter 6
Organization and Classification of
Diseases and Disorders

24. • Blocks T20-T32
– Classify burns and corrosions
• Corrosion new in ICD-10-CM
• Burn codes
– Thermal burns, except sunburns
• Electricity and radiation
• Corrosion
– Chemical burns
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Organization and Classification of
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25. • Classification change
– T36-T50, Poisonings by and adverse effect of drugs,
medicaments, and biological substances
– New term
• Underdosing
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Organization and Classification of
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26. • Example:
T46.1 Poisoningby,adverseeffectof,andunderdosingof
calcium-channelblockers
T46.1X1,Poisoningbycalcium-channelblocker,accidental(unintentional)
T46.1X2,Poisoningbycalcium-channelblocker,intentionalselfharm
T46.1X3,Poisoningbycalcium-channelblocker,assault
T46.1X4,Poisoningbycalcium-channelblocker,undetermined
T46.1X5,Adverseeffectofcalcium-channelblocker
T46.1X6,Underdosingofcalcium-channelblocker
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Organization and Classification of
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27. Activity–Chapter19OrganizationandClassification
ICD-10-CM ICD-9-CM
S12.0 805.01
S41 880
S43.50 840.0
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28. • Chapter20:Externalcausesofmorbidity(V00-Y99)
• ICD-10-CM
– Externalcauses
• Nosupplementalclassification
– ICD-9-CM
• Ecodesdisseminated
– ICD-10-CMChapters19and20
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Organization and Classification of
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29. • Terminology changes
– Example:
– ICD-10-CM
• V45, Car occupant injured in collision with railway or railway
vehicle
– ICD-9-CM
• E810, Motor vehicle traffic accident involving collision with
train
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Organization and Classification of
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30. Example:
ICD-9-CM E884.0, Fall from playground equipment
ICD-10-CM W09, Fall on and from playground equipment
W09.0, Fall on or from playground slide
W09.1, Fall from playground swing
W09.2, Fall on or from jungle gym
W09.8, Fall on or from other playground
equipment
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Organization and Classification of
Diseases and Disorders

31. Activity–Chapter20OrganizationandClassification
ICD-10-CM ICD-9-CM
W00-W19 E880-E888
W54-W64 E905-E906
Y38 E979
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32. • Chapter21:Factorsinfluencinghealthstatusandcontact
withhealthservices(Z00-Z99)
• Rephrasedtitles
– Z08,Encounterfor follow up examination after completed
treatment for malignant neoplasm
• Comparedto:
– V67.2,Follow up examination following chemotherapy
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Organization and Classification of
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33. • Decreased specificity
– ICD-10-CM
• Z23, Encounter for immunization
– ICD-9-CM
• V03, V04, V05, and V06
– Identify types of immunizations
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Organization and Classification of
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34. Activity–Chapter21OrganizationandClassification
ICD-10-CM ICD-9-CM
Z33.2 635
Z91.010 V15.01
Z96 V43
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35. Final Thoughts
For more information on ICD-10 and/or Health
Information Management, contact Kim Turner,
MBA, RHIA at 786-494-5896
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36. References
American Medical Association (2012).
American Health Information Management Association (2015).
2015 ICD-10-CM Coder training manual. Chicago, IL: AHIMA.
36LART Consulting Group, Inc. 2015