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- 1. ICD-10-CM Training 1Live Change Grow Network 2019 813-368-9990 Kimyatta Turner, MBA, RHIA LART Consulting Group, Inc.
- 2. Chapter 2 • Session 2: Overview of Content and Format Live Change Grow Network 2019 813-368-9990 2
- 3. Chapter 2 Overview of Content and Format Understand: • Format • Alphabetic Index and Tabular List • Level of specificity • Demonstrate knowledge of the ICD-10-CM content and format Live Change Grow Network 2019 813-368-9990 3
- 4. Chapter 2 Overview of Content and Format • Alphanumeric categories rather than numeric categories. • Rearranged chapters. • Title changes. • Regrouped conditions. • ICD-10 has almost twice as many categories as ICD-9. • Minor changes have been made in the coding rules for mortality. • Note: Category restructuring and code reorganization Live Change Grow Network 2019 813-368-9990 4
- 5. Chapter 2 Overview of Content and Format • Two parts: – Section 1—Index to Diseases and Nature of Injury. — Neoplasm Table. — Table of Drugs and Chemicals. – Section 2— Index to External Causes. Alphabetic Index Live Change Grow Network 2019 813-368-9990 5
- 6. Chapter 2 Overview of Content and Format Example: Aberrant (congenital) – see also Malposition, congenital - adrenal gland Q89.1 - artery (peripheral) Q27.8 -- basilar NEC Q28.1 -- cerebral Q28.3 - breast Q83.8 Alphabetic Index Live Change Grow Network 2019 813-368-9990 6
- 7. Chapter 2 Overview of Content and Format Coding Tip: These codes would be read: Q89.1, Congenital malformations of adrenal gland Q27.8, Other specified congenital malformations of peripheral vascular system Q28.1, Other malformations of precerebral vessels Q28.3, Other malformation of cerebral vessels Q83.8, Other congenital malformations of breast Alphabetic Index Live Change Grow Network 2019 813-368-9990 7
- 8. • Morphology codes • No longer in Alphabetic Index • Manifestation codes Chapter 2 Overview of Content and Format Alphabetic Index Live Change Grow Network 2019 813-368-9990 8
- 9. Chapter 2 Overview of Content and Format • 21 chapters • Subdivided: Blocks of three alphanumeric character categories Tabular List Live Change Grow Network 2019 813-368-9990 9
- 10. Example: Chapter 7: Diseases of the eye and adnexa (H00-H59) This chapter contains the following blocks: H00-H05: Disorders of eyelid, lacrimal system and orbit H10-H11: Disorders of conjunctiva H15-H22: Disorders of sclera, cornea, iris and ciliary body H25-H28: Disorder of lens Chapter 2 Overview of Content and Format Tabular List Live Change Grow Network 2019 813-368-9990 10
- 11. Example (continued): H30-H36: Disorders of choroid and retina H40-H42: Glaucoma H43-H44: Disorders of vitreous body and globe H46-H47: Disorders of optic nerve and visual pathways H49-H52: Disorders of ocular muscles, binocular movement, accommodation and refraction H53-H54: Visual disturbances and blindness H55-H57: Other disorders of eye and adnexa H59: Intraoperative and post procedural complications and disorders of eye and adnexa, not elsewhere classified Chapter 2 Overview of Content and Format Tabular List Live Change Grow Network 2019 813-368-9990 11
- 12. Example: “Exposure to supersonic waves” : W42.0 Initial encounter: W42.0XXA Chapter 2 Overview of Content and Format Tabular List Live Change Grow Network 2019 813-368-9990 12
- 13. Tabular List Activities: • Find code A54.22, Gonococcal prostatitis. Compare it to code 098.12 in ICD-9-CM. • Locate codes C41.9, Malignant neoplasm of bone and articular cartilage, unspecified and M90.60, Osteitis deformans in neoplastic disease, unspecified site. Compare codes to 170.9 and 731.1 in ICD-9-CM. Chapter 2 Overview of Content and Format Tabular List Live Change Grow Network 2019 813-368-9990 13
- 14. • ICD-10-CM, different order • Chapter 12: Diseases of the skin and subcutaneous tissue • Chapter 13: Diseases of the musculoskeletal system and connective tissue • Chapter 14: Diseases of the genitourinary system • Chapter 15: Pregnancy, childbirth and the puerperium • Chapter 16: Certain conditions originating in the perinatal period • Chapter 17: Congenital malformations, deformations and chromosomal abnormalities Chapter 2 Overview of Content and Format Tabular List Live Change Grow Network 2019 813-368-9990 14
- 15. References American Medical Association (2012). American Health Information Management Association (2015). 2015 ICD-10-CM Coder training manual. Chicago, IL: AHIMA Live Change Grow Network 2019 813-368-9990 15
Editor's Notes
- Hello and welcome to Session 2 of ICD-10 training by LART Consulting Group. I am Kimyatta Vinson, a Registered Health Information Administrator and I will be your presenter throughout this training. These trainings are broken down into sessions that are easy to digest along with action steps for you to take in order to begin to master ICD-10-CM.
- In this session, we will cover the overview of content and format of ICD-10-CM
- After going through this lesson, you should: Understand the format used in ICD-10-CM. Understand the Alphabetic Index and Tabular List. Understand the level of specificity. Demonstrate knowledge of the ICD-10-CM content and format.
- Some general changes to ICD10 include: alphanumeric categories rather than numeric categories. Some chapters have been rearranged. Some titles have changed. Conditions have been regrouped. ICD-10 has almost twice as many categories as ICD-9. Minor changes have been made in the coding rules for mortality. It is important to note that within a number of ICD10CM Chapters, category restructuring and code reorganization have occurred resulting in the classification of certain diseases and disorders different than what is currently seen in ICD9CM.
- The alphabetic index is divided into two parts – the index to diseases and injuries and the index to external causes. Similar to ICD9CM, within the index of diseases and injury there is a neoplasm table and a table of drugs and chemicals
- The alphabetic index in ICD10CM is formatted the same way as the index in ICD9CM. Main terms set in boldface are listed in alphabetical order. Then, indented beneath the main term, any applicable subterm or essential modifier will be shown in their own alphabetic list. The indented subterm is always read in combination with the main term. Nonessential modifiers appear in parentheses and do not affect the code number assigned. The dash at the end of an index entry indicates that additional characters are required
- (Read slide)
- Morphology codes are no longer listed in the alphabetic index alongside descriptors and standard ICD10CM codes. Additionally, morphology codes no longer have a separate appendix in ICD10CM as in ICD9CM. ICD10CM alphabetic index includes the suggestion of some manifestation codes in the same manner as ICD9CM, by including the code as a second code, show in brackets, directly after the underlying or etiology code (which should always be reported first)
- The ICD-10-CM Tabular List is divided into 21 chapters. These chapters are further subdivided into subchapters or blocks that contain three character categories and, similar to ICD9CM categories, form the foundation of the code. Each chapter in the Tabular List of ICD10CM begins with a summary of the blocks to provide an overview of the categories within the chapter. For some chapters, the body or organ system is the axis of the classification. Other chapters, such as Chapter 1: Certain infectious and parasitic diseases, group together conditions by etiology or nature of the disease process. ICD-9-CM has a single chapter for Diseases of the Nervous and Sense Organs whereas ICD-10-CM places these conditions into three separate chapters. ICD-10-CM also does not separate out the ICD-9-CM codes that explain the External Causes of Injury and Poisonings (E codes) and the Factors Influencing Health Status and Contact with Health Services (V codes) from the core classification.
- For example, chapter 7 diseases of the eye and adnexa (H00 through H59) contains the following blocks
- Most, but not all, categories are further subdivided into four or five character subcategories. If a category is not further subdivided it is considered to be a valid code, such as P90, Convulsions of newborn. The fourth character 8, when placed after a decimal point is used to indicate some other specified category, and the fourth character 9 placed after a decimal point is usually reserved for an unspecified condition. This represents another classification modification with the separation of Not Elsewhere Classified (NEC) and Not Otherwise Specified (NOS) codes. ICD9CM sometimes combines these two into a single code. In ICD10CM, the Other Specified and Unspecified have their own code. Five and six character codes provide even greater specificity or additional information about the condition being coded. Similar to ICD9CM, ICD10CM codes must be used to the highest number of characters available or the highest level of specificity. When a category has been subdivided into four, five, or six character codes, the code assigned must represent the highest level of specificity represented within ICD10CM.
- Certain categories have an additional seventh character. The seventh character must always be the seventh and final character of the code. When the code contains fewer than 7 characters, placeholder X must be used to fill in the empty character. For example, the code for Exposure to supersonic waves is a four character code that requires a seventh character to describe whether this is the initial or subsequent encounter or sequela. If this were the initial encounter, this code is written as W42.0XXA
- To become more familiar with the draft ICD10CM Tabular List of Diseases and Injuries, review the following entries in the ICD10CM code book.
- The order of the ICD-10-CM chapters is a bit different from ICD-9-CM. In ICD-10-CM, disorders of the immune mechanism are included with Diseases of the blood and blood forming organs. In contrast, the immunity disorders are found in the ICD9CM chapter for Endocrine, Nutritional and Metabolic Diseases. In addition, certain chapters are reordered. The ICD10CM codes for Diseases of the skin and subcutaneous tissue (chapter 12) and Diseases of the musculoskeletal system and connective tissue (Chapter 13) follow the chapter for Diseases of the digestive system. Next are the chapters for Diseases of the genitourinary system (chapter 14), Pregnancy, childbirth and the puerperium (chapter 15), Certain conditions originating in the perinatal period (chapter 16) and Congenital malformations, deformations and chromosomal abnormalities (Chapter 17)
- Thank you for tuning in to the Live Change Grow Network. I’m Kimyatta Vinson. For further information on how to book an onsite training session, email me at: livechangegrownetwork@gmail.com