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1. Pathway of ICD codes
ICD-10-CM CODING PATHWAY
Step 1: Review Documentation
•Read the provider’s note carefully.
•Identify the main diagnosis, symptoms, conditions, external causes, and other relevant details.
•Check for laterality, specificity, acuity, stage, episode of care, etc.
Step 2: Locate Main Term in Alphabetic Index
•Open the ICD-10 Alphabetic Index.
•Find the main condition (example: "Pneumonia").
•Look for subterms for specificity (e.g., organism, type, complication).

2. Pathway of ICD codes
ICD-10-CM CODING PATHWAY
Step 3: Verify in Tabular List
Confirm the code in the Tabular List.
Follow chapter-specific guidelines, instructional notes, excludes notes, “use additional code” notes, etc.
Assign the most specific code.
Step 4: Apply Coding Guidelines
Use conventions:
Excludes1 vs Excludes2
Code first/Use additional code
Combination codes
Apply General Guidelines (Section I of ICD-10-CM Official Guidelines).

3. C H A P TER 1 ( A 0 0– B 99 ) : C E RTAIN IN FEC TIO U S & PAR A S ITIC D IS EA S ES
I D E N T I F Y I N F E C T I O U S A G E N T ( B A C T E R I A , V I R U S , PA R A S I T E ) .
C O D E O R G A N I S M - S P E C I F I C I N F E C T I O N ( E . G . , B 2 0 H I V, A 1 5 T B ) .
I F S E P S I S → C O D E U N D E R LY I N G I N F E C T I O N F I R S T, T H E N S E V E R E S E P S I S ( R 6 5 . 2 - ) .
C H A P TER 2 ( C 0 0– D 4 9) : N EO PLA SM S
I D E N T I F Y S I T E + L AT E R A L I T Y + B E H AV I O R ( M A L I G N A N T, B E N I G N , I N S I T U ,
U N C E R TA I N ) .
C O D E P R I M A R Y S I T E F I R S T, T H E N S E C O N D A R Y / M E TA S TAT I C .
I F C H E M O T H E R A P Y, R A D I AT I O N , O R I M M U N O T H E R A P Y → U S E Z 5 1 . 0 – Z 5 1 . 1 2 F I R S T,
F O L L O W E D B Y C A N C E R D I A G N O S I S .
C H A P TER 3 ( D 5 0– D 8 9) : BL O O D & IM M U N E D I SO R D ER S
L O O K F O R T Y P E O F A N E M I A ( I R O N D E F I C I E N C Y, C H R O N I C D I S E A S E ,
C H E M O T H E R A P Y- R E L AT E D ) .
C E R TA I N A N E M I A S S E C O N D A R Y T O C H R O N I C D I S E A S E / C A N C E R → C O D E
U N D E R LY I N G F I R S T.
CHAPTER-WISE ICD-10-CM CODING FLOW

4. Chapter 4 (E00–E89): endocrine, nutritional & metabolic
•Diabetes:
•IDENTIFY TYPE (1, 2, OTHER) + COMPLICATION (RENAL,
OPHTHALMIC, NEUROPATHY, ETC.).
•Thyroid, obesity, malnutrition coded with cause + complication.
Chapter 5 (f01–f99): mental & behavioral disorders
Code by specific disorder (depression, schizophrenia, substance use).
Substance use codes: pick use/abuse/dependence and any associated
complications.
Chapter 6 (g00–g99): nervous system
•Stroke: code type + laterality + residual deficits (use I69.- For
sequelae).
•Epilepsy: specify type + controlled/uncontrolled.
CHAPTER-WISE ICD-10-CM CODING FLOW

5. C H A P TER 7 ( H 0 0 – H 5 9 / H 6 0 –H 9 5 ) : EY E & EA R D IS O R D E R S
C O D E BY LATER A L ITY ( R IG H T, LE FT, BILATER A L, U N SP EC IF IED ) .
C H R O N I C V S AC U TE, T Y PE O F G LA U C O M A , H EA R IN G L OS S , ETC .
C H A P TER 9 ( I0 0 – I9 9 ) : C IR C U LATORY S Y ST EM
M I: AC U TE V S O L D , IN ITIA L V S S U BS EQ U EN T.
H Y PE RT EN S IO N : S PE C IFY W ITH /W ITH O U T H E A RT/K ID N EY
IN VOLV EM EN T.
U S E C O M B IN ATIO N C O D ES W H E N P O SS IBLE .
C H A P TER 1 0 ( J 0 0 – J 99 ) : R E SP IR ATORY
PN E U M ON IA : O R G A N ISM SPE C IFI C IF AVA ILA B LE.
C O PD /A S TH M A : SP EC IF Y T Y P E, SE V ER I TY, W ITH /W ITH O U T
EX A C ER B ATIO N .
CHAPTER-WISE ICD-10-CM CODING FLOW

6. C H A P TER 11 ( K 0 0 – K 9 5 ) : D IG ES TIV E
U LC E R S : S P EC IFY S ITE, AC U TE/C H R O N IC , W IT H /WIT H O U T
H EM O R R H A G E/PE R FO R AT IO N .
LIV ER D I SEA SE : S PEC IFY C A U SE ( A LC O H O LIC , V IR A L, ETC . ) .
C H A P TER 1 2 ( L0 0 – L9 9 ) : S K IN
C ELL U LITIS : S ITE + LATER A LIT Y.
PR E SS U R E U L C ER S : SIT E + S TAG E .
C H A P TER 1 3 ( M 0 0 –M 9 9 ) : M U SC U LO S K ELETAL
A RTH R ITIS: R H EU M ATO ID , O S TEO A RT H R ITI S, G O U T – S PEC IFY S ITE +
LATER A L ITY.
FR A C TU R ES: ID EN TIF Y S ITE, L AT ER A L ITY, EPIS O D E O F C A R E ( IN ITIA L ,
SU BS EQ U EN T, S EQ U E LA ) .
C H A P TER 1 4 ( N 00 – N 9 9 ) : G EN I TOU R IN A RY
K ID N E Y FAIL U R E: AC U TE V S C H R O N IC V S A C U TE O N C H R O N IC .
PR E G N A N C Y C O M P LIC ATIO N S : U S E C H A PT ER 15 FIR S T IF PATIEN T IS
PR E G N A N T.
CHAPTER-WISE ICD-10-CM CODING FLOW

7. C H A P TER 1 5 ( O0 0 – O 9 A ) : P R EG N A N C Y, C H IL D BIRTH & P U ER P ER IU M
A LWAYS C O D E O - C O D ES F IR ST W H E N A PP LIC A B LE.
IN C L U D E W EEK S O F G ES TATIO N ( Z3 A .- ) .
FO L LO W S EQ U EN C IN G R U L ES ( U N D ER LY IN G C O N D IT IO N , O U TC O M E O F
D EL IV ERY, C O M P LIC ATIO N S ) .
C H A P TER 1 6 ( P0 0 –P 9 6) : N EWB O R N
C O D E BY BIRTH C O N D ITIO N ( PR EM AT U R ITY, BIRT H T R A U M A ,
R ES P IR ATO RY ISS U ES ) .
M ATE R N A L C O N D ITIO N S AFF EC T IN G N EWB O R N → P0 0 – P0 4 .
C H A P TER 1 7 ( Q0 0 – Q 9 9 ) : C O N G EN ITAL AN O M A LIE S
C O D E EX A C T C O N G EN ITAL AN O M A LY.
M U LT IPLE AN O M A L IES → C O D E EA C H .
C H A P TER 1 8 ( R 00 – R 9 9 ) : S Y M PTO M S & SI G N S
U S E W H E N N O D E FIN IT IV E D IA G N O SIS IS G IV EN .
D O N O T C O D E S Y M PTO M S IF T H EY AR E PART O F A C O N F IR M ED
D IA G N O SIS .
CHAPTER-WISE ICD-10-CM CODING FLOW

8. C H A P TER 1 9 ( S0 0 – T8 8) : IN J U RY, PO I SO N IN G
FR A C TU R ES , W O U N D S : SPE C IF Y S ITE + L ATE R A LIT Y + EN C O U N TE R
( IN I TIA L, S U BS EQ U E N T, SE Q U ELA ) .
PO IS O N IN G S: D R U G + IN TE N T ( A C C ID EN TAL, IN TEN TIO N A L , AD V E R S E
EF FEC T) .
C H A P TER 2 0 ( V 00 – Y 9 9 ) : EX TER N A L C A U S ES
U S E SEC O N D A RY C O D E S O N LY ( N E V ER FIR S T) .
PR OV ID E C A U S E O F IN J U RY ( FALL, AC C ID E N T, AS SA U LT ) .
C H A P TER 2 1 ( Z00 – Z9 9 ) : FAC TO R S IN FLU EN C I N G H EA LTH
S C R EEN IN G , AF TER C A R E, H IS TO RY O F C O N D ITIO N S , IM M U N IZATIO N S .
Z- C O D ES M AY B E F IR S T-LIS TE D IF R E A SO N F O R V IS IT IS N O T A
C U R R EN T IL LN ES S /IN J U RY.
CHAPTER-WISE ICD-10-CM CODING FLOW

9. ✅ FINAL STEP: SEQUENCE THE CODES CORRECTLY
PRINCIPAL DIAGNOSIS: MAIN REASON FOR ENCOUNTER.
SECONDARY CODES: ADDITIONAL CONDITIONS AFFECTING CARE.
FOLLOW OFFICIAL ICD-10-CM GUIDELINES FOR SEQUENCING.
CHAPTER-WISE ICD-10-CM CODING FLOW

10. THANK YOU
INSTAGRAM:--framefusionbc
TELEGRAM:-- -https://t.me/framefusionBCmedicalstudy
FACEBOOK:--https://www.facebook.com/profile.php?id=61571854200591&mibextid=ZbWKwL
Prepared by BHAVANA
B.PHARM