Transcript ICD-9 Coding

Intro to ICD-9 Coding
Review
Diagnostic Coding – (Coding I)
Organization of ICD-9 Volume 1
(17 Chapters Plus E & V Codes)
001-139
140-239
240-279
280-289
290-319
320-389
390-459
460-519
520-579
580-589
630-676
680-709
Infectious and Parasitic Diseases
Neoplasms
Endocrine, Nutritional and Metabolic Diseases
Diseases of the Blood and Blood-forming
Organs
Mental Disorders
Diseases of the Nervous System and Sense
Organs
Diseases of the Circulatory System
Diseases of the Respiratory System
Diseases of the Digestive System
Diseases of the Genitourinary System
Complications of Pregnancy, Childbirth, and
the Puerperium
Diseases of the Skin and Subcutaneous Tissue
Organization of ICD-9 Volume 1
(17 Chapters Plus E & V Codes)
710-739 Diseases of the Musculoskeletal System &
Connective Tissue
740-759 Congenital Anomalies
760-779 Certain Conditions Originating in the Perinatal
Period
780-799 Symptoms, Signs and Ill-defined Conditions
800-999 Injury and Poisoning
E800-E999 Supplementary Classification of the External
Causes of Injury and Poisoning
V01-V82
Supplementary Classification of factors
influencing Health Status and Contact with
Health Services
Anatomy of ICD-9 Code
ICD-9 Volume 2




Section 1 - Alphabetic Index to Diseases
Section 2 - Table of Drugs and Chemicals
Section 3 - Index to External Causes (ECodes)
Handy Tables


Hypertension
Neoplasms
Using ICD-9 Book

Identify Main Term in the Diagnostic
Statement
Locate Main Term in the Alphabetic Index
(Volume 2 [First])
 Verify Code Number in the Tabular List
(Numeric Index/Volume 1 [Second])
Diagnostic Statement – Chest Pain


786.5
Using ICD-9 Book

Turn to that ICD code in Volume 1
786.5
786.50
786.51
786.52
Chest pain
Chest pain, unspecified
Precordial pain
Painful respiration
Pain:
Pleurodynia
anterior chest wall
pleuritic
EXCLUDES
786.59
epidemic pleurodynia (074.1)
Other
Discomfort
Pressure
Tightness
in chest
Using ICD-9 Book





Look up diagnosis in Volume 2
Go to Code # in Volume 1
Pick specific location, type, severity,
complication, and/or manifestation
Find appropriate 4th and 5th digits
Diagnostic Statement - Bronchitis,
acute, probably viral
466.0
New Acute or Chronic Problem
that you can’t diagnose this visit

Code the symptom
Abdominal swelling or mass in epigastric
area
789.36
Elevated blood pressure
796.2
New Acute or Chronic Problem
that you can’t diagnose this visit

Code the symptom
Changes in skin texture
782.8
Abnormal chest sounds
786.7
Code The Diagnostic Statements
Unspecified localized salmonella infection
003.20
Acute pulmonary manifestations due to radiation
508.0
Three Classifications of V Codes
1.
Problem-oriented V Codes
– identify circumstances that could affect the patient in
the future but are neither a current illness or injury.
Personal history of exposure to radiation
2.
V15.3
Service-oriented V Code – identify/define exams, aftercare, ancillary services, or
therapy.
Follow-up examination following chemotherapy
3.
V67.2
Fact-oriented V Code – do not describe a problem or a service; they simply
state a fact.
Alcoholism within the family
V61.41
Check-up for Chronic Problem, Well
Child, Well Adult with No Complaints,
Sequelae, or Complications



Use a V Code and/or Code for
Chronic Problem
Look up Examination in Volume 2
Diagnostic Statement - Well Child
V20.2
General Physical
V70.0
Follow-up for Previous Acute
Condition, with no problems




Don’t Code for the acute condition
which no longer exists
Use a V Code
Look up “History of” or “Aftercare”
unless it was an accident
Diagnostic Statement - Follow-up for
pneumonia (fully healed)
V12.6
Follow-up to Previous Acute
Problem, there are complications


Look up “Late Effects” or the
specific condition(s)
Diagnostic Statement - Patient
develops infection in wound on
hand you sutured three days ago
906.1
Chronic Problems with Sequelae



Requires two codes:
Code the Chronic Problem first
Code the Complication second
Diagnostic Statements
Type 2 DM with neurological manifestations
250.60 & 357.2
Type 2 diabetic develops peripheral
neuropathy
Peripheral Neuropathy
250.6 & 337.1
Table of Drugs and Chemicals
Defining E Codes – Columns 2-5

Accident codes identify accidental overdose of a drug, wrong
substance given or taken, a drug taken inadvertently, accidents that
occur in the usage of drugs and biologicals in medical and surgical
procedures.

Therapeutic Use codes indicate an adverse effect or reaction to
a drug that was administered correctly, either therapeutically or
prophylactically.

Suicide Attempt codes identify the effects of drugs or substance
taken to cause self-inflicted injury or to attempt suicide.

Assault codes in indicate situations where drugs or substance are
“purposely inflicted” by another person with the intent to cause
bodily harm, injure, or kill.

Undetermined codes apply when the intent of the poisoning or
injury cannot be determined as intentional accidental.
Accidents, Suicides, Poisonings
. . . External Causes


Use E codes and/or Injury and
Poisoning
Look up injury in Index,
circumstances in E-Codes
Diagnostic Statements - Elderly patient fell,
sprained internal collateral ligament in
ankle while stepping from curb:
Sprains and strains of ankle and foot 845.01
Fall on or from sidewalk curb E880.1
Drug Side-Effects


Use Section 2 of Volume 2
Will require 3 codes:
1.
2.
3.
the side effect,
the code for poisoning for the drug and
the E-code for the therapeutic use of
the drug.
Diagnostic Statements - Patient develops hives
after taking penicillin
Allergic urticaria 708.0
Penicillin poisoning 960.0
Therapeutic penicillin E930.0
Quiz
Look-up “Late Effects” under:
“Late Effects” or specific condition.
Look-up “E Codes” in:
Section 3
Look-up “V Codes” in:
History of or :Aftercare, unless an accident
References and Resources








eMD
Medical Abbreviation
Encoder Pro and Codeit-Fast
ICD-9-CM online
ICD Decoder
AHIMA
Medi lexion
Medical Coding Tips







Medical Conditions &
Diseases
RXList
Medicine Net
Merck Manual
American Association of
Medical Biller
Tabers Online
RN Student