Pediatrics Top 50 Diagnoses (In Order of Usage) 2014
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1 V20.2 Routine infant or child health check Z Encounter for routine child health exam w/abnormal findings ** Use additional code to identify abnormal findings Z Encounter for routine child health exam exam w/o abnormal findings V72.19 Other exam of ears and hearing Z01.10 Encounter for exam for ears and hearing w/o Z Encounter for hearing exam following failed hearing Z Encounter for exam of ears and hearing w/abnormal ** Use additional code to identify abnormal findings V72.0 Exam of eyes and vision Z01.00 Encounter for exam of eyes and vision w/o abnormal findings Z01.01 Encounter for exam of eyes and vision w/abnormal findings ** Use additional code to identify abnormal findings Extrinsic asthma unspecified J Unspecified asthma w/ (acute) exacerbation J Unspecified asthma w/status asthmaticus J Unspecified asthma uncomplicated Acute upper respiratory infection of J06.9 Acute upper respiratory infection unspecified unspecified site Otitis Media unspecified H66.90 Otitis media unspecified unspecified ear ** Use additional code for any associated perforated tympanic membrane (H72.-) ** Use additional code to identify: Z77.22 Exposure to environmental tobacco smoke P96.81 Exposure to tobacco smoke in the perinatal period Z History of tobacco use Z57.31 Occupational exposure to environmental tobacco smoke F17- Tobacco dependence Z72.0 Tobacco use H66.91 Unspecified otitis media right ear H66.92 Unspecified otitis media left ear H66.93 Unspecified otitis media bilateral H65.00 Acute serous otitis media unspecified ear H65.01 Acute serous otitis media right ear H65.02 Acute serous otitis media left ear H65.03 Acute serous otitis media bilateral H65.04 Acute serous otitis media recurrent right ear H65.05 Acute serous otitis media recurrent left ear H65.06 Acute serous otitis media recurrent bilateral H65.07 Acute serous otitis media recurrent unspecified ear H Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous) right ear Page 1 of 10
2 382.9 Otitis Media unspecified (cont.) H Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous) left ear H Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous) bilateral H Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous) recurrent right ear H Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous) recurrent left ear H Acute and subacute allergic otitis media (mucoid) H Acute and subacute allergic otitis media (mucoid) H Acute and subacute allergic otitis media (mucoid) H Other acute nonsuppurative otitis media right ear H Other acute nonsuppurative otitis media left ear H Other acute nonsuppurative otitis media bilateral H Other acute nonsuppurative otitis media recurrent H Other acute nonsuppurative otitis media recurrent H Other acute nonsuppurative otitis media recurrent H Other acute nonsuppurative otitis media recurrent H Other acute nonsupperative otitis media unspecified H65.20 Chronic serous otitis media unspecified ear H65.21 Chronic serous otitis media right ear H65.22 Chronic serous otitis media left ear H65.23 Chronic serous otitis media bilateral H65.30 Chronic mucoid otitis media unspecified ear H65.31 Chronic mucoid otitis media right ear H65.32 Chronic mucoid otitis media left ear H65.33 Chronic mucoid otitis media bilateral H Chronic allergic otitis media right ear H Chronic allergic otitis media left ear H Chronic allergic otitis media bilateral H Chronic allergic otitis media unspecified ear H Other chronic nonsuppurative otitis media right ear H Other chronic nonsuppurative otitis media left ear H Other chronic nonsuppurative otitis media bilateral H Other chronic nonsuppurative otitis media unspecified ear H65.90 Unspecified nonsuppurative otitis media unspecified ear H65.91 Unspecified nonsuppurative otitis media right ear H65.92 Unspecified nonsuppurative otitis media left ear H65.93 Unspecified nonsuppurative otitis media bilateral H Acute suppurative otitis media w/o spontaneous rupture of ear drum, right ear. H Acute suppurative otitis media w/o spontaneous rupture of ear drum, left ear. H Acute suppurative otitis media w/o spontaneous rupture of ear drum, bilateral H Acute suppurative otitis media w/o spontaneous rupture of ear drum, recurrent right ear. Page 2 of 10
3 382.9 Otitis Media unspecified (cont.) H Acute suppurative otitis media w/o spontaneous rupture of ear drum, recurrent left ear. H Acute suppurative otitis media w/o spontaneous rupture of ear drum, recurrent bilateral H Acute suppurative otitis media w/o spontaneous rupture of ear drum, recurrent unspecified ear H Acute suppurative otitis media w/o spontaneous rupture of ear drum, unspecified ear H Acute suppurative otitis media w/spontaneous rupture of ear drum, right ear. H Acute suppurative otitis media w/spontaneous rupture of ear drum, left ear. H Acute suppurative otitis media w/spontaneous rupture of ear drum, bilateral H Acute suppurative otitis media w/spontaneous rupture of ear drum, recurrent right ear. H Acute suppurative otitis media w/spontaneous rupture of ear drum, recurrent left ear. H Acute suppurative otitis media w/spontaneous rupture of ear drum, recurrent bilateral H Acute suppurative otitis media w/spontaneous rupture of ear drum, recurrent unspecified ear H Acute suppurative otitis media w/spontaneous rupture of ear drum, unspecified ear H66.10 Chronic tubotympanic suppurative otitis media H66.11 Chronic tubotympanic suppurative otitis media right H66.12 Chronic tubotympanic suppurative otitis media left H66.13 Chronic tubotympanic suppurative otitis media H66.20 Chronic atticoantral suppurative otitis media unspecified ear H66.21 Chronic atticoantral suppurative otitis media right ear H66.22 Chronic atticoantral suppurative otitis media left ear H66.23 Chronic atticoantral suppurative otitis media bilateral H66.3X1 Other chronic suppurative otitis media right ear H66.3X2 Other chronic suppurative otitis media left ear H66.3X3 Other chronic suppurative otitis media bilateral H66.3X9 Other chronic suppurative otitis media unspecified ear H66.40 Suppurative otitis media unspecified unspecified ear H66.41 Suppurative otitis media unspecified right ear H66.42 Suppurative otitis media unspecified left ear H66.43 Suppurative otitis media unspecified bilateral H66.91 Unspecified otitis media right ear H66.92 Unspecified otitis media left ear H66.93 Unspecified otitis media bilateral Cardiac murmurs undiagnosed R01.1 Cardiac murmur unspecified Page 3 of 10
4 462 Acute pharyngitis J02.8 Acute pharyngitis due to other specified organisms ** Use additional code (B95-B97) to identify infectious agent J02.0 Streptococcal pharyngitis J02.9 Acute pharyngitis unspecified Cystic fibrosis w/o mention of meconium ileus E84.9 Cystic fibrosis unspecified E84.0 Cystic fibrosis w/pulmonary manifestations ** Use additional code to identify any infectious organism present such as: Pseudomonas (B96.5) Acute lymphoid leukemia w/o mention of having achieved remission/failed remission E84.11 Meconium ileus in cystic fibrosis E84.19 Cystic fibrosis w/other intestinal manifestations E84.8 Cystic fibrosis w/other manifestations C91.90 Lymphoid leukemia unspecified not having achieved remission C91.00 Acute lymphoblastic leukemia not having achieved remission C91.10 Chronic lymphocytic leukemia of B-cell type not having achieved remission C91.30 Prolymphocytic leukemia of B-cell type not having achieved remission C91.40 Hairy cell leukemia not having achieved remission C91.50 Adult T-cell lymphoma/leukemia (HTLV-1 associated) not having achieved remission C91.60 Prolymphocytic leukemia of T-cell type not having achieved remission C91.A0 Mature B-cell leukemia Burkitt-type not having achieved remission C91.Z0 Other lymphoid leukemia not having achieved remission DM w/o mention of complications type 1 not E10.9 Type I diabetes mellitus w/o complications stated as uncontrolled Malignant neoplasm of adrenal gland C74.90 Malignant neoplasm of unspecified part of unspecified adrenal gland C74.00 Malignant neoplasm of cortex of unspecified adrenal gland C74.01 Malignant neoplasm of cortex of right adrenal gland C74.02 Malignant neoplasm of cortex of left adrenal gland C74.10 Malignant neoplasm of medulla of unspecified C74.11 Malignant neoplasm of medulla of right adrenal gland C74.12 Malignant neoplasm of medulla of left adrenal gland C74.91 Malignant neoplasm of unspecified part of right adrenal gland C74.92 Malignant neoplasm of unspecified part of left adrenal gland Page 4 of 10
5 V74.1 Special screening exam for pulmonary Z11.1 Encounter for screening for respiratory tuberculosis tuberculosis Cough R05 Cough V01.1 Contact w/ or exposure to tuberculosis Z20.1 Contact w/ and (suspected) exposure to tuberculosis Drug withdrawal syndrome in newborn P96.1 Neonatal withdrawal symptoms from maternal use of drugs of addiction P96.2 Withdrawal symptoms from therapeutic use of drugs in newborn DM w/o mention of complication type 1 E10.65 Type I diabetes mellitus w/hyperglycemia uncontrolled Esophageal reflux K21.9 Gastro-esophageal reflux w/o esophagitis K21.0 Gastro-esophageal reflux w/esophagitis Constipation unspecified K59.00 Constipation unspecified K59.01 Slow transit constipation K59.02 Outlet dysfunction constipation K59.09 Other constipation Asthma unspecified J Unspecified asthma uncomplicated * Use additional code to identify: Z77.22 Exposure to environmental tobacco smoke P96.81 Exposure to tobacco smoke in the perinatal period Z History of tobacco use Z57.31 Occupational exposure to environmental tobacco smoke F17 Tobacco dependence Z72.0 Tobacco use J45.20 Mild intermittent asthma uncomplicated J45.21 Mild intermittent asthma w/(acute) exacerbation J45.22 Mild intermittent asthma w/status asthmaticus J45.30 Mild persistant asthma uncomplicated J45.31 Mild persistant asthma w/(acute) exacerbation J45.32 Mild persistant asthma w/status asthmaticus J45.40 Moderate persistant asthma uncomplicated J45.41 Moderate persistant asthma w/(acute) exacerbation J45.42 Moderate persistant asthma w/status asthmaticus J45.50 Severe persistant asthma uncomplicated J45.51 Severe persistant asthma w/(acute) exacerbation J45.52 Severe persistant asthma w/status asthmaticus J Unspecified asthma w/(acute) exacerbation J Unspecified asthma w/status asthmaticus J Exercise induced bronchospasm J Cough variant asthma J Other asthma Ventricular septal defect Q21.0 Ventricular septal defect Ostium secundrum type atrial septal defect Q21.1 Atrial septal defect Page 5 of 10
6 034.0 Streptococcal sore throat J02.0 Streptococcal pharyngitis Abdominal pain unspecified site R10.9 Unspecified abdominal pain R10.0 Acute abdomen Abdominal pain unspecified site R10.9 Unspecified abdominal pain R10.11 Right upper quadrant pain R10.12 Left upper quadrant pain R10.13 Epigastric pain R10.2 Pelvic pain R10.30 Lower abdominal pain unspecified R10.31 Right lower quadrant pain R10.32 Left lower quadrant pain R10.33 Periumbilical pain R Right upper quadrant abdominal tenderness R Left upper quadrant abdominal tenderness R Right lower quadrant abdominal tenderness R Left lower quadrant abdominal tenderness R Periumbilical abdominal tenderness R Epigastric abdominal tenderness R Generalized abdominal tenderness R Abdominal tenderness, unspecified site R Right upper quadrant rebound abdominal tenderness R Left upper quadrant rebound abdominal tenderness R Right lower quadrant rebound abdominal tenderness R Left lower quadrant rebound abdominal tenderness R Periumbilical rebound abdominal tenderness R Epigastric rebound abdominal tenderness R Generalized rebound abdominal tenderness R Rebound abdominal tenderness unspecified site R10.84 Generalized abdominal pain Regional enteritis small intestine with large intestine K50.80 Crohn's disease of both small and large intestine w/o complication ** There are codes available to use that describe complications as well: K Crohn's disease of both small and large intestine w/rectal bleeding K Crohn's disease of both small and large intestine w/intestinal obstruction K Crohn's disease of both small and large intestine w/fistula K Crohn's disease of both small and large intestine w/abscess K Crohn's disease of both small and large intestine w/other complications K Crohn's disease of both small and large intestine w/unspecified complications * Use additional code to identify manifestations such as: psyoderma gangrenosum (L88) Unspecified viral infection B34.9 Viral infection unspecified Attention deficit disorder w/hyperactivity F90.0 Attention-defict hyperactivity disorder, predominantly inattentive type Page 6 of 10
7 Attention deficit disorder w/hyperactivity (cont.) F90.1 Attention-defict hyperactivity disorder, predominantly hyperactive type F90.2 Attention-defict hyperactivity disorder, combined type F90.8 Attention-defict hyperactivity disorder, other type F90.9 Attention-defict hyperactivity disorder, unspecified type * Note: codes w/in this category may be used regardless of the age of the patient. These disorders generally have onset w/in the childhood or adolescent years, but may continue throughout life or not be diagnosed until adulthood. V65.49 Other specified counseling Z71.89 Other specified counseling V70.0 Routine general medical exam at health care facility Z00.00 Encounter for general adult medical exam w/o abnormal findings Z00.01 Encounter for general adult medical exam w/abnormal findings ** Use additional code to identify abnormal findings Abdominal pain generalized R10.84 Generalized abdominal pain Cardiac dysrhythmias other specified I49.8 Other specified cardiac arrhythmias 486 Pneumonia organism unspecified J18.9 Pneumonia unspecified organism J18.8 Other pneumonia unspecified organism ** Code first associated influenza if applicable (J09.01-, J09.11-, J10.0-, J11.0-) Fever, unspecified R50.9 Fever unspecified R50.2 Drug induced fever R50.82 Postprocedural fever R50.83 Postvaccination fever R50.84 Febrile nonhemolytic transfusion reaction Chest pain unspecified R07.9 Chest pain, unspecified ** There are more specific code choices. R07.89 Other chest pain, anterior wall R07.2 Precordial pain R07.1 Chest pain on breathing R07.81 Pleurodynia Polyarticular juvenile rheumatoid arthritis M08.3 Juvenile rheumatoid polyarthritis (seronegative) chronic or unspecified M08.00 Unspecified juvenile rheumatoid arthritis of unspecified site ** Code also any associated underlying condition such as K50- Regional enteritis (Crohn's disease) K501 Ulcerative colitis Cardiac dysrhythmia unspecified I49.9 Cardiac arrhythmia unspecified Page 7 of 10
8 692.9 Contact dermatitis & other eczema of L25.9 Unspecified contact dermatitis unspecified nature unspecified cause ** Code first (T36-T65) to identify drug or substance Contact dermatitis & other eczema of unspecified cause L30.9 Dermatitis unspecified ** There are more specific code choices. L23.0 Allergic contact dermatitis due to metals L23.1 Allergic contact dermatitis due to adhesives L23.2 Allergic contact dermatitis due to cosmetics L23.3 Allergic contact dermatitis due to drugs in contact with skin L23.4 Allergic contact dermatitis due to dyes L23.5 Allergic contact dermatitis due to other chemical products L23.6 Allergic contact dermatitis due to food in contact with the skin L23.7 Allergic contact dermatitis due to plants, except food L23.81 Allergic contact dermatitis due to animal (cat) (dog) dander L23.89 Allergic contact dermatitis due to other agents L23.9 Allergic contact dermatitis due to unspecified cause L24.0 Irritant contact dermatitis due to detergents L24.1 Irritant contact dermatitis due to oils and greases L24.2 Irritant contact dermatitis due to solvents L24.3 Irritant contact dermatitis due to cosmetics L24.4 Irritant contact dermatitis due to drugs in contact with the skin L24.5 Irritant contact dermatitis due to other chemical products L24.6 Irritant contact dermatitis due to food in contact with skin L24.7 Irritant contact dermatitis due to plants, except food L24.81 Irritant contact dermatitis due to metals L24.89 Irritant contact dermatitis due to other agents L24.9 Irritant contact dermatitis unspecified cause L25.0 Unspecified contact dermatitis due to cosmetics L25.1 Unspecified contact dermatitis due to drugs in contact with skin L25.2 Unspecified contact dermatitis due to dyes L25.3 Unspecified contact dermatitis due to other chemical products L25.4 Unspecified contact dermatitis due to food in contact with skin L25.5 Unspecified contact dermatitis due to plants except food Page 8 of 10
9 692.9 Contact dermatitis & other eczema of L25.8 Unspecified contact dermatitis due to other agents unspecified cause (cont.) L27.0 Generalized skin eruption due to drugs and medicaments taken internally L27.1 Localized skin eruption due to drugs and medicaments taken internally L27.2 Dermatitis due to ingested food L27.8 Dermatitis due to other substances taken internally L27.9 Dermatitis due to unspecified substance taken internally ** Code first (T36-T65) to identify drug or substance Otalgia unspecified H92.09 Otalgia unspecified ear H92.01 Otalgia right ear H92.02 Otalgia left ear H92.03 Otalgia bilateral V04.81 Need for prophylactic vaccination and Z23 Encounter for immunization inoculation influenza ** Code first any routine childhood exam ** Note: Procedure codes are required to identify the types of immunizations given. In ICD-10-CM there is only one diagnostic code available for immunizations Short stature E34.3 Short stature due to endocrine disorder R62.52 Short stature (child) Acute lymphoid leukemia in remission C91.01 Acute lymphoblastic leukemia in remission Cystic fibrosis w/mecomium ileus E84.1 Cystic fibrosis w/pulmonary manifestations * Use additional code to identify any infectious organism present such as: Pseudomonas (B96.5) Acute sinusitis unspecified J01.90 Acute sinusitis unspecified * There are more specific code choices: J01.00 Acute maxillary sinusitis unspecified J01.01 Acute recurrent maxillary sinusitis J01.10 Acute frontal sinusitis unspecified J01.11 Acute recurrent frontal sinusitis J01.20 Acute ethmoidal sinusitis unspecified J01.21 Acute recurrent ethmoidal sinusitis J01.30 Acute sphenoidal sinusitis J01.31 Acute recurrent sphenoidal sinusitis J01.40 Acute pansinusitis unspecified J01.41 Acute recurrent pansinusitis J01.80 Other acute sinusitis J01.81 Other acute recurrent sinusitis unspecified J01.91 Acute recurrent sinusitis unspecified Syncope and collapse R55 Syncope and collapse Nonspecific reaction to tuberculin skin test w/o active tuberculosis R76.1 Abnormal reaction to tuberculin test Page 9 of 10
10 Diarrhea R19.7 Diarrhea unspecified K59.1 Functional * There are many combination codes in ICD-10-CM that include diarrhea as a manifestation Asthma unspecified w/acute exacerbation J Unspecified asthma w/(acute) exacerbation * There are other code choices available in ICD-10-CM J45.21 Mild intermittent asthma w/(acute) exacerbation Asthma unspecified w/acute exacerbation J45.31 Mild persistent asthma w/(acute) exacerbation J45.41 Moderate persistent asthma w/(acute) exacerbation J45.51 Severe persistent asthma w/(acute) exacerbation Multiple Vaccinations & Innocculations Z23 Encounter for immunization ** Code first any routine childhood exam ** Note: Procedure codes are required to identify the types of immunizations given. In ICD-10-CM there is only one diagnostic code available for immunizations. DISCLAIMER: This is a guide for a possible range of ICD-10 codes matched to an ICD-9 code. This list is not the complete list of all possible matching ICD-10 codes. Review of the documentation may lead to an even more specific ICD-10 code. Page 10 of 10
J02.0 Streptococcal pharyngitis Yes No No 0 0 J03.00 Acute streptococcal tonsillitis, unspecified Yes No No 0 0
034.0 Streptococcal sore throat J02.0 Streptococcal pharyngitis J03.00 Acute streptococcal tonsillitis, unspecified J03.01 Description Acute recurrent streptococcal tonsillitis Use additional code to identify:
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Fast Forward. ICD-9-CM Code ICD-10-CM Code(s) ICD-9-CM Code ICD-10-CM Code(s) 311 Depressive disorder, not elsewhere classified.
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