Prescription Drug Monitoring and Toxicology ICD-10-CM. resource guide. Provided as a service of Quest Diagnostics. 1 ICD-10-CM Resource Guide

Transcription

1 Prescription Drug Monitoring and Toxicology ICD-10-CM resource guide Provided as a service of Quest Diagnostics 1 ICD-10-CM Resource Guide

2 Table of contents About ICD-10 3 Pain Management: Top Mappings 4 Addiction Medicine: Top Mappings 10 2 ICD-10-CM Resource Guide

3 About ICD-10 ICD-10-CM/PCS (International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding System) consists of two parts: 1. ICD-10-CM for diagnosis coding 2. ICD-10-PCS for inpatient procedure coding ICD-10-CM is for use in all U.S. healthcare settings. Diagnosis coding under ICD-10-CM uses 3 to 7 digits instead of the 3 to 5 digits used with ICD-9-CM, but the format of the code sets is similar. ICD-10-PCS is for use in U.S. inpatient hospital settings only. ICD-10-PCS uses 7 alphanumeric digits instead of the 3 or 4 numeric digits used under ICD-9-CM procedure coding. Coding under ICD-10-PCS is much more specific and substantially different from ICD-9-CM procedure coding. IMPORTANT NOTE Your facility must provide ICD-10 codes to Quest Diagnostics with each specimen. Due to the high specificity of ICD-10, Quest Diagnostics will be unable to translate ICD-9 codes to ICD-10 codes. ICD-10-CM Resource Guide 3

4 Pain management top mappings Other anxiety s F41.9 Anxiety Opioid related s F11.20 Opioid dependence F Opioid dependence w/ intoxication F Opioid dependence w/ intoxication delirium F Opioid dependence w/ intoxication w/ perceptual disturbance F Opioid dependence w/ intoxication F11.23 Opioid dependence w/ withdrawal F11.24 Opioid dependence w/ opioid-induced mood F Opioid dependence w/ induced psychotic w/ delusions F Opioid dependence w/ induced psychotic w/ hallucinations F Opioid dependence w/ opioid-induced psychotic F Opioid dependence w/ opioid-induced sexual dysfunction F Opioid dependence w/ opioid-induced sleep F Opioid dependence w/ other opioid-induced F11.29 Opioid dependence w/ opioid-induced Other psychoactive substance related s F19.20 Other psychoactive substance dependence Pain G89.28 Other chronic post procedural pain G89.4 Chronic pain syndrome Other joint s M Pain in right shoulder M Pain in left shoulder M Pain in shoulder M Pain in right knee M Pain in left knee M Pain in knee 4 ICD-10-CM Resource Guide

5 Spondylosis M47.21 Other spondylosis radiculopathy OA-AX M47.22 Other spondylosis w/ radiculopathy cervical region M47.23 Other spondylosis w/ radiculopathy cervicothoracic M47.26 Other spondylosis w/ radiculopathy lumbar region M47.27 Other spondylosis w/ radiculopathy lumbosacral region M47.28 Other spondylosis radiculopathy sacral & sacrococcygeal M Spondylosis w/o myelopathy/ radiculopathy OA-AX region M Spondylosis w/o myelopathy/ radiculopathy cervical region M Spondylosis w/o myelopathy/ radiculopathy cervicothoracic region M Spondylosis w/o myelopathy/ radiculopathy lumbar region M Spondylosis w/o myelopathy/ radiculopathy lumbosacral region M Spondylosis w/o myelopathy/ radiculopathy sacral & sacrococcygeal region M Other spondylosis OA-AX region M Other spondylosis cervical region M Other spondylosis cervicothoracic region M Other spondylosis lumbar region M Other spondylosis lumbosacral region M Other spondylosis sacral & sacrococcygeal region Thoracic, thoracolumbar, and lumbosacral intervertebral disc s M51.14 Intervertebral disc w/ radiculopathy thoracic M51.15 Iv disc w/ radiculopathy thoracolumbar region M51.16 Intervertebral disc w/ radiculopathy lumbar region M51.17 Iv disc w/ radiculopathy lumbosacral region ICD-10-CM Resource Guide 5

6 Pain Management Top Mappings M51.26 Other intervertebral disc displacement lumbar region M51.27 Other intervertebral disc displacement lumbosacral region M51.36 Other intervertebral disc degeneration lumbar region M51.37 Other intervertebral disc degeneration lumbosacral region Cervical disc s M50.10 Cervical disc w/ radiculopathy cervical region M50.11 Cervical disc w/ radiculopathy OA-AX region M Mid-cervical disc, M Cervical disc at C4-C5 level with radiculopathy M Cervical disc at C5-C6 level with radiculopathy M Cervical disc at C6-C7 level with radiculopathy M50.13 Cervical disc radiculopathy cervicothoracic region M50.30 Other cervical disc degeneration cervical region M50.31 Other cervical disc degeneration OA-AX region M Other cervical disc degeneration, mid-cervical region, level M Other cervical disc degeneration at C4-C5 level M Other cervical disc degeneration at C5-C6 level M Other cervical disc degeneration at C6-C7 level M50.33 Other cervical disc degeneration cervicothoracic region Intraoperative and postprocedural complications and s of musculoskeletal system M96.1 Postlaminectomy syndrome NEC Dorsalgia M54.11 Radiculopathy OA-AX region M54.12 Radiculopathy cervical region M54.13 Radiculopathy cervicothoracic region M54.14 Radiculopathy thoracic region 6 ICD-10-CM Resource Guide

7 M54.15 Radiculopathy thoracolumbar region M54.16 Radiculopathy lumbar region M54.17 Radiculopathy lumbosacral region M54.2 Cervicalgia M54.5 Low back pain M54.89 Other dorsalgia M54.9 Dorsalgia Myositis M60.80 Other myositis site M Other myositis right shoulder M Other myositis left shoulder M Other myositis shoulder M Other myositis right upper arm M Other myositis left upper arm M Other myositis upper arm M Other myositis right forearm M Other myositis left forearm M Other myositis forearm M Other myositis right hand M Other myositis left hand M Other myositis hand M Other myositis right thigh M Other myositis left thigh M Other myositis thigh M Other myositis right lower leg M Other myositis left lower leg M Other myositis lower leg M Other myositis right ankle and foot M Other myositis left ankle and foot M Other myositis ankle and foot M60.88 Other myositis other site M60.89 Other myositis multiple sites M60.9 Other myositis Other and soft tissue s M79.1 Myalgia ICD-10-CM Resource Guide 7

8 Pain Management Top Mappings M Pain in right arm M Pain in left arm M Pain in arm M Pain in right leg M Pain in left leg M Pain in leg M Pain in limb M Pain in right upper arm M Pain in left upper arm M Pain in upper arm M Pain in right forearm M Pain in left forearm M Pain in forearm M Pain in right hand M Pain in left hand M Pain in hand M Pain in right finger(s) M Pain in left finger(s) M Pain in finger(s) M Pain in right thigh M Pain in left thigh M Pain in thigh M Pain in right lower leg M Pain in left lower leg M Pain in lower leg M Pain in right foot M Pain in left foot M Pain in foot M Pain in right toe(s) M Pain in left toe(s) M Pain in toe(s) M79.7 Fibromyalgia Other headache syndromes G44.1 Vascular headache, not elsewhere classified Headache R51 Headache 8 ICD-10-CM Resource Guide

9 Dislocation and sprain of joints and ligaments of lumbar spine and pelvis S33.5Xxa Sprain ligaments lumbar spine initial encounter Long term (current) drug therapy Z79.3 Long-term current use of hormonal contraceptives Z Long-term current use of opiate analgesic Z Other long-term current drug therapy Encounter for other aftercare Z51.81 Encounter for therapeutic drug level monitoring Alcohol related s F10.10 Alcohol abuse ICD-10-CM Resource Guide 9

10 Addiction Medicine Top Mappings Addiction Medicine Top Mappings F Alcohol abuse w/ intoxication F10.19 Alcohol abuse w/ alcohol-induced F10.20 Alcohol dependence F10.21 Alcohol dependence in remission F Alcohol dependence w/ intoxication F Alcohol dependence w/ intoxication F10.29 Alcohol dependence w/ alcohol-induced Opioid related s F11.10 Opioid abuse F Opioid abuse w/ intoxication F Opioid abuse w/ intoxication F11.19 Opioid abuse w/ opioid-induced F11.20 Opioid dependence F11.21 Opioid dependence in remission F Opioid dependence w/ intoxication delirium F Opioid dependence w/ intoxication w/ perceptual disturbance F Opioid dependence w/ intoxication F11.23 Opioid dependence w/ withdrawal F11.24 Opioid dependence w/ opioid-induced mood F Opioid dependence w/ induced psychotic w/delusions F Opioid dependence w/ induced psychotic w/ hallucinations F Opioid dependence w/ opioid-induced psychotic F Opioid dependence w/ opioid-induced sexual dysfunction 10 ICD-10-CM Resource Guide

11 F Opioid dependence w/ opioid-induced sleep F Opioid dependence w/ other opioid-induced F11.29 Opioid dependence w/ opioid-induced F11.90 Opioid use F11.99 Opioid use w/ opioid-induced Cannabis related s F12.10 Cannabis abuse F12.19 Cannabis abuse w/ cannabis-induced F12.20 Cannabis dependence F Cannabis dependence w/ intoxication F Cannabis dependence w/ intoxication delirium F Cannabis dependence w/ intoxication w/ perceptual distance F Cannabis dependence w/ intoxication F Cannabis dependence w/ psychotic w/ delusions F Cannabis dependence w/ psychotic w/ hallucinations F Cannabis dependence w/ psychotic F Cannabis dependence w/ cannabis-induced anxiety F Cannabis dependence w/ other cannabis-induced F12.29 Cannabis dependence w/ cannabis-induced F12.99 Cannabis use w/ cannabis-induced Sedative, hypnotic, or anxiolytic related s F13.10 Sedative hypnotic or anxiolytic abuse F Sedative/hypnotic/anxiolytic abuse w/ intoxication F13.19 Sedative hypnotic/anxiolytic abuse w/ induced ICD-10-CM Resource Guide 11

12 Addiction Medicine Top Mappings F13.20 Sedative hypnotic/anxiolytic dependence F Sedative hypnotic/anxiolytic dependence w/ intoxication F Sedative hypnotic/anxiolytic dependence w/ intoxication delirium F Sedative hypnotic/anxiolytic dependence w/ intoxication F Sedative hypnotic/anxiolytic dependence w/ withdrawal F Sedative hypnotic/anxiolytic dependence w/ withdrawal delirium F Sedative hypnotic/anxiolytic dependence w/ withdrawal w/ perceptual disturbance F Sedative hypnotic/anxiolytic dependence w/ withdrawal F13.24 Sedative hypnotic/anxiolytic dependence w/ induced mood F Sedative hypnotic/anxiolytic dependence induced psychotic delusions F Sedative hypnotic/anxiolytic dependence induced psychotic hallucinations F Sedative hypnotic/anxiolytic dependence induced psychotic F13.26 Sedative hypnotic/anxiolytic dependence induced persisting amnestic F13.27 Sedative hypnotic/anxiolytic dependence induced persisting dementia F Sedative hypnotic/anxiolytic dependence induced anxiety F Sedative hypnotic/anxiolytic dependence w/ induced sexual dysfunction F Sedative hypnotic/anxiolytic dependence w/ induced sleep F Sedative hypnotic/anxiolytic dependence w/ other induced 12 ICD-10-CM Resource Guide

13 F13.29 Sedative hypnotic/anxiolytic dependence w/ induced F13.90 Sedative hypnotic or anxiolytic abuse F13.90 Sedative hypnotic/anxiolytic use F13.99 Sedative hypnotic/anxiolytic use w/ induced Cocaine related s F14.10 Cocaine abuse F Cocaine abuse w/ intoxication F14.19 Cocaine abuse w/ cocaine-induced F14.20 Cocaine dependence F Cocaine dependence w/ intoxication F Cocaine dependence w/ intoxication delirium F Cocaine dependence w/ intoxication w/ perceptual disturbance F Cocaine dependence w/ intoxication F14.23 Cocaine dependence w/ withdrawal F14.24 Cocaine dependence w/ cocaine-induced mood F Cocaine dependence w/ induced psychotic w/ delusions F Cocaine dependence w/ induced psychotic w/ hallucinations F Cocaine dependence w/ cocaine-induced psychotic F Cocaine dependence w/ cocaine-induced anxiety F Cocaine dependence w/ cocaine-induced sexual dysfunction F Cocaine dependence w/ cocaine-induced sleep F Cocaine dependence w/ other cocaineinduced F14.29 Cocaine dependence w/ cocaine-induced ICD-10-CM Resource Guide 13

14 Addiction Medicine Top Mappings F14.90 Cocaine use F14.99 Cocaine use w/ cocaine-induced Other stimulant related s F15.10 Other stimulant abuse F Other stimulant abuse w/ intoxication F15.19 Other stimulant abuse w/ induced F15.20 Other stimulant dependence F Other stimulant dependence w/ intoxication F Other stimulant dependence w/ intoxication delirium F Other stimulant dependence intoxication w/ perceptual disturbance F Other stimulant dependence w/ intoxication F15.23 Other stimulant dependence w/ withdrawal F15.24 Other stimulant dependence w/ induced mood F Other stimulant dependence w/ induced psychotic w/ delusions F Other stimulant dependence induced psychotic w/ hallucinations F Other stimulant dependence w/ induced psychotic F Other stimulant dependence w/ induced anxiety F Other stimulant dependence w/ induced sexual dysfunction F Other stimulant dependence w/ induced sleep F Other stimulant dependence w/ other induced F15.29 Other stimulant dependence w/ induced F15.90 Other stimulant use F15.99 Other stimulant use w/ induced 14 ICD-10-CM Resource Guide

15 Hallucinogen related s F16.19 Hallucinogen abuse w/ induced F16.20 Hallucinogen dependence F Hallucinogen dependence w/ intoxication F Hallucinogen dependence w/ intoxication w/ delirium F Hallucinogen dependence w/ intoxication F16.24 Hallucinogen dependence w/ hallucinogen-induced mood F Hallucinogen dependence w/ psychotic w/ delusions F Hallucinogen dependence w/ psychotic w/ hallucinations F Hallucinogen dependence w/ psychotic F Hallucinogen dependence w/ anxiety F Hallucinogen dependence w/ hallucinogen persisting perception F Hallucinogen dependence w/ other hallucinogen-induced F16.29 Hallucinogen dependence w/ hallucinogen-induced F16.90 Hallucinogen use F16.99 Hallucinogen use w/ induced Nicotine dependence F Nicotine dependence F Nicotine dependence in remission F Nicotine dependence w/ nicotine-induced F Nicotine dependence cigarettes F Nicotine dependence cigarettes in remission F Nicotine dependence cigarettes w/ nicotine-induced ICD-10-CM Resource Guide 15

16 Addiction Medicine Top Mappings F Nicotine dependence chewing tobacco F Nicotine dependence chewing tobacco in remission F Nicotine dependence chew tobacco w/ nicotene-induced F Nicotine dependence other tobacco product F Nicotine dependence other tobacco product in remission F Nicotine dependence other tobacco product w/ induced Inhalant related s F18.10 Inhalant abuse F18.19 Inhalant abuse w/ inhalant-induced F18.21 Inhalant dependence in remission F18.29 Inhalant dependence w/ inhalant-induced F18.99 Inhalant use w/ inhalant-induced Other psychoactive substance related s F19.19 Other psychoactive substance abuse w/ induced F19.20 Other psychoactive substance dependence F19.21 Other psychoactive substance dependence in remission F19.29 Other psychoactive substance dependence w/ induced F19.90 Other psychoactive substance use F19.99 Other psychoactive substance use w/ induced Schizophrenia F20.0 Paranoid schizophrenia Schizoaffective s F25.0 Schizoaffective bipolar type F25.1 Schizoaffective depressive type F25.8 Other schizoaffective s F25.9 Schizoaffective 16 ICD-10-CM Resource Guide

17 Major depressive, recurrent F33.1 Major depressive recurrent moderate F33.2 Major depressive recurrent severe w/o pyschotic Bipolar F31.9 Bipolar Unspecified mood [affective] F39 Unspecified mood affective Other anxiety s F41.1 Generalized anxiety Abuse of non-psychoactive substances F55.0 Abuse of antacids F55.1 Abuse of herbal or folk remedies F55.2 Abuse of laxatives F55.3 Abuse of steroids or hormones F55.4 Abuse of vitamins F55.8 Abuse of other non-psychoactive substances Reaction to severe stress, and adjustment s F43.10 Post-traumatic stress F43.11 Post-traumatic stress acute F43.12 Post-traumatic stress chronic Major depressive F32.9 Major depressive single episode Attention-deficit hyperactivity s F90.0 Attention-deficit hyperactivity predominantly inattentive type F90.1 Attention-deficit hyperactivity predominantly hyperactive type F90.2 Attention-deficit hyperactivity combined type F90.8 Attention-deficit hyperactivity other type F90.9 Attention-deficit hyperactivity type Encounter for medical observation for suspected diseases and conditions ruled out Encounter for examination and observation for other reasons Z03.89 Encounter for observation other suspected diseases & conditions ruled out Z04.9 Encounter for examination and observation for reason ICD-10-CM Resource Guide 17

18 Disclaimer This list is intended to assist ordering physicians in providing ICD-10 diagnosis codes as required by Medicare and other Insurers. It includes the diagnosis narratives and the codes that are most commonly submitted for toxicology and pain management tests orders, but is not a complete list. The list was compiled from the ICD-10-CM 2015 book. The responsibility for correct coding belongs to the ordering physician. The ICD-10-CM book should be used as a complete reference. 18 ICD-10-CM Resource Guide

19 Notes ICD-10-CM Resource Guide 19

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