ICD-10 Back Up The Truck. Andrea Romero, RHIT, CCS, CPC NMHIMA Leadership Conference April 10, 2014

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1 ICD-10 Back Up The Truck Andrea Romero, RHIT, CCS, CPC NMHIMA Leadership Conference April 10, 2014

2 ICD-10 IS DELAYED AGAIN

3 Classification Structure ICD-9-CM Infectious and Parasitic Diseases ( ) Neoplasms ( ) ICD-10-CM Certain Infectious and Parasitic Diseases (A00 B99) Neoplasms (C00 D49)

4 Infectious and Parasitic Diseases Sepsis, Severe Sepsis and Septic Shock

5 Neoplasms Primary malignant neoplasms overlapping site boundaries Anemia associated with malignancy

6 Classification Structure ICD-9-CM Endocrine, Nutritional, and Metabolic Diseases & Immunity Disorders ( ) Diseases of the Blood and Blood-Forming Organs ( ) ICD-10-CM Diseases of the Blood and Blood-Forming Organs and Certain Disorders Involving the Immune Mechanism (D50 D89) Endocrine, Nutritional, and Metabolic Diseases (E000 E89)

7 Blood and Blood-Forming Organs Anemia of chronic disease

8 Endocrine, Nutritional, and Metabolic Diseases & Immunity Disorders No Significant changes

9 Classification Structure ICD-9-CM Mental, Behavioral, and Neurodevelopmental Disorders ( ) Diseases of the Nervous System and Sense Organs ( ) ICD-10-CM Mental, Behavioral, and Neurodevelopmental Disorders (F01 F99) Diseases of the Nervous System (G00 G99) Diseases of the Eye and Adnexa (H00 H59) Diseases of the Ear and Mastoid Process (H60 H95)

10 Mental, Behavioral, and Neurodevelopmental Disorders Pain disorders related to psychological factors Mental and behavioral disorders due to psychoactive substance use

11 Nervous System Nervous System Dominant/nondominant side Diseases of Eye and Adnexa have own chapter Glaucoma Diseases of the Ear and Mastoid Process have own chapter

12 Classification Structure ICD-9-CM Diseases of the Circulatory System ( ) Diseases of the Respiratory System ( ) Diseases of the Digestive System ( ) ICD-10-CM Diseases of the Circulatory System (I00 I99) Diseases of the Respiratory System (J00 J99) Diseases of the Digestive System (K00 K95)

13 Circulatory System Atherosclerosis and angina pectoris Sequelae of Cerebrovascular disease Acute Myocardial Infarction Subsequent acute myocardial infarction

14 Respiratory System No significant changes

15 No changes Digestive System

16 Classification Structure ICD-9-CM Diseases of the Genitourinary System ( ) Complications of Pregnancy, Childbirth, and the Puerperium ( ) Diseases of the Skin and Subcutaneous Tissue ( ) Diseases of the Musculoskeletal System and Connective Tissue ( ) ICD-10-CM Diseases of the Skin and Subcutaneous Tissue (L00 L99) Diseases of the Musculoskeletal System and Connective Tissue (M00 M99) Diseases of the Genitourinary System (N00 N99) Pregnancy, Childbirth, and the Puerperium (O00 O9A)

17 Skin and Subcutaneous Pressure Ulcers

18 Musculoskeletal Site and Laterality Acute traumatic versus chronic or recurrent musculoskeletal conditions Coding of Pathologic Fractures Osteoporosis

19 Genitourinary System No significant changes

20 Pregnancy Final character for trimester 7 th character for fetus identification Alcohol and tobacco use during pregnancy, childbirth and the puerperium Poisoning, toxic effects, adverse effects and underdosing in a pregnant patient Abuse in a pregnant patient

21 Classification Structure ICD-9-CM Congenital Anomalies ( ) Certain Conditions Originating in the Perinatal Period ( ) ICD-10-CM Certain Conditions Originating in the Perinatal Period (P00 P96) Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00 Q99)

22 Perinatal Period Use of codes from other chapters with codes from Chapter 16 Use of Chapter 16 codes after the Perinatal period Low birth weight and immaturity status Stillbirth

23 Congenital Anomalies No significant changes

24 Classification Structure ICD-9-CM Symptoms, Signs, and Ill- Defined Conditions ( ) Injury and Poisoning ( ) ICD-10-CM Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00 R99) Injury, Poisoning and Certain Other Consequences of External Causes (S00 T88)

25 Signs and Symptoms Repeated falls Coma scale Functional quadriplegia

26 Injury and Poisoning Application of 7 th characters in chapter 19 Initial vs. subsequent encounter for fractures Poisoning Underdosing

27 Classification Structure ICD-9-CM Supplemental Classifications Classification of Factors Influencing Health Status and Contact with Health Service (V01 V85) Classification of External Causes of Injury and Poisoning (E800 E999) ICD-10-CM External Causes of Morbidity (V00 Y99) Factors Influencing Health Status and Contact with Health Service (Z00 Z99)

28 External Causes External cause code used for length of treatment Place of occurrence, activity and status codes used only once, at initial encounter for treatment Intent

29 Factors Influencing Health Status and Contact with Health Service Encounter for weaning from mechanical ventilator Observation categories Aftercare Z codes not used for aftercare of injuries Encounter for Obstetrical and Reproductive Services

30 Questions?

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