Review Intro to ICD-9 Coding Review (Coding I) Diagnostic Coding – (Coding I)

Volume 1 ( E & V Codes Organization of ICD-9 Volume 1 ( 17 Chapters Plus E & V Codes ) 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

Diseases of the Musculoskeletal System & Connective Tissue Congenital Anomalies Certain Conditions Originating in the Perinatal Period Symptoms, Signs and Ill-defined Conditions Injury and Poisoning E800-E999Supplementary Classification of the External Causes of Injury and Poisoning V01-V82 Supplementary Classification of factors influencing Health Status and Contact with Health Services Volume 1 ( Organization of ICD-9 Volume 1 ( 17 Chapters Plus E & V Codes )

Anatomy of ICD-9 Code

ICD-9 Volume 2  Section 1 - Alphabetic Index to Diseases  Section 2 - Table of Drugs and Chemicals (E- Codes)  Section 3 - Index to External Causes (E- Codes)  Handy Tables Hypertension Neoplasms

Using ICD-9 Book Main Term  Identify Main Term in the Diagnostic Statement LocateMain TermAlphabetic Index Volume 2 [First]) Locate Main Term in the Alphabetic Index (Volume 2 [First]) VerifyCode NumberTabular List Volume 1 [Second]) Verify Code Number in the Tabular List (Numeric Index/Volume 1 [Second]) Diagnostic Statement – Chest Pain Diagnostic Statement – Chest Pain 786.5

Using ICD-9 Book  Turn to that ICD code in Volume Chest pain Chest pain, unspecified Precordial pain Painful respiration Pain:Pleurodynia anterior chest wall pleuritic epidemic pleurodynia (074.1) Other Discomfort Pressurein chest Tightness EXCLUDES

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 4 th and 5 th digits  Diagnostic Statement - Bronchitis, acute, probably viral 466.0

 Code the symptom Abdominal swelling or mass in epigastric area Elevated blood pressure New Acute or Chronic Problem that you can’t diagnose this visit

 Code the symptom Changes in skin texture Abnormal chest sounds New Acute or Chronic Problem that you can’t diagnose this visit

Unspecified localized salmonella infection Code The Diagnostic Statements Acute pulmonary manifestations due to radiation 508.0

Three Classifications of V Codes Personal history of exposure to radiation 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. Service-oriented V Code – identify/define exams, aftercare, ancillary services, or therapy. Follow-up examination following chemotherapy 3. Fact-oriented V Code – do not describe a problem or a service; they simply state a fact. Alcoholism within the family V15.3 V67.2 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 V70.0 General Physical

Follow-up for Previous Acute Condition, with no problems  Don’t Code for the acute condition which no longer exists  Use a V Code “History of”“Aftercare”  Look up “History of” or “Aftercare” unless it was an accident  Diagnostic Statement -  Diagnostic Statement - Follow-up for pneumonia (fully healed) V12.6

Follow-up to Previous Acute Problem, there are complications “Late Effects”  Look up “Late Effects” or the specific condition(s)  Diagnostic Statement -  Diagnostic Statement - Patient develops infection in wound on hand you sutured three days ago 906.1

Chronic Problems with Sequelae two codes:  Requires two codes: first  Code the Chronic Problem first second  Code the Complication second Diagnostic Statements Diagnostic Statements Type 2 DM with neurological manifestations Type 2 diabetic develops peripheral neuropathy & Peripheral Neuropathy & 337.1

Columns 2-5 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 - Diagnostic Statements - Elderly patient fell, sprained internal collateral ligament in ankle while stepping from curb: Sprains and strains of ankle and foot Fall on or from sidewalk curb E880.1

Drug Side-Effects  Use Section 2 of Volume 2  Will require 3 codes: side effect 1. the side effect, code for poisoning for the drug 2. the code for poisoning for the drug and E-code for the therapeutic use of the drug Diagnostic Statements - 3. the E-code for the therapeutic use of the drug. Diagnostic Statements - Patient develops hives after taking penicillin Allergic urticaria Penicillin poisoning Therapeutic penicillin E930.0

“Late Effects” Look-up “Late Effects” under: “Late Effects” or specific condition. Quiz “E Codes” Look-up “E Codes” in: Section 3 “V Codes” Look-up “V Codes” in: History of or :Aftercare, unless an accident

References and Resources  eMD eMD  Medical Abbreviation Medical Abbreviation  Encoder Pro and Code- it-Fast Encoder Pro and Code- it-Fast  ICD-9-CM online ICD-9-CM  ICD Decoder ICD Decoder  AHIMA AHIMA  Medi lexion Medi lexion  Medical Coding Tips Medical Coding Tips  Medical Conditions & Diseases Medical Conditions & Diseases  RXList RXList  Medicine Net Medicine Net  Merck Manual Merck Manual  American Association of Medical Biller Medical Biller  Tabers Online Tabers Online  RN Student RN Student