CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14) SXS13ierPPT-INTC06_P2

Diseases of Digestive System, Chapter 11 K00-K95 Unspecified GI hemorrhage, K92.2 Combination codes with hemorrhage Example: K57.21, Diverticulitis of large intestine with perforation and abscess with bleeding The categories are sequenced in a manner that follows the path of the digestive system from the mouth to the anus, beginning with disorders of the teeth. For a hemorrhage to be reported active bleeding is not necessary; however, documentation must support the fact that active bleeding has occurred. SXS13ierPPT-INTC06_P2

Diseases of the Skin and Subcutaneous Tissue, Chapter 12 L00-L99 Also codes to report conditions of the: Nails Sweat glands Hair Hair follicles Chapter 12 describes diseases or conditions of the Integumentary System. Does the integumentary system only include the skin? (No) What else is included in the integumentary system? (glands, nails, hair and hair follicles) What are the two glands that are covered in the integumentary system? (sweat and sebaceous) SXS13ierPPT-INTC06_P2

Infections Use additional code before L00 directs coder to report the infection with B95-B97 If there isn’t a combination code to describe the diagnosis (cellulitis) and cause (staph infection) then both of these diagnoses would be coded out to fully describe the condition. SXS13ierPPT-INTC06_P2

Pressure Ulcers Stage 1: erythema (redness) of skin Stage 2: partial loss of skin (epidermis or dermis) Stage 3: full thickness loss of skin (up to but not through fascia) Stage 4: full thickness loss (extensive destruction and necrosis) Pressure ulcers develop when the circulation is decreased to that area of the body. Pressure ulcers are graded and reported based on: Depth of the ulcer Categorized in stages SXS13ierPPT-INTC06_P2

Diseases of the Musculoskeletal System and Connective Tissue, Chapter 13 M00-M99 Most codes specify: Site: Location on the body Laterality: Right, left, unilateral, bilateral Some codes include “multiple sites” such as: M15.-, Polyosteoarthritis including multiple sites Chapter 13 describes diseases or conditions of the bone, joints, and muscles. A medical dictionary will always be a handy tool to use when there are medical terms that you may not know. For example, dorsopathies. SXS13ierPPT-INTC06_P2

Infectious Arthropathies M00-M02 Direct infections Invades synovial tissue Invades the joint Invasive organism has been identified Indirect infections Reactive: Microbial infection identified but not in joint Postinfective: Microbial antigen present, but not constant and no evidence of multiplication SXS13ierPPT-INTC06_P2

Pathological Fractures Also known as (AKA): Spontaneous fracture Fracture reported in addition to underlying condition responsible for fracture Never assign a code for a traumatic fracture and pathological fracture of same bone 7th character indicates treatment plans, such as A for initial The 7th character A (initial encounter) is assigned as long as the patient is receiving active treatment for the fracture. Other 7th characters: D (subsequent) is assigned when all active treatment is completed G, K, and P are assigned subsequent, non-routine encounters S is assigned for a sequela SXS13ierPPT-INTC06_P2

Osteoporosis M80 and M81 Systemic condition that affects bones Fracture sustained with trauma that would not usually cause a fracture Site is not a component of codes Category M80, Osteoporosis with current pathological fracture Age and other osteoporosis codes Category M81, Osteoporosis without current pathological fracture Osteoporosis is a systemic condition Meaning all bones of the musculoskeletal system are affected SXS13ierPPT-INTC06_P2

CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14) Conclusion CHAPTER 6 CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14) Slide 10 SXS13ierPPT-INTC06_P2