1. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 1 CHAPTER 11 CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14)

2. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 2 Diseases of Digestive System, Chapter 11 K00-K94K00-K94 Unspecified GI hemorrhage, K92.2Unspecified GI hemorrhage, K92.2 Combination codes with hemorrhageCombination codes with hemorrhage –Example: K57.21, Diverticulitis of large intestine with perforation and abscess with bleeding

3. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 3 Diseases of the Skin and Subcutaneous Tissue, Chapter 12 L00-L99L00-L99 Also codes to report conditions of the:Also codes to report conditions of the: –Nails –Sweat glands –Hair –Hair follicles

4. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 4 Infections Use additional code before L00 direct coder to report the infection with B95- B97Use additional code before L00 direct coder to report the infection with B95- B97

5. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 5 Pressure Ulcers Stage I: erythema (redness) of skinStage I: erythema (redness) of skin Stage II: partial loss of skin (epidermis or dermis)Stage II: partial loss of skin (epidermis or dermis) Stage III: full thickness loss of skin (up to but not through fascia)Stage III: full thickness loss of skin (up to but not through fascia) Stage IV: full thickness loss (extensive destruction and necrosis)Stage IV: full thickness loss (extensive destruction and necrosis)

6. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 6 Disease of the Musculoskeletal System and Connective Tissue, Chapter 13 M00-M99M00-M99 Most codes specify:Most codes specify: –Site: Location on the body –Laterality: Right, left, unilateral, bilateral Some codes include “multiple sites” such as:Some codes include “multiple sites” such as: –M15, Polyosteoarthritis including multiple sites

7. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 7 Infectious Arthropathies M00-M02M00-M02 Direct infectionsDirect infections –Invades synovial tissue –Invades the joint –Invasive organism has been identified Indirect infectionsIndirect infections –Reactive: Microbial infection identified but not in joint –Postinfective: Microbial antigen present, but not constant and no evidence of multiplication

8. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 8 Pathological Fractures Also known as (AKA): Spontaneous fractureAlso known as (AKA): Spontaneous fracture Fracture reported in addition to underlying condition responsible for fractureFracture reported in addition to underlying condition responsible for fracture Never assign a code for a traumatic fracture and pathological fracture of same boneNever assign a code for a traumatic fracture and pathological fracture of same bone 7 th character indicates status, such as A for initial7 th character indicates status, such as A for initial

9. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 9 Osteoporosis M80 and M81M80 and M81 Systemic condition that affects bonesSystemic condition that affects bones Fracture sustained with trauma that would not usually case a fractureFracture sustained with trauma that would not usually case a fracture Site is not a component of codesSite is not a component of codes Category M80, Osteoporosis with current pathological fractureCategory M80, Osteoporosis with current pathological fracture –Age and other osteoporosis codes Category M81, Osteoporosis without current pathological fractureCategory M81, Osteoporosis without current pathological fracture

10. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 10 Conclusion CHAPTER 11 CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14)